Tracking functional brain changes in patients with depression under psychodynamic psychotherapy using individualized stimuli.

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Daniel Wiswede

Full Text Available 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.

The Overall Diagnosis: Psychodynamic Psychiatry, Six-Minute Psychotherapy, and Patient-Centered Care.

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Weinberg, Elizabeth; Mintz, David

2018-06-01

Optimal patient care in psychiatry necessitates attention to the treatment relationship and to the patient's experience as an individual. The growth of patient-centered medicine has led to an increased appreciation of the importance of the biopsychosocial formulation, the personhood of both the patient and the physician, the autonomy and authority of the patient, and the therapeutic alliance. Patient-centered medicine, developed by the seminal psychoanalytic theorist Michael Balint, has its roots in psychodynamic concepts. A psychodynamic approach to psychopharmacology improves psychiatric prescribing, and guides the psychiatrist in providing brief, limited psychotherapy, similar to that which the Balints recommended in primary care practice. Copyright © 2018 Elsevier Inc. All rights reserved.

The treatment of chronic post-traumatic nightmares using psychodynamic-interpersonal psychotherapy: a single-case study.

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Kellett, S; Beail, N

1997-03-01

This article presents a single-case experimental study of a woman suffering a traumatized reaction to a road traffic accident (RTA). In addition to meeting the DSM-IV (APA, 1994) criteria for the diagnosis of PTSD, the client suffered recurrent bizarre nightmares. The client reported at assessment, that each night her dreams were dominated by a terrifying hooded cloaked faceless figure. The central aim of the study therefore was to assess the efficacy of a psychodynamic-interpersonal (PI) style psychotherapy in the context of an unusual PTSD reaction. The methodology employed an A/B multiple baseline time series design, with six month follow-up. A and B represent a series of dream diary observations under two conditions: assessment/baseline (A) and treatment/intervention (B). Treatment consisted of a manualized psychodynamic-interpersonal (PI) psychotherapy to facilitate insight into the content and meaning of the nightmares. The intervention reduced the frequency and associated distress of the nightmares to zero. Follow-up at six months noted the long-term efficacy of the psychotherapy. The study is discussed with reference to the assimilation model of psychotherapeutic change.

Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: study protocol for a randomized controlled trial

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Zwerenz Rüdiger

2012-12-01

Full Text Available Abstract Background There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. Our study determines the efficacy of a manualized short-term psychodynamic psychotherapy and predictors of outcome by personality and quality of the therapeutic relationship. Methods/design Eligible breast cancer patients with comorbid depression are assigned to short-term psychodynamic psychotherapy (up to 20 + 5 sessions or to treatment as usual (augmented by recommendation for counseling center and physician information. We plan to recruit a total of 180 patients (90 per arm in two centers. Assessments are conducted pretreatment, after 6 (treatment termination and 12 months (follow-up. The primary outcome measures are reduction of the depression score in the Hospital Anxiety and Depression Scale and remission of depression as assessed by means of the Structured Clinical Interview for DSM IV Disorders by independent, blinded assessors at treatment termination. Secondary outcomes refer to quality of life. Discussion We investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment. Trial registration ISRCTN96793588

A proposed model of psychodynamic psychotherapy linked to Erik Erikson's eight stages of psychosocial development.

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Knight, Zelda Gillian

2017-09-01

Just as Freud used stages of psychosexual development to ground his model of psychoanalysis, it is possible to do the same with Erik Erikson's stages of development with regards to a model of psychodynamic psychotherapy. This paper proposes an eight-stage model of psychodynamic psychotherapy linked to Erik Erikson's eight stages of psychosocial development. Various suggestions are offered. One such suggestion is that as each of Erikson's developmental stages is triggered by a crisis, in therapy it is triggered by the client's search. The resolution of the search often leads to the development of another search, which implies that the therapy process comprises a series of searches. This idea of a series of searches and resolutions leads to the understanding that identity is developmental and therapy is a space in which a new sense of identity may emerge. The notion of hope is linked to Erikson's stage of Basic Trust and the proposed model of therapy views hope and trust as essential for the therapy process. Two clinical vignettes are offered to illustrate these ideas. Psychotherapy can be approached as an eight-stage process and linked to Erikson's eight stages model of development. Psychotherapy may be viewed as a series of searches and thus as a developmental stage resolution process, which leads to the understanding that identity is ongoing throughout the life span. Copyright © 2017 John Wiley & Sons, Ltd.

