Category: Psychotherapy

Introduction

Children in psychodynamic psychotherapy: Changes in global functioning is a study that was conducted by Fredrik Odhammar, Eva C. Sundin, Mattias Jonson, and Gunnar Carlberg as part of Erica Process and Outcome Study on children. The study was carried out with the aim of establishing the effectiveness of the participants global functioning following psychodynamic psychotherapy. The participants involved children who had undergone psychodynamic psychotherapy. The work of Odhammar and the other researchers will be appraised in this critique, with particular emphasis on the research topic, the theoretical coherence, and logical structure, and the research design used. Also, the major findings of the study, their validity and reliability, and their practical implications to clinical practice will be examined.

Brief Summary

Odhammar and other researchers carried out their study as part of the Erica Process and Outcome Study. This is a study that investigated childrens global functioning following psychodynamic psychotherapy with the main focus being to establish whether global functioning is enhanced after treatment. The researchers assessed the factors that are thought to influence global functioning, such as age, sex, type of disorder, and co-morbidities among others using quantitative and statistical methods. The participants in the study included 33 children between the ages of 5 and 10 years who had been involved in psychodynamic psychotherapy at the same time with their parents. Twenty-nine (29) of the study participants were diagnosed with some mental health disorders, whereas fifteen (15) of the participants were diagnosed with co-morbid conditions. The diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).

The psychotherapists used CGAS and HCAM tools to measure the participants global functioning. From the study, the researchers showed that psychodynamic psychotherapy significantly enhanced the childrens global functioning, even though the study did not establish any significant relationship in regard to factors like age and sex that are thought to influence global functioning. The researchers also sought to disambiguate the complex relationship existing between the psychodynamic psychotherapy procedure and the enhancement in global functioning. The researchers, thus, incorporated a qualitative study approach whereby in-depth case studies were performed using data generated from questionnaires that were obtained from two therapies and filled at intervals of 3 months. The researchers sampled two such therapies, including one that reported great improvement and one that reported minimal improvement in global functioning as measured under CGAS. On evaluation, the researchers established that significant changes, such as the achievement of set goals, in the patients were not regularly captured in the measurements on the CGAS (Odhammar et al. 2011).

Theoretical approaches and evaluation of the study by Odhammar et al. (2011)

To justify the need for their study, Odhammar et al. (2011) researched extensively about psychodynamic psychotherapy through broad literature review. The intense research on available relevant literature was important in improving the studys reliability and validity, in addition to bringing out the research topic clearly (Riegelman, 2005). The researchers, therefore, started by illustrating the magnitude of psychological conditions among young people and the increasing range of psychotherapies and other interventions for children with these mental disorders. From the literature review, the researchers demonstrated that the increasing incidents of mental disorders in young people require the mental health sectors to avail knowledge concerning variables that influence therapy outcomes.

Odhammar et al. (2011) highlight the increasing number of studies that have been carried out in response to the need to identify the variables that affect psychotherapeutic outcomes in young people. According to Odhammar et al. (2011), a dominant feature of these studies is that the findings are not consistent. This makes it hard for inferences to be done. The researchers in particular highlighted studies that have been conducted to establish the effects of gender on child psychotherapy, whereby some findings indicated that females showed improved outcomes than males the following psychotherapy. Other studies on the same demonstrated no significant differences based on gender. Similarly, Odhammar et al. (2011) explored literature that investigated the impact of gender on psychotherapy outcomes. The researchers also found discrepancies in the findings, with some studies showing that younger children responded much better to psychotherapy compared to those who are much older. Nevertheless, other studies have failed to establish a link between a persons age and the treatment outcomes (Odhammar et al., 2011).

The researchers further explored the reviews that have been carried out on psychotherapy studies, indicating the various beliefs as embraced by different people concerning cognitive behavioral therapy. From the analyses, it comes out that some people advocate for systemic therapy evaluations, whereas others are for psychodynamic time-limited therapies. With regard to psychodynamic psychotherapy, which was the core aspect of the study, the researchers also further analyzed literature reporting on how other conditions influence treatment outcomes. From these analyses, the researchers demonstrated that the existing information is also conflicting concerning the duration of psychodynamic psychotherapy. Whereas some studies showed that time-limited interventions produced desirable outcomes, other studies indicate that therapy outcome is positively associated with the duration taken to carry out the procedure.

The researchers indicate the need for further studies that can be able to address the observed shortcomings. These studies ought to be more detailed and adequately explore factors that influence effective therapeutic outcomes. This, according to the researchers, demands a comprehensive understanding of the treatment process and comprehending any other variables such as those related to the therapeutic procedure, individual patient, therapist, and the formation of a therapeutic alliance. These are variables that underlie change factors with respect to treatment outcome. In reinforcing their research topic, Odhammar et al. (2011) also point to the challenges involved in quantifying outcome aspects like quality of life, in addition to the failure of efficacy studies to represent real practical settings. This calls for the need for naturalistic studies.

The motivation for the Study

Odhammar et al. (2011) were motivated by the recognition that psychological problems are on the rise among children, yet research on this field fails to adequately address the variables that influence psychotherapy outcomes. The contradictions in research findings on child psychotherapy from various studies also motivated the researchers to conduct the study. Odhammar and the other researchers hoped to advance knowledge concerning the variables that influence psychotherapy treatment outcomes in children through this study, thereby allowing for effective interpretation.

Research Questions

Odhammer et al. (2011) formulated research questions to address different aspects of psychodynamic psychotherapy in children. The main area was assessing changes in global functioning in young people following psychodynamic psychotherapy. Another aspect of the research questions was establishing variables that influence the likely changes in global functioning following therapy, while the last part of the research questions aimed at qualitatively analyzing the deviations of the outcomes by evaluating processes of therapy.

Research Design

The study by Odhammer et al. (2011) was naturalistic in design, combining both quantitative and qualitative techniques to assess global functioning following psychotherapy. This design allowed the subjects to be observed in the natural settings, thus allowing the description of outcomes to be performed without controlling the situation. The design was also significant in examining the outcomes and drawing inferences since the variables could easily be conceptualized and operationalized. The quantitative technique involved the use of questionnaires that were administered to psychotherapists and parents of the participants, whereas the qualitative study was conducted through comprehensive case studies.

Study Findings

The study results demonstrated that global functioning in children improved significantly following psychodynamic psychotherapy, indicating the effectiveness of the treatment modality. In quantitative analyses, the factors that determine enhancement of global functioning under CGAS scale were shown to be, age, sex, diagnosis, co-morbidity, frequency and number of sessions, length in weeks of child therapy and a number of sessions for parents (Odhammar et al. 2011, p. 267). These factors, however, showed no major relationship with the change scores. Under the HCAM measurement, global functioning was also shown to be large, especially with regard to general mood and mood shifts, ability to tolerate frustration and control impulses, development of confidence and self-esteem and ability to cope with very stressful events (Odhammar et al. 2011, p. 267). Qualitative analyses showed that significant enhancements obtained following treatment are frequently missed in psychometric tools, thus they are often not considered as important outcome factors following treatment.

Limitations of the Study

The findings of the study may not be readily generalized to the entire population given that the participants were mainly included in the study using clinical criteria. In addition, the study did not include a comparison group in order to obtain a deep comprehension of the level of a desirable outcome. The fact that it is psychotherapists who were measuring the global functioning of the participants also implies that the results may be biased. Additionally, the number of participants was small. This would have affected the validity, reliability and the ability to generalize of the study findings (Odhammar et al., 2011).

Clinical Implications of the study

The study was significant in clinical practice given that it helped in closing the knowledge gap concerning the effect of psychodynamic psychotherapy in global functioning. The research further highlighted the effect of various factors, such as age and gender, on global functioning; besides giving insights on the way the treatment modality influences outcomes. The study, therefore, contributes to knowledge regarding factors that influence psychodynamic child psychotherapy outcomes, the knowledge that will be critical in the management and treatment of psychological disorders in young people.

Reliability and Validity of the Study

The use of a small population in the study enhanced transferability of the results since the researchers were able to obtain a natural and interpretative understanding of the variables that affect psychotherapy outcomes. Nevertheless, the small number of participants means that the findings cannot be readily generalized to the entire population. It will, therefore, be important for future research on the same area to include a large population in order to improve the ability to generalize the findings. The use of both qualitative and quantitative methods enhanced the reliability of the study findings since the researchers were able to combine the strengths of the two methods (Riegelman, 2005). The methods also facilitated the interpretation of the study findings since the data generated provided deep insights on various aspects of the study topic. The study can also be said to have achieved high credibility given the diverse amount of literature that was reviewed.

References

Odhammar, F., Sundin, E. C., Jonson, M., & Carlberg, G. (2011). Children in psychodynamic psychotherapy: changes in global functioning. Journal of child Psychotherapy, 37(3), 261-279. Web.

Riegelman, R. K. (2005). Studying a study and testing a test: How to read the medical evidence, 5th Ed. Philadelphia, PA: Lippincott Williams & Wilkins. Web.

