Counselling Psychology Quarterly最新文献_第9页

“Talk to me like I’m a human” An interpretative phenomenological analysis of the psychotherapy experiences of young people in foster care in Ireland “像人一样和我说话”——爱尔兰寄养青少年心理治疗经历的解释性现象学分析

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-04-23 DOI: 10.1080/09515070.2022.2062702

Daire Gilmartin, Rosaleen McElvaney, M. Corbally

ABSTRACT Many young people in foster care experience significant mental health difficulties, leading to attendance at services where engaging them in psychotherapy that adequately meets their diverse needs is an ongoing challenge. There is a dearth of research exploring the experiences of young people in foster care, and even less on their experiences of therapeutic engagement. Using Interpretative Phenomenological Analysis (IPA), individual interviews were conducted with seven young people in foster care about their experiences of psychotherapy. Four superordinate themes were identified: being powerless; risking relationship; opening up; and finding connection. Young people revealed complex intrapersonal and interpersonal processes where they felt disempowered, drew on their courage to gradually build trust in therapists, were able to share their innermost thoughts and feelings and established deeper connections with themselves and others. This lived experience, illustrating a journey of relational connection, aligns with recognition theory, highlighting young people’s need for authentic recognition as individuals in their totality, for psychotherapy that offered emotional connection and opportunities for systemic relational growth. The study illuminates the inherent challenges of working with this population, while informing practice about how to engage with young people in foster care in a meaningful and helpful way.

摘要许多被寄养的年轻人都经历了严重的心理健康问题，导致他们在服务中接受心理治疗，以充分满足他们的不同需求是一项持续的挑战。关于年轻人在寄养中的经历，缺乏研究，关于他们参与治疗的经历的研究更少。使用解释现象学分析（IPA），对七名寄养青少年进行了个体访谈，了解他们的心理治疗经历。确定了四个上级主题：无能为力；风险关系；对外开放；以及寻找联系。年轻人揭示了复杂的个人和人际过程，在这些过程中，他们感到被剥夺了权力，他们鼓起勇气逐渐建立对治疗师的信任，能够分享自己内心的想法和感受，并与自己和他人建立了更深的联系。这种生活经历说明了一段关系联系的旅程，与认知理论相一致，强调了年轻人作为个体整体需要真正的认知，需要心理治疗来提供情感联系和系统关系成长的机会。这项研究阐明了与这一群体合作的内在挑战，同时为实践提供了如何以有意义和有益的方式与寄养中的年轻人接触的信息。

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引用次数: 2

Counseling psychology doctoral students’ experiences of authenticity: a collaborative autoethnography 咨询心理学博士生的真实性体验:一个合作的自我民族志

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-04-18 DOI: 10.1080/09515070.2022.2063260

NaYeon Yang, Greta Jankauskaite, Judith A. Gerstenblith, Justin W Hillman, Ruogu J. Wang, Thomas P. Le, C. Hill

ABSTRACT Given the importance of authenticity in counseling psychology, we used a collaborative autoethnography approach to explore our experiences of authenticity as counseling psychology doctoral students. Six (3 women, 2 men, 1 gender flexible man; 3 European American, 2 Asian American, 1 Asian; 5 3rd-year students, 1 2nd-year student) students in one counseling psychology doctoral program in the Mid-Atlantic United States reflected on the factors that facilitated and hindered our ability to be authentic by writing four one-to-five page journal entries, reading the journals in four three-hour group meetings, receiving non-judgmental feedback, and editing the journal entries. In the journals, we explored our understanding of authenticity, the development of our authentic selves, our experience of authenticity in graduate school, the role of authenticity in our relationships, the way in which our authenticity has been shaped by external forces, and our process of balancing the costs and benefits when deciding whether or not to be authentic in a given situation. Themes that emerged from the data revealed that we had received mixed messages about authenticity in our graduate program and that our ability to be authentic varied depending on whether we were in the role of therapist, teacher, researcher, or student. Further, family and peer relationships, hierarchical structures, and privileged and marginalized social identities enhanced or inhibited our experiences of authenticity in graduate school. Implications for graduate students and recommendations for future research are discussed.

