Sample records for psilocybin-assisted group psychotherapy

  1. Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder

    Directory of Open Access Journals (Sweden)

    Michael P. Bogenschutz


    Full Text Available After a hiatus of some 40 years, clinical research has resumed on the use of classic hallucinogens to treat addiction. Following completion of a small open-label feasibility study, we are currently conducting a double-blind placebo-controlled clinical trial of psilocybin-assisted treatment of alcohol use disorder. Although treatment effects cannot be analyzed until the study is complete, descriptive case studies provide a useful window into the therapeutic process of psychedelic-assisted treatment of addiction. Here we describe treatment trajectories of three participants in the ongoing trial to illustrate the range of experiences and persisting effects of psilocybin treatment. Although it is difficult to generalize from a few cases, several qualitative conclusions can be drawn from the data presented here. Although participants often find it difficult to describe much of their psilocybin experience, pivotal moments tend to be individualized, extremely vivid, and memorable. Often, the qualitative content extends beyond the clinical problem that is being addressed. The participants discussed in this paper experienced acute and lasting alterations in their perceptions of self, in the quality of their baseline consciousness, and in their relationship with alcohol and drinking. In these cases, experiences of catharsis, forgiveness, self-compassion, and love were at least as salient as classic mystical content. Finally, feelings of increased “spaciousness” or mindfulness, and increased control over choices and behavior were reported following the drug administration sessions. Ultimately, psilocybin-assisted treatment appears to elicit experiences that are extremely variable, yet seem to meet the particular needs of the individual.

  2. Group Psychotherapy in Iceland. (United States)

    Ívarsson, Ómar


    In this overview of group psychotherapy in Iceland, an attempt will be made to describe how it is practiced today, give some glimpses into its earlier history, and clarify seven issues: (1) the standing of group psychotherapy in Iceland, its previous history, and the theoretical orientation of dynamic group therapy in the country; (2) the role of group therapy in the health care system; (3) how training in group therapy is organized; (4) the relationship between group psychotherapy research and clinical practice; (5) which issues/processes can be identified as unique to therapy groups in Iceland; and (6) how important are group-related issues within the social background of the country; and (7) what group work holds for the future.

  3. Spiritually and religiously integrated group psychotherapy

    DEFF Research Database (Denmark)

    Viftrup, Dorte Toudal; Hvidt, Niels Christian; Buus, Niels


    WE SYSTEMATICALLY REVIEWED THE RESEARCH LITERATURE ON SPIRITUALLY AND RELIGIOUSLY INTEGRATED GROUP PSYCHOTHERAPY TO ANSWER THE FOLLOWING THREE QUESTIONS: first, how are spirituality and religiosity defined; second, how are spiritual and religious factors characterized and integrated into group......, 8 articles were considered eligible for the review. Findings from the evaluation suggested that the concepts of spirituality and religiosity were poorly conceptualized and the way in which spiritual and religious factors were integrated into such group psychotherapies, which distinguished it from...

  4. Spiritually and religiously integrated group psychotherapy

    DEFF Research Database (Denmark)

    Viftrup, Dorte Toudal; Hvidt, Niels Christian; Buus, Niels


    WE SYSTEMATICALLY REVIEWED THE RESEARCH LITERATURE ON SPIRITUALLY AND RELIGIOUSLY INTEGRATED GROUP PSYCHOTHERAPY TO ANSWER THE FOLLOWING THREE QUESTIONS: first, how are spirituality and religiosity defined; second, how are spiritual and religious factors characterized and integrated into group...... psychotherapy; and, third, what is the outcome of the group psychotherapies? We searched in two databases: PsycINFO and PubMed. Inclusion and exclusion criteria and checklists from standardized assessment tools were applied to the research literature. Qualitative and quantitative papers were included. In total......, 8 articles were considered eligible for the review. Findings from the evaluation suggested that the concepts of spirituality and religiosity were poorly conceptualized and the way in which spiritual and religious factors were integrated into such group psychotherapies, which distinguished it from...

  5. Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders. (United States)

    Thomas, Kelan; Malcolm, Benjamin; Lastra, Dan


    Recent research suggests that functional connectivity changes may be involved in the pathophysiology of psychiatric disorders. Hyperconnectivity in the default mode network has been associated with psychopathology, but psychedelic serotonin agonists like psilocybin may profoundly disrupt these dysfunctional neural network circuits and provide a novel treatment for psychiatric disorders. We have reviewed the current literature to investigate the efficacy and safety of psilocybin-assisted therapy for the treatment of psychiatric disorders. There were seven clinical trials that investigated psilocybin-assisted therapy as a treatment for psychiatric disorders related to anxiety, depression, and substance use. All trials demonstrated reductions in psychiatric rating scale scores or increased response and remission rates. There were large effect sizes related to improved depression and anxiety symptoms. Psilocybin may also potentially reduce alcohol or tobacco use and increase abstinence rates in addiction, but the benefits of these two trials were less clear due to open-label study designs without statistical analysis. Psilocybin-assisted therapy efficacy and safety appear promising, but more robust clinical trials will be required to support FDA approval and identify the potential role in clinical psychiatry.

  6. Nondisclosure in psychotherapy group supervision

    DEFF Research Database (Denmark)

    Reichelt, Sissel; Gullestad, Siri Erika; Hansen, Bjørg Røed


    The aim of this study was to investigate aspects of nondisclosure in a sample of 55 student therapists, working within a group format of supervision. The study constituted one part of a larger study, with the other, parallel part addressing nondisclosure in supervisors. The participants were...... of students experienced that the groups became more closed throughout the supervision, and blamed their supervisors for inadequate handling of the group process. This is an issue that needs further exploration....

  7. Analytic and Systemic Specialized Incest Group Psychotherapy

    DEFF Research Database (Denmark)

    Elkjaer, Henriette Kiilsholm; Mortensen, Erik Lykke; Poulsen, Stig Bernt

    PURPOSE: Women with long-term sequalae of child sexual abuse (CSA) were randomly assigned to analytic (Group A) or systemic group psychotherapy (Group S). Pre-post-analysis indicated that both therapies led to significant improvement, but overall Group S had significantly better outcome than Group...... A. This study investigates if gains are maintained one and five years following termination, and if the groups differ in gains. METHOD: 106 women started on allocated intervention. Psychological distress (GSI from SCL-90R), psycho-social functioning (GAF), and global life quality (GLQ), were...... maintained statistical significant improvement on GSI, GAF and GLQ five years post-treatment. No significant difference was found in gains between groups....

  8. Analysis of transference in Gestalt group psychotherapy. (United States)

    Frew, J E


    In Gestalt therapy, transference is viewed as a contact boundary disturbance which impairs the patient's ability to accurately perceive the present therapy situation. The boundary disturbances in Gestalt therapy most closely related to the analytic notion of transference are projection, introjection, and confluence. In Gestalt group psychotherapy, group members interfere with the process of need identification and satisfaction by distorting their contact with each other through projecting, introjecting, and being confluent. The Gestalt group therapist uses interventions directed to individuals and to the group to increase participants' awareness of these boundary disturbances and of the present contact opportunities available to them when these disturbances are resolved. In formulating interventions, the leader is mindful of the function of boundary disturbances to the group-as-a-whole as well as to individuals.

  9. Feedback in Group Psychotherapy for Eating disorders

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Poulsen, Stig; Lindschou, Jane


    OBJECTIVE: To investigate the effect of client feedback in group psychotherapy on attendance and treatment outcome for patients with eating disorders. METHOD: We conducted a randomized clinical trial with central randomization stratified for diagnosis and treatment type according to a computer...... outcome was rate of attendance to treatment sessions; the secondary outcome was severity of eating disorder symptoms measured with the Eating Disorder Examination interview. Exploratory outcomes were psychological distress measured with the Symptom Checklist-90-R and the Outcome Rating Scale, social......-generated allocation sequence concealed to the investigators. One-hundred and 59 adult participants, diagnosed with bulimia nervosa, binge eating disorder, or eating disorder not otherwise specified according to DSM-IV, were included. Eighty participants were allocated to the experimental group, and 79 participants...


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    Richard G. Erskine


    Full Text Available This article is the Keynote Address given at the 4th International Integrative Psychotherapy Association Conference, April 17, 2009. In speaking to the conference theme of “Acute Trauma, Cumulative Neglect, and Chronic Stress” the article describes some of the principles of Relational Group Psychotherapy. The theory of methods is based on the concept that the healing of trauma, neglect and stress occurs through a contactful therapeutic relationship. Relational group psychotherapy draws from several developments in group therapy, particularly the cybernetic feedback and other-centered models. It emphasizes the healing power of relationships between group members and the importance of phenomenological inquiry, affective attunement, identification, and relational-needs. The leader’s tasks are to stimulate the flow of contactful dialogue and to teach about human needs and healthy relationships.

  11. Impact of Bereavement-Oriented Group Psychotherapy for School ...

    African Journals Online (AJOL)

    Psychological debriefing is widely applied for victims who encounter overwhelming trauma. This study aimed at assessing the anxiety levels and psychiatric morbidity of class mates of the victims of a plane crash and also to carry out bereavement-oriented group psychotherapy to alleviate observed psychopathology in the ...

  12. Psychotherapies (United States)

    ... talk therapy”) is a term for a variety of treatment techniques that aim to help a person identify and ... this be assured? If you are interested in reading more about evidence based therapies, see the links at the end of this material. Psychotherapies and Other Treatment Options Psychotherapy ...

  13. The State of the Art of Group Psychotherapy in Spain. (United States)

    Martinez-Taboada, Cristina; Amutio, Alberto; Elgorriaga, Edurne; Arnoso, Ainara


    (1) What is the history and the theoretical orientation of group therapy in Spain? (2) How is training organized? (3) What role does group psychotherapy play in the health system in Spain? (4) What is the relationship between group psychotherapy research and clinical practice in Spain? (5) What topics can be identified as unique to therapy groups in Spain? (6) How are group-related issues important within the social background of Spain? and (7) What does group work hold for the future? Although not even a century has passed since the birth of this discipline, there have already been many events associated with the management of power and knowledge, the development of a sense of community, and the evolution of the political and social life of our country. Group therapy training is still evolving and is properly supported and accredited by prestigious institutions. In the 2013 Symposium of the Spanish Society of Group Psychotherapy and Group Techniques (SEPTG), the need for joint group theories and techniques within the profession's activities was clearly highlighted. Further, the enthusiasm of group psychotherapists to open themselves to specific social perspectives (health, education, community prevention, organizations) is a way of encouraging society to untangle conscious and unconscious knots that are created in social interaction.

  14. A case study of psychodynamic group psychotherapy for bipolar disorder. (United States)

    Gonzalez, Jodi M; Prihoda, Thomas J


    This study examines the effectiveness of long-term outpatient psychodynamic group psychotherapy for individuals with bipolar disorder who may have psychiatric comorbidity. The Integrative Outpatient Model (IOM) includes psychoeducation regarding illness, illness management, and exploration of dynamic and interpersonal issues. At one-year follow up, group members had significantly less depressive symptomatology and were less likely to be in a mood episode, compared to controls. There were no between-group differences in manic symptoms or global assessments of functioning. For group-treated patients, the number of days well per week improved significantly; there were no significant improvements in the control group. This pilot study indicates that psychodynamic group psychotherapy is feasible as a component of treatment for bipolar disorder diagnoses. The results suggest benefits on depressive, but not manic symptoms. The 73% retention rate suggests that further study of this treatment is warranted, especially in the cases of patients for whom pharmacotherapy alone is not sufficient.

  15. Dr. Irvin Yalom Discusses Group Psychotherapy. (United States)

    Forester-Miller, Holly


    In this interview, Dr. Irvin Yalom, director of the Adult Psychiatry Clinic at Stanford University School of Medicine, discusses his beginnings as a group psychotherapist, current issues in group work, and the future of group work. (Author/TE)

  16. Ethical issues in record keeping in group psychotherapy. (United States)

    Knauss, Linda K


    This article discusses numerous ethical issues regarding the keeping of records in group psychotherapy, those activities that have to do with the creating, retaining, storing, releasing, and disposing of them. A central dilemma for the group therapist is whether to keep records separately for each individual group member or to keep one record for the group as a whole. Confidentiality of records, patient access, and release of information tend to be more complex issues for group psychotherapists than for individual psychotherapists. Although notes written about the entire group may capture important themes, such notes can compromise the privacy and confidentiality of individual group members. An individual record for each patient is recommended.

  17. Working through a psychotherapy group's political cultures. (United States)

    Ettin, Mark F; Cohen, Bertram D


    Macropolitical evolution, starting with authoritarian monarchism, has moved through anarchistic transitions either to the totalitarianism of fascism and communism or to liberal and social democracy. We posit analogous micropolitical development in process-oriented therapy groups: "dependence" and "counterdependence" corresponding to monarchism and anarchism; and "independence" and "interdependence" to liberal and social democracy, respectively. Transition from counterdependence to independence and interdependence may be: (1) facilitated through group members' cooperative experience of rebellion, or (2) blocked by collective identification, the internalization of dystopian or utopian fantasies that coalesce as "group-self" perceptions. We explore how group therapists work clinically with and through these several "political cultures" in the service of group and self transformation.

  18. Group psychotherapy and neuro-plasticity: an attachment theory perspective. (United States)

    Flores, Philip J


    This article selectively highlights relevant areas of neuroscience research which have direct application for attachment theory and group psychotherapy. Emerging evidence from the neurosciences is revealing that the developing brain of the infant, sculpted by the earliest attachment relationships, continues to be malleable in adulthood and can be profoundly influenced by ongoing relationships throughout one's lifespan. Advances in the neurosciences are also supporting the idea that strong attachment bonds and external interpersonal interactions that arise within the context of these attachments are registered as a person's neurophysiology and neurobiology. Attachment theory in particular provides a common language and conceptual framework from which the contributions from the neurosciences can be made applicable to group psychotherapy.


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    Oana Maria Popescu


    Full Text Available One of the most important tendencies in child psychotherapy is the integration of various psychotherapeutic approaches and technical interventions belonging to different orientations. Based on the Harry Potter stories, the „Wizarding School” structured group therapy program is a 12-step integratively oriented program applicable in personal development, individual and group therapy for children aged 6 to 13 (at present being adapted for adult psychotherapy. The program takes place within a fairy tale, being therefore a type of informal hypnotic trance. The interventions are drawn from the lessons described in Harry Potter’s story at Hogwarts, based on the fundamental principles of child psychotherapy and including elements of play therapy, art therapy, hypnotherapy, cognitive- behavioural therapy, transactional analysis, supportive therapy, family therapy and person centred therapy. From a theoretical point of view the program is based on elements from a number of psychotherapeutic approaches, the main concept being that we need to create a therapeutic myth that is acceptable to a child. The program is not suitable for children with structural deficits, who have difficulties in making the difference between fantasy and reality.

  20. Brief group psychotherapy for the spousally bereaved: a controlled study. (United States)

    Lieberman, M A; Yalom, I


    A consecutive sample of mid- and late-life bereaved spouses were randomly assigned to treatment and no-treatment groups. Two hypotheses were tested: (1) that brief group psychotherapy during the early stages of loss would facilitate adjustment assessed by measures of mental health, positive psychological states, social role, and mourning; and (2) that positive effects would be maximized for subjects who were more distressed psychologically. Although group participants, compared with untreated controls, did over 1 year show modest improvement on role functioning and positive psychological states, overall the study failed to find substantial support for the two major hypotheses. Both experimental and control groups showed improvement over the year, particularly on measures of mental health and mourning. Differential benefit was not observed for the high-risk group.

  1. The spirit of Jungian group psychotherapy: from taboo to totem. (United States)

    Ettin, M F


    Practitioners of analytical psychology were late in coming to the practice of group psychotherapy because Carl Jung effectively forbade the treatment of individuals in stranger groups. This article explores Jung's objections to group therapy and, by way of a conceptual review of the literature, expands on the practice that grew up proximate to his death. It is argued that Jungian theory is especially conducive to collective treatment because it is concerned with the relationship between oppositions (whether in persons or between people) and uses synthetic and symbolic processes to bring about an integration of the one with the many. For Jungians who espouse a theory of symbolic transformation, archetype, and myth, the group is embodied in individuals and can be accessed by working with individuals in groups.

  2. Group psychotherapy for HIV-seropositive patients with major depression. (United States)

    Levine, S H; Bystritsky, A; Baron, D; Jones, L D


    Patients were recruited from the UCLA AIDS Research Center who had previously been referred to psychiatry for participation in an open-label pilot treating patients with major depression with fluoxetine. They chose to participate in group therapy for continuing distress in coping with their HIV-seropositive status, dissolution of their support system, "accepting patienthood," and on being placed on an experimental medical protocol. The group was a closed, twenty-session, homogeneous (for patient characteristics), psychoeducational, supportive, and cognitively oriented psychotherapy group. We found this to be a successful intervention in helping patients manage HIV illness and in providing the coping skills and social support necessary to function at home, work, and in their interaction with their health care providers.

  3. Efficacy of meaning-centered group psychotherapy for cancer survivors : a randomized controlled trial

    NARCIS (Netherlands)

    van der Spek, N; Vos, J; van Uden-Kraan, C F; Breitbart, W.; Cuijpers, P; Holtmaat, K; Witte, B I; Tollenaar, R.A.E.M.; Verdonck-de Leeuw, I M

    BACKGROUND: The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU). METHOD: A total of 170 cancer survivors were randomly assigned

  4. Group affective learning in training for psychotherapy and psychoanalysis. (United States)

    Scharff, Jill Savege; Scharff, David E


    This paper describes The Group Affective Model, a method for teaching psychoanalytic concepts and their clinical application, using multi-channel teaching, process and review in group settings, and learning from experience in an open systems learning community for psychoanalysts and psychotherapists. This innovation arose in response to criticism of existing methods in psychoanalytic education that have subordinated the primary educational task to that of the training analysis. Noticing this split between education and training analysis, between cognition and affect, and between concepts of individual and group unconscious processes, we developed the Group Affective Model for teaching and learning psychoanalysis and psychotherapy in an open psychological space in which students and faculty experience individual and group processes of digestion, assimilation, and review, which demonstrate the concepts in action and make them available for internalization selectively. We discuss our philosophy and our educational stance. We describe our institution and our participants. We give examples of teaching situations that we have studied to provide some insight about assimilation and internalization of the concepts and clinical approaches being taught. We discuss the transferability of the Group Affective Model to other teaching settings and psychoanalytic training institutions and propose it as the fourth pillar of psychoanalytic training, next to analytic treatment, clinical supervision, and didactic seminars. Copyright © 2017 Institute of Psychoanalysis.

  5. Group supervision in a private setting: Practice and method for theory and practice in psychotherapy

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    Graziana Mangiacavallo


    Full Text Available The report aims to tell the experience of a supervision group in a private setting. The group consists of professional psychotherapists driven by the more experienced practitioner, who shares a clinical reasoning on psychotherapy with younger colleagues. The report aims to present the supervision group as a methode and to showcase its features. The supervision group becomes a container of professional experiences that speak of the new way of doing psychotherapy

  6. Drop-out from a psychodynamic group psychotherapy outpatient unit. (United States)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin


    BACKGROUND. Drop-out from psychotherapy is common and represents a considerable problem in clinical practice and research. Aim. To explore pre-treatment predictors of early and late drop-out from psychodynamic group therapy in a public outpatient unit for non-psychotic disorders in Denmark. Methods. Naturalistic design including 329 patients, the majority with mood, neurotic and personality disorders referred to 39-session group therapy. Predictors were socio-demographic and clinical variables, self-reported symptoms (Symptom Check List-90-Revised) and personality style (Millon Clinical Multiaxial Inventory-II). Drop-out was classified into early and late premature termination excluding patients who dropped out for external reasons. Results. Drop-out comprised 20.6% (68 patients) of the sample. Logistic regression revealed social functioning, vocational training, alcohol problems and antisocial behavior to be related to drop-out. However, early drop-outs had prominent agoraphobic symptoms, lower interpersonal sensitivity and compulsive personality features, and late drop-outs cognitive and somatic anxiety symptoms and antisocial personality features. Clinical and psychological variables accounted for the major part of variance in predictions of drop-out, which ranged from 15.6% to 19.5% (Nagelkerke Pseudo R-Square). Conclusion. Social functioning was consistently associated with drop-out, but personality characteristics and anxiety symptoms differentiated between early and late drop-out. Failure to discriminate between stages of premature termination may explain some of the inconsistencies in the drop-out literature. Clinical implications. Before selection of patients to time-limited psychodynamic groups, self-reported symptoms should be thoroughly considered. Patients with agoraphobic symptoms should be offered alternative treatment. Awareness of and motivation to work with interpersonal issues may be essential for compliance with group therapy.

  7. Religious Transformation Among Danish Pentecostals Following Personal Crisis and Group Psychotherapy

    DEFF Research Database (Denmark)

    Viftrup, Dorte Toudal; la Cour, Peter; Buus, Niels


    was applied for generating and analyzing the data-material. The findings suggested that all participants encountered a secondary religious transformation following the personal crisis or religiously integrated group psychotherapy. From a religious development perspective, however, the transformations......The aim was to explore transformations of religiosity experienced by Danish Pentecostals following a crisis and religiously integrated group psychotherapy. The study included semistructured interviews with 18 participants. The qualitative method of interpretative phenomenological analysis...

  8. Attitudes Towards (Psychotherapy) Groups: Results of a Survey in a Representative Sample. (United States)

    Strauss, Bernhard; Spangenberg, Lena; Brähler, Elmar; Bormann, Bianca


    Based upon observations indicating decreasing attractiveness of groups within and outside the clinical field, the present study aimed to determine attitudes toward, and expectations of, groups in a representative sample of 2512 German citizens. The survey also included questions specifically related to group psychotherapy and its acceptance. In addition, psychological characteristics of respondents (measures of narcissism, psychological impairment, and emotion regulation) and socio-demographic variables were assessed to examine their potential association with group-related attitudes. In total, the survey revealed a relatively positive picture of attitudes and expectations toward groups in general and psychotherapy groups in particular. Those with more open attitudes towards groups were comparatively less distressed, anxious, and depressed; they favored emotional reappraisal instead of suppression as the dominant strategy to regulate their emotions. Contrary to prediction, narcissism did not influence attitudes towards groups. The results are related to current discussions of the attractiveness of groups and to implications for the practice of group psychotherapy.

  9. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. (United States)

    Bogenschutz, Michael P; Forcehimes, Alyssa A; Pommy, Jessica A; Wilcox, Claire E; Barbosa, P C R; Strassman, Rick J


    Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants' responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration (p psilocybin session (at week 4) strongly predicted change in drinking during weeks 5-8 (r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5. There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms. NCT02061293. © The Author(s) 2015.

  10. Change mechanisms of schema-centered group psychotherapy with personality disorder patients. (United States)

    Tschacher, Wolfgang; Zorn, Peter; Ramseyer, Fabian


    This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain. 69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome. The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders.

  11. The 12th Curative Factor: Love as an Agent of Healing in Group Psychotherapy. (United States)

    Bemak, Fred; Epp, Lawrence R.


    Proposes love as a curative factor in group psychotherapy. Transference within a group may originate with needs and desires for love. By unmasking transference, subsequent healing may arise from a process of mourning in which group members recognize how their projection of past love onto other group members and onto the psychotherapist is…

  12. Group Psychotherapy with Transgender and Gender Nonconforming Adults: Evidence-Based Practice Applications. (United States)

    Heck, Nicholas C


    Although there are descriptions of transgender-affirmative group psychotherapy services in the literature, there is limited research on the topic. Mental health professionals who plan to offer such services should draw on evidence-based treatments, where appropriate, and have a working knowledge of current standards of care, practice guidelines, and counseling competencies. This article reviews and synthesizes the existing research and scholarship on this topic, placing an emphasis on group-specific competencies and intervention components that can be integrated into psychotherapy groups for transgender and gender nonconforming clients. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Ethics and endings in group psychotherapy: saying good-bye and saying it well. (United States)

    Mangione, Lorraine; Forti, Rosalind; Iacuzzi, Catherine M


    Endings in group psychotherapy are suffused with complexity and potential conflict, some of which entail ethical quandaries. Ethical issues attending endings in group therapy are explored through a discussion of informed consent, time and role boundaries, privacy and confidentiality, unplanned endings, therapist-initiated termination, and competence. Findings from an exploratory survey of members of the American Group Psychotherapy Association and clinical-ethical vignettes are presented to highlight these issues. Clinicians need to develop and maintain ethical fitness and awareness, including attunement to personal responses, to endings and loss.

  14. Group Positive Psychotherapy and Depression of Females Affected by Multiple Sclerosis

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    Tayebeh Khayatan


    Full Text Available Objectives: Multiple Sclerosis is one of the most important and prevalent central nervous system diseases, causing disorders such as depression among affected patients. Positive psychotherapy is also a new approach that can be effective in reducing the depression of these people. This study aims to investigate the efficiency of group positive psychotherapy for decreasing the depression among females affected by Multiple Sclerosis. Methods: A samples of 30 females affected by Multiple Sclerosis with mild to moderate depression were participated, and were divided into two groups, intervention and control. Both groups completed Beck Depression Inventory II (BDI-II at the beginning, he intervention group received six sessions of positive psychotherapy. After the intervention both group completed the questionnaire again. Data was analyzed by descriptive and inferential statistical methods. Results: The result demonstrated that, the decline of depression was more in the intervention group than the control group. Moreover in the intervention group than control group, there was obtained significant reduction in both sub-scales of Beck Depression Inventory II. Discussion: Results of this study indicated that group positive psychotherapy is effective in reducing the depression of females affected by Multiple Sclerosis. This treatment can be widely used in the caring centers for treatment of people affected by Multiple Sclerosis and this can be justified because of its low cost and good efficiency.

  15. [Attainment of generic therapy goals in a specialized group psychotherapy for phobic outpatients]. (United States)

    Trachsel, Manuel; Itten, Simon; Stauffer, Barbara; Holtforth, Martin Grosse; Hofer, Dieter


    Individual therapy goals of psychotherapy patients either focus on symptom relief (disorder specific) or on improvements also in other functional areas (generic). The present study with 62 outpatients in a cognitive behavioral group psychotherapy (CBGT) investigated whether patients attain their disorder specific goals better than their generic therapy goals. Results indicated that patients reached disorder specific goals to a higher degree than the generic goals, although the group treatment specifically targeted the disorder specific goals. Implications of the results for the assessment and therapy of phobic patients are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Changes in personality functioning as a result of group psychotherapy with elements of individual psychotherapy in persons with neurotic and personality disorders - MMPI-2. (United States)

    Cyranka, Katarzyna; Rutkowski, Krzysztof; Mielimąka, Michał; Sobański, Jerzy A; Smiatek-Mazgaj, Bogna; Klasa, Katarzyna; Dembińska, Edyta; Müldner-Nieckowski, Łukasz; Rodziński, Paweł


    The study of group psychotherapy influence on the personality functioning of patients on treatment for neurotic disorders and selected personality disorders (F4-F6 under ICD-10). The study concerned 82 patients (61 women and 21 men) who underwent intensive short-term group psychotherapy in a day ward. A comprehensive assessment of the patients' personality functioning was carried out at the outset and the end of the psychotherapy utilising the MMPI-2 questionnaire. At the treatment outset the majority of the study patients demonstrated a considerable level of disorders in five MMPI-2 clinical scales (Depression, Hysteria, Psychopathic Deviate, Psychastenia, Schizophrenia) and moderate pathology in Hypochondria. In the Mania scale most patients obtained results comparable to the healthy population when the treatment commenced. Having undergone the psychotherapy treatment, the majority of the examined were observed to demonstrate positive changes in those areas of personality functioning which were classified as severe or moderate pathology. Short-term intensive comprehensive group psychotherapy with elements of individual psychotherapy leads to desirable changes in personality functioning.

  17. Change mechanisms of schema-centered group psychotherapy with personality disorder patients.

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    Wolfgang Tschacher

    Full Text Available BACKGROUND: This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain. METHODOLOGY AND FINDINGS: 69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome. CONCLUSIONS/SIGNIFICANCE: The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders.

  18. Effectiveness of group psychotherapy compared to social support groups in patients with primary, non-metastatic breast cancer

    NARCIS (Netherlands)

    Vos, Petra J.; Visser, Adriaan P.; Garssen, Bert; Duivenvoorden, Hugo J.; de Haes, Hanneke C. J. M.


    The aim of the present study is to compare the effectiveness of experiential-existential group psychotherapy with a social support group for women with a primary breast cancer on psychosocial adjustment. A total of 67 well-adjusted women, who had been operated not earlier than 4 months before start

  19. Evaluation of the effects of group psychotherapy on cognitive function in patients with multiple sclerosis with cognitive dysfunction and depression

    Directory of Open Access Journals (Sweden)

    Emine Bilgi


    Full Text Available Objective This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS who are also diagnosed with depression and cognitive dysfunction. Method MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI. The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered. Results Depression and cognitive dysfunction were comorbid in 15 (13.9% of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test. Conclusion Group psychotherapy might decrease cognitive impairment in MS patients.

  20. Where Thanatos Meets Eros: Parallels between Death Education and Group Psychotherapy. (United States)

    Stillion, Judith M.


    Suggests that research aimed at examining the effect of death education courses may be limited by the instructor's lack of awareness of the conditions necessary to promote change. Explores the parallels between death education and group psychotherapy and the factors inherent in seminar-type death education courses. (Author/JAC)

  1. "Depressia" in Post-Katrina New Orleans: Cultural and Contextual Adaptations to Group Interpersonal Psychotherapy (United States)

    Moran, Tracy E.; Larrieu, Julie A.; Zeanah, Paula; Evenson, Amber; Valliere, Jean


    Postpartum depression (PPD) affects a significant portion of women and has serious negative short- and long-term consequences for the woman, infant, and family. This article highlights the feasibility and acceptability of group interpersonal psychotherapy (IPT-G), a manualized approach to PPD treatment, with a high risk and underserved sample of…

  2. Group Psychotherapy for Women with a History of Incest: The Research Base. (United States)

    Marotta, Sylvia A.; Asner, Kimberly K.


    Demonstrates the wide range of adequacy of current studies on group psychotherapy for women with incest histories. Because the studies differed in methodology and reporting, they were categorized and assessed by six criteria: design, sample, inclusion criteria, replicability, analysis, and outcome. Implications for both researchers and…

  3. Guidelines for Individual and Group Psychodynamic Psychotherapy for the Treatment of Persons Diagnosed with Psychosis and/or Schizophrenia. (United States)

    Ivezić, Slađana Štrkalj; Petrović, Branka Restek; Urlić, Ivan; Grah, Majda; Mayer, Nina; Stijačić, Dubravka; Jendričko, Tihana; Martić-Biočina, Sanja


    The hereby presented guidelines for the use of psychodynamic psychotherapy are based on references and research in the field of individual and group therapy and they refer to psychotherapy for patients suffering from the first psychotic episode, schizophrenia, schizoaffective psychosis, bipolar disorder and paranoid psychosis. The aim was to provide an overview of present literature and to give recommendations based on current knowledge. Clinical experience and research of the outcomes of psychodynamic psychotherapy encourage positioning of such treatments among recommendations for treating various mental disorders, as well as in the field of psychotherapy of patients with psychotic disorders (PD).

  4. Forensic psychotherapy. (United States)

    Riordan, Daniel


    This paper describes the role forensic psychotherapy has in the assessment and treatment of mentally disordered offender patients, and its role in the supervision of individual therapists, staff groups or whole organisations which contain and manage this patient population. Forensic psychotherapy has a valuable role to play in the management of mentally disordered forensic patients. As forensic services continue to develop in Australia and New Zealand and interest in this field continues to grow, then the future of forensic psychotherapy looks bright.

  5. In-patient, short-term group psychotherapy ? a therapeutic option for Bundeswehr soldiers?


    Zimmermann, Peter; Kr?ger, Norbert; Willmund, Gerd; Str?hle, Andreas; Heinz, Andreas; Hahne, Hans Heiner


    Objective: This study is to assess the efficacy of short-term group psychotherapy rooted in depth psychology for Bundeswehr soldiers suffering from depressive, neurotic, stress, or personality disorders. Method: 103 participants in the in-patient, closed group setting were evaluated prospectively and compared with a non-randomized waitlisted control group. Results: In all relevant SCL-90-R (Symptom-Check-List-90) and MMPI-K (Minnesota-Multiphasic-Personality-Inventory short-form) scales thera...

  6. Outcome of systemic and analytic group psychotherapy for adult women with history of intrafamilial childhood sexual abuse: a randomized controlled study

    DEFF Research Database (Denmark)

    Lau, M; Kristensen, Ellids


    Research suggests that group psychotherapy for adults with a history of child sexual abuse (CSA) is generally beneficial. Only few studies have included random assignment. This study compared the effects of analytic (A) and systemic group psychotherapy (S) on CSA.......Research suggests that group psychotherapy for adults with a history of child sexual abuse (CSA) is generally beneficial. Only few studies have included random assignment. This study compared the effects of analytic (A) and systemic group psychotherapy (S) on CSA....

  7. The Effect of Positive Group Psychotherapy and Motivational Interviewing on Smoking Cessation: A Qualitative Descriptive Study. (United States)

    Lee, Eun Jin

    The purpose of this study was to describe the process and evaluate the effect of positive group psychotherapy and motivational interviewing as an intervention for smoking cessation. A qualitative descriptive study was conducted at a university in South Korea. Positive group psychotherapy and motivational interviewing were attended by 36 smokers for 1 hour once a week, for 6 hours. A recorded exit interview was conducted after the intervention. The resulting transcripts were analyzed with content analysis and thematic analysis. Among the 36 study participants, the importance of stopping smoking was rated higher in the successful cessation (defined as those who ceased smoking for at least 3 months; hereafter, success group) group (8.6 ± 0.4, n = 10) than in the failed cessation (defined as those who did not cease smoking for at least 3 months; hereafter, failure group) group (7.75 ± 0.3, n = 26; p compliments about efforts for smoking cessation." The importance of and confidence in smoking cessation were predictors for successful cessation for 3-6 months. Motivational interviewing increased motivations, whereas positive group psychotherapy increased positive thoughts and confidence.

  8. A manifesto of community-focused psychotherapy for the social participation: Does individual and group psychotherapy still meet the care needs of the society?

    Directory of Open Access Journals (Sweden)

    Simone Bruschetta


    Full Text Available This paper presents a critical, on a social-political level, of development of psychotherapy, seen as the health discipline, especially in that part of the world called West, scientifically established itself through the evaluation of the effectiveness of its two most common types of setting: Individual and Group- Psychotherapy. Through a social-anthropological interpretation of mental processes which it underpins, and a group analytical analysis of organizational and institutional dynamics that led to its evolution, the authors highlight the significant impasse in which psychotherapy finds itself today compared to new and more pervasive forms of mental suffering. Following on of the latest scientific research on the functioning of the mind and of new policy proposals from the World Health Organization, it is suggested so a form of basic psychotherapy, focused on the quality of the mental health of human contexts, defined Community-Focused Psychotherapy. This new form of psychotherapy is wrong simply understood as a new setting, alongside the classic individual, group, or family setting, but as a political-cultural background and a theoretical-methodological framework, so for different psychotherapeutic treatment (individual, group , family put in place in cases of specific psychopathological symptoms, as for a number of other clinical and social programs, carried out by professionals, workers and (formerly users, who support the empowerment of people, with serious psychological disorders or severe mental illness, in their own social contexts of belonging, and in their own recovery, through the active participation of all those therapeutic processes that support their care. 

  9. Self psychology and its relationship to the practice of group psychotherapy. (United States)

    Berry, C E


    This article discusses self psychology as a theory of personality development and conceptual framework for diagnosing psychopathology. It seeks to show how specific components of this theory, including selfobjects, bipolar self, mirroring, tension arc, and nuclear self, can be compared with the "curative factors" of group psychotherapy, as presented by Yalom (1975). These include altruism, group cohesiveness, universality, interpersonal learning, guidance, and family reenactment. Existing literature is used to explain both theories and develop their synthesis.

  10. Dreams and fantasies in psychodynamic group psychotherapy of psychotic patients. (United States)

    Restek-Petrović, Branka; Orešković-Krezler, Nataša; Grah, Majda; Mayer, Nina; Bogović, Anamarija; Mihanović, Mate


    Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.

  11. Social difficulties influence group psychotherapy adherence in abused, suicidal African American women. (United States)

    Ilardi, Dawn L; Kaslow, Nadine J


    The social brain model emphasizes improving our understanding of the relational factors that influence treatment adherence. Consistent with this framework, which has been applied to medical adherence, it was hypothesized that insecure attachment styles, interpersonal hassles, and low levels of social support would explain group psychotherapy attendance. Results from 51 abused and suicidal low-income, African American women who attended at least 1 session of an empowerment group psychotherapy indicated that lower attendance was related to (a) insecure attachment styles (fearful) and (b) interpersonal hassles (perceived social differences, lack of social acceptability, social victimization). Perceived social support did not predict group therapy attendance. The value of addressing attachment styles and interpersonal factors to enhance treatment participation is underscored.

  12. The different patterns of group climate critical incidents in high and low cohesion sessions of group psychotherapy. (United States)

    Braaten, L J


    The total data set for this study consisted of 958 critical incidents from high and low cohesion sessions in person-centered group psychotherapy. These incidents were typically noted on a group climate questionnaire at the end of each session. Altogether 211 clients and students participated in twenty-six groups. The high cohesion sessions were dominated by the following cohesion dimensions in rank order: self-disclosure and feedback (24.0%); attraction and bonding (20.2%); listening and empathy (20.0%); process performance and goal attainment (15.0%); and support and caring (10.6%). The corresponding rank order for the low cohesion sessions was strikingly different: avoidance and defensiveness (43.5%); conflict and rebellion (22.2%); and self-disclosure and feedback (8.9%). Apparently then, there are very different patterns of critical incidents in high and low cohesion sessions of group psychotherapy.

  13. The written summary as a group psychotherapy technique. (United States)

    Yalom, I; Brown, S; Bloch, S


    During the past 18 months, we have been preparing detailed written summaries of the events of group therapy meetings, which have then been mailed to the group members. This technique was introduced initially as a device to provide structure in a very anxious group. We soon realized that the summary had a great potential for enhancing therapist effectiveness and it came to assume a number of other functions. In this report, we describe our experience with this technique, emphasizing its importance as a tool to improve the cognitive integration of the group therapy experience for both patient and therapist.

  14. The mother-daughter relationship in eating disorders: the psychotherapy group of mothers

    Directory of Open Access Journals (Sweden)

    Alicia Weisz Cobelo


    Full Text Available Psychotherapeutic interventions that bring about differentiation, separation, individuation and autonomy in the mother-daughter relationship are recommended as treatment for eating disorders. With this goal in mind, a psychotherapy group for mothers was organized in an outpatient program for adolescents with eating disorders at a public institution, as one of the psychotherapeutic approaches in the multidisciplinary treatment of adolescent patients. Evidence suggests that this approach can be relevant and effective in the treatment of eating disorders.

  15. Evaluating short-term group psychotherapy with pre-adolescents

    Directory of Open Access Journals (Sweden)

    Graziella Vizziello


    Full Text Available This research aims to assess, with a quantitative and qualitative methodology, the process of a preadolescents’ group therapy. The process has been considered at a qualitative level both through the drawings, as mediating objects, and observation of the sessions; and at a quantitative level through the transcripts examined with the TCM. Five pre-adolescents, aged between 11 and 13 years attended the group. Sessions are on a weekly basis of one hour and a half each. Every cycle of therapy lasts 8 sessions. Between cycles there are 2 months during which the preadolescent attends sessins with his parents in order to work through the changes in the group , and decide weather he needs another cycle. The analysis of the process was carried out by monitoring the evolution of the drawings and the presence/extension of Therapeutic Cycles, as well as the Shift Events. New forms of communication have been clearly identified , from an initial situation where sporadic short Therapeutic Cycles occurred in the sessions to an integration of the group, as shown by the wide presence of Therapeutic Cycles sessions and the shared drawings.Keywords: Group; TCM; Drawing; Interactive behaviours 

  16. The context of transference interpretations in analytical group psychotherapy. (United States)

    Debbane, E G; De Carufel, F


    Transference interpretation varies with the underlying understanding of the concept of transference. We view the phenomena of transference in its multiple connections; its relationship to countertransference, its relationship to a particular kind of remembering that unfolds in sequence rather than in representation and its relationship to working through. The transference is expressed in the context of a "total situation" and in order to unfold, requires a time-space frame which variation will modify the nature of the transference available for interpretation. The analytical frame applied to a group situation creates an environment that promotes rapid and sometimes massive regression. We have introduced the notion of levels of transference to account for the state of self/object differentiation present in the group. This varies with the amount of regression, and depends on the severity of splitting, projection and projective identification. In terms of transferential objects available in the group, we recognize the analyst, other members and the group as a whole. The latter carries the more primitive transference and the underlying phantasy structure of the group transactions. We briefly described some possible errors in the interpretation of transference and their potential consequences.

  17. Self-structure and self-transformation in group psychotherapy. (United States)

    Cohen, B D; Ettin, M F


    This article first outlines a theory of self-structure as a hierarchically organized multiplicity of versions of self. It then describes self-transformation as a two-part process: (Part 1) the articulation and strengthening of individual self-boundaries, and (Part 2) the reclaiming of split-off, denied, or projected aspects of self. Clinically, both parts are products of the communicative interaction among members, the therapist, and the group as a whole. A parallel conception of group development posits that the group, as an object and as a social system, also needs to: (a) articulate and strengthen its boundaries so that it may (b) contain the sustained interdependent, sometimes conflictual, interactivity among members that is essential to the self-reclaiming process.

  18. Effectiveness and predictors of in-patient, short-term group psychotherapy with soldiers of the German Federal Armed Forces


    Willmund, Gerd-Dieter


    Psychotherapy has since increasing deployments of german soldiers in foreign countrys high relevance in the German Federal Armed Forces. This study is to assess the efficacy and analysis of predictos for efficacy of short-term group psychotherapy rooted in depth psychology for Bundeswehr soldiers suffering from depressive, neurotic, stress, or personality disorders. Method: 103 participants in the in-patient, closed group setting were evaluated prospectively and compared with a non-random...

  19. [Mythodrama--a group psychotherapy model for work with children and adolescents]. (United States)

    Guggenbühl, A


    This article discusses group psychotherapy as a possible crisis intervention technique for children and juveniles with behavioral problems at school or whose families are going through divorce, or as an intervention technique in trouble some school classes. The therapeutic group work at the Children and Juvenile Educational Counselling Centre in Bern, Switzerland, is described - "mythodrama" or the "tales, fiction and horror technique", a therapeutic approach which was developed during the last couple of years. The tale at the beginning of the article serves as an introduction and is followed by a description of the different phases of mythodrama. Finally, the main elements of this approach are summarized.

  20. Change in Attachment Dimensions in Women with Binge-Eating Disorder Following Group Psychodynamic Interpersonal Psychotherapy. (United States)

    Maxwell, Hilary; Tasca, Giorgio A; Grenon, Renee; Faye, Megan; Ritchie, Kerri; Bissada, Hany; Balfour, Louise


    To examine the role of attachment dimensions, including coherence of mind and reflective functioning, in developing and maintaining binge-eating disorder (BED) and in determining group psychotherapy outcomes for women with BED. We hypothesize that higher pre-treatment attachment dimension scores will predict better treatment outcomes for women with BED and will increase at follow-up. Women with BED attended 16 sessions of group therapy and completed the Adult Attachment Interview (AAI) at pre-treatment. Participants completed outcome measures (i.e., binge-eating frequency and symptoms of depression) at pre-, post-, six months, and 12 months post-treatment. Treatment completers completed the AAI at six months post-treatment. Treatment outcomes improved significantly from pre- to 12 months post-treatment. Greater Reflective Functioning scores at pre-treatment were related to greater decreases in binge eating across the four time points, whereas Coherence of Mind scores were not. For treatment completers, there were significant increases in Reflective Functioning at six months post-treatment, and about a third of treatment completers experienced clinically significant increases in both attachment dimensions at six months post-treatment. Greater reflective functioning at the outset is important for improvements in binge eating in the longer term and group psychotherapy can facilitate change in reflective functioning.

  1. Eroticism in group psychotherapy: psychoanalytic reflections on desire, agony, and ecstasy. (United States)

    Tylim, Isaac


    To fully understand the complexities of eroticism in groups, it may be necessary to review a conceptual differentiation of desire and its allies: agony and ecstasy. This article suggests that psychoanalytic group psychotherapy is made for neither agony nor ecstasy. Sexual excitement maybe; eroticism and desire, yes; agony and ecstasy, no. While agony or ecstasy imply a threat to the survival of the group, eroticism and desire reaffirm its existence. In this manner the group may be converted into a theater where desire may be celebrated, while the threat of being dissolved in the depths or exaltation of agony and ecstasy is elaborated and worked through: "Desire is desire only if it succeeds in postponing something".

  2. Efficacy of client feedback in group psychotherapy with soldiers referred for substance abuse treatment. (United States)

    Schuman, Donald L; Slone, Norah C; Reese, Robert J; Duncan, Barry


    This study investigated whether routine monitoring of client progress, often called "client feedback," via an abbreviated version of the Partners for Change Outcome Management System (PCOMS) resulted in improved outcomes for soldiers receiving group treatment at an Army Substance Abuse Outpatient Treatment Program (ASAP). Participants (N = 263) were active-duty male and female soldiers randomized into a group feedback condition (n = 137) or a group treatment-as-usual (TAU) condition (n = 126). Results indicated that clients in the feedback condition achieved significantly more improvement on the outcome rating scale (d = 0.28), higher rates of clinically significant change, higher percentage of successful ratings by both clinicians and commanders, and attended significantly more sessions compared to the TAU condition. Despite a reduced PCOMS protocol and a limited duration of intervention, preliminary results suggest that the benefits of client feedback appear to extend to group psychotherapy with clients in the military struggling with substance abuse.

  3. Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. (United States)

    Breitbart, William; Rosenfeld, Barry; Gibson, Christopher; Pessin, Hayley; Poppito, Shannon; Nelson, Christian; Tomarken, Alexis; Timm, Anne Kosinski; Berg, Amy; Jacobson, Colleen; Sorger, Brooke; Abbey, Jennifer; Olden, Megan


    An increasingly important concern for clinicians who care for patients at the end of life is their spiritual well-being and sense of meaning and purpose in life. In response to the need for short-term interventions to address spiritual well-being, we developed Meaning Centered Group Psychotherapy (MCGP) to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose in their lives, even as they approach the end of life. Patients with advanced (stage III or IV) solid tumor cancers (N=90) were randomly assigned to either MCGP or a supportive group psychotherapy (SGP). Patients were assessed before and after completing the 8-week intervention, and again 2 months after completion. Outcome assessment included measures of spiritual well-being, meaning, hopelessness, desire for death, optimism/pessimism, anxiety, depression and overall quality of life. MCGP resulted in significantly greater improvements in spiritual well-being and a sense of meaning. Treatment gains were even more substantial (based on effect size estimates) at the second follow-up assessment. Improvements in anxiety and desire for death were also significant (and increased over time). There was no significant improvement on any of these variables for patients participating in SGP. MCGP appears to be a potentially beneficial intervention for patients' emotional and spiritual suffering at the end of life. Further research, with larger samples, is clearly needed to better understand the potential benefits of this novel intervention. (c) 2009 John Wiley & Sons, Ltd.

  4. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

    in women with a history of CSA participating in both analytic and systemic specialized incest group psychotherapy. Improvement was maintained for both groups at 5-year-follow-up. The trajectories of PTSD symptoms and GSI for the two groups differed significantly, however. Implications of the difference...

  5. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... may be given one-on-one and through support groups, enabling people with BPD to interact with ... Psychotherapy A form of psychotherapy in which consistency, support from others, and a hopeful attitude are used ...

  6. Development of a music group psychotherapy intervention for the primary prevention of adjustment difficulties in Korean adolescent girls. (United States)

    Kim, Sunah; Kverno, Karan; Lee, Eun Mi; Park, Jeong Hwa; Lee, Hyun Hwa; Kim, Hyun Lye


    Traditionally, adolescent mental health in Korea has not been a prime focus for educators, health workers, and politicians, yet a majority of sampled adolescents report interpersonal sensitivity (Kim, 2003). Thirty-five adolescent girls took part in a six-session school-based music group psychotherapy pilot intervention designed to promote relationships and improve self-control skills. Participants identified several outcome benefits that may serve as protective factors in their continued social and emotional development. Music is a medium that promotes interpersonal relatedness among Korean adolescent girls. More research is necessary to identify long-term benefits of preventive music group psychotherapy interventions among the adolescent population.

  7. The Effect of Spiritual and Religious Group Psychotherapy on Suicidal Ideation in Depressed Patients: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Hossein Ebrahimi


    Full Text Available Introduction: Suicide is a great economical, social and public health problem. It is prevalent worldwide and has a lot of negative effects on individuals, families and society. Depression is often prelude to Suicide. An important part of the treatment of the mentally ill patients is spiritual-religious psychotherapy which should be done after physical treatment. The aim of this study was to determine the effect of spiritual and religious group psychotherapy on suicidal ideation in depressed patients. Methods: 51 depressed patients with suicidal ideation from Razi hospital (Tabriz, Iran participated in this clinical trial. To collect Data questionnaire was used which included demographic and Beck Suicide Scale Ideation. Experimental group participated in 10 sessions of group psychotherapy. Each section lasted 1 hour. Two weeks after the last section post test was done. Statistical software SPSS ver 13 was used for data analysis. Results: Results of independent t-test revealed no difference between two groups in terms of suicidal ideation before intervention but after study there is a statistical difference. Also the results of ANCOVA test showed a significant relationship between spiritual group therapy and decrease in suicidal ideation, so that this intervention can make 57% of variance in suicidal ideation of experimental group.Conclusion: Regarding positive effect of spiritual and religious group psychotherapy on decreasing suicidal ideation of depressed patients, we suggest this intervention to be held in Psychiatric Wards and also more study on depression and other psychiatric patients with greater sample size would be helpful.

  8. The effectiveness of group positive psychotherapy on depression and happiness in breast cancer patients: A randomized controlled trial (United States)

    Dowlatabadi, Mohammad Mehdi; Ahmadi, Seyed Mojtaba; Sorbi, Mohammad Hossein; Beiki, Omid; Razavi, Tayebeh Khademeh; Bidaki, Reza


    Background Breast cancer is one of the most prevalent cancers in women in the world. It causes fear, despair, and takes a tremendous toll on psychological status. Objective To determine the effectiveness of group positive psychotherapy on the depression and happiness of breast cancer patients. Methods This randomized controlled trial was conducted with 42 breast cancer patients in The Oncology Center at Kermanshah, Iran in 2015. The Data were gathered before intervention and ten weeks afterwards. The data were collected using Beck’s Depression Inventory (BDI-II) and Oxford’s happiness Inventory (OHI). The data were analyzed by SPSS-16, Kolmogorov-Smirnov (K-S), chi-squared, and multivariate analysis of covariance (MANCOVA). Results The results showed a significant reduction in the depression of the group on positive psychotherapy compared with the control group. Also the positive psychotherapy group experienced a significant increase in the patients’ happiness, while there was no significant increase in the control group. Conclusion The results of this research showed the effectiveness of positive psychotherapy on the reduction of mental pressure and the improvement of the mental status of breast cancer patients. This economical therapy can be used to increase patients’ psychological health. Clinical Trial Registration The trial was registered at the Iranian Registry of Clinical Trials (IRST) with the identification number IRCT2013101410063N4. Funding The authors received financial support for the research from Kermanshah University of Medical Sciences. PMID:27123227

  9. Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: a randomized controlled trial. (United States)

    Bjornsson, Andri S; Bidwell, L Cinnamon; Brosse, Alisha L; Carey, Gregory; Hauser, Monika; Mackiewicz Seghete, Kristen L; Schulz-Heik, R Jay; Weatherley, Donald; Erwin, Brigette A; Craighead, W Edward


    In this randomized controlled trial, cognitive-behavioral group therapy (CBGT) for social anxiety disorder (SAD) was compared to group psychotherapy (GPT), a credible, structurally equivalent control condition that included only nonspecific factors of group treatment (such as group dynamics). Participants were 45 college students at the University of Colorado with a primary diagnosis of SAD. Each treatment condition comprised eight group sessions lasting 2 hr each. Independent assessors (blind to treatment assignment) assessed participants at baseline and posttreatment with the Clinical Global Impression Scale (CGI) and the Liebowitz Social Anxiety Scale (LSAS). Both treatments were found to be equally credible. There were five noncompleters in the CBGT condition (21.7%) and only one in the GPT condition (4.3%). There were no statistically significant differences posttreatment (controlling for pretreatment scores) between the two treatment conditions, and both treatments were found to be efficacious. Effect sizes for CBGT were similar to earlier studies, and adherence ratings revealed excellent adherence. Treatment of SAD appears to be moving toward individual CBT, partly because of high attrition rates and underutilization of group dynamics in group CBT. However, group therapy has unique therapeutic ingredients, and it may be too early to give up on group treatment altogether. Discussion of these findings included future directions with this treatment modality, especially whether these two types of group treatment could be combined and whether such combination might serve to decrease attrition, enhance efficacy, and facilitate dissemination. © 2011 Wiley Periodicals, Inc.

  10. Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: protocol of a randomized controlled trial.

    NARCIS (Netherlands)

    van der Spek, N.; Vos, J.; van Uden-Kraan, C.F.; Breitbart, W.; Cuijpers, P.; Knipscheer-Kuipers, K.; Willemsen, V.W.B.; Tollenaar, R.A.; van Asperen, C.J.; de Leeuw, I.M.


    Background: Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors

  11. The association between retrospective outcome evaluations and pre-post-treatment changes in psychodynamic group-psychotherapy

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin


    In the present study of 203 patients in psychodynamic group psychotherapy, we explore associations between patient and therapist global retrospective outcome evaluations (ROE), and pre-post-treatment changes on the Symptom Check List 90 Revised (SCL-90-R) and non-symptomatic focus of therapy. The......, and associated with personality factors or domains not captured by standard questionnaires....

