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Psychotherapy

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O F F I C I A L P U B L I C AT I O N O F D I V I S I O N 2 9 O F T H E
A M E R I C A N P S Y C H O L O G I C A L A S S O C I AT I O N

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www.divisionofpsychotherapy.org

In This Issue

A Q-sort Model for the Empirical

E
Investigation of Psychotherapy Integration

Discourse and Healing

T
The Fundamental Nature of the
Political Process

I
Student Paper Award:
The Relationship Between Patients’
Representations of Therapists and Parents

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Division 29 2007 APA Conference
Program
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2007 VOLUME 42 NO. 3

 Division of Psychotherapy 䡲 2007 Governance Structure
President
Jean Carter, Ph.D
5225 Wisconsin Ave., N.W. #513
Washington DC 20015
Ofc: 202–244-3505
E-Mail: jcarterphd@aol.com
President-elect
Jeffrey Barnett, Psy.D.
747 Buckeye Ct.
Millersville, MD 21108
E-Mail: drjbarnett1@comcast.net
Secretary
Armand Cerbone, Ph.D., 2006-2008
3625 North Paulina
Chicago IL 60613
Ofc: 773-755-0833 Fax: 773-755-0834
E-Mail: arcerbone@aol.com
Treasurer
Steve Sobelman, Ph.D., 2007-2009
Department of Psychology
Loyola College in Maryland
Baltimore, MD 21210
Ofc: 410-617-2461
E-Mail: sobelman@loyola.edu
Past President
Abraham W. Wolf, Ph.D.
MetroHealth Medical Center
2500 Metro Health Drive
Cleveland, OH 44109-1998
Ofc: 216-778-4637 Fax: 216-778-8412
E-Mail: axw7@cwru.edu
COMMITTEES AND TASK FORCES
COMMITTEES
Fellows
Vacant
Membership
Chair: Annie Judge, Ph.D.
2440 M St., NW, Suite 411
Washington, DC 20037
Ofc: 202-905-7721
E-Mail: Anniejudge@aol.com
Student Development Chair
Michael Garfinkle, 2007
Derner Institute for Advanced
Psychological Studies
Adelphi University
1 South Avenue
Garden City, NY 11530
Nominations and Elections
Chair: Jeffrey Barnett, Psy.D,
Professional Awards
Chair: Abe Wolf, Ph.D.
ELECTED BOARD MEMBERS
Board of Directors Members-at-Large
J. G. Benedict, Ph.D., 2006-2008
6444 East Hampden Ave., Ste D
Denver, CO 80401
Ofc: 303-753-9258,or 303-526-1101
Fax: 753-6498
E-Mail: JGBENEDICT@aol.com
James Bray, Ph.D., 2005-2007
Dept of Family & Community Med
Baylor College of Med
3701 Kirby Dr, 6th Fl
Houston , TX 77098
Ofc: 713-798-7751 Fax: 713-798-7789
E-Mail: jbray@bcm.tmc.edu
Irene Deitch, Ph.D., 2006-2008
Ocean View-14B
31 Hylan Blvd
Staten Island, NY 10305-2079
Ofc: 718-273-1441
E-Mail: ProfID@AOL.COM
Jennifer Kelly, Ph.D., 2007-2009
Atlanta Center for Behavioral Medicine
3280 Howell Mill Rd. #100
Atlanta, GA 30327
Ofc: 404-351-6789
E-Mail: jfkphd@aol.com
Finance
Chair: Bonnie Markham, Ph.D., Psy.D.
52 Pearl Street
Metuchen NJ 08840
Ofc: 732-494-5471
Fax 206-338-6212
E-Mail:
drbonniemarkham@hotmail.com
Education & Training
Chair: Jean M. Birbilis, Ph.D., L.P.
University of St. Thomas
1000 LaSalle Ave., TMH 455E
Minneapolis, Minnesota 55403
Ofc: 651-962-4654
E-Mail: jmbirbilis@stthomas.edu
Continuing Education
Michael J. Constantino, Ph.D.
Department of Psychology
612 Tobin Hall - 135 Hicks Way
University of Massachusetts
Amherst, MA 01003-9271
Ofc: 413-545-1388
Fax: 413-545-0996
Diversity
Chair: Jennifer F. Kelly, Ph.D.
Michael Murphy, Ph.D., 2007-2009
Professor and Director of Clinical
Training
Department of Psychology
Indiana State University
Terre Haute, IN 47809
Ofc: : 812-237-2465 Fax: 812-237-4378
E-Mail:
mmurphy4@isugw.indstate.edu.
Libby Nutt Williams, Ph.D., 2005-2007
Chair, Dept of Psychology
St. Mary’s College of Maryland
18952 E. Fisher Rd.
St. Mary’s City, MD 20686
Ofc: 240- 895-4467 Fax: 240-895-4436
E-Mail: enwilliams@smcm.edu
APA Council Representatives
Norine G. Johnson, Ph.D., 2005-2007
13 Ashfield St.,
Roslindale, MA 02131
Ofc: 617-471-2268 Fax: 617-325-0225
E-Mail: NorineJ@aol.com
John C. Norcross, Ph.D., 2005-2007
Department of Psychology
University of Scranton
Scranton, PA 18510-4596
Ofc: 570-941-7638 Fax: 570-941-7899
E-Mail: norcross@uofs.edu
Program
Chair: Jeffrey J. Magnavita, Ph.D.
Glastonbury Psychological
Associates PC
300 Hebron Ave., Ste. 215
Glastonbury , CT 06033
Ofc: 860-659-1202
Fax: 860-657-1535
E-Mail: magnapsych@aol.com
Psychotherapy Research
Chair: William B. Stiles, Ph.D.
Department of Psychology
Miami University
Oxford, OH 45056
Voice: 513-529-2405
Fax: 513-529-2420
Email: stileswb@muohio.edu

PSYCHOTHERAPY BULLETIN
Published by the
DIVISION OF
PSYCHOTHERAPY
American Psychological Association
6557 E. Riverdale
Mesa, AZ 85215
602-363-9211
e-mail: assnmgmt1@cox.net
EDITOR
Craig N. Shealy, Ph.D.
ASSOCIATE EDITOR
Harriet C. Cobb, Ed.D.
CONTRIBUTING EDITORS
Washington Scene
Patrick DeLeon, Ph.D.
Practitioner Report
Ronald F. Levant, Ed.D.
Education and Training
Jean M. Birbilis, Ph.D.
Psychotherapy Research
William Stiles, Ph.D.
Perspectives on
Psychotherapy Integration
George Stricker, Ph.D.
Student Features
Michael Garfinkle, M.A.
STAFF
Central Office Administrator
Tracey Martin
Website
www.divisionofpsychotherapy.org
PSYCHOTHERAPY BULLETIN
Official Publication of Division 29 of the
American Psychological Association
2007 Volume 42, Number 2
CONTENTS
President’s Column ................................................2
Perspectives on Psychotherapy Integration ........4
A Q-sort Model for the Empirical Investigation
of Psychotherapy Integration
Interview with Dr. Leon VandeCreek ......................12
Student Feature ......................................................15
Psychotherapists as Witnesses
Psychotherapy Research ......................................17
Discourse and Healing
Washington Scene ..................................................21
The Fundamental Nature of the
Political Process
Division 29 2007 APA Conference Program ......23
Student Award Paper ............................................32
The Relationship Between Patients’
Representations of Therapists and Parents
Membership Application......................................47
N O F P S Y C H O THE
O
RA P Y
D I V I SI
29
ASSN.
AMER I
C
A
N PSYCHOLOGI C
AL
PRESIDENT’S COLUMN
Opportunities Galore!
As I write this column,
the year is half over.
We have many things
that are well begun,
and those good begin-
nings create even
more opportunities, as
well as reflecting the
good work that has
happened so far.
Congratulations to our newly
elected officers
We extend a warm welcome to president-
elect designate Nadine Kaslow and
Members at Large Norman Abeles and
Michael Constantino (Early Career
Psychologist position). Congratulations!
Reorganization and Bylaws Revision
You, the members, have recently approved
a revision of our Bylaws that result in a reor-
ganization of our Board of Directors. The
goal is to provide greater opportunity on
the Board, to increase the effectiveness of
our initiatives vis-à-vis the APA, and to
enhance our ability to attend to the needs of
our members. With the Bylaws revision, we
have increased the number of members-at-
large to 8 and transformed them into
Domain Representatives. The Domain
Representatives will work collaboratively
with committee chairs as they share respon-
sibility for our Division’s areas of interest
and expertise. The Domains are as follows:
Science and Scholarship
Education and Training
Psychotherapy Practice
Public Interest
Early Career Psychologists
Membership
Two Seats for Diversity
And we will continue to have the chair of
our Student Development Committee with
2
Jean Carter, Ph.D.
a voting seat on the Board.
By the time of convention we will have
the current members at large moved into
the Domain Representative positions and
be ready to roll at the September Board
meeting!
Convention Fun!
We have an exciting convention program,
thanks to Jeffrey Magnavita, our VERY hard
working Program Chair. See the special
insert to find your favorite programs! I want
to highlight a few special programs. This
year we will present our awards and recog-
nize our hard working volunteers at a spe-
cial event that will come right before our
social hour. Please plan to attend them both!
Conversation Hour (N): Awards and
Recognition
8/17 Fri: 5:00 PM – 5:50 PM
San Francisco Marriott Hotel
Golden Gate Salons B1 and B2
Social Hour
8/17 Fri: 6:00 PM – 6:50 PM
San Francisco Marriott Hotel
Golden Gate Salons B1 and B2
Board member Libby Nutt Williams, ably
assisted by Membership Chair Annie Judge
and Student Development Committee
member Erin Howard, has developed a
special event for our Students and Early
Career Psychologists. Leaders in our field
will host lunch tables for informal discus-
sion. Watch for the door prize drawing!
Lunch with the Masters: Luncheon for
Graduate Students and Early Career
8/18 Sat: 12:00 PM – 1:50 PM
San Francisco Marriott Hotel
Nob Hill Rooms A and B
continued on page 3
Looking Ahead
As we move toward the fall, the Board will
continue the transition to Domain
Representatives. Incoming Program Chair
Nancy Murdock will continue to develop
plans that are already underway for the
2008 Convention. President-elect Jeff
Barnett will complete plans for the special,
exciting MidWinter Meeting and CE
Program to be held in St Petersburg
Beach, Florida, January 12, 2008, with a
day long CE offering from our own Don
Meichenbaum—put it on your calendar
today!