Introduction

Psychotherapy is an essential phenomenon in the modern world because numerous people are suffering from mental health issues. That is why medical professionals should provide such individuals with appropriate care to help them achieve positive outcomes. However, current practice shows that there appear significant challenges when it comes to delivering care. It relates to the fact that numerous factors prevent patients from utilizing health services, and these factors include race, gender, and other personal peculiarities. Among these phenomena, socioeconomic status (SES) of patients is of crucial concern because it contributes to the fact that numerous individuals are left without access to psychotherapy.

The situation above is a central topic of the article by Epping, Muschik, and Geyer (2017) and the work by Villatoro, Mays, Ponce, and Aneshensel (2018). Thus, the purpose of the present study is to review the two pieces of research and analyze how they address the topic under consideration. That is why it is necessary to read these peer-reviewed articles and comment on their content. The method above means that it is essential to use an appropriate design. Thus, the given study will focus on how the articles discuss the problem, review the literature used, evaluate the methods of these works, present overall expression, and generate conclusions. As for the findings, they state that the articles present useful theoretical information that can positively influence psychotherapy practice.

Evaluating the Problem Discussed

The two articles under critique address the problem and describe it clearly. On the one hand, Villatoro et al. (2018) stipulate that there are differences in mental health services utilization according to social status, race, and gender of patients. The researchers state that the variations above result in the fact that some individuals do not have access to psychotherapy even if they have severe mental disorders. Consequently, the authors introduce the topic understandably, and they support each idea above with credible sources, which eliminates any possible doubts concerning the relevance of the information presented.

On the other hand, the work by Epping et al. (2017) begins by describing the fact that a significant part of research analyzes how and why disease occurs. At the same time, little attention is drawn to whether there are any inequalities in the utilization of mental health services. Thus, the authors explain the direction of their research clearly and are going to investigate the problem within the German context. Here, one should also emphasize that these scientists use numerous studies on the given subject to support their ideas and create the feeling that the article is based on reliable data.

Evaluating the Literature Reviewed

As has been mentioned above, the two articles focus on reliable and credible sources. However, it is necessary to comment on them in detail to determine whether the studies have a clear theoretical framework. Thus, it is possible to say that Villatoro et al. (2018) have cited a sufficient number of sources, including more than 80 books and scholarly articles. This list does not have any pieces of literature that are irrelevant to the study. Furthermore, the authors draw appropriate attention to various sources, which means that there is no bias in presenting the references. At the same time, it is a weakness of the work by Villatoro et al. (2018) that it cites a few outdated sources that were published in the late 20^th century.

As for the article by Epping et al. (2017), its reference list includes 30 entries that also include a few outdated sources. All these books and journal entries introduce relevant information because they address numerous topics reviewed by Epping et al. (2017). In addition to that, it is impossible to mention that the authors draw inappropriate attention to some ideas. It so because they use one or two sources to support every notion that they describe. Consequently, the information above demonstrates that the two articles are based on robust theoretical frameworks, which strengthens the credibility of the data presented.

Evaluating the Methods

The study by Villatoro et al. (2018) implies a relatively easy research process that is described in detail. It is so because the researchers focused on individuals who had participated in three epidemiological studies and interviewed them with the help of previously developed questionnaires. As a result, any reader can duplicate the given research process in case of necessity. This method seems to be valid for the given study because interviews of respondents are useful to obtain the required data.

However, it is necessary to consider the fact that this method can imply bias because some individuals can improperly evaluate the causes of their poor access to psychotherapy. Here, this risk is overcome by the extensive sample that includes 14,906 people Villatoro et al. (2018, p. 8). The respondents are of different races, ages, and social statuses, which contributes to achieving impartial results that reflect the current situation in the health care industry.

At the same time, the article by Epping et al. (2017) follows a similar method, and the researchers analyze information from an anonymized dataset. They determine whether there is any correlation between an SES of a person and their mental health. Consequently, every reader can duplicate this research process if necessary. The given article deals with 746,963 respondents, but the most significant attention is drawn to 10,711 psychotherapy patients, including 3,066 men and 7,645 women (Epping et al., 2017, p. 4). Age, income, occupational, and educational varieties are preserved to eliminate the risk of bias and reach impartial results.

Presenting Overall Impression

The two articles under consideration are said to give useful theoretical information that can be further applied in practice. On the one hand, Villatoro et al. (2018) present guidance for individuals on how to identify mental disorders and what to do with them.

Furthermore, the authors stipulate that their conclusions demonstrate the need to improve mental health care utilization in the United States. Thus, the article describes the necessity to develop and implement interventions to increase psychotherapy access among representatives of low SES groups. Consequently, the work by Villatoro et al. (2018) is a basis for responsible individuals to address the issue practically. On the other hand, Epping et al. (2017) also demonstrate that there are some problems with psychotherapy access. The authors insist on the fact that their work should be the guidance for psychotherapists who need to draw specific attention to patients with a low SES and provide them with decent care.

Even though the conclusions above are significant and refer to the essential topic, the articles are written understandably. It refers to the fact that these scholars use simple language to describe even the most complicated phenomena. Furthermore, the visuals are useful in the given pieces of research because they make it easier for readers to understand the ideas expressed. In addition to the fact that the articles are appropriately structured, the tables and charts are useful for readers to comprehend the distribution of respondents and identify any tendencies.

Conclusion

The study by Villatoro et al. (2018) determines how the rates of mental health services utilization depend on individual peculiarities of patients. The authors have reviewed numerous credible sources to create a trustworthy and reliable theoretical framework for their research. To achieve the necessary results, these scientists have analyzed a few epidemiological surveys to select the sample that is necessary for their study. This sample is relatively extensive, and it includes representatives of various racial, gender, age, and socioeconomic groups. Consequently, Villatoro et al. (2018) state that it is necessary to influence the health care industry in the United States to increase access to therapy. As for the future of this research, it can focus on specific steps that can improve mental health services utilization rates in the US.

At the same time, Epping et al. (2017) draw attention to any regularities between an SES of a patient and the utilization of mental health services. The authors have reviewed a sufficient number of reliable sources and analyzed an extensive sample to conclude that representatives of low SES groups suffer from inadequate access to therapy. This article stipulates that the problem can be addressed if psychotherapists draw more attention to the given group of patients. Further research on this subject can refer to covering a different country and developing policy measures to increase psychotherapy access rates. Consequently, the information above stipulates that the two articles under consideration are essential pieces of research that have the potential to improve the theory and practice of the health care industry.

References

Epping, J., Muschik, D., & Geyer, S. (2017). Social inequalities in the utilization of outpatient psychotherapy: Analyses of registry data from German statutory health insurance. International Journal for Equity in Health, 16, 1-8.

Villatoro, A. P., Mays, V. M., Ponce, N. A., & Aneshensel, C. S. (2018). Perceived need for mental health care: The intersection of race, ethnicity, gender, and socioeconomic status. Society and Mental Health, 8(1), 1-24.

Presenting Concern

The client resorted to a counselor because he realized his drinking problems caused a chain of unpleasant situations in his life. More specifically, James identified having alcoholic inclinations caused by enormous stress associated with his work. James drinking problem took a toll on his family life since his wife threatened to leave with their two children. Additionally, the client specified that he is currently having a tense relationship with a leader of the firm due to his drinking episodes which make him skip working days.

Case Conceptualization

The client is a Caucasian heterosexual male living in a family of four. His family might put a strain on his emotional health since he has to provide his wife and children with material goods. In addition, James is a religious person, which may be the factor contributing to his desire to be treated. He has an upper management position at a multinational biotechnology research and development firm. It means that his job puts much pressure on him and does not allow him to relax for too long. James resorted to alcohol to unwind the conversation with his boss and other leaders in the company. Finally, his personal life began to suffer since his wife wanted to split with him.

Assessment

A clinician may use a guide titled Helping patients who drink too much. This assessment tool will be helpful in identifying the degree of severity of the condition. Furthermore, it is an excellent means of determining the proper treatment (Rabow et al., 2019). AUDIT Alcohol Screening Tool will be the following method of appraising James state. This screening will help identify a clients drinking patterns and feelings when consuming alcohol and recognize if a patient is exposed to alcohol-related harms.

Diagnostic Impressions

The provisional diagnosis for James is alcohol use disorder which is the cause of his mishaps. Alcohol intake violates the average balance of the activity of various body systems, causing a natural chain reaction. Alcoholic beverages are consumed in systematic intake of small doses or unsystematic intake of large quantities (Smith, 2017). The continuation of drunkenness leads to a gradual decrease in patients both socially and personally. The fact that James family and working relations are falling apart proves the previous statement.

The rationale for Diagnostic Impressions: Note: Use the DSM-5 to explain how the clients symptoms are reflected in the diagnostic criteria for each diagnosis that you render.

As per the DSM-5, the criteria for alcohol use disorder in James case are the following:

• He wants to reduce alcohol consumption but cannot succeed.
• He continues drinking, disregarding the family and work problems.
• He has intoxication after drinking (KM, 2017).
• Sometimes, James consumes more alcohol than intended.
• He uses drinks as a means of mitigating communication (KM, 2017).

