Θεραπευτική σχέση: αλλαγές και προκλήσεις σε ένα ταχέως εξελισσόμενο περιβάλλον

The aim of this short Commentary is to convey some thoughts and concerns that have arisen after reading the excellent articles included in this Special Issue. The focus will be on three particular points: (a) The differences that seem to exist, not so much regarding the general definition of therapeutic alliance, but rather with respect to the identification of the specific characteristics of this phenomemon and the factors that shape it. (b) The need to understand therapeutic alliance after taking into account the complex interactions that take place between several biological, psychological and social factors. Finally, (c) the impact of recent advancements, such as the great innovations in digital technology and health care, on therapeutic alliance. In any case, it is certain that our perception of therapeutic alliance will continue to evolve and change in the future.

Κατανοώντας τα κοινωνικο-παρωθητικά χαρακτηριστικά των αρχηγών-θυτών του εκφοβισμού: Ο ρόλος των κοινωνικών στόχων και των λειτουργιών της επιθετικότητας

The present study examines the role of social goals of ringleader bullies on school bullying according to Social Information Processing Model as well as the role of proactive and reactive aggression. The sample consisted of 222 fifth-grade and sixth-grade elementary school students from Northern Greece, who completed self-report questionnaires and responded to questions regarding social scenarios of ambiguous intent shown on video. The results showed that boys choose revenge more often than girls. Furthermore, ringleader bullies and ringleader bully followers choose more often, than the uninvolved, revenge as a motive in a social scenario of ambiguous intent. It is noteworthy that ringleader bullies choose more often than ringleader bully followers the social goal of building a relationship, while both ringleader bullies and ringleader bully followers adopt both forms of aggression, proactive and reactive, more than the uninvolved. The findings underline the motivational role of social goals in bullying, contribute to the discussion regarding ringleader bullies’ social cognition and emphasize the necessity of intervention programs focusing on social motives of preadolescent bullies.

Η θεραπευτική σχέση στην υπαρξιακή-ανθρωπιστική προσέγγιση

This article intends to highlight the importance of the psychotherapeutic relationship and the way with which it is viewed by the Existential-Humanistic approach to psychotherapy and counseling. The introduction includes a brief overview of the various existential approaches and the common way with which they all view therapy. The article continues by relating the basic premises of the Existential-Humanistic approach as well as its understanding of human beings and of the process of psychotherapy. Furthermore, the factors that contribute to the establishment of the psychotherapeutic relationship are being analyzed. The Existential-Humanistic approach to psychotherapy gives emphasis to the value of a true dialogue between two human beings who are there serving the interests of the one. In order for the therapeutic relationship to be effective there needs to be a clear framework that helps the members feel safe. In this “sanctuary” the two individuals have an “I-Thou” encounter. The “presence” of both parties serves as the catalyst for change through this mutual and honest way of relating.

Η Θεραπευτική σχέση στη συστημική ψυχοθεραπεία οικογένειας και ζεύγους: απόψεις σε εξέλιξη

The relationship between therapist and client plays a central role in the quality and effectiveness of psychotherapy, independently from the therapeutic approach adopted by the therapist. The therapeutic relationship in the frame of Systemic Family and Couple Psychotherapy (SFCP), presents several peculiarities, especially when displayed in the "classical" therapeutic context of systemic psychotherapy, where complex and multifaceted relationships develop between therapists and family members, in front and through the one-way mirror, forming a network of "multiple bonds". Modern views on therapeutic relationship in SFCP have been influenced by the development of the "second order cybernetic", since the late 1980s, and the subsequent "linguistic shift", according to which the therapist, as a part of the therapeutic system, dialogues with family members, contributing to co-constructs new realities, as a therapeutic change cannot result from a didactic / guiding relationship. In this context, the emotions and feelings of the members of the therapeutic system come to the fore, whilst the issue of clients’ resistance to the treatment process is completely redefined. The research regarding the therapeutic relationship in the systemic approach, using both quantitative and qualitative methods, focused on a variety of dimensions, e.g., the impact of the session context and the used techniques, the degree of empathy between therapists and clients, and the therapeutic alliance that develops between them. In more recent years, the provision of mental health services using digital practices raised new challenges and concerns regarding the development of the therapeutic relationship in the new conditions of cooperation between therapist(s) and client(s) in online settings.