Psychodynamic psychotherapy, religious beliefs, and self-disclosure.

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Tillman, J G

1998-01-01

The intersection of psychodynamic psychotherapy and religious beliefs may present technical challenges for the psychotherapists; particularly if patients request to know more about the therapist's religious beliefs. Contrary to a recent technical recommendation for therapists to self-disclose personal religious beliefs when asked to do so, I suggest that such a request is complex and requires a thoughtful grounding in psychotherapeutic theory. Disclosing personal beliefs to patients runs the risk of being off-task as well as holding oneself out as an exemplar for the patient. Rather than adopt a formulaic response to requests for information, to deepen the understanding of the patient and the work of therapy, the therapist needs a complex understanding based on a careful diagnostic assessment of the patient, as well as an assessment of the current status of the psychotherapeutic venture. The workings of patients' particular transferences are often evident in requests for personal information and require careful evaluation and consideration. Likewise, countertransference elements may influence the type of response offered by the therapist. Using ethical principles as a guide is different from using them as a rule. The nexus of religious belief, psychosocial context, psychotherapy, and self-disclosure provides a potentially rich source of understanding when explored in the psychotherapeutic situation.

The Effect of Interpersonal Psychotherapy and other Psychodynamic Therapies versus ‘Treatment as Usual’ in Patients with Major Depressive Disorder

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Jakobsen, Janus Christian; Hansen, Jane Lindschou; Simonsen, Erik; Gluud, Christian

2011-01-01

Background Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment in systematic reviews. Methods/Principal Findings Cochrane systematic review methodology with meta-analysis and trial sequential analysis of randomized trials comparing the effect of psychodynamic therapies versus ‘treatment as usual’ for major depressive disorder. To be included the participants had to be older than 17 years with a primary diagnosis of major depressive disorder. Altogether, we included six trials randomizing a total of 648 participants. Five trials assessed ‘interpersonal psychotherapy’ and only one trial assessed ‘psychodynamic psychotherapy’. All six trials had high risk of bias. Meta-analysis on all six trials showed that the psychodynamic interventions significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference −3.12 (95% confidence interval −4.39 to −1.86;Pinterpersonal psychotherapy or psychodynamic therapy compared with ‘treatment as usual’ for patients with major depressive disorder. The potential beneficial effect seems small and effects on major outcomes are unknown. Randomized trials with low risk of systematic errors and low risk of random errors are needed. PMID:21556370

Psychodynamic psychotherapy versus cognitive behavior therapy for social anxiety disorder: An efficacy and partial effectiveness trial

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Bögels, S.M.; Wijts, P.; Oort, F.J.; Sallaerts, S.J.M.

2014-01-01

Objectives: Comparing the overall and differential effects of psychodynamic psychotherapy (PDT) versus cognitive behavior therapy (CBT) for social anxiety disorder (SAD). Design: Patients with a primary SAD (N = 47) were randomly assigned to PDT (N = 22) or CBT (N = 27). Both PDT and CBT consisted

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

2017-08-01

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.

The place of psychodynamic psychotherapy in the integrated treatment of posttraumatic stress disorder and trauma recovery.

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Moss, Eric

2009-06-01

Psychodynamic psychotherapists treating posttraumatic stress disorder (PTSD) sufferers can draw on an accumulated body of trauma studies from their own field to guide their work. However, these reports, often based on case studies or conceptual reviews, do not have the same empirical conclusiveness as more recent evidence-based research demonstrating the efficacy of cognitive-behavioral and body-oriented therapies. In this article, a psychodynamic psychotherapist reflects on his treatment of an Israeli man who developed PTSD after enduring 4 terrorist attacks. The author shows how assimilative integration offered him a theory- and research-based model that helped him comfortably combine separate treatment interventions. He also shows how this model helped him locate with some precision the specific contribution of psychodynamic psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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

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

2008-01-01

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....

[Psychotherapy of patients with brain lesions: an integrative model based on neuropsychological and psychodynamic perspectives].

