Money Matters in Psychiatric Assessment, Case Formulation, Treatment Planning, and Ongoing Psychotherapy: Clinical Psychoeconomics.

ABSTRACT: Trainees often receive little guidance concerning money matters in patients' lives and treatment, that is, clinical psycho-economics. Accordingly, this article considers: a) practical approaches to inquiring about intrapsychic and interpersonal influences of money matters pertinent to psychiatric assessment; b) how money matters should impact case formulation; c) how money matters realistically impact treatment planning; and d) money matters in ongoing psychotherapy affecting transference, countertransference, and clinical supervision. To supplement their clinical experiences, the authors conducted a limited narrative review via PubMed, followed by snowballing for articles of interest. Evidence suggests that money matters influencing intrapsychic and interpersonal lives commonly cause emotional distress, generating a range of dysfunctional behaviors. These reactions manifest as explicit conflicts, implicit issues, and unequivocal money-related pathologies. Clinical vignettes illustrate specific issues. By explicitly addressing money matters in patient's intrapsychic and interpersonal lives, trainees can enrich their assessments, case formulations, treatment planning, and ongoing psychotherapy.

Individual analysis: a failure or a shared experience of social justice.

The process of Jungian analysis is reviewed and considered as inexorably intertwined with our lives in society and with aspects of our social interactions that long for interpersonal and restorative justice. Various models are reviewed, including Fanon, Gambini, Kimbles, Levine, Saban - each with an eye toward Jung's injunction that we must move beyond 'knowledge' toward 'eating and digesting', thereby metabolizing and shifting our way of living. Dissociated aspects of the analytic couple are discussed, both as represented by and articulating transgenerational issues, phantoms, and as presented in often neglected aspects of embodiment. Jeremy Harris's Slave Play is offered as an amplification of ubiquitous and unacknowledged transgenerational presences in our analytic interactions. Clinical examples explore countertransference aspects that illustrate Jung's challenge, such as an unwitting prejudice toward analysis as equalling transformation and integrating resolution, or toward analysis as leaving unexamined the presumptions of class structures and privilege. A personal dream is offered to illustrate a necessary reorientation of the analyst's ego toward an attitude in which rebirth comes only in and through interaction with the collective. It is argued that only with such interaction, which manifests movement toward social justice, is there an efficacious analysis.

L'article examine le processus de l'analyse Jungienne et le considère comme entremêlé inexorablement avec nos vies dans la société et les aspects de nos interactions sociales qui désirent ardemment une justice interpersonnelle et réparatrice. Plusieurs modèles sont examinés, entre autres Fanon, Gambini, Kimbles, Levine, Saban - chacun dans la perspective de l'injonction de Jung que nous devons avancer au-delà du « savoir ¼ et vers « manger et digérer ¼ - métabolisant et de ce fait décalant notre façon de vivre. Les aspects dissociés du couple analytique sont examinés, représentés par les questions et fantômes transgénérationnels et articulant ces mêmes questions. Mais aussi comme présents dans des aspects d'incarnation souvent négligés. La pièce de théâtre Slave Play de Jeremy Harris est donnée comme une amplification des présences transgénérationnelles non-reconnues mais omniprésentes dans nos interactions analytiques. Des exemples cliniques explorent les aspects contre-transférentiels qui illustrent le défi de Jung, tels qu'un préjugé non intentionnel; de considérer que l'analyse égalise la transformation et va vers une résolution qui intègre, ou bien d'envisager l'analyse comme laissant non examinées les présomptions de structures de classe et les privilèges. Un rêve personnel est donné comme illustration de la nécessaire réorientation du moi de l'analyste vers une attitude dans laquelle la renaissance arrive seulement dans et à travers l'interaction avec le collectif. Il est soutenu que c'est seulement avec une telle interaction, qui montre le mouvement vers la justice sociale, qu'une analyse efficace est possible.

