Abstracts
Résumé
La capacité de mentalisation du thérapeute, habileté lui permettant de comprendre le monde interne du patient et le sien en contexte clinique, est un processus à la fois cognitif et affectif pouvant être opérationnalisé à l’aide du construit d’Activité Mentale du Thérapeute (AM-T). La grille d’AM-T comprend trois échelles mesurant les modes rationnel/objectif, réactif/impulsif et réflexif/mentalisant. Les AM-T de 107 thérapeutes expérimentés et en formation ont été mesurées. Trois profils distincts d’AM-T ont été identifiés. Une différence en ce qui a trait à l’expérience a été retrouvée entre les profils. Les implications théoriques et cliniques de ces profils seront discutées.
Mots-clés :
- activité mentale du thérapeute,
- mentalisation,
- expérience clinique,
- variable du thérapeute,
- processus thérapeutiques
Abstract
The mentalization capacity of the therapist is considered central to imagining and understanding the internal experience and reactions of the patient as well as their own. Mentalization involves cognitive and affective processes in a clinical context that can be conceptualized and operationalized for research as the Therapist’s Mental Activity (TMA). The TMA measure includes three scales to assess the rational/objective, reactive/unconscious and reflective/mentalizing modes. The TMA of 107 experienced and trainee therapists was measured. Three distinct profiles of TMA were identified and were associated with experience. The theoretical and clinical implications of these profiles are discussed.
Keywords:
- therapist’s mental activity,
- mentalization,
- clinical experience,
- therapist as a variable,
- therapeutic process
Appendices
Bibliographie
- Ackerman, S. J., & Hilsenroth, M. J. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23(1), 1-33.
- Allen, J. G., Fonagy, P., & Bateman, A. W. (2008). Mentalizing in clinical practice. Arlington, VA : American Psychiatric Association.
- Anderson, T., Ogles, B. M., Patterson, C. L., Lambert, M. J., & Vermeersch, D. A. (2009). Therapist effects: Facilitative interpersonal skills as a predictor of therapist success. Journal of Clinical Psychology, 65(7), 755-768.
- Baldwin, S. A., & Imel, Z. E. (2013). Therapist effects: Findings and methods. In M. J. Lambert (Éd.), Bergin and Garfield’s handbook of psychotherapy and behavior change (p. XX, 6e éd.). Hoboken, NJ : John Wiley & Sons.
- Bateman, A. W., & Fonagy, P. (2004). Mentalization-based treatment of BPD. Journal of Personality Disorders, 18(1), 36-51.
- Bateman, A. W., & Fonagy, P. (2012). Handbook of mentalizing in mental health practice. Arlington, VA : American Psychiatric Association.
- Beutler, L. E., Forrester, B., Gallagher-Thompson, D., Thompson, L., & Tomlins, J. B. (2012). Common, specific, and treatment fit variables in psychotherapy outcome. Journal of Psychotherapy Integration, 22(3), 255-281.
- Bond, M. (2004). Empirical studies of defense style : Relationships with psychopathology and change. Harvard Review of Psychiatry, 12(5), 263-278.
- Bond, M., & Wesley, S. (1996). Manual for the defense style questionnaire. Montreal, McGill University.
- Bond, M. P. (1995). The development and properties of the Defense Style Questionnaire. In H. R. Conte & R. Plutchik (Éds), Ego defenses : Theory and measurement (p. 202-220). New York, NY : John Wiley & Sons.
- Choi-Kain, L. W., & Gunderson, J. G. (2008). Mentalization : ontogeny, assessment, and application in the treatment of borderline personality disorder. The American Journal of Psychiatry, 165(9), 1127-1135.
- Dubé, J. E., & Normandin, L. (1999). The mental activities of trainee therapists of children and adolescents : The impact of personal psychotherapy on the listening process. Psychotherapy, 36(3), 216-228.
- Dubé, J. E., & Normandin, L. (2007). Mental activity and referential activity of beginning therapists: a construct validity study of the Countertransference Rating System (CRS). American Journal of Psychotherapy, 61(4), 351-374.
- Duncan, B. L. (2012). The Partners for Change Outcome Management System (PCOMS): The heart and soul of change project. Canadian Psychology/Psychologie canadienne, 53(2), 93-104.
- Ensink, K., Maheux, J., Normandin, L., Sabourin, S., Diguer, L., Berthelot, N., et al. (2013). The impact of mentalization training on the reflective function of novice therapists: A randomized controlled trial. Psychotherapy Research, 23(5), 526-538.
- Ensink, K., Normandin, L., & Maheux, J. (2007). La psychothérapie focalisée sur le transfert (TFP) et le fonctionnement réflexif. Santé mentale au Québec, 32(1), 75-92.
- Epstein, L., & Feiner, A. H. (1993). Countertransference: The therapist's contribution to the therapeutic situation. New York, NY : Jason Aronson.
- Fonagy, P. (1999). Psychoanalytic theory from the viewpoint of attachment theory and research. In J. Cassidy & P. R. Shaver (Éds), Handbook of attachment: Theory, research, and clinical applications (p. 595-624). New York, NY : Guilford Press.
- Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2004). Affect regulation, mentalization, and the development of the self. New York, NY : Karnac Books.
- Fonagy, P., & Luyten, P. (2009). A developmental, mentalization-based approach to the understanding and treatment of borderline personality disorder. Development and Psychopathology, 21(4), 1355-1381.
- Gerson, B. (2013). The therapist as a person: Life crises, life choices, life experiences, and their effects on treatment (Vol. 6). New York, NY : Routledge.