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Ouss-Ryngaert, Lisa

2010-12-01

Our model of psychotherapy for patients with brain lesions is based on an integrative approach of psychobehavioral symptoms, especially from the neuropsychological and psychodynamic perspectives. Adjustment of technical modalities and aims of psychoanalytical therapy is required for these patients. The analysis of the influence of cognitive disorders on transference and contre-transference plays a major role, including the role of procedural processes in changes in the intersubjective relationship between the patient and the therapist. Two vignettes are presented to illustrate our model, which respects the integrity of the cognitive and psychodynamic approaches and can be implemented by only one therapist, using alternatively each lecture, or by a working team bringing to light the different aspects of the same symptom.

Feminist psychodynamic psychotherapy of eating disorders. Theoretic integration informing clinical practice.

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Zerbe, K J

1996-12-01

Ideas derived from feminism and psychoanalytic theory can be combined for the integrated treatment of eating disorder patients. For a large subgroup of patients who continue to have a poor quality of life or inadequate symptom control (despite customary psychopharmacologic and cognitive behavioral interventions), feminist psychodynamic psychotherapy may prove lifesaving. This article explores how the patient may come to grasp more deeply the multiple roles her symptom has played in her psychological survival. Practical suggestions to enrich the psychotherapy as the patient traverses the natural struggles of adult life are emphasized. The importance of understanding and working with transference and countertransference issues while helping the patient accept life's paradoxes, ambiguities, and potential avenues for growth are underscored. The author reviews eight specific areas that warrant attention in psychotherapeutic exploration from a feminist psychoanalytic perspective (Culture as Bedrock Issue; Gender as Organizer of Behavior, Ownership of Body; Moral Development; Development of Personal Voice; Emphasis on Adult Development; Sexual Concerns; and Aggressive Conflicts).

The role of cognitive biases in short-term psychodynamic psychotherapy.

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Kramer, Ueli; Ortega, Diana; Ambresin, Gilles; Despland, Jean-Nicolas; de Roten, Yves

2018-06-01

The concept of biased thinking - or cognitive biases - is relevant to psychotherapy research and clinical conceptualization, beyond cognitive theories. The present naturalistic study aimed to examine the changes in biased thinking over the course of a short-term dynamic psychotherapy (STDP) and to discover potential links between these changes and symptomatic improvement. This study focuses on 32 self-referred patients consulting for Adjustment Disorder according to DSM-IV-TR. The therapists were experienced psychodynamically oriented psychiatrists and psychotherapists. Coding of cognitive biases (using the Cognitive Errors Rating Scale; CERS) was made by external raters based on transcripts of interviews of psychotherapy; the reliability of these ratings on a randomly chosen 24% of all sessions was established. Based on the Symptom Check List SCL-90-R given before and after, the Reliable Change Index (RCI) was used. The assessment of cognitive errors was done at three time points: early (session 4-7), mid-treatment (session 12-17), and close to the end (after session 20) of the treatment. The results showed that the total frequency of cognitive biases was stable over time (p = .20), which was true both for positive and for negative cognitive biases. In exploring the three main subscales of the CERS, we found a decrease in selective abstraction (p = .02) and an increase in personalization (p = .05). A significant link between RCI scores (outcome) and frequency of positive cognitive biases was found, suggesting that biases towards the positive might have a protective function in psychotherapy. Therapists may be attentive to changes in biased thinking across short-term dynamic psychotherapy for adjustment disorder. Therapists may foster the emergence of positive cognitive biases at mid-treatment for adjustment disorder. © 2017 The British Psychological Society.

Outpatient psychodynamic group psychotherapy - outcomes related to personality disorder, severity, age and gender.

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Kvarstein, Elfrida Hartveit; Nordviste, Ola; Dragland, Lone; Wilberg, Theresa

2017-02-01

Outpatient group psychotherapy is frequent within specialist services, recruits a mixed population, but effects are poorly documented. This study investigates long-term outcomes for patients with personality disorder (PD) treated in outpatient, psychodynamic groups within secondary mental health service. A naturalistic study (N = 103) with repeated assessments of process and clinical outcomes. Longitudinal statistics are linear mixed models. The main PDs were avoidant, borderline and NOS PD, mean number of PDs 1.4(SD0.7), 60% females and mean initial age 38(SD10) years. Mean treatment duration was 1.5(SD 0.9) years. Therapist alliance and experienced group climate was satisfactory and stable. Improvements were significant (symptom distress, interpersonal problems, occupational functioning and additional mental health services), irrespective of general PD-severity, but not of PD-type, age or gender. The study demonstrates PD NOS benefits across all outcomes, occupational improvements for avoidant PD, despite prevailing symptoms, but generally poorer outcomes for males and age >38 years. For borderline PD, experienced conflict was stronger, treatment duration shorter and outcomes poor for early drop-outs (28%). Psychodynamic group psychotherapy is a recommendable treatment for moderate PDs, which may address avoidant strategies, but may not meet clinical challenges of borderline PD. The outcome differences related to gender and age are noteworthy. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Evidens for psykodynamisk psykoterapi