Se revisa y considera el proceso de análisis Junguiano en su interconexión inexorable con nuestra vida en sociedad y con aspectos de nuestras interacciones sociales que anhelan por una justicia interpersonal reparadora. Se revisan varios modelos, incluyendo a Fanon, Gambini, Kimbles, Levine, Saban - cada uno con la mirada puesta sobre el mandato de Jung acerca de que debemos movernos más allá del 'conocimiento' hacia 'el comer y la digestión' - metabolizando y por lo tanto modificando nuestra forma de vida. Se discuten los aspectos disociados de la pareja analítica, tanto al ser representados, como a través de su articulación con cuestiones transgeneracionales, fantasmas, y al presentarse en aspectos a menudo negados del cuerpo. La obra teatral Slave Play de Jeremy Harris es ofrecida como amplificación de presencias transgeneracionales no reconocidas y omnipresentes en nuestras interacciones en el análisis. Ejemplos clínicos exploran aspectos de la contratransferencia que ilustran el desafío de Jung, como el prejuicio involuntario hacia el análisis como equivalente de una resolución transformadora e integradora, o hacia el análisis que deja sin examinar los supuestos basados en estructura y privilegios de clase. Se ofrece un sueño personal como ilustración de una reorientación necesaria del ego del analista hacia una actitud en la cual el renacer puede suceder solamente en y a través de la interacción con lo colectivo. Se argumenta que solamente junto a esta interacción, la cual manifiesta movimientos hacia la justicia social, puede haber un análisis eficaz.

O processo de análise junguiana é revisado e considerado como inexoravelmente entrelaçado com nossas vidas na sociedade e aspectos de nossas interações sociais que anseiam por justiça interpessoal e restauradora. Vários modelos são revisados, incluindo Fanon, Gambini, Kimbles, Levine, Saban - cada um com um olhar na determinação de Jung de que devemos ir além do "conhecimento" em direção a "comer e digerir" - metabolizando e, assim, mudar nosso modo de viver. Aspectos dissociados do casal analítico são discutidos, tanto como representados e articulando questões transgeracionais, fantasmas, quanto como apresentados em aspectos frequentemente negligenciados da representação. Slave Play de Jeremy Harris é oferecido como uma amplificação de presenças transgeracionais onipresentes e não reconhecidas em nossas interações analíticas. Exemplos clínicos exploram aspectos de contratransferência que ilustram o desafio de Jung, como um preconceito involuntário em relação à análise como igualar transformação e integração de resolução, ou em relação à análise, como deixar inexaminadas, as presunções de estruturas de classe e privilégios. Um sonho pessoal é oferecido na ilustração de uma reorientação necessária do ego do analista em direção a uma atitude em que o renascimento entra apenas e através da interação com o coletivo. Argumenta-se que somente com essa interação, que manifesta movimento em direção à justiça social, há uma análise eficaz.

The Phenomenology and Dynamics of Wealth Shame: Between Moral Responsibility and Moral Masochism.

In an age of striking inequality in wealth, a related phenomenon, wealth shame, has developed. A multidisciplinary exploration of such shame examines its intrapsychic, intersubjective, transgenerational, and sociopolitical roots in the U.S., as well as its multiple functions: as an ethical response to economic disparity (moral responsibility), as a manifestation of a pervasive shame pattern (moral masochism), and as a defense against pleasure, feelings of superiority, and the fear of being envied. Several clinical vignettes illustrate these themes and are followed by reflections on their clinical implications. The psychoanalytic community's conflicted relationship to social class, money, and wealth is also examined. This conflictedness may inform the analyst's countertransference to wealth shame and his or her ability to appreciate the psychic landscapes of class as they present in the consulting room.

Augmenting Psychiatric Risk Management: Practical Applications of Transference- Focused Psychotherapy (TFP) Principles.

Risk management challenges in psychiatry are made more complicated when they involve the treatment of patients with primary or co-occurring personality disorder pathology. Principles of transference-focused psychotherapy (TFP), a treatment empirically validated for borderline personality disorder (BPD) and with utility for patients with varying personality disorder presentations, are practical, commonsense measures that can guide clinicians in these difficult matters. Applied TFP principles are useful in this area even when clinicians are not engaged in an extended individual psychotherapy. Central to the TFP approach are: (1) an openness to identifying personality disorder pathology; (2) a deliberate process to assess personality disorder diagnoses with attention to severity of illness; (3) an emphasis on the informed consent process, which includes sharing fully with the patient the clinician's diagnostic impression with germane psychoeducation; (4) an expectation for timely contacts at the outset of treatment with prior practitioners and with family members, when indicated; and (5) the development and maintenance of a treatment frame. TFP stresses the active monitoring of three channels of communication (what the patient says, how the patient behaves, and the clinician's countertransference) as a guiding precept that informs clinical decision-making. TFP principles can serve as a useful risk management "checklist" by organizing a clinician's approach to inherently confounding material.