Therapeutic Approach

Psychotherapy is one of the most effective methods of treating alcoholism. Alcohol abuse is a systemic, multifactorial condition; therefore, psychotherapy of alcoholism should be systemic. The treatment of alcoholism with the help of psychotherapy involves the impact on patients in several directions (Smith, 2017). On the one hand, the etiological basis of addiction is being studied, and the counselor must understand why the patients life is reduced to alcohol consumption. On the other hand, the doctor programs the patient for a natural desire to stop drinking alcohol. It is usually suggested to an alcoholic that alcohol causes disgust or instills fear of alcohol consumption (Fitzgerald & Puttler, 2018). Psychotherapy of alcohol use disorder should be combined with drug therapy. Only a complex effect helps to cope with the disease successfully. Additional support for the patient is the understanding of family and loved ones. In general, psychotherapy in the treatment of chronic alcoholism works by changing the human psyche. This complex approach was chosen because James needs to get rid of this bad habit as well as preserve his family and maintain his working position.

Treatment Goals

The primary treatment goal would be investigating the causes of James alcohol abuse. The first step towards disposing of a problem is admitting it and identifying the roots because both the counselor and client must know where it stems from (Singer et al., 2019). The results will be measured during sessions  if James manages to recollect the events leading him to drink, the objective will be achieved.

The second treatment aim is to make James stop drinking alcohol. Throughout the course of psychotherapeutic sessions, James will fill out the screening paper, marking the days when he does not consume a bit of alcohol.

The third initial goal refers to defining the clients future plans. This step is vital because the alcoholic should realize that they are in charge of their lives. In case James describes his further perspectives, the goal is attained.

Relapse Prevention and Continuum of Care: Describe relapse prevention needs and challenges for the client. Discuss the continuum of care plan and recommendations for the client.

If a relapse occurs, a patient needs to undergo medical treatment and detoxing procedures (Sliedrecht et al., 2019). Ideally, psychotherapy for alcoholism should last several years, with several sessions a month. A doctor should prescribe the intake of medical remedies.

Ethical Considerations

The major challenge associated with treating alcohol use disorder is that the patients symptoms may worsen and lead to fatal outcomes. Additionally, the client may refuse to undergo some psychological interventions due to their disbelief.

References

Fitzgerald, H., & Puttler, L. (Eds.). (2018). Alcohol use disorders: A developmental science approach to etiology. Oxford University Press.

KM, L. (2017). Alcohol use disorder: Symptoms, treatment DSM-5 303. Thriveworks.

Rabow, M. W., McPhee, S. J., & Papadakis, M. A. (2019). Current medical diagnosis and treatment 2020. United States: McGraw-Hill Education.

Singer, V., Novalis, P. N., & Peele, R. (2019). Clinical manual of supportive psychotherapy. American Psychiatric Publishing.

Sliedrecht, W., de Waart, R., Witkiewitz, K., & Roozen, H. G. (2019). Alcohol use disorder relapse factors: A systematic review. Psychiatry research, 278, 97115.

Smith, D. (Ed.). (2017). Emerging adults and substance use disorder treatment: Developmental considerations and innovative approaches. Oxford University Press.

Introduction

Psychotherapy is a technique used to treat mental disorder. This study was conducted to establish effect of psychotherapy on phobic patients. Additionally, the study was conducted to follow up on phobic patients after psychotherapy. The study focused on exploring systematic desensitization on phobic patients. Moreover, the study focused on investigating the effect of group therapy on phobic patients. Studies on phobic patients included those suffering from astraphobia, hydrophobia and nyctophobia. Furthermore, the study was conducted on patients suffering from zoophobia. This paper will analyze a research article by Sharma, Vandana and Awadhesh.

Research Methods

The authors utilized different methodologies in arriving at their conclusion. For instance, the authors began by listing various treatments for phobia. This was followed by a discussion on systematic desensitization. In the end, the authors discussed group therapy. These discussions set stage for practical on the two methods of psychotherapy. Based on this research, 110 patients suffering from phobia were selected. The patients underwent screening, which showed that the authors wanted to ensure precision was achieved. The 110 patients were placed in two broad groups namely the untreated and the treated. The authors established that patients with phobia had been with it for at least 3 years. Methodology utilized was systematic and specific to the topic of discussion. Methodology applied was so detailed that everything relating to theoretical framework was included (M. Sharma, & V. Sharma, Upadhyay, 2013).

Core content

These researchers wanted to explore the effect of group therapy as well as systematic desensitization among patients with different phobic issues. To achieve this, they conducted the study among patients with nyctophobia, hydrophobia and astraphobia. Additionally, they explored patients with zoophobia. The survey began with screening for phobic patients aged between 19 and 12 years. This was done to achieve matching socio-economic status. Specific personality characteristics were also targeted using Becks method. The researchers utilized chi-square to analyze results, which were taken from varying variables. Moreover, evaluation of the patients was done at SIMPHs, which is a qualified mental institution in India. However, results which were got differed on the number of responses. Additionally, it was found that symptoms disappeared after 7 months of psychotherapy. In essence, the researchers concluded that psychotherapy was effective in treating phobic patients (Powers, 2010).

According to the researchers, this study was aimed at exploring the effect of group therapy and systematic desensitization on phobic patients. However, result from group therapy was found to differ significantly from results from systematic desensitization. Nonetheless, after 7 months of psychotherapy, the symptoms, which were once dominant in the patients, were found to have disappeared. Rorschach Inkblot test was administered to 110 patients suffering from varying phobic issues. Researchers arrived at the conclusion that group therapy and systematic desensitization were helpful in treating phobic patients. However, this was arrived at after a follow up was done on 44 out of the initial 110 patients involved. Moreover, out of the 44 patients who underwent follow up, a massive number of 43 were treated successfully. In essence, this brought about the conclusion that psychotherapy could be utilized in treatment of patients with phobia (M. Sharma, & V. Sharma, Upadhyay, 2013).

Aim of the article

The authors utilized sources from Freud, Beck, and Manor, among others, to define the terms utilized in the paper. Additionally, the authors examined their sources; they evaluated Freuds use of the term phobia as well as its application. Freud defines phobia as an anxiety hysteria, which focuses on external objects. Throughout the paper, the authors agreed that phobia is focused on external objects. Additionally, they agreed that phobia is not an obsession. Nonetheless, Freud reviewed his position after extended research on phobia. Additionally, the authors mentioned research conducted by Segal and Klein to define phobia as well as establish its root cause. Essentially, the authors set stage for achieving their aim, which was to determine if group therapy and systematic sensitization could treat patients with phobia (M. Sharma, & V. Sharma, Upadhyay, 2013).

Theoretical coherence

This article was theoretically coherent based on the sources utilized in it. Additionally, it was backed with evidence-based research, which focused on both qualitative and quantitative analysis. That is, evidence was traced from numerous samples. In addition, quality of instruments utilized for the study was drawn from theoretical framework. Of great essence to the study was Becks test, which was administered. Additionally, the paper was written in a logical manner. Since the paper was scientific and peer reviewed, it was structured in a professional manner. For instance, the authors began by defining phobia as well as by giving both primary and secondary sources for further research in psychotherapy. Notably, key points in the article were stressed to promote understanding. Furthermore, the authors utilized different sources to ensure that theoretical coherence was achieved. Moreover, the sources were credible and dependable in psychotherapy (M. Sharma, & V. Sharma, Upadhyay, 2013).

Relevance to clinical practice

The article is highly relevant to modern clinical practice. This is evident in the fact that psychotherapy can be conducted on individuals with phobia as well as other ailments with the hope of achieving positive results. Psychotherapy in the article can also be applied in other areas of psychology such as cognitive behavior therapy, gestalt therapy and behavioral therapy, among others. Behavioral therapy is very good as it helps to restructure jointly held beliefs of the family. This is advantageous to families as it promotes unity and strength. The therapeutic process is also important as it works to promote mutual respect between the therapist and client as they collaborate for a common purpose. However, the process is quite difficult on resistant individuals as well as those who are stereotyped on certain beliefs (Yalom & Lescz, 2005).

Group therapy is applicable in healthcare because it helps patients to recover from diseases such as phobia, among others. Gestalt therapy is most applicable in a group context because it emphasizes on direct actions and experiences. This is especially good for clients in a group context that experience anxieties concerning future events as this can be enacted at the present. In addition, this approach would fit multicultural clients if the therapy were used to integrate polarities in clients. Moreover, the therapist should accept his/her clients culture for success. Gestalt approach is very important as it stresses clients awareness of present environment in order to establish his/her next move. This is very helpful as one can only change his/her behavior if he/she understands himself/herself. The approach is quite difficult when working with culturally reserved clients as they become resistant. However, the approach is good in terms of its analysis of present situations as opposed to past occurrences (Yalom & Lescz, 2005).