  12. Group-based interpersonal psychotherapy for posttraumatic stress disorder: theoretical and clinical aspects. (United States)

    Robertson, Michael; Rushton, Paul J; Bartrum, Dee; Ray, Rebecca


    Posttraumatic stress disorder (PTSD) is a condition that engenders both symptomatic distress and severe disruption in interpersonal and social functioning. Most of the empirical research on treatment has emphasized interventions that aim to alleviate the symptoms of PTSD, despite the persisting impairments in social, occupational, and interpersonal functioning. In clinical practice, achieving relief from symptoms such as irritability or phobic avoidance is a worthwhile goal, yet significant distress and disability derived from disruptions to interpersonal attachments, social networks, and confiding intimate relationships persist. Interpersonal psychotherapy (IPT) has been shown to be efficacious in research settings for depression and eating disorders, in both group and individual formats. Recent pilot data also suggests the potential usefulness of IPT in anxiety disorders. The aim of this paper is to provide a rationale for the use of group-based IPT as an intervention for PTSD as part of a management package, arguing from theoretical and clinical viewpoints. The integration of IPT therapeutic processes with the therapeutic group process is discussed, and a detailed case discussion is presented as an illustration.

  13. Group psychotherapy for eating disorders: A randomized clinical trial and a pre-treatment moderator and mediator analyses

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir

    English summary The aim of this thesis was twofold. First, I wanted to examine the effect of client feedback on treatment attendance and outcome in group psychotherapy for eating disorders. Second, I wanted to contribute to the relatively scarce body of research on the consequences of an eating...... disorder on functionality. Group psychotherapy of various types is widely used to treat individuals with eating disorders. Dropout is, however, an important problem in the treatment of these patients, and it is therefore important to find ways to increase attendance. One of the means to address...... the Outcome Rating Scale and the Group Session Rating Scale. The primary outcome was rate of attendance at treatment sessions; the secondary outcome was the severity of eating disorder symptoms measured with the Eating Disorder Examination interview. Exploratory outcomes were psychological distress measured...

  14. Assimilation, reflexivity, and therapist responsiveness in group psychotherapy for social phobia: A case study. (United States)

    Penttinen, Henna; Wahlström, Jarl; Hartikainen, Katja


    This case study examined reflexivity and the assimilation of problematic experiences, especially its progress within and between the Assimilation of Problematic Experiences Scale (APES) Stages 2-3, in group psychotherapy for social phobia. The data consisted of all of one client's turns expressing the two voices of her main problematic experience in 12 sessions, and all replies by the therapist in direct connection to them. The client's utterances were rated on the APES. A detailed analysis of 13 conversational passages revealed that progress in assimilation happened only when the client took a reflexive stance towards her inner experience or outer actions. There were a few instances when she took a reflexive stance, but no progress in assimilation could be noted. A qualitative analysis of three conversational episodes showed how therapist responsiveness facilitated the client's increased reflexivity and progress in assimilation. Reflexivity appears to be a necessary condition for progress in assimilation both at APES Stages 2 and 3, but the model should recognize that reflexivity can appear in diverse forms and at different levels. Therapist responsiveness and sensitivity to the client's assimilation process is crucial for a successful transition from Stage 2 to Stage 3.


    Directory of Open Access Journals (Sweden)

    Jaime Williams


    Full Text Available Mental health day treatment (MHDT programs provide intensive group psychotherapy for patients with psychiatric pathology complicated by personality disorder. Recently, researchers have begun to examine specific components of these programs. Of importance is the theoretical rationale, which may be challenging to understand given the complexity of the treatment. The purpose of this project was to investigate the theory of one MHDT program. Community-based participatory research was chosen and accordingly, all stages of the project were collaborative with the MHDT clinical team. We engaged in a six-month, iterative process of weekly action-reflection cycles wherein material was discussed, analyzed for themes, and the findings presented back to the team to further the conversation. Results summarize this program’s Theories of Dysfunction and Therapeutic Change, which were primarily psychodynamic, but also integrative through assimilation of elements from other paradigms. Usefulness of the research process is discussed and recommendations are provided for others wishing to undergo a similar process.

  16. A case series report of cancer patients undergoing group body psychotherapy [version 1; referees: 2 approved

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    Astrid Grossert


    Full Text Available Background: Disturbances in bodily wellbeing represent a key source of psychosocial suffering and impairment related to cancer. Therefore, interventions to improve bodily wellbeing in post-treatment cancer patients are of paramount importance. Notably, body psychotherapy (BPT has been shown to improve bodily wellbeing in subjects suffering from a variety of mental disorders. However, how post-treatment cancer patients perceive and subjectively react to group BPT aiming at improving bodily disturbances has, to the best of our knowledge, not yet been described. Methods: We report on six patients undergoing outpatient group BPT that followed oncological treatment for malignant neoplasms. The BPT consisted of six sessions based on a scientific embodiment approach, integrating body-oriented techniques to improve patients’ awareness, perception, acceptance, and expression regarding their body. Results: The BPT was well accepted by all patients. Despite having undergone different types of oncological treatment for different cancer types and locations, all subjects reported having appreciated BPT and improved how they perceived their bodies. However, individual descriptions of improvements showed substantial heterogeneity across subjects. Notably, most patients indicated that sensations, perceptions, and other mental activities related to their own body intensified when proceeding through the group BPT sessions. Conclusion: The findings from this case series encourage and inform future studies examining whether group BPT is efficacious in post-treatment cancer patients and investigating the related mechanisms of action. The observed heterogeneity in individual descriptions of perceived treatment effects point to the need for selecting comprehensive indicators of changes in disturbances of bodily wellbeing as the primary patient-reported outcome in future clinical trials. While increases in mental activities related to their own body are commonly

  17. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

    Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...... assigned to systemic group psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline, at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist- 90...

  18. Transferência e psicoterapia de grupo Transferencia y psicoterapia de grupo Transference and group psychotherapy

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    Luiz Paulo de C. Bechelli


    , coexisten múltiples transferencias que los miembros del grupo establecen entre sí, potencializando un gama de posibilidades de sentimientos. Ambas modalidades mantienen en común el presupuesto de que los conflictos psíquicos que impulsaron el paciente a buscar ayuda se pueden reducir o inclusive suprimir mediante la interpretación y la elaboración de la transferencia, que funcionan como procedimientos de cambio en el decurso del proceso terapéutico.This study examines the concept of transference, focusing on its peculiarities in the group context. The nature of the therapeutic situation and the broad freedom given to patients in order to access the unconscious material at their own pace, within a safe environment and with as little censorship as can be managed, transference gradually takes place. Through displacement, the psychotherapist and group members are perceived not as they are, with their real attributes, but as one or more objects that arouse emotions coming from the infant world, more precisely from the collection of deep affective influences. One peculiarity of the group situation when compared to individual psychotherapy is that, in the former, multiple transferences coexist, which group members establish among themselves, enabling a wide range of possible feelings. Both treatment modes share the assumption that unresolved conflicts which stimulated patients to seek for help can be reduced or even abolished through the interpretation and working through of transference, which functions as a process of change throughout the psychotherapy.

  19. Effect of Group Positive Psychotherapy on Improvement of Life Satisfaction and The Quality of Life in Infertile Woman

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    Seyed Teymur Seyedi Asl


    Full Text Available Background: Positive psychotherapy is one of the new approaches in psychology which is innovated for treating psychological disorders and enhancing positive emotions. The aim of this study is to investigate the effectiveness of the group positive psychotherapy on elevation of life satisfaction and quality of life in infertile women. Materials and Methods: In a randomized trial study, Beck Depression Inventory II (BDI-II and clinical interview were used in a pre-test post-test control group design. After analyzing the result of the questionnaire, 36 infertile women who showed signs of mild to moderate depression were randomly placed into two following groups: control (n=18 and intervention (n=18. Before the treatment, the members of both groups answered BDI-II, Satisfaction With Life Scale (SWLS and 12 item Short Form Health Survey (SF-12. The intervention group received six sessions of group positive psychotherapy, but the treatment of the control group began six weeks after the intervention group. Results: The results showed that the life satisfaction scores of the intervention group were significantly elevated from 22.66 in pre-test to 26.13 in post-test (P<0.001, while this improvement was not significant in the control group (P=0.405. The difference between life satisfaction scores of the intervention and the control groups was also significant (F=8.92, P=0.006. However, no significant change in the quality of life level of the intervention and control groups was observed (P=0.136. Conclusion: Thus it can be deduced from the findings that this treatment method could be introduced as solution to increase the life satisfaction in infertile women, but not as a treatment for elevating their quality of life (Registration Number: IRCT2013042810063N3.

  20. Trajectories of long-term outcomes for postnatally depressed mothers treated with group interpersonal psychotherapy. (United States)

    Reay, Rebecca E; Owen, Cathy; Shadbolt, Bruce; Raphael, Beverley; Mulcahy, Rhiannon; Wilkinson, Ross B


    There is evidence that psychological treatments for postnatal depression are effective in the short-term; however, whether the effects are enduring over time remains an important empirical question. The aim of this study was to investigate the depressive symptoms and interpersonal functioning of participants in a randomised controlled trial (RCT) of group interpersonal psychotherapy (IPT-G) at 2 years posttreatment. The study also examined long-term trajectories, such as whether participants maintained their recovery status, achieved later recovery, recurrence or persistent symptoms. Approximately 2 years posttreatment, all women in the original RCT (N = 50) were invited to participate in a mailed follow-up. A repeated measures analysis of variance assessed differences between the treatment and control conditions on depression and interpersonal scores across five measurement occasions: baseline, mid-treatment, end of treatment and 3-month and 2-year follow-up. Chi-square tests were used to analyse the percentage of participants in the four recovery categories. Mothers who received IPT-G improved more rapidly in the short-term and were less likely to develop persistent depressive symptoms in the long-term. Fifty seven percent of IPT-G mothers maintained their recovery over the follow-up period. Overall, IPT-G participants were significantly less likely to require follow-up treatment. Limitations include the use of self-report questionnaires to classify recovery. The positive finding that fewer women in the group condition experienced a persistent course of depression highlights its possible enduring effects after treatment discontinuation. Further research is needed to improve our long-term management of postnatal depression for individuals who are vulnerable to a recurrent or chronic trajectory.

  1. Interpersonal learning is associated with improved self-esteem in group psychotherapy for women with binge eating disorder. (United States)

    Gallagher, Meagan E; Tasca, Giorgio A; Ritchie, Kerri; Balfour, Louise; Maxwell, Hilary; Bissada, Hany


    Yalom and Leszcz (2005) indicated that interpersonal learning is a key therapeutic factor in group psychotherapy. In this study, we conceptualized interpersonal learning as the convergence over time between an individual's and the group's perception of the individual's cohesion to the group. First, we developed parallel measures of: (a) an individual's self-rated cohesion to the group (Cohesion Questionnaire-Individual Version [CQ-I]), and (b) the group's rating of the individual's cohesion to the group (CQ-G) based on the original Cohesion Questionnaire (CQ; Piper, Marache, Lacroix, Richardsen, & Jones, 1983). Second, we used these parallel scales to assess differences between an individual's self-rating and the mean of the group's ratings of the individual's cohesion to the group. Women with binge eating disorder (N = 102) received Group Psychodynamic Interpersonal Psychotherapy. Participants were assigned to homogeneously composed groups of either high or low attachment anxiety. Outcomes were measured pre- and post-treatment, and the CQ-I and CQ-G were administered every fourth group session. We found significant convergence over time between the CQ-I and mean CQ-G scale scores in both attachment anxiety conditions. Participants with higher attachment anxiety had lower individual self-ratings of cohesion and had greater discrepancies between the CQ-I and CG-G compared with those with lower attachment anxiety. There was a significant relationship between greater convergence in cohesion ratings and improved self-esteem at post-treatment. More accurate self-perceptions through feedback from group members may be a key factor in facilitating increased self-esteem in group therapy. Group therapists may facilitate such interpersonal learning, especially for those higher in attachment anxiety, by noting discrepancies and then encouraging convergence between an individual and the group in their perceptions of cohesion to the group. (c) 2014 APA, all rights reserved.

  2. Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: protocol of a randomized controlled trial. (United States)

    van der Spek, Nadia; Vos, Joël; van Uden-Kraan, Cornelia F; Breitbart, William; Cuijpers, Pim; Knipscheer-Kuipers, Kitty; Willemsen, Vincent; Tollenaar, Rob A E M; van Asperen, Christi J; Verdonck-de Leeuw, Irma M


    Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors (MCGP-CS) was designed to help patients to sustain or enhance a sense of meaning and purpose in their lives. The aim of the proposed study is to evaluate the effectiveness and cost-effectiveness of MCGP-CS. Survivors diagnosed with cancer in the last 5 years and treated with curative intent, are recruited via several hospitals in the Netherlands. After screening, 168 survivors are randomly assigned to one of the three study arms: 1. Meaning-Centered Group Psychotherapy (MCGP-CS) 2. Supportive group psychotherapy (SGP) 3. Care as usual (CAU). Baseline assessment takes place before randomisation, with follow up assessments post-intervention and at 3, 6 and 12 months follow-up. Primary outcome is meaning making (PMP, PTGI, SPWB). Secondary outcome measures address quality of life (EORTC-30), anxiety and depression (HADS), hopelessness (BHS), optimism (LOT-R), adjustment to cancer (MAC), and costs (TIC-P, EQ-5D, PRODISQ). Meaning-focused coping is key to adjustment to life after cancer, however, there is a lack of evidence based psychological interventions in this area. Many cancer survivors experience feelings of loneliness and alienation, and have a need for peer support, therefore a group method in particular, can be beneficial for sustaining or enhancing a sense of meaning. If this MCGP-CS is effective for cancer survivors, it can be implemented in the practice of psycho-oncology care. Netherlands Trial Register, NTR3571.

  3. Mindfulness-and body-psychotherapy-based group treatment of chronic tinnitus: a randomized controlled pilot study

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    Kreuzer Peter M


    Full Text Available Abstract Background Tinnitus, the perception of sound in absence of an external acoustic source, impairs the quality of life in 2% of the population. Since in most cases causal treatment is not possible, the majority of therapeutic attempts aim at developing and strengthening individual coping and habituation strategies. Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular in the treatment of stress-related disorders. Here we conducted a randomized, controlled clinical study to investigate the efficacy of a specific mindfulness- and body-psychotherapy based program in patients suffering from chronic tinnitus. Methods Thirty-six patients were enrolled in this pilot study. The treatment was specifically developed for tinnitus patients and is based on mindfulness and body psychotherapy. Treatment was performed as group therapy at two training weekends that were separated by an interval of 7 weeks (eleven hours/weekend and in four further two-hour sessions (week 2, 9, 18 and 22. Patients were randomized to receive treatment either immediately or after waiting time, which served as a control condition. The primary study outcome was the change in tinnitus complaints as measured by the German Version of the Tinnitus Questionnaire (TQ. Results ANOVA testing for the primary outcome showed a significant interaction effect time by group (F = 7.4; df = 1,33; p = 0.010. Post hoc t-tests indicated an amelioration of TQ scores from baseline to week 9 in both groups (intervention group: t = 6.2; df = 17; p  Conclusions Our results suggest that this mindfulness- and body-psychotherapy-based approach is feasible in the treatment of tinnitus and merits further evaluation in clinical studies with larger sample sizes. The study is registered with (NCT01540357.

  4. Psicoterapia em grupo de pacientes com transtorno afetivo bipolar Group psychotherapy for bipolar disorder patients

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    Bernardo Carramão Gomes


    treatment of bipolar patients. However, little is known about the effects of these approaches. OBJECTIVE: Evaluate the effectiveness of Group Therapy in the treatment of bipolar affective disorder. METHOD: Review of the literature using Medline, Lilacs, PubMed e ISI, selecting English language articles published between the years of 1975 and 2005. The reference sections of the selected articles, review articles and specialized books were also consulted. Only randomized controlled trails, with more than twenty subjects, were selected. RESULTS: Five published studies were identified; three of them have been published in the last five years. In three of the selected studies, models of Psychoeducation were used, showing an increase in the adherence to the pharmacological treatment. One showed reduction in the number of relapses and hospital admissions. The other two studies combined psychoeducation with some other form of psychotherapeutic approach. In one of them, not only an increase in the remission period but also symptom reduction was identified, concerning manic episodes. DISCUSSION: There has been a growing interest in evidence based psychotherapy interventions for the treatment of bipolar affective disorder over the last years. This fact contrasts with the low number of studies dedicated to group therapy, which could be very useful in institutions where a great number of patients are assisted. The clinical complexities of this disease, the presence of several comorbidities and the different levels of adherence to pharmacotherapy demand the development of diverse therapeutic options, in order to meet the needs of each individual. The studies show that group therapy could be an effective treatment option that deserves better investigations so that it can be used in clinical practice.

  5. Feedback versus no feedback in improving patient outcome in group psychotherapy for eating disorders (F-EAT)

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Poulsen, Stig Bernt; Waaddegaard, Mette


    Background Continuous feedback on patient improvement and the therapeutic alliance may reduce the number of dropouts and increase patient outcome. There are, however, only three published randomized trials on the effect of feedback on the treatment of eating disorders, showing inconclusive results...... or control group at a ratio of 1:1. The experimental group will receive standard treatment (systemic and narrative group psychotherapy) with feedback intervention, whereas the control group will receive standard treatment only. The participants are diagnosed with bulimia nervosa binge eating disorder......, or an eating disorder not otherwise specified, according to the DSM-IV. In the experimental group feedback to the participants, based on the Outcome Rating Scale (ORS) and the Group Session Rating Scale (GSRS), is actively added to standard treatment. The ORS assesses areas of life functioning known to change...

  6. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

    Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...

  7. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke


    Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...

  8. A small-scale study comparing the impact of psycho-education and exploratory psychotherapy groups on newcomers to a group for people with dementia. (United States)

    Cheston, Richard; Jones, Roy


    The importance of providing emotional support to people newly diagnosed as having dementia is now widely recognised. However, the evidence base for this work is limited, so that it is difficult to draw conclusions either about whether this form of work is effective or which form of intervention might be most suitable for people with dementia. This study compared the effectiveness of exploratory psychotherapy and psycho-educational group interventions for new group members. Participants had received a diagnosis of Dementia of the Alzheimer's type or a similar form of dementia and had a mild level of cognitive impairment. Interventions occurred in ten, weekly sessions with participants attending either a psychotherapy or a psycho-educational group, each of which were facilitated by the same team of clinicians, and had the same amount of therapist contact. Data relating to levels of mood was collected at the start and at the end of the group intervention from eight participants in each arm of the study. Data collection occurred independently from the intervention by a researcher who was blind to the form of intervention. There was a significant interaction between mode of therapy and levels of depression and a borderline significant interaction between therapy type and levels of anxiety. However, once the low affect level of participants in the psycho-educational groups was controlled for, differences between the interventions were non-significant. Although the results that can be drawn from this study are limited, nevertheless it supports previous research indicating that a 10-week group psychotherapy intervention can be effective in reducing levels of depression for people with a mild level of dementia.

  9. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

    Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and gene......Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...... assigned to systemic group psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline, at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist- 90...

  10. Mindfulness-and body-psychotherapy-based group treatment of chronic tinnitus: a randomized controlled pilot study. (United States)

    Kreuzer, Peter M; Goetz, Monika; Holl, Maria; Schecklmann, Martin; Landgrebe, Michael; Staudinger, Susanne; Langguth, Berthold


    Tinnitus, the perception of sound in absence of an external acoustic source, impairs the quality of life in 2% of the population. Since in most cases causal treatment is not possible, the majority of therapeutic attempts aim at developing and strengthening individual coping and habituation strategies. Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular in the treatment of stress-related disorders. Here we conducted a randomized, controlled clinical study to investigate the efficacy of a specific mindfulness- and body-psychotherapy based program in patients suffering from chronic tinnitus. Thirty-six patients were enrolled in this pilot study. The treatment was specifically developed for tinnitus patients and is based on mindfulness and body psychotherapy. Treatment was performed as group therapy at two training weekends that were separated by an interval of 7 weeks (eleven hours/weekend) and in four further two-hour sessions (week 2, 9, 18 and 22). Patients were randomized to receive treatment either immediately or after waiting time, which served as a control condition. The primary study outcome was the change in tinnitus complaints as measured by the German Version of the Tinnitus Questionnaire (TQ). ANOVA testing for the primary outcome showed a significant interaction effect time by group (F = 7.4; df = 1,33; p = 0.010). Post hoc t-tests indicated an amelioration of TQ scores from baseline to week 9 in both groups (intervention group: t = 6.2; df = 17; p < 0.001; control group: t = 2.5; df = 16; p = 0.023), but the intervention group improved more than the control group. Groups differed at week 7 and 9, but not at week 24 as far as the TQ score was concerned. Our results suggest that this mindfulness- and body-psychotherapy-based approach is feasible in the treatment of tinnitus and merits further evaluation in clinical studies with larger sample sizes.The study is

  11. Personality disorder moderates outcome in short- and long-term group analytic psychotherapy: A randomized clinical trial. (United States)

    Lorentzen, Steinar; Ruud, Torleif; Fjeldstad, Anette; Høglend, Per A


    In a randomized clinical trial, short- and long-term psychodynamic group psychotherapy (STG and LTG, respectively) schedules were equally effective for the 'typical' patient during a 3-year study period. Although several studies have reported good effects for patients with personality disorders (PD) in diverse forms of psychotherapy, the significance of treatment duration is unclear. Therefore, we tested the hypothesis that PD patients would improve more during and after LTG than STG. A randomized, longitudinal, prospective study contrasting the outcomes during and after short- and long-term dynamic group psychotherapies. One hundred and sixty-seven outpatients with mood disorders, anxiety disorders, or PD were randomized to STG or LTG (respectively, 20 or 80 weekly sessions of 90 min each). Outcome measures are as follows: symptoms (SCL-90-R), interpersonal problems (IIP-C), and psychosocial functioning (GAF split version: GAF-Symptom and GAF-Function). PD pathology (number of PD criteria items) was selected a priori as a putative moderator of treatment effects. Change during the 3-year study period was assessed using linear mixed models. The study was registered at as NCT 00021417. Our hypothesis was supported, as patients with PD improved significantly more regarding all outcome variables in LTG than STG. For patients without PD, the rate of change was similar across 3 years; however, the rate of change in symptoms and interpersonal problems was higher in STG during the first 6 months. The effectiveness of LTG is higher for patients with co-morbid PD. Patients without PD do not appear to experience additional gain from LTG. Clinical implications: LTG demonstrates better effectiveness than STG for patients with personality disorder co-morbidity (PD). Patients without PD do not appear to experience additional gain from attending LTG. Correct initial allocation to treatment duration may prevent disruptive breaks in relationships and lead to both

  12. Issues Facing Postgraduate International Students: A View from an International Students' Group on A Masters Programme in Art Psychotherapy (United States)

    Skaife, Sally; Reddick, Dean


    This paper describes case study research of four years of a support group for self-identified international students on an MA Art Psychotherapy programme. The research sought to understand the role of the group in the processing of international students' issues, to broaden thinking on the internationalising of curricula. A key finding was that…

  13. A co-vision group between members of the "Laboratorio di Gruppoanalisi" focused on multimodal and community analytic psychotherapy in private practice

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    Simone Bruschetta


    Full Text Available This paper describes the experience of a groupanalytic group of covision to the psychotherapy, understood as peer analytic supervision, composed of four participants and took place inside the Catania site of the scientific association “Laboratorio odi Gruppoanalisi”. The group of covision in question, with a closed setting (four persons and a fixed term (six sessions, was oriented to the peer supervision of four case (herein described cared through the private practice of psychotherapy, particularly with a focus on those cases that require a psychotherapy in multimodal settings and a therapeutic project co-constructed not only with the patient but also with other family, institutional and / or community commitments. Equality between its members and the consequent reshaping of the leadership role in the group, than in the classic setting of the supervision group, are discussed and presented by the authors through the description of the experience of working on clinical cases brought, the reflection on the process and the peculiar dynamics of the group, and the proposal of specific theoretical elaborations on the transformations and the knowledge that the groupanalytic covision provides access.Keywords: Analytic group; Group-analytic co-visio; Peer supervision; Multimodal setting; Community focused Psychotherapy  

  14. Moderators of the effects of meaning-centered group psychotherapy in cancer survivors on personal meaning, psychological well-being, and distress

    NARCIS (Netherlands)

    Holtmaat, Karen; van der Spek, Nadia; Witte, Birgit I; Breitbart, William; Cuijpers, Pim; Verdonck-de Leeuw, Irma M


    PURPOSE: There is evidence to support that meaning-centered group psychotherapy for cancer survivors (MCGP-CS) is an effective intervention for improving personal meaning and psychological well-being, as well as reducing psychological distress. In order to investigate which subpopulations MCGP-CS

  15. An investigation on the effectiveness of group psychodynamic psychotherapy on the personality dimensions in divorced and non-divorce woman with low marital satisfaction

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    Mehdi Mehryar


    Full Text Available Introduction: Present study is aimed at investigating the effectiveness of psychodynamic psychotherapy on the personality characteristics of divorced and non-divorced women with low marital satisfaction. Materials and Methods: This clinical research conducted in the clients referred to Khane Roshan-e-Doost Psychological Studies Institute. They are evaluated clinically through interviews and questionnaires. So, 45 patients selected and divided in three equal groups of divorced women, non-divorced women (married with low marital satisfaction, and control group. Then, the groups of divorced and non-divorced women with low marital satisfaction participated in 24 sessions of psychodynamic psychotherapy. To collect data, Cattel’s 16-item questionnaire and Enrich marital satisfaction questionnaire were used. Data analyzed through multivariate analysis of covariance (MANCOVA. Results: The results of this study indicated that training of psychodynamic psychotherapy caused a significant change in personality traits in divorced women and in married women with low marital satisfaction. Only in factor B (intelligent - low intelligence and factor Q1 (conservatism there was no significant difference between experimental and control groups. The results of correlation between personality factors and low marital satisfaction pointed that there is a significant relationship between all factors of personality except the factor of conservatism.  Conclusion: Based on the results, psychodynamic psychotherapy is effective in significant improvement of most of personality traits. Therefore, applying this method can be useful in improving marital personality traits, reducing divorce and maintaining mental health.

  16. O terapeuta na psicoterapia de grupo El terapeuta en la psicoterapia de grupo The therapist in group psychotherapy

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    Luiz Paulo de C. Bechelli


    la psicoterapia de grupo su singular potencial terapéutico.Nowadays, group psychotherapy designates a broad range of procedures based on different theoretical frameworks, applied to several contexts. The purpose of this study is to understand the group therapist's role, delineating some strategies and necessary abilities for group psychotherapy practice. The authors emphasize the technical-scientific level in which the work with groups is developed and the influence of the therapist's personality on the participants. They conclude that, in order to preserve their role without loosing the specificity of his function due to his involvement in multiple patients' experiences, therapists must have a stable professional identity. Therefore, the therapists' preparation, based on a process of continuing formation, is a necessary condition to enable them to face peculiar situations that occur in the group context and also to assure the singular therapeutic potential of group psychotherapy.

  17. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change (United States)

    Styła, Rafał


    Background: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and “V” shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a “V” shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and “V” shape of SCC change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis. PMID:26579001

  18. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change. (United States)

    Styła, Rafał


    Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and "V" shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a "V" shape or fluctuations is optimal for more disturbed patients. Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and "V" shape of SCC change. The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis.

  19. [New media - new prospects in psychotherapy process research: feedback of text-based processes in internet chat groups]. (United States)

    Haug, Severin; Strauss, Bernhard; Kordy, Hans


    Group psychotherapy via Internet-chat offers not only an optimisation of therapeutic service provision but also new prospects for process research. The communication content could be analysed automatically and therefore text-based process variables could be fed back to the therapist immediately. In a former study , different text-based process variables in therapeutic Internet-chat aftercare groups were validated and the best concurrent validity with psychometric group evaluations was found for the text-based process variable "Activity", operationalised by the number of words and statements that a patient writes during a chat session. Based on this result, Activity was used in this study for the development of a feedback given to the therapist. The feedback was given after the first half of the chat session to alert the therapist to inactive patients and to encourage him to a reflection of his therapeutic strategy. The feedback was given in four different Internet-chat aftercare groups and evaluated in a randomised controlled trial comprising 86 group sessions where the patients' group evaluations were compared between feedback and non-feedback sessions. In addition it was examined whether inactive patients from the first half of the group session were addressed more often by the therapist during the second half of the session and whether they were more active during the second half of the session. Even though the feedback was evaluated by the therapists as helpful in 68 % of the sessions and it resulted in therapeutic modifications in 40 % of the feedback-sessions, no effect on the patients' group evaluations or their activity during the second half of the session could be examined. The results and alternative feedback strategies are discussed.

  20. Power Politics of Family Psychotherapy. (United States)

    Whitaker, Carl A.

    It is postulated that the standard framework for psychotherapy, a cooperative transference neurosis, does not validly carry over to the successful psychotherapy of a two-generation family group. In many disturbed families, the necessary and sufficient dynamics for change must be initiated, controlled, and augmented by a group dynamic power-play,…

  1. The level of emotional intelligence for patients with bronchial asthma and a group psychotherapy plan in 7 steps. (United States)

    Ropoteanu, Andreea-Corina


    Strong emotions, either positive or negative, as well as vulnerability to stress are often major factors in triggering, maintaining and emphasizing the symptoms of bronchial asthma. On a group of 99 patients suffering from moderately and severely persistent allergic bronchial asthma for more than 2 years, I applied a situational test of emotional intelligence, the NEO PI-R personality test provided by D&D Consultants and I also elaborated a psychosocial test form of asthma by which I evaluated the frequency of physical symptoms, the intensity of negative emotional symptoms arisen during or subsequent to the crisis and the level of the patients' quality of life. I have presumed first that if the level of the emotional intelligence grew, this fact would have a significant positive influence on controlling the negative emotional symptoms arisen during or subsequent to the crisis and on patients' quality of life. This was invalidated, the correlations between the mentioned variables being insignificant. Secondly, I have presumed the existence of positive significant correlations between the emotional intelligence coefficient and the personality dimensions: extraversion, openness, conscientiousness and a negative significant correlation between the emotional intelligence coefficient and the dimension neuroticism. This presumption was totally confirmed. Finally, we proposed a group psychotherapy plan in 7 steps for asthmatic patients that has as main objectives to improve symptoms and therefore the patients' quality of life.

  2. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... Resources For Professionals Contact Us Borderline Personality Disorder Resource Center Diagnosis and Treatment Psychotherapy Psychotherapy Diagnosis and Treatment Psychotherapy Questions to Ask ...

  3. Coming to our senses: the application of somatic psychology to group psychotherapy. (United States)

    Cohen, Suzanne L


    Somatic psychology, the interplay of the body, the mind, the emotions, and the social context, significantly contributes to the theory and practice of group therapy. The processing of sensory experiences in the here-and-now of the therapy group helps group members to develop self-awareness, the ability to understand their relationships with others, and the capacity for empathy. When group members know what they experience, they can understand how others feel and resonate emotionally with those feelings. Neurobiology, sensory processing, and attachment theories help us to understand how the sense of self develops somatically. Principles of somatic therapies are applied to group therapy practice in working with attachment disorders, transference impasse, and trauma. The importance and implications of the group therapist's embodied attunement are explored.

  4. [Group psychotherapy. Operative groups at the Instituto del servico de seguridad Social de los Trabajadores del Estado (ISSSTE)]. (United States)

    Margolis, J


    An operational group is defined; how operational groups theory was applied at an ISSSTE clinic is described. It is underlined how operational groups promote change around the corerstone of a "task". The vicissitudes of an operational group with four psychiatrists who worked in community psychiatry at the ISSSTE, are described.

  5. Dreams of deceased children and countertransference in the group psychotherapy of bereaved mothers: clinical illustration. (United States)

    Begovac, Branka; Begovac, Ivan


    This article presents, in the form of a clinical illustration, a therapeutic group of bereaved mothers with special reference to their dreams about their deceased children. The article presents descriptions of the emotions of these mothers and countertransference feelings, a topic that, to our knowledge, has not been frequently studied. The group was small, analytically oriented, slow-open, comprised of women bereaved by the death of a child, and conducted by a female therapist. Over more than three years, the group included 20 members in total. This article describes a number of dreams recorded during a period when the group included seven members. Dreams helped the group members access their emotional pain, helplessness, yearning for a relationship with the deceased, guilt, and feelings of survival guilt. The transference-countertransference relationships were characterized by holding. Countertransference feelings of helplessness predominated. The therapist and the group as a whole contained various emotions, allowing the group members to return to the normal mourning processes from the parallel encouragement of group development and interpersonal relationships.

  6. Doing Anger Differently: Two Controlled Trials of Percussion Group Psychotherapy for Adolescent Reactive Aggression (United States)

    Currie, Michael; Startup, Mike


    This study evaluates efficacy and effectiveness of "Doing Anger Differently" (DAD), a group treatment for reactively aggressive 12-15 year old males. DAD uses percussion exercises to aid treatment. Study 1 compared a ten-week treatment with a waitlist control at pre, post and 6 month (treatment group only) follow-up. Study 2 replicated Study 1,…

  7. A comparative study on the effectiveness of positive psychotherapy and group cognitive-behavioral therapy for the patients suffering from major depressive disorder. (United States)

    Asgharipoor, Negar; Asgharnejad Farid, Aliasghar; Arshadi, Hamidreza; Sahebi, Ali


    Aim of this experimental study is evaluating the effectiveness of two different approaches towards the treatment of major depressive disorder (MDD): Positive-oriented psychotherapy and group cognitive-behavior therapy. Eighteen out-patients suffering from major depression were randomly divided into two groups to be treated according to either of these two approaches. Both groups undertook the treatments for 12 weeks. All the subjects were tested by Beck Depression Inventory, Subjective Wellbeing Scale, Oxford test of Happiness, and the scale of Subjective Units of Distress before and after the treatments. The results show significant differences between the two groups in terms of the variables of happiness and mental distress, suggesting that effectiveness of positive psychotherapy is more than cognitive-behavioral therapy in increasing happiness. These two approaches were significantly different in neither decreasing the acuteness of depression symptoms nor increasing subjective wellbeing. As a whole, the results of this comparative study indicate that positive psychotherapy is more effective in increasing happiness among MDD patients.

  8. [Group psychotherapy. Aspects of mental health in a program of community psychiatry]. (United States)

    Estrade Espinosa, M


    At the ISSSTE, a community psychiatry program was created and is being developed in two areas: the population of beneficiaries who attend two clinics and groups of employees of those same clinics at their respective places of work. The main purpose is to carry out prevention in mental health. In this report only the work in the first session of eight employee operative groups is reported. The method, the difficulties and the characteristics of the groupings are explained. Some theoretical aspects are shown. Results showed: 1. Little correspondence between the internal reality of the beneficiaries. 2. Difficulties in communication which produce differences of criteria with the clinic. 3. Difficulties in the internal distribution of power. 4. Unnecessary expenditure of energy. 5. Suggestions to solve the problems handled in the group. 6. Resistance against responsibilities.

  9. Group counseling and psychotherapy across the cultural divide: the case of Ethiopian Jewish immigrants in Israel. (United States)

    BenEzer, Gadi


    Effective counseling across a cultural divide depends on adaptations or changes of technique to suit the particular intercultural circumstances. The concept of mutual creative space provides a guiding principle for therapists who wish to make such changes. This space is 'negotiated' between the therapist/counselor coming from the 'dominant/mainstream' group within society, and the group participants who arrive from another culture. Mutual creative space consists of the negotiation of power and a process of mutual invention, incorporating the creation, by therapist and participants, of something new that did not exist in either of their cultures of origin. A meaningful encounter and effective group counseling can take place following the negotiation of such a creative space. This is illustrated by the example of intercultural group work with Ethiopian Jewish immigrants in Israel, including an analysis of cultural characteristics of the Ethiopian group and specific ways of negotiating mutual creative space in this case. Issues discussed include: establishing trust in the cross cultural context; the use of body language and its interpretation; the psychologist as an authority figure; active participation vs. hidden learning; and working with dreams in such groups.

  10. The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder. (United States)

    Safak, Yasir; Karadere, Mehmet Emrah; Ozdel, Kadir; Ozcan, Türkan; Türkçapar, Mehmet Hakan; Kuru, Erkan; Yücens, Bengü


    The aim of this study was to determine the effectiveness of cognitive behavioral group therapy (CBGT) in the treatment of the obsessive-compulsive disorder (OCD). The study included 82 patients diagnosed as OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). In all, 37 patients that had their diagnosis confirmed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and agreed to participate were provided group therapy as 14 weekly 90-120-min sessions. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Yale-Brown Obsessive Compulsive Scale-Symptom Checklist (Y-BOCS-SC), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to the patients prior to group therapy (baseline) and again after sessions 2, 5, 8, 12, and 14. In all, 8 patients dropped out of the study for various reasons and 29 completed the group therapy. There were significant reductions in BAI, BDI, and Y-BOCS scores in the patients that completed the group therapy. Additionally, BAI, BDI, and Y-BOCS score did not differ according to age, gender, or level of education. CBGT was associated with significant improvement in OCD symptoms. Neither demographic characteristics (age, gender, and education level), nor clinical characteristics (disease duration, type of obsession, compulsion type, treatment history, and comorbidity pattern) had an effect on treatment outcome. In light of these findings, we think CBGT is an effective option for the treatment of OCD.

  11. A “visiting analyst”. Salomon Resnik in a group psychotherapy session with dual diagnosis patients.

    Directory of Open Access Journals (Sweden)

    Gian Luca Cerutti


    Full Text Available This work examines a group session conducted by Salomon Resnik in the therapeutic community Fermata d'Autobus. The residents of the community have a dual diagnosis. The encounter was video recorded. There were three levels of anaysis. The first is that of the observations of two therapists who participated in the session. The second level includes the observations made by a group of psychotherapists who saw the video registration of the encounter. The third level puts together the previous two. The conclusions pertain to an assessment of a treatment center hosting a "visiting analyst", so as to maintain a generative contact in the dimension of the perturbation. 

  12. Dreams of Deceased Children and Countertransference in the Group Psychotherapy of Bereaved Mothers: Clinical Illustration (United States)

    Begovac, Branka; Begovac, Ivan


    This article presents, in the form of a clinical illustration, a therapeutic group of bereaved mothers with special reference to their dreams about their deceased children. The article presents descriptions of the emotions of these mothers and countertransference feelings, a topic that, to our knowledge, has not been frequently studied. The group…

  13. Lazarus and Group Psychotherapy: AIDS in the Era of Protease Inhibitors (United States)

    Gushue, George V.; Brazaitis, Sarah J.


    A new class of medications, protease inhibitors, has dramatically improved the health of many people with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). This development has had a major impact on the lives of those affected by HIV/AIDS. This article considers how a group is affected by the larger systems of…

  14. Cancer and the experience of meaning: a group psychotherapy program for people with cancer. (United States)

    Greenstein, M; Breitbart, W


    Cancer illness affects people in many ways, physical, financial, and existential. In this paper, we describe a proposed group intervention for individuals with advanced disease who want help finding a sense of meaning at this critical juncture in their lives. This intervention has a brief, semi-structured format, and is informed by the work of Viktor Frankl, empirical findings in the area of meaning and trauma, and the empirical findings of other group interventions for cancer patients. Individual sessions focus on different aspects of meaning, including responsibility to others, creativity, transcendence, and ascertaining one's values and priorities. Having goals on which to focus and feeling like part of a larger whole are critically important to the ability to find meaning and cope with terminal illness. Such goals may be generated by a number of sources, including connectedness with others, or a sense of the temporal continuity of one's own life despite the disruption posed by severe illness. Didactic discussions and experiential exercises help to facilitate exploration of these various elements in group members' lives. The finite structure of the intervention may also highlight these issues, as people who are faced with similar issues work together in a limited time frame in order to accomplish the goals they set out for themselves.

  15. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: An empirical validation of the theoretical model of the self-concept change

    Directory of Open Access Journals (Sweden)

    Rafał eStyła


    Full Text Available Background: Self-concept clarity describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of self-concept clarity change (especially stable increase and V shape observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable self-concept clarity increase is needed for the participants with a rather healthy personality structure, while self-concept clarity change characterized by a V shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M=5.8 was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale, Symptoms’ Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The Self-Concept Clarity Scale was also administered every two weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable self-concept clarity increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and V shape of self-concept clarity change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of self-concept clarity is a sign of a good treatment prognosis.

  16. Predictors of engagement in the Alcoholics Anonymous group or to psychotherapy among Brazilian alcoholics : a six-month follow-up study. (United States)

    Terra, Mauro Barbosa; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Athayde, Luciana Dias; Palermo, Luiz Henrique; Tergolina, Letícia Piccoli; Rovani, Joana Stela; da Silveira, Dartiu Xavier


    To ascertain factors associated with engagement of patients with alcohol dependence in Alcoholics Anonymous (AA) groups and psychotherapy. About 300 hospitalized alcoholics were interviewed at hospitalization and again 3 and 6 months thereafter. Assessment included the administration of standardized instruments. Determinants of engagement in both interventions were assessed through logistic regression analysis. Higher educational level was predictive of engagement in AA after 6 months (OR = 2.19; CI 1.08-4.41). Engagement in psychotherapy after 6 months was related to having a university degree (OR = 3.60; CI 1.6-7.9), to a co-morbid depressive disorder (OR = 3.47; CI 1.8-6.5), to the use of other drugs together with alcohol (OR = 3.08; CI 1.5-6.19), to previous treatment (OR = 2.87; CI 1.29-6.40), and to having a high school degree (OR = 2.44; CI 1.24-4.80). The presence of substance-induced anxiety disorder was associated with non-engagement in psychotherapy (OR = 0.27; CI 0.63-0.003). The identification of predictors of engagement is important to guide clinicians in the choice of the treatment strategies that are more likely to be successful.

  17. Personality Theory and Psychotherapy (United States)

    Fagan, Joen; And Others


    This group of articles discusses various aspects of Gestalt Therapy including its major contributions, role in psychotherapy, and contributions of Gestalt psychology in general. There is some discussion of the philosophical background of Gestalt therapy along with Gestalt theory of emotion. A case study and an annotated bibliography are included…

  18. What Makes Psychotherapy Humanistic? (United States)

    Tisdale, John R.

    Based on an earlier list of characteristics, ten assertions were derived about the nature of psychotherapy upon which it was believed that humanistic therapists would agree. These assertions were then submitted to three groups of therapists (111 returns) listed in the "National Register of Health Service Providers in Psychology":…

  19. The Comparsion of the Efficacy of Group Psychotherapy Based on Acceptance and Commitment Therapy, and Mindfulness on Craving and Cognitive Emotion Regulation in Methamphetamine Addicts

    Directory of Open Access Journals (Sweden)

    Ahmadreza Kiani


    Full Text Available Aim: Today, third wave therapies in psychotherapy shift their attention from challenging cognitions to awareness and acceptance of feelings, emotions, cognitions and behaviors. Therefore, this research aimed to compare of efficacy of group psychotherapy based on acceptance and commitment therapy, with mindfulness on craving and cognitive emotion regulation in methamphetamine addicts. Method: Research method was semi experimental research design with pre-post test and follow up. The population of research was included all of methamphetamine addicts in baharestan, Isfahan. Drug abusers was 34 participants that refered to addiction rehabilitation centers and selected by snowball sampling and finaly divided to 2groups by radomization (acceptance and commitment therapy group and mindfulness groups. Each groups recieved treatment in 12 sessions (At First 2 sessions per week and at last 1 session per week. Two groups assessed by craving test (Ekhtiary, 1387 and cognitive emotion regulation (garnefski et al, 2002, in pretest, post test and follow up. Results: The results showed that two treatment groups had significant effect on craving intensity in post test and follow up. In addition, there was no significant difference in comparing of the efficacy of these two treatments on cognitive emotion regulation and it means that both two traetments had same effect on cognitive emotion regulatin. Conclusion: we can say that acceptance and commitmet therapy and mindfulnesshave effect on reduction psychopathology from using amphetamines due to same theraputic factors.

  20. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... About Us Borderline Personality Disorder (BPD) Diagnosis and Treatment Resources For Professionals Contact Us Borderline Personality Disorder Resource Center Diagnosis and Treatment Psychotherapy Psychotherapy Diagnosis and Treatment Psychotherapy Questions to ...

  1. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available Search About Us Borderline Personality Disorder (BPD) Diagnosis and Treatment Resources For Professionals Contact Us Borderline Personality Disorder Resource Center Diagnosis and Treatment Psychotherapy Psychotherapy Diagnosis and Treatment Psychotherapy ...

  2. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available Search About Us Borderline Personality Disorder (BPD) Diagnosis and Treatment Resources For Professionals Contact Us Borderline Personality Disorder Resource Center Diagnosis and Treatment Psychotherapy Psychotherapy Diagnosis and Treatment Psychotherapy Questions to ...

  3. Feedback versus no feedback in improving patient outcome in group psychotherapy for eating disorders (F-EAT): protocol for a randomized clinical trial (United States)


    Background Continuous feedback on patient improvement and the therapeutic alliance may reduce the number of dropouts and increase patient outcome. There are, however, only three published randomized trials on the effect of feedback on the treatment of eating disorders, showing inconclusive results, and there are no randomized trials on the effect of feedback in group therapy. Accordingly the current randomized clinical trial, initiated in September 2012 at the outpatient clinic for eating disorders at Stolpegaard Psychotherapy Centre, aims to investigate the impact of continuous feedback on attendance and outcome in group psychotherapy. Methods/design The hypothesis is that continuous feedback to both patient and therapist on treatment progress and alliance will increase attendance and treatment outcome. The trial is set up using a randomized design with a minimum of 128 patients allocated to either an experimental or control group at a ratio of 1:1. The experimental group will receive standard treatment (systemic and narrative group psychotherapy) with feedback intervention, whereas the control group will receive standard treatment only. The participants are diagnosed with bulimia nervosa, binge eating disorder, or an eating disorder not otherwise specified, according to the DSM-IV. In the experimental group feedback to the participants, based on the Outcome Rating Scale (ORS) and the Group Session Rating Scale (GSRS), is actively added to standard treatment. The ORS assesses areas of life functioning known to change as a result of therapeutic intervention. The GSRS assesses key dimensions of effective therapeutic relationships. In the control group, the patients fill out the Outcome Rating Scale only, and feedback is not provided. The primary outcome is the rate of attendance to treatment sessions. The secondary outcome is the severity of eating disorder symptoms. Exploratory outcomes are the level of psychological and social functioning, and suicide or self

  4. Feedback versus no feedback in improving patient outcome in group psychotherapy for eating disorders (F-EAT): protocol for a randomized clinical trial. (United States)

    Davidsen, Annika Helgadóttir; Poulsen, Stig; Waaddegaard, Mette; Lindschou, Jane; Lau, Marianne


    Continuous feedback on patient improvement and the therapeutic alliance may reduce the number of dropouts and increase patient outcome. There are, however, only three published randomized trials on the effect of feedback on the treatment of eating disorders, showing inconclusive results, and there are no randomized trials on the effect of feedback in group therapy. Accordingly the current randomized clinical trial, initiated in September 2012 at the outpatient clinic for eating disorders at Stolpegaard Psychotherapy Centre, aims to investigate the impact of continuous feedback on attendance and outcome in group psychotherapy. The hypothesis is that continuous feedback to both patient and therapist on treatment progress and alliance will increase attendance and treatment outcome. The trial is set up using a randomized design with a minimum of 128 patients allocated to either an experimental or control group at a ratio of 1:1. The experimental group will receive standard treatment (systemic and narrative group psychotherapy) with feedback intervention, whereas the control group will receive standard treatment only. The participants are diagnosed with bulimia nervosa, binge eating disorder, or an eating disorder not otherwise specified, according to the DSM-IV. In the experimental group feedback to the participants, based on the Outcome Rating Scale (ORS) and the Group Session Rating Scale (GSRS), is actively added to standard treatment. The ORS assesses areas of life functioning known to change as a result of therapeutic intervention. The GSRS assesses key dimensions of effective therapeutic relationships. In the control group, the patients fill out the Outcome Rating Scale only, and feedback is not provided.The primary outcome is the rate of attendance to treatment sessions. The secondary outcome is the severity of eating disorder symptoms. Exploratory outcomes are the level of psychological and social functioning, and suicide or self-harm. This is measured with the

  5. Feedback versus no feedback to improve patient outcome in group psychotherapy for eating disorders (F-EAT): A randomized clinical trial

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Waaddegaard, Mette; Poulsen, Stig Bernt

    Background: A high rate of dropout in the treatment of eating disorders calls for ways to improve treatment attendance. Research indicates that continuous feedback on patient improvement and the therapeutic alliance reduces the number of dropouts and increases patient outcome. There are, however......, only three published randomized trials on the effect of feedback on the treatment of eating disorders showing inconclusive results, and there are no randomized trials on the effect of feedback in group therapy. Objective: The current randomized clinical trial aims to investigate the impact......: Standard treatment (systemic and narrative group psychotherapy) with feedback intervention using the Outcome Rating Scale (ORS) and Group Session Rating Scale (GSRS), or the control group: Standard treatment only. The primary outcome is rate of attendance. Secondary outcome is severity of eating disorder...

  6. The therapeutic factor inventory-8: Using item response theory to create a brief scale for continuous process monitoring for group psychotherapy. (United States)

    Tasca, Giorgio A; Cabrera, Christine; Kristjansson, Elizabeth; MacNair-Semands, Rebecca; Joyce, Anthony S; Ogrodniczuk, John S


    We tested a very brief version of the 23-item Therapeutic Factors Inventory-Short Form (TFI-S), and describe the use of Item Response Theory (IRT) for the purpose of developing short and reliable scales for group psychotherapy. Group therapy patients (N = 578) completed the TFI-S on one occasion, and their data were used for the IRT analysis. Of those, 304 completed the TFI-S and other measures on more than one occasion to assess sensitivity to change, concurrent, and predictive validity of the brief version. Results suggest that the new TFI-8 is a brief, reliable, and valid measure of a higher-order group therapeutic factor. The TFI-8 may be used for continuous process measurement and feedback to improve the functioning of therapy groups.

  7. Why Is Meaning-Centered Group Psychotherapy (MCGP) Effective? Enhanced Sense of Meaning as the Mechanism of Change for Advanced Cancer Patients. (United States)

    Rosenfeld, Barry; Cham, Heining; Pessin, Hayley; Breitbart, William


    Meaning-Centered Group Psychotherapy (MCGP) has been demonstrated to be an effective method for improving advanced cancer patients' quality of life and reducing their depression, hopelessness, and desire for hastened death. To further understand MCGP, this study examined the mechanisms of change in MCGP on these outcomes via advanced cancer patients' changes of sense of meaning and peace in life. The sample data were from two randomized control trials that compared MCGP (n = 124) to supportive group psychotherapy (n = 94). Mediation effects of treatment status on outcomes (two-month after completion of treatment) via patients' change of sense of meaning and peace (post-treatment minus pre-treatment) were tested. The outcome variables used in these analyses were quality-of-life, depression, hopelessness and desire for hastened death. Significant mediation effects via change of sense of meaning and peace on these outcomes were found. Consistent results were found using intention-to-treated statuses. Weaker, but still significant mediation effects via change of sense of faith on these outcomes were also found. Results supported the hypotheses that improvement due to MCGP is mediated by advanced cancer patients' enhanced sense of meaning. These findings highlight the importance of interventions focused on enhancing sense of meaning, as this appears to be a viable route to improve quality of life and decrease psychological distress among patients with advanced cancer. This article is protected by copyright. All rights reserved.

  8. AIDE-Acute Illness and Depression in Elderly Patients. Cognitive Behavioral Group Psychotherapy in Geriatric Patients With Comorbid Depression: A Randomized, Controlled Trial. (United States)

    Hummel, Jana; Weisbrod, Cecilia; Boesch, Leila; Himpler, Katharina; Hauer, Klaus; Hautzinger, Martin; Gaebel, Andrea; Zieschang, Tania; Fickelscherer, Andrea; Diener, Slawomira; Dutzi, Ilona; Krumm, Bertram; Oster, Peter; Kopf, Daniel


    Comorbid depression is highly prevalent in geriatric patients and associated with functional loss, frequent hospital re-admissions, and a higher mortality rate. Cognitive behavioral psychotherapy (CBT) has shown to be effective in older depressive patients living in the community. To date, CBT has not been applied to older patients with acute physical illness and comorbid depression. To evaluate the effectiveness of CBT in depressed geriatric patients, hospitalized for acute somatic illness. Randomized controlled trial with waiting list control group. Postdischarge intervention in a geriatric day clinic; follow-up evaluations at the patients' homes. A total of 155 randomized patients, hospitalized for acute somatic illness, aged 82 ± 6 years and suffering from depression [Hospital Anxiety and Depression Scale (HADS) scores >7]. Exclusion criteria were dementia, delirium, and terminal state of medical illness. Fifteen, weekly group sessions based on a CBT manual. Commencement of psychotherapy immediately after discharge in the intervention group and a 4-month waiting list interval with usual care in the control group. HADS depression total score after 4 months. Secondary endpoints were functional, cognitive, psychosocial and physical status, resource utilization, caregiver burden, and amount of contact with physician. The intervention group improved significantly in depression scores (HADS baseline 18.8; after 4 months 11.4), whereas the control group deteriorated (HADS baseline 18.1; after 4 months 21.6). Significant improvement in the intervention group, but not in the control group, was observed for most secondary outcome parameters such as the Barthel and Karnofsky indexes. Intervention effects were less pronounced in patients with cognitive impairment or acute fractures. CBT is feasible and highly effective in geriatric patients. The benefits extend beyond effective recovery and include improvement in physical and functional parameters. Early diagnosis

  9. Social Psychotherapy in Brazil. (United States)

    Fleury, Heloisa J; Marra, Marlene M; Knobel, Anna M


    This paper describes the practice of sociodrama, a method created by J. L. Moreno in the 1930s, and the Brazilian contemporary socio-psychodrama. In 1970, after the Fifth International Congress of Psychodrama was held in Brazil, group psychotherapy began to flourish both in private practice and hospital clinical settings. Twenty years later, the Brazilian health care system added group work as a reimbursable mental health procedure to improve social health policies. In this context, socio-psychodrama became a key resource for social health promotion within groups. Some specific conceptual contributions by Brazilians on sociodrama are also noteworthy.