摘要:鉴于真实性在咨询心理学中的重要性，我们采用协作性的自我民族志方法来探索我们作为咨询心理学博士生的真实性体验。6人(女性3人，男性2人，性别灵活的男性1人;3名欧美人，2名亚裔美国人，1名亚洲人;在美国大西洋中部的一个咨询心理学博士项目中，5名三年级学生和12名二年级学生通过写四到五页的日记、在四次三小时的小组会议中阅读日记、接受非评判性的反馈和编辑日记，反思了促进和阻碍我们真实能力的因素。在这些期刊中，我们探讨了我们对真实性的理解，我们真实自我的发展，我们在研究生院对真实性的体验，真实性在我们的人际关系中的作用，我们的真实性是如何被外部力量塑造的，以及我们在决定是否在特定情况下保持真实性时平衡成本和收益的过程。从数据中出现的主题显示，我们在研究生课程中收到了关于真实性的复杂信息，我们的真实性能力取决于我们是治疗师、教师、研究人员还是学生。此外，家庭和同伴关系、等级结构、特权和边缘化的社会身份增强或抑制了我们在研究生院的真实性体验。讨论了对研究生的启示和对未来研究的建议。

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引用次数: 0

Body shame among Asian American college women: the roles of sexual objectification, internalized racism, and ethnic identity strength 亚裔美国女大学生的身体羞耻感:性物化、内化种族主义和种族认同力量的作用

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-04-16 DOI: 10.1080/09515070.2022.2065664

Hsiu-Lan Cheng

ABSTRACT Informed by objectification theory’s tenet that sexual objectification and racism are powerful sociocultural forces that perniciously impact women of color’s mental health, the present study examined the longitudinal links of sexual objectification and three forms of internalized racism (i.e. self-negativity, weakness stereotype, appearance bias) with body shame among Asian American college women (N = 146). Ethnic identity strength, a theorized protective factor in body image literature, was examined as a moderator for the hypothesized longitudinal links. Results indicated that sexual objectification and self-negativity measured at Time 1 had significant and positive bivariate associations with body shame measured at Time 2. However, these variables no longer predicted body shame when body mass index (BMI) was included as a covariate. A significant interaction between appearance bias and ethnic identity strength emerged in predicting body shame. Specifically, high ethnic identity strength exacerbated the detrimental effect of appearance bias on Asian American women’s body shame, whereas low ethnic identity strength buffered this effect. This finding contradicts theoretical views of ethnic identity strength as a protective factor in women of color’s body image development. Practice implications and future research directions are discussed.

根据客体化理论的原则，性客体化和种族主义是强大的社会文化力量，会对有色人种女性的心理健康产生有害影响，本研究考察了性客体化和三种形式的内化种族主义（即自我消极、软弱刻板印象、外表偏见）与亚裔大学女性身体羞耻感的纵向联系（N=146）。种族认同强度是身体形象文献中的一个理论保护因素，被认为是假设纵向联系的调节因素。结果表明，在时间1测量的性客体化和自我否定与在时间2测量的身体羞耻感具有显著且正的双变量关联。然而，当体重指数（BMI）作为协变量时，这些变量不再预测身体羞耻感。在预测身体羞耻感时，外貌偏见和种族认同强度之间存在显著的交互作用。具体而言，高种族认同强度加剧了外表偏见对亚裔女性身体羞耻感的不利影响，而低种族认同强度则缓冲了这种影响。这一发现与种族认同强度作为有色人种女性身体形象发展的保护因素的理论观点相矛盾。讨论了实践意义和未来的研究方向。

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引用次数: 4

Novel contact-kinin inhibitor sylvestin targets thromboinflammation and ameliorates ischemic stroke. 新型接触激肽抑制剂西维素能抑制血栓素炎症并改善缺血性中风。

IF 8 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-04-13 DOI: 10.1007/s00018-022-04257-7

Zhiye Zhang, Chuanbin Shen, Mingqian Fang, Yajun Han, Chengbo Long, Weihui Liu, Min Yang, Ming Liu, Dengdeng Zhang, Qiqi Cao, Xue Chen, Yaqun Fang, Qiumin Lu, Zongliu Hou, Yaxiong Li, Zhenze Liu, Xi Lei, Heyu Ni, Ren Lai

