Therapist’s humanization of the patient: Promoting and interfering factors
Keywords:
humanization of the client in the therapeutic relationship; therapist’s mentalization; therapeutic relationship
Abstract
The dynamic development of research focusing on effective elements in psychotherapy has revealed not only which therapeutic techniques are particularly effective in treating specific disor-ders, but also which elements of the therapeutic relationship make psychotherapy work. The latter include therapeutic alliance and therapist’s empathy. Both of these concepts are complex, multidimensional constructs; they seem to share one crucial element – the humanization (mentalization) of the client: the fact that the therapist ascribes psychological depth and agency to his/her patient. In this context, we formulate a question concerning the factors that might facilitate or interfere with this kind of therapist’s attitude. We look for an answer to this question not only in the literature on psychotherapy but also in the area of social psychology. Taking into consideration the conclusions derived from both research domains, we formulate recommendations for clinical practice intended to humanize the relationship between the therapist and his/her client. We also formulate research questions aimed at empirical verification of the recommendations.
References
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Kofta, M. i Sławuta, P. (2011). Kolektywne poczucie winy a postawy wobec Żydów i procesy ich (de)humanizacji: rola bliskości kulturowej. W: M. Kofta i M. Bilewicz (red.), Wobec obcych. Zagrożenia psychologiczne a stosunki międzygrupowe (s. 147-167). Warszawa: Wydawnictwo Naukowe PWN.
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Lutz, W., Leon, S. C., Martinovich, Z., Lyons, J. S. i Stiles, W. B. (2007). Therapist effects in outpatient psychotherapy: A three-level growth curve approach. Journal of Counseling Psychology, 54(1), 32-39.
Nathan, P. E. i Gorman, J. M. (1998). A guide to treatments that work. New York: Oxford University Press.
Norcross, J. C. (2002). Empirically supported therapy relationships. W: J. C. Norcross (red.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (s. 3-16). New York: Oxford University Press.
Norcross, J. C. i Lambert, M. J. (2011). Evidence-basedtherapy relationships. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-based responsiveness (s. 3-21). New York: Oxford University Press.
Norcross, J. C. i Wampold, B. E. (2011). Evidence-basedtherapy relationships: Research conclusions and clinical practices. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-based responsiveness (s. 423-440). New York: Oxford University Press.
Okiishi, J., Lambert, M. J., Nielsen, S. L. i Ogles, B. M. (2003). Waiting for supershrink: An empirical analysis of therapist effects. Clinical Psychology & Psychotherapy, 10(6), 361-373.
Opotow, S. (1990). Moral exclusion and injustice: An introduction. Journal of Social Issues, 46(1), 1-20.
Peabody, S. A. i Gelso, C. J. (1982). Countertransference and empathy: The complex relationship between two divergent concepts in counseling. Journal of Counseling Psychology, 29(3), 240-245.
Popielski, K. (2008). Psychologia egzystencji. Wartości w życiu. Lublin: Wydawnictwo KUL.
Radey, M. i Figley, C. (2007). The social psychology of compassion. Clinical Social Work Journal, 35(3), 207-214.
Rakowska, J. M. (2011). Użyteczność kliniczna interwencji terapeutycznych wspartych empirycznie – podsumowanie dyskusji. Roczniki Psychologiczne, 14(1), 69-89.
Rogers, C. R. (1992).The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting & Clinical Psychology, 60(6), 827-832 (przedruk oryginalnego artykułu, który ukazał się w 1957 r. w Journal of Consulting Psychology, 21, 95-103).
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Rudman, L. A., Borgida, E. (1995). The afterglow of construct accessibility: The behavioral consequences of priming men to view women as sexual objects. Journal of Experimental Social Psychology, 31, 493-517.
Safran, J. D., Muran, J. C. i Eubanks-Carter, C. (2011). Repairing alliance ruptures. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-based responsiveness (s. 224-238). New York: Oxford University Press.
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Shapiro, D. A., Firth-Cozens, J. i Stiles, W. B. (1989). The question of therapists’ differential effectiveness: A Sheffield Psychotherapy Project addendum. British Journal of Psychiatry, 154, 383-385.