  10. Contribuições da poética social à pesquisa em psicoterapia de grupo Contributions of social poesis to group psychotherapy research

    Directory of Open Access Journals (Sweden)

    Carla Guanaes


    Full Text Available Esse artigo tem por objetivo apresentar algumas contribuições do construcionismo social e da poética social ao entendimento da psicoterapia de grupo e de sua investigação científica. O construcionismo social se define como uma forma alternativa de inteligibilidade em ciência, que privilegia a compreensão do modo como as pessoas constroem sentidos sobre o mundo e sobre si mesmas em suas práticas discursivas. Coerente com essa perspectiva, a poética social caracteriza uma prática de pesquisa útil à investigação dos processos conversacionais, enfatizando a centralidade do pesquisador na construção de sentidos sobre seu objeto de estudo. Nesse artigo, buscamos demonstrar como estas perspectivas podem sustentar uma prática sistemática de pesquisa sobre a psicoterapia de grupo. Para tanto, apresenta os passos metodológicos desenvolvidos em um estudo acerca de um grupo em saúde mental, demonstrando como esses permitiram compreender o processo conversacional por meio do qual o próprio grupo se constituiu como um recurso terapêutico.The objective of this article is to describe some contributions of social constructionism and social poesis in the description of group psychotherapy and its scientific investigation. Social constructionism is an alternative form of intelligibility in science, which focuses on the comprehension of the way people make sense of the world and of themselves in their discursive practices. Concurrent with this perspective, social poesis can be described as a research practice that is useful in investigating the conversational processes, emphasizing the centrality of the researcher in the construction of meanings about its object of study. In this article, we aim to describe how these perspectives can sustain a systematic research practice of group psychotherapy. Thus, we describe some methodological steps developed in a study about a group in a mental health setting, showing how they helped us to comprehend

  11. Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial. (United States)

    Philipsen, Alexandra; Jans, Thomas; Graf, Erika; Matthies, Swantje; Borel, Patricia; Colla, Michael; Gentschow, Laura; Langner, Daina; Jacob, Christian; Groß-Lesch, Silke; Sobanski, Esther; Alm, Barbara; Schumacher-Stien, Martina; Roesler, Michael; Retz, Wolfgang; Retz-Junginger, Petra; Kis, Bernhard; Abdel-Hamid, Mona; Heinrich, Viola; Huss, Michael; Kornmann, Catherine; Bürger, Arne; Perlov, Evgeniy; Ihorst, Gabriele; Schlander, Michael; Berger, Mathias; Tebartz van Elst, Ludger


    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high prevalence in adulthood. There is a recognized need to assess the efficacy of psychotherapy in adult ADHD. To evaluate the efficacy of cognitive behavioral group psychotherapy (GPT) compared with individual clinical management (CM) and that of methylphenidate hydrochloride compared with placebo. Prospective, multicenter, randomized clinical trial of 18- to 58-year-old outpatients with ADHD from 7 German study centers. Patients were recruited between January 2007 and August 2010, treatment was finalized in August 2011, and final follow-up assessments occurred in March 2013. Sessions of GPT and CM were held weekly for the first 12 weeks and monthly thereafter (9 months). Patients received either methylphenidate or placebo for 1 year. The primary outcome was the change in the ADHD Index of the Conners Adult ADHD Rating Scale from baseline to the end of the 3-month intensive treatment (blinded observer ratings). Secondary outcomes included ADHD ratings after 1 year, blinded observer ratings using the Clinical Global Impression Scale, and self-ratings of depression. Among 1480 prescreened patients, 518 were assessed for eligibility, 433 were centrally randomized, and 419 were analyzed as randomized. After 3 months, the ADHD Index all-group baseline mean of 20.6 improved to adjusted means of 17.6 for GPT and 16.5 for CM, with no significant difference between groups. Methylphenidate (adjusted mean, 16.2) was superior to placebo (adjusted mean, 17.9) (difference, -1.7; 97.5% CI, -3.0 to -0.4; P = .003). After 1 year, treatment effects remained essentially stable. Descriptive analyses showed that methylphenidate was superior to placebo in patients assigned to GPT (difference, -1.7; 95% CI, -3.2 to -0.1; P = .04) or CM (difference, -1.7; 95% CI, -3.3 to -0.2; P = .03). Regarding depression, no significant differences were found. In contrast, GPT was superior to CM for all

  12. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... Disorder (BPD) Diagnosis and Treatment Resources For Professionals Contact Us Borderline Personality Disorder Resource Center Diagnosis and Treatment Psychotherapy Psychotherapy Diagnosis and Treatment ...

  13. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... 20 two-hour sessions led by an experienced social worker. When used with other types of treatment ( ... Psychotherapy A form of psychotherapy in which consistency, support from others, and a hopeful attitude are used ...

  14. Psychotherapy of Mood Disorders


    Picardi, Angelo; Gaetano, Paola


    In the last decades, psychotherapy has gained increasing acceptance as a major treatment option for mood disorders. Empirically supported treatments for major depression include cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), behavioural therapy and, to a lesser extent, short-term psychodynamic psychotherapy. Meta-analytic evidence suggests that psychotherapy has a significant and clinically relevant, though not large, effect on chronic forms of depression. Psychothera...

  15. Educational Psychotherapy of Preschoolers. (United States)

    Stein, Myron; Ronald, Doris

    Educational psychotherapy for preschool children and its functioning are described in detail. Also described is the process of training teachers to do this work. The educational psychotherapy process attempts to operate at the interface between education and psychotherapy. The components of catharsis, recall, sharpening and correcting of…

  16. Culture and demoralization in psychotherapy. (United States)

    de Figueiredo, John M; Gostoli, Sara


    In most societies, members of a culture have attempted to help each other in times of trouble with various types of healing methods. Demoralization - an individual experience related to a group phenomenon - responds to certain elements shared by all psychotherapies. This article has three objectives: (1) to review the theoretical background leading to our current views on culture and demoralization in psychotherapy, (2) to discuss the methodological challenges faced in the cross-cultural study of demoralization and psychotherapy, and (3) to describe the clinical applications and research prospects of this area of inquiry. Demoralization follows a shattering of the individual's assumptive world and it is different from homeostatic responses to a stressful situation or from depressive disorders. Only a few comparative studies of this construct across cultures have been undertaken. The presentation of distress may vary widely from culture to culture and even within the same culture. To avoid 'category fallacy', it is important to understand the idioms of distress peculiar to a cultural group. A cultural psychiatrist or psychotherapist would have to identify patient's values and sentiments, reconstruct his/her personal and collective ambient worlds, and only then study demoralization. The limitations of our current diagnostic systems have resulted in methodological challenges. Cultural clinicians should consider using a combination of both 'clinimetric' and 'perspectivistic' approaches in order to arrive at a diagnosis and identify the appropriate intervention. The presenting problem has to be understood in the context of the patient's individual, social and cultural background, and patients unfamiliar with Western-type psychotherapies have to be prepared to guide their own expectations before the former are used. Future research should identify the gaps in knowledge on the effectiveness of cultural psychotherapy at reversing or preventing demoralization. Copyright

  17. Psicoterapia de grupo: como surgiu e evoluiu Psicoterapia de grupo: como surgió y evolucionó Group psychotherapy: how it emerged and evolved

    Directory of Open Access Journals (Sweden)

    Luiz Paulo de C. Bechelli


    group psychotherapy, tracing its roots, main models and theoretical bases. Its origin goes back to the beginning of the past century (1905, after which it evolved for five decades: the formative years. Further on, during the 50's and 60's, group psychotherapy went through a period of theoretical expansion, followed by a period of consolidation in the 70's, and maturation in the 80's and 90's. Finally, the study examines its recent evolution, highlighting the construction of new models. In the last few years, several treatment techniques have been developed to attend specific patient populations, with a variety of medical and psychosocial conditions, which suggests an increasing tendency towards a greater specificity of its application.

  18. [Psychotherapy and efficacy]. (United States)

    Papp, Barbara; Péley, Bernadette


    Evaluation of the efficacy in psychotherapy dates back to the beginnings of psychotherapy itself. However, it is not an easy task to undertake efficacy evaluation because it is expensive and several methodological difficulties may be also present. The authors discuss some questions related efficacy evaluation in psychotherapy, including criteria for selecting the cases and the actual target of evaluation. In addition, the authors analyze the narrative psychological content analysis method which includes the analysis of psychological features and their changes of texts written by the patient about him- or herself. They conclude that this method can open novel perspectives in psychotherapy.

  19. Psychotherapy and Phenomenology

    African Journals Online (AJOL)


    What happens when two people meet and engage in a meaningful conversation, specifically in psycho- therapy? This question has perennially engaged psychology and psychotherapy since its beginnings. Ian Rory Owen's book entitled Psychotherapy and. Phenomenology: On Freud, Husserl and Heidegger is another ...

  20. The Play of Psychotherapy (United States)

    Marks-Tarlow, Terry


    The author reviews the role of play within psychotherapy. She does not discuss the formal play therapy especially popular for young children, nor play from the Jungian perspective that encourages the use of the sand tray with adults. Instead, she focuses on the informal use of play during psychotherapy as it is orchestrated intuitively. Because…

  1. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... Psychotherapy A form of psychotherapy in which consistency, support from others, and a hopeful attitude are used to sustain the patient through periods of crisis and encourage small gains over time. ... For Professionals Disclaimer Privacy Notice © 2017 ...


    Directory of Open Access Journals (Sweden)

    Widyawati Suhendro


    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Schizophrenia is a disease that causes varying descriptions. The symptoms of schizophrenia are divided into two groups, the primary and secondary symptoms. Treatment should be done as soon as possible, because a state of psychotic periods raises the possibility to suffer mental decline. The treatment is carried out must be comprehensive, multimodal, empirically and can be applied to the patient. One therapy that is given is psychotherapy. Psychotherapy is usually combined with pharmacological actions in order to increase the level of maximum healing. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  3. The effect of the one-to-one interaction process with group supportive psychotherapy on the levels of hope, anxiety and self-care practice for patients that have experienced organ loss: an alternative nursing care model. (United States)

    Ruchiwit, Manyat


    This quasi-experimental research examined the effect of the one-to-one interaction process with group supportive psychotherapy on the levels of hope, anxiety and self-care practice for patients that have experienced organ loss. Eighty patients from the hospital units were selected by matched pairs and paired according to gender, interval of age, type and time length of organ loss. Simple-random sampling was used to allocate each subject in the experimental and control groups, which consisted of 40 pairs. Questionnaires included hope, anxiety and self-care practice assessments. The experimental treatments consisted of the one-to-one interaction process with group psychotherapy. The results showed that the patients that received treatments in the experimental group had higher mean scores regarding the differences in levels of hope, anxiety and self-care practice than those in the control group. This integrative approach is an alternative method for giving patients self-confidence in their self-care practice, in maintaining hope and in reducing anxiety. The method assisted patients in understanding their own problems and corrective actions so that they could be accepted by others by exchanging their feelings, thoughts, opinions and experiences through confrontation and self-exploration both individually and in group. © 2012 Blackwell Publishing Asia Pty Ltd.

  4. The therapeutic model of Group Analytic Psychotherapy in Brain's Plasticity modification and expression, in patients with Cognitive and Psychiatric Disorders: A Hypothesis of Neuron-Immune-Analysis and Neuron-Immune-modulation. (United States)

    Mela, Catherine


    Dementia-like situations and depressive symptoms can be caused by a specific neuron circuit blockage, related with remote organic causes that are not cited in the CNS. Excessive cytokine secretion during stress situations is one of these causes which can be related with onset of cognitive symptoms including or accompanied by depressive ones, sometimes in an overlapping way. In both cases, chronic inflammation is a common hidden mechanism causing a vicious circle with mechanisms of somatic chronic stress and vice-versa while the serotonin pathway seems not to get seriously involved. Psychotherapy could dynamically influence the brain's and synaptic plasticity by treating disorders in an analogue with life's emotional trauma and conflicts, and by altering current life's stimuli according to the restoration of memories in the prefrontal lobe and in deeper brain areas. After neurological examinations, EEG, Mini Mental Scale and MRI control, Patients underwent personal and group psychotherapy with selective members of their choice participating in the group. The reduction of the cytokine's levels by participation and psycho-education inside the Group Psychotherapeutic Treatment, could lead to a regulation of IL-1, to the reduction of CRP, to the amelioration of the levels of cortisol thus regulating the inflammation of the bain. The function of the Psychotherapeutic environment as a "container" is strongly associated with stress relief and reduction of the hyper secretion of cortisol, with successful management of the cortisol blood levels, and with impact on the HPA Axis, with consequence to cortisol secretions in the body's organs and glands. EEG and Mini Mental Scale significantly change and improve after Psychotherapy. Medical treatment for depression and dementia failed in comparison with the benefits which emerged from the Psychotherapeutic method.

  5. Advanced psychotherapy training: psychotherapy scholars' track, and the apprenticeship model. (United States)

    Feinstein, Robert E; Yager, Joel


    Guided by ACGME's requirements, psychiatric residency training in psychotherapy currently focuses on teaching school-specific forms of psychotherapy (i.e., cognitive-behavioral, supportive, and psychodynamic psychotherapy). On the basis of a literature review of common factors affecting psychotherapy outcomes and experience with empirically supported and traditional psychotherapies, the authors aimed to develop an advanced contemporary and pragmatic approach to psychotherapy training for eight residents (two per PGY year) enrolled in a specialized Psychotherapy Scholars' Track within an adult general-residency program. The authors developed core principles and clinical practices, and drafted year-by-year educational goals and objectives to teach the psychotherapy scholars. Based on experiential learning principles, we also developed an individualized form of psychotherapy training, which we call "The Apprenticeship Model." The Psychotherapy Scholars' Track, and "Apprenticeship Model" of training are now in their third year. To date, authors report that scholars are highly satisfied with the structure and curriculum in the track. Trainees appreciate the protected time for self-directed study, mentored scholarship, and psychotherapy rotations. Patients and the Psychotherapy Scholars experience the "Apprenticeship Model" of psychotherapy training as authentic and compatible with their needs and resources. The Psychotherapy Scholars' Track developed and piloted in our general psychiatry residency is based on common factors, empirically-supported treatments, and use of experiential learning principles. Whether the Psychotherapy Scholars' Track and "Apprenticeship Model" will ultimately increase residents' psychotherapy skills and positively affect their ability to sustain postgraduate psychotherapy practice in varied settings requires long-term evaluation. The developers welcome empirical testing of the comparative effectiveness of this psychotherapy teaching approach

  6. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... people learn tools, exercises, and concrete things they can do to manage their emotions when certain challenging ... treatment (such as medications or individual psychotherapy), STEPPS can help reduce symptoms and problem BPD behaviors, relieve ...

  7. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... therapy appears to be dialectical behavior therapy (DBT). This type of therapy focuses on the concept of ... therapy for BPD include: Transference-Focused Psychotherapy (TFP) This form of therapy is rooted in the patient’s ...

  8. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... or stress. Systems Training for Emotional Predictability and Problem Solving (STEPPS) This treatment consists of 20 two- ... individual psychotherapy), STEPPS can help reduce symptoms and problem BPD behaviors, relieve symptoms of depression, and improve ...

  9. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... identify and verbally express their emotions, describe their interactions with other people, and talk about themselves and ... stress (particularly the stress of rejection or disappointing interactions with other people). Supportive Psychotherapy A form of ...

  10. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... DBT). This type of therapy focuses on the concept of mindfulness, or being aware of and attentive ... used with other types of treatment (such as medications or individual psychotherapy), STEPPS can help reduce symptoms ...

  11. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... options exist. Transference-Focused Psychotherapy (TFP) Dialectical Behavior Therapy (DBT) Other forms of therapy for BPD include: ... than acting out these emotions impulsively. Schema-Focused Therapy (SFT) This type of therapy focuses on reframing “ ...

  12. Student Attitudes Toward Psychotherapy (United States)

    Farber, Barry A.; Geller, Jesse D.


    Psychotherapy is viewed by college students as highly useful in dealing with living problems, yet--when given the availability of other treatment methods (peer interaction, yoga, meditation)-- it is frequently not the first choice of the student. (MJB)

  13. Borderline Personality Disorder: Psychotherapy

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    Full Text Available Search About Us Borderline Personality Disorder (BPD) Diagnosis and Treatment Resources For Professionals Contact Us Borderline Personality Disorder Resource Center Diagnosis and Treatment Psychotherapy ...

  14. Borderline Personality Disorder: Psychotherapy

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    Full Text Available ... treatment options exist. Transference-Focused Psychotherapy (TFP) Dialectical Behavior Therapy (DBT) Other forms of therapy for BPD ... STEPPS can help reduce symptoms and problem BPD behaviors, relieve symptoms of depression, and improve quality of ...

  15. The influence of psychotherapy on marriage typology

    Directory of Open Access Journals (Sweden)

    Staniszewski Mirosław


    Full Text Available The article analyses the influence of psychotherapeutic group work on matrimonial relations. Such questions are put up in the research as if participating of one of the married couples in a group psychotherapy could indirectly influence the other partner, and also if the type of matrimony could change under the influence of psychotherapy, for example from hierarchical to the partner’s. The article generalizes the classification of marriage types and pays special attention on the types that can be subject to the positive changes as a result of psychotherapeutic influence. Actuality and value of this research lay in estimation of the ability of psychotherapy to influence the matrimony on the whole in case when only one of the partners takes part in the therapy.


    Directory of Open Access Journals (Sweden)

    T.N. Hmylova


    Full Text Available The tendency of psychotherapy modern concepts referring to the short-term forms having been taken into account, we carried out the research aimed at the study of short-term form personality-oriented psychotherapy effect on the anxiety disorder dynamics. 103 patients with neurotic disorders were examined in the neurosis and psychotherapy department of the Bekhterev Psychoneurological Research Institute. The findings revealed the situational and personal anxiety level to be objectively decreased in the short-term group psychotherapy course. The short-term group psychotherapy was proved to bean effective method in anxiety disorders treatment considering indications and limitations.

  17. Psychotherapy of mood disorders. (United States)

    Picardi, Angelo; Gaetano, Paola


    In the last decades, psychotherapy has gained increasing acceptance as a major treatment option for mood disorders. Empirically supported treatments for major depression include cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), behavioural therapy and, to a lesser extent, short-term psychodynamic psychotherapy. Meta-analytic evidence suggests that psychotherapy has a significant and clinically relevant, though not large, effect on chronic forms of depression. Psychotherapy with chronic patients should take into account several important differences between patients with chronic and acute depression (identification with their depressive illness, more severe social skill deficits, persistent sense of hopelessness, need of more time to adapt to better circumstances). Regarding adolescent depression, the effectiveness of IPT and CBT is empirically supported. Adolescents require appropriate modifications of treatment (developmental approach to psychotherapy, involvement of parents in therapy). The combination of psychotherapy and medication has recently attracted substantial interest; the available evidence suggests that combined treatment has small but significant advantages over each treatment modality alone, and may have a protective effect against depression relapse or recurrence. Psychobiological models overcoming a rigid brain-mind dichotomy may help the clinician give patients a clear rationale for the combination of psychological and pharmacological treatment. In recent years, evidence has accumulated regarding the effectiveness of psychological therapies (CBT, family-focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to medication in bipolar disorder. These therapies share several common elements and there is considerable overlap in their actual targets. Psychological interventions were found to be useful not only in the treatment of bipolar depressive episodes, but in all phases of the disorder.

  18. Psychotherapies for Children and Adolescents (United States)

    ... Facts for Families - Vietnamese Psychotherapy for Children and Adolescents: Different Types No. 86; updated February 2017 Psychotherapy ... Therapy (DBT) can be used to treat older adolescents who have chronic suicidal feelings/thoughts, engage in ...

  19. WELLFOCUS PPT: Modifying positive psychotherapy for psychosis. (United States)

    Riches, Simon; Schrank, Beate; Rashid, Tayyab; Slade, Mike


    Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline that has developed somewhat separately from psychotherapy and focuses on amplifying well-being rather than ameliorating deficit. The processes targeted in PPT (e.g., strengths, forgiveness, gratitude, savoring) are not emphasized in traditional psychotherapy approaches to psychosis. The goal in modifying PPT is to develop a new clinical approach to helping people experiencing psychosis. An evidence-based theoretical framework was therefore used to modify 14-session standard PPT into a manualized intervention, called WELLFOCUS PPT, which aims to improve well-being for people with psychosis. Informed by a systematic review and qualitative research, modification was undertaken in 4 stages: qualitative study, expert consultation, manualization, and stake-holder review. The resulting WELLFOCUS PPT is a theory-based 11-session manualized group therapy. (c) 2016 APA, all rights reserved).

  20. Psychotherapies in Acute and Transient Psychoses

    Directory of Open Access Journals (Sweden)

    Manuel González de Chávez


    Full Text Available From a comprehensive and global view -psychological, biological and social - acute and transient psychoses could be considered identity breakdowns with fragmentation of its structure, paranoid mechanism and cognitive regression. Psychotherapies favour evolution of psychotic identity through disorder awareness and knowledge of aspects of patients that make them more vulnerable to psychotic experiences. We underline the key role of group psychotherapy to improve therapeutic relationships and best use of patient’s coping strategies in the chronology of therapeutic interventions and recovery process of these patients.

  1. Introduction: attachment theory and psychotherapy. (United States)

    Levy, Kenneth N


    In this introduction to the JCLP: In Session 69(11) issue on attachment theory and psychotherapy, the key points of attachment theory (Bowlby, , , 1981) and its relevance to psychotherapy are briefly described. The aim of this issue is to provide case illustrations of how an attachment theory perspective and principles can expand our understanding of psychotherapy practice. © 2013 Wiley Periodicals, Inc.

  2. Psychotherapy in Contemporary Psychiatric Practice (United States)

    Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S


    Objective: American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. Method: A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. Results: A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Conclusions: Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services. PMID:26175328

  3. "Psychotherapy" Versus "Treatment" (United States)

    Arkowitz, Hal


    This paper presents comments on "Psychological treatments" by D. H. Barlow. Barlow proposed that we distinguish between the terms "treatment" and "psychotherapy." The author believes that not only is the distinction unnecessary, but that its implications could have negative consequences for the field of clinical psychology. It is the proposed…

  4. Art Therapy Verses Psychotherapy (United States)

    Del Giacco, Maureen


    The purpose of my paper is to identify the difference between psychotherapy and art therapy. Then to introduce a technique within the field of art therapy that is relevant to neuro-plasticity Del Giacco Neuro Art Therapy. The paper identifies the importance of the amygdala and the hippocampus within the role of art therapy. Supporting…

  5. Psychotherapy for Suicidal Clients. (United States)

    Lester, David


    Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

  6. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... 20 two-hour sessions led by an experienced social worker. When used with other types of treatment (such as medications or individual psychotherapy), STEPPS can help reduce symptoms and problem BPD behaviors, relieve symptoms of depression, and improve quality of ...

  7. Piaget and psychotherapy. (United States)

    Friedman, T L


    It is difficult to apply Piaget's theory to psychotherapy because the place of affect in it is ambiguous. When the alternatives are considered, it seems most consistent with Piaget's ideas to regard both cognitive and affective phenomena as problem-solving organizations. Piaget's remarkable discoveries in the cognitive sphere are a consequence of the easy access in that sphere to the kind of problems that need solving, and the phasic development of solutions. But the nature of the problems to be solved or the values to be guarded by a patient in psychotherapy are not knowable independently of the patient's actual behavior. In one respect all that is left from Piaget's approach for psychotherapy generally is the truism that therapy fosters differentiation and integration. However, even if we cannot frame a peculiarly Piagetian paradigm of psychotherapy, Piaget is valuable in posing a subsidiary question, namely, what in therapy fosters problem-solving activity. A reading of Piaget suggests that a patient learns by acting on his therapist and tacitly interpreting the results of his actions, that difficulties in therapy are the material from which therapy proceeds, and that in order to grasp the situation of the patient, the therapist himself may need to act on him and not just think about him. An implied lesson for training would be that supervision should instill a professional identity that is reinforced rather than challenged by therapy difficulties, and does not rely solely on theoretical categorizing.

  8. Psychotherapy and Women's Liberation (United States)

    Holroyd, Jean


    Personality theories and scientific data on women frequently contribute negatively to the psychotherapy of female clients. This paper examines some of the background factors which have shaped our information about women, and then reviews some contemporaneous approaches to the therapy of women. (Author)

  9. Approche communicative et psychotherapie (The Communicative Approach and Psychotherapy). (United States)

    Perramond, Daniel B.


    Reviews different principles and techniques proposed by psychotherapy concerning the facilitation of communication and learning, as they confirm the hypotheses and methodological choices of the communicative approach. (MSE)

  10. [Pharmaco- and psychotherapy in psychiatric ambulatory care]. (United States)

    Burner, M


    Our report describes the evolution of the outpatients' psychiatry in Lausanne. Here is mentioned the constant increase of consultations for new and former cases, and it is statistically shown that this augmentation is not only the result of the increasing population in the "Vaud District" (Canton de Vaud) but rather the consequence of the increasing number of patients with deeper investigations and treatments. It is true that the psychotherapeutic training was the most important in our outpatients' department, but the coming of psychotropic drugs has changed the treatment in certain cases and has developed mixed treatments. The creation of the Psycho-Social Center in the Psychiatric outpatients' department was the beginning of the social action in the institution, with the creation of an emergency department, consultations at the patients' home and treatment made by a team including doctors-outpatients' nurses-social assistants. We have checked that for many outpatients, very often in hard or psycho-reactive situations, there was no opposition between pharmaco-therapy or psychotherapy. So pharmaco-therapy and psychotherapy are often used separately or together in the outpatients' department through individual analytic psychotherapies, group or brief psychotherapies, relaxation, emergency treatments with perfusion of psychotropic and neuroleptic drugs.

  11. Spiritually oriented psychodynamic psychotherapy. (United States)

    Shafranske, Edward P


    Spiritually oriented psychodynamic psychotherapy pays particular attention to the roles that religious and spiritual beliefs, practices, and experiences play in the psychological life of the client. Contemporary psychoanalytic theorists offer multiple approaches to understand the functions of religious experience. Spirituality provides a means to address existential issues and provide a context to form personal meaning. Religious narratives present schemas of relationship and models of experiences salient to mental health, such as hope. God images or other symbolic representations of the transcendent have the power to evoke emotions, which in turn, influence motivation and behavior. While employing theories and techniques derived from psychodynamic psychotherapy, this therapeutic approach encourages the analysis of the functions religion and spirituality serve, while respecting the client's act of believing in faith. Psychotherapists address a client's spirituality by exploring the psychological meaning of such personal commitments and experiences and refrain from entering into discussion of faith claims. (c) 2009 Wiley Periodicals, Inc.

  12. Constructivism and psychotherapy. (United States)

    Mahoney, Michael J; Granvold, Donald K


    Constructivism is a metatheoretical perspective that embraces diverse traditions in medicine, philosophy, psychology, and spiritual wisdom. Constructive psychotherapy emphasizes complex cycles in the natural ordering and reorganizing processes that characterize all development in living systems. Individuals are encouraged to view themselves as active participants in their lives. Within rich contexts of human relationship and symbol systems, people make new meanings as they develop. Techniques from many different traditions can help people find and refine their sense of balance as they develop.

  13. "A randomized controlled trial on the efficacy of mindfulness-based cognitive therapy and a group version of cognitive behavioral analysis system of psychotherapy for chronically depressed patients": Correction to Michalak et al. (2015). (United States)


    Reports an error in "A randomized controlled trial on the efficacy of mindfulness-based cognitive therapy and a group version of cognitive behavioral analysis system of psychotherapy for chronically depressed patients" by Johannes Michalak, Martin Schultze, Thomas Heidenreich and Elisabeth Schramm (Journal of Consulting and Clinical Psychology, 2015[Oct], Vol 83[5], 951-963). In the article there was an error in the Method section in the Statistical Analysis subsection. The last sentence in the seventh paragraph should read "A remitter was defined as a participant with a HAM-D score of 8 or less at posttreatment." (The following abstract of the original article appeared in record 2015-36864-001.) Mindfulness-based cognitive therapy (MBCT) has recently been proposed as a treatment option for chronic depression. The cognitive behavioral analysis system of psychotherapy (CBASP) is the only approach specifically developed to date for the treatment of chronically depressed patients. The efficacy of MBCT plus treatment-as-usual (TAU), and CBASP (group version) plus TAU, was compared to TAU alone in a prospective, bicenter, randomized controlled trial. One hundred and six patients with a current DSM-IV defined major depressive episode and persistent depressive symptoms for more than 2 years were randomized to TAU only (N = 35), or to TAU with additional 8-week group therapy of either 8 sessions of MBCT (n = 36) or CBASP (n = 35). The primary outcome measure was the Hamilton Depression Rating Scale (24-item HAM-D, Hamilton, 1967) at the end of treatment. Secondary outcome measures were the Beck Depression Inventory (BDI; Beck, Steer, & Brown, 1996) and measures of social functioning and quality of life. In the overall sample as well as at 1 treatment site, MBCT was no more effective than TAU in reducing depressive symptoms, although it was significantly superior to TAU at the other treatment site. CBASP was significantly more effective than TAU in reducing depressive

  14. [Meaning in life and mental health: personal meaning systems of psychotherapists and psychotherapy patients]. (United States)

    Löffler, Sabine; Knappe, Rainer; Joraschky, Peter; Pöhlmann, Karin


    This study investigated differences in the personal meaning systems of psychotherapists and psychotherapy patients as well as correlations between meaning in life and mental health. We qualitatively assessed the content and structure of the personal meaning systems of 41 psychotherapists and 77 psychotherapy patients. In addition, the participants completed questionnaires measuring meaning in life (LRI-r-d), sense of coherence (SOC-9L), self-esteem (RSES), satisfaction with life (SWLS), self-efficacy (SWK), and depression (BDI). The personal meaning systems of psychotherapists were more complex and coherent compared to psychotherapy patients. In the group of psychotherapy patients, a more elaborate structure of the personal meaning system correlated with the subjective sense of meaning. We were able to confirm correlations between meaning in life and mental health for most of the instances. Psychotherapists had more elaborate and coherent meaning systems than psychotherapy patients. Especially for psychotherapy patients elaborate and coherent meaning systems turned out to be important for mental health.

  15. Of God and Psychotherapy. (United States)

    Karasu, T Byram


    Psychotherapy is an instrument for remediation of psychological deficits and conflict resolution, as well as an instrument for growth and self-cultivation. In fact, psychotherapy is the finest form of life education. All of this is done without psychotherapists' playing a teacher, a minister, a priest, a rabbi, an imam, or a Buddhist monk, but by being familiar with what they know and more. That "more" is about understanding "the attributes" of gods and religions as they serve the all-too-human needs of believing and belonging. It is about the distillation of common psychological, sociological, moral, and philosophical attributes of religions, and the recognition that the attributes themselves are faith and God. Attributes that serve the affiliative needs define faith, for example, belonging is faith; attributes that serve the divine needs define God, for example, compassion is God. Those who have recovered from their primitive innocence need to formulate their ideas of God and religion, regardless of their affiliation with a religious community. One may need to resonate emotionally with the God of his or her religion, but intellectually need to transcend all its dogma and cultivate a personal concept of divinity free from any theological structure. Such an enlightened person achieves enduring equanimity by striving to own the attributes of Gods--to be godly. This is equally true for psychotherapists as it is for their patients.

  16. Psychotherapy with multiple-sclerosis patients. (United States)

    Langenmayr, A; Schöttes, N


    We wanted to find out if psychotherapy may influence the course of the physical aspects of multiple sclerosis and the consequences of psychotherapy for coping processes. 46 patients diagnosed with multiple sclerosis who had chosen to undergo a 1-yr. group psychotherapy treatment were compared with a control group of 24 multiple-sclerosis patients without such treatment. They were given the Giessen test (personality test), the Achievement Capacities Questionnaire by Kesselring, an intensive interview as well as the content analysis scales of verbal behavior by Gottschalk and Gleser. The various tests were carried out at each of four times of measurement with a 2-yr. follow-up. There were significant changes in the area of relationships and aggressive loosening (interview) between the Therapy and Control groups. Several changes were also found with regard to physical symptoms (Achievement Capacities Questionnaire) in the Therapy group compared to the Control group, e.g., increases in physical mobility and decreases in care of the body. The decreases appear to be a known effect of therapy with psychosomatic disorders. We interpret it psychoanalytically as resistance against releasing anxiety of counter-cathected motives which multiple sclerosis helps to keep unconscious. In a follow-up, the Therapy group showed greater optimism and physical improvements, e.g., decrease in feeling cold and lack of energy. Some positive changes appeared in both groups, such as, for example, an improvement of cognitive impairment (Gottschalk & Gleser). It appears that the attention from the research itself may have affected both groups because some members of both groups were in contact and hence the Control group was also informed about the research project and its underlying hypothesis.

  17. [Group psychotherapy. Experience with a changing process at a clinic of the Instituto del Servicio de Seguridad Social de los Trabajadores del Estado (ISSSTE)]. (United States)

    Velasco de Ongay, M E


    The problems of an ISSSTE clinic were approached within the general systems theory and it was observed that within the group there existed forces to maintain the status-quo and forces towards change; to produce the latter the group was handled during 20 hours with a slightly directive technique. The goals were to improve interpersonal relationships, to increase communication, to make known to individuals their attitudes within a group and make them sensitive to problems they shared with others. The results were good, the status-quo was broken and change started occurring.

  18. Culturally Adapted Psychotherapy and the Legitimacy of Myth: A Direct-Comparison Meta-Analysis (United States)

    Benish, Steven G.; Quintana, Stephen; Wampold, Bruce E.


    Psychotherapy is a culturally encapsulated healing practice that is created from and dedicated to specific cultural contexts (Frank & Frank, 1993; Wampold, 2007; Wrenn, 1962). Consequently, conventional psychotherapy is a practice most suitable for dominant cultural groups within North America and Western Europe but may be culturally incongruent…

  19. [Emotional stress psychotherapy]. (United States)

    Rozhnov, V E


    The concept of emotional stress psychotherapy (ESP) is based on the theoretical understanding of mental process as a system of cross-potentiating synergism of consciousness and the unconscious. Therefore, one can regard this kind of treatment as an appeal to the spiritual components of personality arousing its need of self-perfectioning. Owing to this, ESP turns the demands and higher interests creating a personality dominant to oppose the illness with ensuing depression and apathy. In a sense, this method is a qualitative contrast to S. Freud's psychoanalysis digging in the dark compartments of the soul. As a result of treatment of thousands of neurotic patients and those with psychosomatic disorders and alcoholism, the following techniques of ESP were elaborated: rational, shaped as a socratic dialogue; hypnosuggestive comprising individual or collective hypnosis, extremely loaded with emotions; autosuggestive like mental self-regulation and autogenic training filled with specific emotions.

  20. Humor and creativity in psychotherapy

    Directory of Open Access Journals (Sweden)

    Javier Martín Camacho


    Full Text Available In the current article principal theories on humor are analyzed, relating them to different conceptions of creativity. Finally, some indications for the use of humor in psychotherapy are introduced, highlighting their positive and negative aspects. 

  1. Motivating Institutionalized Adolescents for Psychotherapy. (United States)

    Ranieri, Daniel J.


    Reviews the literature regarding client motivation and client references. Offers recommendations for designing a program to increase motivation for psychotherapy in institutionalized adolescents, based on pretherapy and token economics. (JAC)

  2. Changes in sexual behavior of HIV-infected older adults enrolled in a clinical trial of standalone group psychotherapies targeting depression. (United States)

    Lovejoy, Travis I; Heckman, Timothy G; Sikkema, Kathleen J; Hansen, Nathan B; Kochman, Arlene


    By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30 % of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults.

  3. Culture-sensitive counselling, psychotherapy and support groups in the Orthodox-Jewish community: how they work and how they are experienced. (United States)

    Loewenthal, Kate Miriam; Rogers, Marian Brooke


    There is political and scientific goodwill towards the provision of culture-sensitive support, but as yet little knowledge about how such support works and what are its strengths and difficulties in practice. To study groups offering culture-sensitive psychological and other support to the strictly orthodox Jewish community in London. Semi-structured interviews with service providers, potential and actual users from the community, and professionals serving the community. Interviews asked about the aims, functioning and achievements of 10 support groups. Thematic analysis identified seven important themes: admiration for the work of the groups; appreciation of the benefits of culture-sensitive services; concerns over confidentiality and stigma; concerns over finance and fund-raising; concerns about professionalism; the importance of liaison with rabbinic authorities; need for better dissemination of information. The strengths and difficulties of providing culture-sensitive services in one community were identified. Areas for attention include vigilance regarding confidentiality, improvements in disseminating information, improvements in the reliability of funding and attention to systematic needs assessment, and to the examination of efficacy of these forms of service provision.

  4. Changes in sexual behavior of HIV-infected older adults enrolled in a clinical trial of standalone group psychotherapies targeting depression (United States)

    Lovejoy, Travis I.; Heckman, Timothy G.; Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene


    By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30% of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥ 50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults. PMID:24668254

  5. [Integrated psychotherapy for eating disorders]. (United States)

    Tomizawa, O


    The various psychotherapeutic strategies for eating disorders (EDs) include psychoanalytic, cognitive-behavioral, family oriented, arts therapy and others. In this paper, the psychodynamism of EDs and their therapy are reexamined and considered holistically from "the separate aspects of eating" point of view. That is the separation of eating regulated by biological appetite and the eating or not eating deriving from the patient's mind, unrelated to appetite. A new therapeutic technique called "formalization", which clarifies the separation of aspects of eating are invented. For integrated psychotherapy of EDs, it is necessary to combine the formalization technique of which clarifies and promotes patients' conflicts, and the integrated psychodynamic therapies that treat the promoted conflicts. The psychodynamism of EDs is the subject of much argument by many therapist. Although these arguments differ, they are similar in two points. Firstly, all of them consider EDs as distinctly separate from biological appetites. Secondly, the behavior of patients with EDs are taken as "false solution" or "substitution" of their essential problem. It is impossible to completely separate the physical action of eating mentally, however there may be a second meaning of eating separate from appetite. Seen in this light, psychotherapies are classified into two groups. One supports and sympathizes with these conflicts and the other is an educational one, telling the patients that a false solution is invalid. The former approach is employed by almost all psychodynamic therapies, such as psychoanalysis, family oriented therapy, arts therapy, self-help groups and the like. These therapies treat patients' conflicts with a non-judgemental approach, transform the psychodynamism, and consequently improve the eating behavior. The latter is applied by behavior therapy. Under strict operant conditioning, adequate behavior is reinforced by reward and inadequate behavior is eliminated by punishment

  6. Efficacy of interpersonal psychotherapy for postpartum depression. (United States)

    O'Hara, M W; Stuart, S; Gorman, L L; Wenzel, A


    Postpartum depression causes women great suffering and has negative consequences for their social relationships and for the development of their infants. Research is needed to evaluate the efficacy of psychotherapy for postpartum depression. A total of 120 postpartum women meeting DSM-IV criteria for major depression were recruited from the community and randomly assigned to 12 weeks of interpersonal psychotherapy (IPT) or to a waiting list condition (WLC) control group. Subjects completed interview and self-report assessments of depressive symptoms and social adjustment every 4 weeks. Ninety-nine of the 120 patients completed the protocol. Hamilton Rating Scale for Depression (HRSD) scores of women receiving IPT declined from 19.4 to 8.3, a significantly greater decrease than occurred in the WLC group (19.8 to 16.8). The Beck Depression Inventory (BDI) scores of women who received IPT declined from 23.6 to 10.6 over 12 weeks, a significantly greater decrease than occurred in the WLC group (23.0 to 19.2). A significantly greater proportion of women who received IPT recovered from their depressive episode based on HRSD scores of 6 or lower (37. 5%) and BDI scores of 9 or lower (43.8%) compared with women in the WLC group (13.7% and 13.7%, respectively). Women receiving IPT also had significant improvement on the Postpartum Adjustment Questionnaire and the Social Adjustment Scale-Self-Report relative to women in the WLC group. These findings suggest that IPT is an efficacious treatment for postpartum depression. Interpersonal psychotherapy reduced depressive symptoms and improved social adjustment, and represents an alternative to pharmacotherapy, particularly for women who are breastfeeding.

  7. Interpersonal Psychotherapy with Pregnant Adolescents: Two Pilot Studies (United States)

    Miller, Lisa; Gur, Merav; Shanok, Arielle; Weissman, Myrna


    The objective of this study was to test the feasibility, acceptability and helpfulness of group Interpersonal Psychotherapy (IPT-PA) for depression in pregnant adolescents. Method: Two open clinical trials were conducted of IPT-PA delivered in group format in a New York City public school for pregnant girls. Study 1 tests IPT-PA for management of…

  8. Psychodynamic psychotherapy and clomipramine in the treatment of major depression. (United States)

    Burnand, Yvonne; Andreoli, Antonio; Kolatte, Evelyne; Venturini, Aurora; Rosset, Nicole


    The authors compared a combination of clomipramine and psychodynamic psychotherapy with clomipramine alone in a randomized controlled trial among patients with major depression. Seventy-four patients between the ages of 20 and 65 years who were assigned to ten weeks of acute outpatient treatment for major depression were studied. Bipolar disorder, psychotic symptoms, severe substance dependence, organic disorder, past intolerance to clomipramine, and mental retardation were exclusion criteria. Marked improvement was noted in both treatment groups. Combined treatment was associated with less treatment failure and better work adjustment at ten weeks and with better global functioning and lower hospitalization rates at discharge. A cost savings of 2,311 dollars per patient in the combined treatment group, associated with lower rates of hospitalization and fewer lost work days, exceeded the expenditures related to providing psychotherapy. Provision of supplemental psychodynamic psychotherapy to patients with major depression who are receiving antidepressant medication is cost-effective.

  9. Ego-structuring psychotherapy. (United States)

    Villemoes, Palle


    Psychoanalysis regards psychosis as an early disturbance in the development of the personality, specifically, of the ego. The disturbance occurs during that period prior to the castration complex and thus before the phase when the ordering of relations becomes oedipal. Responsible for this disturbance is, according to Freud, foreclosure (verwerfung) of an important factor that normally accomplishes the primal repression (urverdrängung) and which renders repression proper (verdrängung) out of the question. According to Lacan this factor is the Name of the Father, which instigates the metaphorical dimension as such and, thereby, makes language come into action through a pact between the subject and the Other. In psychosis, Lacan postulates a foreclosure of the Name of the Father, which hinders the unconscious, structured as a language, from safeguarding the ego and the world, that is, the imaginary. Ego-structuring psychotherapy brings the Name of the Father into effect, enabling the psychotic person to become linguistically structured; consequently, a world view develops in the person and he or she becomes a historically determined person engaged in fulfilling a plan for life.

  10. Psychotherapy role expectations and experiences - discrepancy and therapeutic alliance among patients with substance use disorders. (United States)

    Frankl, My; Philips, Björn; Wennberg, Peter


    The main aim of the study was to examine how the discrepancy between role expectations prior to psychotherapy and experiences of ongoing psychotherapy related to therapeutic alliance. We hypothesized that a similarity between patient role expectations and experiences would be associated with a stronger alliance. The study also examined whether different dimensions of psychotherapy role expectations predicted retention in psychotherapy. A naturalistic study design was used with data collected prior to therapy and during the first 6 months of therapy. Patients with substance use disorders completed the Psychotherapy Expectation Questionnaire-short version (PEX-S) at the time of therapy assessment. A subsample of these patients (n = 41; n = 24 in individual therapy and n = 17 in group therapy) provided data from therapy including psychotherapy experiences (also measured with PEX-S) and therapeutic alliance, measured with Working Alliance Questionnaire-short version. For patients in group therapy, discrepancy between role expectations and experiences correlated negatively with alliance. Expectations prior to psychotherapy characterized by defensiveness correlated negatively with therapy retention. The finding that disconfirmation of patients' role expectations in group therapy were associated with weaker therapeutic alliance highlights the importance of discussing psychotherapy expectations at an early stage in treatment. Expectations characterized by defensiveness predicted worse retention in psychotherapy, which indicates that the PEX-S can be helpful in detecting patients at risk for dropout. In targeting a patient's role expectancies prior to treatment, possible discrepancies between patient and therapist are made visible and possible to examine. Clarifying the patient's role expectations and the therapist's rationale might be a first step towards establishing a strong working alliance. Surveying the patient's defensiveness tendencies at the beginning of therapy

  11. Reducing the stigma associated with seeking psychotherapy through self-affirmation. (United States)

    Lannin, Daniel G; Guyll, Max; Vogel, David L; Madon, Stephanie


    Psychotherapy may be underutilized because people experience self-stigma-the internalization of public stigma associated with seeking psychotherapy. The purpose of this study was to experimentally test whether the self-stigma associated with seeking psychotherapy could be reduced by a self-affirmation intervention wherein participants reflected on an important personal characteristic. Compared with a control group, we hypothesized that a self-affirmation writing task would attenuate self-stigma, and thereby evidence indirect effects on intentions and willingness to seek psychotherapy. Participants were 84 undergraduates experiencing psychological distress. After completing pretest measures of self-stigma, intentions, and willingness to seek psychotherapy, participants were randomly assigned to either a self-affirmation or a control writing task, and subsequently completed posttest measures of self-stigma, intentions, and willingness to seek psychotherapy. Consistent with hypotheses, participants who engaged in self-affirmation reported lower self-stigma at posttest. Moreover, the self-affirmation writing task resulted in a positive indirect effect on willingness to seek psychotherapy, though results failed to support an indirect effect on intentions to seek psychotherapy. Findings suggest that self-affirmation theory may provide a useful framework for designing interventions that seek to address the underutilization of psychological services through reductions in self-stigma.

  12. Conducting psychotherapy with an interpreter. (United States)

    Kuay, Justin; Chopra, Prem; Kaplan, Ida; Szwarc, Josef


    This qualitative study assessed how clinicians prepared and used interpreters during psychotherapeutic sessions and investigated the strategies they used to manage the dynamics of this process. Ten therapists were interviewed at the Victorian Foundation for the Survivors of Torture (VFST). A semi-structured interview format was used. Thematic analysis was conducted on transcripts of recorded interviews to identify key themes. Factors affecting the provision of psychotherapy with interpreters agreed with general guidelines for working with interpreters but there were exceptions. The possible roles of the interpreter as a cultural consultant, community advocate and co-therapist were explored. Specific troubleshooting strategies were identified for improving empathy, redefining roles, and adjusting interactions with interpreters. Working with interpreters in psychotherapy is a complex process. These findings may benefit clinicians providing psychotherapy to patients using interpreters. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  13. [Method of existence analytic psychotherapy]. (United States)

    Längle, A


    Introducing questions of individual purpose and meaning into psychotherapy was an important contribution of Viktor Frankl and a necessary supplement to traditional psychotherapy. V. Frankls "Logotherapy" (logos = meaning) however has found its main application in counselling (especially bereavement and grief processes) and prophylactic endeavours (e.g. pedagogics). Suffering from meaninglessness, on the other hand, showed up to be a respectively rare indication for psychotherapeutic interventions in its proper sense. Thus the question was arising how to apply Frankl's valuable meaning-centered concept of man (which he called "Existential Analysis") in a genuine way to other neurosis and to personality disorders, so far "unspecific indications" to Logotherapy. This paper gives an outline and methodological foundation of "Existential Analysis Psychotherapy". A case study finally is illustrating its phenomenological proceeding.

  14. [Dropout behavior during inpatient psychotherapy ]. (United States)

    Martens, Ute; Rempel, Irene; Zipfel, Stephan; Enck, Paul; Teufel, Martin


    Dropouts result in far-reaching consequences for the individual patient, fellow patients, therapists, and the clinic. This study was aimed at early identification of patients with a dropout risk. Data from patients of the Department of Psychosomatic Medicine and Psychotherapy of the Medical University Clinic of Tübingen (Germany) were analyzed retrospectively in a case-control study (matched). Differences in the results of various questionnaires (SCL-90-R, IIP-D, SF-36) regarding reasons for dropout and sociodemographic data were analyzed. A total of 59 dropouts, 50 females and 9 males, were included. They were split into 28 early dropouts and 31 late dropouts. The data were compared between early and late dropouts and control group. Early dropouts were significantly younger than late dropouts; they tended to live with their parents or on their own, and suffered more frequently from eating disorders. Late dropouts lived together with partners and suffered from somatoform disorders more frequently than early dropouts. The reasons given for dropout did not differ between the groups. No differences between dropouts and the controls were found with respect to psychopathology (SCL- 90-R) and quality of life (SF-36). Late dropouts did show significantly lower scores on the scale "autocracy/dominance" than the controls (IIP). Therapy dropout is a multifactorial occurrence. It is generally not predictable, though it may be predicted with different instruments on the basis of a diagnosis, especially with respect to interpersonal behavior patterns. In further studies, targeted interventions should be developed and tested which enable procedures to minimize the risk of dropout and to achieve complete treatment according to patients' intentions.

  15. Written emotional disclosure: a controlled study of the benefits of expressive writing homework in outpatient psychotherapy. (United States)

    Graf, Maria C; Gaudiano, Brandon A; Geller, Pamela A


    The current study investigated the extent to which outpatient psychotherapy clients benefited from Pennebaker's expressive writing protocol (Pennebaker & Beall, 1986) adapted for use as a homework intervention. Participants were randomly assigned to written emotional disclosure or writing control conditions. Pre- and postintervention outcome measures were collected for three consecutive therapy sessions. Clients in the written emotional disclosure group showed significantly greater reductions in anxiety and depressive symptoms as well as greater overall progress in psychotherapy in comparison to the writing control group. Results suggest that emotional disclosure writing homework, in conjunction with outpatient psychotherapy, facilitates therapeutic process and outcome.

  16. [Psychology and psychotherapy in bipolar disorder]. (United States)

    Kupka, R W; de Been, D


    This essay presents recent insights and theories relating to the various psychological mechanisms underlying bipolar disorder and describes a number of the psychotherapies that are based on these mechanisms. Each type of psychotherapy derives from the assumption that bipolar disorder has a neurobiological origin and all the psychotherapies involve long-term pharmacotherapy and comprise many psychoeducational elements. The psychotherapies complement each other and the best and most useful parts of one therapy can be combined with those of others in everyday practice. Patients participating in these psychotherapies can obtain additional support from self help manuals.

  17. Short-term residential psychotherapy: psychotherapy in a nutshell. (United States)

    Bolten, M P


    Psychotherapy in a psychotherapeutic community often is characterized by absence of time limits and by long duration. In this article an account is given of the adaptions that are necessary when short-term treatment is carried out in such a residential setting. Implications for focus, therapy program, and treatment style are presented.

  18. Neuroimaging for psychotherapy research: Current trends (United States)



    Objective This article reviews neuroimaging studies that inform psychotherapy research. An introduction to neuroimaging methods is provided as background for the increasingly sophisticated breadth of methods and findings appearing in psychotherapy research. Method We compiled and assessed a comprehensive list of neuroimaging studies of psychotherapy outcome, along with selected examples of other types of studies that also are relevant to psychotherapy research. We emphasized magnetic resonance imaging (MRI) since it is the dominant neuroimaging modality in psychological research. Results We summarize findings from neuroimaging studies of psychotherapy outcome, including treatment for depression, obsessive-compulsive disorder (OCD), and schizophrenia. Conclusions The increasing use of neuroimaging methods in the study of psychotherapy continues to refine our understanding of both outcome and process. We suggest possible directions for future neuroimaging studies in psychotherapy research. PMID:24527694

  19. The efficacy of various modalities of psychotherapy for personality disorders: a systematic review of the evidence and clinical recommendations. (United States)

    Verheul, Roel; Herbrink, Marjolein


    The aim of this paper is to review the level of empirical evidence for four different formats and settings that are available for psychotherapy delivery, i.e., group psychotherapy, out-patient individual psychotherapy, day hospital psychotherapy, and in-patient psychotherapy. The focus is on studies which include a wide range of DSM-IV-TR Axis II personality disorders. The results show that various psychotherapeutic treatments have proven to be efficacious with respect to reducing symptomatology and personality pathology, and improving social functioning in patients with Cluster A, B, C, or not-otherwise-specified personality disorders. This is especially true for cognitive-behaviorally or psychodynamically oriented out-patient individual psychotherapies. However, some evidence indicates that this also applies to (1) long-term, psychodynamically oriented group psychotherapy, (2) short-term, psychodynamically oriented psychotherapy in a day hospital setting, and (3) various duration variants of psychodynamically oriented, in-patient psychotherapy programmes. The available evidence mostly applies to borderline, dependent, avoidant and not-otherwise-specified personality disorder, and perhaps also paranoid, obsessive-compulsive, and schizotypal personality disorder. It is unknown whether these conclusions also apply to schizoid, antisocial, narcissistic, and histrionic personality disorder.

  20. The current status of psychotherapy

    African Journals Online (AJOL)

    action of psychotherapy is a promising new development that is emanating from modern techniques of neuro- ... modernes de neurosciences et neuroimageries. Peut etre qu'une telle comprehension pourrait mener a .... On the other hand, cognitive therapy, developed in. Philadelphia by the psychiatrist Aaron Beck, has a ...

  1. Ayurvedic concepts related to psychotherapy. (United States)

    Behere, Prakash B; Das, Anweshak; Yadav, Richa; Behere, Aniruddh P


    The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.