Find Division 29 on the Internet. Visit our site at

www.divisionofpsychotherapy.org

3
PERSPECTIVES ON PSYCHOTHERAPY INTEGRATION
A Q-sort Model for the Empirical Investigation of
Psychotherapy Integration
Deborah A. Gillman and Paul L. Wachtel
City College and the Graduate Center, City University of New York
One obstacle to the pursuit of integration
in the field of psychotherapy is the preva-
lence—in teaching, research, and theoreti-
cal discussions—of depictions of the field
that privilege certain labels which refer
more to political divisions within our disci-
pline than they do to fundamental concep-
tual differences. Theoretical allegiances,
whether in the self-identifications of thera-
pists or in research that compares one
approach to another, tend to be depicted in
terms such as psychoanalytic, cognitive-
behavioral, experiential, systemic, and so
forth. These accounts implicitly assume
that these labels each point to a unified and
internally coherent set of axioms and con-
ceptual and therapeutic tools, when in fact
they represent a melange of many ele-
ments, packaged together less by virtue of
logic and coherence than by allegiance to
one of the professional groupings that vie
for influence (and economic advantage) or
by identification with certain elements of
the package that lead therapists to say or
think, “I am A; I am not B.”
The identifications can also frequently be
traced to what labels were highly valued in
the particular place where one went to
graduate school or to the consequences of
assortative socialization and social net-
works. On a small scale, one of us was part
of an institute that split at one point along
“theoretical” lines, but where perhaps the
best predictor of who would choose to be
associated with which theoretical grouping
was who played tennis with whom. Of
course, one might account for these tennis-
partner preferences on the basis of already-
held theoretical assonances. We are sug-
gesting, especially based on the evidence
4
presented below, that this is too simple and
linear an explanation, and that the very
perception of holding the “same” theoreti-
cal view as another reflects a more complex
process in which certain similarities are
foregrounded and other, perhaps equally
weighty, differences are dissolved in the
application of one of the politicized labels
to any particular individual therapist’s
point of view.
Therapists who identify with a particular
orientation are unlikely to in fact identify
with every single feature of that approach,
or even every single important feature.
Rather, what usually occurs, whether
acknowledged or not, is that each therapist
chooses the best crude approximation to
his or her views from among the most
prominent labels available in the profes-
sional community. Actual differences and
similarities among therapists do not neces-
sarily conform very closely to the current
labels that have come to stand for those
similarities and differences. The promi-
nence of those labels, however, makes it
difficult to disentangle perceptually the
threads of similarity and difference, and
hence other configurations and bound-
aries, other ways of representing thera-
pists’ similarities and differences go large-
ly unrecognized. This is especially the case
today, when powerful economic interests
have shaped the very nature of therapy
outcome research, leading to funding
being directed to certain forms of “horse
race” studies between horses whose “own-
ers” are usually the standard labels in the
field (cf. Arkowitz, in press; Goldfried &
Wolfe, 1998; Wachtel, 2006).
continued on page 5
We wish to describe here a study, originally
undertaken with beginning therapists who
identify themselves as psychodynamically
oriented, that we believe has larger signifi-
cance as a methodological template for
studying the entire spectrum of therapeutic
approaches and for seeing afresh the con-
vergences and divergences that actually
exist in the field of psychotherapy. The
methodology employed in this study, cen-
tering on the use of Q-sorts and follow-up
interviews, can, with appropriate modifica-
tions in the content of the Q-sort cards, read-
ily be applied to the views of therapists of
all persuasions. Importantly, the methodol-
ogy described here approaches the mapping
of the field of psychotherapy in a much
more empirical manner that is represented
by the use of such standard labels as psy-
choanalytic, cognitive-behavioral, experien-
tial, systemic, or (to move to the realm that
was the particular focus of the study to be
described next) classical or relational.
Similarities and Differences among
Psychodynamic Therapists: An Empirical
Study
Just as in the larger realm of psychothera-
py, highly politicized labels figure promi-
nently within the sub-realm of psychody-
namic therapy. In the world of psycho-
analysis and psychodynamic therapy, the
two most prominent labels today are “rela-
tional” and “classical” (the latter some-
times designated by other labels such as
contemporary Freudian or structural, but
referring to the same tradition and large
configuration as ideas as the label classical
refers to). In the world of psychoanalytic
discourse, the assumed antinomy between
these two broad schools figures prominent-
ly, and many psychoanalytic and psycho-
dynamic therapists see the psychoanalytic
world very largely in terms of two broad
competing forces. Debates between propo-
nents of these two competing positions have
at times been quite heated (e.g., Bachant,
Lynch, & Richards, 1995; Benjamin, 1995;
Christiansen, 1995; Gill, 1995 Marshall,
1995; Mitchell, 1995); analysts are familiar
with the term “the narcissism of small dif-
ferences.” In contrast, the study described
below illustrates how what look like
opposing schools are actually an amalgam
of ideas and preferences that therapists
employ in their own particular fashion,
picking and choosing specific features
from different approaches rather than
dividing along “official” orientation lines.
After presenting the findings and their
implications for understanding competing
schools within psychoanalysis, we will dis-
cuss how such a conceptualization and
research methodology might be extended
to the larger realms of psychotherapy and
psychotherapy integration.
The study aimed to investigate whether
beginning psychodynamic therapists in fact
can be categorized in their views according
to the classical-relational dichotomy or
whether a more complex configuration is
necessary to capture the structure of their
similarities and differences. The methodolo-
gy consisted of a Q-sort and qualitative
interview administered to thirty doctoral
students in clinical psychology. The Q-sort
offered a particularly appropriate means of
investigating this question because it yield-
ed, for each subject, a personalized profile
of his or her beliefs regarding the subject
domain. Rather than globally endorsing
an entire “orientation,” subjects were asked
to rank the importance and relevance to
them of specific Q-sort statements that
reflect aspects of psychodynamic psy-
chotherapy practice.
A key feature of Q-methodological
research is that it permits a form of factor
analytic procedure that, in contrast with
standard factor analysis, yields findings
that reflect groupings of subjects rather
than test items. Not all studies using Q-
sorts employ this method of analysis. For a
discussion of Q-methodology and the
options for data analysis, see Gillman, 2006,
as well as Kitzinger, 1999, and McKeown &
Thomas, 1988. For examples of other studies
continued on page 6
5
using the methodology employed here,
see Stainton Rogers & Kitzinger, 1995,
and Snelling, 1999.
The final factors of such analyses reflect
clusters of like-minded people based upon
how they complete the Q-sort. This
methodology is particularly well suited to
the question of whether psychodynamic
therapists group themselves into just two
groups (classical and relational) or
whether other configurations better cap-
ture the variations among therapists in
their views about the work. Importantly,
this methodology has the potential to dis-
cern and discover groupings that are not
defined a priori by the researcher
(Kitzinger, 1999). Participants are not
required to identify with a particular pre-
existing viewpoint; instead, it is they who
determine the range and configuration of
views that exists among them.
Q-methodology was also deemed particu-
larly well suited for this exploration of new
clinicians’ views since beginners are often
not well informed about the labels for dif-
ferent paradigms or theories. It is thus dif-
ficult for them to accurately and validly
identify themselves as belonging to a par-
ticular pre-designated orientation, but they
are capable of conveying their orientation
empirically through their ratings of the
various specific Q-sort items. The Q-sort
thus enabled trainees to indicate their
implicit identification with either para-
digm—or with some other organizing con-
figuration—by stating their relative agree-
ment or disagreement not with an orienta-
tion as a whole, but with very specific
ideas or practices. Whether these choices
cohered into “relational” and “classical”
configurations or took on some other con-
figuration altogether could be approached
as an empirical question.
The Q-sort consisted of 54 original state-
ments deriving from a sampling of the
entire literature of psychodynamic therapy
(for a more detailed account of the way in
6
which the items were developed and mod-
ified, as well as of the rest of the methodol-
ogy, see Gillman, 2006). The Q-sort state-
ments were reviewed by a panel of senior
clinicians who were strongly identified
with either the classical or relational tradi-
tion in order to ensure the content validity
of the items. This review process generated
item ratings that categorized items as
clearly reflecting a relational perspective (8
out of 54 or 15%); as clearly reflecting a
classical analytic perspective (14 out of 54
or 26%); as “bridging” the two orientations
rather than being particularly identifiable
as belonging to one or the other (23 out of
54 or 43%); and as reflecting a lack of con-
sensus, with some (of each orientation)
viewing the item as more relational and
some as more classical (9 out of 54 or 17%).
An example of a Q-sort item judged by the
experts to represent a “relational”
approach to theory or clinical practice was,
Therapist self-disclosure is
an inevitable part of the
process. The question is not
whether to disclose, but how
and when to do so.
A representative item judged as clearly
representing a “classical” view was,
Therapeutic progress is most
enhanced by the resolution of
the patient’s difficulties as
much as possible via inter-
pretations rather than
through support, advice, or
other kinds of interventions.
Among the items for which the experts
were split as to whether it belonged to the
classical or relational perspective was,
The therapist is involved in
the construction, not merely
the discovery, of the patient’s
psychic reality.
And a representative “bridging” item, for
which the experts tended to assign a rating
continued on page 7
midway between classical and relational
rather than as characteristic of either, was,
The dynamics of transference
and countertransference are
critical in any treatment, but
it is important not to focus on
them too exclusively. Atten-
tion to the real transactions
that constitute the therapeutic
alliance is also important.
The full list of Q-sort items and their desig-
nation as classical, relational, split consen-
sus, or bridging, can be found in Gillman
(2006).
The Factor Analysis
Analysis of the 30 Q-sort distributions
across the 54 items yielded six factors and
(given the bi-polar nature of one factor)
seven groupings of trainees whose views
were elaborated through interviews. A brief
characterization of the essential common
features for each of the seven groupings is
as follows: (1) those whose highest priority
was their commitment to an egalitarian, col-
laborative approach to treatment, (n =13);
(2) those who considered their approach to
be eclectic and who valued most highly flex-
ibility in practice and orientation (n = 4); (3)
those most influenced by object relations
theory, who emphasized their patients’ and
their own intrapsychic processes (n = 2); (4)
those who were grouped for their preoccu-
pation with the issue of therapist disclosure
(n = 4); (5) those whose endorsements very
closely approximated a classically-oriented
approach, primarily in terms of how they
construe the participation of the therapist in
the treatment dyad (n = 2); (6) those most
clearly allied with a relational approach,
whose identification was expressed by their
prioritizing the importance of therapist sub-
jectivity (n = 2); and (7) a final mixed group
of trainees whose commonality is difficult
to categorize (n = 3). (See Gillman, 2006 for
more details.)
Relevance for Psychotherapy Integration
Research
In practice, many clinicians utilize tech-
niques associated with different “official”
approaches. Within the psychoanalytic
domain, clinicians of all levels of experi-
ence often identify with some elements of
relational or classical models but not others
(Frank, 1999). While some psychodynamic
clinicians come to identify as purely rela-
tional or classical, others, in practice,
choose to emphasize or prioritize only cer-
tain features associated with a given
model. In the present study, the results of
the Q-sort analysis implicitly challenged
the relational vs. classical polarity that is so
broadly assumed by contemporary psy-
chodynamic thinkers. Far from aligning
themselves with one of two dichotomized
orientations, the therapists in this study
implicitly grouped themselves into a much
more variegated set of commonalities and
differences based on their actual views
about theory and practice. A minority of
participants primarily prioritized state-
ments that were anchored specifically in
relational or classical approaches, but the
large majority did not. Their Q-sorts
proved to be largely ‘orientation-blind’ as
they ranked the items according to implic-
it schemes that had little to do with the
statements’ classification by the experts as
“relational” or “classical.” What emerged,
essentially, was a trend among beginning
clinicians to sort through a range of views
that they had been exposed to through
their training and develop their own prac-
tice orientation.
The potential for this methodology to be of
use in studying therapists’ views across the
full therapeutic spectrum (and across a
considerably greater range of experience
than represented in the specific focus of the
study discussed here) should be apparent.
Inclusion of Q-sort statements that derive
from a range of therapeutic approaches (that
is, items not restricted, as in the present
study, to variations within the psychody-
namic—or any other—orientation) would
offer an opportunity to examine the larger
integrative themes that characterize thera-
continued on page 8
7
pists’ actual views and practices and to see
how these views and practices do or do not
fit within the boundaries of the present
“standard labels” in our field (e.g., psycho-
dynamic, cognitive-behavioral, family sys-
tems, experiential). We suspect that even
the participants in this study, who were
specifically chosen for their identification
with the broad area of psychodynamic
therapy, would, if presented with a variety
of “officially” non-psychodynamic items as
part of a larger and more comprehensive
Q-sort, turn out to prioritize at least some
of the non-psychodynamic items over
some others that are more conventionally
psychodynamic. This might especially be
the case if care was taken (as it was in the
present study) to present items in a way
that did not explicitly label them as belong-
ing to one orientation or another and that
attempted to present the items in plain
English rather than in the jargon of one ori-
entation or another.
The therapists who were the subjects of
this study demonstrated that one can iden-
tify with aspects of a particular orientation
but not necessarily identify with that orien-
tation label. Therapists representing Factor
1, for example, identified with many rela-
tionally-oriented ideas, but not with the
label “relational.” In interviews, they stat-
ed that a relational approach was “too
intense, too confrontational” or that “it can
get overused.” It may be anticipated (but of
course needs to be investigated) that in
similar fashion there will be some subjects
in a more broadly pitched study who
endorse certain important features of cog-
nitive-behavioral, experiential, or family
therapy, but who are uncomfortable identi-
fying with the particular labels.
“Bridging” Ideas and the Trend toward
Integration
The most highly endorsed Q-sort state-
ments in this study were those that
bridged the classical-relational divide.
Among this sample of trainees, many
of whom proved to be disaffected from
traditional psychoanalytic models
8
yet not entirely enamored of newer
ones, these “bridging” or consensual
items carried the day. Twenty-four per-
cent of the study participants, for
example, (those loading on Factor I)
particularly prioritized the importance
of the “working alliance,” the “real
relationship,” and the “humanness” of
the therapist (cf. Norcross, 2002). At
the same time, although this was the
largest grouping in the study, many
participants did not prioritize these
items. Thus, what we found was not
simply an endorsement of motherhood
and apple pie, but a rather specific
prime concern that characterized only
a subset of the study sample. Recall
here that the nature of the Q-sort task
does not require participants to state
that these items are not important,
only that they are less important to
them relative to others.
It may further be noted that these Factor I
trainees, when asked subsequent to the Q-
sort to state their orientation using up to
three descriptors, did not necessarily use the
same labels, even though empirically they
loaded on the same factor. The descriptors
they used totaled nine different orientation
labels, including “interpersonal,” “relation-
al,” “eclectic,” and “integrative.” In part,
this diversity of labels, even though the par-
ticipants in this group showed a strong con-
sensus on what most mattered to them in
their practice, reflected the fact that the key
items for them were bridging items, items
that were not exclusively associated with
either the classical or relational school, but
were viewed by the experts as being equal-
ly characteristic of both.
In thinking about the importance to the
participants of ways of working or think-
ing that are common to both of the com-
peting paradigms examined in this study,
one is reminded of the importance of com-
mon factors (e.g., Frank, 1973; Goldfried,
1980) and of the relationship as a crucial
continued on page 9
therapeutic factor that in most studies done
thus far affects outcome even more than the
“approaches” or “techniques” that are the
intended target of most research in this area
(Norcross, 2002). We speculate that, in
developing a broader set of Q-sort items to
investigate (in parallel fashion to the study
described here) the ways that therapists rep-
resenting the full range of currently promi-
nent orientations actually sort themselves in
terms of their specific preferences and ways
of interacting with patients, we would find
that the “bridging” items in that context are
particularly those related to the establish-
ment of a good therapeutic alliance (which
seems to cut across approaches) and those
that contribute to the broader concept of
common factors.
The View from the Trenches
If one views the study by Gillman (2006) as
establishing a potential beachhead for the
broader exploration of commonalities and
differences among therapists of a wider
range of “official” orientations, one may
view the data from this sample of beginning
psychodynamic therapists as a foreshadow-
ing of what might be anticipated from the
latter, broader grouping. We can, of course,
offer here only a small sample of the inter-
view comments made by the therapists in
the study discussed here. What follows are
“bridging statements” in a different sense,
ideas expressed by the upcoming genera-
tion of therapists reflecting their attempts to
make sense of and utilize the range of
approaches to which they have been
exposed in the course of their training. The
names have, of course, been changed to pro-
tect the identities of the participants.
Sandor, one year out of graduate school,
describes his own approach as a mix of
drive structural, object relations, self, fami-
ly systems, and cognitive-behavioral tech-
niques. While in training, he experienced
resistance to his own attempts to integrate:
So it’s in supervision where I’ve faced a cer-
tain degree of conflict when it comes to inte-
grating models. Not so much in figuring
out how to do it in my own work, but in
working with someone who’s a little more of
a purist and doesn’t draw from so many
sources....So when I think about tension in
the field I think about the various infighting
within the department, in my program or
even within the analytic community.
Sandra, a 3rd year student is “still trying to
figure out” what orientation “makes the
most sense” to her. She speculates:
I always assume that I will be a very eclec-
tic therapist, which I think is kind of the
popular way to go now.
Margo, a 5th year student, describes her
graduate training and supervision as
“eclectic” and how this has impacted her
thinking and practice:
I don’t think anyone works clean. You
know, just one theory in mind. And I don’t
think it exists much anymore…I’m very
much into [flexibility]. Flexibility with dif-
ferent techniques, so I can get a taste out of
all of them…Hopefully I’ll be an integrat-
ed therapist one day.
Trainees also reflected upon being trained
in a culture of distrust among proponents
of different schools of thought. Lori, a 5th
year student, has felt a pull from professors
of different orientations to “pick a camp:”
I’ve asked numerous people over the years,
like what’s the difference really? And the
only consistent answer I get is politics.
Ellen, a 6th year student, has also experi-
enced the divide among orientations as
unnecessarily polarized and suspect:
The polarity in the literature is unneces-
sary. The consequence is that people think
the schools are so different. Some things
are…[But there is an] unnecessarily divi-
sive effect on the way folks talk about
things.
Now in her final year of doctoral training,
Ellen feels increasingly free of the tension
among different theoretical approaches—as
well as free from dictates of her supervisors:
I feel I have reached a point where I have
continued on page 10
9
 my own sense of what kind of therapist I
am…There is no wholesale rejection of one
school or the other. I’m picking and choos-
ing what is best from each school!
These and other comments speak to some of
the challenges faced by these psychody-
namic therapists-in-training in response to
their own integrative impulses. Strikingly,
however, they also offer a view of the field
at large as increasingly accepting—perhaps
even taking for granted the presence of—
therapists with an “integrative,” “flexible,”
or “eclectic” mindset. With this view of the
field from the perspective of its newest prac-
titioners, we feel optimistic that some of the
constraints that have arisen from “the war
between the orientations” may be diminish-
ing. We hope as well that we have shown
the potential for the application of the
methodology described here to a broader
inquiry into the thinking and practice of
clinicians from across the therapeutic spec-
trum. Empirical demonstrations of the dif-
ferences between how therapists actually
think, and how they actually are similar or
different from each other, may help further
to decrease the stereotypy of thought that
arises from excessive focus on labels that
are, in the final analysis, at least as much
political as conceptual and substantive.
References
Arkowitz, H. (in press). The therapist as
theorist. Applied and Preventive
Psychology.
Bachant, J.L., Lynch, A.A., & Richards,
A.D. (1995). Relational models in
psychoanalytic theory.Psychoanalytic
Psychology, 12, 1, 71-87.
Benjamin, J. (1995). Comment. Psycho-
analytic Psychology, 12, 4, 595-598.
Christiansen, A. (1995). Commentary:
Primitive splitting in the field of psycho-
analysis. Psychoanalytic Psychology, 12, 4,
599-602.
Frank, J. D. (1973). Persuasion and healing.
Baltimore: Johns Hopkins University
Press.
Gill, M.M. (1995). Classical and relational
10
psychoanalysis. Psychoanalytic Psychology,
12, 1, 89-107.
Gillman, D.A. (2006). An exploration of the
influence of relational and contempo-
rary Freudian paradigms on the think-
ing and practice of beginning clinicians:
A Q-methodological study. Unpublished
doctoral dissertation, City University of
New York
Frank, K.A. (1999). Psychoanalytic
participation: Action, interaction &
integration. Hillsdale, NJ: Analytic Press.
Goldfried, M. R. (1980). Toward the delin-
eation of therapeutic change principles.
American Psychologist, 35, 991-999.
Goldfried, M. R. & Wolfe, B. E. (1998).
Toward a more clinically valid approach
to therapy research. Journal of Consulting
and Clinical Psychology, 66 143-150.
Kitzinger, C. (1999). Researching subjectiv-
ity and diversity: Q methodology in
feminist psychology. Psychology of
Women Quarterly, 23, 2, 267-276.
Kitzinger, C., & Stainton Rogers, R. (1985).
A Q-methodological study of lesbian
identities. European Journal of Social
Psychology, 15, 167-187.
McKeown, B., & Thomas, D. (1988). Q
Methodology. (Series: Quantitative appli-
cations in the social sciences,
No.66). Thousand Oaks, CA: Sage
Publications, Inc.
Marshall, K. (1995). Toward constructive
dialogue: “The ploughshare of evil”
comes again–commentary on the special
section on structural and relational psy-
choanalysis. Psychoanalytic Psychology,
12, 4, 585-592.
Mitchell, S.A. (1995). Commentary on
“contemporary structural psychoanaly-
sis and relationalpsychoanalysis.”
Psychoanalytic Psychology, 12, 4, 575-582.
Norcross, J. C. (Ed.) (2002). Psychotherapy
relationships that work. New York: Oxford
University Press.
Snelling, S.J. (1999). Women’s perspectives
on Feminism: A Q-Methodological
Study Psychology of Women Quarterly, 23,
2, 247-266.
continued on page 11
Stainton Rogers, R. (1995). Q Methodology. Wachtel, P. L. (2006). Psychoanalysis, sci-
In J.A. Smith, R. Harré, & L.V. ence, and hermeneutics: The vicious cir-
Langenhove (Eds.), Rethinking methods in cles of adversarial discourse. Journal of
psychology. London: Sage. European Psychoanalysis, 22, 25-46.

SAVE THE DATE!

Enjoy the warm Florida sunshine in January and

plan to attend this outstanding workshop.

Presenter: Donald Meichenbaum, Ph.D.