Stemplewska-Żakowicz, K. (2009). Diagnoza psychologiczna. Diagnozowanie jako kompetencja profesjonalna. Gdańsk: Gdańskie Wydawnictwo Psychologiczne.
Tajfel, H., Flament, C., Billig, M. G. i Bundy, R. P. (1971). Social categorization and intergroup behavior. European Journal of Social Psychology, 1, 149-178.
Tarnowska, M. (2011). Kiedy odmawiamy „obcym” części człowieczeństwa? Uwarunkowania zjawiska infrahumanizacji. W: M. Kofta i M. Bilewicz (red.), Wobec obcych. Zagrożenia psychologiczne a stosunki międzygrupowe (s. 168-188). Warszawa: Wydawnictwo Naukowe PWN.
Tarnowska, M., Sławuta, P. i Kofta, M. (2012). Procesy dehumanizowania „obcych”: mechanizmy i funkcje. W: M. Drogosz, M. Bilewicz, M. i M. Kofta (red.), Poza stereotypy: dehumanizacja i esencjalizm w postrzeganiu grup społecznych (s. 131-165). Warszawa: Wydawnictwo Naukowe Scholar.
Waytz, A., Gray, K., Epley, N. i Wegner, D. M. (2010). Causes and consequences of mind perception. Trends in Cognitive Sciences, 14(8), 383-388.
Zalewski, B., Filipiak, M. i Tarnowska, M. (2012). Metoda symulowanego klienta w nauczaniu diagnostyki klinicznej w psychologii. Czasopismo Psychologiczne, 18(1), 43-48.
Zuroff, D. C., Kelly, A. C., Leybman, M. J., Blatt, S. J. i Wampold, B. E. (2010). Between- -therapist and within-therapist differences in the quality of the therapeutic relationship: Effects on maladjustment and self-critical perfectionism. Journal of Clinical Psychology, 66(7), 681-697.
Bastian, B. i Haslam, N. (2010). Excluded from humanity: The dehumanizing effects of social ostracism. Journal of Experimental Social Psychology, 46(1), 107-113.
Bastian, B. i Haslam, N. (2011). Experiencing dehumanization: Cognitive and emotional effects of everyday dehumanization. Basic and Applied Social Psychology, 33, 295-303.
Batson, C. D. (2009). These things called empathy: Eight related butdistinct phenomena. W: J. Decetyi i W. J. Ickes (red.), The social neuroscience of empathy (s. 3-15). Cambridge, MA: MIT Press.
Bohart, A., Elliott, R., Greenberg L. i Watson, J. (2002). Empathy. W: J. C. Norcross (red.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (s. 89-108). New York: Oxford University Press.
Brewer, M. B. i Harasty Feinstein, A. S. (1999). Dual processes in the cognitive representation of persons and social categories. W: S. Chaikeni i Y. Trope (red.), Dual-process theories in social psychology (s. 255-270). New York: Guilford Press.
Bride, B., Radey, M. i Figley, Ch. (2007). Measuring compassion fatigue. Clinical Social Work Journal, 35(3), 155-163.
Buber, M. (1992). Ja i Ty. Wybór pism filozoficznych. Warszawa: Instytut Wydawniczy PAX.
Charmaz, K. (2009). Teoria ugruntowana. Praktyczny przewodnik po analizie jakościowej. Warszawa: Wydawnictwo Naukowe PWN.
Czabała, J. C. (2011). Użyteczność kliniczna interwencji wspartych empirycznie (komentarz do tekstu prof. Jadwigi M. Rakowskiej. Roczniki Psychologiczne, 14(1), 35-40.
Dyck, M. J. i O’Donovan, A. (2003). What are the benefits of longer training in psychology? A comment on Helmes and Wilmoth (2002). Australian Psychologist, 38(3), 214-215.
Elliott, R., Bohart, A., Watson, J. i Greenberg L. (2011). Empathy. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-basedresponsiveness (s. 132-152). New York: Oxford University Press.
Fiske, S. T. (1993). Controlling other people.The impact of power on stereotyping. American Psychologist, 48(6), 621-628.
Fiske, S. T., Lin, M. i Neuberg, S. L. (1999). The continuum model: Ten years later. W: S. Chaikeni i Y. Trope (red.), Dual-process theories in social psychology (s. 231-254). New York: Guilford Press.