  2. Effectiveness of Psychotherapy in Personality Disorders Not Otherwise Specified: A Comparison of Different Treatment Modalities. (United States)

    Horn, Eva K; Bartak, Anna; Meerman, Anke M M A; Rossum, Bert V; Ziegler, Uli M; Thunnissen, Moniek; Soons, Mirjam; Andrea, Helene; Hamers, Elisabeth F M; Emmelkamp, Paul M G; Stijnen, Theo; Busschbach, Jan J V; Verheul, Roel


    Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy. A total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups. All treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished. Patients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness. The effectiveness of different modalities of psychotherapy in patients with PDNOS (i.e., short-term vs long-term; outpatient versus day hospital versus inpatient psychotherapy) has not yet been compared. Different modalities of psychotherapy are effective for patients with PDNOS, and positive

  3. The beneficial demands of conducting psychotherapy. (United States)

    Hayes, Jeffrey A


    The practice of psychotherapy requires me to have several qualities: presence, perspective, and self-knowledge. These demands of conducting psychotherapy are discussed from an experiential point of view as primarily beneficial. Practicing psychotherapy also frequently reminds me of important lessons that I need to remember. Case examples are provided to illustrate central concepts, and research findings occasionally are presented to supplement primary clinical ideas. © 2014 Wiley Periodicals, Inc.

  4. Attachment, ethology and adult psychotherapy. (United States)

    Sable, Pat


    This article discusses Bowlby's development of an ethological-evolutionary perspective, and its implications for psychotherapy with adults. According to Bowlby, attachment behavior is instinctive, having emerged throughout the course of evolution to ensure protection and actual survival. Because the environment affects how attachment behavior unfolds, adverse experiences can divert developmental pathways away from resilience, toward dysfunction and emotional distress. Psychotherapy offers the experience of an attachment relationship. Part of the process involves helping patients understand that feelings such as fear and anxiety are inherent responses to safeguard affectional relationships when they are endangered. As working models are re-appraised and revised, there is emphasis on clarifying the attachment experiences that may have intensified these natural feelings.

  5. Implementing Dynamic Assessments in Psychotherapy. (United States)

    Hopwood, Christopher J; Thomas, Katherine M; Luo, Xiaochen; Bernard, Nicola; Lin, Yanli; Levendosky, Alytia A


    In this article, we organize multimethod, multitimescale data around the interpersonal situation, a conceptual framework that can be used to integrate personality, psychopathology, and psychotherapy constructs in order to guide the assessment of clinical dynamics. We first describe the key variables of the interpersonal situation model and articulate methods for assessing those variables as they manifest (a) across different levels of personality, (b) across situations, and (c) within situations. We next use a case to demonstrate how to assess aspects of the interpersonal situation in a manner that enhances case conceptualization and facilitates the evaluation of clinical hypotheses. We also use this case to highlight challenges and decisions involved in implementing dynamic assessment in psychotherapy. We conclude by outlining areas in need of further exploration toward a more sophisticated approach to clinical practice that involves the routine assessment of dynamic processes.

  6. [Problems of bilinguism in psychotherapy]. (United States)

    Fadda, S; Müller, C


    The authors have attempted an introductory study of problems which are inherent to psychoanalytically oriented psychotherapy and psychoanalysis conducted in the second language of a bilingual therapist. This situation seems to be more complex than is usually admitted in current literature. The main problem encountered by the authors in their personal practice stems from the fact that the process of identification becomes complex when the therapist is confronted with regressive and/or progressive shifts in the course of the treatment.

  7. Personal construct psychotherapy of addictions. (United States)

    Klion, R E; Pfenninger, D T


    Personal construct psychotherapy and its utility in understanding and treating addictions is explored. Several clinical phenomena related to chemical dependency are discussed from the perspective of constructivism. Framed within the context of Prochaska, DiClemente, & Norcross' (1992) stages of change model, several psychotherapeutic techniques are outlined. These concepts and techniques are offered as theoretically based heuristics and are intended to illustrate the potential utility of a clinical approach based upon personal construct theory.

  8. Interpersonal Psychotherapy for Postnatal Anxiety Disorder. (United States)

    Chung, J P Y


    Interpersonal psychotherapy is one of two evidence-based formal psychotherapies for perinatal mood disorders. It is a time-limited, non-transference / cognitive-based therapy that focuses on communication and social support and can be easily conducted in a perinatal clinic setting. There is limited patient access to interpersonal psychotherapy in Hong Kong because the therapy is not widely disseminated. This case report aimed to illustrate the principles and techniques of interpersonal psychotherapy in perinatal psychiatry, and to raise interest among mental health professionals in Hong Kong in this evidence-based treatment.

  9. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... borderline personality disorder (BPD). Therapy may be given one-on-one and through support groups, enabling people with BPD ... reassign extreme positive or negative images associated with one person to another person, such as the therapist. ...

  10. Borderline Personality Disorder: Psychotherapy

    Medline Plus

    Full Text Available ... Ask Your BPD Treatment Provider There are different types of therapy for borderline personality disorder (BPD). Therapy may be given one-on-one and through support groups, enabling people with BPD to interact with others. The most effective type of therapy appears to be dialectical behavior therapy ( ...

  11. Combining pharmacotherapy and psychotherapy - the example of ...

    African Journals Online (AJOL)



    May 20, 2003 ... psychotherapy - the example of depressive disorders ... Major depression is used as an example of a disorder where the combination of psychotherapy and pharmacotherapy offer great advantages. The evidence for .... channels of communication between psychiatrist and psycho- therapist. How effective is ...

  12. The Effectiveness of Western Psychotherapy in treating ...

    African Journals Online (AJOL)

    Background: Psychotherapy has been shown to be effective in the treatment of mental disorders in the western world but viewed as an alien method of treatment to Africans. Aim: To review the literature on the effectiveness of psychotherapy in sub- Saharan Africa. Method: A systematic search of Medline, PsychINFO, ...

  13. Evolution, Shame, and Psychotherapy. (United States)

    Brockman, Richard


    Medea, the title character in Euripides' play, murdered her two sons in response to her husband Jason's abandonment. If her behavior can be understood, it is best understood in the context of shame. In an evolutionary context, shame is the affective response to the loss of one's place in the group. This response is related to the neurobiology of pain-not the acute pain experienced through the post-central gyrus, but the chronic, lingering pain that is experienced through the insular and cingulate cortices where homeostasis is regulated "from above." Shame is thus a fall in self-esteem, but shame is also a crisis of homeostasis, a crisis that can lead to drastic and, as in the case of Medea, violent attempts to "repair" the imbalance. Shame is a primitive, evolutionarily preserved response to the loss of one's place in the group.

  14. P-1139 - Increased utilization of health care services after psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt


    Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... a long-term period psychotherapy patients increased their utilization of health care services with a factor 3 compared to a control group....

  15. [Multiprofessional inpatient psychotherapy of depression in old age]. (United States)

    Cabanel, N; Kundermann, B; Franz, M; Müller, M J


    Depression is common in old age but is often underdiagnosed and inadequately treated. Although psychotherapy is considered effective for treating elderly patients with depression, it is rarely applied in inpatient settings. Furthermore, treatment on inpatient units specialized for elderly patients and implementation of a psychotherapeutic treatment approach are currently more the exception. From this background, a multiprofessional inpatient behavioral treatment program (MVT) for elderly depressed patients was developed at a specialized unit of a university-affiliated regional psychiatric hospital. The MVT is based on specific and modularized group therapies accompanied by individual therapeutic interventions. While the provision of group therapies (such as psychotherapy, social skills training, relaxation training, euthymic and mindfulness-based methods, exercise and occupational therapy as well as psychoeducational sessions for relatives) is assigned to specific professional groups, a joint multiprofessional treatment planning is of central relevance. First evaluations of different treatment components support the high acceptability of the MVT and highlight that psychotherapeutic inpatient treatment programs for the elderly are feasible. Further research is required to investigate the clinical efficacy of psychotherapy in elderly depressive inpatients.

  16. [Reality of treatment in psychotherapy: Results of a survey of German psychiatric hospitals]. (United States)

    Laux, G; Sander, K; Artmann, S; Dreher, J; Lenz, J; Hauth, I


    Since the introduction of the qualification as specialist for psychiatry and psychotherapy, in addition to psychopharmacotherapy psychotherapy is an integral component of the treatment of mentally ill people. A survey was carried out to evaluate the reality of clinical routine use of psychotherapy in German psychiatric hospitals. Between October 2011 and March 2012 German hospitals of psychiatry and psychotherapy were contacted by the head organization, the conference of national directors (Bundesdirektorenkonferenz), to participate in a survey regarding the application of psychotherapy in the real clinical world of daily treatment. With an anonymous questionnaire, data were requested as either a printed form or online version. Data from 25 psychiatric hospitals in the year 2010 could be analysed (average number of beds 300 of which 53 were for psychosomatic/psychotherapeutic patients) and a total of 87,000 inpatients were treated whereby 34 % were diagnosed as F1 addictive disorders and 24 % as F3 affective disorders. More than 80 % of the hospitals applied group therapies of relaxation, cognitive behavior therapy, social competence training and specific techniques, such as dialectic-behavior therapy. As individual treatment methods, patients with depressive disorders were treated with cognitive behavior therapy, interpersonal psychotherapy or psychodynamic therapy in more than 50 % of the cases. Relaxation techniques were offered in most cases by the nursing staff, behavior therapy by psychologists and physicians and psychodynamic therapy mainly by psychiatrists.

  17. Synchrony in Dyadic Psychotherapy Sessions (United States)

    Ramseyer, Fabian; Tschacher, Wolfgang

    Synchrony is a multi-faceted concept used in diverse domains such as physics, biology, and the social sciences. This chapter reviews some of the evidence of nonverbal synchrony in human communication, with a main focus on the role of synchrony in the psychotherapeutic setting. Nonverbal synchrony describes coordinated behavior of patient and therapist. Its association with empathy, rapport and the therapeutic relationship has been pointed out repeatedly, yet close evaluation of empirical studies suggests that the evidence remains inconclusive. Particularly in naturalistic studies, research with quantitative measures of synchrony is still lacking. We introduce a new empirical approach for the study of synchrony in psychotherapies under field conditions: Motion Energy Analysis (MEA). This is a video-based algorithm that quantifies the amount of movement in freely definable regions of interest. Our statistical analysis detects synchrony on a global level, irrespective of the specific body parts moving. Synchrony thus defined can be considered as a general measure of movement coordination between interacting individuals. Data from a sequence of N = 21 therapy sessions taken from one psychotherapy dyad shows a high positive relationship between synchrony and the therapeutic bond. Nonverbal synchrony can thus be considered a promising concept for research on the therapeutic alliance. Further areas of application are discussed.

  18. Psychotherapy in the aesthetic attitude. (United States)

    Beebe, John


    Drawing upon the writings of Jungian analyst Joseph Henderson on unconscious attitudes toward culture that patients and analysts may bring to therapy, the author defines the aesthetic attitude as one of the basic ways that cultural experience is instinctively accessed and processed so that it can become part of an individual's self experience. In analytic treatment, the aesthetic attitude emerges as part of what Jung called the transcendent function to create new symbolic possibilities for the growth of consciousness. It can provide creative opportunities for new adaptation where individuation has become stuck in unconscious complexes, both personal and cultural. In contrast to formulations that have compared depth psychotherapy to religious ritual, philosophic discourse, and renewal of socialization, this paper focuses upon the considerations of beauty that make psychotherapy also an art. In psychotherapeutic work, the aesthetic attitude confronts both analyst and patient with the problem of taste, affects how the treatment is shaped and 'framed', and can grant a dimension of grace to the analyst's mirroring of the struggles that attend the patient's effort to be a more smoothly functioning human being. The patient may learn to extend the same grace to the analyst's fumbling attempts to be helpful. The author suggests that the aesthetic attitude is thus a help in the resolution of both countertransference and transference en route to psychological healing.

  19. The Subject in Cognitive Psychotherapy

    Directory of Open Access Journals (Sweden)

    Isabel Caro-Gabalda


    Full Text Available This paper discusses the various subjects embedded in cognitive psychotherapy. The cognitive model developed by Beck, considered as a rationalist and modernist model, will exemplify these subjects. Cognitive therapy should be placed in the modernist historical context and related to a subject characterized as having rationality and the ability to observe and detect cognitions, emotions and behaviors. The paper develops this background introducing three main subject types. The first is the introspective and conscious subject, who is able to observe what is within oneself, has free access, and is conscious of one's cognitive world. The second is the cognitive miser that describes the subject who enters into therapy. The final subject identified, is the trained scientist who is able to develop a more objective knowledge, changing faulty schemas and cognitive distortions. This subject is the one most looked for in cognitive therapy. We could connect these subjects to some of the main elements of cognitive therapy such as the concept of ABC, assessment procedures, cognitive techniques or the relevance of schemas. Finally, the paper suggests some issues for study that could contribute to the theoretical and clinical evolution of cognitive psychotherapy.

  20. The place of additional individual psychotherapy in the treatment of alcoholism: a randomized controlled study in nonresponders to anticraving medication-results of the PREDICT study. (United States)

    Berner, Michael M; Wahl, Sonja; Brueck, Rigo; Frick, Katrin; Smolka, Robert; Haug, Monika; Hoffmann, Sabine; Reinhard, Iris; Leménager, Tagrid; Gann, Horst; Batra, Anil; Mann, Karl


    Goal of the presented study is to evaluate whether alcohol-dependent patients given additional individual psychotherapy after a heavy relapse during pharmacotherapy remain abstinent for longer than those who continue with pharmacotherapy alone. In a randomized, multicenter study, 109 alcohol-dependent patients who had suffered a heavy relapse either while receiving anticraving medication or placebo were randomized into 2 groups. One group received medication, medical management, and additional individual, disorder-specific, cognitive-behavioral psychotherapy, while the control group received medication and medical management only. Main outcome was defined as days until first heavy relapse. Fifty-four patients were randomized to the psychotherapy group, 55 to the control group. Intention-to-treat and completer analyses found no differences between groups, whereas as-treated analyses (patients who actually received psychotherapy compared with those who did not) found a significant effect of psychotherapy. Our data indicate that patients that are willing to attend psychotherapy benefit from receiving psychotherapy in addition to pharmacotherapy. We suggest that it may be beneficial to consider patients' preferences concerning psychotherapy at an earlier stage during treatment. Copyright © 2013 by the Research Society on Alcoholism.

  1. Psicoterapia de grupo e considerações sobre o paciente como agente da própria mudança Psicoterapia de grupo y consideraciones sobre el paciente como agente del propio cambio Group psychotherapy and considerations concerning the patient as an agent for his own change

    Directory of Open Access Journals (Sweden)

    Luiz Paulo de C. Bechelli


    Full Text Available Nas últimas décadas a psicoterapia de grupo tem merecido considerável atenção por parte dos pesquisadores. Tendo por base publicações recentes, os autores tecem considerações sobre a indicação, a necessidade de se adotar critérios de seleção, os resultados esperados e o prognóstico, bem como o processo de mudança. A revisão da literatura evidencia tendência de se reconhecer o cliente como agente de sua própria mudança, e é colocada em relevo a forma particular que este processo assume na psicoterapia de grupo.En las últimas décadas, la psicoterapia de grupo ha merecido considerable atención por parte de los investigadores. Teniendo como base publicaciones recientes, los autores hacen consideraciones sobre la indicación, la necesidad de adoptar criterios de selección, los resultados esperados y el pronóstico, así como también el proceso de cambio. La revisión de la literatura evidencia la tendencia de reconocer el cliente como agente de su proprio cambio, siendo enfatizada la forma particular que este proceso asume en la psicoterapia de grupo.In the last few decades, group psychotherapy has deserved considerable attention from researchers. Based on recent publications, the authors of this work make considerations concerning the indication, the need to adopt a selection criteria, expected results and prognoses as well as the change process. Literature review shows a tendency to recognize the client as an agent for his own change. The particular shape which is taken by this process in group psychotherapy is pointed out.

  2. Predictors of discharge in child psychoanalytic psychotherapy

    Directory of Open Access Journals (Sweden)

    Izabel Cristina Paez


    Full Text Available Introduction: This empirical study was based on the analysis of the results of a study about dropout predictors among in child psychoanalytic psychotherapy. The objectives were to characterize the sample of children discharged from psychoanalytic psychotherapy, examine the association between sociodemographic/ clinical variables and child psychoanalytic psychotherapy discharge, and determine predictors of discharge in child psychoanalytic psychotherapy.Method: This quantitative, descriptive and retrospective study analyzed the clinical records of 600 children treated in three institutions that offer graduate courses in psychoanalytic psychotherapy in Porto Alegre, Brazil.Results: The analysis of clinical records revealed that 24.2% of the child patients were discharged from treatment. Neurological assessment and treatment duration were predictors of discharge in child psychoanalytic psychotherapy.Conclusion: The predictors of discharge and dropout may coincide, but they are not the same. In this sample, the construction of the therapeutic alliance and the understanding of the reasons why children need psychotherapy by their parents or guardians may explain our findings.

  3. Effectiveness of routine psychotherapy: Method matters. (United States)

    McAleavey, Andrew A; Youn, Soo Jeong; Xiao, Henry; Castonguay, Louis G; Hayes, Jeffrey A; Locke, Benjamin D


    Though many studies have shown that psychotherapy can be effective, psychotherapy available in routine practice may not be adequate. Several methods have been proposed to evaluate routine psychological treatments. The aim of this paper is to demonstrate the combined utility of complementary methods, change-based benchmarking, and end-state normative comparisons, across a range of self-reported psychological symptoms. Benchmarks derived from randomized controlled trials (RCTs) and normative comparisons were used to evaluate the effectiveness of psychotherapy in a large (N = 9895) sample of clients in university counseling centers (UCCs). Overall, routine psychotherapy was associated with significant improvement across all symptoms examined. For clients whose initial severity was similar to RCT participants, the observed pre-post effect sizes were equivalent to those in RCTs. However, treatment tended to lead to normative end-state functioning only for those clients who were moderately, but not severely, distressed at the start of psychotherapy. This suggests that although psychotherapy is associated with an effective magnitude of symptom improvement in routine practice, additional services for highly distressed individuals may be necessary. The methods described here comprise a comprehensive analysis of the quality of routine care, and we recommend using both methods in concert. Clinical or methodological significance of this article: This study examines the effectiveness of routine psychotherapy provided in a large network of counseling centers. By comparing multiple established methods to define outcomes in this sample we provide a detailed understanding of typical outcomes. The findings show that, across several different problem areas, routine psychotherapy provided substantial benefit, particularly to clients in the most distress. However, there is room to improve, especially by increasing the number of clients who return to normal functioning by the end of

  4. Parent-infant art psychotherapy: a creative dyadic approach to early intervention. (United States)

    Gray Armstrong, Victoria; Howatson, Rosie


    Art psychotherapy involves the use of the image-making process within a therapeutic relationship to help clients explore and communicate feelings and experiences. This article explores whether art psychotherapy groups can be an effective intervention for parent-infant dyads who may be involved with social work and health teams due to concerns about their relationship, possibly due to postnatal depression or attachment difficulties. We describe a model of parent-infant art psychotherapy groups and examine some of the key themes in this intervention alongside vignettes of case work and quantitative and qualitative evidence from the evaluations of two such groups. We believe that the Create Together group demonstrates how knowledge from research into infant mental health and attachments, together with an understanding of the creative process, can be applied in practice to offer a successful early intervention. © 2015 Michigan Association for Infant Mental Health.

  5. Experience with non-drug therapies (psychotherapy, phytotherapy, reflexotherapy for neurasthenia

    Directory of Open Access Journals (Sweden)

    S.A Bozhko


    Full Text Available Objective: to study the efficiency of treating neurasthenia by psychotherapy in combination with reflexotherapy (acupuncture and phytotherapy. Patients and methods. Psychotherapy or combination treatment (psychotherapy + reflexotherapy, psychotherapy + phytotherapy was performed in 96 neurasthenic patients (65 men and 31 women aged 18 to 40 years. Therapeutic effectiveness was evaluated by psychometric testing using the Clinical Global Impression Scale (CGI, the Spielberger-Hanin test, and the multidimensional fatigue inventory (MFI-20.Results. All the patients underwent a complete treatment cycle for 35 days. After the therapy, all the patients showed a stable reduction in emotional lability and a decrease in the magnitude of somatic complaints. Analysis of CGI data revealed the good therapeutic effect of a combination of non-drug treatments: at the initial stage of therapy, it was rated as improvement; by the end of the third week, a noticeable improvement was recorded in half of all the patients. According to the clinical assessment, practical recovery and considerable improvement were noted in 60.8% of the patients in Group 1, in 69.7% in Group 2, in 37% in Group 3, or in 57.3 of all the patients. The MFI-20 scores for all sections improved significantly. The mean Spielberger-Hanin scores for personal and reactive anxiety decreased from 34.5 to 29.5 and from 35.5 to 32.1, respectively.Conclusion. The combination treatment of neurasthenia was established to be highly effective. A combination of psychotherapy and phytotherapy was more effective for comorbidity of asthenic symptomatology with anxiety and depressive manifestations, so was that of reflexotherapy and psychotherapy for somatoautonomic disorders and an anxious component. Psychotherapy as monotherapy proved to be less efficient.

  6. [Effect of using an interpreter in psychotherapy]. (United States)

    Jensen, Rikke Sander; Nørregaard, Trine Maria; Carlsson, Jessica


    An evaluation of the effect of using an interpreter in psychotherapy is quite complex. In the few existing studies on the use of interpreters in psychotherapy no significant difference was found in treatment outcome related to whether an interpreter was used or not. On the other hand, the inclusion of an interpreter affects the therapeutic alliance and the relationships between the parties. The role of the interpreter in psychotherapy is characterized by diversity, and the included studies indicate the need for training to improve the cooperation between the interpreter and the therapist.

  7. How Can Geography and Mobile Phones Contribute to Psychotherapy? (United States)

    Ferrás, Carlos; García, Yolanda; Aguilera, Adrián; Rocha, Álvaro


    Interdisciplinary relationships between Geography and Psychotherapy are an opportunity for innovation. Indeed, scientific works found on bibliographic databases and concerning this theme are scarce. Geographical sub-fields, such as the Geography of Emotions or Psychoanalytical Geography have started to emerge, theorizing about and interpreting feelings, emotions, moods, sufferings, of the chronically ill or diversified social groups and sites. But a less theoretical and more practical approach, in the sense of proposing, predicting and intervening, is lacking; as well as research into the possibilities offered by communication technologies and mobile phones. In the present work, we present the results of a review of the most relevant scientific works published internationally; we reflect on the contributions of Geography and mobile phones to psychosocial therapies and define the orientation and questions that should be posed in future research, from the point of view of geography and regarding psychotherapy. We conclude that the production of georeferenced data via mobile phones concerning the daily lives of people opens great possibilities for cognitive behavioural therapy and mental health. They allow for the development of personalized mood maps that locate the places where a person experiences greater or lesser stress on a daily basis; they allow for a cartography of emotions, a cognitive cartography of the places we access physically or through the Internet, of our feelings and psychosocial experiences. They open the door to the possibility of offering personalized psychotherapy treatments focusing on the ecological-environmental analysis of the places frequented by the person on a daily basis.

  8. Relationship-focused psychotherapies for eating disorders come of age. (United States)

    Tasca, Giorgio A


    This is a commentary on 3 case studies of relationship-focused therapies for eating disorders. The 3 approaches vary along a number of dimensions, but nevertheless share important similarities especially related to the role played by variables such as interpersonal problems and affect dysregulation. I briefly review research on interpersonal- and attachment-based models of eating disorders that provide the evidence-base for theories of therapy that are relationship-focused. The Interpersonal Psychotherapy case presented by Tanofsky-Kraff, Shomaker, Young, and Wilfley (2016) illustrates how a group context can facilitate change in key role disputes and role transitions in an adolescent at risk of developing an eating disorder later in her life. The Integrative-Dynamic Therapy case presented by Richards, Shingleton, Goldman, Siegel, and Thompson-Brenner (2016) is a novel sequential combination of cognitive-behavioral therapy followed by dynamic psychotherapy for a young adult with bulimia nervosa that likely reflects what most clinicians do in everyday practice. The Psychoanalytic Psychotherapy case presented by Lunn, Poulsen, and Daniel (2016) of a patient with severe personality pathology demonstrates how treatments for eating disorders sometimes must address complex attachment dysfunction, self-organization, and therapist countertransference in order to provide a useful therapeutic experience. Relationship-focused theories and therapies for eating disorders have come a long way over the past decades, thus providing therapists with a wider range of approaches that can be truly personalized to their clients. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  9. Counseling and Psychotherapy: Toward A New Perspective. (United States)

    Ivey, Allen E.


    Considers a person-environment approach as central to a metatheory of counseling and psychotherapy. Suggests counselors remain aware of the social and political frames of their work and the verbal and nonverbal communication between counselor and client. (JAC)


    Directory of Open Access Journals (Sweden)

    Maruša Zaletel


    Full Text Available In their article, the authors present the findings of the study in which they conceptualized the method of psychotherapy with the Parent ego state. Their aim was to explore whether this method could be divided into individual, content-wise separate chronological phases which can be observed with the majority of clients. By using a modified method of content analysis of five psychotherapy transcripts and a video recording of a psychotherapy session, nine chronological phases were identified. In order to illustrate the individual phases, excerpts from the transcripts and the video recording of psychotherapy have been included. The article proposes under what conditions can this method be used, and presents some of its limitations.

  11. Succession and survival in psychotherapy organizations. (United States)

    Khaleelee, Olya


    This paper examines the world of psychotherapy by applying a systemic and psychodynamic understanding of the family business as a way of understanding the dilemmas and challenges of leadership succession. Oedipal factors are explored as an important theme within the succession process. This exploration is set within the context of what function psychotherapy has performed in society over the last thirty years. The hypothesis is that the first generation of leaders aimed to provide containment for the individual citizen at a time of failed dependency in society. The suggestion is that this gave way to the primary task for the second generation, which has been to focus on the therapist in training. The challenge for the third generation is to develop a meaningful role for psychotherapy today and to ensure survival at a time when other shorter therapies such as CBT are gaining ascendancy over longer term psychoanalytic psychotherapy.

  12. Cognitive Behavioral Psychotherapies: History and Development

    Directory of Open Access Journals (Sweden)

    M. Hakan Türkçapar


    Full Text Available Cognitive behavioral therapies are one of the most leading theories between current psychotherapies. As a psychotherapy school, besides sharing the common points reached collectively by the humanity throughout the history, it also achieved in integrating scientific and ampirical experiences into the psychotherapy practice. Having included mainstreams like Stoicism, Kantian philosopy in its historical roots, this approach has similarities with eastern philosophies, budism and sufism. Apart from its historical and cultural roots, cognitive approach integrated with behaviorism which applied scientific method in human psychology for the first time, and also implemented the scientific method in the cognitive field. Cognitive behavioral approaches shall make important contributions in the pathway that psychotherapies will cover. [JCBPR 2012; 1(1.000: 7-14

  13. Transference focused psychotherapy: overview and update. (United States)

    Kernberg, Otto F; Yeomans, Frank E; Clarkin, John F; Levy, Kenneth N


    This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non-analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.

  14. Psychotherapy: from exorcism to cognitive theories

    Directory of Open Access Journals (Sweden)

    Durval Mazzei Nogueira Filho

    Full Text Available The author discusses aspects of psychotherapeutic action. He defends the rationality of the procedure, comments on the splintering of the field of psychotherapy and discusses the usefulness of applying the scientific methodology to this field of knowledge.


    Directory of Open Access Journals (Sweden)

    Richard G. Erskine


    Full Text Available Emotional experience is stored within the amygdala and the limbic system of the brain as affect, visceral, and physiological sensation without symbolization and language. These significant memories are expressed in affect and through our bodily movements and gestures. Such body memories are unconscious non-symbolized patterns of self-in-relationship. Several methods of a body centered psychotherapy are described and clinical case examples illustrate the use of expressive methods within a relational psychotherapy.

  16. Treatment failure in humanistic and experiential psychotherapy. (United States)

    Watson, Jeanne C


    In this article, treatment failure in humanistic experiential psychotherapy is defined and explored. I outline several markers that indicate when treatment is not going well. Factors that contribute to failure include client factors, for example, emotional processing capacities, shame, and impoverished narratives, as well as therapist factors including lack of empathic attunement and inflexibility. Treatment failure is illuminated with a case example drawn from humanistic/experiential psychotherapy, and clinical strategies for dealing with failures are recommended. © 2011 Wiley Periodicals, Inc.

  17. Premature conclusions about psychotherapy for dysthymia


    Cuijpers, P.


    Dr Cuijpers and Colleagues Reply To the Editor: We thank Dr Gaudiano and colleagues for their contribution to the discussion about psychotherapy for dysthymia. We agree very much with Gaudiano et al that we should be careful about drawing definite conclusions about the comparative efficacy of psychotherapy on the basis of 5 trials. Therefore, we have been careful in our meta-analysis of comparative studies to describe this as an important limitation of our study, and we have repeatedly indica...

  18. The effects of blinding on the outcomes of psychotherapy and pharmacotherapy for adult depression: A meta-analysis. (United States)

    Cuijpers, P; Karyotaki, E; Andersson, G; Li, J; Mergl, R; Hegerl, U


    Randomized trials with antidepressants are often run under double blind placebo-controlled conditions, whereas those with psychotherapies are mostly unblinded. This can introduce bias in favor of psychotherapy when the treatments are directly compared. In this meta-analysis, we examine this potential source of bias. We searched Pubmed, PsycInfo, Embase and the Cochrane database (1966 to January 2014) by combining terms indicative of psychological treatment and depression, and limited to randomized trials. We included 35 trials (with 3721 patients) in which psychotherapy and pharmacotherapy for adult depression were directly compared with each other. We calculated effect sizes for each study indicating the difference between psychotherapy and pharmacotherapy at post-test. Then, we examined the difference between studies with a placebo condition and those without in moderator analyses. We did not find a significant difference between the studies with and those without a placebo condition. The studies in which a placebo condition was included indicated no significant difference between psychotherapy and pharmacotherapy (g=-0.07; NNT=25). Studies in which no placebo condition was included (and patients and clinicians in both conditions were not blinded), resulted in a small, but significant difference between psychotherapy and pharmacotherapy in favor of pharmacotherapy (g=-0.13; NNT=14). Studies comparing psychotherapy and pharmacotherapy in which both groups of patients (and therapists) are not blinded (no placebo condition is included) result in a very small, but significantly higher effect for pharmacotherapy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Special population - child and adolescent psychotherapy. (United States)

    Halasz, George


    First, to outline the paradigm change of the past 20 years that has transformed the theory and practice of child and adolescent psychodynamic psychotherapy; second, to update aspects of the current Practice Parameters for Psychodynamic Psychotherapy with Children to align with the paradigm change driven by the principles of regulation theory, relational trauma and repair, and the critical need for clinicians' self-care in trauma informed psychotherapy. The emerging neuroscience-driven paradigm of psychotherapy poses challenges for the child and adolescent psychotherapist: to embrace the new conceptual reference points as organising principles leads to an urgent need to rethink traditional diagnostic formulations and time-honoured techniques for intervention. Our child patients and their families are entitled to benefit from the translation of the new research evidence from attachment regulation theory to clinical psychotherapy. Our clinical psychotherapy should sustain the 'best-interest-of-the-child' standards for well-being while also heeding Frances Tustin's warning for therapists to avoid the 'perpetuation of an error' by overlooking recent developments from allied fields in developmental psychology and the neurosciences.

  20. Effectiveness of intensive psychotherapy in a day hospital evaluated with Neurotic Personality Inventory KON-2006. (United States)

    Sobański, Jerzy A; Klasa, Katarzyna; Cyranka, Katarzyna; Mielimąka, Michał; Dembińska, Edyta; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna; Rutkowski, Krzysztof


    AIM : The aim of this study was to determine the effectiveness of intensive psychotherapy in the day hospital for neurotic and behavioral disorders as well as the assessment of the usefulness of the Neurotic Personality Inventory KON-2006 for routine evaluation of psychotherapy effectiveness. The results of the questionnaires KON-2006 completed by 690 patients (women - 69%, men - 31%, mean age 29 years, SD 8 years) were analyzed. All persons have received comprehensive, mainly psychodynamic psychotherapy (group with elements of individual therapy), in the years 2004-2009 in the Day Hospital for Neurotic and Behavioral Disorders in Krakow. The vast majority of patients achieved after the end of psychotherapy beneficial changes in personality corresponding to various degrees of improvements in terms of the questionnaire KON-2006. Only a few patients deteriorated, somewhat more numerous group did not achieve significant changes or the effects are not possible for unambiguous interpretation. These results are highly correlated with those obtained in the personality questionnaire NEO-PI-R. The Neurotic Personality Inventory KON-2006 appears to be an adequate tool to assess the results of intensive, comprehensive psychotherapy, conducted in the day hospital for neurotic and behavioral disorders.

  1. Transference patterns and working alliance during the early phase of psychodynamic psychotherapy

    Directory of Open Access Journals (Sweden)

    Samardžić Ljiljana


    Full Text Available Background/Aim. Working alliance, as a collaborative part of the therapeutic relationship has been proven to be one of the most powerful therapeutic factors in psychotherapy in general, regardless many technical differences between numerous psychotherapeutic modalities. On the other hand, transference is the basic concept of psychodynamic psychotherapy, and, according to the psychoanalytic theory and practice, it forms a major part of the therapeutic relationship. The aim of our paper was to determine the differences between the groups of patients with low, middle, and high working alliance scores and the dropout group in transference patterns, sociodemographic and clinical parameters, during the early phase of psychodynamic psychotherapy. Methods. Our sample consisted of 61 non-psychotic patients, randomly selected by the method of consecutive admissions and treated with psychoanalytic psychotherapy in the outpatient clinical setting. The patients were prospectively followed during 5 initial sessions of the therapeutic process. The working alliance inventory and Core conflictual relationship theme method were used for the estimation of working alliance and transference patterns, respectively. According to the Working Alliance Inventory scores, four groups of patients were formed and than compared. Results. Our results show a significant difference between the groups of patients with low, middle, and high working alliance inventory scores and the dropout group on the variable - transference patterns in the therapeutic relationship. Conclusion. Disharmonious transference patterns are more frequent in patients who form poor quality working alliance in the early phase of psychotherapy, or early dropout psychotherapy. It is of great importance to recognize transference patterns of a patient at the beginning of the psychotherapeutic process, because of their potentially harmful influence on the quality of working alliance.

  2. The Effects of Parent Participation on Child Psychotherapy Outcome: A Meta-Analytic Review (United States)

    Dowell, Kathy A.; Ogles, Benjamin M.


    Forty-eight child psychotherapy outcome studies offering direct comparisons of an individual child treatment group to a combined parent-child/family therapy treatment group were included in this meta-analytic review. Results indicate that combined treatments produced a moderate effect beyond the outcomes achieved by individual child treatments,…

  3. The Use of Psychotherapy with Cancer Patients: A Review of Recent Literature. (United States)

    Harman, Marsha J.


    Presents recent investigations and reports related to group psychotherapy in cancer patients' treatment. Describes primary characteristics and results of studies examining evidence of therapeutic factors, psychosocial support groups, women's adjustment to mastectomies, training in stress management and coping skills, pain and mood disturbance, and…

  4. Improving the effectiveness of psychotherapy in two public hospitals in Nairobi (United States)

    Falkenström, Fredrik; Gee, Matthew David; Kuria, Mary Wangari; Othieno, Caleb Joseph; Kumar, Manasi


    This paper is the first in a planned series of papers studying the effectiveness of psychotherapy and counselling in Nairobi. It describes a method for checking the effectiveness of psychotherapy and improving service quality in a Kenyan context. Rather than prematurely imposing psychotherapy protocols developed in Western countries in another cultural context, we believe that first studying psychological interventions as they are practised may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems. The initial step is to assess outcome of psychological treatments as they are conducted. This is followed by statistical analyses aimed at identifying patient groups who are not improving at acceptable rates. Therapists will then be trained in a ‘best practice’ approach, and controlled trials are used in a final step, testing new interventions specifically targeted at patient groups with sub-optimal outcomes. PMID:29093948

  5. Cost-effectiveness of psychotherapy for cluster C personality disorders: a decision-analytic model in the Netherlands. (United States)

    Soeteman, Djøra I; Verheul, Roel; Meerman, Anke M M A; Ziegler, Uli; Rossum, Bert V; Delimon, Jos; Rijnierse, Piet; Thunnissen, Moniek; Busschbach, Jan J V; Kim, Jane J


    To conduct a formal economic evaluation of various dosages of psychotherapy for patients with avoidant, dependent, and obsessive-compulsive (ie, cluster C) personality disorders (Structured Interview for DSM-IV Personality criteria). We developed a decision-analytic model to assess the cost-effectiveness of 5 dosages of psychotherapy (ie, long-term outpatient psychotherapy, short-term and long-term day hospital psychotherapy, and short-term and long-term inpatient psychotherapy) over a 5-year time horizon in terms of cost per recovered patient-year and cost per quality-adjusted life-year (QALY). Model parameters were estimated using data from 466 patients with cluster C personality disorders who were admitted to 6 specialist centers of psychotherapy in The Netherlands and assigned to 1 of the 5 treatment groups. Probabilistic analysis was conducted to explore the stability of results over uncertain data ranges. Analyses were conducted from both societal and payer perspectives. From the societal perspective and below a threshold of € 2,637 (US $3,351.92) per recovered patient-year, short-term day hospital psychotherapy resulted in the highest level of benefit for its cost; above the threshold, short-term inpatient psychotherapy was the most cost-effective choice. In terms of cost per QALY, this switch point was at a threshold value of € 16,570 (US $21,062.29) per QALY. From the payer perspective, the optimal strategy changed from short-term day hospital psychotherapy to short-term inpatient psychotherapy at threshold values of € 9,874 (US $12,550.94) per recovered patient-year and € 66,302 (US $84,277.13) per QALY. This study indicates that short-term day hospital psychotherapy and short-term inpatient psychotherapy are the most cost-effective treatment strategies for patients with cluster C personality disorders. The ultimate selection depends on what cost-effectiveness threshold is considered acceptable and what perspective is adopted. © Copyright 2011

  6. [Recommendations for psychotherapy in psychiatric inpatient treatment : Results of the PAKT Study Part I]. (United States)

    Uhlmann, C; Flammer, E; Pfiffner, C; Grempler, J; Längle, G; Eschweiler, G-W; Spießl, H; Steinert, T


    In the S3 treatment guidelines psychotherapy is recommended in all psychological disorders. Therefore, outpatient or inpatient psychotherapy should be recommended by therapists in most cases. On the other hand, it is well known that waiting periods for psychotherapeutic treatment are considerable, which raises the question how the recommendation for psychotherapy is presented in psychiatric hospitals in Germany. The article deals with the question of how frequent the recommendation of psychotherapeutic treatment is made after psychiatric inpatient stay or day care, and if there are differences between hospitals and patient groups. In four psychiatric hospitals in southern Germany the frequency of recommendation for psychotherapy in psychiatric patients was registered and compared to the number of all patients treated in the equivalent time. For this purpose, we analyzed data of the basic documentation in the four participating hospitals. Overall, 9.6 % of the patients received a recommendation of psychotherapeutic treatment. In the psychiatric university hospital a subsequent psychotherapeutic treatment was recommended somewhat more often. Differences between hospitals were present but marginal. Over all participating hospitals, psychotherapy was recommended markedly less frequently in patients with an F2 diagnosis in comparison with patients with F3 or F4 diagnoses. Psychotherapeutic treatment after psychiatric inpatient stay is recommended cautiously. Probably therapists anticipate the fact that the growing demand for psychotherapeutic treatment in general reduces the chances for persons after psychiatric inpatient treatment.

  7. The effects of psychotherapy on neural responses to rewards in major depression. (United States)

    Dichter, Gabriel S; Felder, Jennifer N; Petty, Christopher; Bizzell, Joshua; Ernst, Monique; Smoski, Moria J


    Unipolar major depressive disorder (MDD) is characterized by anomalous neurobiological responses to pleasant stimuli, a pattern that may be linked to symptoms of anhedonia. However, the potential for psychotherapy to normalize neurobiological responses to pleasant stimuli has not been evaluated. Twelve adults with and 15 adults without MDD participated in two identical functional magnetic resonance imaging scans that used a Wheel of Fortune task. Between scans, MDD outpatients received Behavioral Activation Therapy for Depression, a psychotherapy modality designed to increase engagement with rewarding stimuli and reduce avoidance behaviors. Seventy-five percent of adults with MDD were treatment responders, achieving post-treatment Hamilton Rating Scale for Depression score of six or below. Relative to changes in brain function in the matched nondepressed group, psychotherapy resulted in functional changes in structures that mediate responses to rewards, including the paracingulate gyrus during reward selection, the right caudate nucleus (i.e., the dorsal striatum), during reward anticipation, and the paracingulate and orbital frontal gyri during reward feedback. There was no effect of diagnostic status or psychotherapy on in-scanner task-related behavioral responses. Behavioral Activation Therapy for Depression, a psychotherapy modality designed to increase engagement with rewarding stimuli and reduce avoidance behaviors, results in improved functioning of unique reward structures during different temporal phases of responses to pleasurable stimuli, including the dorsal striatum during reward anticipation.

  8. [Psychotherapy of posttraumatic stress disorders]. (United States)

    Schnyder, U


    Since the diagnosis of posttraumatic stress disorder (PTSD) was introduced in DSM-III in 1980, a variety of psychotherapeutic approaches have been developed to address the specific problems and needs of traumatized patients. Successful treatment of PTSD requires a well thought-out therapeutic attitude. The therapist must find a well-balanced position between over-identification and turning away out of helplessness. A sensation-seeking attitude should be avoided as should the danger of vicarious traumatisation. In many instances, PTSD can not be treated sufficiently by psychotherapy alone: a comprehensive, multi-modal treatment plan may include pharmacotherapeutic, physical, social, legal, and other interventions. Early psychotherapeutic interventions in the immediate aftermath of a traumatic event follow the rules of crisis intervention (immediacy, focus on the current problems, time limitation). Special attention should be paid to the issues of developing a trusting therapeutic relationship, creating an atmosphere of safety, helping the patient to regain control over and/or distance himself from intrusive recollections. Eye Movement Desensitization and Reprocessing (EMDR) and other "power therapies" can offer quick relief from symptoms. After collective traumatization, psychological debriefings are widely used although the evidence for their usefulness in preventing PTSD is questionable. In patients with chronic PTSD, the psychotherapist should not work exclusively on the traumatic event and its sequelae: treatment should be oriented towards the future rather than the past. Instead of exploring, the therapist should try to activate the patients' resources and help them to find new meaning in their future life.

  9. [Psychosomatic medicine and psychotherapy in Austria]. (United States)

    Pieringer, Walter; Schüssler, Gerhard


    In present-day Austria, psychosomatic medicine and psychotherapy enjoy significantly more sociopolitical and cultural recognition perhaps as a heritage from the days of the Austrian monarchy -- than is reflected in their real presence. This development can be traced back to prewar times and the repudiation of the destructive national socialistic ideology. There is an immanent conflict between specialization in psychosomatic medicine and psychotherapy as an independent field of medicine and the integration of a psychosomatic basic approach into the general fields of medicine. The organization of psychotherapy is doubly anchored in the laws governing medical practice (PSY diploma) and the statutes governing the practice of psychotherapy; this, however, has not resolved the sensitive and only partially creative tension between the two. Austrian medical health politics are currently characterized by renewed efforts to organize the field of psychosomatic medicine. Should medical psychology and psychotherapy, internal medicine, psychiatry or general medicine provide the foundations for this new organization? This conflict is crucial since it will influence the further development of the entire medical field.

  10. [Summary: Scientific evaluation of EMDR psychotherapy]. (United States)

    Haour, F; de Beaurepaire, C


    The evaluation of psychotherapy methods is made difficult by their practical and theoretical diversities as well as the increasing number of available therapies. Evaluation based on scientific criteria in randomized control trials is providing the highest level of proof and recognition by Health Agencies. A recently described integrative psychotherapy, eye movement desensitization and reprocessing (EMDR), developed by F. Shapiro since 1989, has been confronted with the validation procedure used in pharmacological treatment. It was of interest to review the scientific validation steps carried out for this EMDR psychotherapy and for its mechanisms of action. The practical and methodological protocol of the EMDR psychotherapy for trauma integration is reviewed as well as clinical results and mechanisms. This EMDR therapy, focused on the resolutions of traumas, was started by treating patients with post-traumatic stress disorders (PTSD). The integrative EMDR protocol obtained the highest level of efficiency, for PTSD treatment, twenty years after its first publication. The efficiency of the protocol is now under study and scientific evaluation for troubles in which the trauma experiences are triggers or factors of maintenance of the troubles: anxiety, depression, phobia, sexual troubles, schizophrenia, etc. This new integrative psychotherapy follows the pathways and the timing observed for the evaluation and the validation of other therapies. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  11. Obstacles to early career psychiatrists practicing psychotherapy. (United States)

    Clemens, Norman A; Plakun, Eric M; Lazar, Susan G; Mellman, Lisa


    Though psychiatric residents are expected to be competent psychotherapists on graduation, further growth in skill and versatility requires continued experience in their ongoing career. Maturity as a psychotherapist is essential because a psychiatrist is the only mental health provider who, as a physician, can assume full responsibility for biopsychosocial patient care and roles as supervisor, consultant, and team leader. Graduating residents face an environment in which surveys show a steady and alarming decline in practice of psychotherapy by psychiatrists, along with a decline in job satisfaction. High educational debts, practice structures, intrusive management, and reimbursement policies that devalue psychotherapy discourage early career psychiatrists from a practice style that enables providing it. For the early-career psychiatrist there is thus the serious risk of being unable to develop a critical mass of experience or a secure identity as a psychiatric psychotherapist. Implementation of parity laws and the Affordable Care Act (ACA) will affect the situation in unpredictable ways that call for vigilance and active response. Additional service and administrative demands may result from the ACA, creating ethical dilemmas about meeting urgent patient needs versus biopsychosocial standards of care. The authors recommend 1) vigorous advocacy for better payment levels for psychotherapy and freedom from disruptive management; 2) aggressive action against violations of the parity act, 3) active preparation of psychiatric residents for dealing with career choices and the environment for providing psychotherapy in their practice, and 4) post-graduate training in psychotherapy through supervision/consultation, continuing education courses, computer instruction, and distance learning.

  12. From medicine to psychotherapy: the placebo effect. (United States)

    Justman, Stewart


    If placebos have been squeezed out of medicine to the point where their official place in in clinical trials designed to identify their own confounding effect, the placebo effect nevertheless thrives in psychotherapy. Not only does psychotherapy dispose of placebo effects that are less available to medicine as it becomes increasingly technological and preoccupied with body parts, but factors of the sort inhibiting the use of placebos in medicine have no equivalent in psychology. Medicine today is disturbed by the placebo effect in a way psychotherapy is not. Psychotherapy does not have to grapple with such a disconcerting paradox as successful sham surgery, and unlike those physicians who once pretended to treat the patient's body while actually attempting to treat the mind, the psychotherapist can treat the mind in all frankness. Perhaps it is because psychotherapy is less burdened by doubts about the placebo effect that it was able to come to its aid when it was orphaned by medicine. It is vain to expect something with so long a history as the placebo effect to disappear from the practices of healing.

  13. Effects of Psychotherapy Training and Intervention Use on Session Outcome (United States)

    Boswell, James F.; Castonguay, Louis G.; Wasserman, Rachel H.


    Objective: This study was an investigation of the relationships among therapist training variables, psychotherapy process, and session outcome in a psychotherapy training clinic. The aims were to assess the relationship between "training as usual" and intervention use in individual psychotherapy, to investigate the relationship between therapist…

  14. A review of studies on the psychotherapy of obsessive

    Directory of Open Access Journals (Sweden)

    Quan-chao XING


    Full Text Available Psychotherapy of personality disorder has received more and more attention. As a mental illness of high incidence, a few persons study the psychotherapy of obsessive-compulsive personality disorder.This article overviewed the current situation of the research at home and abroad, in the hope of providing help for the psychotherapy of obsessive-compulsive personality disorder.

  15. Ancient Greek psychotherapy for contemporary nurses. (United States)

    Kourkouta, Lambrini


    Ancient Greek physicians as well as philosophers were fully cognizant of a human being's psychological function and used their particular art to influence individual or social behavior in accordance with their pursuit. This art or technique favorably compares with several of the methods currently called supportive psychotherapy. This psychotherapy was the first form of care for people with mental health problems. Nurses who base their practice on ancient Greek psychotherapy see the patient as a whole, a person who creates meaning in life. Applying the philosophical principles of ancient Greeks helps nurses understand the behavior of people with mental health problems and recognize and facilitate adaptive satisfaction of these psychological needs. In addition, psychiatric nurses are able to help distressed individuals understand their fears and anxieties, so they are freed from the causes of their symptoms that led them to seek therapy in the first place. Consequently, this understanding can make psychiatric nurses' work a living experience and add meaning to their work.

  16. Technology-enhanced human interaction in psychotherapy. (United States)

    Imel, Zac E; Caperton, Derek D; Tanana, Michael; Atkins, David C


    Psychotherapy is on the verge of a technology-inspired revolution. The concurrent maturation of communication, signal processing, and machine learning technologies begs an earnest look at how these technologies may be used to improve the quality of psychotherapy. Here, we discuss 3 research domains where technology is likely to have a significant impact: (1) mechanism and process, (2) training and feedback, and (3) technology-mediated treatment modalities. For each domain, we describe current and forthcoming examples of how new technologies may change established applications. Moreover, for each domain we present research questions that touch on theoretical, systemic, and implementation issues. Ultimately, psychotherapy is a decidedly human endeavor, and thus the application of modern technology to therapy must capitalize on-and enhance-our human capacities as counselors, students, and supervisors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  17. Psychotherapy and the perfect storm of change. (United States)

    Clemens, Norman A


    The author surveys the many forces of change that will have an impact on the practice of psychotherapy in coming years. These include parity, health care reform, federal and state deficits, electronic health records, evidence-based medicine, pay-for-performance, reimbursement issues, and attacks on fee-for-service medicine. Vulnerable aspects of psychotherapy are privacy and confidentiality, individualization and choice of therapy, access to therapy, therapist's choice about participation, denial of coverage based on diagnosis, and sufficient payments to sustain practice. Psychiatric workforce issues may compound the effects. The author identifies some issues calling for vigilance, advocacy, and defense of the key values of psychotherapy and the environment for providing it. (Journal of Psychiatric Practice 2009;15:408-414).

  18. Psychotherapy and black women: a survey. (United States)

    Gray, B A; Jones, B E


    A survey of black and white psychiatrists on the subject of nonpsychotic black female patients in psychotherapy yielded 93 usable responses. Among the findings are a profile of the average black woman in psychotherapy, responses to questions on clinical and therapeutic issues, and the role of racism as reported by the psychiatrists.THE PROFILE OF THE AVERAGE BLACK WOMAN IN PSYCHOTHERAPY THAT EMERGED WAS: she is married, in a technical or semi-professional occupation, with some college experience, in the age range of 26 to 40 years, and most often diagnosed with an anxiety disorder. The most frequent presenting problem is depression, with family problems second in frequency. Developing new coping mechanisms was the most difficult stage of the treatment process. Self-esteem was the most frequent unconscious conflict. Racial discrimination was most often incorportated as a symptom. The impact of racism on the treatment process most frequently occurred in the area of working through conflicts.

  19. [The future of psychotherapy in psychosomatic medicine]. (United States)

    Beutel, Manfred E; Kruse, Johannes; Michal, Matthias; Herzog, Wolfgang


    To review the current perspectives and trends of psychotherapy as a key area of psychosomatic medicine with regard to both societal and scientific challenges as well as patient health care services. Also, to draw conclusions regarding the future training and practice of psychosomatic medicine and psychotherapy. Psychotherapy is confronted with many new challenges because of the high prevalence of mental and psychosomatic disorders, because of their increasing recognition as major health problems and because of the rapid technological and demographic changes going on in modern society. Despite its growth, psychotherapeutic care is still limited in many, especially rural, regions and for patients with complex psychosomatic and somatopsychic disorders. New models of training as well as integrated and multimodal care are needed in order to provide both, rapid, low-threshold and specialized, disorder-specific care.

  20. What should we expect from psychotherapy? (United States)

    Goldfried, Marvin R


    In addressing the very general question of what we should expect from psychotherapy, this article begins by discussing what constitutes relevant evidence on which to base the efficacy and effectiveness of psychotherapy. In this context, an important distinction is made between empirically supported treatments and evidence-based practice. Although there is evidence that psychotherapy does indeed work, there are also findings that there are times when our patients are harmed by our interventions. It is noted that the therapeutic alliance plays an extremely important role in the change process, and that ruptures in the alliance can contribute to our therapeutic failures. In pointing to directions for the future, modifications of how we investigate the outcome of treatment, as well as how to close the gap between research and practice, are offered. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Changing What You Know and Do: The Parent-Child Psychotherapy Program (United States)

    Kaplan, Betty Ann; Venza, James


    The Parent-Child Psychotherapy Program (PPP) is a multifamily group therapy intervention for parents and young children at high risk for intergenerational patterns of neglect, abuse, and disorganized attachment. A "developmental and experiential model" that incorporates principles of attachment theory, the PPP addresses parent and child needs…

  2. Toward a common focus in psychotherapy research. (United States)

    Elkins, David N


    Documenting the schisms in clinical psychology, the author suggests that clinical scientists lay aside theoretical allegiances and work together by adopting a common focus in psychotherapy research on the determinants of effectiveness. Citing evidence showing that personal and interpersonal factors are primary determinants of effectiveness, the author suggests that humanism, broadly defined, provides the best philosophical and theoretical "home" for psychotherapy. Based on the evidence presented in the article, the author describes the revolutionary changes that must occur in research, training, and practice to bring clinical psychology into alignment with the findings of contemporary science. (c) 2012 APA, all rights reserved.

  3. Avoidance motivation in psychological problems and psychotherapy. (United States)

    Holtforth, Martin Grosse


    Avoidance of aversive experiences is common to all human beings. However, when avoidance is too strong, it might be associated with impaired psychological functioning and psychopathology. This article examines the role of avoidance motivation in psychological problems and psychotherapy from conceptual, assessment, and empirical perspectives. The concept of avoidance motivation is introduced, and measures of the intensity and satisfaction of avoidance motivation that the author developed are presented. Empirical findings generated using these measures are also reported. The findings address the role of avoidance motivation in relation to well-being, psychological problems, and psychotherapy outcome. The theoretical and practical implications of these findings are discussed and avenues for further research explored.