Program Title: Core Tasks of Psychotherapy:

What “Expert Psychotherapists Do”

When: Saturday, January 12, 2008 from 9:00 – 4:00 (6 CEs)

Where: Tradewinds Island Resorts

St. Petersburg Beach, Florida

Look for registration information in

the next issue of the Psychotherapy
Bulletin, or, when it becomes available,
on-line at divisionofpsychotherapy.org

N O F P S Y C H O THE
O
RA P Y
D I V I SI

29
ASSN.
AMER I

C
A
N PSYCHOLOGI C
AL

11
INTERVIEW
Interview with Dr. Leon VandeCreek
Michael S. Garfinkle, MA, Adelphi University
Leon D. VandeCreek,
Ph.D. is a fellow and
former President of the
Division of Psycho-
therapy (2005-2006), a
fellow of Divisions 12,
31, and 42, and a fellow
of the American Psycho-
logical Association.
Professor and former
Dean in Wright State University’s School of
Professional Psychology, Dr. VandeCreek has
authored more than 20 books and over 150 arti-
cles and presentations on issues including
professional ethics and risk management.
Michael S. Garfinkle, MA is the Chair of
Student Development of the Division of
Psychotherapy (2006-2008) and is a Ph.D. can-
didate in clinical psychology at Adelphi
University. He is also a research fellow at the
New York Psychoanalytic Institute.
MSG: Can you tell us about the path that ini-
tially brought you to clinical psychology?
LV: As a college student in the 1960s at
Calvin College in Grand Rapids, MI, I did-
n’t really have any professional direction in
mind. I grappled with several different col-
lege majors including sociology, theology,
and eventually settled on psychology in
large part because my advisor said, “you
have to pick something.” So, I picked psy-
chology because I had taken courses in the
subject that I had enjoyed. I finished my
degree in psychology and applied for a
Masters in Clinical Psychology at Bowling
Green State University and once I got into
the clinical side of things, I really got excit-
ed in that area. I finished my Masters
degree and got a job that was half time at a
counseling center and half time teaching at
Tri-State College in Indiana. I stayed there
12
for three years and found that I really liked
teaching as much as I liked my job in the
counseling center. It was also at that time
that I co-authored my first book. I then
went back to graduate school for my Ph.D.
at the University of South Dakota in 1969
and then did an internship in 1971-1972 at
Carter Memorial Hospital in Indianapolis.
MSG: And was that your first experience work-
ing with children?
LV: It was my first major experience. It was
outpatient and inpatient with kids. One of
the interesting things is that this particular
hospital had one of the first autism
research projects, which was my first expe-
rience with major developmental disor-
ders.
MSG: Did that stay with you as an interest?
LV: Only peripherally, as I primarily work
with adults and adolescents, but still per-
form assessments with children. From the
internship in 1972, I moved to a job at the
Indiana University of Pennsylvania and
they were just developing Masters pro-
grams, including in clinical psychology.
Eventually, I became the director of the
Masters Program, and then in the 1980s
was one of the co-authors for a proposal for
a Psy.D. in Clinical Psychology and became
the director of that program. In 1994, I
moved to Wright State to become the dean
of the School of Professional Psychology.
MSG: And what attracted you to Wright
State?
LV: It was an opportunity to be involved at
an administrative level. The School of
Professional Psychology only houses the
doctoral program, so there isn’t the regular
continued on page 13
competition between undergraduates and
graduates, research and practice.
MSG: Among the expansive range of topics you
have written on, you recently published a book
with Samuel Knapp on “Practical Ethics for
Psychologists” (APA, 2006). How did you get
interested in professional ethics?
LV: I’m not sure of the origins…When I
moved for my first postdoctoral job at the
Indiana University of Pennsylvania, one of
the courses I taught was on ethics and I
think I was one of the only people in the
department at the time who wanted to
teach that course. And I’ve taught a course
on ethics every year since 1975.
MSG: And your interest in a positive approach
to practical ethics?
LV: I think the thrust of the past decade has
been to make ethics much more hands-on
and applied and less theoretical and hypo-
thetical. And over the years, I’ve been con-
sidering how to get this message across to
students and make it stick? Ethics for me,
and for students, can be hard to read about
and dull; finding ways to make ethics
appealing and interesting is important.
Also, with the development of positive
psychology, the focus has shifted from how
to avoid getting into trouble, to “how can I
be the best psychologist I can be.”
MSG: What ethical challenges do new clini-
cians face that are different from previous
generations?
LV: All of society is more focused on indi-
vidual rights and the risks that go along
with it. It has become a lot easier to sue
each other and make complaints to licen-
sure boards and there is greater awareness
out there that you can make a complaint to
a board by just writing a brief letter. What
we have is an increased public awareness
of what one’s expectations for service
should be and what to do if those expecta-
tions aren’t met. The threats are much
greater than in the 1970’s and the 1980’s
when there was minimal attention paid to
risk-management, though there was an
awareness of broad ethics. My experience
of students today is that they are fairly
alert and concerned about staying out of
trouble. The concern about teaching ethics
today is not only about teaching students
how to stay out of trouble, but rather also
teaching that ethics can help psychologists
be the best practitioners that they can be.
MSG: You have written on risk management in
working with patients with memories of abuse.
What inspired this work?
LV: That was a hot topic for awhile in the
1990s. That was an area of risk manage-
ment where health professionals, including
psychologists, didn’t pay attention to the
science, to evidence-based practice. And
the general public just caught up to pretty
lousy practice and health professionals
were sued as a result. That topic faded, and
what’s left is really good research in mem-
ory. That’s kind of characteristic of the
ethics/risk management business: that
some of these topics wax and wane, that
some of these topics come in a frenzy and
then fade, like recovered memories and sex
with patients. I think just about everyone
agrees on those topics today.
MSG: In your scholarship, you have written a
fair number of articles on issues of student
training and clinical supervision. Can you
comment on the state of student training in
clinical psychology at present?
LV: I think there has been good research
and literature on supervision in the last
decade, gearing supervision to address
where the student is in training (i.e., the
beginning phase, middle phase, etc.). A
couple of real concerns I have for psy-
chotherapy and assessment training is that
I think that we still have a lot of basic train-
ing and supervision being provided by
folks who are not masters in it. Students
still get supervision in psychotherapy from
continued on page 14
13
faculty who practice very little or who are
not observed themselves to see how good
they are. I think that the supervisors could
be credentialed as Master Psychotherapists
or Master Assessors. In Boulder Model
schools, we hope that the supervisors in
research are scholars themselves. We don’t
want faculty on dissertation committees
who don’t engage in scholarship them-
selves, so why should it be different on the
practice side?
Here’s another example. In some commu-
nities, graduates of the doctoral programs
become the supervisors of the next genera-
tion of doctoral students. Now, while there
may be good ones in the mix, we’re really
running the risk of a very inbred system
without outside critical review. Sometimes
it’s a geographical problem, but we don’t
have any external validation measures in
place for doctoral supervision in most
instances.
Ethics and positive psychology value cre-
dentialing supervisors instead of the cur-
rent practice, which goes something like:
“you’re a good supervisor unless you’ve
been sued, but short of that I’m sure you’re
fine.” No, we need to be able to have ways
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to say with confidence: that’s a really good
psychologist or a really good supervisor.
MSG: Two presidents later, how do you think
the Division of Psychotherapy is doing? Where
would you like to see the Division focus its
efforts?
LV: I made a decision after completing my
past-President year to shift out of a leader-
ship role in the division. I’d been involved
in a leadership role in the Division for
about 15 years. From my vantage point
now, the Division has very good leader-
ship. Division 29, along with other divi-
sions, suffers from declining membership,
likely because of the demographics of new
psychologists and the income of new psy-
chologists. Personally, I’d like the division
to continue working in areas of psy-
chotherapy training and research, how to
assure that good psychotherapy training is
occurring. It’s an important topic and one
that would be well served if the Division
took a leadership role.
MSG: Well, thank you for this interview.
LV: You’re welcome.
Deadlines for Submission
July 1 for Fall Issue
November 1 for Winter Issue
February 1 for Spring Issue
May 1 for Summer Issue
All APA Divisions and Subsidiaries (Task
Forces, Standing and Ad Hoc Committees,
Liaison and Representative Roles) materials
will be published at no charge as space allows.
STUDENT FEATURE
Psychotherapists as Witnesses
Erin Howard, Lehigh University
As the two-year anniversary of Hurricane
Katrina approaches, it becomes increasing-
ly relevant for psychotherapists to consider
its relevance in our work and lives. Has
Katrina, and its continuing aftermath,
affected how we think about our clients?
Has it affected how we think about psy-
chotherapy? About trauma? Has it affected
our attention to, or interest in political
issues? In issues of socioeconomic standing
and social class identity? In advocacy?
Hurricane Katrina demanded the attention
of the entire nation – even of other parts of
the world – and raised a magnifying glass
to our nation’s ability to support its mem-
bers. Lower social class individuals com-
prise not only a significant population in
Gulf Coast areas in general, but also in
those areas most devastated by the hurri-
cane (The Center for Social Inclusion,
2006). Low income individuals are also
among those most vulnerable to the psy-
chological consequences of disaster (Ahern
& Galea, 2006). Despite progress in re-
building and community repair efforts in
the Gulf Coast, studies (e.g., Centers for
Disease Control and Prevention, 2006;
Eisler, 2007) indicate that the mental health
needs of Gulf Coast survivors and resi-
dents are still great. Many psychothera-
pists have responded to this need by vol-
unteering with various crisis response
organizations to support ongoing aid
efforts, though overall, volunteer efforts
are dwindling (The Greater New Orleans
Community Data Center, 2007). The
unusually prolonged exposure to stressors
resulting from Hurricane Katrina and its
aftermath, such as property and job loss
and increased violence, suggests that sur-
vivors may continue to experience a signif-
icant need for mental health care for years
to come (APA Policy and Planning Board,
2006). Certainly, as applied psychology
training programs continue to build on
multicultural and social advocacy
emphases (e.g., Goodman et al., 2004), the
issue of adequately preparing therapists to
manage this clinical demand warrants con-
sideration.
Though nearly two years have passed, our
responses to Hurricane Katrina are also rel-
evant to our future clients and clinical
work. By profession, psychotherapists
serve most fundamentally as witnesses of
humans’ experiences. At its best, the psy-
chotherapy experience invites clients’
deepest truths, those rich in pain, sorrow,
fear, and anger. We request transparency so
that growth is possible. So that clients can
learn to experience joy, peace, and content-
edness in spite of, or perhaps because of,
their darkest moments. Our ability to rec-
ognize and understand the influence of
social class on patients’ problems and life
experiences can be critical in providing
sensitive, helpful treatment – particularly
for those patients who are socioeconomi-
cally disadvantaged or experiencing prob-
lems in which social class status plays a
significant role.
The years to come will bring continued
repair efforts to the Gulf Coast, and even-
tually, the physical destruction left in the
wake of the hurricane may no longer be
visible. People may feel, as some do cur-
rently, that it is time to move on and give
attention and resources to other issues.
How will Katrina have affected us then?
What can we do to remain affected? To
remain witnesses?
continued on page 16
15
References
Ahern, J. & Galea, S. (2006). Social context
and depression after a disaster: The role
of income inequality. Journal of
Epidemiology & Community Health, 60,
766-770.
American Psychological Association Policy
and Planning Board. (2006). APA’s
response to international and national
disasters and crises: Addressing diverse
needs: 2005 annual report of the APA
Policy and Planning Board. American
Psychologist, 61, 513-521.
Centers for Disease Control and
Prevention (2006, January). Assessment
of health-related needs after hurricanes
Katrina and Rita – Orleans and Jefferson
parishes, New Orleans area, Louisiana,
October 17-22, 2005. Morbidity and
Mortality Weekly Report, 55, 38-41.
Eisler, P. (2007, January). New Orleans feels
pain of mental health crisis: Those in
need find very few doctors or facilities.
USA Today. Retrieved on January 23,
16
2007 from http://usatoday.com/news/
nation/2007-01-15-katrina-mental-
health_x.html.
Goodman, L., Liang, B., Helms, J., Latta, R.,
Sparks, E., & Weintraub, S. (2004).
Training counseling psychologists as
social justice agents: Feminist and mul-
ticultural principles in action. The
Counseling Psychologist, 32, 793-837.
The Center for Social Inclusion. (2006,
August). The race to rebuild: The color
of opportunity and the future of New
Orleans. New York: Author. Available
from http://www .centerforsocialinclu-
sion.org/projects_katrina.html.
The Greater New Orleans Community
Data Center. (2007, March). The Katrina
Index: Tracking recovery of New
Orleans and the metro area. New
Orleans, LA: Greater New Orleans
Nonprofit Knowledge Works. Retrieved
on March 17, 2007 from
http://www.gnocdc .org/index.html.
PSYCHOTHERAPY RESEARCH
Discourse and Healing
Robert L. Russell, Ph.D., Medical College of Wisconsin
Our field has made much progress in iden-
tifying core discourse components of ther-
apy but less progress in explaining how
such components heal those suffering from
various forms of psychopathology. In this
brief paper, I describe one very prominent
component of therapeutic discourse, com-
pare it to previously identified common
factors, and offer some thoughts about
how it may function therapeutically.
Over four and half decades ago, Jerome
Frank published his groundbreaking work,
“Persuasion and Healing: A Comparative
Study of Psychotherapy” (1961). As most
students of psychotherapy know, Frank
identified four common factors appearing
in all forms of healing and therapy: the
therapeutic relationship, rationale, task,
and setting. These were said to interact and
influence patients in five ways: through
learning, hope of relief, provision of suc-
cess experiences, emotional arousal, and
alleviation of a demoralizing sense of alien-
ation. The continuing focus of theory,
research and training on these and other
common and specific factors attests to
Frank’s prescience and widespread influ-
ence (Kazdin, 2005; Kiesler, 2004).
What is seldom appreciated, however,
were Frank’s concluding views that 1.) The
state or condition common to all patients
that can be treated by therapy is demoraliza-
tion, 2.) “Insofar as psychopathological
processes are amendable to psychotherapy,
they are conceptualized as expressive disor-
ders of communication…“ and 3.) “The major
psychotherapeutic tools are communicative
symbols—that is, words.“ (p. 323). It is
sobering to remind ourselves that Frank’s
theorizing was undertaken from the point
of view of a psychopathologist as much as
from the point of view of a therapist.
Having embraced aspects of Frank’s views
in the late 1970’s, it was natural for me to
build a research program focused on thera-
peutic and narrative discourse (e.g.,
Czogalik & Russell, 1995; Russell, 1999,
2004; Russell, Bryant, & Estrada, 1995). I
situated this work within a developmental
and pragmatic language framework
(Russell, 2007). Augmenting Frank’s
insights with empirical findings obtained
through time-series based micro-analytic
and other studies of therapeutic discourse
promised to reveal clinically relevant
details. I understood that these would need
consideration from theoretical and practi-
cal perspectives. Such consideration might
then refine and deepen our understanding
of common and specific factors and other
important features of treatment. In addi-
tion, a developmental and pragmatic lan-
guage framework appeared compatible
with Frank’s views about psychopatholo-
gy, the central role of verbal processes in
treatment, and the type of findings that
emerge from linguistic, discourse, narra-
tive and time series based microanalyses of
therapy process.
Empirical findings based on time-series
based studies of therapeutic processes
were recently summarized in a meta-ana-
lytic review (Russell, Jones, & Miller, 2007).
Consideration of these studies revealed
four client and five therapist processes that
comprise the core foci around which thera-
peutic interaction is structured. The four
client foci were organized around the com-
munication of affect, the sometimes painful
therapeutic work of self-formulation and
insight seeking, relationship hopes, wor-
ries, and difficulties, and information
exchange, including communications
continued on page 18
17
about needing help. The five therapist foci
were organized around the use of specific
verbal interventions, the communication
of supportive understanding and empa-
thy, an interest in obtaining further infor-
mation, information pertaining primarily
to the parameters of the treatment, and
personal, self-disclosing information.
Based on analyses of the therapeutic inter-
action of nearly 500 clients and 100 thera-
pists, with ratings obtained on 25,000 units
of discourse on approximately 1000 vari-
ables, these nine core areas of client and
therapist discourse provide an empirically
supported, process-sensitive anatomy of
psychotherapy. In effect, these nine dis-
course foci revealed by analyses conduct-
ed at the micro-analytic level appeared to
comprise core or common factors that cut
across therapies.
The question naturally arises as to whether
these new empirical findings require mod-
ification of, or merely exemplify in empiri-
cal detail, Frank’s original common factors.
As with most complex questions, the
answer is not a simple yes or no. As an
example, I here consider one of the four
common client factors, the client’s provi-
sion of objective information, which had
also emerged in our own studies of thera-
peutic discourse.
In a time series based study of adult thera-
py (Czogalik & Russell, 1994), based on
over 350,000 ratings of client utterances,
the factor Continuing Information
Exchange accounted for the most process
variance. This factor has been prominent
across our studies, disorders, therapists,
and cultures (i.e., therapies conducted in
Germany in German versus therapies con-
ducted in the US in English). This was a
bipolar factor. The process variables with
salient positive loadings on this factor
included neutral description, informing,
continuing, present orientation, and objec-
tive events. Variables with negative load-
ings included minimal display, minimal
technical activity, back channel regulators
(e.g., hmm, ah, oh), lacking indication of
18
temporal orientation, contentless verbal-
izations, and affirming. The interactional
meaning of this factor was glossed as “I am
continuing my exchange of objective infor-
mation about the events currently happen-
ing in my life and showing you I am atten-
tively listening.” (p. 172).
The interactional meaning of this factor did
not figure centrally in Frank’s depiction of
common therapeutic factors. It is focused on
what the client is doing rather than on the
therapist. It would be easy to dismiss
Continuing Information Exchange as mere-
ly a prologue to, or a consequence of, thera-
pists’ therapeutic maneuvers. However,
from a developmental and pragmatic lan-
guage point of view, this dismissal would be
unfortunate. Information exchange may be
as important as the more glamorous techni-
cal interventions by the therapist (e.g., inter-
pretation, reflection, confrontation). I sug-
gest that the alternation between speaking
and listening roles in discourse creates a
pattern of perspective-taking out of which
emerges the basic building blocks of the self
and the interpersonal world. The alterna-
tion provides grounds for the possibility of
linguistic communication per se. This may
be why the socializing agents of society seek
its achievement in children with an intensi-
ty afforded few other functions. How else
can one explain the countless hours spent
by caregivers with their infants, playing
seemingly meaningless games structured in
a turn-taking or alternating pattern? Out of
the alternation of speaking and listening, a
space is created in and through which a self-
in-relation is born.
I suggest that the alternating roles
captured by Continuing Information
Exchange enable the client to re-create this
basic perspectival space for the (re)discov-
ery of their voice and interpersonal ear.
This alternation occurs while clients are