Ischemic stroke is a leading cause of death and disability worldwide. Increasing evidence indicates that ischemic stroke is a thromboinflammatory disease in which the contact-kinin pathway has a central role by activating pro-coagulant and pro-inflammatory processes. The blocking of distinct members of the contact-kinin pathway is a promising strategy to control ischemic stroke. Here, a plasma kallikrein and active FXII (FXIIa) inhibitor (sylvestin, contained 43 amino acids, with a molecular weight of 4790.4 Da) was first identified from forest leeches (Haemadipsa sylvestris). Testing revealed that sylvestin prolonged activated partial thromboplastin time without affecting prothrombin time. Thromboelastography and clot retraction assays further showed that it extended clotting time in whole blood and inhibited clot retraction in platelet-rich plasma. In addition, sylvestin prevented thrombosis in vivo in FeCl₃-induced arterial and carrageenan-induced tail thrombosis models. The potential role of sylvestin in ischemic stroke was evaluated by transient and permanent middle cerebral artery occlusion models. Sylvestin administration profoundly protected mice from ischemic stroke by counteracting intracerebral thrombosis and inflammation. Importantly, sylvestin showed no signs of bleeding tendency. The present study identifies sylvestin is a promising contact-kinin pathway inhibitor that can proffer profound protection from ischemic stroke without increased risk of bleeding.

缺血性中风是导致全球死亡和残疾的主要原因。越来越多的证据表明，缺血性中风是一种血栓-炎症性疾病，其中接触-激肽通路通过激活促凝血和促炎症过程发挥着核心作用。阻断接触-激肽通路的不同成员是控制缺血性中风的一种很有前景的策略。在这里，首次从森林水蛭（Haemadipsa sylvestris）中发现了一种血浆激肽和活性 FXII（FXIIa）抑制剂（西维素，含 43 个氨基酸，分子量为 4790.4 Da）。测试表明，西维素可延长活化部分凝血活酶时间，而不影响凝血酶原时间。血栓弹性成像和血块回缩试验进一步表明，西司他丁能延长全血的凝血时间，抑制富血小板血浆中血块的回缩。此外，在氯化铁诱导的动脉血栓形成模型和卡拉胶诱导的尾部血栓形成模型中，西黄素也能防止体内血栓形成。通过一过性和永久性大脑中动脉闭塞模型评估了西维素在缺血性中风中的潜在作用。通过对抗脑内血栓形成和炎症，西维因能有效保护小鼠免受缺血性中风的伤害。重要的是，西维因没有出血倾向的迹象。本研究发现，西维因是一种很有前景的接触激肽通路抑制剂，它能在不增加出血风险的情况下为缺血性中风提供深层保护。

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引用次数: 0

Change in emotional processing in daily life: relationship with in-session self-esteem 日常生活中情绪处理的变化:与会期自尊的关系

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-03-18 DOI: 10.1080/09515070.2022.2029349

U. Kramer, Hélène Beuchat, Loris Grandjean, J. Despland, A. Pascual-Leone

ABSTRACT In-session emotional processing is a central component of psychotherapy, but little is known about the types and the quality of emotional processing individuals engage in daily life. An ecological momentary assessment (EMA) schedule has been validated to assess distinct emotional experiences as they emerge in daily life. It remains an open question whether changes observed in distinct emotional experiences over a week of assessment are related to in-session self-esteem. In total, N = 42 university students participated in a one-week assessment of emotions using ecological momentary assessment, as well as in a one-session experiential task of resolving self-criticism (using a two-chair dialogue from emotion-focused therapy). The emotions in daily life were self-reported by the participants on a regular basis, and self-esteem was assessed three times during the two-chair dialogue. Two-level hierarchical linear models reveal emotional changes in daily life, and in-session self-esteem is introduced as predictor at level 2. In-session self-esteem was correlated with symptom levels. The results showed that changes in primary maladaptive emotions in the one-week assessment were predicted by state and trait components of in-session self-esteem, which took place at the outset of the EMA. Trait-components of self-esteem were linked with the level of symptoms, whereas state-components of self-esteem were not. The present study underscores the importance of extending research from within-session observations of emotional processing towards daily life. .