  4. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru


    The evidence debate in psychotherapy pays little attention to developing an evidence base for training practices. Understanding effective training requires an examination of what makes training work. This article examines the role of case studies in psychotherapy training. This has not been...... articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory...... to collaborate with other professionals. The paper presents directions for future research into psychotherapy training, specifically proposing an international survey of training practices at psychotherapy training institutions....

  5. [Psychotherapy of patients with personality disorders with predominance of hypochondria]. (United States)

    Burno, M E; Igovskaia, A S


    A standard of psychotherapeutic help to patients with hypochondriac disorder developed in paranoid, schizoid, anxiety and dependent personality disorders is worked out. In this case, hypochondria is inseparable from the personality structure. Patients of investigated group (61 people) received traditional medical treatment, individual differential symptomatic psychotherapy and a short group course with a variant of the therapy by means of creative sell-expression (TCSEB) worked out by M. Burno. This course aimed at preventing new hypochondriac symptoms and acquiring spiritual creative ways to overcome themselves. The control group (70 people) differed from the index-group by not receiving CSEB. A statistical analysis revealed a significant therapeutic efficacy of the mentioned new clinical psychotherapeutic standard compared to the psychotherapeutic tactics without TCSEB.

  6. Facts and values in psychotherapy-A critique of the empirical reduction of psychotherapy within evidence-based practice. (United States)

    Berg, Henrik; Slaattelid, Rasmus


    This paper addresses an implicit presupposition in research-supported psychological treatments and evidence-based practice in psychology. It argues that the notion of research-supported psychological treatments is based on a reductive conceptualisation of psychotherapy. Research-supported psychological treatments hinge upon an empirical reduction where psychotherapy schools become conceptualized as mere collections of empirical propositions. However, this paper argues that the different psychotherapy schools have distinct ethoses that are constituted by normative claims. Consequently, the evaluation of the different psychotherapy schools and the practice of psychotherapy should include the underlying normative claims of these ethoses. © 2017 John Wiley & Sons, Ltd.

  7. Combining pharmacotherapy and psychotherapy - the example of ...

    African Journals Online (AJOL)

    The studies looking at the neurobiological effects of psychotherapy is reviewed and discussed. The practical aspects of combination therapy are presented and problems inherent are indicated and the effectiveness presented. Finally the Canadian Psychiatric Association's comprehensive evidence based clinical guideline ...

  8. [Anxiety disorders: which psychotherapy for whom? (United States)

    Ströhle, A; Fydrich, T


    According to the Federal Healthcare Survey (Bundesgesundheitssurvey), approximately 15% of the German population fulfil the diagnostic criteria for at least one anxiety disorder within (any) 1 year. Women are affected approximately twice as often as men. The study by the Robert Koch Institute included the systematic assessment of panic disorder, agoraphobia, generalized anxiety disorder, social anxiety disorder and specific phobias; therefore, the question for both those affected and the treating therapist is "anxiety disorders: which psychotherapy for whom?" is of great clinical and healthcare political importance. We therefore review the available literature for answering three more specific questions: 1) what are the most suitable forms of psychotherapy, 2) which psychotherapy is most promising for an individual patient and diagnosis (differential evaluation of indications) and 3) what is the best approach to nonresponse or avoidance of the treatment offered? National and international guidelines agree that cognitive behavioral therapy is the psychotherapy of first choice in most patients with anxiety disorders. In cases of nonresponse or lack of availability of the appropriate therapy, psychodynamic therapy or pharmacotherapy can also be recommended. For individualized treatment recommendations we do not have empirical evidence. Also, no evidence-based (individual) recommendations are available for non-responders;however, there are some preferred strategies based on a clinical consensus.

  9. Multicultural Approaches in Psychotherapy: A Rejoinder (United States)

    Owen, Jesse; Leach, Mark M.; Wampold, Bruce; Rodolfa, Emil


    In this rejoinder, the authors address several issues raised by R. L. Worthington and F. R. Dillon (2011) and C. R. Ridley and M. Shaw-Ridley (2011) regarding (a) the measurement of multicultural competencies (MCCs), (b) sampling considerations in multicultural research, and (c) the conceptual frame of multicultural psychotherapy research. The…

  10. Bentuhua: culturing psychotherapy in postsocialist China. (United States)

    Zhang, Li


    The breathless pace of market reform in China has brought about profound ruptures in socioeconomic structures and increased mental distress in the population. In this context, more middle-class urbanites are turning to nascent psychological counseling to grapple with their problems. This article examines how Chinese psychotherapists attempt to "culture" or indigenize (bentuhua) three imported psychotherapy models in order to fit their clients' expectations, desires, and sensibilities: the Satir family therapy, cognitive behavioral therapy, and sandplay therapy. It addresses three interrelated questions: What is the role of culture in adopting, translating, and recasting psychotherapy in contemporary China? How is cultural difference understood and mobilized by therapists in the therapeutic encounter? What kind of distinct therapeutic relationship is emerging in postsocialist China? Data presented here are drawn from my semistructured interviews and extensive participant observation at various counseling offices and psychotherapy workshops in the city of Kunming. My ethnographic account suggests that it is through constant dialog, translation, and re-articulation between multiple regimes of knowledge, cultural values, and social practices that a new form of talk therapy with "Chinese characteristics" is emerging. Finally, I reflect upon what this dialogic process of transformation means for psychotherapy as a form of globally circulating knowledge/practice.

  11. Serious Games for Psychotherapy: A Systematic Review. (United States)

    Eichenberg, Christiane; Schott, Markus


    In the evolving digital age, media applications are increasingly playing a greater role in the field of psychotherapy. While the Internet is already in the phase of being established when it comes to the care of mental disorders, experimentation is going on with other modern media such as serious games. A serious game is a game in which education and behavior change is the goal, alongside with entertainment. The objective of the present article was to provide a first empirical overview of serious games applied to psychotherapy and psychosomatic rehabilitation. Therefore, a systematic literature search, including the terms "serious game" or "computer game" and "psychotherapy" or "rehabilitation" or "intervention" or "mental disorders" in the databases Medline and PsycINFO, was performed. Subsequently, an Internet search was conducted to identify studies not published in journals. Publications not providing empirical data about effectiveness were excluded. On the basis of this systematic literature review, the results of N = 15 studies met inclusion criteria. They utilized primarily cognitive behavioral techniques and can be useful for treating a range of mental disorders. Serious games are effective both as a stand-alone intervention or part of psychotherapy and appeal to patients independent of age and sex. Included serious games proved to be an effective therapeutic component. Nonetheless, findings are not conclusive and more research is needed to further investigate the effectiveness of serious games for psychotherapeutic purposes.

  12. Antidepressants versus interpersonal psychotherapy in treating ...

    African Journals Online (AJOL)

    Both pharmacotherapy and psychotherapy may be equally effective in the treatment of depression in HIV-positive patients. The choice of treatment will be influenced by factors such as adverse effects of antidepressants and adding another medication to an already complex antiretroviral regimen. In such cases, IPT may be ...

  13. Existential psychotherapy of students as learning strategy

    DEFF Research Database (Denmark)

    Dræby, Anders

    According to parts of the existential psychology and psychotherapy the individual's exploration and compliance of his or her life project is central to the experience of living a meaningful life. In many ways, becoming a fully adult individual is about identifying and taking responsibility for th...

  14. Supervision of Psychotherapy: Models, Issues, and Recommendations (United States)

    Westefeld, John S.


    Current models and issues related to psychotherapy supervision are examined. These include ethical and legal issues, problems of interpersonal competence, and multicultural issues. As a part of this analysis, interviews about supervision with five prominent counseling psychologists are included to provide their perspectives. Implications for the…

  15. Interventions and Strategies in Counseling and Psychotherapy. (United States)

    Watts, Richard E., Ed.; Carlson, Jon, Ed.

    This book acknowledges the contributions of Alfred Adler and illustrates the many ways in which Adlerian ideas underpin and influence contemporary therapeutic approaches. It brings together today's leading thinkers to address the practice of counseling and psychotherapy from a social-cognitive perspective. Contributors apply the basic ideas of…

  16. Reflections on Psychotherapy and Aerobic Exercise. (United States)

    Silverman, Wade

    This document provides a series of reflections by a practicing psychologist on the uses of aerobic workouts in psychotherapy. Two case histories are cited to illustrate the contention that the mode of exercise, rather than simply its presence or absence, is the significant indicator of a patient's emotional well-being or psychopathology. The first…

  17. Premature conclusions about psychotherapy for dysthymia

    NARCIS (Netherlands)

    Cuijpers, P.


    Dr Cuijpers and Colleagues Reply To the Editor: We thank Dr Gaudiano and colleagues for their contribution to the discussion about psychotherapy for dysthymia. We agree very much with Gaudiano et al that we should be careful about drawing definite conclusions about the comparative efficacy of

  18. Toward a Neurobiology of Child Psychotherapy (United States)

    Kay, Jerald


    Brain imaging studies have demonstrated that psychotherapy alters brain structure and function. Learning and memory, both implicit and explicit, play central roles in this process through the creation of new genetic material that leads to increased synaptic efficiency through the creation of new neuronal connections. Although there is substantial…

  19. Psychodynamic psychotherapy for the depressive syndrome. (United States)

    Cameron, P M


    Historical approaches of psychotherapy for depression are contrasted with current psychotherapeutic strategies. Now more strategies are focused, structured, time-limited, observable, testable, researchable and data based. The following depressive syndromes are reviewed in terms of the literature that demonstrates the effectiveness of psychotherapy: major depressive disorder, bipolar depressive disorder, depression associated with medical illness such as cancer, myocardial infarction and stroke, resistant depression post-traumatic stress disorder, grief reactions and depression during adolescence, mid-life and the geriatric period of the life cycle. A conceptual model favoring tripartite focus of intervention is recommended. Psychodynamic psychotherapy for depression must consider intrapsychic, interpersonal and family dynamics as well as social supports. A model for each population needs to be studied and developed further. Recommendations for current research are suggested. In the individual modification of psychotherapeutic approaches we must consider the varying maturity of ego defenses and the ego strength of the individual patient. Forty well-designed studies that demonstrate the effectiveness of psychotherapy in the depressive syndromes are quoted in this paper.

  20. [Psychotherapy motivation--factor analysis and validity of a modified version of the Psychotherapy Motivation Questionnaire (FPTM)]. (United States)

    Schweickhardt, Axel; Leta, Rainer; Bauer, Joachim; Fritzsche, Kurt


    Motivation for psychotherapy is seen as a major factor for the success of psychotherapy. Examination of this motivation process requires procedures which recognize motivation for psychotherapy prior to initiation of therapy. Therefore, we reformulated the Psychotherapy Motivation Questionnaire (FPTM). N = 383 patients were given the questionnaire before their first consultation in outpatient psychosomatic treatment. The factorial and criteria validity were tested. The factorial structure of the altered questionnaire is identical to the original version. Confirmative factor analysis affirms "initiative" and "knowledge" as two separate factors. Patients with somatoform disorders and "unexplained physical symptoms" as the reason for referral show less motivation than other patients. Patients with previous experience with psychotherapy show higher motivation. The Psychotherapy Motivation Questionnaire can be used in its adapted version before patients start psychotherapy. The increase in motivation depends on the disorder and the treatment phase. Information and the reason for referral are important variables in motivation. Georg Thieme Verlag KG Stuttgart.New York.

  1. Evidence-based Neuro Linguistic Psychotherapy: a meta-analysis. (United States)

    Zaharia, Cătălin; Reiner, Melita; Schütz, Peter


    Neuro Linguistic Programming (NLP) Framework has enjoyed enormous popularity in the field of applied psychology. NLP has been used in business, education, law, medicine and psychotherapy to identify people's patterns and alter their responses to stimuli, so they are better able to regulate their environment and themselves. NLP looks at achieving goals, creating stable relationships, eliminating barriers such as fears and phobias, building self-confidence, and self-esteem, and achieving peak performance. Neuro Linguistic Psychotherapy (NLPt) encompasses NLP as framework and set of interventions in the treatment of individuals with different psychological and/or social problems. We aimed systematically to analyse the available data regarding the effectiveness of Neuro Linguistic Psychotherapy (NLPt). The present work is a meta-analysis of studies, observational or randomized controlled trials, for evaluating the efficacy of Neuro Linguistic Programming in individuals with different psychological and/or social problems. The databases searched to identify studies in English and German language: CENTRAL in the Cochrane Library; PubMed; ISI Web of Knowledge (include results also from Medline and the Web of Science); PsycINFO (including PsycARTICLES); Psyndex; Deutschsprachige Diplomarbeiten der Psychologie (database of theses in Psychology in German language), Social SciSearch; National library of health and two NLP-specific research databases: one from the NLP Community ( and one from the NLP Group ( From a total number of 425 studies, 350 were removed and considered not relevant based on the title and abstract. Included, in the final analysis, are 12 studies with numbers of participants ranging between 12 and 115 subjects. The vast majority of studies were prospective observational. The actual paper represents the first

  2. Differences in clinical characteristics between patients assessed for NHS specialist psychotherapy and primary care counselling. (United States)

    Chiesa, Marco; Fonagy, Peter; Bateman, Anthony W


    Although several studies have described patient populations in primary care counselling settings and NHS (National Health Service) specialist psychotherapy settings, there is a paucity of studies specifically comparing differences in clinical characteristics between the two groups of patients. The aim of this study is to ascertain if specialist psychotherapy referrals represent a more challenging client group than primary care counselling patients. We compare the socio-demographic features and severity of presentation in the symptomatic, interpersonal problems and global adjustment dimensions of a sample of patients (N=384) assessed by a primary care counselling service located in North London and a sample of patients (N=853) assessed in eight NHS psychotherapy centres located within urban settings in England. Both the groups completed the Brief Symptom Inventory, the Inventory of Interpersonal Problems and Clinical Outcomes in Routine Evaluation Outcome Measure. Patients referred for specialist psychotherapy services were more dysfunctional than those referred for primary care counselling. The linear function constructed to discriminate the groups showed that a combination of more psychotic symptoms, social inhibitions and higher risk of self-harm effectively identified those referred to psychotherapy services, while patients exhibiting greater levels of somatic and anxiety symptoms and non-assertiveness were more likely to be seen in primary care settings. However, similarities between the two samples were also marked, as shown by the overlap in the distribution of clinical outcomes in routine evaluation clinical scores in the two samples. The findings are discussed in terms of their implications for policy and service delivery of these two types of psychological therapy services.

  3. Ethical dimensions of psychotherapy: a personal perspective. (United States)

    Chodoff, P


    A substantial increase in the interest devoted to ethical issues has been a defining feature of my 50 years in psychotherapeutic practice. Reasons include a shift from a paternalistic to a contractual model of the doctor-patient relationship, increased litigiousness, and greater emphasis on the business rather than professional aspects of practice. Many ethical violations stem from misuse of therapist power in the psychotherapeutic relationship. One of the most egregious of these is overt sexual acting out between therapist and patient, a dereliction now viewed much more sternly, largely because of the rise of the women's movement. Therapist power can also be misused for purposes of psychopathological gratification, such as to dominate patients or impose values, and by emphasizing financial rewards over patient needs. A sea change I have observed has been the gradual replacement of a two-party by a three-party system of payment for psychotherapy. Among its most serious consequences in the ethical domain has been the weakening of the therapist's guarantee of absolute confidentiality to the patient. Managed care has further compounded the ethical dilemma by imposing a need to choose between the interests of patients and the organizations from which therapists receive remuneration. In their efforts to ensure parity coverage for psychotherapy, therapists need to respond to certain questions about their claims that their work promotes both individual welfare and the common good. Questions include the professional qualifications for skillful practice of psychotherapy, the evidence for its efficacy, the delimitation of the conditions properly treated by psychotherapy, and the extent to which these conditions fall within the medical model and thus satisfy the criterion of medical necessity. I conclude that, in spite of the efforts needed to maintain ethical standards, the "ethical revolution" that I have witnessed has enhanced the integrity and value of psychotherapy, both

  4. For whom does interpersonal psychotherapy work? A systematic review. (United States)

    Bernecker, Samantha L; Coyne, Alice E; Constantino, Michael J; Ravitz, Paula


    The efficacy of interpersonal psychotherapy (IPT) to treat depression and other disorders is well established, yet it remains unknown which patients will benefit more from IPT than another treatment. This review summarizes 46years of clinical trial research on patient characteristics that moderate the relative efficacy of IPT vs. different treatments. Across 57 studies from 33 trials comparing IPT to pharmacotherapy, another psychotherapy, or control, there were few consistent indicators of when IPT would be more or less effective than another treatment. However, IPT may be superior to school counseling for adolescents with elevated interpersonal conflict, and to minimal controls for patients with severe depression. Cognitive-behavioral therapy may outpace IPT for patients with avoidant personality disorder symptoms. There was some preliminary evidence that IPT is more beneficial than alternatives for patients in some age groups, African-American patients, and patients in an index episode of depression. The included studies suffered from several limitations and high risk of Type I and II error. Obstacles that may explain the difficulty in identifying consistent moderators, including low statistical power and heterogeneity in samples and treatments, are discussed. Possible remedies include within-subjects designs, manipulation of single treatment ingredients, and strategies for increasing power such as improving measurement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Randomized, controlled trial of the effectiveness of short-term dynamic psychotherapy and cognitive therapy for cluster C personality disorders. (United States)

    Svartberg, Martin; Stiles, Tore C; Seltzer, Michael H


    This study compared the effectiveness of short-term dynamic psychotherapy and cognitive therapy for outpatients with cluster C personality disorders. Patients (N=50) who met the criteria for one or more cluster C personality disorders and not for any other personality disorders were randomly assigned to receive 40 weekly sessions of short-term dynamic psychotherapy or cognitive therapy. The most common axis I disorders in the patient group were anxiety and depression diagnoses. Therapists were experienced, full-time clinicians and were receiving manual-guided supervision. Outcome variables included symptom distress, interpersonal problems, and core personality pathology. Measures were administered repeatedly during and after treatment, and change was assessed longitudinally by means of growth modeling procedures. The overall patient group showed, on average, statistically significant improvements on all measures during treatment and also during a 2-year follow-up period. Significant changes in symptom distress after treatment were found for the group of patients who received short-term dynamic psychotherapy but not for the cognitive therapy patients. Despite these differences in intragroup changes, no statistically significant differences between the short-term dynamic psychotherapy group and cognitive therapy group were found on any measure for any time period. Two years after treatment, 54% of the short-term dynamic psychotherapy patients and 42% of the cognitive therapy patients had recovered symptomatically, whereas approximately 40% of the patients in both groups had recovered in terms of interpersonal problems and personality functioning. Both short-term dynamic psychotherapy and cognitive therapy have a place in the treatment of patients with cluster C personality disorders. However, factors other than treatment modality may discriminate better between successful and poor outcomes. Such factors should be explored in future studies.

  6. Employing open/hidden administration in psychotherapy research: A randomized-controlled trial of expressive writing (United States)

    Tondorf, Theresa; Kaufmann, Lisa-Katrin; Degel, Alexander; Locher, Cosima; Birkhäuer, Johanna; Gerger, Heike; Ehlert, Ulrike


    Psychotherapy has been shown to be effective, but efforts to prove specific effects by placebo-controlled trials have been practically and conceptually hampered. We propose that adopting open/hidden designs from placebo research would offer a possible way to establish specificity in psychotherapy. Therefore, we tested the effects of providing opposing treatment rationales in an online expressive writing intervention on affect in healthy subjects. Results indicate that it was possible to conduct the expressive writing intervention both covertly and openly, but that participants in the hidden administration condition did not fully benefit from the otherwise effective expressive writing intervention in the long-run. Effect sizes between open and hidden administration groups were comparable to pre-post effect sizes of the intervention. While this finding is important for the understanding of psychotherapy's effects per se, it also proves that alternative research approaches to establish specificity are feasible and informative in psychotherapy research. Trial registration: German Clinical Trials Register DRKS00009428 PMID:29176768


    Directory of Open Access Journals (Sweden)

    Mihael Černetič


    Full Text Available The article explores the relationship between Integrative Psychotherapy and mindfulness on a theoretical as well as practical level. Although mindfulness is not an explicit constituent of Integrative Psychotherapy, the two are arguably a natural fit. Mindfulness has the potential to enhance internal and external contact, a central concept in Integrative Psychotherapy, as well as strengthen a client’s Adult ego state. This article presents a case study whereby Integrative Psychotherapy is analysed from the perspective of mindfulness. Within the course of therapy, parallels were observed between the client's increased mindfulness, improved internal and external contact, strengthened Adult ego state, mastery of introjections, as well as diminished feelings of guilt, improved mood, self care and ability to engage in appropriate separation and individuation. These gains support the conclusion that Integrative Psychotherapy and mindfulness are inherently related and that explicit incorporation of mindfulness may enhance the therapeutic process of Integrative Psychotherapy.

  8. Effectiveness of Existential Psychotherapy in Increasing the Resiliency of Infertile Women

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    z rezaei


    Full Text Available Background and Aim: Many problems are associated with infertility diagnosis, especially for women. Resiliency is one of the strategies which may reduce psychological distress of infertile women. The aim of current research was to study the effectiveness of existential psychotherapy in increasing the resiliency of infertile women. Method: The design of the present study was a semi-experimental research with pretest and posttest with control group. Statistical population consisted of all infertile women of Dehdasht, Iran, in the summer of 2014. Samples were selected at first by available sampling method and after completing resiliency questionnaire, and obtaining score for enter to research, were placement using random sampling method in two experimental and control groups (N = 8 per group. The experimental group participated in 8 sessions of group counseling based on existential approach and control group received no intervention. The gathered data were analyzed using covariance analysis. Results: The results showed that significant differences between the pre-test and post-test scores of the experimental group existed. This difference was significant at the level of 0.01. Therefore, it seemed that existential psychotherapy increased the resiliency of infertile women. Conclusion: The results revealed that existential psychotherapy increased resiliency of infertile women and interventions based on this approach will lead to the improvement of the mental health.

  9. Antidepressants versus interpersonal psychotherapy in treating depression in HIV-positive patients.

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    M Y H Moosa


    Full Text Available Aim. Despite the prevalence of HIV and AIDS in South Africa reaching pandemic proportions, very few studies have been published on co-morbid depression. This study at Chris Hani Baragwanath Hospital was conducted on a group of HIV-positive patients with depression who were receiving antiretroviral treatment. The aim of the study was to describe their response to treatment with either an antidepressant or psychotherapy. Method. The study was prospective, randomised and controlled. The sampling was a convenience sampling, as it included patients attending the HIV clinic. At entry to the study, a clinical diagnostic evaluation and the Hamilton Depression Rating Scale (HAMD were performed on all subjects by the investigator. The depressed patients were randomly assigned to receive either an antidepressant (citalopram or psychotherapy (interpersonal psychotherapy, IPT. The HAMD was repeated at the study endpoint of 8 weeks. Results. Sixty-two HIV-positive persons on antiretrovirals participated in this study. Thirty of them were not depressed and served as controls, and 32 were depressed. There were no significant differences between the controls and the patients (either receiving pharmacotherapy or psychotherapy in respect of any of the socio-demographic characteristics evaluated (p>0.05. Approximately 60% (n=19 of the depressed patients were, randomised to receive pharmacotherapy, while 40.6% (n=13 received IPT. The mean HAMD scores of the patients on pharmacotherapy decreased from 25.7 to 6.2 from entry to completion of the study, and those for patients receiving psychotherapy decreased from 22.5 to 8.2. The decreases in HAMD scores in patient groups receiving either pharmacotherapy or psychotherapy were not significantly associated with any socio-demographic variables (p>0.05. Conclusion. Both pharmacotherapy and psychotherapy may be equally effective in the treatment of depression in HIV-positive patients. The choice of treatment will be

  10. Treatment as usual (TAU) for depression: a comparison of psychotherapy, pharmacotherapy, and combined treatment at a large academic medical center. (United States)

    Blais, Mark A; Malone, Johanna C; Stein, Michelle B; Slavin-Mulford, Jenelle; O'Keefe, Sheila M; Renna, Megan; Sinclair, Samuel J


    Depression is among the most prevalent and burdensome psychiatric disorders in the United States (Kessler et al., Achieves of General Psychiatry 62:617-627, 2005). There is substantial empirical support regarding efficacy of pharmacotherapy, psychotherapy, and combined treatment (both pharmacotherapy and psychotherapy) for treating depression. However, far less is known about the effectiveness of these treatments for real-world patients treated within routine clinical care settings (Cahill et al., The British Journal of Clinical Psychology 49:421-453, 2010). This study seeks to explore the effectiveness of treatment as usual (TAU) for depression in a large cohort of psychiatric outpatients receiving psychotherapy, pharmacotherapy, or combined treatment within an academic medical center. Initial and follow-up self-report assessments were analyzed for 1,322 patients receiving treatment for depression. Using these data, we determined treatment effect sizes, rates of reliable improvement (and deterioration), and rates of clinically significant improvement for psychotherapy, pharmacotherapy, and combined care. On average, all treatments produced significant improvement with effect sizes surpassing our no-treatment benchmark. No significant between-group (treatment) differences in self-report outcomes were found. The rates of reliable change were similar for all treatment groups consistent with past research. The present findings support the effectiveness of psychotherapy, pharmacotherapy, and combined treatment as routinely provided within a large academic medical center for the treatment of real-world patients suffering with depression.

  11. Self and its anxieties in existential psychotherapy

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    Marica Mircea Adrian


    Full Text Available The existence of a self and the imperative of knowing it have gone through philosophy from its beginning until today. Existentialism, starting with Kierkegaard and continuing with Heidegger, relate the scope of the authentic self to that of anxiety. Once the scope of the anxiety of self has been formulated, it entered the sphere of psychological theories. The prolific encounter between existentialism and psychology materializes into the influent contemporary psychological school, named existential psychotherapy. Our analysis wishes to describe the nodal points of this encounter, having as reference points the scope of self and its anxieties. In the first part of the analysis we look into the philosophical premises, referring to the two above mentioned names, while in the second part we present the taking-ups and the applicative adjustments brought up by existential psychotherapy.

  12. [Psychotherapy with Immigrants and Traumatized Refugees]. (United States)

    Erim, Yesim; Morawa, Eva


    In view of the growing proportion of immigrants and refugees in the population of Germany the knowledge on the influence of culture and migration on identity, and mental health presents a substantial basis for effective therapy. This article addresses important topics of psychotherapy with immigrants in general and with refugees in particular. Following issues selected according to their relevance and actuality are highlighted: definition of persons with migration background, migrants and refugees, facts on immigration to Germany, main results and theories on mental health of immigrants, social psychological aspects of intercultural psychotherapy (individualism vs. collectivism, stereotypes, discrimination etc.), psychosomatic diagnostics in intercultural context, diversity management in institutions, language and use of translators, living conditions of immigrants - stress and protective factors in immigrant mental health, post traumatic stress disorders among refugees: their prevalence, risk factors, diagnostics, course, multimodal psychosocial interventions in consulting centers, trauma focused interventions, trauma pedagogics, education and prevention of the volunteers. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Difficulties in integrating spirituality into psychotherapy (United States)

    Schultz-Ross, RA; Gutheil, TG


    The boundary between spiritual and psychotherapeutic issues is not well defined; indeed, the two may be interwoven. A patient's sense of a therapist may closely relate to the patient's assessment of the therapist's spirituality, and a therapist's recognition of the differences between psychopathological and spiritual beliefs may depend on a recognition of his or her own belief system. Changing the profession's approach to this issue is made difficult by 1) a traditional sense within many schools of psychotherapy that spirituality is outside the sphere of appropriate investigation and knowledge; 2) discomfort with personal spiritual issues in educators and trainees; 3) decreased emphasis on aspects of the therapist as important factors in patient outcome; and 4) decreased use of intensive supervision for psychotherapy in some training programs. PMID:9071663

  14. Psychotherapy with people with developmental disabilities

    Directory of Open Access Journals (Sweden)

    Barbara Zafošnik


    Full Text Available People with developmental disabilities can experience any psychological abnormalitiy and psychiatric illness as do people without developmental disabilities. Due to different diagnostic criteria, assessment procedures and instruments, we lack definite prevalence rates for people with developmental disabilities, also suffering from mental health problems, eventhough most studies place the rate at 20 to 40%. One of the possible treatment alternatives for augmenting psychological well-being is psychotherapy, but is extremely rarely used for people with severe and profound disabilities, where speech cannot be the main therapeutic medium. So, those that are included in the psychotherapuetic process are predominantly clients with mild developmental disabilities, and they are mostly in cognitive-behavioral therapy. Recently, two models of (psychotherapy for persons with severe and profound developmental disabilities were developed: developmental-dynamic relationship therapy and attachment-based behaviour therapy for children. Conceptually, they both originate form developmental psychoanalytic theories.

  15. Psychotherapy and sociology: flirtation, marriage or divorce? (United States)

    Cox, M; Cox, C

    Psychotherapy and sociology are themselves products of mixed marriages; each experiences problems of identity and their children face problems of legitimacy. This paper considers the relevance of some sociological perspectives to the psychotherapeutic process, using the following analogies; (1) Flirtation: Why the attraction? 'going steady' or 'femme fatale'? (2) Marriage: Mutual enrichment, cross-fertilisation and new life? Examples of shared perspectives in the work of E. Becker, Erikson, Goffman etc. Influence of psychosocial contexts on psychotherapeutic processes. (3) Divorce: Too little shared life or too much destructive criticism? If the world within man and the world between men are interrelated, psychotherapy and sociology--although at times uneasy bedfellows--have much to give each other.

  16. [Indikationsfragen zur psychotherapie bei psychosomatischen patientinnen.]. (United States)

    Leithner, Katharina; Eder, Anselm; Springer-Kremser, Marianne


    The diagnostic process of psychosomatic patients finally arriving at an indication for psychotherapy is an important point of reference in the present discussion concerning the introduction of special clinics for psychosomatic patients in Austria: equippment of such clinics and standards for the personnel has to relate to the needs of these patients. The Etiology of psychosomatic disturbances includes psychological influences, which, via psychoneuroendocrinolgical mechanisms interact with somatic factors, and individual coping styles, shaped by the social environment and gender-related factors. The initial interview, besides physical complaints, has to assess the patient's reality sense, the affective competence, the cognitive competence, the nature and quality of relations with important others, the subjective illness-theories and the motivation for psychotherapy. The therapeutic method/setting finally choosen has to offer a scientifically based concept of psychosomatic disturbances, according to the different operationalisations of Psychosomatic.

  17. The outcome problem in psychotherapy: a reply. (United States)

    Eysenck, H J


    This reprinted article originally appeared in Psychotherapy: Theory, Research, & Practice, 1964(MONTH), 1(3), 97-100. (The following abstract of the original article appeared in record 1966-01631-001). Comments on the original article by H. H. Strupp (see record 1965-15636-001). In his recent article in this journal, Strupp (1963) has this to say in relation to the outcome problem in psychotherapy: "A brief review of Eysenck's (1952) widely quoted survey, which capitalized upon and added considerably to the existing confusion may be instructive." In reply I would like to suggest that Strupp's review is, in the lawyer's phrase, irrelevant, incompetent and immaterial. Fortunately, the points I wish to make are so simple that they will not take up much space.


    Directory of Open Access Journals (Sweden)

    Vagner Ferreira do Nascimento


    Full Text Available This is a narrative review from scientific literature that aimed to describe concepts and approaches for indications of the therapeutic use of Bach flower remedies in holistic psychotherapy. The review was developed in February 2016 from books, official documents and articles indexed in Lilacs and Scielo databases. Bach flower remedies is a therapeutic method that aims to restore the balance of human being, restoring its vital energy through holistic care. Because the flower essences act on psychic and emotional dimension of individual, when employed in holistic psychotherapy can provide greater autonomy, self-care and effectiveness compared to other alternative methods. The literature indicated that flower essence therapy is a safe practice and can be used in a complementary to health care, but should be performed by qualified professionals. It has also shown to be a promising and important area for nursing professional, but it still requires greater investment in research in the area to support the practice.

  19. Do comorbid anxiety disorders moderate the effects of psychotherapy for bipolar disorder? Results from STEP-BD. (United States)

    Deckersbach, Thilo; Peters, Amy T; Sylvia, Louisa; Urdahl, Anna; Magalhães, Pedro V S; Otto, Michael W; Frank, Ellen; Miklowitz, David J; Berk, Michael; Kinrys, Gustavo; Nierenberg, Andrew


    At least 50% of individuals with bipolar disorder have a lifetime anxiety disorder. Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration, greater illness severity, and poorer treatment response. The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome. In the Systematic Treatment Enhancement Program randomized controlled trial of psychotherapy for bipolar depression, participants received up to 30 sessions of intensive psychotherapy (family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) or collaborative care, a three-session comparison treatment, plus pharmacotherapy. Using the number needed to treat, we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year. A total of 269 patients (113 women) with a comorbid lifetime anxiety disorder (N=177) or without a comorbid lifetime anxiety disorder (N=92) were included in the analysis. Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care (66% compared with 49% recovered over 1 year; number needed to treat=5.88, small to medium effect). For patients without a lifetime anxiety disorder, there was no difference between rates of recovery in psychotherapy compared with collaborative care (64% compared with 62% recovered; number needed to treat=50, small effect). Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care (84% compared with 53% recovered; number needed to treat=3.22, medium to large effect), whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments (54% compared with 46% recovered; number needed to treat=12.5, small effect). Depressed patients with bipolar disorder and comorbid

  20. Do Comorbid Anxiety Disorders Moderate the Effects of Psychotherapy for Bipolar Disorder? Results From STEP-BD (United States)

    Deckersbach, Thilo; Peters, Amy T.; Sylvia, Louisa; Urdahl, Anna; Magalhães, Pedro V.S.; Otto, Michael W.; Frank, Ellen; Miklowitz, David J.; Berk, Michael; Kinrys, Gustavo; Nierenberg, Andrew


    Objective At least 50% of individuals with bipolar disorder have a lifetime anxiety disorder. Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration, greater illness severity, and poorer treatment response. The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome. Method In the Systematic Treatment Enhancement Program randomized controlled trial of psychotherapy for bipolar depression, participants received up to 30 sessions of intensive psychotherapy (family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) or collaborative care, a three-session comparison treatment, plus pharmacotherapy. Using the number needed to treat, we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year. Results A total of 269 patients (113 women) with a comorbid lifetime anxiety disorder (N=177) or without a comorbid lifetime anxiety disorder (N=92) were included in the analysis. Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care (66% compared with 49% recovered over 1 year; number needed to treat=5.88, small to medium effect). For patients without a lifetime anxiety disorder, there was no difference between rates of recovery in psychotherapy compared with collaborative care (64% compared with 62% recovered; number needed to treat=50, small effect). Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care (84% compared with 53% recovered; number needed to treat=3.22, medium to large effect), whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments (54% compared with 46% recovered; number needed to treat=12.5, small effect). Conclusions Depressed patients

  1. Minding the body: psychotherapy and cancer survival. (United States)

    Spiegel, David


    This article reviews evidence regarding effects of psychotherapy on overall cancer survival time. Special emphasis is given to research on adverse effects of depression on cancer survival, breast cancer, and mediating psychophysiological pathways linking psychosocial support to longer survival. It reviews all published clinical trials addressing effects of psychotherapy on cancer survival, emphasizing depression, breast cancer, and psychophysiological evidence linking stress, depression, and support to cancer survival. Systematic literature review and synthesis. Eight of 15 published trials indicate that psychotherapy enhances cancer survival time. No studies show an adverse effect of psychotherapy on cancer survival. Potential psychophysiological mechanisms linking stress to shorter survival include dysregulation of diurnal cortisol, increased pro-inflammatory cytokines, reduced natural killer cell activity, shorter telomeres and lower telomerase activity, glucocorticoid-mediated suppression of p53 and BrCA1 gene expression, and sympathetic nervous system activation of vascular endothelial growth factor. Stress and support affect the course of cancer progression. What is known? Stress and support have been thought to be related to cancer risk and progression, but evidence has been mixed. Depression is a natural co-morbid condition with cancer. It has not been clear how stress and support could physiologically affect the rate of cancer progression. Immune function was not thought to have much relevance to cancer progression. Few other physiological mechanisms linking stress to cancer progression were known. What does this paper add? There is evidence from 15 RCTs indicating that effective psychosocial support improves quantity as well as quality of life with cancer. There is evidence that chronic depression predicts poorer prognosis with cancer. Dysregulated circadian cortisol patterns predict more rapid cancer progression. Inflammatory processes affect cancer

  2. Recognition of psychotherapy effectiveness: the APA resolution. (United States)

    Campbell, Linda F; Norcross, John C; Vasquez, Melba J T; Kaslow, Nadine J


    In August 2012, the American Psychological Association (APA) Council of Representatives voted overwhelmingly to adopt as APA policy a Resolution on the Recognition of Psychotherapy Effectiveness. This invited article traces the origins and intentions of that resolution and its protracted journey through the APA governance labyrinth. We summarize the planned dissemination and projected results of the resolution and identify several lessons learned through the entire process.

  3. Outcome in psychotherapy evaluated by independent judges. (United States)

    Bloch, S; Bond, G; Qualls, B; Yalom, I; Zimmerman, E


    To overcome common limitations in assessing the outcome of psychotherapy, the following method was used: independent assessment by teams of experienced psychotherapists; individualized measures of outcome; and videotaped clinical interviews to allow the judges to rate, at one sitting, a patient's clinical state before and after eight months of therapy. Agreement between the judges' ratings was low both for the severity of the clinical state and for its outcome. Possible reasons for this low agreement are discussed.

  4. On the Movement Toward Psychotherapy Integration (United States)



    The prospect of using psychotherapy integration to enhance therapeutic efficacy increases as clinical discussion and empirical inquiry mount. The authors review briefly the historical origins of integrative thought, discuss the new receptivity with which it is being met, and examine the clinical use of an integrative framework, using progress in the treatment of panic disorder as an example of the potential of integrative treatment strategies. PMID:22700098

  5. [Psychanalitic psychotherapy: practice and indications in the aged]. (United States)

    Claudel, Bertrand


    Use of psychoanalytic psychotherapy for the elderly remains an issue. Even though regular psychoanalysis cure is contraindicated for elderly patients in most cases, yet, face-to-face psychotherapies can prove useful. The methods used for psychoanalytic psychotherapy for elderly patients are different from those applicable to middle age patients. These methods take into account the mourning process experienced by the elderly patient in three spheres: loss of object, loss of function and loss of oneself. Indications concerning psychoanalytic psychotherapy for the elderly have to be carefully assessed and will be detailed throughout the paper.

  6. Applied philosophy and psychotherapy: Heraclitus as case study

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    Johann Beukes


    Full Text Available This article investigates a recent attempt to apply philosophy within the discipline of psychotherapy and to investigate the somewhat undefined realm of philosophical counselling. After introducing the claims of this interdisciplinary exercise and after addressing the problems involved in crossing the boundaries between philosophy and psychotherapy, the article elaborates on  Alex Howard’s (2000 [Philosophy for counselling and psychotherapy: Pythagoras to post-modernism. London: Macmillan] attempt to make explicit use of philosophy in psychotherapy, using his interpretation and application of Heraclitus’ philosophy as case study.

  7. Benefits and Challenges of Conducting Psychotherapy by Telephone. (United States)

    Brenes, Gretchen A; Ingram, Cobi W; Danhauer, Suzanne C


    Telephone-delivered psychotherapy has increased utility as a method of service delivery in the current world, where a number of barriers, including economic hardships and limited access to care, may prevent people from receiving the treatment they need. This method of service provision is practical and has the potential to reach large numbers of underserved people in a cost-effective manner. The aim of this paper is to review the state-of-the-art of telephone-delivered psychotherapy and to identify improvements and possible solutions to challenges. Results of randomized controlled trials indicate high client acceptance and positive outcomes with this method of delivering psychotherapy. Nonetheless, psychotherapists wishing to deliver psychotherapy by telephone face a number of challenges, including a lack of control over the environment, potential compromises of privacy and confidentiality, developing therapeutic alliance without face-to-face contact, ethical and legal issues in providing psychotherapy by telephone, handling crisis situations at a distance, and psychotherapist adjustment to conducting psychotherapy in an alternative manner. There remains a need for further research, including direct comparisons of face-to-face psychotherapy with telephone-delivered psychotherapy and feasibility of telephone delivery of psychotherapies other than cognitive behavioral therapy.

  8. [Psychotherapy for pregnant women with psychiatric disorders]. (United States)

    Müldner-Nieckowski, Łukasz; Cyranka, Katarzyna; Smiatek-Mazgaj, Bogna; Mielimąka, Michał; Sobański, Jerzy; Rutkowski, Krzysztof


    Pregnancy is a major life change for many women. The related biological changes, especially complications in its course and in the course of delivery, carry a risk of developing a variety of psychological problems and mental disorders. However, their treatment is challenging due to the teratogenic effects of most psychoactive drugs and specific requirements for entering different psychotherapeutic programs. Mental disorders during pregnancy are undoubtedly an important issue for both gynecology and psychiatry. There is still a discussion considering the question whether psychotherapy during pregnancy is safe, although no scientifically valid data contradicting the safety of psychotherapy during pregnancy has been published so far. Together with psychotherapy - as a treatment of choice - clinicians approve some other relatively safe treatment methods for psychiatric disorders in pregnant women. Light therapy, limited pharmacotherapy, ECT are included. The goal of this paper is to review current opinions of clinicians and researches concerning possibilities, indications and outcome of psychological treatments as a way to help pregnant women who suffer from different psychiatric conditions, and also because this subject is not yet present in Polish psychiatric journals.

  9. The Arts, Crafts, and Sciences of Psychotherapy. (United States)

    Benjamin, Lorna Smith


    Contemporary training and practice of psychotherapy and the research that supports it is the subject of this review. I discuss it in the light of what I value most from my own professional training, which was, in my opinion, highly privileged by comparison with what is offered today. A minimal hoped-for outcome is that younger readers will find valuable tidbits here and there that will be useful in their own versions of psychotherapy. A maximal hope is that a few individuals who choose to maintain clinical skills as well as emphasize psychotherapy research might be encouraged to follow their instincts toward excellence. They would allow their curiosity to bloom and their work to be creative and more adherent to the rules of natural science than time allows in these days of dashboards that count funding associated with numbers of publications, grants, teaching, and service hours. Admittedly, that path less well traveled would be risky, because what truly is new takes time to develop and implement and the outcomes when research truly can disconfirm hypotheses (as distinct from fail to confirm them) are, well, uncertain. © 2015 Wiley Periodicals, Inc.

  10. Multimedia psychodynamic psychotherapy: a preliminary report. (United States)

    Nesci, Domenico Arturo


    Mourning the death of a beloved person is one of life's most stressful events. This psychotherapy case study describes a form of psychodynamic psychotherapy that the author developed in working with a patient who suffered from complicated grief after the death of her father from lung cancer. During sessions, the therapist worked with the patient to collect pictures and organize a "strip of life" of her father's most meaningful moments. The patient then wrote a short text associated with each picture. Finally, she chose music to be added to this "slide show" or "psychodynamic montage" as its soundtrack. The resulting multimedia presentation was finally posted on the Internet on a website to which only the patient and her relatives and friends had access via a password. This therapeutic strategy was effective in helping this patient resolve her symptoms of complicated grief. The author suggests that this new approach to psychodynamic psychotherapy may be a cost-effective and well-received tool for use in institutions such as hospices and general hospitals.

  11. The Ghent Psychotherapy Study (GPS) on the differential efficacy of supportive-expressive and cognitive behavioral interventions in dependent and self-critical depressive patients : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Meganck, Reitske; Desmet, Mattias; Bockting, Claudi|info:eu-repo/dai/nl/258267992; Inslegers, Ruth; Truijens, Femke; De Smet, Melissa; De Geest, Rosa; Van Nieuwenhove, Kimberly; Hennissen, Vicky; Hermans, Goedele; Loeys, Tom; Norman, Ufuoma Angelica; Baeken, Chris; Vanheule, Stijn


    Background: Major depressive disorder is a leading cause of disease burden worldwide, indicating the importance of effective therapies. Outcome studies have shown overall efficacy of different types of psychotherapy across groups, yet large variability within groups. Although patient characteristics

  12. Implementation of video telehealth to improve access to evidence-based psychotherapy for posttraumatic stress disorder. (United States)

    Lindsay, Jan A; Kauth, Michael R; Hudson, Sonora; Martin, Lindsey A; Ramsey, David J; Daily, Lawrence; Rader, John


    Increasing access to psychotherapy for posttraumatic stress disorder (PTSD) is a primary focus of the Department of Veterans Affairs (VA) healthcare system. Delivery of treatment via video telehealth can expand availability of treatment and be equally effective as in-person treatment. Despite VA efforts, barriers to establishing telehealth services remain, including both provider acceptance and organizational obstacles. Thus, development of specific strategies is needed to implement video telehealth services in complex healthcare systems, like the VA. This project was guided by the Promoting Action on Research Implementation in Health Services framework and used external facilitation to increase access to psychotherapy via video telehealth. The project was conducted at five VA Medical Centers and their associated community clinics across six states in the South Central United States. Over a 21-month period, 27 video telehealth clinics were established to provide greater access to evidence-based psychotherapies for PTSD. Examination of change scores showed that participating sites averaged a 3.2-fold increase in unique patients and a 6.5-fold increase in psychotherapy sessions via video telehealth for PTSD. Differences between participating and nonparticipating sites in both unique patients and encounters were significant (p=0.041 and p=0.009, respectively). Two groups emerged, separated by degree of engagement in the facilitation intervention. Facilitation was perceived as useful by providers. To our knowledge, this is the first prospective study of external facilitation as an implementation strategy for telehealth. Our findings suggest that external facilitation is an effective and acceptable strategy to support providers as they establish clinics and make complex practice changes, such as implementing video telehealth to deliver psychotherapy.

  13. Impact of pain on the outcome of group psychotherapy

    Directory of Open Access Journals (Sweden)

    John S. Ogrodniczuk


    Full Text Available Este estudio ex post facto investigó la influencia del dolor físico en el resultado de la psicoterapia grupal en pacientes con depresión mayor, después de controlar tipo de psicoterapia recibida, uso de medicación antidepresiva y alexitimia (para tener en cuenta la tendencia a somatizar sensaciones desagradables o negativas. Los datos provienen de 48 pacientes psiquiátricos externos con depresión mayor comórbida y duelo complicado que participaron en un estudio aleatorizado de dos tipos de psicoterapia grupal para duelo complicado. Los pacientes evaluaron su propio dolor usando la subescala SF-36 de Dolor Físico. Para medir los resultados de la psicoterapia se utilizaron el Inventario de Depresión de Beck, el Inventario Breve de Síntomas-53 y la Escala de Ajuste Social. La alexitimia fue evaluada utilizando la Escala de Alexitimia de Toronto. Mayores niveles de dolor físico al comienzo del estudio estuvieron asociados, después de 12 semanas de psicoterapia grupal, con menores mejoras en síntomas depresivos, malestar psiquiátrico general y menor funcionamiento social. La variable dolor explicó entre el 13 y el 21% de la variabilidad en el resultado del tratamiento. El efecto negativo del dolor fue consistente en ambos tipos de psicoterapia grupal. El efecto del uso de medicación antidepresiva sobre el impacto del dolor en el resultado del tratamiento fue similar para ambos tipos de psicoterapia grupal. Reconocer y tratar el dolor comórbido podría mejorar el resultado del tratamiento psicoterapéutico en pacientes deprimidos.

  14. Impact of pain on the outcome of group psychotherapy


    Ogrodniczuk, John S.; Piper, William E.; Joyce, Anthony S.


    Este estudio ex post facto investigó la influencia del dolor físico en el resultado de la psicoterapia grupal en pacientes con depresión mayor, después de controlar tipo de psicoterapia recibida, uso de medicación antidepresiva y alexitimia (para tener en cuenta la tendencia a somatizar sensaciones desagradables o negativas). Los datos provienen de 48 pacientes psiquiátricos externos con depresión mayor comórbida y duelo complicado que participaron en un estudio aleatorizado de dos tipos de p...

  15. Do changes on MCMI-II personality disorder scales in short-term psychotherapy reflect trait or state changes?

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin


    The Millon Clinical Multiaxial Inventory (MCMI) has become an important and commonly used instrument to assess personality functioning. Several studies report significant changes on MCMI personality disorder scales after psychological treatment. The aim of the study was to investigate whether pre......-post-treatment changes in 39-session psychodynamic group psychotherapy as measured with the MCMI reflect real personality change or primarily reflect symptomatic state changes. Pre-post-treatment design included 236 psychotherapy outpatients. Personality changes were measured on the MCMI-II and symptomatic state changes......-term psychotherapy reflect change in symptomatic state. The MCMI-II Base Rate cut-off points probably include too many patients, justifying the introduction of new scoring procedures in the MCMI-III....

  16. Characteristics of Patients Involved in Psychotherapy in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Sabina Alispahić


    Full Text Available Introduction: The aim of this study was to determine the demographic and clinical characteristics of Bosnian and Herzegovinian patients involved in psychotherapeutic treatments in order to explore the current situation of psychotherapy in Bosnia and Herzegovina.Methods: The study included 213 patients (154 women and 47 men undergoing diverse psychotherapeutic treatments. Data about demographic and clinical characteristics were collected by questionnaire. Following characteristics were documented: age, sex, education, employment status, marital status, specific problem that got the client involved in psychotherapy, type of psychotherapy, and use of psychopharmacology.Results: Majority of the patients undergoing psychotherapy are age up to 40 and female. They are by vast majority holding a university degree and are employed. Nearly equal number of patients is living in partnership or marriage compared to single or never been married. Most frequent reasons for getting involved in the psychotherapy treatment are of the intrapersonal nature (depression, anxiety and panic attacks. Majority of the patients were involved in gestalt and cognitive behavioral psychotherapy, and at the same time majority of those were not prescribed medicaments.Conclusions: We point out and overview some of the most prominent socio-demographic traits of patients undergoing psychotherapy, the ones that could be important in the future research with the higher degree of control. In the terms of personal initiative, psychotherapy stops being a taboo in Bosnia and Herzegovina. However, there is still a long path until it reaches integration in daily life of the people.

  17. The Experiential as a Unifying Construct in Psychotherapy. (United States)

    Bohart, Arthur C.

    Although the importance of an experiential component in differing approaches to psychotherapy has been acknowledged, confusion over the concepts of "experience" and "emotion" has resulted in a focus on emotion rather than experience. The fundamental change event in psychotherapy is a kind of experiential learning or reorganization, and while…

  18. Conceptual Frame for Selecting Individual Psychotherapy in the Schools (United States)

    Hughes, Tammy L.; Theodore, Lea A.


    Psychotherapy is a service-delivery that is provided for both general and special education students. This manuscript examines a conceptual framework for determining when to employ psychotherapy within the school-based setting. Decisions are informed by the relationship between problem behavior, therapeutic techniques, short-term outcomes, and…

  19. Solicited diary studies of psychotherapy in qualitative research

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward


    Diary studies are scarce within the field of qualitative psychotherapy research. In this article arguments for and against the employment of solicited diaries studies in qualitative psychotherapy research are investigated. The strengths of diary studies are presented along with arguments concerning...

  20. Learning from traumatic experiences with brief eclectic psychotherapy for PTSD

    NARCIS (Netherlands)

    Gersons, Berthold P. R.; Schnyder, Ulrich


    Brief eclectic psychotherapy for PTSD (BEPP) is an evidence-based therapeutic approach that combines and integrates elements from psychodynamic, cognitive-behavioral, and directive psychotherapy. Psychoeducation is done jointly with the patient and his or her partner. Exposure, a structured writing

  1. Shapes of Early Change in Psychotherapy under Routine Outpatient Conditions (United States)

    Stulz, Niklaus; Lutz, Wolfgang; Leach, Chris; Lucock, Mike; Barkham, Michael


    Although improvement of clients' state is a central concern for psychotherapy, relatively little is known about how change in outcome variables unfolds during psychotherapy. Client progress may follow highly variable temporal courses, and this variation in treatment courses may have important clinical implications. By analyzing treatment progress…

  2. The current status of psychotherapy | Gureje | West African Journal ...

    African Journals Online (AJOL)

    A fundamental understanding about the mechanisms of action of psychotherapy is a promising new development that is emanating from modern techniques of neurosciences and neuroimaging. Whether such understanding will lead to a renaissance in the clinical utility of psychotherapy is still early to say. However, there is ...

  3. Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial (United States)


    Background Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. Methods/Design The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD). Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA) controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. Discussion The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically depressed patients. Trial

  4. Foco, estrutura e conteúdo da interpretação integrativa em psicoterapia de grupo (PG de longa duração Foco, estructura y contenido de la interpretación integrada en psicoterapia de grupo (PG de larga duración Focus, structure and content of integrative interpretation in long term group psychotherapy (GP

    Directory of Open Access Journals (Sweden)

    José Onildo Betioli Contel


    ón, con una serie de situaciones de las cuales retira el contenido de interpretaciones que cree ser el más apropiado para el individuo y para el grupo. Él necesita, por ejemplo, decidir sobre qué contenido debe centrar su interpretación. ¿Sería mejor el enfoque sobre el individuo, sobre la interacción entre los individuos o sobre el grupo en su totalidad? OBJETIVO: Describir detalles de las sesiones 33ª e 34ª de PG para explicitar enfoque, estructura y contenido de la interpretación integrativa. MÉTODO: La selección adecuada de dos sesiones consecutivas de PG de ocho pacientes adultos, de elevado funcionamiento mental, de ambos sexos, se hizo por ocasión de la admisión de dos nuevos miembros. Para la aplicación de la técnica de la interpretación integrada en las sesiones seleccionadas, se utilizaron conceptos psicodinámicos actuales. RESULTADOS: La expresión de hostilidad, predominante en la 34ª sesión, reveló la ambivalencia y el conflicto en PG coincidiendo con la admisión e incorporación de dos nuevos miembros. El liderazgo puntual del psicoterapeuta se utilizó de la interpretación integrada con base en contenidos de las sesiones 33ª e 34ª y en sesiones de contenidos correlativos, del pasado del grupo. DISCUSIÓN: La interpretación integrada consideró cuatro niveles de funcionamiento del grupo: 1. individual; 2. subgrupo de dos miembros; 3. grupo en su totalidad y; 4. regresión del grupo para un estadio anterior y menos elaborado de desarrollo. CONCLUSIÓN: En primer lugar, el psicoterapeuta buscó mantener la expresión de hostilidad entre dos miembros en un nivel de seguridad y enseguida, usando la interpretación integrada, ayudó al grupo a trascenderse y comprender la experiencia cognoscitiva y emocional en la 34ª sesión, especialmente, la lucha por dominación entre los nuevos y los antiguos miembros.INTRODUCTION: In group psychotherapy, group leaders are confronted with a myriad of variables in attempting to frame an



    Sobanski, Jerzy A.; Klasa, Katarzyna; Rutkowski, Krzysztof; Dembinska, Edyta; Müldner-Nieckowski, Łukasz


    Introduction: Qualification for treatment of neurotic disorders in a day hospital is connected with a process of selection carried out by experienced therapists – psychiatrists and psychologists – of patients for intensive, everyday group psychotherapy, combined withelements of individual therapy, as well as with the patients’ own decisions, made by them between ambulatory visits. Expectations and motivations of patients are the crucial indicators for the process of treatment. These factors i...