speaking about objective events and listen-
ing to someone who is responding to them.
This factor seems to be about locating the
continued on page 19
client within the objective coordinates
defining their current situation. The client
is trying to give voice to the contexts, situ-
ations, and events that she currently finds
herself in. These are communicated to the
therapist as best as the client can, in fits and
starts, a broken branch here, an overturned
stone there, with the growing hope that the
therapist has heard her communications
well enough to identify her current “land-
scape of action“ (Bruner, 1986, p.14). Thus,
by joining in, the therapist can start to spec-
ify the client’s landscape, its contours and
contents, by a useful set of descriptors (i.e.,
words). Far from being only the transfer of
information from a speaker to a hearer, this
first factor functions as a discourse com-
pass for the client: “I am trying to commu-
nicate the objective events in my current
life that continue to be topics of my con-
versational concern. These comprise the
conversational topography of my objective
existence now. Can anyone, can you, hear
where I am. I am listening to and for you.”
The existentialists might say that all clients
are alienated from their own existence and
are thus estranged from others as well. The
voice of the therapist, then, contains hope
of both reunion and communion. The
client strains to listen to the therapist.
There is work being done, perhaps even
remoralization, in the acknowledgement of
the therapists voice, in the anticipation of
being known by, and knowing, an affirm-
ing other. Every head nod, every back
channel indicator, every affirmation and
display of attention to the therapist’s voice,
pulls the client back into the crucible of
communication, where her socialization
and character were once forged and where
it can now be forged again.
If Continuing Information Exchange, along
with the alternation of speaking and listen-
ing roles it implies, is a common client fac-
tor in all types of therapies, does its
absence from Frank’s list suggest that its
influence on progress or outcome affects
change via mechanisms that he did not
identify? Again the answer may not be a
simple yes or no. The demoralizing sense
of alienation could be lessened as the client
learns, sometimes emotionally, that she can
share her world in the relationship with the
therapist. She could experience success in
relating interpersonally in both speaking
and listening roles. As the client gains a
voice and tunes her ear, her landscape may
become less demoralizing, perhaps provid-
ing a glimmer of hope, if for no other reason
than that it now houses a self in relational
dialogue. Consequently, the client’s alter-
nation of the provision of information with
their communication of active listening
may function in some of the same ways as
the more paradigmatic therapist or treat-
ment related factors featured in Frank’s
treatise so many years ago.
On the other hand, the underlying
mechanism, the common curative factor,
may simply be exposure to and participa-
tion in affirming discourse exchanges,
including but not restricted to Continuing
Information Exchange (Russell, Green-
wald, Shirk, 1991; Shirk & Russell, 1996).
This, after all, is how expressive and adap-
tive communication is learned in the first
place. Ideally, future research on discourse
processes in therapy will proceed with
methods capable of capturing both con-
stituent processes and holistic forms of
communicative interaction.
References
Bruner, J. (1986). Actual Minds, Possible
Worlds. Cambridge, MA: Harvard
University Press.
Czogalik, D., & Russell, R. L. (1994). Key
processes of client participation in psy-
chotherapy: Chronography and narra-
tion. Psychotherapy, 31, 170-182.
Czogalik, D., & Russell, R. L. (1995).
Interactional structures of therapist and
client participation in adult psychother-
apy: P-technique and chronography.
Journal of Consulting and Clinical
Psychology, 63, 28-36.
Frank, J. D. (1961). Persuasion and healing: A
comparative study of psychotherapy.
continued on page 20
19
 Baltimore: The Johns Hopkins
University Press. (Quotes are from the
1974 revised edition, New York:
Schocken Books).
Kazdin, A.E. (2005). Treatment outcomes,
common factors, and continued neglect
of mechanisms of change. Clinical Psy-
chology: Science and Practice, 11, 184-188.
Kiesler, D. J. (2004). Intrepid pursuit of the
essential ingredients of psychotherapy.
Clinical Psychology: Science and Practice,
11, 391-395.
Russell, R. L. (1999). Child psychotherapy
process research: Suggestions for the
new millennium. In S. W. Russ and T. H.
Ollendick (Eds.), Handbook of psychother-
apies with children and families (p. 541-
552). New York: Klower
Academic/Plenum Publishers.
Russell, R.L. (2004). Minding our thera-
peutic tales: Treatments in perspec-
tivism. In L.E. Angus& J. McLeod (Eds.)
The Handbook of Narrative and
Psychotherapy (pp. 211-226). Thousand
Oaks, CA: Sage Publications, Inc.
Russell, R. L. (2007). Social Com-
munication Impairments: Pragmatics.
In R.L. Russell & M.D.
Simms (Eds.) Language, Communication, and
Literacy: Pathologies and Treatments.
Pediatric Clinics of North American, 54,
483-506.
Russell, R., Bryant, F., & Estrada, A. U.
(1995). Confirmatory p-technique analy-
ses of therapist discourse: High versus
low quality child therapy sessions.
Journal of Consulting and Clinical
Psychology, 64, 1366-1376.
Russell, R. L., Greenwald, S. & Shirk, S. R.
(1991). A meta-analytic review of lan-
guage changein child psychotherapy.
Journal of Consulting and Clinical
Psychology, 59, 916-919.
Russell, R. L., Jones, M.E. & Miller, S.A.
(2007). Core process components in
20
psychotherapy: A synthetic review of
P-technique studies. Psychotherapy
Research, 17, 271-288. Shirk, S. & Russell,
R. L.(1996). Change processes in child psy-
chotherapy: Revitalizing treatment and
research. New York: Guilford Press.
Robert L. Russell, Ph.D. is currently Professor
of Pediatrics at the Medical College of
Wisconsin/Children’s Hospital of Wisconsin.
He is Director of Research at the Child
Development Center and a member of the
School Performance Program in which he pro-
vides assessment and treatment for school aged
children with learning, language, and psychi-
atric disorders. Dr. Russell received his Ph.D.
from Clark University in 1984 and an MA in
Linguistics in 1986 from the University of
North Carolina, Chapel Hill. He has taught at
the University of Kentucky, New School for
Social Research, and at Loyola University prior
to his current appointment. He is currently
conducting research on the pragmatic language
competence of children with language disorders
and ADHD in addition to his research on
processes of treatment in child and adolescent
therapy. The current piece shares the title of a
book-in-progress.
Address for editorial correspondence:
Robert L. Russell, Ph.D.
Professor, Pediatrics
Director of Research
Child Development Center
Medical College/Children’s Hospital of
Wisconsin
Department of Pediatrics
8701 Watertown Plank Rd.
PO Box 26509
Milwaukee, Wisconsin 53226 0509
Phone: 414-456-4430
Email: rrussell@mcw.edu
WASHINGTON SCENE
The Fundamental Nature of the Political Process
Pat DeLeon, former APA President
A State-Based Dialogue: On July 10, 2007
the Governor of the State of Hawaii vetoed
SB 1004 which would have allowed appro-
priately trained psychologists, working
within our state’s community health cen-
ters, to prescribe. As Mike Sullivan
observed: “A veto was inevitable some-
where sooner or later. Hawaii came closer
than anytime in over two decades – major
progress. Hats off to Jill and Robin and
Ray!” The Governor’s veto message: “The
stated purpose of this bill ‘is to authorize
appropriately trained and supervised
licensed medical psychologists practicing
in federally qualified health centers, to pre-
scribe psychotropic medications for the
treatment of mental illness.’ This bill is
objectionable because its actual effect goes
beyond its stated purpose by allowing psy-
chologists who obtain the second of two
tiers of prescriptive authority established
by the bill—a prescription certificate – to
practice outside of federally qualified
health centers (FQHCs) and to prescribe
medications to individuals who are not
patients at FQHCs. Furthermore, this bill
does not require medical supervision of
psychologists holding a prescription cer-
tificate. This bill is also objectionable
because psychologists do not have the
training necessary to prescribe drugs and
this bill does not require sufficient didactic
and clinical training for prescriptive
authority....
“In addition, this bill gives psychologists
with prescriptive authority a scope of prac-
tice broader than that afforded to the PDP
[DoD] psychologists. PDP psychologists
were limited to prescribing psychotropic
medications to patients between the ages
of 18 and 65 with mental conditions but
without medical complications as evaluat-
ed by the supervising psychiatrist. This bill
allows psychologists to prescribe psy-
chotropic medications to patients of all
ages, including children, elderly, and those
with medical illnesses in addition to med-
ical conditions. Psychologists with limited
didactic and clinical training are not pre-
pared to handle the side effects of psy-
chotropic medications on patients with
medical complications. In recognition of
this concern, both the Board of Medical
Examiners and the Board of Psychology,
the professional licensing bodies for these
two professions, have asked that this bill
not become law. For the foregoing reasons,
I am returning Senate Bill No. 1004 without
my approval.”
The ApA President: “We welcome (the)
veto of this legislation and the legislature’s
decision not to attempt to override
her veto. These actions placed the health
and welfare of patients above politics.
Psychiatric disorders—and medications—
have an impact on the patient’s whole
body, not just his or her brain.... (I)t is dan-
gerous and unwise to allow prescribing of
pharmacologic treatments by those... who
have no medical training. Properly pre-
scribed, psychiatric medications are safe
and effective, but they are not without
risks.... Moreover, over half of all patients
with mental illnesses have other medical
complications that must be taken into con-
sideration when prescribing psychiatric
medications. This also clearly requires
medical education and training and exper-
tise. The APA applauds the leadership and
continued efforts by patients, their families
and physicians in Hawaii to ensure that
Hawaiians are not subjected to substan-
dard and potentially dangerous care. The
continued on page 22
21
APA strongly supports its state associa-
tions in their ongoing efforts to vigorously
resist efforts to allow psychologists to
practice medicine without the benefit of
medical school and supervised medical
residency.”
It is important in the public policy arena to
periodically reflect upon the “bigger pic-
ture.” This year a chiropractor-access bill
passed the Hawaii legislature to be vetoed
by the Governor at the recommendation of
the Hawaii Medical Association. The HMA
President: “The governor has stated her
intent to veto HB 436, which would man-
date that Medicaid and QUEST cover chi-
ropractic services. I support the veto of this
bill. Medicaid and QUEST are intended to
be basic medical assistance programs.
Chiropractic services are not basic medical
services that should be included in this
‘safety net’ state program. The stated pur-
pose of this bill is to ‘improve healthcare
access in Hawai’i by requiring medical
assistance programs such as QUEST and
Medicaid to include chiropractic coverage.’
However, enactment of this law will harm
access to quality healthcare. Current physi-
cian reimbursement rates under Medicaid
and QUEST have remained low. As a con-
sequence of low reimbursement rates, a
substantial number of Hawai’i physicians
have had to stop accepting Medicaid or
QUEST. Other physicians have left the
state. Accordingly, any additional money
that is available for these two programs
should be spent on increasing physician
reimbursement rates. It would be a bad
precedent if this bill became law. If more
people use chiropractic services than were
anticipated, then even more money will
have to be appropriated to cover these ser-
vices. In addition, in tough financial times,
other services may have to be cut to ensure
that these services remain fully funded.”
We would ask: Is organized medicine real-
ly interested in fostering the health policy
changes necessary such that the healthcare
environment of the 21st century will affir-
matively embrace patient-centered, indi-
22
vidualized care in which educated con-
sumers will actively utilize the most up-to-
date technology to ensure that they have
access to the type (and quality) of health-
care that they desire? Does organized med-
icine have any appreciation for the critical
importance of the psychosocial-economic-
cultural gradient of care or the benefit to
patients inherent in non-silo oriented,
interdisciplinary care? Given the half-
truths and misrepresentations in the
Governor’s veto message, does organized
medicine really believe in data-based,
objective determinations of quality care –
including decades of evidence demonstrat-
ing that a wide range of non-physician
healthcare providers provide outstanding
(if not superior) care? Jim Quillin’s testi-
mony: “With respect to safety, medical psy-
chologists certified in Louisiana saw a total
of 7,260 patients in 2005, after receiving the
authority to prescribe. Of those patients,
3,863 (53%) were provided prescriptions....
There were no adverse events associated
with this expanded practice.” Does orga-
nized medicine appreciate that patients are
ultimately responsible for their own health
care—for determining what services, and
from which providers, they will receive?
Perhaps one should consider politics a full
contact sport. We recommend the insight-
ful book Food Fight by two of our profes-
sion’s visionaries, Kelly Brownell and
Katherine Horgen. The focus of their con-
cern is America’s growing obesity crisis,
especially among our nation’s children.
This year, the Robert Wood Johnson
Foundation announced a $500 million ini-
tiative, over five years, to Reverse
Childhood Obesity, noting that about 25
million kids and teens in the nation are
overweight or obese: “Childhood obesity is
one of the most urgent and serious health
threats confronting our nation. It deserves
a serious response.” Called by critics the
“Mullah of the Twinkie tax,” Kelly truly
appreciates that to make a lasting differ-
continued on page 26
 DIVISION 29 2007 APA CONVENTION PROGRAM
San Francisco, California
FRIDAY, AUGUST 17, 2007
Symposium: Forgiveness Reconsidered—
Exploring Underlying Constructs and
Their Application to Psychotherapy
8/17 Fri: 8:00 AM - 9:50 AM
Moscone Center, Room 310
Chair: Donna S. Davenport, PhD
Participant/1st Author: Andrew Reichert, BA
Participant/1st Author: Rod Hetzel, PhD
Participant/1st Author: Donna S. Davenport,
PhD
Participant/1stAuthor: Randolph Pipes, PhD
Discussant: Michael Duffy, PhD
Symposium: Emotion-Focused Therapy of
Depression—An Evidence-Based
Psychotherapy
8/17 Fri: 10:00 AM - 11:50 AM
Moscone Center, Room 3007
Chair: Leslie S. Greenberg, PhD
Participant/1st Author: Leslie S. Greenberg,
PhD
Participant/1st Author: Jeanne C. Watson, PhD
Participant/1st Author: Robert K. Elliott, PhD
Symposium: Can We Identify MVPs
(Most Valued Psychotherapists)—
Therapists Effects in Psychotherapy
8/17 Fri: 12:00 PM - 1:50 PM
Moscone Center, Room 2006
Chair: Raymond A. DiGiuseppe, PhD
Participant/1st Author: Jeb Brown, PhD
Participant/1st Author: Stevan L. Nielsen, PhD
Participant/1st Author: William B. Stiles, PhD
Discussant: Raymond A. DiGiuseppe, PhD
Symposium: Lying in Psychotherapy—
Clients’ Views, Therapists’ Views, Theoretical
and Practical Considerations
8/17 Fri: 2:00 PM - 2:50 PM
Moscone Center, Room 3012
Chair: Randolph Pipes, PhD
Participant/1st Author: Randolph Pipes, PhD
Participant/1st Author: Leslie Martin, PhD
Participant/1st Author: Caroline Burke, PhD
Discussant: Annette S. Kluck, PhD
Poster Session One
8/17 Fri: 3:00 PM - 3:50 PM
Moscone Center, Halls ABC
Participant/1st Author: Megan M. MacNamara,
MA
Participant/1st Author: Priscilla R. Fleischer,
PhD, MSW
Participant/1st Author: Satoko Kimpara, MS
Participant/1st Author: Matteo Bertoni, MS,
MA
Participant/1stAuthor: Anne C. Erlebach, MA
Participant/1st Author: Sarah Knox, PhD
Participant/1st Author: Barbara M. Kaplan, PhD
Participant/1st Author: Georgiana S. Tryon, PhD
Participant/1st Author: Rafael S. Harris, Jr, PsyD
Participant/1st Author: Mona Bapat, MS
Participant/1st Author: Chris Brown, PhD
Participant/1st Author: Michele B. Hill, PhD
Participant/1st Author: Courtney A. Swatta,
PsyD
Participant/1st Author: George J. Kallas, PsyD,
PhD
Participant/1st Author: Shelah D. Adams, MA
Participant/1st Author: Pedja Stevanovic, BA
Participant/1st Author: Sara J. Lederer, MA
Participant/1st Author: Hung-Bin Sheu, MA,
MEd
Participant/1st Author: Gregory S. Chasson, MA
Participant/1st Author: Clara E. Hill, PhD
Participant/1st Author: Shelley N. Osborn, BS
Participant/1st Author: Satoko Shiraishi, MA
Participant/1st Author: Lee A. Thrash, PhD
Participant/1st Author: Zac E. Imel, MA
Participant/1st Author: Kristin M. Perrone, PhD
Conversation Hour: Awards and Recognition
8/17 Fri: 5:00 PM - 5:50 PM
San Francisco Marriott Hotel, Golden Gate
Salons B1 and B2
Social Hour
8/17 Fri: 6:00 PM - 6:50 PM
San Francisco Marriott Hotel, Golden Gate
Salons B1 and B2
continued on page 16
23
SATURDAY, AUGUST 18, 2007
Symposium: Unifying Principles of
Psychotherapy—What Have We Learned
From 100 Years of Clinical and Empirical
Investigation?
8/18 Sat: 8:00 AM - 9:50 AM
Moscone Center, Room 3009
Chair: Jeffrey J. Magnavita, PhD
Participant/1st Author: Jacques P. Barber, PhD
Participant/1st Author: Jay L. Lebow, PhD
Participant/1st Author: Lorna Smith Benjamin,
PhD
Participant/1stAuthor: Arthur Freeman, EdD
Discussant: Theodore Millon, PhD, DSc
Luncheon for Graduate Students and Early
Career
8/18 Sat: 12:00 PM - 1:50 PM
San Francisco Marriott Hotel, Nob Hill Rooms
A and B
Symposium: Evidence-Based Psychodynamic
and Cognitive Therapies—Recent Findings
and Future Challenges
8/18 Sat: 2:00 PM - 3:50 PM
Moscone Center, Room 307
Cochair: Jacques P. Barber, PhD
Cochair: Robert J. DeRubeis, PhD
Discussant: William B. Stiles, PhD
Poster Session Two
8/18 Sat: 4:00 PM - 4:50 PM
Moscone Center, Halls ABC
Participant/1st Author: Tamara S. Shafer, BA
Participant/1st Author: Timothy P. Melchert,
PhD
Participant/1st Author: Jennifer L. Wilson, BA
Participant/1st Author: J. Alison Bess, PhD
Participant/1st Author: Zohar Itzhar-Nabarro,
PhD
Participant/1st Author: Matthew J. Taylor, PhD
Participant/1st Author: Nancy A. Fry, MBA
Participant/1st Author: Christy D. Hofsess, MEd
Participant/1st Author: Robinder P. Bedi, PhD
Participant/1st Author: Rebecca Oakes, PhD
Participant/1st Author: Rachel E. Crook Lyon,
PhD
Participant/1st Author: Lana O. Beasley, MA
Participant/1stAuthor: Frank Fedde, MA
Participant/1stAuthor: Scott A. Baldwin, PhD
24
Participant/1st Author: Jill C. Slavin, MA
Participant/1st Author: Brian H. Stagner, PhD
Participant/1st Author: Jeffrey A. Rings, MA
Participant/1st Author: Melissa S. Roffman, MA
Participant/1st Author: John L. Powell, MA
Participant/1st Author: Arne Kristian
Henriksen, PhD
Participant/1st Author: Robert J. Reese, PhD
Participant/1st Author: Steven G. Benish, MSE
Participant/1st Author: Melissa K. Smothers,
MA
Participant/1st Author: Frances A. Kelley, PhD
Participant/1st Author: William K. Lamb, PhD
Participant/1st Author: J.R. Fuller, PhD
Participant/1st Author: Diana L. Sanchez, MA
Participant/1st Author: Yun-Jy Yeh, MEd
Participant/1st Author: Valerie R. Wilson, MA
Participant/1st Author: D. Brian Smothers, MA
Participant/1st Author: Erlanger A. Turner, MS
Symposium: Psychotherapist Self-Care—
Leaving It at the Office
8/18 Sat: 4:00 PM - 5:50 PM
Moscone Center, Room 307
Chair: John C. Norcross, PhD
Participant/1st Author: Judith S. Beck, PhD
Participant/1st Author: Laura S. Brown, PhD
Participant/1st Author: Lillian Comas-Diaz, PhD
Participant/1st Author: Florence W. Kaslow, PhD
Participant/1st Author: Michael P. Leiter, PhD
Participant/1st Author: Alvin R. Mahrer, PhD
Discussant: James D. Guy, PhD
SUNDAY, AUGUST 19, 2007
Symposium: Psychotherapists Around the
World—-Meeting Needs of the Global Village
8/19 Sun: 9:00 AM - 10:50 AM
Moscone Center, Room 309
Chair: Craig N. Shealy, PhD
Participant/1st Author: Gregg R. Henriques,
PhD
Participant/1st Author: Shagufa Kapadia, PhD
Participant/1st Author: Noelle Robertson, PhD
Participant/1st Author: Eleanor H. Wertheim,
PhD
Discussant: Jeffrey J. Magnavita, PhD
continued on page 17
Symposium: Guiding Evidence-Based
Practice With Outcome Data
8/19 Sun: 11:00 AM - 12:50 PM
Moscone Center, Room 309
Chair: David W. Smart, PhD
Participant/1st Author: David D. Dayton, BA
Participant/1st Author: Takuya Minami, PhD
Participant/1st Author: Russell J. Bailey, BS
Participant/1st Author: Richard L. Isakson, PhD
Discussant: Brent S. Mallinckrodt, PhD
MONDAY, AUGUST 20, 2007
Symposium: Culturally Competent
Intervention for Abused, Suicidal African
American Women
8/20 Mon: 8:00 AM - 9:50 AM
Moscone Center, Room 3003
Cochair: Nadine J. Kaslow, PhD
Cochair: Natalie C. Arnette, PhD
Participant/1st Author: Natalie C. Arnette, PhD
Discussant: Nadine J. Kaslow, PhD
Workshop: Two Become One and Then There
Are None! Relationships and Couples
Therapy Revisited
8/20 Mon: 11:00 AM - 11:50 AM
Moscone Center, Room 2006
Cochair: Robert W. Resnick, PhD
Cochair: Rita F. Resnick, PhD
Symposium: International Perspectives on
Feminist Multicultural Psychotherapy—-
Content and Connection
8/20 Mon: 12:00 PM - 1:50 PM
Moscone Center, Room 262
Chair: Elizabeth Nutt Williams, PhD
Participant/1st Author: Laura S. Brown, PhD
Participant/1st Author: Norine G. Johnson, PhD
Participant/1st Author: Ellyn Kaschak, PhD
Participant/1st Author: Kathryn L. Norsworthy,
PhD
Discussant: Oksana Yakushko, PhD