Geller, S. M. i Greenberg, L. S. (2002). Therapeutic presence: Therapists’ experience of presence in the psychotherapy encounter. Person-Centered & Experiential Psychotherapies, 1(1-2), 71-86.
Geller, S. M., Greenberg, L. S. i Watson, J. C. (2010). Therapist and client perceptions of therapeutic presence: The development of a measure. Psychotherapy Research, 20(5), 599-610.
Haque, O. S. i Waytz, A. (2012). Dehumanization in medicine: Causes, solutions, and functions. Perspectives on Psychological Science, 7(2), 176-186.
Harris, L. T. i Fiske, S. T. (2009). Social neuroscience evidence for dehumanised perception. European Review of Social Psychology, 20, 192-231.
Haslam, N. (2006). Dehumanization. An integrative review. Personality and Social Psychology Review, 10(3), 252-264.
Horvath, A. O. i Bedi, R. P. (2002). The alliance. W: J. C. Norcross (red.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (s. 37-69). New York: Oxford University Press.
Horvath, A. O., Del Re, A. C., Flückiger, C. i Symonds, D. (2011). Alliance in individual psychotherapy. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-based responsiveness (s. 25-69). New York: Oxford University Press.
Johnson, W. B. i Campbell, C. D. (2004). Character and fitness requirements for professional psychologists: Training directors’ perspectives. Professional Psychology: Research and Practice, 35(4), 405-411.
Józefik, B. (2011). Komentarz do artykułu prof. Jadwigi M. Rakowskiej „Użyteczność kliniczna interwencji psychoterapeutycznych wspartych empirycznie”. Roczniki Psychologiczne, 14(1), 47-51.
Kępiński, A. (1989). Poznanie chorego (wyd. 2). Warszawa: Państwowy Zakład Wydawnictw Lekarskich.
Kofta, M. (2009). Uprzedzenia wobec obcych – od antypatii do dehumanizacji. W: J. Kozielecki (red.), Nowe idee w psychologii: psychologia XXI wieku (s. 274-295). Gdańsk: Gdańskie Wydawnictwo Psychologiczne.
Kofta, M., Baran, T. i Tarnowska, M. (2014). Dehumanization as a denial of human potentials: The naïve theory of humanity perspective. W: P. Bain, J. Vaesi i J. Ph. Leyens (red.), Humanness and dehumanization (s. 257-275). New York: Psychology Press.
Kofta, M. i Sławuta, P. (2011). Kolektywne poczucie winy a postawy wobec Żydów i procesy ich (de)humanizacji: rola bliskości kulturowej. W: M. Kofta i M. Bilewicz (red.), Wobec obcych. Zagrożenia psychologiczne a stosunki międzygrupowe (s. 147-167). Warszawa: Wydawnictwo Naukowe PWN.
Lambert, M. J. i Barley, D. E. (2002). Research summary on the therapeutic relationship and psychotherapy outcome. W: J. C. Norcross (red.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (s. 17-32). New York: Oxford University Press.
Leyens, J. P., Paladino, M. P., Rodriguez-Torres, R., Demoulin, S., Rodriguez-Perez, A. i Gaunt, R. (2000). The emotional side of prejudice: The attribution of secondary emotions to ingroups and outgroups. Personality and Social Psychology Review, 4, 186-197.
Lutz, W., Leon, S. C., Martinovich, Z., Lyons, J. S. i Stiles, W. B. (2007). Therapist effects in outpatient psychotherapy: A three-level growth curve approach. Journal of Counseling Psychology, 54(1), 32-39.
Nathan, P. E. i Gorman, J. M. (1998). A guide to treatments that work. New York: Oxford University Press.
Norcross, J. C. (2002). Empirically supported therapy relationships. W: J. C. Norcross (red.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (s. 3-16). New York: Oxford University Press.
Norcross, J. C. i Lambert, M. J. (2011). Evidence-basedtherapy relationships. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-based responsiveness (s. 3-21). New York: Oxford University Press.
Norcross, J. C. i Wampold, B. E. (2011). Evidence-basedtherapy relationships: Research conclusions and clinical practices. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-based responsiveness (s. 423-440). New York: Oxford University Press.