Another method mentioned in group therapy is behavior therapy. Techniques involved in behavioral therapy include behavioral and psychoanalytic techniques, among others. In addition, the approaches involved included acceptance based and mindfulness approaches, among others. Other techniques used included relaxation training, applied behavioral analysis, multimodal therapy, systematic desensitization, self-modification programs, eye movement reprocessing and desensitization, exposure therapies and social skills training, among others. Behavioral approach is widely used due to its numerous techniques and methods. This allows it to be applied in many problems, which range from anxiety, to group problems, among others. In addition, it is well placed to work in people from diverse cultures due to its uniqueness. Moreover, the therapist is expected to be creative in order to adapt to any type of client. Based on the above facts alone, it can be noted that the authors research made a great impact in clinical practice because the article introduced cheaper ways of treating phobia in patients. Moreover, this research paper gave an insight into numerous applications in clinical practice (B. Sadock & V. Sadock, 2007).

Recommendations

As much as this article was well researched, it also opened avenues for future research. For instance, it would be recommendable that the researchers advance further and examine the reasons why the two outcomes differed. Additionally, it would be important to ensure that follow up is done on all participants in order for minority views to be taken in too. Additionally, the authors should give a detailed comparison between group theory and systematic desensitization outcomes.

Conclusion

This article was well research since it had resources from credible scholars like Segal, Klein, and Freud, among others. Moreover, the study was conducted based on known theoretical framework. It is also worth noting that analysis of the paper was done in an effective manner using chi-square. This reflected the fact that the article was credible and reliable based on its outcomes. Additionally, the article proved that group therapy and systematic desensitization were effective in treating patients with phobia.

References

Powers, A. (2010). Finding the evidence in PubMed (MEDLINE). Web.

Sadock, B. & Sadock, V. (2007). Kaplan and Sadocks Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. New York, NY: Lippincott Williams & Wilkins.

Sharma, M., Sharma, V., & Upadhyay, A. (2013). Effect of Psychotherapy in Phobic Patients and Their Follow-up. SIS Journal of Projective Psychology & Mental Health, 20(1) 36-41.

Yalom, I. & Lescz, M. (2005). Theory and Practice of Group Psychotherapy (5th ed.). New York, NY: Basic Books.

For years, the terms psychotherapy and counseling have been used interchangeably due to the fact that the notions share many similarities. Notably, both disciplines involve developing a safe, therapeutic, and healing relationship between a patient and a therapist. Conversely, one of the key differences between the two fields is that counseling entails a short-term consultation while psychotherapy involves a long-term treatment. This essay provides three examples of negative behaviors from three videos and explains the most effective intervention between psychotherapy and counseling approaches. Moreover, it explains how a neurobiological viewpoint of mental health would interpret the impact of violence upon an individual. Additionally, it gives the best counseling approach to helping a person who is repeatedly subjected to violence. Finally, it provides a brief reflection of how counseling changes in society.

The videos, Case study clinical CBT: First session with a client with symptoms of depression, The psychodynamic approach, and Smoking behavior change strategies, present patients exhibiting three examples of negative behaviors. In the first video, the patient is showing signs of depression and has opted for social withdrawal (Johnson, 2014). The second film highlights the case of a man who is chronically violent against his wife but is full of defenses (INTELECOM Intelligent Telecommunications, 2006). Finally, the third film presents various clients with tobacco addiction who are unable to quit (Guth, 2000). The most effective technique of addressing such negative behaviors is psychotherapy approaches because they lead to long-term solutions (McLeod, 2013). Typically, these treatment methods extensively and intensively explore a patients psychological history as opposed to counseling approaches, which focus on current issues (McLeod, 2013). Thus, psychotherapy techniques would be the most appropriate techniques to deal with behaviors demonstrated by patients in the three films.

Violence is among the social ills that have far-reaching repercussions for perpetrators and victims alike. A neurobiological view of mental health can describe the effect of assault on a victim by comparing the patients signs of psychological disorders and empirical findings (McLeod, 2013). For instance, research indicates that people who are exposed to frequent assaults are highly likely to develop acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) (McLeod, 2013). These mental conditions are connected to numerous symptoms,, such as fear, anxiety, episodic dissociation, and sadness. Such signs can help assess the impact of violence on a person from a neurobiological perspective.

Given a situation in which an individual is constantly exposed to assault, the person-centered approach would be the most effective counseling technique to help the victim. This method starts and ends with experiencing, where patients are seen as responding to the world based on their moment-by-moment life encounters (McLeod, 2013). As a result, the person-centered approach focuses on fulfilling two fundamental needs: self-actualization and the need to be valued and loved by others. In this method, the therapeutic process centers on greater disclosure of experience. With time, the client develops a sense of inner referent as they explore their issues in a personal manner, which allows the processing of feelings as opposed to reasoning (McLeod, 2013). The patient gradually starts showing signs of psychological loosening, such as tears, moistness in the eyes, muscular relaxation, and sighs accompanied by open feelings expressions. Therefore, the person-centered approach would be the ideal counseling technique for an individual who is frequently subjected to violence.

In conclusion, psychotherapy approaches would be the most convenient method in dealing with such negative behaviors as signs of depression, addiction, and defense because they offer long-lasting solutions. As violence and addictions continue to be an issue of societal concern, a neurobiological perspective can be instrumental in the interpretation of the impact of the assault on victims by comparing empirical findings and a persons mental status. In circumstances where an individual is experiencing frequent cases of violence, the person-centered approach would be the most suitable counseling intervention. Overall, counselors have a valuable contribution to the world as they help people overcome numerous life stressors. However, this profession is subject to changes due to innovations and modifications in society. As the world continues to face emerging challenges, counseling also evolves to remain relevant.

References

Guth, J. (2000). Smoking behavior change strategies. [Video]. Films on Demand. Web.

INTELECOM Intelligent Telecommunications. (2006). The psychodynamic approach. [Video]. INTELECOM Online. Web.

Johnson, J. (2014). Case study clinical example CBT: First session with a client with symptoms of depression (CBT model). [Video]. YouTube. Web.

McLeod, J. (2013). An introduction to counselling (5^th ed.). McGraw-Hill Education.

Affirmative Psychotherapy for American Jews by Schlosser (2006) is an enlightening article that aims to address the issue of oppression among Jewish Americans.

According to the author, psychotherapists have failed to address matters relating to ethnicity, race and culture affecting the Jewish community in America. As a result, Jewish Americans have received inadequate consideration in clinical work and professional literature.

In place of actual understanding or knowledge about American Jews, people tend to rely a lot on suppositions and stereotypes that exist owing to the substantial variability among the Jews.

The article helps the reader to understand the Jewish culture and the American Jews, including effective ways that help to ensure that the Jewish community gets access to culturally harmonious and positive psychotherapy services.

Schlosser (2006) offers guidance that would enable psychotherapists to work effectively with American Jewish clients. For instance, the author provides vital demographic information relating to this community.

He also presents information relating to Jewish culture and Judaism, including the various psychotherapeutic interventions suitable for the Jewish Americans. Psychologists have developed comprehensive interventions that help to address the issue of culture.

These interventions are critical because they enable psychologists to consider the influence that cultural factors have on people. Despite these developments, experts in the field of psychology have not explored the issues of culture, identity and ethnicity affecting Jewish Americans.

For example, the experts have not documented any studies on the psychotherapeutic interventions that are most suitable for Jewish American clients.

According to Schlosser (2006), Jewish Americans are an ethnic minority because their population represents approximately 2 percent of the total population in America. Recent statistics indicate that there are nearly 12 to 17 million Jews in the world.

Five to six million of the Jewish population lives in America. Jewish Americans also represent a unique cultural group that deserves consideration in the multicultural literature. As the author notes, most Jewish Americans live in large cities such as Chicago and California.

The three cities in America with the highest number of Jews include Los Angeles, Miami and New York. The Jewish people have a history that is both long and rich.

Many people across different parts of the world identify themselves as Jews. Ashkenazim is among the major Jewish ancestries. Other leading ancestries include Sephardim and Mizrachim.

Judaism represents a lot for the Jews. While some Jews view it as a culture and religion, others view it as an embodiment of ethnicity and traditions. Due to their inconceivable diversity, it is impossible to group Jews into a particular demographic class.

Jews have different ways of expressing their identities. In addition, different Jews have different levels of devotion to their law. This means that there is no standardized way of being Jewish.

Moreover, Jews demonstrate wide differences in their practices and holiday observances. Besides, there are notable differences in their ethnic and cultural categorization.

The main issues affecting many Jewish Americans include antisemitism, the Holocaust and the perception of their religion (Schlosser, 2006).

To ensure success in providing affirmative psychotherapy, psychotherapists must strive to increase their awareness of the Jewish people. The psychotherapists must understand the feelings and thoughts that they have regarding the Jews.

In addition, they must deal with any antisemitic perceptions before working with Jewish American patients (Schlosser, 2006). Besides, they have to demonstrate consciousness when asking about Jewish identity.

Likewise, the psychotherapists need to bond with their clients and exercise caution when interpreting their interpersonal suspicions. Furthermore, the psychotherapists should realize that Jews have high regard for insightful conversations and emotional expressions.

Reference

Schlosser, L. Z. (2006). Affirmative Psychotherapy for American Jews. Psychotherapy: Theory, Research, Practice, Training, 43 (4), 424-435.