Symposium: Cognition and Suicide—-

Theory, Research, and Therapy
8/20 Mon: 10:00 AM - 10:50 AM
Moscone Center, Rooms 202/204/206
Chair: Lisa A. Firestone, PhD
Participant/1st Author: David Jobes, PhD
Participant/1st Author: M. David Rudd, PhD
Participant/1st Author: Gregory K. Brown, PhD

N O F P S Y C H O THE
O
RA P Y
D I V I SI

29
ASSN.
AMER I

C
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N PSYCHOLOGI C
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25
ence, one must have vision, persistence,
and presence. “Proposals to change the
food environment present the food indus-
try and the nation with serious challenges.
The industry must fight off unwanted leg-
islative, regulatory, and legal action that
could damage business while at the same
time it engages in practices such as mar-
keting to children that are increasingly
unpopular. The nation must decide how to
deal with the food industry. Food compa-
nies confront the paradox of claiming pub-
lic health as their priority while knowing
that profits increase when people eat more.
If the nation moves to a healthier diet,
some segments of the industry will benefit
and others will suffer.... Without active dis-
cussion, the nation will default to current
practices.... Tight connections between the
food industry and key governmental offi-
cials are legendary.... Striking parallels
exist between the beginning of the war on
tobacco and where the nation stands now
with food. First let us address a key issue –
that food and tobacco are not the same. We
agree that they are not the same. People do
not have to smoke, but they must eat.”
Kelly and his colleague highlight food
industry tactics that are highly relevant for
all who seek to modify the status quo of
healthcare (including obtaining prescrip-
tive authority): • Claim commitment to
public health; • Influence public policy
directly; • Seek influence through cam-
paign contributions; • Silence critics by
suing or intimidation; and, • Shift the
focus of discussion. “First they ignore you.
Then they laugh at you. Then they fight
you. Then you win” [M.K. Gandhi]. Being
personally involved is critical. Mike is
absolutely correct. Our sincerest congratu-
lations and appreciation to Robin
Miyamoto, Jill Oliveira, Ray Folen, and
HPA Executive Director Carol Parker.
Hawaii’s psychologists have made a major
contribution to society and our profession.
Louisiana’s Jim Quillin: “I thought of a
cold day in a duck blind many years ago
when my father told me that there would
come times in my life when I’d remember
26
what he was to tell me—‘Son, if you don’t
quit, you win.’ He was right.”
A Federal Dialogue: This Summer, Senator
Enzi, ranking member of the Health,
Education, Labor and Pensions (HELP)
Committee, introduced legislation (S. 1783)
laying out a healthcare vision for the 21st
century. “Health care reform is one of the
biggest needs in this country. It is the
fastest escalating price in this country. It is
the biggest cost to companies and individ-
uals in this country. We need to have a
solution. I have been working with Senator
Kennedy (who)... has a very full plate with
the Higher Education Act, the higher edu-
cation reconciliation, information technolo-
gy, and I could go on to mention about 53
bills we are working on in that committee.
So I have had some latitude as ranking
member to try to pull together some infor-
mation—some legislation that would deal
with health care for this Nation. This is a
work in progress. This is not a finished
document....
“Without the work of everyone on this, it
can’t be done. If it gets polarized, it can’t be
done. This is something which has to be
done in a very bipartisan way. I hope we
have a framework from which we can all
operate, making changes, finding third
ways. I work on an 80-percent rule. I antic-
ipate and from experience have found that
usually everybody can agree on 80 percent
of the issues, and among the 80 percent of
the issues on which they agree, they can
agree on 80 percent of any one of those
issues. You never get a perfect bill around
here. If you can get 80 percent, you can get
a lot done. That is what we are trying to do
on health care.... Eighty percent would be a
huge difference and will help out a lot of
people.
“So I rise today to talk about an issue that
is literally a heartbeat away from devastat-
ing the lives of every American; that is, our
current health care crisis. Undeniably, we
continued on page 27
have a problem. There are 46.1 million
Americans, according to the last tabula-
tion, who are uninsured. Now, we always
talk about that figure and change it slight-
ly differently because there are 7 million of
those people who make over $80,000 a year
and don’t have insurance, so they must
chose not to have insurance, but they are
uninsured.... Health care costs are outstrip-
ping inflation. They are increasing annual-
ly at three times the rate of the Consumer
Price Index. It is little surprise that three
out of every four Americans are concerned
about health care—three out of four....
Thankfully, I am not here today to talk
about these problems; I am here to provide
real solutions. Americans need and
deserve real solutions to this crisis now,
and they are counting on this body to work
together to get that. The time has come to
move beyond the rhetoric and principles to
true comprehensive health care reform.
Congress could enact 10 major steps for
health care reform. These 10 steps are the
basis of the legislation I am introducing
today, the Ten Steps to Transform Health
Care in America, or simply ‘Ten Steps’....
“First, we eliminate unfair tax treatment of
health insurance, which expands choices
and coverage and gives all Americans
more control over their health care.... The
second step would increase affordable
options for working families to purchase
health insurance through a standard tax
deduction.... The third step is what makes
this a hybrid approach. I couple the stan-
dard deduction with a refundable,
advanceable, assignable tax-based subsidy.
That is a mouthful, but it ensures that
Americans receive this credit in a meaning-
ful way that allows them to purchase real
insurance coverage.... The fourth key step
is to provide market-based pooling to
reduce growing health care costs and
increase access not only for small business-
es, unions and other kinds of organizations
and their workers, members, and fami-
lies.... Of course, a big elephant in the room
was dealing with those who were misled to
fear how the initial proposal dealt with
insurance mandates.... While the next step
is probably one of the most obvious ones, it
is also one many have not yet discussed.
Currently, HIPPA portability protections
are provided to group health plans....
However, those consumer protections are
not provided nearly as well to individuals
who are purchasing in the individual
market. Ten Steps blends the individual
and group market to extend important
HIPPA portability protections... so the
insurance security can better move with
you from job to job.... The sixth step
emphasizes preventive benefits and helps
individuals with chronic diseases better
manage their health. America should have
health care, not sick care. Prevention, pre-
vention, prevention. That makes a big dif-
ference in the cost.... (A)nother key step is
to give individuals the choice to convert
the value of their Medicaid and SCHIP pro-
gram benefits into private health insur-
ance, putting them in control of their
health care, not the Federal Government....
The eighth step is a bipartisan proposal...
the ‘Wired for Health Care Quality Act,’
which encouraged the adoption of cutting-
edge information technologies in health
care to improve patient care, reduce med-
ical errors, and cut health care costs....
(T)he ninth step helps future providers and
nurses pay for their education while
encouraging them to serve in areas with
great need.... The final step decreases the
skyrocketing cost of health care by restor-
ing reliability in our medical justice system
through State-based solutions.... The
Institute of Medicine... estimated that pre-
ventable medical errors kill between 44,000
and 98,000 Americans each year.... We have
an opportunity, we have an obligation to
take care of the people of this country, and
they are demanding it. Let’s work from a
basis of some information and see where
we can take it so that we get a solution and
we get action now.”
continued on page 28
27
Ray: “Organized medicine poorly repre-
sents the public sector physician working in
underserved areas. Facing limited resources
and strapped with huge patient care loads,
these colleagues greatly appreciate and sup-
port the other helping professionals who are
willing to share the load. It is dismaying
that, in contrast, organized medicine is most
interested in protecting turf. They use
28
unfounded scare tactics and fill their testi-
mony with outright lies and distortions.
When it comes to scope of practice, objective
data and disconfirming evidence be
damned, resulting in countless thousands
being denied necessary health care.”
Aloha,
Pat DeLeon
29
 THE AMERICAN PSYCHOLOGICAL FOUNDATION
and
APA Division 29
The Division of Psychotherapy
present the
14th Annual
Rosalee G. Weiss Lecture
for Outstanding Leaders in Psychology
“Racial Microaggressions in Everyday Life:
Impact on Mental Health & Clinical Practice”
Delivered by
Derald Wing Sue, Ph.D.
Chair: Anthony Jackson, Ph.D.
Sunday, August 19, 2007
3:00 p.m. to 3:50 p.m.
Moscone Center • Room 200

Dr. Weiss established the Rosalee G. Weiss Lecture Series in 1994 to honor his
wife, and he ensured its perpetuity with a gift to the Foundation in 1999.
Divisions 29 and 42, upon approval by the APF Board of Trustees, select an annu-
al lecturer to speak at the APA convention. The individual must be an outstand-
ing leader in the arts or sciences whose work has had significant impact on the
discipline of psychology or an outstanding leader in any of the specialty areas
within the sphere of psychology.

About Derald Wing Sue, Ph.D.

Derald Wing Sue, Ph.D., is a pioneer in the field of multi-

cultural psychology. While some scholars were doubtful of
the practicality of multicultural psychology, Wing Sue had
already written and researched in the field extensively,
being one of the frontrunners to uncover the flourishing dis-
cipline. Wing Sue received his doctorate from the University
of Oregon, and is a professor of psychology and education
in the Department of Counseling and Clinical Psychology at
Columbia University. His research challenges monocultural
foundation of psychology. In 1972, he co-founded and
served as the first president of the Asian American Psychological Association. He
has also served as president of the Society for the Psychological Study of Ethnic
Minority Issues and the Society of Counseling Psychology (Division 17 of
American Psychological Association). Wing Sue has worked to set up cultural
diversity training programs for many companies and organizations. Today, two
of Wing Sue’s books have been identified as the most frequently cited works in
multicultural psychology, indeed a testament of his contribution to the field.

