Writers on psychotherapeutic thought have commented on the dearth of literature on the subject of termination, especially in the anxieties and apprehension that termination may arouse in the therapist. This paper addresses the concept of termination anxiety as it affects the therapist by 1) tracing the various sources of uneasiness around the ending of therapy and 2) theorizing about the possible defense maneuvers a therapist uses in order to circumvent the anxiety. Subsequently, it considers some implications of termination anxiety and its effects on ongoing therapy.Writers on psychotherapeutic thought and process have commented on the noticeable dearth of literature and lack of study concerning the termination phase of therapy (
Seventy-two alcoholics being treated at Veritas Villa were divided into an experimental and a control group. In addition to the regular treatment program both groups received four subliminal exposures of a verbal message in each of six sessions over a 2-week period. The messages were MOMMY AND I ARE ONE (experimental) and PEOPLE ARE WALKING (control), administered under double-blind conditions. In keeping with the main hypothesis, the experimental Ss were rated as significantly more involved in treatment. In addition, among the alcoholics who were more symptomatic to begin with, the MOMMY message, when contrasted with the control, lowered anxiety and depression, enhanced self-concept, and reduced alcohol consumption after a 3-month follow-up.
Over the last few decades a growing number of psychotherapy scholars as well as psychotherapy researchers have joined a paradigm shift, moving from a reductionist to a complexity-oriented epistemology. Many authors recognize that when human subjectivity is the object of intervention and study, it is appropriate to resist simplification and to assume a more complex approach. While this paradigm shift is taking place not only in psychology but also in other disciplines, many psychotherapists still share the assumption that psychotherapy practice and psychotherapy research have opposite values; hence, they are worlds that cannot be reconciled. Considering this as one of the main reasons preventing a useful integration of evidence-based practice and clinical training in psychotherapy, we conducted an online survey of 126 Italian trainees from three differently-oriented psychotherapy institutes (cognitive-behavioral, relational-psychoanalytic and relational-systemic) to explore the epistemology underling the clinical and research practices. After presenting a clinical vignette, we asked questions about diagnostic considerations, case formulations, and treatment plans; we also asked questions about participants’ involvement in research projects or in research methodology courses and about willingness to be involved in future research studies in their clinical practice. We found some significant differences among trainees with different orientations, but in general most of the responses reflected a positivistic epistemology underlying both clinical and research activities. These findings suggest that a deeper awareness of one’s own epistemological assumptions could help trainees foster a more theory-coherent and research-informed clinical practice.
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