Countertransference and Psychological Assessment: Direct and Indirect Exposure.

Countertransference (CT) is usually conceptualized as emerging in the course of psychotherapy. This study explores whether CT manifests itself in the context of assessment and if the modality of exposure to participants (interviewer and observer) affects the intensity and nature of CT. Evaluators either led (direct exposure) or observed (indirect exposure) a 6-hour interview with a subject focusing on attachment and personality. Interviewers and evaluators then completed a measure of CT, the Therapist Response Questionnaire for a total of 43 subjects. Results show significant CT reactions for both interviewers and observers that were globally as intense in both conditions, although lower positive/satisfying and helpless/inadequate CTs were reported by observers. Moreover, intraclass correlations suggest that interviewers' and observers' CT reactions toward the same interviewee show an important degree of similarity. These results highlight the presence of CT in assessment contexts and support the existence of an objective part to CT reactions.

Supervisory countertransferences and impingements in evaluating readiness for graduation: Always present, routinely under-recognized.

Utilizing detailed, in-depth material from supervisory hours from around the world (explored in End of Training Evaluation groups), this paper shows that supervisors are subject to multiple, diverse and, at times, ongoing intense countertransferences and impingements on their ability to evaluate candidates' progress. Multiple external and internal sources of these impingements are explored. It is suggested that supervisory countertransferences and their manifestation in parallel enactments remain under-recognized, their impact underappreciated, and the information they contain underutilized. It is argued that the recognition, containment, and effective use of the parallel process phenomena and supervisory countertransferences are essential in order to evaluate candidates' progression and readiness to graduate. Common signals of such entanglements in the supervisor's evaluative function are identified. Three remedies, each of which provides a 'third,' are offered to assist supervisors in making effective use of their countertransference: self-supervision, consultation, and institutional correctives.

Translation and cross-cultural adaptation of the Rating Scale for Countertransference (RSCT) to American English / Tradução e adaptação transcultural da Escala para Avaliação de Contratransferência para a língua inglesa americana

Abstract Introduction: The Rating Scale for Countertransference (RSCT) - originally, Escala para Avaliação de Contratransferência (EACT) - is a self-administered instrument comprising questions that assess 23 feelings (divided into three blocs, closeness, distance, and indifference) that access conscious countertransferential emotions and sentiments. This paper describes the process of translation and cross-cultural adaptation of the RSCT into American English. Methods: This study employed the guidelines proposed by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force for Translation and Cultural Adaptation which define 10 steps for translation and cross-cultural adaptation of self-report instruments. Additionally, semantic equivalence tools were employed to select the final versions of terms used. The author of the RSCT gave permission for translation and took part in the process. The instrument is available for use free of charge. Results: Analysis of the back-translation showed that just seven of the 23 terms needed to be adjusted to arrive at the final version in American English. Conclusions: This study applied rigorous standards to construct a version of the RSCT in American English. This version of the RSCT translated and adapted into American English should be of great use for accessing and researching countertransferential feelings that are part of psychodynamic treatment.

Resumo Introdução: A Escala para Avaliação de Contratransferência (EACT) é um instrumento autoaplicável composto por perguntas que avaliam 23 sentimentos (divididos em aproximação, em afastamento e em indiferença), que permite acessar os sentimentos contratransferenciais conscientes. Este trabalho descreve o processo de tradução e adaptação transcultural da EACT para a língua inglesa americana. Métodos: O presente estudo utilizou a diretriz por força-tarefa proposta pela International Society for Pharmacoeconomics and Outcomes Research (ISPOR) que realiza em 10 passos a tradução e a adaptação transcultural de instrumentos autoaplicáveis. Além disso, ferramentas de equivalência semântica foram utilizadas para selecionar a versão final dos termos. O autor da EACT autorizou e participou do processo de tradução. O instrumento está disponível para uso gratuito. Resultados: A avaliação da retrotradução mostrou que somente sete termos tiveram que ser ajustados para a realização da versão final na língua inglesa americana. Conclusão: O presente estudo construiu, segundo rígidos padrões, uma versão na língua inglesa americana da EACT. A versão traduzida e adaptada da EACT para a língua inglesa americana pode ser de grande utilidade para acessar e pesquisar sentimentos contratransferenciais que fazem parte do tratamento psicodinâmico.