30
 DIVISION 29 STUDENT PAPER AWARDS

Each year, the Student Development Committee of the Division of Psychotherapy

calls for papers for three awards, which are then juried by the members of the
committee. In 2007, the committee received nearly 30 submissions of high caliber
from students across North America. Each winning submission receives a com-
memorative plaque and a cash prize, presented at the annual meeting of the APA
in San Francisco. Psychotherapy Bulletin is pleased to publish the winning paper
from each award category.

Ms. Jesse Metzger, of Columbia University, is the recipient of this year’s Donald
K. Freedheim Student Development Award. The Freedheim Award is conferred
on the author of the best paper written on psychotherapy theory, practice, or
research. This year’s winner, written by Ms. Metzger is titled: Between Patients’
Representations of Therapists and Patients.

Mr. Peter Panthauer, of Adelphi University, is the recipient of this year’s Diversity
Award. The Diversity Award is conferred on the author of the best paper that
address issues of race, gender, and cultural issues in psychotherapy. Mr.
Panthauer’s award-winning paper is titled: Therapy with Lesbian Couples.

Ms. Deleene Menefee, of the University of Houston, is the recipient of this year’s
Mathilda B. Canter Education and Training Award. The Canter award is
conferred on the author of the best paper on education, supervision, or training
of psychotherapists. Ms. Menefee’s paper on Perceptions of Trainee Attachment in
the Supervisory Relationship, was this year’s award winning paper.

