The purpose of this study was to investigate the use and perceived effects of immediacy in 16 cases of open-ended psychodynamic psychotherapy. Of 234 immediacy events, most were initiated by therapists and involved exploration of unexpressed or covert feelings. Immediacy occurred during approximately 5% of time in therapy. Clients indicated in post-therapy interviews that they remembered and profited from immediacy, with the most typical observed consequences being clients expressing feelings about the therapist/therapy and opening up/gaining insight. Amount of immediacy was associated with therapists' but not clients' ratings of session process and outcome. Therapists focused more on feelings and less on ruptures, and initiated immediacy more often with fearfully than with securely attached clients. Implications for practice, training, and research are offered.

We investigated changes over 12 to 42 months in 23 predoctoral trainees during their externship training in a psychodynamic/interpersonal psychotherapy clinic. Over time, trainees increased in client-rated working alliance and real relationship, therapist-rated working alliance, client-rated interpersonal functioning, ability to use helping skills (e.g., challenges, immediacy), higher-order functioning (e.g., conceptualization ability, countertransference management), feelings about themselves as therapists (e.g., more authentic, more self-aware), and understanding about being a therapist (e.g., theoretical orientation, curiosity about client dynamics). In contrast, trainees did not change in engaging clients (return after intake or for at least 8 sessions), judge-rated psychodynamic techniques in third and ninth sessions across clients (although trainees used more cognitive-behavioral techniques over time in third but not ninth sessions), or changes in client-rated symptomatology. Trainees primarily attributed changes to graduate training, individual and group supervision, research participation, and working with clients. Implications for training and research are discussed.

We examined the effectiveness of the Hill model of helping skills training for 191 undergraduate students in six sections of a semester-long course. Students completed self-report, performance, and nonverbal measures at the beginning; they conducted one 20-min helping session at the beginning and another toward the end of the semester; and they completed self-efficacy measures at the end of the semester. Students' helping skills improved over the course of the semester, as evidenced by higher helper-and volunteer client-rated session quality, reduced proportion of words spoken in sessions, increased proportion of exploration skills used in sessions, and increased self-efficacy for using helping skills. Self-reported empathy predicted four of the five helping skills criteria at the beginning-of-semester assessment. Facilitative interpersonal skills predicted end-of-semester self-efficacy in helping skills when controlling for retrospective prelevels and instructor effects. Implications for training and research are presented.

The Use of ImmedIacy In sUpervIsory relaTIonshIps clara e. hIll and shUdarshana GUpTa 12 Imagine that Joan (a supervisee) is very angry at dr. s. (her supervisor) because dr. s. constantly interrupts the supervision session and takes phone calls, but Joan says nothing to dr. s. about the disruptions and acts as if everything is fine. or, consider that dr. s. has overheard people talking in the lunchroom about Joan's dissatisfaction with supervision, but Joan has said nothing to dr. s. how should Joan and dr. s. deal with these situations?We propose that immediacy, or the supervisor and supervisee talking together directly about the relationship, could help to resolve some of the problems in the above situations. Unfortunately, although there is talk in the supervision literature about the importance of openly processing the supervisory relationship (e.g., mueller & Kell, 1972;stoltenberg & mcneill, 2012), there is minimal empirical research. hence, we first briefly review the literature about immediacy in psychotherapy, and then we make propositions about how immediacy could be used in supervision. We next review a study on working with

Twenty-five volunteer clients participated in 1 session with an early remembered dream (ERD) and 1 session with the most recent dream (MRD), using the Hill ( 2004) model of dream work. ERDs were 4 times more likely to be nightmares and 2.6 times more likely to be recurrent dreams than were MRDs, but ERDs and MRDs did not differ in emotional intensity or salience. In terms of outcomes, no differences were found between sessions involving ERDs and MRDs, but salient dreams led to better session outcome. Both therapists and clients preferred working with and clients more often implemented action plans with MRDs than with ERDs.