Η θεραπευτική σχέση στη γνωσιακή συμπεριφοριστική θεραπεία

The article describes the distinctive features of the therapeutic relationship in cognitive behavioral therapy (CBT) and the ways of dealing with problems in the therapeutic interaction. The development of the way that the therapeutic relationship is understood within the context of cogntive behavioral therapy is presented, from the initial view that the therapeutic relationship is a necessary but not sufficient condition in order to achieve therapeutic change, to the modern view that the therapeutic change is produced by the therapeutic techniques, as well as the therapeutic relationship. The role of the therapist and the features of the therapeutic alliance in CBT are described, central among which is collaborative empiricism and Socratic questioning. The difficulties in the therapeutic relationship and the ways that can be addressed are discussed in the context of the related concepts of resistance, of ruptures in the therapeutic alliance and of transference and countertransference. The rationale regarding boundaries to the therapeutic relationship is discussed. In conclusion, in CBT the emphasis on the therapeutic relationship is not so central as in other therapeutic models and the relationship is integrated with techniques, although there is ongoing effort to enhance and expand the understanding of the therapeutic interaction. Nonetheless the quality of the relationship is not inferior to that of other treatment models and the therapeutic change in CBT is attributed equally to the implementation of techniques and relationship factors.

Θεραπευτική σχέση: δυναμικές αλληλεπιδράσεις και ο ρόλος του φύλου

The article emphasizes, first of all, the importance of various aspects of the psychotherapeutic relationship -such as the therapeutic alliance, the cooperation, the empathy, the goal agreement-, which have been proven to influence the therapeutic outcome and are consistently linked with the mental health improvement of the patient, regardless of the different theoretical conditions and principles of the psychotherapeutic approaches. On the other hand, it is recognized that identifying the quality characteristics that contribute to and influence the psychotherapeutic relationship and process is a difficult task, as it depends on the therapeutic boundaries of this relationship, the characteristics of the therapist, but also on factors related with the patient, such as his/her attitudes, expectations, motivations and commitment to a process of change. One element that seems to characterize the identity of each member individually, but also the dynamic processes of interaction between the therapeutic dyad, is gender. For this reason, the article underlines the importance of gender in shaping the communication and cooperation between therapists and patients, while stating also that awareness of the gender dynamics, in combination with other identity characteristics, is a prerequisite for an effective and ethical practice.

Η θεραπευτική σχέση στην ψυχοδυναμική συμβουλευτική και ψυχοθεραπεία: σύγχρονα κλινικά και εμπειρικά δεδομένα

In the psychodynamic approach, the therapeutic relationship stands at the core of the therapeutic process and constitutes a key factor of the effectiveness of treatment. As such, highlighting the psychodynamic components associated with the therapeutic relationship can help reinforce the role of counseling and clinical psychologists, by offering a broader understanding of the various dynamic interactions in clinical work. Specifically, the present paper delineates particular aspects of the therapeutic relationship (e.g. therapeutic alliance, transference, countertransference, real relationship) that should be taken into account in counseling and psychotherapy as essential components of the therapeutic relationship. Current empirical data are presented to demonstrate the importance of these parameters for the therapeutic process and outcome. Emphasis is also placed on the conditions that need to be fulfilled in order to ensure a relationship of therapeutic value, such as the importance of the therapeutic framework and the role of the psychologists / psychotherapists in dealing with enactments. Finally, the benefits of using the potential of the therapeutic relationship in clinical practice are highlighted, for improving both someone’s relationship with oneself and with others.