My primary approach towards counseling and psychotherapy is rooted in the concept of psychodynamic analysis, which is mainly based on psychoanalysis developed by Sigmund Freud. It is important to note that the given theory emphasizes the criticality of driving forces within a person’s mind, and it is especially applicable to unconscious influences (Sommers-Flanagan & Sommers-Flanagan, 2018). In other words, the approach accentuates the relevance of a patient’s or client’s inner needs and mental issues, which are buried deep beneath the conscious layer of thoughts. The psychodynamic approach, as its name suggests, focuses and addresses the dynamic forces, which directly or indirectly affect an individual.

The psychodynamic theory and counseling approach was historically developed by Sigmund Freud due to his early works on hysteria in the late 1890s. At the beginning of the 20th century, Freud developed his core theories based on the case of hysteria, which was focused on the explanation, where the issue is the result of a past traumatic experience rather than a physical factor (Sommers-Flanagan & Sommers-Flanagan, 2018). In other words, unconscious and hidden problems of the memory affected a person’s current state, where the manifestation was the hysteria itself. In the following years, Freud refined his theory with the collaborative efforts of other well-known psychologists, such as Carl Jung.

The basis of all assumptions of the psychodynamic theory is rooted in the notion of all behavioral issues originating from the unconscious part of the mind. In other words, the concept can be called as psychic determinism, which emphasizes the fact that all behavioral patterns and elements of behavior have a causal origin, and thus, they do not emerge on their own (Sommers-Flanagan & Sommers-Flanagan, 2018). One of the most critical phases of human development is a person’s childhood, which has the strongest and long-lasting impact on the behavioral aspects of an individual. The psychodynamic theory accentuates that one’s psyche is comprised of three major components, which are Superego, Ego, and Id (Sommers-Flanagan & Sommers-Flanagan, 2018). These elements of a mind are tightly interconnected and play a major role in shaping a person’s behavior, and the corresponding issues are the result of problems, which originate from these parts of a psyche.

The role of a therapist or psychotherapist is of paramount importance because it is he or she who identifies and attempts to fix the underlying mental issue causes. The professional can utilize a wide range of methodological tools to access the unconscious aspect of a client’s mind. Therefore, the therapist is an important element of the therapy process because he or she is the one who identifies the underlying problematic areas of the behavioral disturbance.

The goal of the therapeutic process of the psychodynamic approach is to find the cause within the subconscious mind that results in a specified issue.

The techniques might include hypnosis, slips of the tongue, projective tests, free associations, and dream analysis, which can possess their own set of advantages and disadvantages (Sommers-Flanagan & Sommers-Flanagan, 2018).

In conclusion, the basis for my approach to counseling and psychotherapy process is the psychodynamic theory, which was developed and implemented by Sigmund Freud in the early 1900s. The core of the concept focuses on the notion of the subconscious, where the author assumes that all behavioral problems have a root origin in the unconscious mind. In other words, the client himself or herself does not understand that many problems are the result of past experiences, such as childhood disturbances. The theory was first derived from the case involving hysteria, where it was identified that past traumatic events were the key trigger of hysteric behaviors.

Reference

Sommers-Flanagan, J., & Sommers-Flanagan, R. (2018). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques (3^rd ed.). John Wiley and Sons.

Introduction

As humans face their day to day life experiences, several mental health issues or behavioral problems are bound to incessantly occur. Quite a number of children are victims of family violence and this causes them to be at a risk of social complications and mental disarrays including anger, suicidal intentions, depressions and awareness dearth hyperactivity disorders (ADHD). Other cases include drug addiction, eating disorders, learning disabilities or work related complications that may befall adults.

Equine Assisted Psychotherapy also known as EAP is a form of psychotherapy which cartels horses and psychotherapy to help restore self-esteem, trust, personal confidence as well as group-cohesion in people with the above issues (Schultz et al., 2007). This yearns to gauge what EAP entails, its correlation with other forms of equine therapies, how it is done and its use in assisting people with various difficulties.

Definition

EAP is the teaming up of human certified therapists and horses with the common goal of helping people who have succumbed to mental health problems, relationship complications, lack of life skills, grievance, loss, ADHD or short temper. EAP is also used to aid those who desire to focus on their own professional development (Jaleh, 2010). In fact, horses are used because of their prey-animal instincts that allow them make quick and precise assessment of their surroundings thus responding appropriately.

They have incredible insight in comprehending human body language besides being utterly honest and incapable of pretense. These enable horses to avail honest response to the client during their interactions. Conversely, a therapist organizes treatment plans and diagnoses while monitoring the process to ensure nothing goes astray. They are there purposely for the therapeutic parts of the sessions although other roles may come up.

EAP utilizes experimental vision oriented therapy which enhances the therapeutic process by applying a client’s ability to create metaphors. This is how humans relate to other peoples experiences. Metaphors of characteristics of a client situation, persona or people in their life in this case are the horse and all other requirements of an EAP session. Jaleh (2010) states that in this process only horse interactions on the ground are used while horse riding is not.

Equine Assisted psychotherapy versus Traditional psychotherapy

EAP unlike the traditional forms of therapy achieves quick and noticeable changes in the client within the first or subsequent periods. The instant reactions of the horse to the human actions and behavior assist the victim in meeting the therapeutic target in a short period. The brevity of psychotherapy period sets this method apart from other traditional forms of psychotherapy.

Moreover, the process conveys its lessons through various senses including visual, dynamic and acoustic which enable the client to retain lessons learnt for a longer period. According to Jaleh (2010) assertions, it is clear that numerous research studies can attest to this.

EAP versus other Equine Assisted Therapies

There are numerous other equine assisted therapies. Though partially similar, there are observable differences between them.

Equine-Facilitated Psychotherapy (EFP)

Like EAP, this is an experimental therapeutic process that comprises of horses and individuals or groups. It entails control, lunging and grooming of the horse. However, it mainly depends on activities done while riding the horse and hence making it different from EAP (Shultz, 2005).

EAP is considered better than EFP since its ground undertakings involve a horse creating more and appropriate opportunities for client development and enlightenment. Riding a horse in the process makes it the main focus rather than an instrument of the procedure. One has time to focus on issues affecting him and thus facilitating healing.

Hippo therapy

This is another form of physical, professional or speech therapy that borrows the services of a horse. The rhythmic characteristics of horse riding are utilized in dealing with the physical restrictions of the client making it different from EAP.

Horses versus other animals

Horses are EAP preferred animal since they offer therapeutic advantages that are not available in other animals. The most conspicuous is their size that ranges between eight hundred to twelve hundred pounds. This acts as a metaphor to the client in handling intimidation and life challenges.

Basically, horses are social animals with attitudes and temperaments. Each plays a precise role in their groups and derives excitement in enjoying themselves. Individuals can relate with them since they impart metaphorical lessons (Addiction, 2011). Their ability to reflect back human nonverbal cues offers lessons on use of verbal or non-verbal communication.

Conducting of EAP sessions

A new client in an EAP center is taken to tour the facility upon which an introduction to horses is made. However, horses’ background data is withheld to facilitate efficient formation of a metaphor by the client. This in turn sets grounds for fresh and new relationships. The emotional security and physical safety of the client is optimized by the session structure. The speed of the therapy depends on that of the client though in the first encounter the client may be allowed to groom the horse. Fearful clients are allowed to start with the pony.

In the second and all subsequent sessions the clients are given the freedom to make choices of the horses they want to work with during the day. During this time, the mental health specialist consults with the equine expert on the clients’ changes since the previous period. Depending on the client’s problem, an activity is selected by the psychotherapeutic team (Addiction, 2011). These activities aid the client in discovering and overcoming various mental or behavioral difficulties.

Since the horse can mirror the clients’ behavior, the equine professional observes changes in behavior or attitude patterns in the horse while the mental therapist observes the client. Through their discussions they come up with open ended and nonjudgmental questions that help the client relate the observations to their life. As the clients approach their therapies goals the questions are changed into those that help find answers to the current predicament.

Issues assisted by EAP

Equine Assisted Psychotherapy is used to solve problems that psychologists, counselors and even coaches solve. Such problems include:

Drug addiction

EAP is majorly used for cases in which talk therapy is difficult for some unknown reason. Interactions with the horse not only help the person relax but also become symbols of frustrations being faced. This helps to float their emotions in a serene comforting surrounding. Observations of interactions help therapist comprehend the unfulfilled wants and dreams of the addict. Via EAP addict does not only rediscover their hidden self but ways of assisting them similarly become evident (Addiction, 2011).

At-risk adolescents along with life skills

These are children faced with the risk of failure in life due certain factors such as poverty, learning difficulties, family violence, molestation or abusive parents. Such children may exhibit withdrawal tendencies and depression. In an attempt to change the behavior of the horse, youths are compelled to change their behavior first thus learning how to be responsible of what they do. Caring for the horse imparts lessons on benefits of handwork and overdue gratification.

Anger management, relationship building and depression

Horses have the ability to reflect nonverbal communication in humans. Since horse mode of communication is via non-verbal cues, individuals are encouraged to face and influence change in a potent and nonthreatening way. Interactions help human lower their defenses and become open to new thoughts and attitudes.