- Goldfeld, P., Terra, L., Abuchaim, C., Sordi, A., Wiethaeuper, D., Bouchard, M.-A., et al. (2008). Mental states as part of countertransference responses in psychotherapists facing reports of traumatic events of mourning and sexual violence. Psychotherapy Research, 18(5), 523-534.
- Grenyer, B. F. S., Mathews, R., Stokes, D., & Crea, K. (2010). The Australian Psychology Workforce 2: A national profile of psychologists' education, training, specialist qualifications and continuous professional development. Australian Psychologist, 45(3), 168-177.
- Guess, P. (2006). Test Reviews : Loranger, AW (2001). OMNI Personality Inventory. Journal of Psychoeducational Assessment, 24(2), 160-166.
- Heimann, P. (1960). Counter transference. British Journal of Medical Psychology, 33(1), 9-15.
- Jacobs, T. J. (1999). Countertransference past and present: A review of the concept. The International Journal of Psycho-Analysis, 80(3), 575-594.
- Jones, E. E. (2000). Therapeutic action. A guide to psychoanalytic therapy. Northvale, NJ : Jason Aronson.
- Karlsson, R., & Kermott, A. (2006). Reflective-functioning during the process in brief psychotherapies. Psychotherapy, 43(1), 65-84.
- Lambert, M. J. (2010). Prevention of treatment failure: The use of measuring, monitoring, and feedback in clinical practice. Washington, DC : American Psychological Association.
- Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38(4), 357-361.
- Larson, J. P., & Choi, H.-S. (2010). The effect of university training and educational legislation on the role and function of school psychologists. Journal of Applied School Psychology, 26(2), 97-114.
- Lecomte, C., Savard, R., Drouin, M.-S., & Guillon, V. (2004). Qui sont les psychothérapeutes efficaces? Implications pour la formation en psychologie. Revue québécoise de psychologie, 25(3), 73-102.
- Lecours, S., Bouchard, M.-A., & Normandin, L. (1995). Countertransference as the therapist's mental activity: Experience and gender differences among psychoanalytically oriented psychologists. Psychoanalytic Psychology, 12(2), 259-279.
- Loranger, A. (2001). OMNI Personality Inventories: professional manual. Lutz, FL: Psychological Assessment Resources.
- Loranger, A. (2003). Inventaire de personnalité OMNI (K. Parent, Trad.). Lutz, FL: Psychological Assessment Resources.
- Maheux, J. (2014). Les processus mentaux lors de l’écoute thérapeutique et leurs liens avec les caractéristiques du thérapeute (thèse de doctorat, Université Laval, Québec, Canada). Récupéré de : http://theses.ulaval.ca/archimede/meta/30554
- Markowitz, J. C., & Milrod, B. L. (2011). The importance of responding to negative affect in psychotherapies. American Journal of Psychiatry, 168(2), 124-128.
- Mohr, D. C. (1995). Negative outcome in psychotherapy: A critical review. Clinical Psychology : Science and Practice, 2(1), 1-27.
- Moyers, T. B., & Miller, W. R. (2013). Is low therapist empathy toxic? Psychology of Addictive Behaviors, 27(3), 878-884.
- Normandin, L. (1991). La réflexivité dans le contre-transfert comme élément constitutif du travail et de l’espace thérapeutique (thèse de doctorat non publiée, Université de Montréal, Montréal, Canada).
- Normandin, L., & Bouchard, M.-A. (1993). The effects of theoretical orientation and experience on rational, reactive, and reflective countertransference. Psychotherapy Research, 3(2), 77-94.
- Normandin, L., & Ensink, K. (2007). La GAC 1 : grille d’analyse du contre-transfert dans le traitement des troubles graves de la personnalité. Santé mentale au Québec, 32(1), 57-74.
- Parent, K. (2005). Bénéfices respectifs de deux modèles de formation à la pratique clinique et influence de variables de personnalité et de variables liées à l’ajustement émotionnel sur l’activité mentale de futurs psychothérapeutes (thèse de doctorat non publiée, Université Laval, Québec, Canada).
- Perry, R. (2010). Becoming an effective psychotherapist : adopting a theory of psychotherapy that's right for you and your client [Book Review]. Psychotherapy in Australia, 16(3), 83-84.
- Rizq, R., & Target, M. (2010). "If that's what I need, it could be what someone else needs." Exploring the role of attachment and reflective function in counselling psychologists' accounts of how they use personal therapy in clinical practice : a mixed methods study. British Journal of Guidance & Counselling, 38(4), 459-481.
- Rønnestad, M. H., & Skovholt, T. M. (2003). The journey of the counselor and therapist : Research findings and perspectives on professional development. Journal of Career Development, 30(1), 5-44.
- Séguin, M.-H., & Bouchard, M.-A. (1996). Adaptive regression and countertransference mental activity. Psychoanalytic Psychology, 13(4), 457-474.
- Sexton, T. L., & Kelley, S. D. (2010). Finding the common core: Evidence-based practices, clinically relevant evidence, and core mechanisms of change. Administration and Policy in Mental Health and Mental Health Services Research, 37(1), 81-88.
- Stiles, W. B., Honos-Webb, L., & Surko, M. (1998). Responsiveness in psychotherapy. Clinical psychology : Science and Practice, 5(4), 439-458.
- Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ : Lawrence Erlbaum.
- Williams, E. N., Judge, A. B., Hill, C. E., & Hoffman, M. A. (1997). Experiences of novice therapists in prepracticum: Trainees', clients', and supervisors' perceptions of therapists' personal reactions and management strategies. Journal of Counseling Psychology, 44(4), 390-399.
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