  6. Psychodynamic Psychotherapy for Children and Adolescents: An Old Friend Revisited (United States)

    Delgado, Sergio V.


    The treatment of children and adolescents with psychotherapy is gradually losing ground to psychopharmacology. The author reviews the value the various forms of psychotherapy have in the treatment of children and the importance of having a clear curriculum for teaching this skill in residency programs. Although the importance of psychodynamic psychotherapy has a long history in the treatment of children, the reluctance some faculty have in recommending this form of therapy may be due to limited experience and limited knowledge of its benefits. The author highlights that a psychodynamic diagnostic evaluation is essential to assess a child’s suitability for psychotherapy. The characteristics of children who will benefit from psychodynamic psychotherapy, their defense mechanisms, and optimal characteristics of their parents are reviewed. The qualifications a psychiatrist needs to succeed in this endeavor are discussed. Two cases illustrate not only the importance in the suitability of the patient, but also the application of psychodynamic theory to practice. PMID:19727254

  7. Predicting Psychotherapy Dropouts: A Multilevel Approach. (United States)

    Kegel, Alexander F; Flückiger, Christoph


    The role of therapeutic processes in predicting premature termination of psychotherapy has been a particular focus of recent research. The purpose of this study was to contrast outpatients who completed therapy and those who dropped out with respect to their self-reported in-session experiences of self-esteem, mastery, clarification and the therapeutic alliance. The 296 patients with mixed disorders were treated with an integrative form of cognitive-behavioural therapy without pre-determined time limit (M = 20.2 sessions). Multilevel analyses indicated that patients who did not completetreatment reported, on average, lower levels of self-esteem, mastery and clarification and lower ratings of their therapeutic alliance in treatment in contrast to patients who completed therapy. Patient-reported change in self-esteem experiences over the course of treatment turned out to be the strongest predictor of dropout from psychotherapy or successful completion. When dropout occurred before the average treatment length was reached, patients reported fewer clarifying experiences as early as the first session and their ratings of the therapeutic alliance were characterized by an absence of positive development. Both of these aspects seem to be involved in patients' decisions to leave treatment early. The findings underscore the importance of the therapeutic process in understanding the mechanisms behind treatment dropout. Analyses data from 296 patients at a private outpatient clinic in a routine practice setting (CBT). Completer/dropout definition: presence or absence of measurement battery at post-assessment. Focuses on change in therapy processes by investigating post-session reports. Finds that positive changes in self-esteem experiences is the most robust predictor of dropout, followed by ratings of clarification experiences and the global alliance. In line with recent dropout research, these process indicators might help to detect therapeutic situations that are

  8. [The importance of transference in Junguian psychotherapy]. (United States)

    Scotillo, Irene Alejandra


    Transference is an absolutely natural and spontaneous process which cannot be developed in an artificial and voluntary manner by the therapist. Transference is carried out in a subjective interpersonal relation consisting of a patient and an analyst. Jung will say he feels happy when transference takes place calmly or runs virtually unnoticed and the therapist can then focus on other therapeutic factors that play an important role. One could argue that Jungian psychotherapy consists of two people who get together to try to understand what is happening in the subconscious of one of them. The Jungian therapist is an active therapist who encourages and helps the patient to develop its individuation.

  9. A Kantian critique of cognitive psychotherapy. (United States)

    Yesavage, J A


    Modern cognitive psychotherapies such as those practiced by George Kelly, Aaron Beck, and Albert Ellis are examined from the perspective of Immanuel Kant's critique of eighteenth-century cognitive philosophy. Parallel strengths and weaknesses are found in the psychotherapeutic and philosophical systems. The major strengths of the systems are based upon their abilities to predict phenomena based upon an understanding of concepts used to organize experience. The major weaknesses of the systems arise when one takes such concepts to be too concrete. It is argued that modern psychiatrists interested in cognitive techniques may relearn some important but forgotten, facts about the strengths and limits of cognition by reviewing Kantian philosophy.

  10. Review of Psychotherapy as a human science. (United States)

    Langan, Robert


    Reviews the book, Psychotherapy as a human science by Daniel Burston and Roger Frie (see record 2006-12980-000). In this book, the authors show how philosophical assumptions pervade therapeutic praxis. "In our view, philosophy is inherent to the very practice of psychotherapy" (p. 2). There is a "common ground that unites the therapists of today with the philosophers of the past" (p. 17). Their effort succeeds brilliantly in reconnecting psychology and philosophy and, by that homecoming, to ground psychotherapy (including contemporary psychoanalysis) as a "human science." The book begins by sketching ideas about truth we inherit from the Greeks, then shows how Descartes and Pascal helped launch the Enlightenment with their thinking about truth and the limits of reason. Kant, Hegel, and Marx broaden the scope to include reason, the unconscious, and the course of history. Kierkegaard and Nietzsche interject angst and authenticity. Dilthey proposes a human science neither scientistic nor irrational. Husserl launches phenomenology as the proper study of experience; Scheler, Jaspers and Heidegger react in their particular ways. Freud and Jung come to loggerheads over the unconscious. Buber, Binswanger, and Boss further develop existential-phenomenological perspectives in terms of human interrelatedness. Confrontation with the other and the limits of reciprocity engage Sartre, Lacan, and Laing. Psychoanalysis grows intersubjectively through the work of Sullivan, Fromm, Merleau-Ponty, Benjamin, and Stolorow. Postmodernism's excess, Frie and Burston conclude, requires acknowledgment of an authentic self answerable for choices in life: '...[W]e are both determined by, and exercise our agency in determining, the communicative contexts in which we exist" (p. 262). Psychotherapy from this existential-phenomenological perspective becomes "a rigorous exploration of our ways of making meaning--both consciously and unconsciously" (p. 263). The book ends, then, with an affirmation

  11. Psychotherapy in a changing postindustrial society. (United States)

    Lesse, S


    Psychotherapy in a postindustrial society will differ markedly from that practiced in the past and present. It will be necessary for psychotherapists to comprehend the interrelationships of macrosocial as well as microsocial forces in relation to intrapsychic dynamics. In a parallel fashion the psychotherapist will find it necessary to be aware of the interrelationship of biodynamic and psychodynamic processes. This paper outlines the sociologic and technologic forces that are likely to mold the postindustrial era and their relationship to psychologic stress and illness as they will be in the period 2000-2025.

  12. The Sociology of Regulation: The Case of Psychotherapy and Counselling and the Experience of the Arts Therapies (United States)

    Waller, Diane; Guthrie, Michael


    This article draws on insights from the sociology of professions to explore the regulatory debate in the psychotherapy and counselling field contrasted with the regulation of arts therapists (art, drama and music therapists). A partial explanation is offered, illustrating the applicability of theory to these groups, but with adaptations to reflect…

  13. [Interpersonal psychotherapy from research to practice]. (United States)

    Rahioui, H; Blecha, L; Bottai, T; Depuy, C; Jacquesy, L; Kochman, F; Meynard, J-A; Papeta, D; Rammouz, I; Ghachem, R


    Interpersonal therapy (IPT) is a brief, structured psychotherapy initially intended to treat adult depression that was developed in the 1970s and manualized in 1984 by G. Klerman and his team. Two main theories served as a basis for its design: Bowlby's attachment theory and communication theory. Klerman theorized that tensions and problems in interpersonal relationships (i.e. disputes) cause psychological distress in vulnerable individuals that may lead to a major depressive episode. Clinical and epidemiological studies have shown that an insecure attachment style is strongly associated with lifetime depression. Severe depressive episodes have been correlated with avoidant attachment in women. IPT is based on the hypothesis that recent or ongoing disturbances in interpersonal relationships either trigger or follow the onset of mood disorder. In practice, IPT assists patients in analysing their interpersonal relationship modes, correlating their relational states with their mood and in learning to use better communication. Resolving difficulties in interpersonal relationships through the use of better communication skills promotes the improvement of depressive symptoms. Klerman identified four interpersonal areas that seem to be highly correlated with depressive episodes: grief (a close and important personal relation who has died), interpersonal disputes (conflicts with significant people such as a spouse or another close family member), role transition (significant life changes such as retirement, parenthood or chronic and invalidating illness) and interpersonal deficits (patients who have limited social contacts and few interpersonal relations). Classically, IPT is planned around 12-16 weekly sessions. During the initial sessions, the therapist will explore all existing interpersonal relations and any significant dysfunctions, both recent and ongoing. Following this interview, the area the patient considers as driving the current depressive episode will be

  14. [Healthier after Psychotherapy? Analysis of Claims Data (Lower Saxony, Germany) on Sickness Absence Duration before and after Outpatient Psychotherapy]. (United States)

    Epping, Jelena; de Zwaan, Martina; Geyer, Siegfried


    Introduction In employed populations sickness absence can be used as a good indicator of health status. In the present study, it was examined how periods of sickness absence are developing within one year before and after psychotherapy under comparison of three types of psychotherapy (behavior therapy, psychodynamic psychotherapy, and psychoanalysis), all fully covered by statutory health insurance. Methods and data The analyses were performed with pseudonymized claims data from the AOK Niedersachsen, a statutory health insurance (N=2,900,065 insured). Certified sickness absences before and after psychotherapy were examined for 9,916 patients. Parallelized controls were used to build a comparison of the length of sickness absences. Analyses were performed separately for women and for men. Results Within one year before starting psychotherapy, patients had longer sickness absences than controls on average. There was a reduction in the length of sickness absence of 20 days (median) within one year before to 12 days (median) within one year after the psychotherapy. The obtained differences between types of psychotherapy were considerable. Discussion Differences in terms of sickness absences may in part be explained by socio-demographic differences. Patients who underwent psychoanalysis were younger and had higher educational levels. However, it remains unclear why the differences of sickness absence periods were that high. It has to be discussed whether self-selection of patients with better health into psychoanalysis had occurred. Conclusions Patients undergoing psychoanalysis differ from patients who underwent other types of psychotherapy in terms of their duration of sickness absence as well as socio-demographic profile. Thus, due to differences in the composition of patients future research in psychotherapy will have to differentiate by type of psychotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Cultural adaptability as an attribute of therapies: the case of Morita psychotherapy. (United States)

    Reynolds, D K; Kiefer, C W


    Morita psychotherapy, a form of therapy developed in Japan some sixty years ago, has survived extensive changes in Japanese society, and is now enjoying popularity in the United States. This gives us an opportunity to look closely at the concept of 'cultural fit' between an important therapeutic technique and its social milieu, and to speculate about recent changes in American culture that may account for the growing popularity of Moritism. In contrast to Western style 'talking therapies' like psychoanalysis, Morita psychotherapy is relatively group-centered, ritualistic, and behavioristic. On would expect to find these features in a Japanese therapy, but their acceptance in America suggests that previously popular Western techniques may not be optimum for handling certain problems of the post-industrial American. McLuhan, Peacock, Douglas, and others have suggested some emerging traits of Western character that might shed some light on this question.

  16. The effectiveness of short- and long-term psychotherapy on personality functioning during a 5-year follow-up. (United States)

    Lindfors, Olavi; Knekt, Paul; Heinonen, Erkki; Härkänen, Tommi; Virtala, Esa


    Only few randomized trials comparing sustained effects of short- and long-term psychotherapies in personality functioning are available. In this study we compared the effects of two short-term therapies and long-term psychodynamic psychotherapy on patients' personality functioning during a 5-year follow-up. Altogether 326 patients of the Helsinki Psychotherapy Study, with anxiety or mood disorder, were randomly assigned to either short-term psychotherapy of about six months (solution-focused therapy (SFT, n=97) or short-term psychodynamic psychotherapy (SPP, n=101)), or to long-term psychodynamic psychotherapy (LPP, n=128), lasting on average three years. Outcomes in personality functioning (i.e., self-concept, defense style, interpersonal problems, and level of personality organization) were assessed five to seven times using, respectively, questionnaires (SASB, DSQ, IIP) and interview (LPO) during the 5-year follow-up from randomization. Personality functioning improved in all therapy groups. Both short-term therapies fared better than LPP during the first year of follow-up, by faster improvement in self-concept and decrease in immature defense style. SFT also showed more early reduction of interpersonal problems. However, LPP thereafter showed larger and more sustained benefits than SFT and SPP, through greater changes in self-concept. Additionally, LPP outperformed SFT at the end of the follow-up in IIP and LPO, after adjustment for auxiliary treatment. No differences were noted between the short-term therapies at any measurement point. Auxiliary treatment was used relatively widely which limits generalization to exclusive use of short- or long-term therapy. LPP seems to be somewhat more effective than short-term therapies in facilitating longterm changes in personality functioning. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Psychotherapy, psychoanalysis and urban poverty in Argentina. (United States)

    Epele, Maria Esther


    Based on ethnographic research carried out in the Buenos Aires Metropolitan Area, this paper examines the views of social actors on the psychoanalytically-oriented psychotherapy focused on marginalized populations. From Foucault's perspective on the forms of truth-telling, the aim of this paper is to analyze, as a preliminary research report, treatments according to the native ways of speaking and listening, which dominate the description of therapeutic experiences of patients who come to the treatment without any professional intermediation. The neoliberal transformations of the past decades in Argentina changed both the landscape of the public health system and the daily lives of marginalized people. Considering such changes, this paper examines the ways in which verbal actions (speaking and listening) take place in psychotherapy and mark the course not only of treatments but also the temporal rhythms of their development, and their various levels of efficacy. Finally, the discussion focuses on how ways of speaking and listening in treatments are modeled not only by institutional dynamics but also by the characteristics these verbal activities take in everyday life under the logics of power that prevail over them.

  18. [New Developments in Video Games for Psychotherapy]. (United States)

    Brezinka, Veronika


    A literature survey on new developments in the area of video games and psychotherapy of children and adolescents was conducted. Despite the omnipresence of computers and the internet, development of therapeutic games seems rather slow. The video game Treasure Hunt was introduced in 2008 to support treatment of children with internalizing and externalizing disorders. Camp Cope-A-Lot was developed for treatment of anxious children, whereas the self-help game SPARX is directed at depressed adolescents. Rage-Control is a biofeedback game for children with anger problems. The game Zoo U aims to assess and train social skills of primary school children. Ricky and the Spider for young children with obsessive compulsive disorder is meant to support the cognitive-behavioural treatment of these patients. Clash- Back is a French game for adolescents with externalizing problems. Possible reasons for the relatively slow development of therapeutic games are the high methodological demands concerning an evaluation as well as the high costs of game development. Nonetheless, computers and the internet are bound to influence psychotherapy with children and adolescents in the long run.

  19. Indian family systems, collectivistic society and psychotherapy. (United States)

    Chadda, Rakesh K; Deb, Koushik Sinha


    Indian society is collectivistic and promotes social cohesion and interdependence. The traditional Indian joint family, which follows the same principles of collectivism, has proved itself to be an excellent resource for the care of the mentally ill. However, the society is changing with one of the most significant alterations being the disintegration of the joint family and the rise of nuclear and extended family system. Although even in today's changed scenario, the family forms a resource for mental health that the country cannot neglect, yet utilization of family in management of mental disorders is minimal. Family focused psychotherapeutic interventions might be the right tool for greater involvement of families in management of their mentally ill and it may pave the path for a deeper community focused treatment in mental disorders. This paper elaborates the features of Indian family systems in the light of the Asian collectivistic culture that are pertinent in psychotherapy. Authors evaluate the scope and effectiveness of family focused psychotherapy for mental disorders in India, and debate the issues and concerns faced in the practice of family therapy in India.

  20. Establishing psychiatric registrars' competence in psychotherapy: a portfolio based model. (United States)

    Naidu, T; Ramlall, S


    During most of the latter part of the last century, South Africa has followed international trends in the training of psychiatrists. Training programmes have become increasingly focused on the neurobiological aspects of psychiatric disorders with less attention being paid to psychotherapy. This is consistent with developments in psychiatric research. In the clinical arena this manifests as a focus on pharmacological and medically based interventions and a resulting relative inattention to non-pharmacological interventions, most especially psychotherapy. In an effort to address this imbalance there has been an international initiative, over the past two decades, to establish an acceptable level of competence in psychotherapy in the training of psychiatrists. A South African programme is needed that can take account of international trends and adapt them for the local context. In order to produce a programme for establishing competence in psychotherapy for psychiatric registrars at the Nelson R. Mandela School of Medicine, the authors examine directives for the development of psychotherapy skills from international regulatory bodies for graduate medical training and their application. Defining and setting preliminary standards for competence is emphasized. A programme based on five core psychotherapy components using a portfolio based model to facilitate learning and assessment of competence in psychotherapy, is proposed.

  1. When worlds collide: blending the divergent traditions of pharmacotherapy and-psychotherapy outcome research. (United States)

    Miller, William R; Locastro, Joseph S; Longabaugh, Richard; O'Malley, Stephanie; Zweben, Allen


    The multisite COMBINE Study brought together a team of alcoholism investigators who varied in whether their expertise was primarily in pharmacotherapy research or in studying psychotherapy. The process of designing a single trial that tested combinations of psychotherapy and pharmacotherapy highlighted the differences in these two research traditions and necessitated a number of compromises that are the focus of this article. The COMBINE trial was designed to investigate the efficacy, separately and in combination, of two medications (i.e., naltrexone, acamprosate) with Medical Management and a state-of-the-art psychotherapy, known as the Combined Behavioral Intervention. Pharmacotherapy researchers favored studying outcome during the treatment period when medications were administered, viewing behavioral intervention as a means for minimizing variance during treatment and providing ethical care in placebo-controlled studies. In contrast, psychotherapy researchers focused on assessment of outcomes after treatment, regarding the behavioral intervention as a source of long-lasting change, necessitating careful training and monitoring of its implementation. The two traditions also differed on variables of interest in studying treatment process and secondary outcomes and methods of data collection and analysis. Some of the solutions reached by the COMBINE Study Research Group included studying both the short-term and long-term effects of treatment and selective inclusion of measures designed to evaluate processes specific to medications and to behavioral interventions. The successful compromises reached by the COMBINE Study Research Group may be helpful to other transdisciplinary research teams undertaking a combined evaluation of promising medications and behavioral interventions for alcoholism.

  2. The movement toward integrating the psychotherapies: an overview. (United States)

    Beitman, B D; Goldfried, M R; Norcross, J C


    There is a growing tendency among psychotherapists to ignore the ideological barriers dividing schools of psychotherapy and to define what is common among them and what is useful in each of them. After a brief introduction the authors provide a short glossary of terms often associated with psychotherapy integration. They then characterize integrative-eclectic therapists, describe the forces fostering their emergence, and outline recurrent themes of the movement and points of contention within it. The authors hope to encourage clinical thinking about the less ideological approaches to psychotherapy and to advance the integrative movement, which is likely to influence psychotherapeutic practice for decades to come.

  3. [The contribution of psychotherapy to a therapeutic approach of bipolar disorders that combines psychotherapy and pharmacotherapy]. (United States)

    Spivacow, Miguel Alejo


    The author assumes that genetic and environmental factors interact in the etiology of Bipolar Disorders. The main goal of this article is to discuss the contribution of psychotherapy in a therapeutic approach to Bipolar Disorders that includes both psychopharmacological treatment and psychotherapy. The central tenet of the paper is that the psychotherapeutic approach to depression focuses on the personality structure as a whole and identifies the predominant psychodynamic factors: the disparity between actual and ideal self-representations, the loss of internal objects, the impact of the vicissitudes of symbiotic relationships on the psychic equilibrium. In the treatment of mania, the psychotherapeutic interventions are considered to be significantly less useful than in the treatment of depression.

  4. Online Self-Help as an Add-On to Inpatient Psychotherapy: Efficacy of a New Blended Treatment Approach. (United States)

    Zwerenz, Rüdiger; Becker, Jan; Knickenberg, Rudolf J; Siepmann, Martin; Hagen, Karin; Beutel, Manfred E


    Depression is one of the most frequent and costly mental disorders. While there is increasing evidence for the efficacy of online self-help to improve depression or prevent relapse, there is little evidence in blended care settings, especially combined with inpatient face-to-face psychotherapy. Therefore, we evaluated whether an evidence-based online self-help program improves the efficacy of inpatient psychotherapy. A total of 229 depressed patients were randomly allocated either to an online self-help program (intervention group [IG]; Deprexis) or an active control group (CG; weekly online information on depression) in addition to inpatient psychodynamic psychotherapy. Both groups had access to their respective experimental intervention for 12 weeks, regardless of inpatient treatment duration. Reduction of depressive symptoms, as measured with the Beck Depression Inventory-II, was the primary outcome at the end of the intervention (T2). Depressive symptoms were statistically significantly lower in the IG compared to the active CG at T2 with a moderate between-group effect size of d = 0.44. The same applied to anxiety (d = 0.33), quality of life (d = 0.34), and self-esteem (d = 0.38) at discharge from inpatient treatment (T1). No statistically significant differences were found regarding dysfunctional attitudes (d = 0.14) and work ability (d = 0.08) at T1. This is the first evidence for blended treatment combining online self-help with inpatient psychotherapy. The study opens new and promising avenues for increasing the efficacy of inpatient psychotherapy. Future studies should determine how integration of online self-help into the therapeutic process can be developed further. © 2017 S. Karger AG, Basel.

  5. Initial and last manifest dream reports of patients in psychodynamic psychotherapy and combined psychotherapy/pharmacotherapy. (United States)

    Glucksman, Myron L; Kramer, Milton


    The initial and last manifest dream reports (MDRs) of 30 patients who had either successfully terminated, or continued to make satisfactory progress at an advanced stage of psychodynamic psychotherapy and combined psychotherapy/pharmacotherapy, were rated according to the following variables: Affect and Affect Valence; Affect Valence of Associations and Direction of Association Themes; Dream Narrative; Psychodynamic Formulation; Transference; and Dream Theme. Similar to previous studies, the initial MDRs contained more negative than positive affect. Conversely, the last MDRs contained more positive than negative affect. Associations to initial MDRs contained more negative affect; on the other hand, associations to last MDRs contained more positive affect. Direction of association themes were more negative in initial MDRs and more positive in last MDRs. Dream narratives were more negative in initial MDRs and more positive in last MDRs. Psychodynamic formulations were more negative in initial MDRs and more positive in last MDRs. Transference was more negative in initial MDRs and more positive in last MDRs. Relational and injury dream themes occurred more frequently than others in both initial and last MDRs. Initial MDRs contained more injury dream themes than last MDRs. The findings of this study demonstrate that there is a correlation between MDR variables and clinical improvement during treatment. The patients in this study were selected by MG, the treating therapist, on the basis of satisfactory progress. The MDRs of patients who failed to progress or did poorly were not discussed in this report. The findings, therefore, must be taken as preliminary and indicate the need for further research on manifest dreams during psychotherapy and combined psychotherapy/pharmacotherapy.

  6. Is Interpersonal Psychotherapy Infinitely Adaptable? A Compendium of the Multiple Modifications of IPT (United States)



    We employed standard literature search techniques and surveyed participants on the International Society for Interpersonal Psychotherapy listserve ( to catalogue the multiple and highly creative ways in which Klerman’s and Weissman’s original concept of interpersonal psychotherapy (IPT) has been modified to meet the needs of a vast range of patient populations. Focusing first on adaptations of the individual treatment model for subgroups of adult patients, we next describe further adaptations of four major off-shoots of IPT: interpersonal counseling (IPC), IPT for adolescents (IPT-A), group IPT (IPT-G) and most recently, brief IPT (IPT-B). We then discuss IPT “in-laws,” those treatments that have married IPT with of other forms of psychotherapy for patients with bipolar disorder, panic symptomatology, and substance abuse. We conclude with that although there have been myriad successful adaptations of IPT, there remain some conditions for which IPT adaptations have not been found to be efficacious. PMID:26453344

  7. [Interpersonal psychotherapy and pharmacotherapy for post-stroke depression. Feasibility and effectiveness]. (United States)

    Finkenzeller, W; Zobel, I; Rietz, S; Schramm, E; Berger, M


    Only few studies investigated the effectiveness of psychotherapy in post-stroke depression (PSD). The aim of this feasibility study was to compare interpersonal psychotherapy, pharmacotherapy, and their combination regarding depression and rehabilitation outcome. Post-stroke depression was found in 35% of 485 stroke patients examined. Seventy-four PSD patients were randomised to one of three treatment conditions. Severity of depression was measured by the Hamilton Depression Rating Scale and the Hospital Anxiety and Depression Scale. The Barthel Index and a questionnaire for health-related quality of life were used as measurements of rehabilitation outcome. There were no significant differences between the three groups in patient mood or rehabilitation outcome. Concerning the severity of depression, quality of life, and social support, all patients showed benefits from antidepressive treatment. In addition a correlation was found between rehabilitation outcome and depression. In this feasibility study all antidepressive treatments were successfully implemented in the rehabilitation of post-stroke depressed patients. Combination therapy (interpersonal psychotherapy plus medication) was as effective as one of those elements alone. Because of the small sample size however, further randomized trials are required.

  8. What is the role of psychotherapy in the treatment of bipolar disorder? (United States)

    Colom, F; Vieta, E; Martínez, A; Jorquera, A; Gastó, C


    The authors review and criticize the different roles developed by psychotherapy in the treatment of bipolar disorder, from psychodynamic conceptions to a biopsychosocial model. The main computerized database (Medline, Current Contents, Psychological Abstracts) have been consulted, using the terms 'psychotherapy', 'psychosocial' and 'bipolar disorder' as key words. Psychoanalysis, psychoeducation, family therapy, cognitive-behavioral therapy and interpersonal therapy have been used in the treatment of bipolar patients. To date, none have established efficacy in controlled clinical trials regarding aspects such as hospitalization, recurrences or suicidal behavior, as medication alone does. Research on this issue usually undergoes methodological pitfalls. Nonetheless, the psychoeducative approach combined with several cognitive-behavioral techniques, either in group or individually, seem to be the most promising, focusing on information, treatment compliance, and illness management skills. There is a need for systematic clinical research on psychotherapy applied to bipolar disorder in order to show its true usefulness. Psychoeducation should prove its positive influence on the course and outcome of bipolar disorder.

  9. The right brain is dominant in psychotherapy. (United States)

    Schore, Allan N


    This article discusses how recent studies of the right brain, which is dominant for the implicit, nonverbal, intuitive, holistic processing of emotional information and social interactions, can elucidate the neurobiological mechanisms that underlie the relational foundations of psychotherapy. Utilizing the interpersonal neurobiological perspective of regulation theory, I describe the fundamental role of the early developing right brain in relational processes, throughout the life span. I present interdisciplinary evidence documenting right brain functions in early attachment processes, in emotional communications within the therapeutic alliance, in mutual therapeutic enactments, and in therapeutic change processes. This work highlights the fact that the current emphasis on relational processes is shared by, cross-fertilizing, and indeed transforming both psychology and neuroscience, with important consequences for clinical psychological models of psychotherapeutic change. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  10. Thirty years of teaching psychotherapy skills. (United States)

    Lewis, J M


    The author outlines a basic model for teaching psychotherapeutic skills that includes five modules relating to (1) the dynamics of exploration, designed to encourage the patient's affective expression; (2) relationship structure, considering patterns of patient-therapist interaction along a closeness/separateness continuum; (3) affect, empathy, and distance regulation, emphasizing the crucial significance of identifying correctly and responding empathically to patients' affective messages; (4) basic cognitive interventions, focused on techniques for facilitating the patient's narrative flow and capacity to analyze experiences, and for formulating the patient's psychopathology; and (5) the therapist's use of self. The author concludes by examining why systematic psychotherapy training is particularly important at this time, in light of such pressures as managed health care, neuroscientific advances and psychopharmacologic breakthroughs, and the wave of self-help organizations.

  11. The use of autobiography in psychotherapy. (United States)

    Sommer, Robert


    First-person narratives may have advantages as adjuncts in psychotherapy. They provide an inside view of mental disorders expressed in the person's own words, emphasize issues that the person deems important, are interesting to read with strong story lines, are less didactic than self-help books, and offer identification with a protagonist. Recent trends in published autobiographies are described. There has been an increase in the number of published autobiographies describing mood disorder relative to schizophrenia, of psychotherapists going public with personal experiences of mental disorder, and of books expressing a positive view of treatment. The article includes case vignettes and a practitioner-recommended list of autobiographies on addictive disorders, death and grieving, and mood disorders. Copyright 2003 Wiley Periodicals, Inc.

  12. Reluctance to change and end psychotherapy

    Directory of Open Access Journals (Sweden)

    John E. Berg


    Full Text Available Reluctance to change therapy has clinical and economic implications. Therapists are expected to deliver treatment in a oneto- one setting ending up with patient improvement. Such an achievement is difficult to overview. There is great uncertainty as to what works in psychotherapies despite research efforts. Prolonged treatment duration with little positive effect may be caused by factors inherent in therapist and patient and the external environment. Two cases are discussed illustrating the need for better surveillance of what happens in the therapy room. Responsibility for the progress in therapy rests on the shoulders of the therapist. When therapy becomes detrimental to patient and therapist, we do not have a comprehensive system to interfere or help. Delayed recovery emanates as an increase in costs to society and the family. This is the case when return to work after treatment is partly or completely retarded.

  13. The Use of Dreams in Psychotherapy (United States)

    Schredl, Michael; Bohusch, Claudia; Kahl, Johanna; Mader, Andrea; Somesan, Alexandra


    Since the publication of Sigmund Freud's The Interpretation of Dreams, dream interpretation has been a standard technique often used in psychotherapy. However, empirical studies about the frequency of working on dreams in therapy are lacking. The present study elicited, via a self-developed questionnaire, various aspects of work on dreams applied by psychotherapists in private practice. The findings indicate that dreams were often used in therapy, especially in psychoanalysis. In addition, a significant relationship was found between the frequency of the therapists' working on their own dreams and frequency of work on dreams in therapy. Because work on dreams was rated as beneficial for the clients, further studies investigating the effectiveness and the process of working on dreams will be of interest. PMID:10793127

  14. Individual patient data meta-analysis of combined treatments versus psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for adult depression: a protocol. (United States)

    Weitz, Erica; Kleiboer, Annet; van Straten, Annemieke; Hollon, Steven D; Cuijpers, Pim


    There are many proven treatments (psychotherapy, pharmacotherapy or their combination) for the treatment of depression. Although there is growing evidence for the effectiveness of combination treatment (psychotherapy + pharmacotherapy) over pharmacotherapy alone, psychotherapy alone or psychotherapy plus pill placebo, for depression, little is known about which specific groups of patients may respond best to combined treatment versus monotherapy. Conventional meta-analyses techniques have limitations when tasked with examining whether specific individual characteristics moderate the effect of treatment on depression. Therefore, this protocol outlines an individual patient data (IPD) meta-analysis to explore which patients, with which clinical characteristics, have better outcomes in combined treatment compared with psychotherapy (alone or with pill placebo), pharmacotherapy and pill placebo. Study searches are completed using an established database of randomised controlled trials (RCTs) on the psychological treatment of adult depression that has previously been reported. Searches were conducted in PubMed, PsycInfo, Embase and the Cochrane Central Register of Controlled Trials. RCTs comparing combination treatment (psychotherapy + pharmacotherapy) with psychotherapy (with or without pill placebo), pharmacotherapy or pill placebo for the treatment of adult depression will be included. Study authors of eligible trials will be contacted and asked to contribute IPD. Conventional meta-analysis techniques will be used to examine differences between studies that have contributed data and those that did not. Then, IPD will be harmonised and analysis using multilevel regression will be conducted to examine effect moderators of treatment outcomes. Study results outlined above will be published in peer-reviewed journals. Study results will contribute to better understanding whether certain patients respond best to combined treatment or other depression treatments and provide

  15. Reprint of "The Effects of Psychotherapy: An Evaluation." (United States)

    Eysenck, H. J.


    As part of the American Psychological Association's centennial, this article presents a reprint of an original work published in 1952 in the "Journal of Consulting Psychology" examining the evidence relating to the actual effects of psychotherapy. (NB)

  16. Enhancing the Personalization of Psychotherapy With Dynamic Assessment and Modeling. (United States)

    Fisher, Aaron J; Boswell, James F


    Clinicians have long recognized the importance of tailoring psychotherapy interventions to the needs and characteristics of the individual patient. However, traditional approaches to clinical assessment, service delivery, and intervention research have not been conducive to such personalization. Contrary to traditional nomothetic approaches, idiographic assessment and modeling of intraindividual dynamic processes holds tremendous promise for tailoring the implementation of psychotherapy to the individual patient. In this article, we (a) present an argument for assessing person-specific dynamics, (b) provide a detailed description of a method that harnesses person-specific dynamic assessment and modeling for use in routine psychotherapy, (c) present exemplar clinical cases illustrating these methods, and (d) discuss how these methods can be translated into routine clinical assessment and psychotherapy.

  17. College Psychotherapy at a Hong Kong Counseling Center (United States)

    Leung, Eugenie Y.


    This article presents an online interview about college psychotherapy at a Hong Kong counseling center. The interview discusses how students generally feel about going for counseling or therapy and how common it is in Hong Kong.

  18. Effectiveness of psychotherapy for severe somatoform disorder: meta-analysis

    NARCIS (Netherlands)

    Koelen, Jurrijn; Houtveen, J.H.|info:eu-repo/dai/nl/21422841X; Abbass, A.; Eurelings-Bontekoe, L.H.M.; van Broeckhuysen, S.; Luyten, P.; Bühring, M.E.F.; Geenen, R.|info:eu-repo/dai/nl/087017571


    BACKGROUND: Patients with severe somatoform disorder (in secondary and tertiary care) typically experience functional impairment associated with physical symptoms and mental distress. Although psychotherapy is the preferred treatment, its effectiveness remains to be demonstrated. AIMS: To examine

  19. Qualitative psychotherapy research: the journey so far and future directions. (United States)

    Levitt, Heidi M


    This article documents the evolution of qualitative psychotherapy research over the past 3 decades. Clients' and therapists' accounts of their experiences in psychotherapy provide a window into the psychotherapy relationship and its mechanisms of change. A sizable body of literature has been generated that uses qualitative methods to collect and analyze these accounts and to shed light on the psychotherapy process. It notes changes in the field such as growing numbers of dissertations and publications using qualitative methods as well as a strengthening emphasis on qualitative research within graduate education and research funding bodies. Future recommendations include developing principles for practice from qualitative methods and conducting qualitative meta-analyses. Other recommendations include forming journal review policies that support the publication of qualitative research and that focus on coherence in adapting methods to meet research goals, in light of a study's characteristics and epistemological framework, rather than focusing on sets of procedures. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  20. Hazards of long-term psychotherapy during psychiatric residency. (United States)

    Dubovsky, S L; Scully, J H


    When he laid the groundwork for modern standards of training psychiatrists, Freud (1937) asked, "Where and how is the poor wretch to acquire the ideal qualifications which he will need in his profession? The answer is, in an analysis of himself" (p. 248). Fromm-Reichmann (1950), an equally important influence on psychiatric education, echoed this sentiment when she professed that "any attempt at intensive psychotherapy is fraught with danger, hence unacceptable, where not preceded by the future psychiatrist's personal analysis" (p. 42). Although most psychiatric residencies do not require personal psychotherapy (Pasnau and Russell 1975), many educators and their trainees still consider psychoanalysis or long-term reconstructive psychotherapy at least a valuable experience and at most a necessary step toward becoming a complete psychiatrist. In our experience, however, psychoanalysis and related psychotherapies can have adverse effects during the turmoil of residency training.

  1. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment (United States)

    McMartin, Kristen; Gajic-Veljanoski, Olga; Wells, David; Higgins, Caroline; Walter, Melissa


    Background Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. Methods We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Results Interpersonal therapy compared with usual care reduced

  2. Internet and video technology in psychotherapy supervision and training. (United States)

    Wolf, Abraham W


    The seven articles in this special section on the use of Internet and video technology represent the latest growth on one branch of the increasingly prolific and differentiated work in the technology of psychotherapy. In addition to the work presented here on video and the Internet applications to supervision and training, information technology is changing the field of psychotherapy through computer assisted therapies and virtual reality interventions.

  3. Toward a neurobiology of psychotherapy: basic science and clinical applications. (United States)

    Etkin, Amit; Pittenger, Christopher; Polan, H Jonathan; Kandel, Eric R


    Psychotherapy is used commonly to treat a variety of mental illnesses, yet surprisingly little is known about its biological mechanisms especially in comparison with pharmacotherapy. In this review we survey the current knowledge about changes in brain function following psychotherapeutic intervention that are detectable with current neuroimaging techniques. We also consider the possible role for neuroimaging in refining clinical diagnoses and predicting treatment outcome, which would benefit both clinical decision-making and the cognitive neuroscience of psychotherapy.


    Directory of Open Access Journals (Sweden)

    Karmen Urška Modic


    Full Text Available This article describes a qualitative study of helpful aspects of the therapeutic relationship in Integrative Psychotherapy. Participants of the study were sixteen clients who were in the process of Integrative Psychotherapy for at least a year. Participants were interviewed with the adapted version of the Change Interview (Elliott, 1999, which involves a semi-structured empathic exploration of the client's experience in therapy. The analysis of the clients’ experience of Integrative Psychotherapy revealed six categories of helpful aspects of therapeutic relationship: the therapist’s empathic attunement, the therapist’s acceptance, the match between the client and the therapist, feelings of trust and safety, feeling of connection, and experience of a new relational experience. Based on results of the research, we developed a model of the healing relationship in integrative psychotherapy. This model describes the interrelatedness of these six helpful aspects of the therapeutic relationship. The categories of empathic attunement and acceptance proved to be the most important categories relating to the therapist’s contribution to the healing therapeutic relationship. Clients described that the therapist’s empathic attunement and acceptance influenced the development of safety and trust, feelings of connection and promotion of new relational experiences. The results of this study are discussed in relation to the theories of Integrative Psychotherapy and research regarding the therapeutic relationship in psychotherapy.

  5. Segmented assimilation and attitudes toward psychotherapy: a moderated mediation analysis. (United States)

    Rogers-Sirin, Lauren


    The present study examines the relations between acculturative stress, mental health, and attitudes toward psychotherapy, and whether these relations are the same for immigrants of color and White immigrants. This study predicted that acculturative stress would have a significant, negative relation with attitudes toward psychotherapy and that this relation would be moderated by race (immigrants of color and White immigrants) so that as acculturative stress increases, attitudes toward psychotherapy become more negative for immigrants of color but not White immigrants. Finally, mental health was predicted to mediate the relation between acculturative stress and attitudes toward psychotherapy for immigrants of color, but not White immigrants. Participants were 149 first-generation, immigrant, young adults, between the ages of 18 and 29, who identified as White, Black, Latino, or Asian. A significant negative correlation was found between acculturative stress and attitudes toward psychotherapy. A moderated mediation analysis demonstrated that the negative relation between acculturative stress and attitudes toward psychotherapy was mediated by mental health symptoms for immigrants of color but not White immigrants. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  6. Meaning in life in psychotherapy: The perspective of experienced psychotherapists. (United States)

    Hill, Clara E; Kanazawa, Yoshi; Knox, Sarah; Schauerman, Iris; Loureiro, Darren; James, Danielle; Carter, Imani; King, Shakeena; Razzak, Suad; Scarff, Melanie; Moore, Jasmine


    Our goal was to explore the meaning experienced psychotherapists derive from providing psychotherapy, their beliefs about the role of meaning in life (MIL) in psychotherapy, how they worked with MIL with a client who explicitly presented concerns about MIL, and how they worked with a different client for whom MIL was a secondary and more implicit concern. Thirteen experienced psychotherapists were interviewed and data were analyzed using consensual qualitative research. Therapists derived self-oriented meaning (e.g., feeling gratified, fulfilled, connected) and other-oriented meaning (helping others, making the world a better place) from providing psychotherapy. They believed that MIL is fundamental and underlies all human concerns, including those brought to therapy. In contrast to the clients who had implicit MIL concerns, clients who explicitly presented MIL concerns were reported to have more interpersonal problems and physical problems, but about the same amount of psychological distress and loss/grief. Therapists used insight-oriented interventions, support, action-oriented interventions, and exploratory interventions to work with MIL with both types of clients, but used more exploratory interventions with implicit than explicit MIL clients. MIL is a salient topic for experienced, existentially oriented psychotherapists; they work with MIL extensively with some clients in psychotherapy. We recommend that therapists receive training to work with MIL in therapy, and that they pay attention to MIL concerns when they conduct psychotherapy. We also recommend additional research on MIL in psychotherapy.

  7. Cost-effectiveness of psychotherapy for cluster B personality disorders. (United States)

    Soeteman, Djøra I; Verheul, Roel; Delimon, Jos; Meerman, Anke M M A; van den Eijnden, Ellen; Rossum, Bert V; Ziegler, Uli; Thunnissen, Moniek; Busschbach, Jan J V; Kim, Jane J


    Recommendations on current clinical guidelines are informed by limited economic evidence. A formal economic evaluation of three modalities of psychotherapy for patients with cluster B personality disorders. A probabilistic decision-analytic model to assess the cost-effectiveness of out-patient, day hospital and in-patient psychotherapy over 5 years in terms of cost per recovered patient-year and cost per quality-adjusted life-year (QALY). Analyses were conducted from both societal and payer perspectives. From the societal perspective, the most cost-effective choice switched from out-patient to day hospital psychotherapy at a threshold of 12,274 euros per recovered patient-year; and from day hospital to in-patient psychotherapy at 113,298 euros. In terms of cost per QALY, the optimal strategy changed at 56,325 euros and 286,493 euros per QALY respectively. From the payer perspective, the switch points were at 9895 euros and 155,797 euros per recovered patient-year, and 43,427 euros and 561,188 euros per QALY. Out-patient psychotherapy and day hospital psychotherapy are the optimal treatments for patients with cluster B personality disorders in terms of cost per recovered patient-year and cost per QALY.

  8. Understanding the Change Process Involved in Solving Psychological Problems: A Model-based Approach to Understanding How Psychotherapy Works. (United States)

    Marken, Richard S; Carey, Timothy A


    A review of the literature on psychotherapy suggests that improvements in effectiveness, efficiency and accessibility have been hampered by a lack of understanding of how psychotherapy works. Central to gaining such understanding is an accurate description of the change process that occurs when someone solves a psychological problem. We describe the Perceptual Control Theory (PCT) model of human functioning, which can be used to understand the nature of psychological problems and how they are solved. PCT suggests that problems can be broadly grouped into two categories: those that can be solved using existing skills and those that require the generation of new skills. In general, psychological problems belong in the second category. PCT describes a fundamental form of learning in which existing structures and systems are reorganized to create new skills, perspective and insights. Psychotherapy based on PCT is aimed at directing reorganization to the source of the problem. Understanding the phenomenon of control is central to understanding how psychotherapy works. Conflict could be considered a general formulation for psychological distress. Therapy will be efficient when the reorganization process is focused at the right level of the client's control hierarchy. Therapy will be effective only when the client's reorganization system-not the therapist-has managed to come up with a solution to the client's problem. What the client says about the nature and reason for their problem is less important than the point of view from which these problems are being discussed. Copyright © 2014 John Wiley & Sons, Ltd.

  9. Psychotherapy Knowledge Translation and Interpersonal Psychotherapy: Using Best-Education Practices to Transform Mental Health Care in Canada and Ethiopia. (United States)

    Ravitz, Paula; Wondimagegn, Dawit; Pain, Clare; Araya, Mesfin; Alem, Atalay; Baheretibeb, Yonas; Hanlon, Charlotte; Fekadu, Abebaw; Park, Jamie; Fefergrad, Mark; Leszcz, Molyn


    Psychotherapies, such as Interpersonal Psychotherapy (IPT), that have proven effective for treating mental disorders mostly lie dormant in consensus-treatment guidelines. Broadly disseminating these psychotherapies by training trainers and front-line health workers could close the gap between mental health needs and access to care. Research in continuing medical education and knowledge translation can inform the design of educational interventions to build capacity for providing psychotherapy to those who need it. This paper summarizes psychotherapy training recommendations that: adapt treatments to cultural and health organizational contexts; consider implementation barriers, including opportunity costs and mental health stigma; and engage local opinion leaders to use longitudinal, interactive, case-based teaching with reflection, skills-coaching, simulations, auditing and feedback. Community-based training projects in Northern Ontario, Canada and Ethiopia illustrate how best-education practices can be implemented to disseminate evidence-supported psychotherapies, such as IPT, to expand the therapeutic repertoire of health care workers and improve their patients' clinical outcomes.

  10. Psychotherapies for PTSD: what do they have in common?

    Directory of Open Access Journals (Sweden)

    Ulrich Schnyder


    Full Text Available Over the past three decades, research and clinical practice related to the field of traumatic stress have developed tremendously. In parallel with the steady accumulation of basic knowledge, therapeutic approaches have been developed to treat people suffering from posttraumatic stress disorder (PTSD and other trauma-related psychological problems. Today, a number of evidence-based treatments are available. They differ in various ways; however, they also have a number of commonalities. Given this situation, clinicians may wonder which treatment program to use, or more specifically, which treatment components are critical for a successful therapy. In this article, seven pioneers who have developed empirically supported psychotherapies for trauma-related disorders were asked to compose an essay of three parts: first, to provide a brief summary of the treatment they have developed; second, to identify three key interventions that are common and critical in treating PTSD; and third, to suggest important topics and future directions for research. The paper ends with a summary highlighting the identified commonalities (psychoeducation; emotion regulation and coping skills; imaginal exposure; cognitive processing, restructuring, and/or meaning making; emotions; and memory processes, pointing to future directions such as trying to better understand the underlying mechanisms of action, and developing treatments that are tailored to the needs of different patient groups.

  11. Quality assessment of randomized control trials applied psychotherapy for chronic pains in iran: a systematic review of domestic trials. (United States)

    Faizi, Fakhrudin; Tavallaee, Abbas; Rahimi, Aboulfazl; Saburi, Amin; Saghafinia, Masoud


    Keeping in mind the burden of psychotherapy can play a crucial role concerning chronic pain (CP). Psychotherapy techniques are widely used to relief Chronic Pain (CP) worldwide. Appling psychotherapy needs to consider both individual and popular cultures. In addition to international requirements; nation-wide legitimacy should be regarded too. Psychological methods have provided a lot of articles in Iran, but they were neglected by the reviewers because the documents only have abstracts in English. The current study aimed to assess all Farsi Randomized Control Trials (RCTs) addressing psychotherapy to relieve chronic pains. Six nation-wide medical databases were investigated in 2012 using the keyword chronic pain in the Abstracts, systematically. Appling PICO question format (patient problem or population, intervention, comparison, and outcomes) all the interventional studies were reviewed for eligibility. Retrieving full text (in Farsi) and making the articles indistinguishable, two native reviewers assessed the quality of the articles independently using Jadad scale. Inclusion criteria met 1542 abstracts. After refining and excluding, seventeen experimental studies were retrieved and evaluated. Mean quality score of Jadad was 1.53 ± 1.37 (median = 1.0). Cognitive Behavior Therapy (CBT) was the dominant approach (11 out of 17) and the majority (6 out of 17 studies) of the treated cases was Low Back Pain (LBP). Patient-therapist gender adjustment has clearly reported in most of the studies, based on the requirements. Cognitive Behavior Therapy was more effective than the other psychotherapy approaches relieving chronic pain in the studies. Well-designed studies and comprehensive clarification of the studies demonstrating groups, intervention, follow-up and drop outs can improve the quality of the RCTs.

  12. If You Get Better, Will I? An Actor-Partner Analysis of the Mutual Influence of Group Therapy Outcomes (United States)

    Paquin, Jill D.; Kivlighan, D. Martin, III; Drogosz, Lisa M.


    The effectiveness of group psychotherapy has been empirically studied and supported over several decades; however, there remains much to understand regarding the specific factors contributing to effective group psychotherapy. The current study uses Kashy and Kenny's (2000) actor-partner interdependence model (APIM) to examine the relationship…

  13. Effectiveness of Spiritually Augmented Psychotherapy on Dysfunctional Attitudes in Patients with Dysthymic Disorder

    Directory of Open Access Journals (Sweden)

    Amrollah Ebrahimi


    Full Text Available Background: The aim of this study was to evaluate the efficacy of spiritually augmented psychotherapy (SAPT on the dysfunctional attitudes of patients with dysthymic disorder. Methods: A mixed qualitative and quantitative method was used in the present study. SAPT model was prepared in the first phase, and in the second phase, a double-blind randomized clinical trial was performed. The study subjects consisted of 62 patients with dysthymic disorder selected from several clinical centers of Isfahan University of Medical Sciences in Isfahan, Iran. The participants were randomly assigned to 3 experimental groups and 1 control group. The first group received 8 sessions of SAPT treatment, the second group also had 8 sessions of cognitive behavioral therapy (CBT which was specific to dysthymic disorder, and third group were under antidepressant treatment. The Dysfunctional Attitudes Scale was used to evaluate all the participants in 4 measurement stages. The data were analyzed using repeated measures MANCOVA. Results: Findings showed that SAPT had higher efficacy on the modification of dysfunctional attitudes than CBT and medication (p < 0.05. Conclusion: These findings supported the efficacy of psychotherapy enriched with cultural structures and spiritual teachings.

  14. Relative efficacy of psychotherapy and combined therapy in the treatment of depression: A meta-analysis.

    NARCIS (Netherlands)

    Maat, S.M.; Dekker, J.J.M.; Schoevers, R.A.; Jonghe, de F.


    0.001). Conclusions In the acute treatment of adult psychiatric outpatients with major depressive disorder, patient compliance with combined therapy matches compliance with psychotherapy alone. Combined therapy is more efficacious than psychotherapy alone. However, these results depend on severity

  15. Clinical Thanatology and Psychotherapy: Some Reflections on Caring for the Dying Person. (United States)

    Feigenberg, Loma; Shneidman, Edwin S.


    Explores the relationship between psychotherapy and clinical thanatology relative to working with dying patients and their survivors. Eight special characteristics of thanatological exchanges are explained including comments on time, transference, aspirations, and empathy. Conversation, heirarchical exchange, psychotherapy, and thanatological…

  16. Client attachment security predicts alliance in a randomized controlled trial of two psychotherapies for bulimia nervosa

    DEFF Research Database (Denmark)

    Folke, Sofie; Daniel, Sarah Ingrid Franksdatter; Poulsen, Stig Bernt


    Objective: This study investigated the relation between clients’ attachment patterns and the therapeutic alliance in two psychotherapies for bulimia nervosa. Method: Data derive from a randomized clinical trial comparing cognitive-behavioral therapy and psychoanalytic psychotherapy for bulimia...

  17. Glucocorticoids enhance extinction-based psychotherapy. (United States)

    de Quervain, Dominique J-F; Bentz, Dorothée; Michael, Tanja; Bolt, Olivia C; Wiederhold, Brenda K; Margraf, Jürgen; Wilhelm, Frank H


    Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, double-blind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions. Subjects returned for a posttreatment assessment 3-5 d after the last treatment session and for a follow-up assessment after 1 mo. Adding cortisol to exposure therapy resulted in a significantly greater reduction in fear of heights as measured with the acrophobia questionnaire (AQ) both at posttreatment and at follow-up, compared with placebo. Furthermore, subjects receiving cortisol showed a significantly greater reduction in acute anxiety during virtual exposure to a phobic situation at posttreatment and a significantly smaller exposure-induced increase in skin conductance level at follow-up. The present findings indicate that the administration of cortisol can enhance extinction-based psychotherapy.

  18. Use of extratransference interpretation in psychoanalytic psychotherapy

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    Jojić Boris R.


    Full Text Available Background. In psychoanalytic psychotherapy, the transference analysis takes the central position of the work. The work in the extratransference sphere and experience in a professional practice with extratransference interventions have not been reported much in the literature. Extratransference sphere includes less transferring relation to a psychotherapist, transference to other objects, or may refer to the external reality rather than the psychic reality or fantasy. Case report. We pointed out extratransference interventions. We demonstrated an application of a genetic interpretation and reconstruction, too, which could restore and establish the connections between the past and the present, in order to understand the influences of the current reality and the past, and helping us, further, to resolve the infantile conflicts. Conclusion. Interpretation of extratransference situations takes an important part of an analytical work and it is an essential category of the interpretation. Analytic understanding should include transference and extratransference spheres, fantasy and reality, past and present. Working with neurotic patterns and character resistance needs an optimal choice of intervention in the given moment of the analytic process. Extratransference interventions are an essential category of intervention, irreplaceable for its effectiveness in the analytic process.