The associations with the horses instill lessons of respect, problem confrontation and preservation of health wise relationships with other people. Companionship brings in a sense of mutual working as a team for groups that undertake the program (Shultz, 2005).

Conclusion

EAP is not a new idea in the history of therapy. Its efficacy makes it certain that it will continue being used for a long time. People are beginning to realize how this animal-human bonding helps save and restructure many lives. With everyday inventions in the social forums EAP specialists are taking their time to advertise their services to those who are ignorant of this process.

This offers frustrated people a second chance to live. In essence, many conferences are held while associations that deal with EAP and other animal related therapies are formulated to help as many people as possible to restructure. Whether we are the ones directly in need of it or the loved ones, it becomes imperatively clear that we cannot deny that this procedure is an integral part of our lives.

References

Addiction, D. (2011). Drug Addiction Treatment at the Ranch. Web.

Jaleh, C. (2010). How Equine Assisted Psychotherapy Can Help You Heal. Web.

Shultz, B. (2005). The Effects Equine-Assisted Psychotherapy on the Psychological Functioning of At-Risk Adolescents ages 12-18. Web.

Schultz, P. N., Remick-Barlow, G. A. & Robbins, L. (2007). Equine-assisted psychotherapy: a mental health promotion/intervention modality for children who have experienced intra-family violence. Web.

Introduction

It is very important for the Christian psychotherapists to have proper knowledge and understanding of the scriptures. The utilization of systematic theology offers the apparatuses that are required in giving guidance in the approach to understanding God’s character and His mission.

Employing this approach will serve as a basis for a functional working model for the counselors to engage in the suitable integration of faith and counseling in order to create hope and healing of man in all aspects of life (Clinton & Hawkins, 2009). This paper is going to discuss the impact of the fruits of the Holy Spirit on psychotherapy. This is going to be discussion under three sections; theology, mission, and counseling. There will be a summary of the discussion in the conclusion section.

Theology

In Christianity, it is assumed that human beings are created to relate to God. In the book of Psalms 41:1, this is regarded as the basic need where it is pointed out that “as the deer longs for flowing streams of water, so my soul longs for you, O God” (Fayard, 2006, p.10). It is suggest by the Psalmist, as well as Augustine that spirituality is a fundamental driving force that has clear psychological implications (Fayard, 2006).

This implications as well give a reflection of a spirituality which is not just rational, but has anthropomorphic elements as well. Human beings are designed to thirst for their creator as a person, and God is willing to respond at all times (Grenz, 1994). This point of view is contradicted by those that for an amorphous spirituality or regard religion as “no more than a cultural narrative” (Joseph, 2003, p.14).

Jesus pointed out that the greatest law is “Love your God with all your heart and wilh all your soul and with all your mind “and the second is “Love your neighbor as yourself” (Mathew chapter 22). It is stated in the Bible that God is love. According to the book of 1Corinthians13, Paul points out that any experience that has no love is useless. Love is as well looked at from of interpersonal and ethical point of view (Hodge, 1975).

It is stated in the book of John, chapter 13 and verses 34 and 35 that “A new command I give you: Love one another. As I have loved you, so you must love one another…by this all men will know that you are my disciples, if you love one another” (Fayard, 2006, p.11). Love tends to be the arranging rule of divine doings.

In the present times, psychotherapy is dominated by either “the empirically supported protocols from Cognitive-Behavioral Therapy or by Eastern informed humanistic strategies” (Fayard, 2006, p.10). Within this context, boosting of the contexts of being loved and also loving is of significance. There is a tendency among the Cognitivists to engage in overemphasizing a rationalist point of view, but on the other hand, there is a tendency for the humanists to put focus on a “self-referencing ethic” (Fayard, 2006, p, p.11).

Bergin (1980) points out that “values are an inevitable and almost omnipresent part of the therapeutic process” (Bergin, 1980, p.95). Evidence has been offered by the researches that have been conducted that the values of the therapist have an influence on every psychotherapy phase, encompassing the theories of the therapeutic change as well as personality, evaluation strategies, treatment goals, design and choosing of the interventions, and assessment of the outcomes of therapy (Grider, 1994; McCullough, 1999).

The values of the therapist have influence on the patients, most of the time taking on their moral, religious values as well as health (Miller, 1999).

In Christianity, there is an assumption of moral order which gives the reflection of the Creator’s image in the creature. The book of Exodus chapter 20 expresses the values that create boundaries: inner differentiation and “the regulation of interpersonal social adjustment that flow from a personal and collective ethic informed by love” (Fayard, 2006, p.11).

The book of Galatians gives a reflection of the virtues at the heart of the values held by Christianity which include self control, love, goodness, gentleness, kindness, peace, faithfulness and joy, and embodied in the individual and Jesus Christ’s life (Fayard, 2006).

Of greater importance is the assumption which is put forward in Christianity that the completeness of Imago Dei can only be a product of spiritual processes. It was pointed out by the creator of modern Adventism that culture, putting the will into effect, human endeavor, and educations have their appropriate field, but here they are ineffective.

“They may produce an outward correctness of behaviors, but they can no change the heart…That power is Christ” (White, 1892, p.11). This implies that the emphasis on values can just go as far with no clear understanding of grace as being a base.

The Christian psychotherapists have to be faithful to the patient’ values and at the same time, they should have acknowledgement of the moral implications, relationships, and conduct. A large number of psychotherapists would concur with the virtues expressed as being the fruits of the Holy Spirit (Saunders, et al, 2010).

Positive Psychology suggests the same listing (Peterson & Seligman, 2004). The profession has been challenged by Doherty (1996), to consider the moral challenges in a serious manner. Fayard (2006) suggested that Exodus 20 offers a significant compass in this line.

Mission

All through the Scripture, the main theme is the restoration of nations. In order for this mission to go on, there is a need for believers to possess the outpouring power of the Holy Spirit. This kind of power makes it possible for the believers to go out and serve as witnesses. The Holy Spirit provides discernment for one to be perceptive to all forms of the needs of the needy people. The mission Dei model requires one to be culturally competent.

By one being a therapist and at the same time a minister, it is essential for him or her to have the understanding of various cultural limitations and strengths. This can be realized through sufficient training in cultural competency, referred to as Sue’s cultural competence. This training gives a highlight of the strengths, values and ethical guiding principles among other important cultural information.

All human beings are created in the image and likeness of God. Since all human beings are created in the image of God, which is not similar to any other thing He created, they have the duty to serve as His representatives and should also represent His interests and serve as His ambassadors for all creatures.

By making human beings in His own image, He offers them a value. This is a respect that is given to all Human beings, and it is supposed to serve as the ‘hand’ which Christians are in a position to use to reach out other people to show them God’s character through the acts of acceptance, as well as love (Wright, 2006).

Therefore, it is imperative for the therapists to portray love and acceptance to their clients (Rogers, 1961). Being Christian counselors, these people are called not just to have recognition of this value, but they as well need to go a mile further to turning out to be God’s ambassadors to their clients to provide them with love, dignity and acceptance which are traced in the character of God (McMinn & Campbell, 2007).

The Imago Dei concept has two significant missiological implications. First, it illustrates the ability of human beings to fellowship with God. The other implication is that human beings are created with the ability to serve as God’s representatives (Vicedom, 1965). Even if the fall of man injured God’s fellowship with man, through the Imago Dei, it is possible to make a restoration of a man in order for him to fellowship with God (Hope, 1987).

Through Jesus’ redemptive sacrifice on the cross, the plan God has is to ensure restoration of all human beings to Himself. This can be clearly seen in the “Great Commission” as portrayed in the book of Mathew, Chapter 28 and verses 19 and 20, where Jesus makes a command to his disciples “to go into the entire world and make disciples from all nations”. Jesus Christ did not engage in ruling any person out as being incapable of being redeemed (Packer, 1973).

The Creator made all human beings as male and female. He commissioned Human beings to have power over the entire creation. Among the ways in which an indication of this was given is Adam giving names to all animals. In the book of Genesis, chapter one and verse twenty eight, there is the establishment of the precedent to the writings of Paul that came later in book of 2 Corinthians chapter five and verse 20 in which it is taught that the Christians are to serves as ambassadors of God and should represent Him.

It is also pointed out that all human beings were created to have equal qualifications to ensure this purpose is accomplished. Jews and Gentiles alike were offered the gift of the Holy Spirit in the book of Acts and have a common commission to set out to be God’s representatives to all nations. York (2000) pointed out that “God’s creation of humankind in His image establishes both the scope and agency of God’s mission…God’s mission will be to all peoples” (York, 2000, p.23).

Cheong & DiBlasio (2007) points out that “a Christian counseling perspective of love must emerge from an understanding of God’s character, redemptive work throughout history, and command to love” (p.14). God made a choice to reveal Himself in two different ways; a general way and a special way.

Through the God’s revelation, human beings are in a position to see how the reconciliation as well as redemption are being played all through the history and lives of human beings. Beginning from the time man felt short of the glory of God to this very moment and to the future, the plan of God has been and will always be in motion (Clinton, Hart & Ohlschlager, 2005).