Η σχέση της μουσικής εκπαίδευσης με τις φωνολογικές και αναγνωστικές δεξιότητες μαθητών προσχολικής και πρώτης σχολικής ηλικίας

The aim of the study was to evaluate the effect of the training of morphological awareness of spelling words by 27 students following 4th and 6th grades of a primary school. They were compared with a group of 26 classmates who did not take part in the intervention. All students were assessed via standardized tests of spelling and reading comprehension and non-standardized tests of analogy and meaning of compounds. The intervention included a pre-test, an educational program and a post-test. Experimental material entailed compound words categorized into two conditions of morphophonological transparency (transparent/ non-transparent) and two conditions of compositionality (Modern Greek/Ancient Greek morphemes). Results showed that the systematic exercise of the morphological structure of words improved students' spelling performance in every compound type. Considerably, non-transparent items entailing ancient morphemes received the highest gains, where students presented the lowest performance before intervention. These findings underline the importance of morphological awareness in the acquisition of spelling of morphologically complex vocabulary, whose teaching is important in the highest grades of primary school.

Αντιληπτές γονικές πρακτικές και εσωτερικευμένα συμπτώματα στα παιδιά: ο ρόλος της θυματοποίησης και της ιδιοσυγκρασίας του αρνητικού συναισθήματος μέσα από μοντέλα διαμεσολάβησης και ρύθμισης

The development of internalized symptoms in children is a complex process involving various factors. In particular, research has linked parental practices to the development of internalized symptoms in children. However, this factor alone cannot fully explain the development of internalized symptoms in children, as other factors seem to influence this process. The purpose of this study is to examine the factors and mechanisms by which children develop internalized symptoms. In particular, the research examines how the relationship between parental practices and internalized symptoms is influenced by mediator and moderator factors, such as victimization and temperament. The research includes 374 children and their parents. The children attended the 5th and 6th grade of elementary school and the 1st and 2nd grade of high school and were between the ages of 10 and 14. The children completed the following tools: the Revised Olweus Bully/Victim Questionnaire, the Positive and Negative Affect Scale for Children and the Parental Bonding Instrument. The parents completed the Child Behavior Checklist – Parent Report, CBCL (Achenbach System for Empirically Based Assessment). For the statistical analysis of the data, the process method of the SPSS was used to construct mediation and moderated models that examine the relationship between parental practices and internalized symptoms, with victimization as mediator and temperament of negative affectivity as moderator factor. The results of the research highlighted that the relationship between parental practices and internalized symptoms is mediated by victimization, suggesting that a significant part of the above relationship is due to the mediation of victimization. The research also showed that negative affectivity temperament functions as a moderator factor in the relationship between parenting practices and internalized symptoms, suggesting that children with negative affectivity temperament develop more internalized symptoms when their parents use negative parenting practices. The research findings can contribute to the psychosocial and psycho-emotional empowerment of children, through the design of appropriate prevention and intervention programs.

Η θεραπευτική συμμαχία: ορισμοί, αναστοχασμοί και θεραπευτικές προεκτάσεις

The present literature review aims to offer an in-depth examination and critical evaluation of the concept of the therapeutic alliance, as it has been historically unfolded in psychotherapy theory, research and practice. The construct of the alliance holds particular theoretical and practical significance for counselling psychologists, who are expected to demonstrate an understanding of the therapeutic relationship and alliance as conceptualised in different models (HCPC, 2015), as well as the ability to engage in relational practice (BPS, 2015). The critical literature review therefore opens with an examination of the concept of the therapeutic alliance as defined and conceptualised in the major schools of psychotherapy. Core alliance measures are also presented and critically evaluated in relation to their methodological rigour and usefulness in alliance research and practice. The relationship between the therapeutic alliance and outcome is critically reflected upon, whilst giving thorough consideration to therapist, client and interactive factors impacting the development and maintenance of the therapeutic alliance, thus possibly mediating and/ or moderating the relationship between alliance and treatment outcome. Contemporary re-conceptualisations and critiques of alliance theory and research are in turn thoroughly examined and critically discussed. Taking into account the primacy of the therapeutic relationship in Counselling Psychology (BPS, 2005), the literature review concludes with a presentation of the therapeutic implications of alliance theory and research for practitioner psychologists in general and counselling psychologists in particular, irrespective of their therapeutic orientation, in order to enhance their therapeutic skills and efficacy.