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Values and therapy orientations of psychotherapy trainees: A twelve-year update

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Abstract

Psychotherapy orientations, self-declared fortes in conducting therapy, and interpersonal values were studied among psychiatry residents and psychology interns in the late 1960s and early 1980s. A distinct pattern of psychotherapy orientations and fortes emerged which transcended professional backgrounds and proved stable across generations, despite some interactions between training and time. Subjects' professed areas of expertise were closely aligned with their beliefs about what methods are most effective in psychotherapy, and both these variables were significantly associated with their value profiles. The correlation matrix suggested a three-factor model of related psychotherapy and value orientations surrounding the three predominant modalities: insight, corrective emotional experiences, and learning. It was proposed that the data support the importance of value dimensions in contributing to psychotherapists' adoption of specific treatment strategies and their developing expertise in corresponding techniques.

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... Last, interaction of personal and professional development involved understanding one's own conflicts, values, and ideas and how they impact upon therapy. The importance of these findings is highlighted by research showing considerable stability in therapists' values about psychotherapy across professions and theoretical orientations (Kay & Vardy, 1984). ...
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Thesis (Ph. D.)--University of Maryland, 1966. Includes bibliographical references (leaves 110-114). Vita. Microfilm.
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Psychotherapeutic technique is commonly assumed to be an important source of variance in the process and outcome of psychotherapy. It was postulated that at least 3 dimensions are essential to adequately characterize therapeutic technique. The hypothesized dimensions were psychoanalytic, impersonal vs. personal, and directive techniques. An inventory to assess therapeutic technique preferences was constructed and administered to 265 psychotherapists. 3 independent hypothesized factors were confirmed. Pattern scores of therapists on the factors related to their profession, sex, and amount of personal psychotherapy, but not to experience. The results provide a basis for classifying psychotherapists according to their characteristic techniques and for studying the effects of technique on treatment process and outcome.
Values and psychotherapy orientations among psychiatry and psychology traineesJPsychiat Educ, 1984 (in, press), 14. Lo CY: Countermovements and conservative movements in the contemporary US
  • Vardy
  • Mm
  • Kay
  • Sr
Vardy MM, Kay SR: Values and psychotherapy orientations among psychiatry and psychology trainees.JPsychiat Educ, 1984 (in, press), 14. Lo CY: Countermovements and conservative movements in the contemporary US. Ann Rev Sociology 8:107-134, 1982.
Psychiatrists' models of mental illness and their personal background The therapeutic value of psychotherapists' values and therapy orien-tations
  • Toone
  • Murray R Bk
  • A Care
Toone BK, Murray R, Care A, et al.: Psychiatrists' models of mental illness and their personal background. PsychoIMed 9:165-178, 1979, 12. Vardy MM, Kay SR: The therapeutic value of psychotherapists' values and therapy orien-tations. Psychiatry 45:226-233, 1982.
The social fate of a therapeutic ideology: the rise and decline of psychoanalysis in the USA
  • M M Vardy
  • MM Vardy
Manual for Survey of Interpersonal Values
  • L V Gordon
  • LV Gordon
Persuasion and Healing: A Comparative Study of Psychotherapy
  • J D Frank
  • JD Frank
Psychiatrists' models of mental illness and their personal background
  • B K Toone
  • R Murray
  • A Care
  • BK Toone