Counseling

The clearly seen form of integration of counseling and faith is found in the way the counselor behaves. However, this does not imply that the counselors who utilize the “Christian practices” possess integrated learning and faith” (Alexander, n.d, p.1). In simple terms, it may imply that they have done away with “their training altogether” (Alexander, n.d, p.1). Alexander (n.d) points out that:

Prayer, use of the Bible, healing of the memories through inviting God into the situation, use of Christian symbols and ritual, deliverance, laying on of hands, and involvement in church life are all Biblically based practices which Christians might draw on in their counseling practice (Alexander, n.d, p.1).

In a large number of cases, such practices would be utilized only in those situations where clients were Christians and had permitted their use. Among the church counseling centers, there are those that may utilize these practices regularly, holding the belief that in case people come to Christian centers that are open, they’ll have to have the willingness to accept a practice like this (Keating & Fretz, 1990; Rose, et al, 2001).

Indication would be given by professional training that would be always looking for permission for those practices that are not utilized willingly by the profession, and the Christians should draw a difference between “counseling” and “ministry” as being a part of the care duty. According to Tan (1996), “if the client shows no interest at all in religion or spiritual issues, then the therapist has to respect the client’s preferences” (Tan, 1996, p.370).

A large number of Christian counselors have received subjective evidence of practices that are apparently “disrespectful of uninformed clients and which amount to spiritual abuse when used without explanation or choice being given” (Alexander, n.d, p.2). A suggestion of three ethical guidelines is given by Nelson and Wilson (1984).

The first guideline is in relation to when handling clinical problems that will be assisted by religious or spiritual intervention. The second is if they are operating in the belief system of the person him or herself and the third is, if they have keenly defined the counseling agreement to encompass these resources or practices.

Then, having these practices integrated would call for the counselor to think through his or her beliefs in regard to the person’s nature, the healing process and the disease nature. The counselor is supposed to be in a position to carry out the articulation of their position on all of these areas and therefore give good reason for their use of any practice they take up (Martin, 2000).

For instance, in case a counselor holds a belief that healing originates from the renewal of the mind, shifting of the usual thought patterns, and brings together with a cognitive behavioral understanding theoretical context, they would be fully in line with “helping a self-identified Christian client recognize unbiblical thought patterns and replace these with verses which fit with the context of Biblical thinking as a whole – for example, an understanding of grace and God’s acceptance” (Alexander, n.d, p.1).

Another counselor who holds a belief that the larger portion of adult behavior is brought about by childhood neglect issues has a high likelihood to “draw on a psychodynamic understanding of attachment and to use inner healing, relating to helping the client find God as the longed-for parent” (Alexander, n.d, p2).

They may come to an agreement to pray together and make a request to the Holy Spirit to give the revelation of keys to healing. This as well, is a theological and theoretical understanding integration. As on the one hand, these theoretical positions and practices may contradict one another, but on the other hand, they are confirmation of integration of faith, as well counseling and clear practice (Bartz, 2009).

The counselors are supposed to engage in thinking through whatever Christian practices are and get the understanding of the way they are connected to the theoretical as well as theological beliefs they hold. It is also imperative that they become aware of the way they give the explanation to these practices and the way to ask for permission for their utilization with the clients. In this regard, it can be pointed out that it is very important to have recognition of the breadth of Christian practice and theology.

A member of the Anglican Church may prefer using a crucifix in the course of counseling and be comfortable with this but on the other hand, he or she may be afraid of the inviting the Holy Spirit. However, a member of the Pentecostal Church may have a different feeling (Clinton & Hawkins, 2009). It is very vital that counselors make no assumptions that since a person is a Christian, he/she is willing to accept whatever practice the counselor may be aware of. Those practices suit their “particular church experience” (Alexander, n.d, p.2).

Among the Christians, there are those who may engage in counseling without mentioning the name of God at all, and still be “Jesus” to the people they are counseling. Moreover, there are those that may continually, and with awareness, follow the guidance of the Holy Spirit in a situation in which they can reveal what they are actually undertaking (Tan & Gregg, 1997; Collins, 2007). An important portion of integration is the “own being” of the counselors, their personal integrity, as well as their spiritual growth.

Conclusion

The fruits of the Holy Spirit have several impacts on psychology. It is very import for the Christian psychotherapists to understand the scriptures well, in order for them to help in counseling people who may need their assistance. Christianity makes an assumption that human beings are created to relate to God.

Christian psychotherapists have to be faithful to the patients’ values and, at the same time, they should acknowledge the moral implications, relationships and conduct, being aware that all human beings are made in the image of God. The dominating theme in the scriptures is the restoration of nations.

In order for this mission to go on, there is the need for believers to possess the outpouring power of the Holy Spirit. There is need for the counselors to follow the guidance of the Holy Spirit in situations in which they can reveal to their clients what they are undertaking (Tan, 1997; Collins, 2007) in the process of counseling. They need to integrate faith and psychotherapy and the important portion of integration is the “own being” of the counselors, their personal integrity, as well as their spiritual growth.

References

Alexander, I. (n.d). Integration in the practice of Christian counselors. Web.

Bartz, J. D. (2009). Theistic existential psychotherapy. Psychology of Religion and Spirituality, 1(2), 69-80.

Bergin, A. (1980). Psychotherapy and religious values. Journal of Consulting and Clinical Psychology. 48 (1), 95-105.

Cheong, R. & DiBlasio, F. (2007). Christ-love and forgiveness: A biblical foundation for counseling practice. Journal of Psychology and Christianity, 26(1), 14-25. Web.

Clinton, T., Hart, A., & Ohlschlager, G. (2005). Caring for people God’s way: Personal and emotional issues, addictions, grief, and trauma. Nashville, TN: Nelson Reference & Electornic.

Clinton, T. & Hawkins, R. (2009). The quick-reference guide to biblical counseling: Personal and emotional issues. Grand Rapids, MI: Baker Books.

Collins, G. (2007). Christian counseling: A comprehensive guide (3rd ed.). Nashville, TN: Thomas Nelson.

Fayard, C. (2006). Christianity and psychotherapy: Clinical implications from a Seventh-Day Adventist biblical anthropology. Web.

Grenz, S. J. (1994). Theology for the community of God. Nashville, TN: Broadman & Holman Publishers.

Grider, J. K. (1994). A Wesleyan-Holiness Theology. Kansas City, MO: Beacon Hill Press.

Hodge, C. (1975). Systematic Theology. Grand Rapids, MI: Wm. B. Eerdmans.

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Introduction

Human beings have been experiencing numerous challenges in the course of life for a considerably long period of time now. Different intervention strategies have been employed in order to counter the problems with an attempt to solve them amicably.

Many psychological researchers have made attempts to explore the possibility of enhancing the effectiveness of handling the challenges experienced in life. Psychotherapy is one of the most focused upon field by the scientists in the recent past. It is a process employed by a psychotherapist when attending to the clients.

Psychotherapy involves interpersonal counseling sessions where the psychotherapist and the client interact closely with an aim of aiding the patient overcome the problems associated with life. The primary focus of most intervention measures is to help the client enhance the feeling of self-worth and hence promote their well-being for a better living.

Psychotherapy can be defined as a process geared towards the relief of distressing or a challenge in an individual by someone else, using a predetermined approach from a given theory or paradigm, and the psychotherapist must have some professional training as far as offering the services is concerned (Plante, 1998).

A ray of techniques are employed by the psychotherapists depending on the relationship built from experience, dialogue, and continued interaction.

Other strategies including promoting communication and the emphasis on the need for a behavior change with an aim of improving the client’s psychological health as well as the need to improve relationships among groups, for instance among members of family.

Psychotherapy is such a broad field that it can be practiced by different professionals and practitioners with varying qualifications.

For instance, it can be performed by psychiatrists, clinical psychologists, counseling psychologists, rehabilitation counselors, music therapists, mental health counselors, clinical social workers, marriage and family therapists, occupational therapists, psychiatric nurses, and psychoanalysts (Plante, 1998).

Given the broadness of psychotherapy, it has the capacity to assert itself as a profession on its own. There are several forms of psychotherapy but most of them use spoken means for exchanging information.

Other forms of communication include; the written word, drama, narratives, music, story telling, and the use of art. Psychotherapy is normally conducted in a structured environment between a trained psychotherapist and the client(s).

Over a long period of time now, psychotherapy has always been conducted in response to either different clinically diagnosable problems or non-specified mental expressions in human beings resulting from crises in life. Some therapeutic involvements are modeled to attend to clients in the symptom-based approach.

However, most interventions by psychotherapists do not employ the medical model when attending to their client(s). Clients, therefore, respond differently to all the various approaches and greatly determine whether they are satisfied by the services offered or not. The need to find out client satisfaction after a session in psychotherapy has been at the center of many researches for the past two decades.

Virtually all therapeutic encounters involve the discussion of very sensitive as well as strictly personal issues with the client. As a result, psychotherapists are often bound legally to observe confidentiality as far as sharing client’s information is concerned.

The techniques employed in measuring client’s satisfaction have not been as effective as they should be. This paper seeks to focus on the outcomes and session evaluation in psychotherapy. It will discuss and review existing research, the contributing factors, and propose direction towards achieving better treatment in psychotherapy in order to ensure client satisfaction.