  19. Was ist eine erfolgreiche Psychotherapie? Was ist erfolgreich in der Psychotherapie? (United States)



    What Is Successful Treatment? What Is Success in Therapy? - Observations on Psychotherapy ResearchThe author raises the following questions: What are the criteria for the evaluation of successful psychotherapeutic treatment? Which are the suitable research methods for the assessment of psychotherapeutic success? He proposes a research paradigm based on multiple criteria and multiple methods. Psychotherapeutic treatment success must be assessed on different levels: aetiology of disease, disease as nosologic category (e. g. depression), symptomatology, consequences (psychic, physical, social, economical) of disease. He further develops a research logic that is multimethodical: Results from different research methods must be aggregated on the basis of convergent findings. The three 'key research methods' in psychotherapy research are: single-case studies, controlled trials, naturalistic catamnestic research. Statements about any psychotherapeutic method or intervention strategy are only valid when results from these different study types converge. It may be a very severe bias when findings from only one study type (e. g. controlled trials) are generalised as a final verdict on certain psychotherapeutic methods.

  20. A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy. (United States)

    Berghout, Caspar C; Zevalkink, Jolien; Hakkaart-van Roijen, Leona


    Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy. Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent. Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICER--that is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapy--was estimated at 52,384 euros per QALY gained. Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.

  1. Applications of Mindfulness in Psychotherapy – Contemporary Dilemmas

    Directory of Open Access Journals (Sweden)

    Borut ŠKODLAR


    Full Text Available Mindfulness has without doubt been the fastest spreading and most popular concept in psychotherapy in the last two decades. Its influence exceeds that of any other individual concept or approach in modern psychotherapy. However, there are many dilemmas, open questions and controversies related to this rapid, almost fanatic spread, which obviously compensates for a certain lack in modern Euro- and Americo-centric societies. Similarly, we are witnessing in the West a lack of reflection, a process of limitless idealization, and the search for a panacea. This all flows with a tint of colonialism, presumptuously taking over ideas, concepts and techniques without a proper study of the primary sources, and with all the accompanying negative side-effects: profiteering, self-promotion, unethical conduct, empty promises of instant rewards, and so on. In the present paper, the development of interest in mindfulness in psychotherapy, as well as the research findings and dilemmas, and concepts and mechanisms of applying mindfulness in psychotherapy, will be reviewed. The main purpose of the paper is to contribute to the critical reflection in studying and applying mindfulness in psychotherapy.

  2. Integrative Treatment of Personality Disorder. Part I: Psychotherapy. (United States)

    Jovanovic, Mirjana Divac; Svrakic, Dragan


    In this paper, we outline the concept of integrative therapy of borderline personality, also referred to as fragmented personality, which we consider to be the core psychopathology underlying all clinical subtypes of personality disorder. Hence, the terms borderline personality, borderline disorder, fragmented personality, and personality disorder are used interchangeably, as synonyms. Our integrative approach combines pharmacotherapy and psychotherapy, each specifically tailored to accomplish a positive feedback modulation of their respective effects. We argue that pharmacotherapy and psychotherapy of personality disorder complement each other. Pharmacological control of disruptive affects clears the stage, in some cases builds the stage, for the psychotherapeutic process to take place. In turn, psychotherapy promotes integration of personality fragments into more cohesive structures of self and identity, ultimately establishing self-regulation of mood and anxiety. We introduce our original method of psychotherapy, called reconstructive interpersonal therapy (RIT). The RIT integrates humanistic-existential and psychodynamic paradigms, and is thereby designed to accomplish a deep reconstruction of core psychopathology within the setting of high structure. We review and comment the current literature on the strategies, goals, therapy process, priorities, and phases of psychotherapy of borderline disorders, and describe in detail the fundamental principles of RIT.

  3. [Psychodynamic psychotherapy and the treatment of pathological gambling]. (United States)

    Rosenthal, Richard J


    The search for empirically based treatments for pathological gambling is in its infancy, with relatively few clinical trials and an absence of naturalistic studies. Treatment retention of gamblers has been a problem; cognitive-behavioral treatment and pharmacotherapy studies report especially high dropout rates. Psychodynamic approaches, with their emphasis on the therapeutic relationship, and the meaning of the patient's self-destructive and seemingly irrational behaviors, and on obstacles to self-forgiveness, might improve outcome. After a description of psychodynamic psychotherapy, the literature on both short-term and longer therapies is reviewed regarding their efficacy for a variety of disorders. With regard to pathological gambling, the author summarizes the early (1914-1970) psychoanalytic literature then reviews the more recent psychodynamic psychotherapy literature on pathological gambling. A review of the recent psychodynamic psychotherapy literature on pathological gambling failed to disclose a single randomized controlled study of treatment efficacy or effectiveness. However, there are eight positive outcome studies described as multi-modal eclectic; half of those seem to utilize psychodynamic approaches. Two of the more successful programs are described. A review of the outcomes literature for psychodynamic psychotherapy demonstrates efficacy for a variety of disorders sufficient to justify a clinical trial for pathological gambling. Short-term psychodynamic psychotherapy, with its focus on core issues, may be particularly applicable to the pathological gambler's need to avoid or escape intolerable affects and problems. Longer therapies may be needed to modify an avoidant coping style and defenses.

  4. Transference, transference interpretations, and transference-focused psychotherapies. (United States)

    Levy, Kenneth N; Scala, J Wesley


    The concept of transference and the use of transference interpretations in psychotherapy have been highly controversial topics garnering frequent attention both within psychoanalysis and across multiple orientations of psychotherapy. In this article, we review the empirical evidence as it bears on this controversy and discuss the implications of the evidence for psychoanalysis, psychodynamic psychotherapy, and therapy in general. We provide a brief historical and contextual overview, followed by a discussion of the development of the concept of transference. We then discuss the evidence for the concept of transference from basic psychological research and contend that these findings are not only consistent with a social-cognitive and information processing model, but that they may also indicate conflict and defensive processes suggestive of a dynamic transference process model. We continue with a discussion of the evidence for the concept of transference from psychotherapy research and examine process findings relating to the use of transference interpretations and transference-focused psychotherapies. Finally, we present the implications of this emerging evidence for clinical practice. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  5. Achieving Full Scope of Practice Readiness Using Evidence for Psychotherapy Teaching in Web and Hybrid Approaches in Psychiatric Mental Health Advanced Practice Nursing Education. (United States)

    McCoy, Kathleen T


    Radical changes in role, education, and practice have affected how education of advance practice nurses and practice deliverables occur. This article examines the effects of distance education upon the teaching/learning of psychotherapy in integrating Web-based technology and platforms. With the advent and proliferation of online programs of study, the question begs: How do distance-linked programs successfully introduce, practice, and supervise one-to-one and group psychotherapy training? By employing evidence-based education strategies, technology, and strong interpersonal skills and evidence-based therapies, a charter Psychiatric Mental Health Nurse Practitioner Doctor of Nursing Practice program paved an innovative and successful path. In that program, they prepared their students for full scope of practice, upon graduation, inclusive of psychotherapy as well as the other highly demanding and compressed requirements of the 3-year program. This article explores that journey and its recommendations for application derived from this 2010 cohort. © 2017 Wiley Periodicals, Inc.

  6. A randomized clinical trial of cognitive behavioural therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis

    DEFF Research Database (Denmark)

    Sørensen, Per; Birket-Smith, M; Wattar, U


    Hypochondriasis is common in the clinic and in the community. Cognitive behavioural therapy (CBT) has been found to be effective in previous trials. Psychodynamic psychotherapy is a treatment routinely offered to patients with hypochondriasis in many countries, including Denmark. The aim...... of this study was to test CBT for hypochondriasis in a centre that was not involved in its development and compare both CBT and short-term psychodynamic psychotherapy (STPP) to a waiting-list control and to each other. CBT was modified by including mindfulness and group therapy sessions, reducing the therapist...

  7. The challenge of professional identity for Chinese clinicians in the process of learning and practicing psychoanalytic psychotherapy: the discussion on the frame of Chinese culture. (United States)

    Yang, Yunping


    One important element in psychoanalysis, which is derived from Western culture, is individualization: the independency and autonomy of an individual are highly valued. However, one of the significant essences in Chinese culture is that the collective interests transcend the individual interests and the interests of social groups are more important than those of families. Therefore, when learning and practicing psychoanalytic psychotherapy, Chinese clinicians inevitably experience conflicts derived from this difference of cultural values. This article attempts to use a historical perspective to discuss the current challenges of professional identity for Chinese clinicians learning and practicing psychoanalytic psychotherapy and psychoanalysis. Copyright © 2011 Institute of Psychoanalysis.

  8. The Therapy Process Observational Coding System for Child Psychotherapy Strategies Scale (United States)

    McLeod, Bryce D.; Weisz, John R.


    Most everyday child and adolescent psychotherapy does not follow manuals that document the procedures. Consequently, usual clinical care has remained poorly understood and rarely studied. The Therapy Process Observational Coding System for Child Psychotherapy-Strategies scale (TPOCS-S) is an observational measure of youth psychotherapy procedures…

  9. [The most frequently cited articles in the SCI and SSCI of the Zeitschrift fur Psychosomatische Medizin und Psychotherapie (Journal of Psychosomatic Medicine and Psychotherapy) -- a review and analysis]. (United States)

    Brahler, Elmar; Rüger, Ulrich


    We investigate which articles out of the entire fifty volumes of the Zeitschrift fur Psychosomatische Medizin und Psychotherapie (Journal of Psychosomatic Medicine and Psychotherapy (Psychoanalysis) have been most frequently cited. These articles are analysed according to the groups of authors and topics. The citation frequency was determined in the source journals listed by the ISI and contained in the SCI and SSCI data banks. 58 articles were cited at least ten times, and five of these articles were cited at least twenty times. One article was cited 45 times and thus was the top runner. The authors who are particularly important in their specialized areas dominated, and the most frequently cited articles were distributed quite evenly in both psychosomatic and psychotherapeutic topics. A relatively large number of articles in this journal have a sustained influence among experts in the field. Since there are not many of German journal listed in the ISI data banks or have only recently been included by them, the number of citations is most likely considerably higher.

  10. The use of analogy in individual psychotherapy with young and pre-adolescents: "Superman, Bimbo and the big, grey wolf". (United States)

    Baird, F


    For various reasons, youngsters often have difficulty in discussing important issues in individual psychotherapy. Therapists, also, may find it hard to uncover underlying issues and dynamics. This paper describes three separate techniques for using analogy in individual therapy with the 10 to 15-year-old age group. These techniques were developed while the author was a member of a multi-disciplinary team operating within an out-patient, adolescent psychiatric clinic.


    Directory of Open Access Journals (Sweden)

    Andrea eCLARICI


    Full Text Available Oxytocin is a neuropeptide that is active in the central nervous system and is generally considered to be involved in prosocial behaviors and feelings. In light of its documented positive effect on maternal behaviour, we designed a study to ascertain whether oxytocin exerts any therapeutic effects on depressive symptoms in women affected by maternal postnatal depression. A group of 16 mothers were recruited in a randomized double-blind study: the women agreed to take part in a brief course of psychoanalytic psychotherapy (12 sessions, once a week while also being administered, during the 12-week period, with a daily dose of intranasal oxytocin (or a placebo. The pre-treatment evaluation also included a personality assessment of the major primary-process emotional command systems described by Panksepp (1998 and a semi-quantitative assessment by the therapist of the mother’s depressive symptoms and on her personality. No significant effect on depressive symptomatology was found following the administration of oxytocin (as compared to a placebo during the period of psychotherapy. Nevertheless, a personality trait evaluation of the mothers, conducted in our overall sample group, showed a decrease in the narcissistic trait only within the group who took oxytocin. The depressive (dysphoric trait was in fact significantly affected by psychotherapy (this effect was only present in the placebo group so it may reflect a positive placebo effect enhancing the favorable influence of psychotherapy on depressive symptoms but not in the presence of oxytocin. Based on these results, we confirm our hypothesis that what is generally defined as postnatal depression may include disturbances of narcissistic affective balance, and oxytocin supplementation can counteract that type of affective disturbance.

  12. Animal-assisted therapy with chronic psychiatric inpatients: equine-assisted psychotherapy and aggressive behavior. (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Shaffer, Thomas M; Yellin, Mary; Desai, Prital J; Amin, Ruchi; Bouchard, Axel; Montalvo, Cristina


    Animal-assisted therapy (AAT), most frequently used with dogs, is being used increasingly as an adjunctive alternative treatment for psychiatric patients. AAT with larger animals, such as horses, may have unique benefits. In this randomized controlled study, equine and canine forms of AAT were compared with standard treatments for hospitalized psychiatric patients to determine AAT effects on violent behavior and related measures. The study included 90 patients with recent in-hospital violent behavior or highly regressed behavior. Hospitalization at the 500-bed state psychiatric hospital was two months or longer (mean 5.4 years). Participants were randomly selected to receive ten weekly group therapy sessions of standardized equine-assisted psychotherapy (EAP), canine-assisted psychotherapy (CAP), enhanced social skills psychotherapy, or regular hospital care. Participants' mean age was 44, 37% were female, 76% had diagnoses of schizophrenia or schizoaffective disorder, and 56% had been committed involuntarily for civil or forensic reasons. Violence-related incident reports filed by staff in the three months after study intake were compared with reports two months preintake. Interventions were well tolerated. Analyses revealed an intervention group effect (F=3.00, df=3 and 86, p=.035); post hoc tests showed specific benefits of EAP (p<.05). Similar AAT effects were found for the incidence of 1:1 clinical observation (F=2.70, df=3 and 86, p=.051); post hoc tests suggested benefits of CAP (p=.058) as well as EAP (p=.082). Covariance analyses indicated that staff can predict which patients are likely to benefit from EAP (p=.01). AAT, and perhaps EAP uniquely, may be an effective therapeutic modality for long-term psychiatric patients at risk of violence.

  13. Directive approach for Chinese clients receiving psychotherapy: Is that really a priority?

    Directory of Open Access Journals (Sweden)

    Chi Ting Connie eNg


    Full Text Available The academic literature often suggests that Chinese people prefer directive approaches in therapy. However, studies on this topic are often based on therapists’ self-reports: clients’ perceptions are rarely considered. What does directive approach mean? Is it what clients prefer? Using cultural psychology and medical anthropology as a theoretical framework, the ethnography explored the experience of psychotherapy from Chinese clients’ perspectives. Specifically, using ethnographic interview, eight informants, two male and six female, ranging in age from 40 to 55, were interviewed twice in-depth about their experiences of seeing Chinese therapists. All informants are Chinese immigrants who reside in a major Canadian city and saw at least one Chinese therapist in a community counselling agency within one year prior to the interview. In the first interview, informants created groups of cards describing a list of hypothesized cultural knowledge regarding psychotherapy. After initial data analysis, the cards were presented to the informants in the second interviews, in which they confirmed and/or rejected the hypotheses by grouping, reorganizing, and ranking the cards. In the end each informant created a number of mind-maps with the cards, which served as a representation of informants’ psychological reality of psychotherapy based on their ordinary language. The maps were then further analysed for themes among informants. Results suggest that clients appreciate therapists who give homework, analyse their problems, talk about strategies that other clients have found useful, chat, and provide resources. Results also highlight informants’ understanding of their own responsibility for the therapeutic relationship which has never been documented before and has important clinical implications.

  14. Is Exposure Necessary? A Randomized Clinical Trial of Interpersonal Psychotherapy for PTSD. (United States)

    Markowitz, John C; Petkova, Eva; Neria, Yuval; Van Meter, Page E; Zhao, Yihong; Hembree, Elizabeth; Lovell, Karina; Biyanova, Tatyana; Marshall, Randall D


    Exposure to trauma reminders has been considered imperative in psychotherapy for posttraumatic stress disorder (PTSD). The authors tested interpersonal psychotherapy (IPT), which has demonstrated antidepressant efficacy and shown promise in pilot PTSD research as a non-exposure-based non-cognitive-behavioral PTSD treatment. The authors conducted a randomized 14-week trial comparing IPT, prolonged exposure (an exposure-based exemplar), and relaxation therapy (an active control psychotherapy) in 110 unmedicated patients who had chronic PTSD and a score >50 on the Clinician-Administered PTSD Scale (CAPS). Randomization stratified for comorbid major depression. The authors hypothesized that IPT would be no more than minimally inferior (a difference CAPS score) to prolonged exposure. All therapies had large within-group effect sizes (d values, 1.32-1.88). Rates of response, defined as an improvement of >30% in CAPS score, were 63% for IPT, 47% for prolonged exposure, and 38% for relaxation therapy (not significantly different between groups). CAPS outcomes for IPT and prolonged exposure differed by 5.5 points (not significant), and the null hypothesis of more than minimal IPT inferiority was rejected (p=0.035). Patients with comorbid major depression were nine times more likely than nondepressed patients to drop out of prolonged exposure therapy. IPT and prolonged exposure improved quality of life and social functioning more than relaxation therapy. This study demonstrated noninferiority of individual IPT for PTSD compared with the gold-standard treatment. IPT had (nonsignificantly) lower attrition and higher response rates than prolonged exposure. Contrary to widespread clinical belief, PTSD treatment may not require cognitive-behavioral exposure to trauma reminders. Moreover, patients with comorbid major depression may fare better with IPT than with prolonged exposure.


    Directory of Open Access Journals (Sweden)

    Carmelita Gomes Rodrigues


    Full Text Available Online psychotherapy is a form of psychotherapy conducted by means of synchronous Internet sessions that are still not allowed in Brazil, except in a few instances defined by the Resolution 011/2012 of the Federal Council of Psychology. Such restriction is based on the understanding that the research available is insufficient to authorize a widespread use of this type of service. Studies on therapeutic alliance in psychological care provided exclusively over the internet show that the establishment of the therapeutic relationship in synchronous online calls occurs much like it does in face-to-face therapeutic processes, considering both, its benefits and challenges. This article aims to broaden the understanding of the online psychotherapy and to question its prohibition, signaling the dangers it entails, vis-a-vis the increasing demand for the service and its widespread use in disregard with the current restrictions. This article also makes suggestions for the regulation of the service in Brazil.

  16. Toward a renewal of personology in psychotherapy research. (United States)

    Stolorow, Robert D


    The articles by Elkins (D. N. Elkins, 2012, Toward a common focus in psychotherapy research, Psychotherapy, 49, pp. 450-454) and Hayes (S. C. Hayes, 2012, Humanistic psychology and contextual behavioral perspectives, Psychotherapy, 49, pp. 455-460) serve as a springboard for a call for a renewal of personological methods in studies of the psychotherapeutic relationship-methods that can investigate the emotional worlds of patient and psychotherapist as well as the relational systems constituted by the interplay between them. I believe only such idiographic research can illuminate the nexus of humanistic elements in which the psychotherapeutic process takes form. The beginnings of the author's own phenomenological-contextualist psychoanalytic perspective hark back to a series of personological studies of the subjective origins of psychoanalytic theories. (c) 2012 APA, all rights reserved.

  17. Criteria of Progress in Child Psychotherapies According to Psychotherapists

    Directory of Open Access Journals (Sweden)

    Lilian Pereira de Medeiros Guimarães


    Full Text Available This study aimed to perform a survey with psychotherapists, regarding the criteria they consider relevant to measure the progress of children in psychotherapy and whether the criteria indicated by them differ according to the therapist’s theoretical approach. Therapists were contacted electronically and answered a questionnaire composed of items with criteria of positive change present in the literature. Participants were 154 child therapists from different regions of Brazil. The analysis regarding the criteria of positive change that the participants indicated and their theoretical approach suggested that, despite the theoretical differences, in practice psychotherapists seem to adopt similar criteria to interpret progress in child psychotherapies. The criteria mentioned may be useful for a better systematization of the psychotherapy techniques for children. However, due to the lack of elements to evaluate the sample’s representativeness, caution is advised in generalizing the results.

  18. Parent-Infant Psychotherapy and Postpartum Depression: The Fathers Participation

    Directory of Open Access Journals (Sweden)

    Milena da Rosa Silva


    Full Text Available Given the specificities of postpartum maternal depression, the literature recommends that fathers become involved in psychological interventions within this context. This study presents an investigation of the participation of fathers in parent-infant psychotherapy in the context of maternal postpartum depression. Two families participated in this study, both with a child aged between 7 and 8 months old, whose mothers showed depressive symptoms. These families participated in parent-infant psychotherapy lasting approximately 12 sessions. Analysis of the fathers’ participation in psychotherapy showed that their presence during sessions enables the therapy to address aspects of parenthood, and also reduce the feeling of mothers as being the only ones responsible for the family’s process of change. In regard to the technique, the presence of fathers during sessions allows the therapist to see and address the issues concerning mother-father-infant during sessions.

  19. Reducing the dreaded: change of avoidance motivation in psychotherapy. (United States)

    Holtforth, Martin Grosse; Grawe, Klaus; Egger, Oliver; Berking, Matthias


    Abstract All humans avoid aversive experiences. Avoidance motivational goals are defined as ontogenetically developed mental representations of avoided transactions, and avoidance motivation as the totality of an individual's avoidance motivational goals. Based on previous research, avoidance motivation is hypothesized to contribute to the development and maintenance of psychopathology. The authors tested the hypotheses that the intensity of avoidance motivation is reduced by outpatient psychotherapy, that the intensity of avoidance motivation after therapy approaches normality, and that change in avoidance motivation is related to other kinds of therapy outcomes. Seventy-six outpatients completed a self-report measure of avoidance motivational goals before and after therapy. All hypotheses were confirmed. Explorative analyses found differential patterns of change of avoidance motivational goals as well as relationships with psychotherapy outcomes. The authors discuss the role of avoidance motivation in psychotherapy practice and research and outline areas for future research.

  20. [What place is there for psychotherapy in public psychiatry?]. (United States)

    Kramer, U; Ambresin, G; de Roten, Y; Fassassi, S; Hedjal, A; Herrera, F; Kolly, S; Pomini, V; Preisig, M; Despland, J-N


    The question of the place of psychotherapy in psychiatric public care is posed in this article. We will address this question first by presenting two clinical and research programmes which were implemented in a clinical psychiatric unit, section Karl Jaspers (Service of General Psychiatry) of the Department of Psychiatry CHUV, in Lausanne with the collaboration of the University Institute of Psychotherapy. The first one puts forward psychodynamic psychotherapy of depressed inpatients; the clinical programme and the research questions on efficacy of this treatment are discussed. The second focuses on the early treatment of patients with Borderline Personality Disorder, in particular in its research question on the effect of the motive-oriented therapeutic relationship in this process. We conclude by underlining the convergences of the two programmes.

  1. Virtual reality as a new imaginative tool in psychotherapy. (United States)

    Vincelli, F; Riva, G


    Imagination, experience and memory play a central role in psychotherapy. These elements are fundamental in the life of everyone but also in the etiology of many psychological disturbance. Thanks to Virtual Reality (VR) it is possible to transcend the absolute and relative limits linked to individual potential. The imagines re-created through VR may be more vivid and real than the one that most subjects are able to describe through their own imagination and their own memory. In this chapter we focus the attention on imaginative techniques to find new ways of applications in psychotherapy. We will explore the way VR can be used to improve the efficacy of traditional techniques. VR produces a change with respect to the traditional relationship between client and therapist. Virtual experiences is a third way between "in imagination" and "in vivo" techniques in psychotherapy.


    Directory of Open Access Journals (Sweden)

    Ferran Burgal Juanmartí


    Full Text Available The main objective of this investigation is the efficacy comparison of the different psychotherapies for Borderline Personality Disorder (BPD, with the aim of analyzing and understanding which therapies obtain better results and why. To this end, a systematic review was carried out on the current psychotherapies for BPD. First of all, the results showed that the psychotherapies most used for BPD were Dialectical Behavior Therapy (DBT, Mentalization-Based Treatment (MBT and Schema-Based Therapy (SBT, among others, and all of them were efficacious. It should be noted that each of these therapies, as shown in the results, was efficacious in treating various symptoms, such as parasuicidal behavior control, however, some aspects such as emotional regulation were still resistant to treatment in many cases. Therefore, further investigations should be carried out to include elements of emotional regulation and measuring their efficacy.

  3. Psychotherapy Experiences of Perpetrators of Child Sexual Abuse. (United States)

    Thomas, Sandra P; Phillips, Kenneth D; Blaine, Susan K


    Cynicism about treatment of sex offenders pervades both professional and lay literature. A Cochrane review of randomized controlled trials concluded there is no evidence to support any psychological intervention for sex offenders, but RCT design has limitations for evaluating sex offender treatment. Rarely has a qualitative approach been used to explore perceptions of offenders themselves about their psychotherapy experiences. The purpose of this study was to discover the meaning of therapy experiences to 11 community-dwelling perpetrators of child sexual abuse. They had received therapy during incarceration or after release, or both. Secondary analysis was conducted of phenomenological interviews about participants' early life, during which they spontaneously revealed insights gleaned during therapy in adulthood. Rigor of the analysis was enhanced by reading transcripts aloud and thematizing them in an interdisciplinary interpretive group. Five interrelated themes constituted a gestalt comprising the essence of the therapy experience: "This treatment, it's just totally changed my whole world." Themes included: "It just stripped away all the pretense, all the lies, all the manipulation;" "I didn't understand myself; I found out all about myself through this;" "Nobody knew any of my secrets; that (therapy) was the first time that I got to tell my story;" "The group has become a family for me;" and "I'm very ashamed of what I've done; this treatment has really helped me, gave me a second chance." These findings stand in contrast to cynicism about sex offender therapy and lend support to the increased optimism expressed by several contemporary scholars. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Basics of the ascetical (christian) psychotherapy. (United States)

    Ilievski, N


    It is obvious that contemporary man is suffering. His sufferings often seem pointless and causeless. Modern science more and more comes to reveal and acknowledge that human sufferings have a psychosomatic basis. In some of the cases, these sufferings are noogenic neuroses. They do not originate from the psychological dimension but from the noological or spiritual one of human existence. The pointlessness of life is the basic cause for the noogenic neurosis and depression from which the humankind suffers. e. Hence, the many escapes from such experienced reality into various addictions. Possible way towards healing is to retrieve one's meaning of life, to strengthen his will to meaning. Religion has always been - and still remains - a powerful and appealing purpose that fulfills the life and being of the believers. This article demonstrates the systematization of the spiritual development of a person presented in a table of the harmony of the ascetic-hesychastic struggle, according which everyone can find his place on the ladder of spiritual development, become aware, and reconciliate the mode of personal struggle according to his spiritual development. The reconciliation of the primary function of the mind with its secondary function - the intellect, is of an essential importance. Contemporary religious psychology do not regard man merely as a biological or a psychological being. The subject matter of research is the human being as a whole, as a spiritual person that is characterized by autonomy, regarding the biological and psychological processes. The importance of understanding the spiritual level of human existence enables holistic approach and experiencing of the human personality as a whole. Furthermore, it offers new perspectives of psychotherapeutic action not only within the range of the classical psychotherapeutic modalities but also within the range of the applied Christian Psychotherapy.

  5. Art Therapy Strategies to Raise Self-Esteem in Female Juvenile Offenders: A Comparison of Art Psychotherapy and Art as Therapy Approaches (United States)

    Hartz, Liz; Thick, Lynette


    This exploratory, quasi-experimental study compared the impact of 2 art therapy approaches on the self-esteem of 27 female juvenile offenders. Participants took part in an art psychotherapy or an art as therapy group intervention. Self-esteem was measured with a questionnaire designed by the authors and the Harter Adolescent Self-Perception…

  6. The renewal of humanism in European psychotherapy: developments and applications. (United States)

    Längle, Alfried A; Kriz, Jürgen


    In Europe, humanistic psychotherapy is becoming increasingly widespread. Not only are the explicitly "humanistic" psychotherapies being robustly used, they are increasingly being integrated into approaches not traditionally viewed as humanistic. One can therefore observe a progression in the personalization of methodology within European modes of practice. In the past several decades, humanistic psychology has inspired the expanding use of existential-phenomenological modes of practice. This theoretical base, coupled with recent trends in person-centered systems theory, points toward an invigorating future for humanistic forms of practice in Europe, despite the political trends toward psychotherapeutic practice in Germany. (c) 2012 APA, all rights reserved.

  7. Spiritual energy of Islamic prayers as a catalyst for psychotherapy. (United States)

    Henry, Hani M


    Islamic prayers can produce spiritual energy that may yield many psychological benefits, such as amelioration of stress and improvement in subjective well-being, interpersonal sensitivity, and mastery. Islamic prayers can also be integrated into mainstream therapeutic interventions with religious Muslim clients, and this integration can mobilize, transform, and invigorate the process of psychotherapy. This paper provides methods that can be used for the explicit integration of Islamic prayers into traditional psychotherapy. Further, the paper offers strategies for avoiding potential pitfalls that may hamper this process. Finally, a case study illustrating this therapeutic integration and its psychological benefits will be presented.

  8. Benefits and Challenges of Conducting Psychotherapy by Telephone


    Brenes, Gretchen A.; Ingram, Cobi W.; Danhauer, Suzanne C.


    Telephone-delivered psychotherapy has increased utility as a method of service delivery in the current world, where a number of barriers, including economic hardships and limited access to care, may prevent people from receiving the treatment they need. This method of service provision is practical and has the potential to reach large numbers of underserved people in a cost-effective manner. The aim of this paper is to review the state-of-the-art of telephone-delivered psychotherapy and to id...

  9. Psychotherapy: Adaptation or Walking Together? (A Roadside Conversation

    Directory of Open Access Journals (Sweden)

    Nina Bychkova


    Full Text Available The article concerns psychotherapeutic work in the perspective of existential approach. Two trends are discerned in modern psychotherapy regardless of the known division into different schools – the adaptation therapy, and the one viewing a person in the context of his Personal being in the world. Therapy here is understood as the Way of mutual personal growth of both the therapist and the client. Distinction is singled out as one of the central points in forming the meanings, essential for both the normal development of a child and in psychotherapy, and remaining significant for spiritual growth in adults. 

  10. The relationship between the therapeutic alliance and treatment outcome in two distinct psychotherapies for chronic depression. (United States)

    Arnow, Bruce A; Steidtmann, Dana; Blasey, Christine; Manber, Rachel; Constantino, Michael J; Klein, Daniel N; Markowitz, John C; Rothbaum, Barbara O; Thase, Michael E; Fisher, Aaron J; Kocsis, James H


    This study tested whether the quality of the patient-rated working alliance, measured early in treatment, predicted subsequent symptom reduction in chronically depressed patients. Secondarily, the study assessed whether the relationship between early alliance and response to treatment differed between patients receiving cognitive behavioral analysis system of psychotherapy (CBASP) vs. brief supportive psychotherapy (BSP). 395 adults (57% female; Mage = 46; 91% Caucasian) who met criteria for chronic depression and did not fully remit during a 12-week algorithm-based, open-label pharmacotherapy trial were randomized to receive either 16-20 sessions of CBASP or BSP in addition to continued, algorithm-based antidepressant medication. Of these, 224 patients completed the Working Alliance Inventory-Short Form at Weeks 2 or 4 of treatment. Blind raters assessed depressive symptoms at 2-week intervals across treatment using the Hamilton Rating Scale for Depression. Linear mixed models tested the association between early alliance and subsequent symptom ratings while accounting for early symptom change. A more positive early working alliance was associated with lower subsequent symptom ratings in both the CBASP and BSP, F(1, 1236) = 62.48, p alliance and psychotherapy type was significant, such that alliance quality was more strongly associated with symptom ratings among those in the CBASP treatment group, F(1, 1234) = 8.31, p = .004. The results support the role of the therapeutic alliance as a predictor of outcome across dissimilar treatments for chronic depression. Contrary to expectations, the therapeutic alliance was more strongly related to outcome in CBASP, the more directive of the 2 therapies. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  11. A delay-discounting measure of preference for racial/ethnic matching in psychotherapy. (United States)

    Swift, Joshua K; Callahan, Jennifer L; Tompkins, Kelley A; Connor, Dana R; Dunn, Rose


    In this study, we sought to compare racial/ethnic minority participants' preference for racial/ethnic matching in psychotherapy with preferences for other methods of addressing cultural factors in treatment. Using a delay-discounting method, college students (331 racial/ethnic minority students from 2 universities) and a nationwide sample of self-reported clients (n = 77) were asked to indicate their strength of preference for 4 different methods for addressing culturally related variables in psychotherapy, including a desire to (a) work with a therapist whose race/ethnicity matches their own, (b) work with a therapist with a high level of multicultural training and experience, (c) receive a culturally adapted treatment, and (d) receive a therapist who is also a member of a racial/ethnic minority group, but not the same as the participant (i.e., a racial/ethnic minority pairing). We found that participants were willing to make significant sacrifices in treatment efficacy in order to receive each of the variables tested. In both samples, preferences were significantly stronger for therapist multicultural training/experience and use of culturally adapted treatments compared with racial/ethnic matching and racial/ethnic minority pairing. Further analyses indicated that clients expressed stronger preferences for racial/ethnic match and minority pairing than college student participants, and preference strength for 3 of the 4 scenarios was significantly related to strength of minority culture identification. The results of this study have important implications for preference accommodation in psychotherapy with racial/ethnic minority individuals. (c) 2015 APA, all rights reserved).

  12. [Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program]. (United States)

    Krischer, Maya; Ponton-Rodriguez, Tamara; Gooran, Ghazal Rostami; Bender, Stephan


    Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program This paper focuses on the concept of transference focused psychotherapy (TFP) modified for juvenile borderline patients. Adolescents with borderline developmental personality disorder (bpd) have an essential deficit in their personality structure that leads to oscillations in their self-esteem and in a "split" perception of the world. They suffer from a variety of symptoms and severe impairments on their own and their families' quality of life. Their fragmented perception of themselves and others make relationships almost unbearable for them. Relationships are mostly marked by severe anxiety of resentment and rejection. For these patients this causes intolerable trouble at school where every day conflicts take place. Self-mutilation and suicidal thoughts often seem the only way out. By now, there is an agreement that an early specialized assessment and treatment is necessary in order to stop the typical consequences of their self-mutilative and dysfunctional behavior. Still, in contrast to adult age, empirical evidence is missing which proves the effectiveness of treating adolescent borderline patients. In this paper we present a research project on the effectiveness of transference focused psychotherapy with adolescent borderline patients (TFP-A) in a day clinic setting, combining TFP with group skills training as known from dialectic behavior therapy (DBT). Furthermore, we give first results on analyzing the effectiveness of our day clinic treatment program based on TFP-A, focusing on improving core symptoms such as affective problems, aggressive behavior against self and others and interpersonal problems.

  13. Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy: protocol of a randomised controlled trial. (United States)

    Kok, Robin N; van Straten, Annemieke; Beekman, Aartjan; Bosmans, Judith; de Neef, Manja; Cuijpers, Pim


    Phobic disorders are highly prevalent and constitute a considerable burden for patients and society. As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics, this time can be used for guided self-help interventions. The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric outpatients, as well as the cost-effectiveness of this pre-treatment waiting list intervention. A randomised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders. Patients suffering from at least one DSM-IV classified phobic disorder (social phobia, agoraphobia or specific phobia) are randomly allocated (at a 1:1 ratio) to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy, or a control group followed by face-to-face psychotherapy. Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy. Clinical and economic self-assessment measurements take place at baseline, post-test (five weeks after baseline) and at 3, 6, 9 and 12 months after baseline. Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction. Patients are expected to need fewer face-to-face sessions, reducing total treatment cost and increasing speed of recovery. Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as demand for outpatient treatment increases while budgets decrease. Netherlands Trial Register NTR2233.

  14. Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy: protocol of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Kok Robin N


    Full Text Available Abstract Background Phobic disorders are highly prevalent and constitute a considerable burden for patients and society. As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics, this time can be used for guided self-help interventions. The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric outpatients, as well as the cost-effectiveness of this pre-treatment waiting list intervention. Methods/design A randomised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders. Patients suffering from at least one DSM-IV classified phobic disorder (social phobia, agoraphobia or specific phobia are randomly allocated (at a 1:1 ratio to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy, or a control group followed by face-to-face psychotherapy. Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy. Clinical and economic self-assessment measurements take place at baseline, post-test (five weeks after baseline and at 3, 6, 9 and 12 months after baseline. Discussion Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction. Patients are expected to need fewer face-to-face sessions, reducing total treatment cost and increasing speed of recovery. Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as demand for outpatient treatment increases while budgets decrease. Trial registration Netherlands Trial Register NTR2233

  15. Cognitive-behavioural psychotherapy and alopecia areata

    Directory of Open Access Journals (Sweden)

    Marta Kuty-Pachecka


    Full Text Available Alopecia areata (also known as spot baldness is a disease with multifactorial aetiology, including genetic, hormonal, autoimmune and  psychological factors as well as nervous system disorders. This disorder belongs to  the group of dermatological conditions modified by psychological factors. Clinical experience indicates that stress and psychological aspects contribute significantly to the onset and/or exacerbation of alopecia areata. Pharmacological treatment of this dermatosis is often ineffective or insufficient. Therefore, a holistic approach to the disease, including both medical and  psychological aspects, is  crucial. It  is  emphasised in  the subject literature that some forms of  psychotherapy and pharmacotherapy used in patients with alopecia areata improve their psychophysical condition, and, consequently, stimulate the regrowth of their hair. Research has shown that cognitive-behavioural therapy complements dermatological treatment of alopecia areata, improving the quality of life of patients. The aim of cognitive and behavioural techniques is, on the one hand, to change the maladaptive negative convictions about oneself, the world, and the disease, and, on the other hand, to acquire the ability to cope with negative emotional states and difficult situations, such as a disease. The aim of the paper is to present the results of a literature review on the efficiency of pharmacotherapy and the role of cognitive-behavioural therapy in alopecia areata.

  16. Tracking Functional Brain Changes in Patients with Depression under Psychodynamic Psychotherapy Using Individualized Stimuli (United States)

    Wiswede, Daniel; Taubner, Svenja; Buchheim, Anna; Münte, Thomas F.; Stasch, Michael; Cierpka, Manfred; Kächele, Horst; Roth, Gerhard; Erhard, Peter; Kessler, Henrik


    Objective Neurobiological models of depression posit limbic hyperactivity that should normalize after successful treatment. For psychotherapy, though, brain changes in patients with depression show substantial variability. Two critical issues in relevant studies concern the use of unspecific stimulation experiments and relatively short treatment protocols. Therefore changes in brain reactions to individualized stimuli were studied in patients with depression after eight months of psychodynamic psychotherapy. Methods 18 unmedicated patients with recurrent major depressive disorder were confronted with individualized and clinically derived content in a functional MRI experiment before (T1) and after eight months (T2) of psychodynamic therapy. A control group of 17 healthy subjects was also tested twice without intervention. The experimental stimuli were sentences describing each participant's dysfunctional interpersonal relationship patterns derived from clinical interviews based on Operationalized Psychodynamic Diagnostics (OPD). Results At T1 patients showed enhanced activation compared to controls in several limbic and subcortical regions, including amygdala and basal ganglia, when confronted with OPD sentences. At T2 the differences in brain activity between patients and controls were no longer apparent. Concurrently, patients had improved significantly in depression scores. Conclusions Using ecologically valid stimuli, this study supports the model of limbic hyperactivity in depression that normalizes after treatment. Without a control group of untreated patients measured twice, though, changes in patients' brain activity could also be attributed to other factors than psychodynamic therapy. PMID:25275317

  17. The Treatment of Nonmelancholic Depression: When Antidepressants Fail, Does Psychotherapy Work? (United States)

    Parker, Gordon; Graham, Rebecca; Sheppard, Elizabeth


    Objective: Treatment-resistant depression (TRD) is used as a descriptive or diagnostic term and has generated many management guidelines weighting antidepressant (AD) therapy, but which may be an inappropriate paradigm for the nonmelancholic disorders where psychotherapy may be a more salient modality. This study sought to evaluate the effectiveness of psychological therapy in patients whose nonmelancholic depressive condition had been resistant to at least 2 ADs. Method: Principal analyses compared 32 patients, diagnosed with a nonmelancholic depression who received 12 weeks of psychological therapy, with a small control group. Comparative analyses failed to find a distinct therapeutic effect, leading to an extension study pursuing candidate explanatory factors for this lack of response, including psychosocial factors. Results: While our sample showed a 41% response and 22% remission rate to psychotherapy, their improvement pattern was similar to the control group, thus arguing against any specific therapeutic benefit. Explanatory factors nominated by the treating psychologist weighted personality issues for 35% of the patients, distal stressors for 22%, and comorbid anxiety conditions for 18%. When sample members were compared with an age- and sex-matched sample of patients with nonmelancholic depression who improved distinctly during a similar 12-week period, rates of such putative personality, stress, and anxiety risk factors did not differ, arguing against the likelihood of these factors compromising improvement. Conclusions: Patients with nonmelancholic TRD also failed to demonstrate a clear response to a psychotherapeutic approach, while our pursuit of clinically explanatory variables was not supported empirically. PMID:25004496

  18. Misuse of Statistical Tests in Three Decades of Psychotherapy Research. (United States)

    Dar, Reuven; And Others


    Reviews misuse of statistical tests in psychotherapy research studies published in "Journal of Consulting and Clinical Psychology" in 1967-68, 1977-78, and 1987-88. Focuses on inappropriate uses of null hypotheses tests and p values, neglect of effect size, and inflation of Type I error rate. Concludes with practical suggestions for rational…

  19. [Psychotherapy in somatic diseases--for example gastrointestinal disorders]. (United States)

    Moser, Gabriele


    The functional gastrointestinal disorders (FGID) are the most frequent clinical conditions seen in practice. Up to 60% of these patients is also suffering from psychosocial problems. Therefore it is important to define the patient's complaints in terms of a biopsychosocial disorder, to acknowledge the relevance of the psychosocial aspects and to provide an integrated psychosomatic treatment or a psychotherapy if indicated. Most of the research on psychotherapy in FGID to date has focused on the irritable bowel syndrome and different methods of treatments were studied (e.g., cognitive-behavioral therapy, dynamic psychotherapy, hypnotherapy, and relaxation). Randomised controlled studies have shown that psychotherapy is superior to conventional medical therapy. Hypnotherapy is successful not only for irritable bowel syndrome but also for functional dyspepsia. Predictors of a positive response to psychological treatment generally are: (1) awareness that stress exacerbates their bowel symptoms, (2) at least mild anxiety or depression, (3) the predominant bowel symptom is abdominal pain or diarrhea and not constipation, (4) the abdominal pain waxes and wanes in response to eating, defecation, or stress rather than being constant pain, and 5) the symptoms are of relatively short duration. Benefits persist over years, and in the long run, clinic visits and health care costs can be reduced.

  20. Integrating Spirituality into Counselling and Psychotherapy: Theoretical and Clinical Perspectives (United States)

    Daniels, Carla; Fitzpatrick, Marilyn


    In recent decades, spirituality has become a prominent focus of psychological inquiry. As research begins to elucidate the role of spiritual beliefs and behaviours in mental health and the influences of spirituality in psychotherapy, developing therapist competency in this domain has increased in importance. This article will first situate…

  1. Interpersonal Psychotherapy for Postpartum Depression : A Treatment Program




    Postpartum depression is a frequent complication of childbirth. Postpartum depression is associated with disruptions in interpersonal relationships, and the puerperium is a period of major role transition. In contrast to other subtypes of depression, however, postpartum depression often is not treated with medication, which is relatively contraindicated for women who are breastfeeding. Interpersonal psychotherapy (IPT) focuses specifically on the effects of depression on interp...

  2. Integrating Expressive Methods in a Relational-Psychotherapy

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine


    Full Text Available Therapeutic Involvement is an integral part of all effective psychotherapy.This article is written to illustrate the concept of Therapeutic Involvement in working within a therapeutic relationship – within the transference -- and with active expressive and experiential methods to resolve traumatic experiences, relational disturbances and life shaping decisions.

  3. The Intersystem Model of Psychotherapy: An Integrated Systems Treatment Approach (United States)

    Weeks, Gerald R.; Cross, Chad L.


    This article introduces the intersystem model of psychotherapy and discusses its utility as a truly integrative and comprehensive approach. The foundation of this conceptually complex approach comes from dialectic metatheory; hence, its derivation requires an understanding of both foundational and integrational constructs. The article provides a…

  4. Psychotherapy for Peace and Conflict Resolution | Olowu | IFE ...

    African Journals Online (AJOL)

    Psychotherapy is any form of psychological treatment for behavioural or emotional problems. Peace and Conflict resolution are current and relevant issues in contemporary societies. This paper attempts to present psychotherapeutic techniques for dealing with hostility, resentment, manipulation, sexual harassment, ...

  5. Evidence-Based Youth Psychotherapy in the Mental Health Ecosystem (United States)

    Weisz, John R.; Ugueto, Ana M.; Cheron, Daniel M.; Herren, Jenny


    Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…

  6. Inherent Self, Invented Self, Empty Self: Constructivism, Buddhism, and Psychotherapy (United States)

    McWilliams, Spencer A.


    Constructivist and Buddhist approaches to counseling and psychotherapy share increasing popularity as well as similar epistemological assumptions and understanding of human dysfunction and its amelioration. These approaches can be seen as consistent with postmodern psychology, which is distinguished from a realist or foundationalist view. This…

  7. Implementing Interpersonal Psychotherapy in a Psychiatry Residency Training Program (United States)

    Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen


    Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…

  8. The Practice of Psychotherapy in Mexico: Past and Present (United States)

    Stark, Marcella D.; Frels, Rebecca K.; Chavez, Rafael Reyes; Sharma, Bipin


    This article explores the history of psychotherapy in Mexico and describes past and current practices of psychological services, training, and supervision for Mexican international students in the United States. Sample curricula, texts, and universities in Mexico are listed. Implications for training underscore the importance of collaboration and…

  9. Effectiveness of Child Psychoanalytic Psychotherapy in a Clinical Outpatient Setting (United States)

    Deakin, Elisabeth Kuhn; Tiellet Nunes, Maria Lucia


    The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6-11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All…

  10. Psychosis and the dynamics of the psychotherapy process

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Harder, Susanne


    The role of psychotherapy in the treatment of psychoses remains controversial but there is improving acceptance that an understanding of the dynamics of the psychological processes involved in treatment and in the disorder itself may be important. Psychosis is understood as a detachment...



    Divac Jovanovic, Mirjana; Svrakic, Dragan


    In this paper, we outline the concept of integrative therapy of borderline personality, also referred to as fragmented personality, which we consider to be the core psychopathology underlying all clinical subtypes of personality disorder. Hence, the terms borderline personality, borderline disorder, fragmented personality, and personality disorder are used interchangeably, as synonyms. Our integrative approach combines pharmacotherapy and psychotherapy, each specifically tailored to ...

  12. Gestalt psychotherapy in the outpatient treatment of borderline ...

    African Journals Online (AJOL)

    improved functioning, significantly reduced problems of social adjustment and communication, as well as a tendency of engagement in close personal relationships and increased levels of trust. The feelings of deprivation and the role of. Gestalt psychotherapy in the outpatient treatment of borderline personality disorder: a ...

  13. Addressing Anger Using Sensorimotor Psychotherapy and Cognitive Behaviour Therapy (United States)

    Flynn, Sarah M.


    A young woman initiated counselling services at a community agency to address her explosive anger that was a remnant of childhood physical and emotional abuse. Sensorimotor psychotherapy was used to help this client learn how to monitor and regulate her sensorimotor processes. In conjunction with this approach, Cognitive behavioural therapy was…

  14. Counselling and Psychotherapy in Dialogue with Complementary and Alternative Medicine (United States)

    Lees, John


    Counselling and psychotherapy is attracting government interest and intervention, for instance the proposal to regulate the profession by the Health Professions Council. Many therapists see this as a threat to its fundamental principles due to the fact that government policy is influenced by the medical model and managerialism. This article looks,…

  15. Contemporary ethical dilemmas in psychotherapy: cosmetic psychopharmacology and managed care. (United States)

    Sperry, L; Prosen, H


    Two contemporary ethical dilemmas facing psychotherapists have been noted and described: cosmetic psychopharmacology and the practice of psychotherapy in a managed care environment. Regarding cosmetic psychopharmacology: It was noted that whether a psychotherapist endorses the use of psychotropic agents for cosmetic purposes, such as self-transformation, seems to be a function of the severity of the client/patient symptoms as well as the psychotherapist's view of human nature and the human condition. However, recent research indicates that certain traits or reflections of the human condition, such as irritability, may actually be neurotransmitter deficiencies that are responsive not only to psychotropic agents but also to non-drug interventions. These findings add an additional dimension to discussions of the ethics of cosmetic psychopharmacology. Regarding psychotherapy in a managed care environment: Several ethical dilemmas, including confidentiality, were discussed. These dilemmas were outlined rather than analyzed in detail. Some of them will become major "thorns" of concern for the practice of psychotherapy. Others will be less consequential. Of critical concern is that limitations by managed care on the technique and optimal length of treatment of psychotherapy can conceivably lessen its efficacy for some patients and could possibly eliminate this powerful treatment procedure for others.

  16. Making connections and thinking through emotions: between geography and psychotherapy


    Bondi, Liz


    The current upsurge of interest in emotions within geography has the potential to contribute to critical perspectives that question conventional limits to scholarship. Three precursors of emotional geographies are discussed in this context (humanistic, feminist and non-representational geographies). Connections between emotional geographies and psychotherapy are explored with a view to resisting the equation of emotion with individualised subjective experience, and developing s...

  17. The efficacy of long-term psychotherapy: Methodological research issues

    NARCIS (Netherlands)

    Maat, S.M.; Dekker, J.J.M.; Schoevers, R.A.; Jonghe, de F.


    In evidence-based medicine (EBM) hierarchy, randomized controlled trials (RCTs) are ranked higher than cohort studies. However, cohort intervention studies are frequently, and RCTs rarely, used to investigate long-term psychotherapy (LTP). The authors compare the two methods and provide critical

  18. Cognitive Behavioral Analysis System of Psychotherapy for Chronic Depression (United States)

    Arnow, Bruce A.


    Cognitive Behavioral Analysis System of Psychotherapy (CBASP) was developed specifically for the chronically depressed patient. CBASP has been shown to be as efficacious as medication singly, and in combination with antidepressant medication is associated with notably high response rates in chronic depression. CBASP's core procedure, "situational…

  19. Psychotherapy: Unity In Diversity | Ofovwe | IFE PsychologIA

    African Journals Online (AJOL)

    While some psychotherapies are archeological in nature; exploring the unconscious for meaning for the conscious, others are active and problem focused, some are uncovering while some supportive, some uphold existential principles while some are empirically driven, the list seems endless. Despite these seemingly ...

  20. Breaking through to Teens: Psychotherapy for the New Adolescence (United States)

    Taffel, Ron


    This book presents groundbreaking strategies for psychotherapy with today's teens, for whom high-risk behavior, lack of adult guidance, and intense anxiety and stress increasingly come with the territory. Ron Taffel addresses the key challenge of building a therapeutic relationship that is strong enough to promote real behavioral and emotional…

  1. Neurocognitive psychotherapy for adult attention deficit hyperactive disorder

    Directory of Open Access Journals (Sweden)

    Susmita Halder


    Full Text Available Previously thought as a childhood disorder, attention-deficit hyperactivity disorder (ADHD is reported to be spreading at an increasing rate and affecting 4% to 5% of the adult population. It is characterized by persistent problems of inattention, hyperactivity and impulsivity. We present the case of an adult ADHD patient intervened with neurocognitive psychotherapy.

  2. [Bioethics and psychotherapy: which moral assumptions sustain psychotherapeutical acts?]. (United States)

    Figueroa, Gustavo


    Since about 1970 biomedical ethics crystallized into a full-fledged discipline. The so called "ethical turn" is a fundamental conceptual challenge for the field of medicine and has generated heated controversy. Today, the ancient psychotherapeutic framework is under the severest strain in its long history. To review the relationship between psychotherapy and the conceptual shift in moral theory. To forge a new model for the patient-physician relationship, speech acts and nature of man derived from a "pragmatic turn" of bioethics. Research findings suggest that behavior, cognitive and psychodynamic psychotherapies are speech-acts constituted by a hierarchy of subordinate acts distributed on three levels: the level of the locutionary act, the act of saying; the level of the illocutionary act (or force), what we do in saying and the level of the perlocutionary act, what we provoke by the fact that we speak. Advances in linguistic research have led to a more sophisticated understanding of how psychotherapy affects ethical issues. These developments point towards a new era of psychotherapeutical theory and practice in which specific modes of psychotherapy can be designed to target specific dilemmas of medical ethics.

  3. Gestalt psychotherapy in the outpatient treatment of borderline ...

    African Journals Online (AJOL)

    psychotherapy for patients with BPD has been the treatment of choice.1,2 A number of papers show the use ... irritability was prominent, the behavior was unpredictable, impulsive, not constructive, and the risk of .... sleep and increased demand and intake of specific food items. (fruit juices and milk). In addition, he started ...

  4. The Use of Digital Narratives to Enhance Counseling and Psychotherapy (United States)

    Pillay, Yegan


    Technological advances have impinged on every aspect of contemporary phenomenological experiences, including counseling and psychotherapy. The author explores the intersection of narrative therapy, specifically the traditional memory book, with the advances in information technology in the formulation of the digital memory book. The digital memory…

  5. Transforming Losses―A Major Task of Spiritually Integrated Psychotherapy

    National Research Council Canada - National Science Library

    Frick, Eckhard


    .... True consolation connects the individual and the archetypical mourning. Spiritually integrated psychotherapy may accompany this process by amplification. Christian mysticism takes its starting point from the experience of Jesus Christ's lost body, and this may be understood as a model of spiritual transformation.