Family Traditions, Cultural Values, and the Clinician's Countertransference: Therapeutic Assessment of a Young Sicilian Woman.

Despite recent advances in models and instruments to understand the role of a client's cultural background, clinical psychologists are not immune to implicit cultural biases that are potentially damaging to the therapeutic alliance. In this article, I present a Therapeutic Assessment with a young Sicilian woman conducted in a university-based student clinic in Italy. During the assessment, I assumed that because we were both Italians, my client shared my perspective (northern Italian) about family and individual values, which resulted in a therapeutic impasse when I responded on the basis of my individual and culturally shaped view of interpersonal and family relationships without appreciating important differences between my own and my client's microcultures. To overcome the impasse, I had to openly acknowledge such differences and reorient myself to my client's goals. I discuss the core processes involved in such a repair in the context of a cross-cultural psychological assessment.

Translation and cross-cultural adaptation of the Rating Scale for Countertransference (RSCT) to American English.

INTRODUCTION:: The Rating Scale for Countertransference (RSCT) - originally, Escala para Avaliação de Contratransferência (EACT) - is a self-administered instrument comprising questions that assess 23 feelings (divided into three blocs, closeness, distance, and indifference) that access conscious countertransferential emotions and sentiments. This paper describes the process of translation and cross-cultural adaptation of the RSCT into American English. METHODS:: This study employed the guidelines proposed by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force for Translation and Cultural Adaptation which define 10 steps for translation and cross-cultural adaptation of self-report instruments. Additionally, semantic equivalence tools were employed to select the final versions of terms used. The author of the RSCT gave permission for translation and took part in the process. The instrument is available for use free of charge. RESULTS:: Analysis of the back-translation showed that just seven of the 23 terms needed to be adjusted to arrive at the final version in American English. CONCLUSIONS:: This study applied rigorous standards to construct a version of the RSCT in American English. This version of the RSCT translated and adapted into American English should be of great use for accessing and researching countertransferential feelings that are part of psychodynamic treatment.

The Relationship between Theoretical Orientation and Countertransference Expectations: Implications for Ethical Dilemmas and Risk Management.

UNLABELLED: Countertransference (CT) awareness is widely considered valuable for differential diagnosis and the proactive management of ethical dilemmas. We predicted that the more practitioners' theoretical orientation (TO) emphasizes insight into the dynamics of subjective mental life, the better they will be at using their CT expectations in differential diagnosis with high-risk patients. To test this hypothesis, we compared psychodynamic therapy (PDT) practitioners who emphasize insight into subjective mental life with practitioners who do not emphasize this epistemology. Results indicated that PDT practitioners expected significantly more CT than practitioners of cognitive-behavioural therapy (CBT) and other practitioners (e.g., family systems, humanistic/existential and eclectic) to patients with borderline personality organization overall. PDT practitioners had significantly more CT expectations to patients with borderline-level pathologies as compared with neurotic-level patients than both CBT and other practitioners. PDT practitioners were significantly more expectant of CT issues than CBT practitioners with respect to the personality disorders most associated with acting out and risk management problems (e.g., paranoid, psychopathic, narcissistic, sadistic, sadomasochistic, masochistic, hypomanic, passive-aggressive, counterdependent and counterphobic). The other practitioners generally had CT expectations between PDT and CBT. These findings suggest that clinical training into CT may be useful in differential diagnoses and in helping to avoid ethical dilemmas regardless of one's theoretical preference. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Insight into countertransference can be used to help with differential diagnoses and to help prevent possible management problems with acting out patients. The Psychodynamic Diagnostic Manual is a useful taxonomy in that it includes countertransference as a diagnostic aid.

Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy.

OBJECTIVES: The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality. METHODOLOGY: This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers. Assessments of each patient-therapist pair were conducted between their fourth and 10th sessions. RESULTS: The CT distance domain exhibited a moderate negative correlation with TA, particularly its sub-dimension representing the patient's capacity for work in therapy. Moderate positive correlations were observed between CT distance and the splitting defense mechanism and between CT closeness and suppression defenses, in addition to moderate negative correlation between CT indifference and the fantasy defense mechanism. Another finding was higher scores for CT indifference in association with socioeconomic classes D and E. CONCLUSIONS: The quality of CT may provide a source of information about TA. A high degree of CT distance represents a low level of TA, particularly with relation to the patient's working capacity, although presence of the splitting defense mechanism can affect CT, to the extent that it constitutes a confounding variable. The concept of CT is useful to psychotherapists, providing a source of information about the patient's internal world and about certain elements of therapy, such as the quality of TA, which is important for good treatment results.

