Clinical Implications for Working with Gay Men A Self Psychological Treatment Approach.

Specific training for conducting psychotherapy with gay men is limited for psychologists, particularly when using a Self Psychology theoretical orientation (Robertson, 1996). In fact, psychologists often are faced with conflicting and contradictory points of view that mirror society's condemnation of homosexuality (Robertson, 1996). This paper is written from a self-psychological perspective to address the lack of a constructive body of literature that explains the unique treatment needs which impact gay men. Estimates of the prevalence of male homosexuality have generated considerable debate. A common assumption is that there are homosexual and non-homosexual men. However, scientists have long been aware that sexual responsiveness to others of the same sex, like most human traits, is continuously distributed in the population (Michaels, 1996). Still the presumption exists that such traits are stable within each man over time (Michaels, 1996). Conflating same-sex sexual experiences with a categorization of the man as homosexual is problematic, in that defining sexuality solely on the basis of experience excludes people who fantasize about sex with others of the same sex but never have sexual contact. Thus, most modern conceptions of sexual orientation consider personal identification, sexual behavior, and sexual fantasy (McWhirter, Sanders & Reinisch, 1990). Gay men's mental health can only be understood in the context of homosexuality throughout history, since religious and moral objections to sexual attraction between men have existed for centuries. Men who desired other men were regarded as sinful and depraved if not ill or abnormal, and same sex contacts were not distinguished from lewd behaviors (Weeks, 1989). Although most people, regardless of sexual orientation, have experienced some feelings of personal rejection, rarely do heterosexuals become targets for disapproval based on the nature of their attractions and behaviors relative to the same and to the other sex. For lesbians, bisexuals, and gay men, however, homosexuality becomes the focus of aspects of themselves that make them feel hated and hateful (Isay, 1989). While gay men and lesbians are often considered together because of the same-sex nature of their relationships and the similar issues that they may experience in their treatment within society, there are many issues where they might be best studied separately. Issues involving with health, parenthood, sexuality and perceived roles and status in society, for example, are often related more to gender than to any shared concept of a 'gay and lesbian community'. Many issues surrounding lesbians and lesbian culture will have more to do with women's issues, and some issues involving with gay men will have more to do with the gay male subculture and with masculinity. The author of this paper has limited experience in working with lesbian and bisexual individuals, and although it is likely that some of the concepts articulated in this paper could translate to working with lesbian and bisexual individuals, further research is indicated to examine the beneficence of utilizing a Self Psychological orientation in psychotherapy with lesbian women and bisexual individuals. This paper presents an overview of the literature including historical treatments of homosexuality, the history of Self Psychology, key principles in Self Psychology, research on Self Psychology, identity development models for gay men, and Self Psychological perspectives on identity development related to gay men. The literature review is followed by a section on treatment implications for psychologists seeking to treat gay men, including case vignettes based on work from my own practice. I have preserved the anonymity of clients by changing demographics, and rearranging and combining presenting issues and historical backgrounds among the case examples.

Multicultural education in Clinical Psychology Programs and the needs of racial minority trainees.

With more racial minorities entering the field of clinical psychology, the training needs of racial minority students in doctoral programs must be considered. Few studies address training in multicultural education from the perspective of racial minority students despite their increasing presence in the field. This may be due to assumptions educators make based on their level of competency in the area of multiculturalism. Thus, the goal of this exploratory study is to help determine the multicultural training needs of racial minorities enrolled in clinical psychology programs. This exploratory study was quantitative and used snowball sampling to survey racial minority trainees in doctoral programs in clinical psychology. Sixty one participants completed the survey. Results indicated that multicultural/diversity classes are valued by racial minority students and are relevant to them. However, the majority of students do not feel challenged, suggesting that their needs are not being fully met. It is recommended that their unique needs be included in the curriculum for multicultural education.

The Clinical Utility of the Adult Attachment Projective Picture System: A Clinician's Perspective

The Adult Attachment Projective Picture System (AAP) is the first performance- based measure of adult attachment to be developed. The purpose of the measure is to provide a clinical understanding of an adult client's attachment status and associated coping mechanisms. The AAP is a relatively new measure that has yet to be examined from a utility perspective. In the current study, seven psychologists completed a structured survey in order to identify their perspectives of the AAP and its utility as a clinical instrument. A phenomenological qualitative analysis of the data was conducted to derive themes about the AAP and its clinical utility. Analyses aimed to answer the following: What clinical considerations do clinician's focus on when deciding to use this measure? What are common factors among clinician's who do use the measure as well as those who do not? What aspects of the measure are user-friendly and what aspects are difficult? General themes that emerged include (a) the clinical information provided by the AAP is viewed by those who use it as unique and beneficial; (b) time commitment and cost for the clinician are common considerations when clinician's are deciding whether or not to use the AAP or when pursuing training; (c) the AAP provides an increased understanding of one's relational capacities and defenses; and (d) the coding system and transcription process are difficult aspects of the AAP and influence how and/or when it is used. In addition to these themes, multiple respondents discussed potential changes for the AAP that would increase their future use of the instrument. Finally, the implications of these results are discussed.

An Evaluation of Sport Psychology Service Delivery in Collegiate Athletics

Sport and Performance Psychology is an ever-evolving specialty. While its development continues, it has not been without its challenges. Sport and performance psychologists work in a variety of settings and often come from similar, yet inherently different, training backgrounds. Individuals from both sport sciences and psychology have made compelling arguments as to which approach provides quality services to their respective clients. The question that remains, however, is what are these quality services? Who are the clients and what do they need from professionals in the field?Collegiate student athletes inherently face a number of typical issues related to their age and development. They also face a number of atypical difficulties as a result of their status as student athletes. As such, they provide an adequate sample of potential presenting issues for sport and performance psychologists. This current study utilized a qualitative, exploratory method to evaluate the presenting issues that brought clients to seek services from professionals.This paper seeks to establish a foundation for the development of a theoretical basis of the psychology of human performance, including both performance and general mental health concerns, and how sport and performance psychologists can most effectively intervene in this process. This paper is based on an analysis of seven years of service delivery within a NCAA Division I athletic department.Results indicate that collegiate student athletes seek services related to performance enhancement and general mental health at relative equal frequency. As such, training and service delivery in both areas would be most beneficial and best serve this population.  

What We Don't Know Can Hurt Us: Clinical Inference Bias and Constructed Memories of Sexual Abuse.

The false memory/recovered memory debate, research regarding the malleability of memory, and the current lack of methods for validating recovered memories all support the view that heightened care is required of therapists dealing with clients whom they suspect have been sexually abused. The judgmental heuristics that underlie the major clinical inference biases of confirmatory bias, biased covariation, base rate fallacies, and schematic processing errors are all relevant to the processes leading to therapist-client constructions of memories of sexual abuse. Suggestions for minimizing each of these biases are offered. Personal motivations of the client and client suggestibility are factors that may contribute to the construction of memories of sexual abuse, and suggestions for minimizing the impact of these motivations are offered. In conclusion, general suggestions for minimizing the impact of clinical inference biases within the sexual abuse treatment context are summarized.