心理治疗中的情绪处理是心理治疗的核心组成部分，但人们对日常生活中情绪处理的类型和质量知之甚少。生态瞬间评估(EMA)计划已被验证，以评估不同的情绪体验，因为他们出现在日常生活中。在一周的评估中观察到的不同情绪体验的变化是否与治疗中的自尊有关，这仍然是一个悬而未决的问题。总共有N = 42名大学生参加了为期一周的情绪评估，使用生态瞬间评估，以及解决自我批评的一项体验任务(使用情感聚焦疗法的两椅对话)。日常生活中的情绪由参与者定期自我报告，自尊在两椅对话中被评估了三次。两层次线性模型揭示了日常生活中的情绪变化，并在第2层次引入了会话自尊作为预测因子。治疗期间的自尊与症状水平相关。结果表明，在为期一周的评估中，主要适应不良情绪的变化是由在EMA开始时发生的会话中自尊的状态和特质成分预测的。自尊的特质成分与症状水平相关，而自尊的状态成分与症状水平无关。目前的研究强调了将研究从会话内观察情绪处理扩展到日常生活的重要性。

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引用次数: 2

The self-critical patient in clinical supervision: a qualitative study of therapists’ alliance struggles and emotional reactions in short-term psychodynamic psychotherapy for depression 临床监督中的自我批评患者:抑郁症短期心理动力治疗中治疗师联盟斗争与情绪反应的定性研究

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-03-13 DOI: 10.1080/09515070.2022.2050676

Vicky Hennissen, K. Van Nieuwenhove, R. Meganck, Dries Dulsster, Juri Krivzov, M. Desmet

ABSTRACT Self-critical perfectionism has been linked to alliance impairments due to patients’ distancing attitudes. However, systematic research on therapists’ emotional experiencing when working with self-critical patients is scarce. This qualitative study explores how therapists perceive, emotionally experience, and react to self-critical patients’ interpersonal dynamics. We studied narrative data from clinical supervisions where psychodynamic psychotherapists discussed self-critical patients (N = 7) within the context of an RCT on Major Depressive Disorder. Consensual Qualitative Research was applied to identify recurrent patterns in the data. As a global impediment to treatment, therapists observed a pattern of non-engagement. Patients’ superficial and avoidant way of communicating, hostility or aggressiveness in the alliance, and low or inaccurate treatment expectations emerged as main obstacles to the therapeutic process, evoking negative affect in therapists. More vulnerable aspects of the patient and case formulation emerged as having a mitigating effect on unfavorable therapist reactions. Our findings confirm longstanding clinical and theoretical accounts associating therapeutic work with self-critical patients with negative affect in therapists. Our study suggests that negative responses may be enacted in therapy which can reinforce poor alliance. We discuss the role of supervision in helping therapists to become aware of and manage negative responses, engage in case conceptualization, and advance clinical work.

由于患者的疏远态度，自我批评的完美主义与联盟损伤有关。然而，关于治疗师在治疗自我批评患者时的情绪体验的系统研究很少。本定性研究探讨了治疗师如何感知、情感体验和应对自我批评患者的人际关系动态。我们研究了来自临床监督的叙述性数据，在一项关于重度抑郁症的随机对照试验中，精神动力心理治疗师讨论了自我批评患者(N = 7)。采用共识定性研究来确定数据中的重复模式。作为一种全球性的治疗障碍，治疗师观察到一种不参与的模式。患者肤浅和回避的沟通方式，联盟中的敌意或攻击性，低或不准确的治疗期望成为治疗过程的主要障碍，引起治疗师的负面影响。更脆弱的方面的病人和病例配方出现了缓解不利的治疗师的反应。我们的研究结果证实了长期存在的临床和理论研究，这些研究将治疗工作与治疗师中具有负面影响的自我批评患者联系起来。我们的研究表明，消极反应可能会在治疗中产生，从而加强不良的联盟。我们讨论了监督在帮助治疗师意识到和管理负面反应、参与案例概念化和推进临床工作中的作用。

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引用次数: 1

Facilitative interpersonal relationship training enhances novices’ therapeutic skills 促进人际关系培训可提高新手的治疗技能

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-03-13 DOI: 10.1080/09515070.2022.2049703

M. Perlman, T. Anderson, J. Finkelstein, Victoria K Foley, Scott Mimnaugh, Caroline V Gooch, Kevin C David, Shelby J. Martin, J. Safran

ABSTRACT Relatively little research focuses on the impact of therapeutic, relational skills training for untrained helpers. The current study is a randomized control trial, which tested a novel, research-informed training protocol that integrated elements of alliance-focused training (AFT) and facilitative interpersonal skills (FIS) in a sample of college undergraduates interested in social helping careers. The AFT/FIS training was compared to a time-matched video demonstration of cognitive therapy (CT video). All participants were assessed on their Facilitative Interpersonal Skills (FIS) and emotional reactions to FIS stimuli pre- and post-training. After controlling for baseline effects, participants in the AFT/FIS training saw a significant increase in post-training FIS, especially in the areas of empathy, alliance bond capacity, and alliance rupture repair responsiveness. AFT/FIS participants also saw increases in positive and affiliative emotional reactions to FIS clips compared to participants in the CT video training. Implications for future empirical investigations and training initiatives are discussed.