Okiishi, J., Lambert, M. J., Nielsen, S. L. i Ogles, B. M. (2003). Waiting for supershrink: An empirical analysis of therapist effects. Clinical Psychology & Psychotherapy, 10(6), 361-373.
Opotow, S. (1990). Moral exclusion and injustice: An introduction. Journal of Social Issues, 46(1), 1-20.
Peabody, S. A. i Gelso, C. J. (1982). Countertransference and empathy: The complex relationship between two divergent concepts in counseling. Journal of Counseling Psychology, 29(3), 240-245.
Popielski, K. (2008). Psychologia egzystencji. Wartości w życiu. Lublin: Wydawnictwo KUL.
Radey, M. i Figley, C. (2007). The social psychology of compassion. Clinical Social Work Journal, 35(3), 207-214.
Rakowska, J. M. (2011). Użyteczność kliniczna interwencji terapeutycznych wspartych empirycznie – podsumowanie dyskusji. Roczniki Psychologiczne, 14(1), 69-89.
Rogers, C. R. (1992).The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting & Clinical Psychology, 60(6), 827-832 (przedruk oryginalnego artykułu, który ukazał się w 1957 r. w Journal of Consulting Psychology, 21, 95-103).
Rosenhan, D. L. (1973). On being sane in insane places. Science, 179, 250-258.
Rudman, L. A., Borgida, E. (1995). The afterglow of construct accessibility: The behavioral consequences of priming men to view women as sexual objects. Journal of Experimental Social Psychology, 31, 493-517.
Safran, J. D., Muran, J. C. i Eubanks-Carter, C. (2011). Repairing alliance ruptures. W: J. C. Norcross (red.), Psychotherapy relationships that work: Evidence-based responsiveness (s. 224-238). New York: Oxford University Press.
Salvio, M. A., Beutler, L., Wood, J. i Engle, D. (1992). The strength of the therapeutic alliance in three treatments for depression. Psychotherapy Research, 2(1), 31-36.
Shapiro, D. A., Firth-Cozens, J. i Stiles, W. B. (1989). The question of therapists’ differential effectiveness: A Sheffield Psychotherapy Project addendum. British Journal of Psychiatry, 154, 383-385.
Stemplewska-Żakowicz, K. (2009). Diagnoza psychologiczna. Diagnozowanie jako kompetencja profesjonalna. Gdańsk: Gdańskie Wydawnictwo Psychologiczne.
Tajfel, H., Flament, C., Billig, M. G. i Bundy, R. P. (1971). Social categorization and intergroup behavior. European Journal of Social Psychology, 1, 149-178.
Tarnowska, M. (2011). Kiedy odmawiamy „obcym” części człowieczeństwa? Uwarunkowania zjawiska infrahumanizacji. W: M. Kofta i M. Bilewicz (red.), Wobec obcych. Zagrożenia psychologiczne a stosunki międzygrupowe (s. 168-188). Warszawa: Wydawnictwo Naukowe PWN.
Tarnowska, M., Sławuta, P. i Kofta, M. (2012). Procesy dehumanizowania „obcych”: mechanizmy i funkcje. W: M. Drogosz, M. Bilewicz, M. i M. Kofta (red.), Poza stereotypy: dehumanizacja i esencjalizm w postrzeganiu grup społecznych (s. 131-165). Warszawa: Wydawnictwo Naukowe Scholar.
Waytz, A., Gray, K., Epley, N. i Wegner, D. M. (2010). Causes and consequences of mind perception. Trends in Cognitive Sciences, 14(8), 383-388.
Zalewski, B., Filipiak, M. i Tarnowska, M. (2012). Metoda symulowanego klienta w nauczaniu diagnostyki klinicznej w psychologii. Czasopismo Psychologiczne, 18(1), 43-48.
Zuroff, D. C., Kelly, A. C., Leybman, M. J., Blatt, S. J. i Wampold, B. E. (2010). Between- -therapist and within-therapist differences in the quality of the therapeutic relationship: Effects on maladjustment and self-critical perfectionism. Journal of Clinical Psychology, 66(7), 681-697.
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