  6. [Review of several different forms of psychotherapy in treatment of depression]. (United States)

    Zogg, W


    The present article endeavours to introduce, in a concise form, selected forms of psychotherapy for the treatment of depressions. In particular behaviour therapy (BT), cognitive therapy (CT), interpersonal psychotherapy (IPT) and a psychoanalytically oriented and inspired therapy, subsequently named psychodynamic therapy (PT), are described. The attempt to offer a brief presentation of these treatment methods follows essentially the descriptions of Elizabeth Schramm in her book "Interpersonelle Psychotherapie". We thank the author for giving her kind consent to our publication. Our main concern is to enable the reader to recognize the essential characteristics and differences between these treatment forms, so that he can give the depressive patient advice on the choice of an adequate treatment. The first three brief psychotherapies have been developed specifically for the treatment of depressions. The psychodynamically (psychoanalytically) oriented approach is the most frequently used. CT, BT and IPT in particular have in common that they offer a temporally limited, clearly structured treatment programme in the sense of a manual, and are thus teachable and conveyable and efficient with respect to costs. We would point out, however, that combinations between the different treatment forms are possible and that a strict distinction between the separate methods is chiefly of didactic value. Essential to all treatment methods is the empathic and supporting relation to the patient. The therapist should play an active role and should convey the hope that the patient can be helped. All the described treatment forms are suited for the treatment of light to moderately severe depressions, with or without concomitant psychopharmacological therapy. In psychodynamic therapy the tendency is to dispense with medication, whereas CB, CT and IPT tend to integrate the use of psychoactive drugs in their treatment schedules. In our opinion psychopharmacological treatment should on no

  7. Abandono de psicoterapia com crianças Child psychotherapy dropout

    Directory of Open Access Journals (Sweden)

    Elisabeth Kuhn Deakin


    Full Text Available OBJETIVO: Comparar uma amostra de 24 crianças que completaram 12 meses de psicoterapia psicanalítica com uma amostra de 38 crianças que interromperam prematuramente o tratamento. MÉTODO: Trata-se de um estudo quantitativo em dois grupos de crianças; tratamento quase-experimental de medida única antes do início da psicoterapia psicanalítica individual. RESULTADOS: Foram encontradas diferenças estatisticamente significantes nas seguintes variáveis: sexo, sintomas, frequência dos atendimentos, capacidade da criança de controlar as emoções e os impulsos, medida pelo teste Rorschach e nas escalas de sociabilidade, queixas somáticas e comportamentos internalizantes, tais como ansiedade e depressão, medidas pelo Child Behavior Checklist. CONCLUSÕES: Este estudo revelou que a psicoterapia psicanalítica é efetiva no tratamento da criança do sexo feminino que apresenta transtornos internalizantes, tais como ansiedade e depressão, tem maior descontrole de emoções e impulsos e recebe atendimento com uma frequência de duas vezes por semana por pelo menos 12 meses.OBJECTIVE: To compare a sample of 24 children who completed 12 months of psychoanalytical psychotherapy with a sample of 38 children who dropped out from treatment before 12 months of intervention. METHOD: Quantitative study involving two groups of children. Quasi-experimental treatment of single measure before the beginning of individual psychoanalytical psychotherapy. RESULTS: Statistically significant differences were found in the following variables: gender, symptoms, frequency of sessions, child's impulse and emotion control (measured using the Rorschach test and sociability scales, somatic complaints and internalizing behaviors, such as anxiety and depression (measured using the Child Behavior Checklist. CONCLUSIONS: CThe results revealed that child psychoanalytical psychotherapy is effective in the treatment of female children with internalizing disorders, such as

  8. [Psychoanalysis and psychoanalytic oriented psychotherapy: differences and similarities]. (United States)

    Rössler-Schülein, Hemma; Löffler-Stastka, Henriette


    Psychoanalysis as well as Psychoanalytic Psychotherapy derived from Psychoanalysis are efficient methods offered by the Austrian health care system in the treatment for anxiety, depression, personality disorders, neurotic and somatoform disorders. In both methods similar basic treatment techniques are applied. Therefore differentiation between both treatment options often is made pragmatically by the frequency of sessions or the use of the couch and seems to be vague in the light of empirical studies. This overview focuses a potential differentiation-the objective and subjective dimensions of the indication process. Concerning the latter it is to investigate, if reflective functioning and ego-integration can be enhanced in the patient during the interaction process between patient and psychoanalyst. Empirical data underline the necessity to investigate to which extent externalizing defence processes are used and to integrate such factors into the decision and indication process. Differing treatment aims display another possibility to differentiate psychoanalysis and psychoanalytic psychotherapy. Psychoanalytic psychotherapy aims for example more at circumscribed problem-foci, the capability for self-reflexion is one of the most prominent treatment effects in psychoanalysis that results in on-going symptom reduction and resilience. The most prominent differentiation lies in the utilization of technical neutrality. Within Psychoanalytic Psychotherapy neutrality has sometimes to be suspended in order to stop severe acting out. Empirical evidence is given concerning the differentiation between psychoanalysis and psychoanalytic psychotherapy, that treatment efficacy is not correlated with the duration of the treatment, but with the frequency of sessions. Results give support to the assumption that the dosage of specific and appropriate psychoanalytic techniques facilitates sustained therapeutic change.

  9. Content Coding of Psychotherapy Transcripts Using Labeled Topic Models. (United States)

    Gaut, Garren; Steyvers, Mark; Imel, Zac E; Atkins, David C; Smyth, Padhraic


    Psychotherapy represents a broad class of medical interventions received by millions of patients each year. Unlike most medical treatments, its primary mechanisms are linguistic; i.e., the treatment relies directly on a conversation between a patient and provider. However, the evaluation of patient-provider conversation suffers from critical shortcomings, including intensive labor requirements, coder error, nonstandardized coding systems, and inability to scale up to larger data sets. To overcome these shortcomings, psychotherapy analysis needs a reliable and scalable method for summarizing the content of treatment encounters. We used a publicly available psychotherapy corpus from Alexander Street press comprising a large collection of transcripts of patient-provider conversations to compare coding performance for two machine learning methods. We used the labeled latent Dirichlet allocation (L-LDA) model to learn associations between text and codes, to predict codes in psychotherapy sessions, and to localize specific passages of within-session text representative of a session code. We compared the L-LDA model to a baseline lasso regression model using predictive accuracy and model generalizability (measured by calculating the area under the curve (AUC) from the receiver operating characteristic curve). The L-LDA model outperforms the lasso logistic regression model at predicting session-level codes with average AUC scores of 0.79, and 0.70, respectively. For fine-grained level coding, L-LDA and logistic regression are able to identify specific talk-turns representative of symptom codes. However, model performance for talk-turn identification is not yet as reliable as human coders. We conclude that the L-LDA model has the potential to be an objective, scalable method for accurate automated coding of psychotherapy sessions that perform better than comparable discriminative methods at session-level coding and can also predict fine-grained codes.

  10. Specific vs nonspecific factors in psychotherapy. A controlled study of outcome. (United States)

    Strupp, H H; Hadley, S W


    This study explored the relative contribution of the therapist's technical skills and the qualities inherent in any good human relationship to outcome in time-limited individual psychotherapy. Highly experienced psychotherapists treated 15 patients drawn from a relatively homogeneous patient population (male college students, selected primarily on the basis of elevations on the depression, anxiety, and social introversion scales of the Minnesota Multiphasic Personality Inventory). By traditional diagnostic categories, they would be classified as neurotic depression or anxiety reactions. Obsessional trends and borderline personalities were common. A comparable patient group was treated by college professors chosen for their ability to form understanding relationships. Patients treated by professors showed, on the average, as much improvement as patients treated by professional therapists. Treated groups slightly exceeded the controls. Group means, however, obscured considerable individual variability.

  11. Changes in Prefrontal-Limbic Function in Major Depression after 15 Months of Long-Term Psychotherapy (United States)

    Buchheim, Anna; Viviani, Roberto; Kessler, Henrik; Kächele, Horst; Cierpka, Manfred; Roth, Gerhard; George, Carol; Kernberg, Otto F.; Bruns, Georg; Taubner, Svenja


    Neuroimaging studies of depression have demonstrated treatment-specific changes involving the limbic system and regulatory regions in the prefrontal cortex. While these studies have examined the effect of short-term, interpersonal or cognitive-behavioural psychotherapy, the effect of long-term, psychodynamic intervention has never been assessed. Here, we investigated recurrently depressed (DSM-IV) unmedicated outpatients (N = 16) and control participants matched for sex, age, and education (N = 17) before and after 15 months of psychodynamic psychotherapy. Participants were scanned at two time points, during which presentations of attachment-related scenes with neutral descriptions alternated with descriptions containing personal core sentences previously extracted from an attachment interview. Outcome measure was the interaction of the signal difference between personal and neutral presentations with group and time, and its association with symptom improvement during therapy. Signal associated with processing personalized attachment material varied in patients from baseline to endpoint, but not in healthy controls. Patients showed a higher activation in the left anterior hippocampus/amygdala, subgenual cingulate, and medial prefrontal cortex before treatment and a reduction in these areas after 15 months. This reduction was associated with improvement in depressiveness specifically, and in the medial prefrontal cortex with symptom improvement more generally. This is the first study documenting neurobiological changes in circuits implicated in emotional reactivity and control after long-term psychodynamic psychotherapy. PMID:22470470

  12. Do changes on MCMI-II personality disorder scales in short-term psychotherapy reflect trait or state changes? (United States)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin


    The Millon Clinical Multiaxial Inventory (MCMI) has become an important and commonly used instrument to assess personality functioning. Several studies report significant changes on MCMI personality disorder scales after psychological treatment. The aim of the study was to investigate whether pre-post-treatment changes in 39-session psychodynamic group psychotherapy as measured with the MCMI reflect real personality change or primarily reflect symptomatic state changes. Pre-post-treatment design included 236 psychotherapy outpatients. Personality changes were measured on the MCMI-II and symptomatic state changes on the Symptom Check List 90-R (SCL-90-R). The MCMI Schizoid, Avoidant, Self-defeating, and severe personality disorder scales revealed substantial changes, which could be predicted from changes on SCL-90-R global symptomatology (GSI) and on the SCL-90-R Depression scale. The MCMI Dependent personality score was the only MCMI personality scale showing significant change when the SCL-90-R Depression change score was included as a covariate. Splitting patients into those with and without personality disorders did not change the results. Observed changes on MCMI-II personality disorder scales in short-term psychotherapy reflect change in symptomatic state. The MCMI-II Base Rate cut-off points probably include too many patients, justifying the introduction of new scoring procedures in the MCMI-III.

  13. Mood and Global Symptom Changes among Psychotherapy Clients with Depressive Personality

    Directory of Open Access Journals (Sweden)

    Rachel E. Maddux


    Full Text Available The present study assessed the rate of depressive personality (DP, as measured by the self-report instrument depressive personality disorder inventory (DPDI, among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.

  14. Interpersonal psychotherapy versus brief supportive therapy for depressed infertile women: first pilot randomized controlled trial. (United States)

    Koszycki, Diana; Bisserbe, Jean-Claude; Blier, Pierre; Bradwejn, Jacques; Markowitz, John


    Infertility is strongly associated with depression, yet treatment research for depressed infertile women is sparse. This study tested for the first time the feasibility and preliminary efficacy of interpersonal psychotherapy (IPT), the evidence-based antidepressant intervention with the greatest peripartum research support, as treatment for depressed women facing fertility problems. Patients who met DSM-IV criteria for major depressive disorder of at least moderate severity were randomized to either 12 sessions of IPT (n = 15) or brief supportive psychotherapy (BSP; n = 16), our control intervention. Eighty percent of IPT and 63 % of BSP patients completed the 12 sessions of therapy. Patients in both treatments improved. IPT produced a greater response rate than BSP, with more than two-thirds of women achieving a >50 % reduction in scores on the Montgomery-Åsberg Depression Rating Scale (MADRS). IPT also tended to have lower posttreatment scores on the Beck Depression Inventory, Clinical Global Impression-Severity Scale, and anxiety subscale of the Hamilton Depression Rating Scale, with between-group effect sizes ranging from 0.61 to 0.76. Gains persisted at 6-month follow-up. This pilot trial suggests that IPT is a promising treatment for depression in the context of infertility and that it may fare better than a rigorous active control condition. Should subsequent randomized controlled trials support these findings, this will inform clinical practice and take an important step in assuring optimal care for depressed women struggling with infertility.

  15. Attenuation of Frontostriatal Connectivity During Reward Processing Predicts Response to Psychotherapy in Major Depressive Disorder. (United States)

    Walsh, Erin; Carl, Hannah; Eisenlohr-Moul, Tory; Minkel, Jared; Crowther, Andrew; Moore, Tyler; Gibbs, Devin; Petty, Chris; Bizzell, Josh; Smoski, Moria J; Dichter, Gabriel S


    There are few reliable predictors of response to antidepressant treatments. In the present investigation, we examined pretreatment functional brain connectivity during reward processing as a potential predictor of response to Behavioral Activation Treatment for Depression (BATD), a validated psychotherapy that promotes engagement with rewarding stimuli and reduces avoidance behaviors. Thirty-three outpatients with major depressive disorder (MDD) and 20 matched controls completed two runs of the monetary incentive delay task during functional magnetic resonance imaging after which participants with MDD received up to 15 sessions of BATD. Seed-based generalized psychophysiological interaction analyses focused on task-based connectivity across task runs, as well as the attenuation of connectivity from the first to the second run of the task. The average change in Beck Depression Inventory-II scores due to treatment was 10.54 points, a clinically meaningful response. Groups differed in seed-based functional connectivity among multiple frontostriatal regions. Hierarchical linear modeling revealed that improved treatment response to BATD was predicted by greater connectivity between the left putamen and paracingulate gyrus during reward anticipation. In addition, MDD participants with greater attenuation of connectivity between several frontostriatal seeds, and midline subcallosal cortex and left paracingulate gyrus demonstrated improved response to BATD. These findings indicate that pretreatment frontostriatal functional connectivity during reward processing is predictive of response to a psychotherapy modality that promotes improving approach-related behaviors in MDD. Furthermore, connectivity attenuation among reward-processing regions may be a particularly powerful endophenotypic predictor of response to BATD in MDD.

  16. Amygdala response to self-critical stimuli and symptom improvement in psychotherapy for depression. (United States)

    Doerig, Nadja; Krieger, Tobias; Altenstein, David; Schlumpf, Yolanda; Spinelli, Simona; Späti, Jakub; Brakowski, Janis; Quednow, Boris B; Seifritz, Erich; Holtforth, Martin Grosse


    Cognitive-behavioural therapy is efficacious in the treatment of major depressive disorder but response rates are still far from satisfactory. To better understand brain responses to individualised emotional stimuli and their association with outcome, to enhance treatment. Functional magnetic resonance imaging data were collected prior to individual psychotherapy. Differences in brain activity during passive viewing of individualised self-critical material in 23 unmedicated out-patients with depression and 28 healthy controls were assessed. The associations between brain activity, cognitive and emotional change, and outcome were analysed in 21 patients. Patients showed enhanced activity in the amygdala and ventral striatum compared with the control group. Non-response to therapy was associated with enhanced activity in the right amygdala compared with those who responded, and activity in this region was negatively associated with outcome. Emotional but not cognitive changes mediated this association. Amygdala hyperactivity may lessen symptom improvement in psychotherapy for depression through attenuating emotional skill acquisition. © The Royal College of Psychiatrists 2016.

  17. [Treatment for chronic depression: cognitive behavioral analysis system of psychotherapy (CBASP)]. (United States)

    Wiersma, J E; van Schaik, D J F; Blom, M B J; Bakker, L; van Oppen, P; Beekman, A T F


    Chronic depression is a common disorder in secondary care. Treatment results for this group of depressed patients are often disappointing and the existing treatment protocols are insufficiently tailored to chronic MDD. For this reason, an effective psychotherapeutic treatment will constitute a welcome addition to the range of treatments currently available for chronically depressed patients. To describe 'cognitive behavioral analysis system of psychotherapy' (CBASP), the first form of psychotherapy specifically designed for the treatment of chronic depression. This article describes the evidence, rational and the most important techniques of CBASP. In the United States CBASP has proven to be effective in one trial. As a result of these findings, CBASP is recommended in the Dutch treatment guidelines as an evidence-based treatment option for chronic depression. However, the findings have not yet been replicated and little is known about possible ways of implementing CBASP in the Netherlands. For this reason a randomised controlled trial on the effectiveness of CBASP has started in three psychiatric hospitals in the Netherlands. CBASP is recommended as a treatment option for chronic depression in the Dutch treatment guidelines, but evidence should be further supported by additional research.


    Markowitz, John C.; Lipsitz, Joshua; Milrod, Barbara L.


    Background Interpersonal psychotherapy (IPT) has demonstrated efficacy in treating mood and eating disorders. This article critically reviews outcome research testing IPT for anxiety disorders, a diagnostic area where cognitive behavioral therapy (CBT) has dominated research and treatment. Methods A literature search identified six open and five controlled trials of IPT for social anxiety disorder (SAD), panic disorder, and posttraumatic stress disorder. Results Studies were generally small, underpowered, and sometimes methodologically compromised. Nonetheless, minimally adapted from its standard depression strategies, IPT for anxiety disorders yielded positive results in open trials for the three diagnoses. In controlled trials, IPT fared better than waiting list (N = 2), was equipotent to supportive psychodynamic psychotherapy (N = 1), but less efficacious than CBT for SAD (N = 1), and CBT for panic disorder (N = 1) in a methodologically complicated study. IPT equaled CBT in a group residential format (N = 1). Conclusions IPT shows some promise for anxiety disorders but has thus far shown no advantages in controlled trials relative to other therapies. Methodological and ecological issues have complicated testing of IPT for anxiety disorders, clouding some findings. The authors discuss difficulties of conducting non-CBT research in a CBT-dominated area, investigator bias, and the probable need to further modify IPT for anxiety disorders. Untested therapies deserve the fairest possible testing. Depression and Anxiety 00:1–10, 2014. PMID:24493661

  19. Critical review of outcome research on interpersonal psychotherapy for anxiety disorders. (United States)

    Markowitz, John C; Lipsitz, Joshua; Milrod, Barbara L


    Interpersonal psychotherapy (IPT) has demonstrated efficacy in treating mood and eating disorders. This article critically reviews outcome research testing IPT for anxiety disorders, a diagnostic area where cognitive behavioral therapy (CBT) has dominated research and treatment. A literature search identified six open and five controlled trials of IPT for social anxiety disorder (SAD), panic disorder, and posttraumatic stress disorder. Studies were generally small, underpowered, and sometimes methodologically compromised. Nonetheless, minimally adapted from its standard depression strategies, IPT for anxiety disorders yielded positive results in open trials for the three diagnoses. In controlled trials, IPT fared better than waiting list (N = 2), was equipotent to supportive psychodynamic psychotherapy (N = 1), but less efficacious than CBT for SAD (N = 1), and CBT for panic disorder (N = 1) in a methodologically complicated study. IPT equaled CBT in a group residential format (N = 1). IPT shows some promise for anxiety disorders but has thus far shown no advantages in controlled trials relative to other therapies. Methodological and ecological issues have complicated testing of IPT for anxiety disorders, clouding some findings. The authors discuss difficulties of conducting non-CBT research in a CBT-dominated area, investigator bias, and the probable need to further modify IPT for anxiety disorders. Untested therapies deserve the fairest possible testing. © 2014 Wiley Periodicals, Inc.

  20. Post-traumatic growth in adult survivors of brain injury: a qualitative study of participants completing a pilot trial of brief positive psychotherapy. (United States)

    Karagiorgou, Olga; Evans, Jonathan J; Cullen, Breda


    Post-traumatic growth (PTG) can occur following acquired brain injury (ABI). It has been proposed that people experiencing psychological distress following ABI may benefit from a positive psychotherapy intervention (PPT) aimed at increasing well-being; PPT may also influence PTG. We aimed to investigate PTG experiences in participants of a positive psychotherapy pilot trial. ABI survivors who had received PPT or treatment as usual (TAU) were interviewed individually after the end of the trial. Thematic analysis was conducted, to code transcripts for known themes from PTG literature as well as newly emerging themes. Four participants (age = 46-62; n = 3 male; months since injury = 11-20) from the PPT group and three (age = 58-74; n = 2 male; months since injury = 9-22) from the TAU group were interviewed. Six themes were shared across both groups: personal strength, appreciation of life, relating to others, optimism/positive attitude, feeling fortunate compared to others, and positive emotional/behavioral changes. Two themes were expressed by PPT participants only: lifestyle improvements and new possibilities. One TAU participant reported spiritual change. A greater understanding of the development of PTG following ABI may help rehabilitation clinicians to promote better adjustment by focusing on clients' potential for positive change and enhancing their capacity for growth. Implications for Rehabilitation Post-traumatic growth is "positive psychological change experienced as the result of the struggle with highly challenging life circumstances." This is the first qualitative investigation of post-traumatic growth in participants in a positive psychotherapy trial following acquired brain injury. Several post-traumatic growth themes were shared by participants from the positive psychotherapy and treatment as usual study arms, with additional themes evident only in positive psychotherapy participants. A greater understanding of post

  1. Social Problem Solving and Depressive Symptoms over Time: A Randomized Clinical Trial of Cognitive-Behavioral Analysis System of Psychotherapy, Brief Supportive Psychotherapy, and Pharmacotherapy (United States)

    Klein, Daniel N.; Leon, Andrew C.; Li, Chunshan; D'Zurilla, Thomas J.; Black, Sarah R.; Vivian, Dina; Dowling, Frank; Arnow, Bruce A.; Manber, Rachel; Markowitz, John C.; Kocsis, James H.


    Objective: Depression is associated with poor social problem solving, and psychotherapies that focus on problem-solving skills are efficacious in treating depression. We examined the associations between treatment, social problem solving, and depression in a randomized clinical trial testing the efficacy of psychotherapy augmentation for…

  2. Therapists' group attachments and their expectations of patients' attitudes about group therapy. (United States)

    Marmarosh, Cheri L; Franz, Victoria A; Koloi, Mosetsanagape; Majors, Rebekah C; Rahimi, Amanda M; Ronquillo, Jonne G; Somberg, Rachel J; Swope, Jessica S; Zimmer, Katherine


    A large body of literature has supported the application of attachment theory to the understanding of psychotherapy. In addition, a more recent social psychological literature is exploring the application of attachment theory to the area of group dynamics and group process. The current study is designed to integrate these two distinct bodies of literature. In a preliminary fashion, we examined the relationship between group therapists' group attachment styles and their assumptions and expectations of their patients' attitudes about group psychotherapy. Seventy-six therapists completed the Smith, Murphy & Coats (1999) measure of group attachment style. They also completed the Revised Group Therapy Survey (Carter, Mitchell, & Krautheim, 2001) from the viewpoint of a typical patient they treat. As hypothesized, therapists with more group attachment anxiety assumed that patients would hold more negative myths and misconceptions about group treatment than therapists with less group attachment anxiety. The utility of a group attachment construct in future research and practice is discussed.

  3. Effect of Disorder-Specific vs Nonspecific Psychotherapy for Chronic Depression: A Randomized Clinical Trial. (United States)

    Schramm, Elisabeth; Kriston, Levente; Zobel, Ingo; Bailer, Josef; Wambach, Katrin; Backenstrass, Matthias; Klein, Jan Philipp; Schoepf, Dieter; Schnell, Knut; Gumz, Antje; Bausch, Paul; Fangmeier, Thomas; Meister, Ramona; Berger, Mathias; Hautzinger, Martin; Härter, Martin


    Chronic depression is a highly prevalent and disabling disorder. There is a recognized need to assess the value of long-term disorder-specific psychotherapy. To evaluate the efficacy of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared with that of nonspecific supportive psychotherapy (SP). A prospective, multicenter, evaluator-blinded, randomized clinical trial was conducted among adult outpatients with early-onset chronic depression who were not taking antidepressant medication. Patients were recruited between March 5, 2010, and October 16, 2012; the last patient finished treatment on October 14, 2013. Data analysis was conducted from March 5, 2014, to October 27, 2016. The treatment included 24 sessions of CBASP or SP for 20 weeks in the acute phase, followed by 8 continuation sessions during the next 28 weeks. The primary outcome was symptom severity after 20 weeks (blinded observer ratings) as assessed by the 24-item Hamilton Rating Scale for Depression (HRSD-24). Secondary outcomes were rates of response (reduction in HRSD-24 score of ≥50% from baseline) and remission (HRSD-24 score ≤8), as well as self-assessed ratings of depression, global functioning, and quality of life. Among 622 patients assessed for eligibility, 268 were randomized: 137 to CBASP (96 women [70.1%] and 41 men [29.9%]; mean [SD] age, 44.7 [12.1] years) and 131 to SP (81 women [61.8%] and 50 men [38.2%]; mean [SD] age, 45.2 [11.6] years). The mean (SD) baseline HRSD-24 scores of 27.15 (5.49) in the CBASP group and 27.05 (5.74) in the SP group improved to 17.19 (10.01) and 20.39 (9.65), respectively, after 20 weeks, with a significant adjusted mean difference of -2.51 (95% CI, -4.16 to -0.86; P = .003) and a Cohen d of 0.31 in favor of CBASP. After 48 weeks, the HRSD-24 mean (SD) scores were 14.00 (9.72) for CBASP and 16.49 (9.96) for SP, with an adjusted difference of -3.13 (95% CI, -5.01 to -1.25; P = .001) and a Cohen d of 0.39. Patients undergoing

  4. Manualized supportive-expressive psychotherapy versus nonmanualized community-delivered psychodynamic therapy for patients with personality disorders: bridging efficacy and effectiveness. (United States)

    Vinnars, Bo; Barber, Jacques P; Norén, Kristina; Gallop, Robert; Weinryb, Robert M


    Time-limited manualized dynamic psychotherapy was compared with community-delivered psychodynamic therapy for outpatients with personality disorders. In a stratified randomized clinical trial, 156 patients with any personality disorder diagnosis were randomly assigned either to 40 sessions of supportive-expressive psychotherapy (N=80) or to community-delivered psychodynamic therapy (N=76). Assessments were made at intake and 1 and 2 years after intake. Patients were recruited consecutively from two community mental health centers (CMHCs), assessed with the Structural Clinical Interview for DSM-IV Axis II Personality Disorders, and included if they had a diagnosis of any DSM-IV personality disorder. The outcome measures included the presence of a personality disorder diagnosis, personality disorder severity index, level of psychiatric symptoms (SCL-90), Global Assessment of Functioning Scale score, and number of therapy sessions. General mixed-model analysis of variance was used to assess group and time effects. In both treatment conditions, the global level of functioning improved while there were decreases in the prevalence of patients fulfilling criteria for a personality disorder diagnosis, personality disorder severity, and psychiatric symptoms. There was no difference in effect between treatments. During the follow-up period, patients who received supportive-expressive psychotherapy made significantly fewer visits to the CMHCs than the patients who received community-delivered psychodynamic therapy. Manualized supportive-expressive psychotherapy was as effective as nonmanualized community-delivered psychodynamic therapy conducted by experienced dynamic clinicians.

  5. The impact of gender on treatment effectiveness of body psychotherapy for negative symptoms of schizophrenia: A secondary analysis of the NESS trial data. (United States)

    Savill, Mark; Orfanos, Stavros; Bentall, Richard; Reininghaus, Ulrich; Wykes, Til; Priebe, Stefan


    Despite promising findings from small-scale studies suggesting that body psychotherapy may be an effective treatment for negative symptoms, these results were not replicated in a recent multisite trial. In this trial a far smaller proportion of women were recruited relative to earlier studies, which may be an issue given the gender mix of the sample evaluated has been found to affect trial outcomes in schizophrenia. Using data from our multisite trial, the interaction between gender and treatment allocation as a predictor of outcomes was examined in 275 participants (72 women and 203 men) randomised to either a body psychotherapy or Pilates group. Negative symptoms were found to significantly reduce in women randomised to the body psychotherapy condition in comparison to Pilates, while no such effect was detected in men. Consistent with the smaller trials, this improvement was found to relate predominantly to expressive deficits. These findings suggest that body psychotherapy may be an effective treatment for negative symptoms in women. These findings emphasise the importance of sample characteristics in determining trial outcome in psychological treatment studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Spiritual and Religious Issues in Psychotherapy with Schizophrenia: Cultural Implications and Implementation

    Directory of Open Access Journals (Sweden)

    Uma Chandrika Millner


    Full Text Available The topics of spirituality and psychotherapy have often been controversial in the literature on schizophrenia treatment. However, current research indicates many potential benefits of integrating issues of religion and spirituality into psychotherapy for individuals with schizophrenia. In this paper, implications are presented for incorporating spiritual and religious issues in psychotherapy for individuals with schizophrenia. A background on the integration of spirituality into the practice of psychotherapy is discussed. The literature on spiritually-oriented psychotherapy for schizophrenia is provided. Clinical implications are offered with specific attention to issues of religious delusions and cultural considerations. Lastly, steps for implementing spiritually-oriented psychotherapy for individuals with schizophrenia are delineated to assist providers in carrying out spiritually sensitive care.

  7. Hidden points of view in cross-cultural psychotherapy and ethnography. (United States)

    Krause, Inga-Britt


    This article examines the challenges posed by cross-cultural psychotherapy in a creolized world, and the way this intersects with issues faced by the ethnographer. It proposes 'the relational subject,' implicit in systemic psychotherapy and social anthropology, as a framework for an understanding of communication. In cross-cultural psychotherapy, this assumption is central to non-discriminatory and equitable treatment. Drawing on Bateson's ethnographic work, the article connects 'the relational subject' to what Bateson, following Whitehead, called 'the fallacy of misplaced concreteness' and later referred to as 'context.' The article examines the choices of 'context' first in ethnography and systemic psychotherapy and then in Bateson's own analysis of the Naven ritual. It is suggested that cross-cultural psychotherapy is psychotherapy in which the therapist keeps in mind, both her own and her client's contexts. This means an assessment of process (performative aspects) as well as content (semiotic aspects) and attention to 'moments' rather than longer sequences in the therapy.

  8. Disagreement between therapist raters and independent evaluators in a controlled clinical trial of interpersonal psychotherapy for depressed pregnant women. (United States)

    Spinelli, Margaret G; Endicott, Jean; Goetz, Raymond R


    The randomized controlled trial in which both the patient and the treating clinician are kept blinded to the treatment is the "gold standard" for treatment research assignment. However, in psychotherapy research, evaluations can only be single blind; thus, such studies are inherently more limited. A 12-week, bilingual, parallel-design, controlled clinical treatment trial compared interpersonal psychotherapy for antepartum depression (IPT-P) with a parenting education program (PEP) provided to a control group. An outpatient sample of 142 women who met DSM-IV criteria for major depressive disorder was randomly assigned to IPT-P or PEP between September 2005 and May 2011. Only 110 cases were assessed at baseline and had at least 1 other treatment week of paired ratings by a therapist and a blinded independent evaluator (IE). The 17-item Hamilton Depression Rating Scale and the Clinical Global Impressions Scale were administered weekly by a therapist and every 4 weeks by a blinded IE. We examined cross-informant agreement on ratings of mood and global improvement and severity. Nonblinded therapists consistently rated the IPT-P treatment group as more improved than the PEP control group throughout treatment, whereas the ratings by the blinded IE were significantly higher than the therapist ratings, indicating less improvement in the IPT-P group compared with the control group. The ratings suggest that rater bias may have caused the therapist raters to perceive subjects as more improved because of the expectation that IPT-P would be more effective than the PEP control condition. Ratings in psychotherapy research must be made by anonymous participation in treatment and an independent clinical evaluator who is blind to all therapy.

  9. Psychotherapy Participants Show Increased Physiological Responsiveness to a Lab Stressor Relative to Matched Controls


    Patrick R Steffen; Louise eFidalgo; Dominic eSchmuck; Yoko eTsui; Tracy eBrown


    Accumulating evidence indicates that psychotherapy participants show increased physiological responsiveness to stress. The purpose of the present study was to examine differences between individuals participating in outpatient psychotherapy and matched controls using an experimental design. Forty-two psychotherapy participants and forty-eight matched controls were assessed on cardiovascular and cortisol functioning at baseline, during the Trier Social Stress Test (TSST), and during a twenty-m...

  10. Aaron Temkin BECK: After Cricitical Thinking to A Creative Psychotherapy Theory


    Mehmet DÝNÇ


    There is growing interest in the cognitive psychotherapy all around the world including Turkey. According to American Institute of cognitive Therapy; cognitive psychotherapy is the fastest growing and most rigorously studied kind of talk therapy and it is practiced around the world, taking hold in places from the Middle East to Japan. Cognitive psychotherapy was designed first by Aaron Temkin Beck in 1950’s. He has published over 450 articles and authored or co-authored seventeen books a...

  11. Aaron Temkin BECK: After Cricitical Thinking to A Creative Psychotherapy Theory


    DİNÇ, Mehmet


    There is growing interest in the cognitive psychotherapy all around the world including Turkey. According to American Institute of Cognitive Therapy; cognitive psychotherapy is the fastest growing and most rigorously studied kind of talk therapy and it is practiced around the world, taking hold in places from the Middle East to Japan. Cognitive psychotherapy was designed first by Aaron Temkin Beck in 1950’s. He has published over 450 articles and authored or co-authored sevent...

  12. Buddhist psychology, psychotherapy and the brain: a critical introduction. (United States)

    Kelly, Brendan D


    Buddhist psychology is increasingly informing psychotherapeutic practice in the western world. This article: (a) provides a general background to Buddhist tradition; (b) outlines the central tenets of Buddhist psychology, with particular emphasis on the practice of meditation; (c) provides an overview of research into the effects of Buddhist practice on the brain; (d) outlines the relationships between Buddhist psychology and existing forms of psychotherapy; (e) provides an overview of Buddhist approaches to specific psychiatric disorders and the psychological aspects of physical disorders; and (f) discusses the emergence of Buddhist psychotherapy in western societies and explores likely future developments. There is a need for further research into the neuroscientific correlates of Buddhist concepts of mind and the evidence-base for the use of specific techniques (e.g., meditation) in psychotherapeutic practice.

  13. Social Integration as Professional Field: Psychotherapy in Sweden

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    Eva Johnsson


    Full Text Available The present article describes and analyses the emergence and development of a professional field called social integration. Ideas, theories, and occupational practices forming this field are explored, particularly those related to the development of a new discipline, that of psychotherapy. The development of three occupations (psychiatry, psychology and social work and their professionalisation is described through their qualitative and quantitative take‑offs in particular historical periods. Three periods are identified: formation, 1850-1920, when psychiatry was defined as a medical sub-discipline; consolidation, 1920-1945, with the institutionalisation of psychiatric care, and with psychoanalysis and mental hygiene as qualitatively new cognitive bases for practitioners; and professionalisation, 1945-1980, with the deinstitutionalisation of psychiatric care and the professionalisation of psychologists and social workers. New ideas on subjectivity and individualism, new welfare state institutions, as well as collaborative professionalism all favoured the creation of psychotherapy as professional knowledge, and a possible new profession of psychotherapists.

  14. Keeping psychotherapy notes separate from the patient record. (United States)

    DeLettre, Julie L; Sobell, Linda Carter


    Doctoral level psychologists (N = 464) who were members of the American Psychological Association and who identified themselves as clinical practitioners were surveyed about their knowledge and utilization of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule that allows practitioners to keep their psychotherapy notes separate from their patients' records if they involve electronic submissions. Although 79% of those surveyed said they were aware of the HIPAA privacy rule allowing for a separate set of notes, slightly less than half (46%) reported currently using such notes even though half (49%) felt that patients benefit most from the use of a separate set of psychotherapy notes. Surprisingly, 21% said they had never heard of the HIPAA provision allowing for a separate set of notes. Considering that when this provision was introduced it was heralded as a major benefit for mental health practitioners, its low utilization is surprising. Perhaps clinical practitioners would benefit from continuing education about the benefits of such notes.

  15. Learning from traumatic experiences with brief eclectic psychotherapy for PTSD

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    Berthold P. R. Gersons


    Full Text Available Brief eclectic psychotherapy for PTSD (BEPP is an evidence-based therapeutic approach that combines and integrates elements from psychodynamic, cognitive-behavioral, and directive psychotherapy. Psychoeducation is done jointly with the patient and his or her partner. Exposure, a structured writing task, and memorabilia are used to help patients accessing, feeling and expressing their suppressed emotions related to the traumatic experience. In the domain of meaning stage, patients will learn how they and their view of the world have changed, and that they have become “sadder but wiser”. Much emphasis is put on the vulnerability of human beings. Finally, an individually tailored farewell ritual is done to end treatment, to reunite with loved ones, and to go on with life.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  16. Psychosynthesis: a transpersonal model for hypnotically mediated psychotherapy. (United States)

    Appel, Philip R


    Psychosynthesis is one of the first Western transpersonal models of personality and psychotherapy. It was developed in 1910 by the Italian psychiatrist Roberto Assagioli. In this article, basic constructs involving the realms of consciousness, subpersonalities, and the importance of the will, and the neo-Jungian functions, will be introduced and related to the practice of hypnotically mediated psychotherapy. That which makes this model unique is its recognition of the human spirit and how that impacts consciousness and its inclusion as an important element to be included in therapy. A guideline for selecting interventions based upon the patient's symptom will be described as well as a discussion of some of the therapy techniques associated with this model.

  17. Functional analytic psychotherapy: a behavioral relational approach to treatment. (United States)

    Tsai, Mavis; Yard, Samantha; Kohlenberg, Robert J


    Functional analytic psychotherapy (FAP) is a relational approach to psychotherapy that is behavioral, yet involves an intensive, emotional, and in-depth therapy experience. FAP is approachable by therapists of diverse theoretical backgrounds owing to the minimal use of behavioral jargon, and can be used as an addition or complement to other interventions. The methods described in this article-being aware of clients' clinically relevant behaviors, being courageous in evoking clinically relevant behaviors, reinforcing improvements with therapeutic love, using behavioral interpretations to help clients generalize changes to daily life, and providing intensive and personal experiential training of FAP practitioners-maximize the impact of the therapeutic relationship to promote change and personal growth for both clients and therapists. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  18. Outcomes of psychotherapy from the perspective of the users. (United States)

    Valkonen, Jukka; Hanninen, Vilma; Lindfors, Olavi


    Psychotherapy is widely held to be an effective means to decrease depression. It seems, however, that not everyone benefits from every kind of therapy, and the relevant outcomes vary from person to person. In this article, the pre-therapy views and post-therapy experiences of 14 users of either long-term psychodynamic psychotherapy or short-term solution-focused therapy are analyzed. The interviewees' personal views about their depression and therapy are approached with the concept of inner narrative. Three "basic stories" or orientations were found: life historical, situational and moral. These offered people different contexts from which to evaluate the outcomes of their therapy. The findings suggest that a person's expectations, hopes and values are worth taking into account to ensure positive therapy outcomes.

  19. Psychotherapy for Borderline Personality Disorder: Progress and Remaining Challenges. (United States)

    Links, Paul S; Shah, Ravi; Eynan, Rahel


    The main purpose of this review was to critically evaluate the literature on psychotherapies for borderline personality disorder (BPD) published over the past 5 years to identify the progress with remaining challenges and to determine priority areas for future research. A systematic review of the literature over the last 5 years was undertaken. The review yielded 184 relevant abstracts, and after applying inclusion criteria, 16 articles were fully reviewed based on the articles' implications for future research and/or clinical practice. Our review indicated that patients with various severities benefited from psychotherapy; more intensive therapies were not significantly superior to less intensive therapies; enhancing emotion regulation processes and fostering more coherent self-identity were important mechanisms of change; therapies had been extended to patients with BPD and posttraumatic stress disorder; and more research was needed to be directed at functional outcomes.

  20. Kant, cognitive psychotherapy, and the hardening of the categories. (United States)

    Nevid, Jeffrey S


    Contemporary models of psychotherapy owe a considerable intellectual debt to philosophy, even though the contributions of philosophers to contemporary practice in the field often go unrecognized. A case in point is Kant's epistemology, which is foundational to cognitive approaches to psychotherapy. Here, it is argued that the rigid use of certain judgments represented in Kant's conceptual scheme underlies patterns of distorted or dysfunctional thinking associated with emotional disorders. Kantian judgments of necessity, disjunction, particularity and universality have counterpoints in contemporary conceptions of cognitive distortions. Moreover, Kantian epistemology has important therapeutic implications with respect to helping people with emotional disorders recognize and challenge rigidly held judgments or categories of understanding. The Kantian perspective also leads us to consider the cognitive frameworks or thought structures that underlie dysfunctional thinking patterns.

  1. Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes. (United States)

    Barnett, Jeffrey E


    Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided.

  2. Psychotherapy practice and research. Repairing a strained alliance. (United States)

    Goldfried, M R; Wolfe, B E


    Although the gap between psychotherapy practice and research has been present for some time, recent pressures for accountability from outside the system-managed health care and biological psychiatry-necessitate that we take steps to close this gap. One such step has been for psychotherapy researchers to specify a list of empirically validated therapies. However, as researchers who also have a strong allegiance to clinical practice, we are concerned that the conceptual and methodological constraints associated with outcome research may become clinical constraints for the practicing therapist. We firmly believe that, more than ever before, the time is ripe for us to develop a new outcome research paradigm that involves an active collaboration between researcher and practicing clinician.



    Snežana Manojlović; Julijana Nikolić-Popović


    The group and analytically-oriented psychotherapy of schizoid patients shows some peculiarities springing from the characteristics of the schizoid process itself that necessarily impose certain modifications of the therapeutic goals in techniques.The aim of the paper is to determine precisely the specific effect of the illness process upon the group psychotherapy process, that is, implications upon the therapeutic engagement.The verbal therapeutic interventions in a small psycho therapeutic g...

  4. Practical tips for sexual counseling and psychotherapy in premature ejaculation. (United States)

    Rowland, David; Cooper, Stewart


    A number of milestones in the treatment of premature ejaculation (PE) have occurred over the past five decades, including the development of various behavioral and cognitive techniques as well as pharmacotherapies that modify neurophysiological processes involved in ejaculation. Nevertheless, the notion that sexual responses such as PE are influenced by physiological, psychobehavioral, cultural, and relationship factors is as valid now as it was 50 years ago, and therefore, interventions should consider all such domains in the development of effective treatment strategies. Provide an overview of which patients with PE are suitable to receive psychosexual treatment and the psychological approaches for managing this disorder. Review of the literature. Psychosexual treatments that integrate behavioral, psychological, and relationship functioning. PE is typically a couple's problem and, therefore, psychotherapy is best when the partner is involved. Before embarking on psychotherapy, the clinician should obtain a medical history pertaining to sexual-, psychological-, and relationship-related factors, so that the treatment strategy can be tailored to the needs of the individual. General strategies underpinning integrative, "process-oriented" elements of psychotherapy most relevant to PE are: developing the therapist-patient relationship; expressing empathy, genuineness, and positive regard; motivational interviewing, i.e., developing motivation to change; developing discrepancy; working through resistance; identifying PE-related affect, cognitions, and behaviors (including interaction with partners); and supporting self-efficacy. The four main domains that encompass psychotherapy techniques specific to the treatment of PE are: behavioral; cognitive; affective; and relational. Sustained positive outcomes in PE may be obtained using a combination treatment strategy that addresses all elements of PE, including psychological and biological factors. Psychosexual treatments

  5. Videoconference for psychotherapy training and supervision: two case examples. (United States)

    Rousmaniere, Tony; Abbass, Allan; Frederickson, Jon; Henning, Inés; Taubner, Svenja


    Psychotherapy supervision and training are now widely available online. However, many supervisors still may be unclear on how online supervision actually works, or what it actually looks like in practice. In this article, three case examples of online videoconference-based supervision programs will be described. Partial transcripts from two online supervision sessions are provided. The benefits and limitations of online supervision are discussed, including discussion of supervision process, ethics, privacy, and security.


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    Karina Aleksandrovna Melkumova


    Full Text Available The use of cognitive behavioral psychotherapy (CBPT methods in the treatment of patients with chronic pain is considered. Despite the existing difficulties in evaluating the efficiency of CBPT, numerous studies have shown good results when it is used both alone and as part of a multidisciplinary approach. The use of CBPT methods may be considered as an effective non-drug treatment for chronic back pain

  7. Nonrelativist ethical standards for goal setting in psychotherapy. (United States)

    Brace, Kerry


    In this article, I discuss two principles that can be viewed as universally applicable in psychotherapy and counseling: respect for clients' welfare and respect for their self-determination. Consideration of the practical application of these principles leads to the formulation of a set of guidelines to aid therapists and counselors in making choices about instrumental and end goals. These guidelines are intended to be applicable regardless of the particular personal and cultural values of the therapist and client.

  8. Towards a community psychotherapy for the contemporary mental disorders

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    Raffaele Barone


    Full Text Available The authors develop some reflections on the relationship between the emergence of new mental disorders and post-industrial society. They argue that the new social mandate of mental health professionals is to help the community to develop co-evolutionary practices for preventing and treating the fragmentation of psychic life that characterizes today's contexts of contemporary life.Keywords: Community psychotherapy; Contemporary mental disorders; Post-industrial society

  9. Equine-Assisted Psychotherapy: An Emerging Trauma-Informed Intervention


    Page Walker Buck; Nadine Bean; Kristen de Marco


    Equine-assisted psychotherapy (EAP) has emerged as a promising, evidence-based intervention for the treatment of trauma and stressor-related disorders. This experiential therapy offers an option for clients whose traumatic experiences render traditional talk therapies ineffective. Initial research on the most robust model of EAP, developed by the Equine Assisted Growth and Learning Association (EAGALA), indicates strong, positive effects for children, adolescents and adults who have experienc...

  10. [The theoretical basis of "process-oriented psychotherapy"]. (United States)

    Heretik, A; Simkovic, M


    Process-oriented psychotherapy /POP/ is an eclectic trend. It is based on Jungian psychology but is inspired also by some dynamic schools and oriental philosophy, in particular Taoism. The essence of the psychotherapeutic method is work with signals in the communication channels. By their reinforcement the personality attains contact with the secondary process behind the borderline of identity. In addition to psychopathological indications it uses somatic symptoms and diseases which are considered a purposeful message of the dream body.

  11. [Psychotherapies for the Treatment of Phantom Limb Pain]. (United States)

    Cárdenas, Katherine; Aranda, Mariana

    The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed. To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitization and reprocessing eye movements and hypnosis. The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitization and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomized trials are required. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. The application of attachment theory to a psychotherapy case



    M.A. The purpose of this study is to illustrate the psychotherapeutic use of Attachment Theory. Attachment Theory is an interpersonal theory which refers to the way an individual internalises an emotional-cognitive model of his relationships with his various attachment figures. These models of ways of relating are reflected in the way an individual speaks. The methodology of the study entailed conducting the semi-structured Adult Attachment Interview to elicit a psychotherapy client's narr...

  13. The effect of interpersonal psychotherapy on marriage adaptive and postpartum depression in Isfahan

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    Mahnaz Hajiheidari


    Conclusions: The findings of this research confirm marriage interpersonal psychotherapy on the depression recovery and the increasing marriage satisfaction of women suffering from postpartum depression.

  14. [What type of psychotherapy in the management of chronic pelvic and perineal pain?]. (United States)

    Picard-Destelan, M; Rigaud, J; Riant, T; Labat, J-J


    How to propose psychotherapy in a patient with chronic pelvic and perineal pain? Description of the psychological and behavioural profile of patients with chronic pelvic and perineal pain, the indications for proposing psychotherapy and the reasons for choosing a particular type of psychotherapy. Very few studies have analysed the impact of psychotherapy in the treatment of chronic pelvic and perineal pain and more extensive studies should be conducted. Advice concerning the modalities of referring a patient to a psychotherapist, based on a multidisciplinary approach. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  15. Reasons for dropping out of psychotherapy from psychotherapists’ points of view: a qualitative study

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    Habibolah Khazaie


    Full Text Available Background: dropping out of treatment is a common problem to providing psychotherapeutic services that can negatively affect the process. Exploration of the reasons for dropping out of psychotherapy is necessary to design specific intervention in this area. This study was aimed to explore the reasons for dropping out of psychotherapy from psychotherapists’ points of views. Methods: This qualitative content analysis study was conducted on 12 psychotherapists who were working in Kermanshah city. They were selected by purposeful sampling. Data were collected through semi-structured interviews. The taped interviews were transcribed and analyzed. Results: 5 main categories and 12 subcategories were extracted from the data. The main categories were financial problems in psychotherapy, incorrect beliefs and expectations toward psychotherapy, dual nature of psychotherapy, unprepared structure of education and supervision in psychotherapy, and inappropriate referral system in psychotherapy. Economic difficulties of clients, negative attitudes, poor supervision over psychotherapy, and inappropriate referral time were among the extracted subcategories. Conclusion: The results showed that there are economic, cultural and social aspects for dropping out of psychotherapy. These aspects are suggested to be taken into consideration in providing psychotherapeutic services.

  16. Can the use of humor in psychotherapy be taught? (United States)

    Valentine, Lisa; Gabbard, Glen O


    Despite an abundance of literature detailing the potential benefits of the use of humor in therapy, humor is rarely taught to psychiatric residents as a method of therapeutic intervention. This communication attempts to explain how current understanding of attachment theory and neuroscience may assist psychiatric faculty and supervisors in their teaching of humorous therapeutic interventions. This article reviews and synthesizes the extant literature on the use of humor, as well as recent work in neuroscience, attachment theory, and mentalization. Humor can be conceptualized as an instance of implicit relational knowing and may thus contribute significantly to the therapeutic action of psychotherapy as a subcategory of "moments of meeting" between therapist and patient. However, training residents to use humor in psychotherapy requires more individualized attention in supervision and classroom seminars. Factors such as individual proclivities for humorous repartee, mentalizing capacity, and an authentic interest in adding humor to the session may be necessary to incorporate spontaneous humor into one's technique. New findings from the areas of attachment theory, neuroscience, and right-hemisphere learning are providing potential opportunities for sophisticated teaching of the use of humor in psychotherapy.

  17. Incorporation of massage into psychotherapy: an integrative and conjoint approach. (United States)

    Posadzki, Paul; Parekh-Bhurke, Sheetal


    This article presents the potential integration of psychotherapy and massage when considering the essence of their beneficial effects. The essence of this model of practice is multifaceted, combining principles from anatomy, physiology and neuroscience with psychotherapy to benefit patient care. It has been advocated that possessing multidisciplinary knowledge from these areas of science enhances psychotherapists' holistic care of their depressive patients. A narrative review of the literatures and a qualitative, conceptual synthesis has been performed to create a new theoretical-pragmatic construct. This article introduces the concept of massage practice as a part of psychotherapy practice and presents the potential integration of psychotherapeutic knowledge with clinical decision-making and the management of depressive symptoms. The authors emphasize the usefulness of multi- and interdisciplinary knowledge in the psychotherapeutic process and explain how this knowledge might be extrapolated and incorporated into theoretical and practical settings to benefit depressive patients. The justification for this concept is also presented. The principles set out in this article may be a useful source of information for psychotherapists concerned about their patients' holistic well-being in addition to the psychopathology for which they have sought treatment. Researchers and psychotherapists can obtain valuable and additional knowledge through cross-fertilization of ideas across the arguments presented here.

  18. The future of psychotherapy outcome research: science or political rhetoric? (United States)

    Peebles, J


    Although the relationship between research and clinical psychology has at times been conflicted, it has also been productive. Psychologists from both specialties have benefited from each others' work. The area of psychotherapy outcome research represents an important interface between the fields of clinical and research psychology. In an era of scarce resources and demands for accountability, there is pressure for researchers to justify the value of clinical practices. Recently, numerous articles have appeared recommending changes to the way psychotherapy research is conducted. The authors of these articles emphasize with urgency the importance of conducting and reporting research in a manner that will influence the decisions of policymakers and sanction funding for psychotherapy services. This article is an exploration of the impact of these recommendations, whose objective appears to be the promotion of psychological techniques for inclusion in clinical practice guidelines. It is argued that such recommendations may be in conflict with the philosophy and methods of science and may adversely affect public perception, perhaps leading psychologists to be seen as political lobbyists rather than clinicians and researchers.

  19. Issues of spirituality and religion in psychotherapy supervision. (United States)

    Bienenfeld, David; Yager, Joel


    We note gaps between the basic science of psychotherapy and the spiritual dimensions of religious life; between the beliefs and practices of patients and those of therapists; and between evidence for the influence of spirituality on health and the lack of its integration into psychotherapeutic training. We attempt to provide a framework to bridge this gap in supervision. We reviewed the literature on the roles of spirituality and religion in mental health and illness; on the place of religion in psychotherapy; and on the pedagogy of spirituality. Issues requiring attention include definitions of terms; awareness of personal beliefs; consideration of the boundaries between religiosity and pathology; and distinction between religious structures and personal beliefs. A format for addressing these issues in supervision includes: assisting the trainee with self-awareness; providing tools for spiritual assessment of the patient; providing developmental schema for spirituality; and maintaining awareness of the intersubjectivity of the patient-therapist field and the trainee-supervisor field. Existing literature provides usable frameworks for integrating religion and spirituality into psychotherapy supervision. We offer suggestions on how this may be accomplished.

  20. Treatment of adolescents with depression: the effect of transference interventions in a randomized controlled study of dynamic psychotherapy

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    Ulberg Randi


    Full Text Available Abstract Background Depression in adolescents seems to be a growing problem that causes mental suffering and prevents young people from joining the workforce. There is also a high risk of relapse during adult life. There is emerging evidence for the effect of psychodynamic psychotherapy in adolescents. In-session relational intervention (that is, transference intervention is a key component of psychodynamic psychotherapy. However, whether depressed adolescents profit most from psychodynamic psychotherapy with or without transference interventions has not been stated. Object The effect of transference interventions in depressed adolescents and the moderator moderating effect of quality of object relations, personality disorder and gender will be explored. Methods and study design The First Experimental Study of Transference Work–In Teenagers (FEST–IT will be a randomized clinical trial with a dismantling design. The study is aimed to explore the effects of transference work in psychodynamic psychotherapy for adolescents with depression. One hundred patients ages 16 to 18 years old will be randomized to one of two treatment groups, in both of which general psychodynamic techniques will be used. The patients will be treated over 28 weeks with either a moderate level of transference intervention or no transference intervention. Follow-up will be at 1 year after treatment termination. The outcome measures will be the Psychodynamic Functioning Scales (PFS, Inventory of Interpersonal Problems–Circumplex Version (IIP-C, Global Assessment of Functioning (GAF, and the total mean score of Symptom Checklist–90 (Global Severity Index; GSI, Beck Depression Inventory (BDI, and Montgomery Åsberg Rating Scale (MADRS. The quality of adolescents’ relationships will be a central focus of the study, and the Adolescent Relationship Scales (ARS and Differentiation–Relatedness Scale (DRS will also be used. Change will be assessed using linear-mixed models