相对而言，很少有研究关注治疗性、关系技能培训对未受过训练的帮助者的影响。本研究是一项随机对照试验，在对社会帮助职业感兴趣的大学本科生样本中，测试了一种新颖的、有研究依据的培训方案，该方案将联盟重点培训(AFT)和促进性人际交往技能(FIS)的要素结合起来。将AFT/FIS训练与时间匹配的认知治疗视频演示(CT视频)进行比较。在训练前和训练后，对所有参与者的促进性人际交往能力(FIS)和对FIS刺激的情绪反应进行评估。在控制基线效应后，AFT/FIS训练的参与者在训练后的FIS显著增加，特别是在共情、联盟纽带能力和联盟破裂修复反应方面。与CT视频训练的参与者相比，AFT/FIS参与者对FIS片段的积极和附属情绪反应也有所增加。讨论了对未来实证调查和培训倡议的影响。

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引用次数: 4

Failure in psychotherapy: a qualitative comparative study from the perspective of patients diagnosed with depression 心理治疗失败:抑郁症患者视角的定性比较研究

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-03-08 DOI: 10.1080/09515070.2022.2047614

Nicolás Suárez-Delucchi, Alex Keith-Paz, Mahaira Reinel, Sofía Fernandez, Mariane Krause

ABSTRACT This qualitative study’s objective was to understand how failure in psychotherapy develops from depressed patients’ perspective. Forty-seven patients were interviewed after brief psychotherapy. Data analysis was conducted according to Grounded Theory. Patients evaluated their own psychotherapies’ outcome according to their subjective criteria. Then, negative, positive and mixed-results evaluations were compared in the main categories. Results showed that patients reporting negative evaluations considered null or adverse outcomes as failure. Distrust in their psychotherapists (both as persons and professionals) developed in early stages of the process and was apparently hard to revert. This early onset of distrust led patients to a lack of collaboration and an unreceptive attitude. They perceived their psychotherapist as not understanding, distant, and uninterested, losing focus on relevant problems and not providing new information. The relationship was experienced as uncomfortable and distant, and sometimes became harmful. Therefore, distrust led patients to regard their psychotherapies as an unhelpful experience, in contrast to what occurred in patients with positive or mixed results evaluations. Conclusions contribute to a clarification of how patients conceptualize failure and suggest reevaluating the relevance of their perspective, which seems not to be fully reflected in current outcome measures. Clinicians should consider building trust as a baseline and encourage patients to disclose even the earliest negative feelings about treatment and psychotherapist

本定性研究的目的是从抑郁症患者的角度了解心理治疗失败是如何发展的。47名患者在接受简短的心理治疗后接受了采访。根据扎根理论进行数据分析。患者根据自己的主观标准评估自己的心理治疗效果。然后，在主要类别中比较消极、积极和混合结果评价。结果显示，报告阴性评价的患者认为无效或不良结果为失败。在治疗的早期阶段，他们对心理治疗师(无论是个人还是专业人士)产生了不信任，显然很难恢复。这种早期的不信任导致患者缺乏合作和不接受的态度。他们认为他们的心理治疗师不理解、疏远、不感兴趣，失去了对相关问题的关注，也没有提供新的信息。这种关系让人感到不舒服和疏远，有时甚至变得有害。因此，不信任导致患者将他们的心理治疗视为一种无益的经历，而与此形成对比的是，结果评估为积极或好坏参半的患者的情况。结论有助于澄清患者如何概念化失败，并建议重新评估他们观点的相关性，这似乎没有完全反映在当前的结果测量中。临床医生应该考虑建立信任作为基线，并鼓励患者披露甚至最早对治疗和心理治疗师的负面感受

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引用次数: 1

Social perception of sexual harassment in informal relations. 非正式关系中性骚扰的社会认知

IF 1 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-02-25 eCollection Date: 2022-01-01 DOI: 10.5114/cipp.2021.110026

Dariusz Drążkowski, Monika Ganclerz

Background: Perception of sexual harassment in informal relations is a largely uninvestigated topic. This study aimed to bridge this gap by examining the effect of the type of relationship between the perpetrator and the victim on the perception of harassment. Furthermore, we considered potential factors moderating the tested relationships: acceptance of gender stereotypes and sex.