Although there exists a number of research findings concerning client satisfaction in psychotherapy, advanced and thorough research in session evaluation in psychotherapeutic satisfaction as well as proposals for enhancing the effectiveness of therapeutic interventions need to be conducted.

Literature Review

Researchers have made significant progress in an attempt to enhance the quality of services offered to the client by psychotherapists. Analyses of outcome and evaluation of client satisfaction from psychotherapeutic sessions by researchers have been done with an aim of drawing meaningful conclusions for improving the various intervention approaches.

As much as there are a number of research findings and conclusions, so are the numbers of unaddressed deficiencies in enhancing the effectiveness of psychotherapeutic interventions. This section seeks to focus on the works done by six researchers that will highlight the need for conducting a project for my stated thesis.

In a journal article by Laszloffy (2000), research findings to investigate the implications of client satisfaction feedback for fresh family therapists are discussed.

In the study, the researcher integrated the client’s perspective on session satisfaction as opposed to the traditional pattern by researchers to ignore this aspect and relying only on therapist’s perspective. Client-satisfaction ratings of therapy sessions were solely used to assess outcome and to select sample.

The rating scale was designed such that the client rated the outcome of a given therapy as either “extremely satisfying” or “extremely dissatisfying”. The client sample was collected from a degree-granting marital and family therapy (MFT) training program in the United States.

It involved separate phone interviews with the therapists and clients within 1-2 months following the termination of the case. All the participants were informed about the project and they participated voluntarily by signing a consent form. Audio-taped interviews were conducted by 8 MFT master’s students.

The researcher investigated two closed-ended questions: “Were there any changes in presenting problem (yes or no)?” and “Please rate how satisfied/dissatisfied you are with the therapy you received/provided (on a 7-point Likert scale).”

The following open-ended questions were also asked: “What was particularly good about the therapeutic experience?” “What was particularly not good about the therapeutic experience?” and “How would you describe your relationship with your therapist/clients?”

The results from the sample were analyzed in terms of what was regarded as good and not good about therapy experience as well as the perception associated with the client-therapist relationship (Laszloffy, 2000).

The research question that the analyst used to find out the themes linked to the divergent outcomes was: What specific factors/themes appear to be linked to clients’ overall satisfaction or dissatisfaction with the therapy experience (i.e., therapeutic outcome)?”

This research question is in tandem with my thesis where deeper factors contributing to client satisfaction/dissatisfaction need to be investigated.

According to the research findings, a number of inherent themes were established. Most clients were positive with their relationship with their therapists. Those who were positive reported that they felt connected.

For the therapists, language barrier hindered their desire to develop positive relationship with their clients, but no hostility was implied by those who were extremely dissatisfied. Differences in the levels of client satisfaction were also found to originate from the varying definition of therapeutic goals.

The conclusion drawn indicated that clients and the therapists had remarkable congruent perceptions of the therapy experience (Laszloffy, 2000). This supports the thesis in that some important contributing factors were identified as determining client satisfaction in therapy sessions.

However, the sample used was very small and specific such that no generalizations can be made about the conclusions reached. The absence of a dialectical data-gathering method similar to qualitative research may have interfered with the results and hence validity of the conclusions.

Another research by Simmons and Doherty (1998) focused around the same topic of investigation. The author addressed the question of whether academic training backgrounds make any difference among practicing marriage and family therapists and the client’s satisfaction.

The study investigated members of the American Association for Marriage and Family Therapy with academic training in psychology, social work, counseling, and marriage and family therapy by comparing their performance on a wide range of clinical practice variables, and their clients were surveyed as far as their satisfaction and outcomes were concerned.

The findings showed highly similar practice patterns and client outcomes across all four disciplinary groups. Just like the findings by Laszloffy (2000), this research sought to explore the role that educational training background may have on client satisfaction. The research concluded that professional discipline does not make any meaningful difference in the outcomes of psychotherapy.

The findings of the study, however, cannot be generalized outside the members of the American Association for Marriage and Family Therapy although the 33% response rate raises even further doubts.

Also, the role of ethnicity and race was not properly taken into account since the therapists and the clients were 96.6% European American and the report identified this as a limitation (Simmons & Doherty, 1998). Hence, it is consistent with my thesis statement that further research into factors affecting client outcome in psychotherapy sessions is needed.

An earlier research by Howard, Moras, Brill, Martinovich, and Lutz (1996), investigated the comparative efficacy and effectiveness of clinical interventions, aggregated over groups of patients. They advocated the monitoring of a patient’s progress over the course of treatment.

The research concluded that despite the accumulation of evidence showing that psychotherapeutic interventions are efficacious and effective for mental health problems, the provision of such treatments is faced with major challenges. The concern raised here will be captured in the project that I intend to pursue in relation to the thesis statement.

In an attempt to predict the evaluation of psychotherapy sessions, just as is mentioned in the thesis above, Eugster and Wampold (1996) conducted a research using 114 therapists and 119 patients.

They used the Comparative Scale of Psychotherapy Session Constructs designed to measure 9 process variables and how they are related to the session evaluation from the therapists’ and patients’ perspectives. The findings revealed significant difference between the session evaluations for the two groups.

Therapist expertness predicted therapist session evaluation while therapist real relationship predicted the patient session evaluation (Eugster & Wampold, 1996).

The study findings also showed that there are both similarities and significant differences in how patients as well as therapists evaluate psychotherapy sessions. The research had its own limitations.

The participating therapists were from a small group of experts; hence, the findings could not be generalized. Furthermore, the research sought to explore the overall systematic differences between therapists and patients and not on individual basis. The project to be pursued will scale down its perspective to focus on the individual dyads.

A recent research which was conducted by Reese, Norsworthy, and Rowlands (2009) sought to explore and attempt to solve the question of whether continuous feedback system does improve psychotherapy outcome.

The authors hypothesized that the use of outcome data on a continuous basis to monitor treatment progress plays a role in enhancing psychotherapy outcome.

The research findings indicated that those patients who used the Partners for Change Outcome Management System (PCOMS) demonstrated significant treatment progress compared to those who did receive treatment usually (Reese et al., 2009).

Furthermore, the findings revealed that the clients who use PCOMS experienced reliable change and within fewer sessions. Also, it was established that fewer premature termination of treatment was reported by the clients who used PCOMS. The researchers assessed the result using statistical calculations.

The use of the system proved to be a major limitation in this study. Moreover, the study was not consistent since a significant number of clients had no data, meaning they did not participate fully in the study and thus the conclusions may be invalid, to some degree.

More appropriate techniques of collecting data and ensuring that there is full participation of the clients in the project to evaluate patient satisfaction will be prioritized in my project.

Hollon and Dimidjian (2010) conducted the latest research to find out if there were any harmful effects of psychotherapy. The researchers hypothesized that patients can be harmed by treatment or by decisions that are made about those treatments.

They were motivated by numerous cases of the harmful effects of psychotherapy which has been established through research that the scope could be broader than is thought. The article defines several ways in which treatment can cause harm to patients. The factors that hinder the detection of the harm have also been discussed.

The data was collected through randomized clinical trials. Their desire was to highlight the impact of psychotherapy itself (Hollon &Dimidjian, 2010). This could actually be a significant factor that affects session satisfaction in psychotherapy which the project seeks to investigate.

Conclusion

From the above research findings by various investigators, it is evident that quite a number of studies have been conducted around the field of psychotherapy and client satisfaction. Conducting a deeper research that will build on the challenges experienced by earlier researchers is therefore justified.

We can therefore conclude that despite the fact that there exists a number of research findings concerning client satisfaction in psychotherapy, advanced and thorough research in session evaluation in psychotherapeutic satisfaction as well as proposals for enhancing the effectiveness of therapeutic interventions need to be conducted.

References

Eugster, S. L. & Wampold, B. E. (1996). Systematic effects of participant role on evaluation of the psychotherapy session. Journal of Consulting and Clinical Psychology. 64 (5), 1020-1028

Hollon, S. D. & Dimidjian, S. (2010). How would we know if psychotherapy were harmful? Journal of American Psychological Association. 19-32.

Howard, K. I., Moras, K., Brill, P. L., Martinovich, & Z., Lutz, W. (1996). Evaluation of psychotherapy: efficacy, effectiveness, and patient progress. American Psychological Association. 51 (10), 1059-1064

Laszloffy, T. A. (2000). The implications of client satisfaction feedback for beginning family therapists: back to the basics. Journal of Marital and Family therapy. 26 (3), 391-397

Plante, T. G. (1998). Measuring treatment outcome and client satisfaction among children and families: A case report. [Peer Reviewed Journal Article]. Journal of Professional Psychology. 29 (1), 52-55

Reese, R. J., Norsworthy, L. A., & Rowlands, S. R. (2009). Does a continuous feedback system improve psychotherapy outcome? Journal of American Psychological Association. 46 (4), 418-431

Simmons, D. S. & Doherty, W. J. (1998). Does academic training background make a difference among practicing marriage and family therapists? Journal of Marital and Family Therapy. 24 (3), 321-336