Human resources and their possible forensic meanings.

Forensics (forensic--before the Forum) means the application of knowledge from different scientific fields in order to define facts in judicial and/or administrative procedures. Nowadays forensics, besides this, finds its application even in different economic processes. For example, forensics enters the commercial areas of business intelligence and of different security areas. The European Commission recognized the importance of forensics, and underscored the importance of development of its scientific infrastructure in member States. We are witnessing the rise of various tragedies in economic and other kinds of processes. Undoubtedly, the world is increasingly exposed to various forms of threats whose occurrences regularly involve people. In this paper we are proposing the development of a new approach in the forensic assessment of the state of human resources. We are suggesting that in the focus should be the forensic approach in the psychological assessment of awareness of the individual and of the critical infrastructure sector operator (CISO) in determining the level of actual practical, rather than formal knowledge of an individual in a particular field of expertise, or in a specific scientific field, and possible forensic meanings.

Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy / Contratransferência e aliança terapêutica no início da psicoterapia psicodinâmica de adultos

Objectives:The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality.Methodology: This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers. Assessments of each patient-therapist pair were conducted between their fourth and 10th sessions.Results: The CT distance domain exhibited a moderate negative correlation with TA, particularly its sub-dimension representing the patient's capacity for work in therapy. Moderate positive correlations were observed between CT distance and the splitting defense mechanism and between CT closeness and suppression defenses, in addition to moderate negative correlation between CT indifference and the fantasy defense mechanism. Another finding was higher scores for CT indifference in association with socioeconomic classes D and E.Conclusions: The quality of CT may provide a source of information about TA. A high degree of CT distance represents a low level of TA, particularly with relation to the patient's working capacity, although presence of the splitting defense mechanism can affect CT, to the extent that it constitutes a confounding variable. The concept of CT is useful to psychotherapists, providing a source of information about the patient's internal world and about certain elements of therapy, such as the quality of TA, which is important for good treatment results.

Objetivos: O objetivo principal desta pesquisa foi avaliar a relação entre a contratransferência (CT) e a aliança terapêutica (AT) no início da psicoterapia psicodinâmica. O objetivo secundário é avaliar a associação da CT com as variáveis da dupla e da CT com as demais variáveis do paciente avaliadas, que foram os mecanismos de defesa, sintomatologia e funcionalidade.Metodologia:Trata-se de um estudo transversal com 30 pacientes do ambulatório de psicoterapia de dois serviços de psiquiatria, atendidos por 17 terapeutas. As avaliações ocorreram entre quarto e décimo encontros da dupla.Resultados:A dimensão da CT distância apresentou correlação negativa moderada com a AT, especialmente sua dimensão que representa a capacidade de trabalho em terapia do paciente. Foram verificadas correlações moderadas positivas entre CT distância e cisão e entre CT proximidade e supressão, além da correlação moderada negativa da CT indiferença com fantasia. Outro dado encontrado foi a presença de maiores níveis da CT indiferença diante de pacientes da classe socioeconômica D e E.Conclusões:A qualidade da CT pode servir de fonte de informações sobre a AT. A presença de alta CT que indica distância está relacionada a baixa AT, sobretudo em relação a capacidade de trabalho do paciente, ainda que a presença de cisão pode influenciar a CT, de forma que representa uma variável de confusão. A CT é um conceito útil ao psicoterapeuta, servindo como fonte de informações sobre o mundo interno do paciente e sobre elementos da psicoterapia, como a qualidade da AT, importante para os bons resultados dos tratamentos.

How Clinicians Feel about Working with Spouses of the Chronically Ill.

Clinicians who provide psychotherapy to spouses or partners of the chronically ill were solicited through listserves of psychodynamic and other organizations. The current report excluded those therapists working with spouses of dementia patients. Interviews were conducted with clinicians who responded. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of therapy patients. A comparison is drawn that shows both overlap and distinctions between the experiences of those therapists engaging with spouses of chronically ill patients without a dementing process and those working with spouses of chronically ill patients who do suffer from a dementing process.