Participants and procedure: In total, 369 participants were assigned to one of three conditions including a female victim and a male perpetrator who was either her neighbor, coworker, or supervisor.

Results: The participants assessed the harasser to be responsible. The supervisor's behavior was considered more punishable than that of the colleague or neighbor. The male participants reported that the perpetrator was less deserving of punishment than female participants.

Conclusions: The findings suggest that social norms regarding sexual harassment in formal and informal relationships are similar, excluding harassment by supervisors, which was rated as most punishable.

背景:对非正式关系中性骚扰的感知是一个很大程度上未被调查的话题。这项研究旨在通过研究加害者和受害者之间的关系类型对骚扰感知的影响来弥合这一差距。此外，我们考虑了调节测试关系的潜在因素:接受性别刻板印象和性别。参与者和程序:总共有369名参与者被分配到三种情况中的一种，包括一名女性受害者和一名男性犯罪者，后者要么是她的邻居，同事，要么是主管。结果:参与者评估骚扰者的责任。主管的行为被认为比同事或邻居的行为更应该受到惩罚。男性参与者报告说，犯罪者比女性参与者更不应该受到惩罚。结论:研究结果表明，正式和非正式关系中性骚扰的社会规范是相似的，但不包括主管的骚扰，后者被认为是最应受到惩罚的。

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引用次数: 1

Therapeutic activities after assimilation setbacks in the case of Alicia 艾丽西亚同化障碍后的治疗活动

IF 3 Q3 PSYCHOLOGY, APPLIED

Counselling Psychology Quarterly

Pub Date : 2022-01-11 DOI: 10.1080/09515070.2021.2023467

Isabel Caro Gabalda, W. Stiles

ABSTRACT This case study addressed what therapists do after assimilation setbacks. Previous research has shown that most setbacks reflect the client switching between strands of the problem and that most setbacks can be classified as balance strategy setbacks (BS) or setbacks due to the therapist exceeding the client’s zone of proximal development (TZPD). Alicia was a 26-year-old woman diagnosed as depressed and treated with a directive kind of therapy for 26 sessions. Sessions were transcribed and rated with the Assimilation of Problematic Experiences Scale (APES). Almost all setbacks could be classified as BS or TZPD. The therapist's succeeding interventions were coded with the List of Therapist’s Activities after a Setback and qualitatively described and summarized. Alicia showed improvement on the outcome measures, and the APES. Therapist activities following setbacks showed that exploratory activities and supportive and clarifying intentions seemed relatively more common after BS setbacks, whereas directive activities and intentions were relatively more common after TZPD setbacks. Results tended to support the conceptualization of setbacks as a switch of strands and suggested elaborations. In this directive therapy, the therapist tended to pursue the intended line of work after setbacks, using systematically different activities depending on which type of setback occurred.

本案例研究探讨了同化挫折后治疗师的做法。先前的研究表明，大多数挫折反映了来访者在问题的不同方面之间的切换，大多数挫折可以归类为平衡策略挫折(BS)或治疗师超出来访者的近端发展区(TZPD)而导致的挫折。Alicia是一名26岁的女性，她被诊断为抑郁症，接受了26次指导性治疗。记录会话并使用问题经验同化量表(APES)进行评分。几乎所有的挫折都可以归类为BS或TZPD。治疗师的后续干预是用挫折后治疗师的活动清单编码的，并定性地描述和总结。艾丽西亚在结果测量上有所改善，而在类人猿方面也有所改善。挫折后的治疗师活动表明，在BS挫折后，探索性活动、支持性和澄清性意图似乎相对更常见，而在TZPD挫折后，指导性活动和意图相对更常见。结果倾向于支持将挫折概念化为股的转换和建议的详细说明。在这种指导性治疗中，治疗师倾向于在挫折后从事预期的工作，根据发生的挫折类型系统地使用不同的活动。

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引用次数: 1