Michael S. Garfinkle
Chair, Student Development Committee

31
STUDENT PAPER
The Relationship Between Patients’ Representations
of Therapists and Parents
Jesse A. Metzger, Teachers College, Columbia University
Abstract
The purpose of this exploratory research was to
examine and compare the formal properties of
psychotherapy patients’ internalized represen-
tations of their parents and those of their thera-
pists. A further comparison was made between
representations of parents following recall of a
pleasant memory of the parent (“good parent”
representations), and representations of parents
following recall on an unpleasant memory of
the parent (“bad parent” representations).
Results indicate that patients represent their
therapists significantly less in the form of
images and “felt” sensations than either the
“good” or the “bad parent,” and that their ther-
apist representations are significantly less vivid
overall than either parent representation.
Results further indicated that the more patients
tend to represent their “bad parent” in the form
of images and “felt” sensations, the more they
tend to represent their therapist in the form of
real or imagined dialogues; by contrast, the
more patients tend to represent their “good par-
ent” imagistically, the less they tend to repre-
sent their therapist in lexical form. The findings
and their implications are discussed.
The Relationship Between
Patients’ Representations of
Therapists and Parents
Patients beginning therapy carry with
them the influence of previously internal-
ized relationships, most saliently, those of
their primary caregivers or parents. From
this object relational perspective, therapy
can be looked at as a process of under-
standing and reworking representations.
Success of therapy depends on both the
beginning contents and organization of the
patient’s representational world, and the
therapist’s recognition of and sensitivity to
that world. The organization—or form (vs.
32
content)—of patients’ representations is
the focus of the present research.
In psychology as well as the arts, the study
of representation has addressed the dis-
tinction between the form of a representa-
tion and its content. The content is the
what, the form is the how—the manner,
shape, or defining characteristic by which a
representation is known. With respect to
mental representations of internalized
objects, Geller, Cooley, and Hartley (1981-
82) have observed that forms of representa-
tions do not merely act “on behalf” of con-
tent, they in fact play a role in shaping con-
tent: “formal processes are implicated in
perceiving an object, in re-representing the
object in its physical absence, and in com-
municating the experience from one per-
son to another” (p. 130).
Understanding how patients represent sig-
nificant others in the mind has much clini-
cal utility in terms of assessing and facili-
tating the flexibility with which patients
represent these significant others.
Theoretical (Bruner, 1964; Horowitz, 1983)
and empirical work (Geller et al., 1981-82;
Geller & Farber, 1993; Orlinsky, Geller,
Tarragona, & Farber, 1993; Rosenzweig,
Farber, & Geller, 1996) has demonstrated
the existence of three categories of repre-
sentational form used by individuals when
calling forth representations of significant
others or events: imagistic, enactive, and
lexical (Horowitz). The imagistic mode
involves the calling forth of visual, audito-
ry, olfactory, and other perceptual images,
and is distinct among the three modes in its
‘proximity’ to perception and affect. The
enactive mode is characterized by the
experience of “felt” bodily sensations, or
continued on page 33
the sense of diffuse, emotionally-laden
atmospheres. The lexical mode—the clear-
est, most logical, and most communicable
of the modes—is characterized by language-
based or conceptual thought.
In Horowitz’s (1983) view, the flexible
interrelatedness of the three modes of rep-
resentational thought is a sign of psycho-
logical health, giving an individual’s expe-
riences depth and breadth of meaning.
However, individuals can sometimes
become one-sided, have only one mode
available, or vacillate in an unintegrated
way among the modes: “Characterological
styles result, in part, from a restrictive
selection of and preferences for certain
modes of representing experience and the
use of various strategies to negotiate the
relationships among them” (Geller et al.,
1981-82, pp. 130-131). What is happening
in such cases, proposes Horowitz, is that
repression is occurring at the boundaries
between these representational systems. A
goal of psychotherapy is thus to reestablish
continuity between ideas and attitudes in
various modes of representation.
Patients’ representations of their therapists
The first known systematic study of the
forms of therapist representation was
undertaken by Geller et al. (1981-82). Using
as a conceptual starting point Bruner’s
(1964) and Horowitz’s (1972) categories of
representational form, the authors devel-
oped the Therapist Embodiment Scale
(TES) as a system for characterizing the
forms in which “evocative memories” of
significant others enter awareness. A factor
analysis of the TES in the Geller et al. con-
firmed the presence of the three distinct
representational modalities in patients’
representations of their therapists: imagis-
tic, haptic (later renamed “enactive”), and
conversational-conceptual (used inter-
changeably with “lexical”). Each of these
modalities makes possible a different form
of imaginatively reliving the experience of
being in the physical presence of the thera-
pist. Patients with high scores on the imag-
istic factor are especially able to schemati-
cally represent the nonverbal, perceptual-
ly-based aspects of therapy sessions.
Patients with high scores on the enactive
factor experience tend to evoke their thera-
pist via “certain characteristic bodily sen-
sations” and are aware of “a particular
emotional atmosphere” that gives them a
sense that their therapist is “with them”;
this mode of representation can be distin-
guished from that comprised of particular
images or notional thought. Finally,
patients with high scores on the lexical fac-
tor tend to represent the therapeutic inter-
action in terms of real or imagined dia-
logues with the therapist.
Research using the TES has shown that
patients typically use all three modalities
to evoke representations of their therapists
and the therapeutic relationship, but that
auditory and visual imagery tend to be the
most characteristic forms of therapist rep-
resentation (Geller & Farber, 1993; Orlinsky
et al., 1993; Wzontek, Geller, & Farber,
1995). Other variables, such as the length of
time in therapy and whether the subject is
a current or former patient, have been
studied in connection with the modalities
of therapist representations. Research on
whether length of time in therapy affects
patients’ tendency to represent their thera-
pist via particular modalities has yielded
mixed results. Two studies investigating
the hypothesis that patients’ internalized
representation of their therapists vary with
time in treatment—with patients in early
phases of treatment having less articulated
and differentiated representations than
those in latter phases—did not confirm this
hypothesis (Barchat, 1989; Wzontek et al.,
1995). However, in an examination of pos-
sible non-linear trends, Rosenzweig et al.
(1996) found that patients within three
phases of therapy differed significantly in
the extent to which they employed the
imagistic mode of therapist representation.
Specifically, patients who had been in ther-
apy between one and three years tended to
use visual imagery in evoking a represen-
continued on page 34
33
tation of their therapist more often than
patients who had been in therapy either
less than one year or more than three years.
In an examination of whether therapist
representations depend on termination sta-
tus, Geller and Farber (1993) demonstrated
that current and former patients did not
differ significantly in the extent to which
they employed each of the three factor-
generated modalities to represent their
therapists. Furthermore, among patients
currently in therapy, the frequency of use
of discrete forms to represent the therapist
was unrelated to the number of sessions
attended. These findings are consistent
with those of Barchat (1989) and Wzontek
et al. (1995), described above. Among those
who have terminated therapy, however,
the number of sessions attended was found
to be significantly related to preferred
mode of representation: the greater the
number of sessions, the less frequent the
use of the imagistic mode of representing
one’s therapist and the more frequent the
use of the lexical mode. These findings
were interpreted to mean that current
patients’ modes of constructing representa-
tions of the information contained in their
unfolding therapy experiences do not
become progressively more conceptual
and less sensory in nature during the
course of therapy. Once terminated, how-
ever, patients appear to more frequently
invoke the therapist’s voice as a preferred
modality of representation.
In terms of outcome, in Geller et al.’s (1981-
82) original study, self-reported improve-
ment was significantly correlated with the
use of the imagistic and enactive modes of
representation: the tendency to experience
the therapist imagistically or in terms of
“felt” sensations was associated with posi-
tive self-perceived outcomes. Subsequent
research using the same instrument (the
Therapist Embodiment Scale, or TES) has
yielded similar results. For example,
Honig, Farber, and Geller (1997) found
that, in a community-based sample of cur-
rent patients, patients’ perceptions of how
34
helpful treatment had been thus far was
positively correlated with the tendency to
use the imagistic and enactive modes of
representing the therapist. In an examina-
tion of both current and former psy-
chotherapy patients, Geller and Farber
(1993) found that whereas among patients
currently in therapy, self-reported
improvement was significantly correlated
with the tendency to represent the thera-
pist in the imagistic mode, among former
patients, use of the enactive mode was pos-
itively correlated with outcome. Because
patients who possess this latter representa-
tional capacity are able to remain “in
touch” with their therapist’s presence, and
to “sense” the emotional atmosphere that
accompanies feelings of relatedness, the
authors concluded that “in more successful
therapies, the therapist apparently
becomes ‘a felt part of’ the patient” (p.
177). These findings taken together suggest
that the tendency to embody the therapist
imagistically and/or in terms of “felt” sen-
sations is associated with better outcomes.
Parental representations
Parental representations, in contrast to
therapist representations, have not been
subject to research via different modalities
as defined in the present study. However,
research has both compared parental and
therapist representations in terms of devel-
opmental level, and examined the relation-
ship of parent and therapist representa-
tional level to outcome. This research can
serve as a broader context in which to
embed the more specific definitions of rep-
resentational “multimodality” utilized in
the present study.
The developmental or conceptual level of
object representations has been a focus of
study in recent years (see Blatt &
Auerbach, 2001). Based in developmental
object relations theory, in this line of
research representations are seen as exist-
ing on a continuum, with low-level repre-
sentations being concrete, literal, fixed, and
continued on page 35
global, and high-level representations
being more differentiated, complex, inte-
grated, and abstract (Blatt, Wiseman,
Prince-Gibson, & Gatt, 1991). Research
examining the conceptual levels of parent
and therapist representations has shown
that there is a significant correlation
between the two, particularly when the
parent represented is the mother (Bender,
Farber, & Geller, 1997; Honig et al., 1997).
Honig et al. (1997), for example, found that
patients who formed more highly integrat-
ed and differentiated representations of
their mothers were more likely to form
highly integrated and differentiated repre-
sentations of their therapists, whereas
patients whose maternal representations
were more primitive and less differentiated
tended to create therapist representations
that reflected these same qualities. The
finding is consistent with theory and
research that suggest that an individual’s
level of object representation is relatively
stable and generalizable (e.g., Bowlby,
1988). However, Honig et al. also found
that the overall level of the maternal object
representation, as well as its level of com-
plexity, was significantly higher than over-
all level of therapist representation. Thus,
although patients’ levels of object represen-
tation were found to be positively correlat-
ed, the overall mean scores for conceptual
level of therapist and maternal representa-
tions differed significantly. The authors
attribute this finding to the fact that
patients had only known their therapists
for a limited time and could not develop
realistically complex, differentiated repre-
sentations of them.
Other research, however, has shown that
therapist representations, as well as parent
representations, become more complex
and differentiated over treatment and that
this higher developmental level is associat-
ed with better clinical outcomes (Blatt &
Auerbach, 2001; Diamond, Kaslow,
Coonerty, & Blatt, 1990; Stayner, 1994).
These findings support the notion that rep-
resentational structures that organize expe-
rience and patterns of interpersonal relat-
ing can become more differentiated, inte-
grated and more intersubjectively related
during clinical treatment. The implications
of these findings include the potential use-
fulness of evaluating the differentiation-
relatedness of patients’ descriptions of self
and significant others in clinical practice.
As Blatt and Auerbach note, “comparison
of the changes in patients’ representations
of parents and therapist suggests the cru-
cial role of the therapist in facilitating clin-
ical change (2001, p. 147).
As mentioned, although the research
reviewed in this section did not examine the
formal properties of parental and therapist
representations as defined in the present
study (i.e., imagistic, enactive, and lexical),
the findings taken together suggest that
helping patients to develop more differenti-
ated and complex representations of objects
leads to better outcomes. Whether the flexi-
ble interplay among the three modes of rep-
resentational thought (Horowitz, 1983) rep-
resents more “differentiated” or “complex”
representational thinking is a question that
cannot be answered by the present study.
However, if representational form is consid-
ered to play a critical role in the shaping of
content, it is reasonable to assume that the
greater the multimodal flexibility, the
greater the complexity and richness of rep-
resentational thought.
“Good parent” vs. “bad parent”
representations
There appear to be at least two potentially
clinically relevant reasons for distinguish-
ing between “good parent” and “bad par-
ent” representations. First, it may be useful
to discover whether “good parent” and
“bad parent” representations differ from
each other in form. Are “bad parents” more
vividly experienced in the form of images,
whereas “good parents” are more vividly
experienced as “felt” parts of oneself?
Although the degree to which one experi-
ences the “good” or “bad parent” in a par-
ticular modality is likely to depend on that
continued on page 36
35
individual’s characteristic style (Geller et
al., 1981-82; Horowitz, 1983), a goal of the
present research is to determine whether
there are general patterns to the ways in
which patients represent these differing
mental constructs.
In addition, to separate the “good parent”
and the “bad parent” is to gain a fuller
understanding of the nature of the “bad
parent” representation. Writers working
from clinical, case study perspectives (e.g.,
Loewenstein, 2004), as well as those work-
ing from transtheoretical positions (e.g.,
Westen, 1991) have likewise observed that
representations of the so-called “bad par-
ent” may become dissociated from
patients’ awareness, particularly when
there are severe disturbances in early object
relationships. Thus, by focusing attention
explicitly on representations of the “bad
parent,” information about the representa-
tion of this particular construct may be
more fully understood. Furthermore, parti-
tioning out the ‘purely’ “bad parent”—
clarifying the ways in which he or she is
represented—may be beneficial in under-
standing particular biases or restrictions
the patient may have in terms of moving
flexibly among modes of thought. For
example, when it comes to imagining the
“bad parent,” do patients typically revert
to the enactive mode of representation?
(That is, do “bad parents” evoke more
unformulated, “felt” sensations than do
“good parents”? ) If so, this may be a signal
that unformulated experiences of “bad-
ness” need to be translated into the more
accessible imagistic or lexical forms.
A second reason for teasing apart the
“good parent” from the “bad parent” is
that comparing each of these separately to
the therapist representation offers an
opportunity to see which of the parental
representations the therapist representa-
tion more closely resembles. Are therapists
coming to resemble the “good parent” or
the “bad parent” in how they are repre-
sented in the mind of the patient? This
kind of discovery could enable the thera-
36
pist to make inferences about the transfer-
ence relationship and to guide the treat-
ment accordingly. As McWilliams (2004)
has observed, the therapist simultaneously
serves both as a new object (who differs
from previous, disappointing objects of
attachment) and as a figure to whom old,
maladaptive patterns of relating inevitably
get transferred. Understanding whether
patients tend to transfer their “good par-
ent” or their “bad parent” onto the thera-
pist can provide information about which
of these functions the therapist primarily
serves. Although the present study does
not seek to elucidate under what particular
circumstances patients differentially trans-
fer the “good” or “bad parent” onto the
therapist (and it is assumed that patients
do both at different times, or perhaps even
simultaneously), it can elucidate whether
there are general patterns to these types of
transference among patients in therapy.
An important methodological question
relates to how or under what circumstances
we can expect patients to call forth represen-
tations of their “good” and “bad parents.” In
therapy with adults, discussions of parents
typically revolve around significant memo-
ries, often those occurring early in life. There
is some evidence to suggest that certain
kinds of memories reflect core object rela-
tional themes, thus achieving some degree
of isomorphism with representations as
defined throughout this paper.
Broadly speaking, autobiographical mem-
ories are the most likely to evoke object
representations. Pillemer’s (1998) distinc-
tion between the imagistic (sensory, per-
ceptual, affective, and automatic) level and
the verbal (language-based and purpose-
ful) level of autobiographical memories—
in its striking resemblance to Horowitz’s
(1983) distinction between imagistic
(and/or enactive) and lexical modes of rep-
resentation—lends support to the use of
autobiographical memories as a stimulus
for parental representations. Within the
continued on page 37
class of autobiographical memories, fur-
ther subtypes can be delineated that bear
directly on the evocation of object repre-
sentations. Singer and colleagues, for
example, have demonstrated that “self-
defining” memories (vivid memories that
reflect enduring concerns or unresolved
conflicts of the personality) are linked to
critical relationship themes that are
expressed in both patients’ intimate rela-
tionships and the transference dynamics of
the therapy (Singer & Blagov, 2004; Singer
& Singer, 1994). Finally, early memories
may be particularly evocative of represen-
tations. In a discussion of Martin
Mayman’s early memories technique, by
which patients produce memories about
their early experiences and relationships
with caregivers, Fowler, Hilsenroth, and
Handler (2000) note that one of the benefits
of early memories is their ability to “sum-
marize the patient’s subjectively experi-
enced history, allowing the therapist to
comprehend the patient’s view of self,
other, and their world view” (p. 30).
In summary, given the evidence that self-
defining, autobiographical, and early
memories are vivid, personally meaning-
ful, and isomorphic with the representa-
tions they are intended to evoke, it can be
reasonably assumed that guiding patients
to produce these types of memory—either
pleasant or unpleasant—about their rela-
tionship with a parent will produce mean-
ingful representations of the “good” and
“bad parent.”
Research Questions
To date, no study has examined the formal
(i.e., imagistic, enactive, and lexical) prop-
erties of parent representations, nor has
there been any explicit comparison of the
formal properties of parent and therapist
representations. Given the lack of data to
support any specific hypotheses, the ques-
tions posed in the present study are con-
sidered exploratory in nature. Specifically,
these questions are: 1) Are there differences
in form and/or overall vividness between
“good parent”/“bad parent” representa-
tions and therapist representations? Put
differently, are there ‘preferred’ modes of
representational thought and/or degrees
of vividness depending on whether the
patient calls to mind their therapist, their
“good parent,” or their “bad parent”? 2)
What are the relationships among the dif-
ferent forms of representation used for the
different target figures? 3) Are there differ-
ences in form between representations of
the “good parent” and representations of
the “bad parent”?
Method
Participants
The sample consisted of a total of 20 psy-
chotherapy patients, drawn from two dif-
ferent sources. One group of subjects was
drawn from a subject pool utilized by
Farber, Geller, and Rohde (1995).
Specifically, this group consisted of 12 indi-
viduals who were currently in therapy at
the time of that study. These subjects were
recruited by Farber et al. from a university-
based training clinic in a large urban com-
munity. The sample consisted of 9 women
and 3 men who volunteered to participate
in a research project on the process of psy-
chotherapy. The age range of these subjects
was between 24 and 45.
For the purposes of the current study, a sec-
ond group of subjects was recruited from the
same university-based clinic (in the academ-
ic year of 2005-2006) in order to increase the
sample size. This group consisted of eight
individuals (seven women, one man), all
currently in therapy at the clinic, who volun-
teered to participate in a research project on
“patient views of psychotherapy.” Their
ages ranged from 23 to 58.
The combined sample thus included a total
of 16 women and 4 men with a mean age of
30. Sixteen of the subjects were White,
three were Black, and one designated
“other” as his or her ethnic category. In
terms of education level, five of the sub-
jects had attended some college, four had
continued on page 38
37
completed college, eight had attended
some graduate school, and three had com-
pleted a masters degree. In terms of marital
status, ten were single, five were in rela-
tionships, and five were married. The sub-
jects had been in therapy an average of 14
months, with a range from 1 month to 91
months (7.5 years). Frequency of sessions
ranged from once to twice weekly; the
mean number of sessions was 98.7.
Instruments and Procedure
Subjects were given a packet of materials to
complete and return to a box located in the
clinic. Included in this packet were an
informed consent form, a face sheet
requesting demographic information, the
Therapist Representation Inventory,
revised version (TRI-II; Geller, Behrends,
Hartley, Farber, & Rohde, 1992), and the
Parent Representation Inventory (PRI;
Smirnoff, 1986). Information about the the-
oretical underpinnings, development, and
psychometric properties of the TRI can be
found in Geller et al. (1981-1982).
Information about the PRI can be found in
Smirnoff (1986).
The face sheet requested the subject’s gen-
der, age, educational level, ethnicity, and
marital status. In addition, subjects were
asked to report for how long their current
(and any past) psychotherapy had contin-
ued, and the number of times per week
attended.
The TRI-II (Geller et al., 1992) has five
parts, is self-administered, and is designed
to measure the content, form, function, and
other phenomenological properties of
patients’ internal representations of their
therapists. The PRI has two parts, is self-
administered, and is designed to measure
the form and other phenomenological
properties of patients’ internal representa-
tions of their parents following the recall of
both a pleasant and an unpleasant early
memory. Included in the present study is
an analysis of one subscale of the TRI (the
Therapist Embodiment Scale [TES]), and
both subscales of the PRI (the Parent
38
Embodiment Scale-Pleasant [PES-p] and
the Parent Embodiment Scale-Unpleasant
[PES-u]).
Whereas the first group of subjects com-
pleted a number of other measures in addi-
tion to the demographic face sheet, TRI-II,
and PRI, the second group completed only
these measures. Only participants in the
second group received a nominal compen-
sation for their participation.
The Therapist Embodiment Scale (TES). The
TES is a method for assessing the formal
properties of patients’ internal representa-
tions (as distinct from their particular the-
matic contents). It asks patients to rate the
relative contribution of words, pictures,
sounds, bodily sensations, and so forth to
their conscious experiences of the therapist
outside therapy. The TES is a 12-item, nine-
point, Likert-type rating scale wherein
patients are asked to determine the extent
to which (1 = not at all typical; 3 = slightly
typical; 5 = moderately typical; 7 = quite
typical; 9 = highly typical) each item typi-
fies the means by which they evoke images
of their therapist. A factor analysis (princi-
pal axes with varimax rotations) per-
formed by Geller et al. (1981-1982) generat-
ed a three-factor solution to the TES, with
each factor seen as representing a distinct
form of representation (cf. Horowitz, 1983).
In the present study, one item from the 12-
item scale was removed prior to data
analyses, since that item had failed to load
onto any factor in Geller et al.’s original
analysis. However, the one item that was
shown by Geller et al. to load onto two fac-
tors was retained, given the exploratory
nature of the present study and the fact
that overlap between the two factors was
statistically controlled in the data analyses.
The first factor (Imagistic) contains five
items that assess the extent to which
patients’ use perceptual (visual, auditory)
imagery in imagining the therapist in his or
her absence (e.g., “I picture a specific
continued on page 39
expression on my therapist’s face”; “I imag-
ine a particular quality to the sound of my
therapist’s voice”). Patients with high scores
on this factor are especially able to schemat-
ically represent the nonverbal aspects of
therapy sessions. The second factor
(Enactive) contains three items and reflects
experiences that are kinesthetically or pro-
prioceptively felt rather than cognitively
experienced (e.g., “I experience myself in
certain bodily sensations”; “I am aware of a
particular emotional atmosphere which
gives me the sense that my therapist is ‘with
me’”). The third factor (Conversational-
Conceptual) contains three items and
reflects the degree to which the therapist
representation takes the form of abstract
ideas or concepts that comprise the lan-
guage of the therapeutic interaction (e.g., “I
think of specific comments my therapist has
made to me”). In addition to assessing the
formal properties of representations (per the
factors), the TES also provides a measure of
the overall vividness of the representation’s
manifest configuration (per the overall
score) (Geller et al., 1981-1982).
The Parent Embodiment Scale-Pleasant (PES-
p) and Unpleasant (PES-u). The PES-p and
PES-u are companion pieces to the TES;
they are identical to the TES, but differ in
that they are administered following the
subject’s recall of either a pleasant memory
of their relationship with a parent, or an
unpleasant memory of their relationship
with a parent (“Please reflect on a specific
pleasant/unpleasant memory of your rela-
tionship with either your mother or your
father from your early childhood. Imagine
and relive this incident in as much detail as
possible: Try to remember thoughts, feel-
ings, and sensations”). The items of the
PES-p and PES-u are identical to those of
the TES, except that the words “my thera-
pist” are replaced with “him or her” (refer-
ring to the parent being imagined). Like
the TES, the PES-p and the PES-u assess
both the formal properties and overall
vividness of patients’ internal representa-
tions of their parents.
Results
Overall Scale and Factor Reliability
Given that one of the goals of this research
was to understand how the “good parent”
and the “bad parent” are represented in the
minds of patients (since the TES has never
been used for anyone other than thera-
pists), the factor structures of the TES, PES-
p, and PES-u were examined. As can be
seen in Table 1, moderate reliability was
obtained for the overall scales and most of
the scale factors. The average reliability for
the Imagistic factor across all three scales is
.63; the average reliabilities for the Enactive
and Conversational-Conceptual factors are
.47 and .49, respectively. The moderate reli-
ability of the both the scales overall and the
factors supports their use in the data analy-
ses that follow.
Descriptive Data and Comparisons Among
Overall Scale and Factor Means
As an initial step in the data analysis, the
overall and factor means on the TES, PES-
p, and PES-u were computed. As can be
seen in Table 2, based on the nine-point rat-
ing scale, the means for the Imagistic and
Conversational-Conceptual scores on the
TES fell between designations for “slightly
typical” and “moderately typical,” and the
mean for the Enactive scores on the TES fell
between “not at all typical” and “slightly
typical.” The means for all three factor
scores on both the PES-p and the PES-u all
fell around “moderately typical.” The
overall mean for the TES fell around
“slightly typical,” whereas the overall
means for the PES-p and PES-u fell around
“moderately typical” on the nine point
scale. Examination of the average item
factor means (adjusted means) indicates
that whereas for the PES-p and PES-u, the
Imagistic factor has the highest mean
of the three factors, for the TES, the
Conversational-Conceptual factor has the
highest mean.
In order to determine if there were
detectable patterns of patients’ tendency to
represent their therapist, their “good par-
continued on page 40
39
ent,” and their “bad parent” in particular
forms, a repeated measures test was con-
ducted. As indicated in Table 2, the extent to
which patients’ representations were imagis-
tic in nature differed significantly depending
on the target figure. Specifically, patients
tended to represent their therapist less imag-
istically than either parent, and to represent
their “good parent” less imagistically than
their “bad parent.” The extent to which
patients’ representations were enactive in
nature also differed significantly depending
on the target figure, with patients tending to
experience their therapists less as a “felt”
part of themselves than either their “good”
or “bad parent.” There were no significant
differences in the extent to which patients
tended to represent their therapists, “good,”
and “bad parents” in conversational-concep-
tual form. In terms of the overall vividness
of representation, patients’ representations
of their therapists were significantly less
vivid than their representations of either the
“good” or the “bad parent.”
Relationship Among Factors
In order to determine whether there were
predictive relationships among the factors of
the three scales, a multivariate analysis of
variance was conducted. As can be seen in
Table 3, the results indicate that higher PES-
u Imagistic scores significantly predicted
higher TES Conversational-Conceptual
scores (l = .372, p = .016; b = .648, p = .005),
and that higher PES-u Enactive scores pre-
dicted higher TES Conversational-
Conceptual scores (l = .451, p = .040; b = .527,
p = .016). That is, the more patients tended to
represent their “bad parent” imagistically
and/or enactively, the more they tended to
represent their therapist in conversational-
conceptual terms. A marginally significant
finding was that higher PES-p Imagistic
scores predicted lower TES Conversational-
Conceptual scores (l = .483, p = .055; b = -
.658, p = .011). In other words, the more
patients tended to represent their “good par-
ent” imagistically, the less they tended to
represent their therapist in conversational-
conceptual terms. No other significant rela-
tionships among the factors were found.
40
Overall Vividness of Representations
To determine whether the overall vivid-
ness of either parental representation
(“good” or “bad”) predicted the overall
vividness of the therapist representation, a
regression analysis was performed. As can
be seen in Table 4, the results indicate that
the vividness of both parental representa-
tions significantly predicted the vividness
of therapist representations, but in oppo-
site directions. The more vivid the “bad
parent” representation, the more vivid the
therapist representation (b = .748, p = .014),
whereas the more vivid the “good parent”
representation, the less vivid the therapist
representation (b = -.792, p = .010).
Descriptive Data: Individual Items
An examination of the mean scores on the
items comprising the TES, PES-p, and PES-
u (see Table 5) indicates that patients typi-
cally use all three modalities (Imagistic,
Enactive, and Conversational-Conceptual)
to evoke representations of their therapists
and their parents following recall of both a
pleasant and unpleasant memory. As indi-
cated in Table 5, the items with the highest
mean scores on the TES were “I think of
specific comments my therapist has made
to me” (M = 5.05) and “My image of my
therapist is not tied to a specific time or
place (M = 4.30). The items with the high-
est mean scores on the PES-p were “I imag-
ine [my parent] in a particular place” (M =
6.70) and “I picture a specific expression on
[my parent’s] face” (M = 5.70). The items
with the highest mean scores on the PES-u
were “I imagine a particular quality to the
sound of [my parent’s] voice” (M = 6.85), “I
imagine [my parent] in a particular place”
(M = 6.65), and “I picture a specific expres-
sion on [my parent’s] face” (M = 6.65).
Discussion
Returning to the first research question,
which asked whether there are differences
in form and/or vividness between “good
parent”/“bad parent” representations and
therapist representations, the findings sug-
continued on page 41
gest that indeed, there are such differences.
One, patients tend to think of their parents
significantly more in the form of images
and “felt” sensations than they do their
therapist, and two, patients’ representa-
tions of both the “good” and “bad parent”
were significantly more vivid overall than
therapist representations. Furthermore,
with respect to the question of the relation-
ships among the different forms of repre-
sentation used for the different target fig-
ures, the results yielded a third finding that
the more patients tend to represent their
“bad parent” in the form of images or
“felt” sensations, the more they tend to
represent their therapist in the form of real
or imagined dialogues. Finally, with
respect to the question of whether there are
differences in form between representa-
tions of the “good parent” and representa-
tions of the “bad parent,” it was found that
patients tend to think of their “bad parent”
significantly more in the form of images
than they do their “good parent.”
The first finding—that therapists, as com-
pared to parents, tend to be represented less
in the form of images and “felt sensations,”
but not less in the form of dialogues—seems
to make intuitive sense, given that the pri-
mary activity of therapy is talking.
Furthermore, Honig et al.’s (1997) reason-
ing—that patients, who have known their
therapists for considerably less time than
their parents, cannot develop as realistically
complex, differentiated representations of
their therapists—may also be applicable
here: given that the therapist is a relatively
new figure in the patient’s life, their repre-
sentation in the patient’s mind is indeed
likely to be less vivid in terms of images, felt
sensations, and overall.
One way to understand the second find-
ing—that the more vivid the “bad parent”
representation, the more vivid the thera-
pist representation, but the more vivid the
“good parent” representation, the less
vivid the therapist representation—is that
the therapist representation is more iso-
morphic with the “bad parent” representa-
tion than the “good parent” representation.
The more vividly the “bad parent” is expe-
rienced, the more the work of therapy is
catalyzed. An intense negative representa-
tion of a parent translates to a more intense
representation of the therapist (positive or
negative, or a mixture), whereas an intense
positive representation of a parent does not
translate to an intense representation of the
therapist; in fact, it appears to dilute it, or
make it less intense. Perhaps having partic-
ularly intense images of the “bad parent”
leads the patient to characteristically cope
with new figures or situations by being
vigilant (i.e., using all their sensory chan-
nels to obtain information). The more vivid
the “badness” of the parent, then, the more
vigilant the patient must be in order to
cope with the expectation of more “bad-
ness” from other figures (e.g., the thera-
pist). Their senses are operative in order to
cope with expected “badness.” This phe-
nomenon may simply not occur in the
presence of vivid feelings of “goodness.”
The somewhat more subtle third finding—
that the more patients tend to represent
their “bad parent” in the form of images or
“felt” sensations, the more they tend to
represent their therapist in the form of real
or imagined dialogues—seems to suggest
that there is something about the (affec-
tively-charged) images and (relatively
unformulated) enactive modes that are
translating to the therapeutic dialogue.
Again, this supposition is fairly intuitive,
given that the reason for going to therapy
is to work out, through talking, the “bad”
stuff from one’s relationship with one’s
parent, not the “good” stuff. That a high
degree of imagistically and experientially-
felt “badness” corresponds with greater
lexical involvement with the therapist may
simply suggest that the patient really is
using the lexical mode to work though
theretofore unformulated “badness.”
However, such use of therapy may also be
defensive in nature, or may not allow the
patient to make full use of the therapist
continued on page 42
41
either as a transferential figure or as a facili-
tator of multi-modal experience (Horowitz,
1983). The question is: are the strongly-expe-
rienced images and felt sensations being too
much translated into words in therapy? (i.e.,
is there “an avoidance of image associations
to contents expressed in words,” or “an inat-
tention to dim or fleeting image episodes”
[p. 289], as Horowitz noted)? Is defensive
intellectualization, in which ideas emerge
without continuity with other ideas and feel-
ings, taking place? If so, we as clinicians
might want to be attentive to the ways in
which vivid (affectively-charged) imagery
or diffuse bodily sensations associated with
the “bad parent” may be getting dissociated
somehow, substituted with language in the
therapeutic dialogue. If the therapist or the
therapeutic situation is represented only or
primarily in lexical terms (and not imagisti-
cally or as a “felt” part of the patient), we
might worry that the therapist as a “healing
figure” or “good object” is not being fully
internalized (that is, the therapist is only
being internalized in one particular form).
When we think of “working through” the
patient’s problems “in the transference,” are
we not assuming that the patient is fully
reexperiencing the parent in the therapist?
The findings of this study suggest that
patients may not be experiencing their ther-
apist as fully as they do either their “good”
or their “bad parent”—they are only per-
haps reexperiencing the therapist on one
level, the lexical one. Their thoughts and
feelings about their therapist may be more
formulated and coherent (lexical), but the
less formulated aspects (images, felt experi-
ences) of the transference may not be taking
hold in the therapy. If indeed one of our
goals as clinicians is to help patients “work
through” relational problems through the
transference, we may need to think about
helping patients access and navigate less
formulated modes of thought (imagistic
and enactive), evoking these modes in ther-
apy such that the patient has access to them
and can bring them to bear upon the thera-
pist him- or herself.
42
The final finding, that patients tend to
think of their “bad parent” significantly
more in the form of images than they do
their “good parent,” may in fact be the
most interesting aspect of this study. It is,
in a sense, the ‘purest’ finding, in that a
comparison is drawn between split repre-
sentations of the same person. If the ther-
apist understands how (especially nega-
tive) representations are being experi-
enced by the patient, he or she might seek
to make interventions commensurate with
the representational properties that com-
prise them. For example, if we know that
the “bad parent” is experienced most
vividly in terms of the quality of his or her
voice, we might ask the patient, “What
did he or she sound like?” in order to
evoke the representation and its attendant
emotions most fully. Such data adds to
our body of knowledge about the ways in
which individuals represent significant
others in the mind; they suggest that dif-
ferently valenced representations may be
encoded differently, which can enable the
therapist to understand how to work dif-
ferentially with them in therapy.
One limitation of the present study is the
small sample size, which limits the gener-
alizability of the findings. In addition, the
splitting of parent representations into
“good” and “bad,” but not splitting thera-
pist representations in a likewise fashion,
may present various conceptual problems.
Still, given that the aim of this exploratory
research was to begin to elucidate the rela-
tionship between therapist and parent rep-
resentations, and to apply the TES to par-
ent representations, the results suggest that
further investigations in this area are not
only warranted but potentially of great
clinical utility.
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Table 1
Reliability Coefficients of Scale Overall and Factor Scores; Averaged Factor Reliabilities
TES PES-p PES-u Average
Imagistic (F1) .54 .66 .68 .63
Enactive (F2) .10 .68 .64 .47
Conversational-Conceptual (F3) .42 .61 .44 .49
Overall .55 .65 .55 -