["There can be no unnecessary risks"]. / « Il ne saurait y avoir de risque inutile ¼.

The psychoanalytical point of view regarding the notion of risks helps us to understand the concept of transference and counter transference. Practice analysis groups provide an opportunity for collective discussion and the sharing of experience of clinical situations. Interview with Didier Gauchy, a psychiatrist-psychoanalyst in Lyon.

Ethically optimal interventions with impaired patients.

It may be difficult to imagine having a severe impairment such as quadriplegia or being dependent on a respirator. There is evidence that when careproviders make treatment decisions for patients who are in these situations, we imagine the patients are worse-off than they report they are -- most patients with even very severe impairments report that they greatly value being alive. This misperception may cause us to make treatment decisions for patients with impairments that we might not make for other patients. In this article I describe how to provide better care for patients who have impairments. This includes not presupposing that the patients' quality of life is decreased, considering with patients how outside factors may be limiting their functioning, and seeking to help offset these factors, if we can, when they exist, to avoid allowing patients' impairments to result in their being truly "disabled".

Improving access in borderline therapy for difficult-to-engage patients: a clinical description.

Debate about suitability or clinicians' low expectations has led to patients with personality disorders being labeled as difficult and being socially excluded from pathways of care. Traditional psychotherapeutic treatments in borderline personality disorder demand too much of these patients' fractured ego structures for meaningful (long-term) therapeutic engagement. However, these patients cause clinicians anxiety and are a burden in health care systems. This article describes the challenge for clinical care teams working in partnership arrangements-psychotherapy and psychiatry services-to provide a containing framework of care. Early access to a pragmatic psychoanalytically oriented group treatment in borderline personality disorder is aimed at offering these patients an opportunity to make transitions in borderline treatment and thus alter the trajectory of their (self-) destructive pathway. A clinical and theoretical case is made for clinicians and health strategists to re-engage in the process of making meaningful early contact with borderline vulnerability. The group-based treatment model in borderline disturbance described in this article has helped forge partnerships between psychotherapy and psychiatric teams in providing in-depth diagnostic and prognostic information early in the patients' journey.

Trauma and countertransference: development and validity of the Assessment of Countertransference Scale (ACS).

OBJECTIVES: The aim of the present study was to investigate the construct validity of the Assessment of Countertransference Scale (ACS) in the context of the trauma care, through the identification of the underlying latent constructs of the measured items and their homogeneity. METHODS: ACS assesses 23 feelings of CT in three factors: closeness, rejection and indifference. ACS was applied to 50 residents in psychiatry after the first appointment with 131 victims of trauma consecutively selected during 4 years. ACS was analyzed by exploratory (EFA) and confirmatory (CFA) factor analysis, internal consistence and convergent-discriminant validity. RESULTS In spite of the fact that closeness items obtained the highest scores, the EFA showed that the factor rejection (24% of variance, α = 0.88) presented a more consistent intercorrelation of the items, followed by closeness (15% of variance, α = 0.82) and, a distinct factor, sadness (9% of variance, α = 0.72). Thus, a modified version was proposed. In the comparison between the original and the proposed version, CFA detected better goodness-of-fit indexes for the proposed version (GFI = 0.797, TLI = 0.867, CFI = 0.885 vs. GFI = 0.824, TLI = 0.904, CFI = 0.918). CONCLUSIONS: ACS is a promising instrument for assessing CT feelings, making it valid to access during the care of trauma victims.

The influence of client socioeconomic status on psychotherapists' attributional biases and countertransference reactions.

Clinical reaction related to client socioeconomic status has not been adequately researched, yet socioeconomic status can profoundly affect psychotherapist perceptions of a client's presenting concerns, symptom severity, and prognosis. Using an online national survey, this study examined the influence of client socioeconomic status on psychotherapist cognitive attributions and countertransference reactions (N = 141). Results revealed no significant differences in cognitive attributions based on socioeconomic status. However, significantly stronger countertransference reactions of being dominated by the client with a higher socioeconomic status were found. In addition, the clients with higher socioeconomic status were ascribed with mild problems compared with the client of lower socioeconomic status. Psychotherapeutic implications are discussed.