Table 2
Means and Standard Deviations of Factor and Overall Scores: Differences Between the TES,
PES-p, and PES-u
TES PES-p PES-u
Factor and Overall M SD Adj. M M SD Adj. M M SD Adj. M F
Imagistic (F1) 19.10a 7.9 (3.82) 25.95b 9.1 (5.19) 28.90 8.8 (5.78) 6.846*
Enactive (F2) 6.45a 3.5 (2.15) 14.15 6.6 (4.72) 13.55 7.0 (4.52) 13.236**
Conv-Conc (F3) 16.90 6.7 (4.23) 16.45 7.7 (4.11) 18.70 6.8 (4.68) .666
Overall 38.35a 11.8 (3.49) 51.05 14.5 (4.64) 54.30 13.3 (4.94) 10.978**

Notes. The TES, PES-p, and PES-u scales were scored on a 9-point basis (1 = not at all typical; 9 = highly
typical); adjusted means reflect average item means. N = 20 in all cases except PES-p Imagistic (F1) and PES-p
Overall (N = 19).
a
Significantly different than PES-p and PES-u (p < .05). b Significantly different than PES-u (p < .05).
* p < .01. ** p < .001.

Table 3
Multivariate Analysis of Variance
TES Imagistic (F1) TES Enactive (F2) TES Conv-Conc (F3)
β β β
PES-p Imagistic (F1) -.208 -.071 -.658a
PES-p Enactive (F2) -.046 -.197 -.029
PES-p Conv-Conc (F3) -.140 -.021 -.114
PES-u Imagistic (F1) -.050 .017 .648**
PES-u Enactive (F2) .392 .304 .527*
PES-u Conv-Conc (F3) .118 .045 .129
Note. Wilks’ Lambda (λ) for PES-u Imagistic (F1) = .372, p = .016; for PES-u Enactive (F2) =
.451, p = .040; for PES-p Imagistic (F1) = .483, p = .055.
a
approaching significance
* p < .05. ** p < .01. continued on page 45
44
Table 4
Regression Analysis for Variables Predicting Vividness of Therapist Representations
Vividness of Therapist Representation
B SE B β
Vividness of Pleasant Parent Representation -.648 .223 -.792*
Vividness of Unpleasant Parent Representation .654 .238 .748*
Note. R2 = .37 (p = .02).
* p = .01

Table 5
TES, PES-p, PES-u Item Endorsement Comparison
TES PES-p PES-u
Item M SD M SD M SD
Factor 1: Imagistic Mode
1. I imagine my therapist (parent) in his/her office
(a particular place) 4.25 3.09 6.70 a 2.85 6.65 b 2.74
2. I picture a specific expression on my therapist’s
(parent’s) face 4.25 2.63 5.70 b 2.52 6.65 b 2.60
3. I see my therapist (parent) gesturing 2.50 2.06 3.95 2.76 5.85 2.83
5. I imagine my therapist (parent) dressed in a certain way 4.00 2.36 4.40 2.78 2.90 2.67
6. I imagine a particular quality to the sound of
my therapist’s (parent’s) voice 4.10 2.99 5.20 2.93 6.85 a 2.43
Factor 2: Enactive Mode
8. I experience myself in certain bodily sensations 2.10 2.00 4.00 2.79 5.75 2.84
10. I imagine myself in physical contact with my
therapist (parent) 1.40 .99 4.95 3.05 3.75 3.04
11. I am aware of a particular emotional atmosphere which
gives me the sense that my therapist (parent) is “with me” 2.95 2.50 5.20 2.53 4.05 3.32
Factor 3: Conversational-Conceptual Mode
4. I imagine just my therapist’s (parent’s) head and face 3.45 2.50 3.85 2.81 3.60 3.08
6. I imagine a particular quality to the sound of my
therapist’s (parent’s) voice 4.10 2.99 5.20 2.93 6.85 a 2.43
7. I think of specific comments my therapist (parent)
has made to me 5.05 a 2.39 4.05 2.76 4.95 2.78
9. My image of my therapist (parent) is not tied to a
specific time or place 4.30 b 3.18 3.35 2.78 3.30 2.77
a
Indicates highest-rated item on scale. b Indicates second-highest-rated item on scale.

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 CONGRATULATIONS TO OUR AWARD WINNERS!

Distinguished Psychologist Award for Contributions to Psychology and

Psychotherapy: The Distinguished Psychologist Award is based on significance
of contributions to the practice, research, and/or training in psychotherapy. The
2007 award is made to Gary R VandenBos, Ph.D. and Carol D Goodheart, Ph.D.

American Psychological Foundation Division of Psychotherapy Early Career

Award is awarded for the first time in 2007, to Michael J. Constantino, Ph.D.

Please join us in celebrating our award winners at the Division 29 Award and
Recognition Hour, Friday, August 17th at 5:00 pm, San Francisco Marriott Hotel,
Golden Gate Salons B1 and B2, to be followed immediately by the Division 29
Social Hour.

ATTENTION GRADUATE STUDENTS AND EARLY

CAREER PROFESSIONALS

You are invited to

“Lunch with the Masters:
For New Professionals Interested in Psychotherapy”
The APA Convention in San Francisco
Saturday, August 18, 2007, 12:00 PM – 1:50 PM
San Francisco Marriott Hotel, Nob Hill Rooms A and B

Come join Drs. Laura Brown, Jean Carter, Beverly Greene,

Theodore Millon and others for lunch and conversation.
No RSVP needed, but please feel free to contact Dr. Libby Nutt Williams
(enwilliams@smcm.edu) for additional information.
Come find out more about Division 29 and invite others to come as well!

You do not need to be a member of Division 29 to attend, but we will have a

special membership deal for graduate students and early career professionals
who do want to join Division 29.

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 N O F P S Y C H O THE
O
THE DIVISION OF PSYCHOTHERAPY

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D I V I SI
29 The only APA division solely dedicated to advancing psychotherapy

ASSN.
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M E M B E R S H I P APPLICATION
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Division 29 meets the unique needs of psychologists interested in psychotherapy.
By joining the Division of Psychotherapy,you become part of a family of practitioners,scholars,and students who exchange ideas in order to advance psychotherapy.
Division 29 is comprised of psychologists and students who are interested in psychotherapy. Although Division 29 is a division of the American Psychological
Association (APA),APA membership is not required for membership in the Division.
JOIN DIVISION 29 AND GET THESE BENEFITS!
FREE SUBSCRIPTIONS TO: DIVISION 29 INITIATIVES
Psychotherapy Profit from Division 29 initiatives such as the
This quarterly journal features up-to-date APA Psychotherapy Videotape Series, History
articles on psychotherapy. Contributors of Psychotherapy book, and Psychotherapy
include researchers, practitioners, and Relationships that Work.
educators with diverse approaches.
Psychotherapy Bulletin NETWORKING & REFERRAL SOURCES
Quarterly newsletter contains the latest news Connect with other psychotherapists so that
about division activities, helpful articles on you may network, make or receive referrals,
training, research, and practice. Available to and hear the latest important information that
members only. affects the profession.

EARN CE CREDITS OPPORTUNITIES FOR LEADERSHIP

Journal Learning Expand your influence and contributions.
You can earn Continuing Education (CE) cred- Join us in helping to shape the direction of our
it from the comfort of your home or office — chosen field. There are many opportunities to
at your own pace — when it’s convenient for serve on a wide range of Division committees
you. Members earn CE credit by reading and task forces.
specific articles published in Psychotherapy
and completing quizzes. DIVISION 29 LISTSERV
As a member, you have access to our Division
DIVISION 29 PROGRAMS listserv, where you can exchange information
We offer exceptional programs at the APA with other professionals.
convention featuring leaders in the field of
psychotherapy. Learn from the experts in
personal settings and earn CE credits at VISIT OUR WEBSITE
reduced rates. www.divisionofpsychotherapy.org

MEMBERSHIP REQUIREMENTS: Doctorate in psychology • Payment of dues • Interest in advancing psychotherapy

Name _________________________________________________ Degree ______________________

Address _____________________________________________________________________________
City __________________________________________ State __________ ZIP ________________
Phone ____________________________________ FAX ____________________________________
Email _______________________________________________________
If APA member, please
Member Type: 䡵 Regular 䡵 Fellow 䡵 Associate provide membership #
䡵 Non-APA Psychologist Affiliate 䡵 Student ($29)
䡵 Check 䡵 Visa 䡵 MasterCard
Card # _______________________________________________ Exp Date _____/_____

Signature ___________________________________________
Please return the completed application along with payment of $40 by credit card or check to:
Division 29 Central Office, 6557 E. Riverdale St., Mesa, AZ 85215
You can also join the Division online at: www.divisionofpsychotherapy.org
 PUBLICATIONS BOARD EDITORS
Raymond A. DiGiuseppe, Ph.D., 2003-2008 Psychotherapy Journal Editor
Psychology Department Charles Gelso, Ph.D., 2005-2009
St John’s University University of Maryland
8000 Utopia Pkwy Dept of Psychology
Jamaica , NY 11439 Biology-Psychology Building
Ofc: 718-990-1955 College Park, MD 20742-4411
DiGiuser@STJOHNS.edu Ofc: 301-405-5909 Fax: 301-314-9566
Gelso@psyc.umd.edu
John C. Norcross, Ph.D., 2002-2008
Department of Psychology Psychotherapy Bulletin Editor
University of Scranton Craig N. Shealy, Ph.D., 2007-2009
Scranton, PA 18510-4596 International Beliefs and Values Institute (IBAVI)
Ofc: 570-941-7638 Fax: 570-941-7899 James Madison University
E-mail: norcross@scranton.edu MSC 2802, 1241 Paul Street
Harrisonburg, VA 22807
Lillian Comas-Diaz, Ph.D., 2002-2007 Phone: 540-568-6835 Fax: 540-568-4232
Transcultural Mental Health Institute E-Mail: shealycn@jmu.edu
908 New Hampshire Ave. N.W., #700
Washington, D.C. 20037 Psychotherapy Bulletin Associate Editor
cultura@erols.com Harriet C. Cobb, Ed.D.
Combined-Integrated Doctoral Program in
Nadine Kaslow, Ph.D., 2006-2011 Clinical/School Psychology
Grady Hospital MSC 7401
Emory Dept. of Psychiatry James Madison University
80 Jesse Hill Jr. Dr. Harrisonburg, VA 22807
Atlanta, GA 30303 Ofc: 540-568-6834
Ofc: 404-616-4757 Fax: 404-616-2898 cobbhc@jmu.edu
Email: nkaslow@emory.edu
Internet Editor
George Stricker, Ph.D., 2003-2008 Bryan S. K. Kim, Ph.D. 2005-2007
Argosy University/Washington DC Department of Psychology
1550 Wilson Blvd., #610 University of Hawaii at Hilo
Arlington, VA 22209 200 W. Kawili Street
Ofc: 703-247-2199 Fax: 301-598-2436 Hilo, Hawaii 96720-4091
E-mail: geostricker@comcast.net Ofc: 808-974-7460 Fax: 808-974-7737
E-mail: bryankim@hawaii.edu
Beverly Greene, Ph.D., 2007-2012
Psychology Student Website Coordinator
St John’s Univ Nisha Nayak
8000 Utopia Pkwy University of Houston
Jamaica , NY 11439 Dept of Psychology (MS 5022)
Ofc: 718-638-6451 126 Heyne Building
E-mail: bgreene203@aol.com Houston, TX 77204-5022
Ofc: 713-743-8600 or -8611 Fax: 713-743-8633
nnayak@uh.edu

PSYCHOTHERAPY BULLETIN
Psychotherapy Bulletin is the official newsletter of Division 29 (Psychotherapy) of the American Psychological
Association. Published four times each year (spring, summer, fall, winter), Psychotherapy Bulletin is designed to:
1) inform the membership of Division 29 about relevant events, awards, and professional opportunities; 2) provide
articles and commentary regarding the range of issues that are of interest to psychotherapy theorists, researchers,
practitioners, and trainers; 3) establish a forum for students and new members to offer their contributions; and,
4) facilitate opportunities for dialogue and collaboration among the diverse members of our association.

Contributors are invited to send articles (up to 4,000 words), interviews, commentaries, letters to the editor,
and announcements to Craig N. Shealy, Ph.D., Editor, Psychotherapy Bulletin. Please note that Psychotherapy
Bulletin does not publish book reviews (these are published in Psychotherapy, the official journal of Division
29). All submissions for Psychotherapy Bulletin should be sent electronically to assnmgmt1@cox.net with the
subject header line Psychotherapy Bulletin; please ensure that articles conform to APA style. Deadlines for
submission are as follows: February 1 (spring), May 1 (summer), July 1 (fall), November 1 (winter). Past issues
of Psychotherapy Bulletin may be viewed at our website: www.divisionofpsychotherapy.org. Other inquiries
regarding Psychotherapy Bulletin (e.g., advertising) or Division 29 should be directed to Tracey Martin at the
Division 29 Central Office (assnmgmt1@cox.net or 602-363-9211).

DIVISION OF PSYCHOTHERAPY (29)

Central Office, 6557 E. Riverdale Street, Mesa, AZ 85215
Ofc: (602) 363-9211 • Fax: (480) 854-8966 • E-mail: assnmgmt1@cox.net
www.divisionofpsychotherapy.org
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N O F P S Y C H O THE

American Psychological Association

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6557 E. Riverdale
Mesa, AZ 85215
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