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Olano, Francisco Alberdi; Rosenbaum, Bent

2017-01-01

Evidence of the effect of psychodynamic psychotherapy (PDT) has been called into question. Thus, an updated review of the effect of short-term and long-term PDT (STPP and LTPP) for anxiety, depression and personality disorders seems necessary. A systematic search of randomized controlled studies ...

The effect of interpersonal psychotherapy and other psychodynamic therapies versus 'treatment as usual' in patients with major depressive disorder

DEFF Research Database (Denmark)

Jakobsen, Janus Christian; Hansen, Jane Lindschou; Simonsen, Erik

2011-01-01

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment...

Psychodynamic psychotherapy for social phobia: a treatment manual based on supportive-expressive therapy.

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Leichsenring, Falk; Beutel, Manfred; Leibing, Eric

2007-01-01

Social phobia is a very frequent mental disorder characterized by an early onset, a chronic unremitting course, severe psychosocial impairments and high socioeconomic costs. To date, no manual for the psychodynamic treatment of social phobia exists. After a brief description of the disorder, a manual for a short-term psychodynamic treatment of social phobia is presented. The treatment is based on Luborsky s supportive-expressive (SE) therapy, which is complemented by treatment elements specific to social phobia. The treatment includes the characteristic elements of SE therapy, that is, setting goals, focus on the Core Conflictual Relationship Theme (CCRT) associated with the patient s symptoms, interpretive interventions to enhance insight into the CCRT, and supportive interventions, in particular fostering a helping alliance. In order to tailor the treatment more specifically to social phobia, treatment elements have been added, for example informing the patient about the disorder and the treatment, a specific focus on shame and on unrealistic demands, and encouraging the patient to confront anxiety-producing situations. More directive interventions are included as well, such as specific prescriptions to stop persisting self-devaluations. The treatment manual is presently being used in a large-scale randomized controlled multicenter study comparing short-term psychodynamic psychotherapy and cognitive-behavioral therapy in the treatment of social phobia.

Advanced Psychotherapy Training: Psychotherapy Scholars' Track, and the Apprenticeship Model

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Feinstein, Robert E.; Yager, Joel

2013-01-01

Background/Objective: 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…

Clinical Holistic Medicine (Mindful,Short-Term Psychodynamic Psychotherapy Complemented with Bodywork in the Treatment of Experienced Mental Illness

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Søren Ventegodt

2007-01-01

Full Text Available Short-term psychodynamic psychotherapy (STPP complemented with bodywork improved 31 of 54 patients (57.4%, 95% CI: 43.21–70.77% who rated themselves mentally ill before treatment. Calculated from this we find 1.41 500. Of the 54 patients, 40% had already had traditional treatment that did not help them. Bodywork helped the patients to confront repressed painful feelings from childhood and this seemingly accelerated and improved the therapy. The patients received in average 20 sessions over 14 months at a cost of 1600 EURO. For the treatment responders, all measured aspects of life (on a five point Likert Scale improved significantly, simultaneously, and radically: somatic health (from 2.9 to 2.3, self-esteem/relationship to self (from 3.5 to 2.3, relationship to partner (from 4.7 to 2.9 [no partner was rated as “6”], relationship to friends (from 2.5 to 2.0, ability to love (from 3.8 to 2.4, self-assessed sexual ability (from 3.5 to 2.4, self-assessed social ability (from 3.2 to 2.1, self-assessed working ability (from 3.3 to 2.4, and self-assessed quality of life (from 4.0 to 2.3. Quality of life as measured with QOL5 improved (from 3.6 to 2.3 on a scale from 1 to 5; p < 0.001. This general improvement strongly indicated that the patient had healed existentially, i.e., had experienced what Aaron Antonovsky (1923–1994 called “salutogenesis”, defined as the process exactly the opposite of pathogenesis. For the treatment responders, the treatment provided lasting benefits, without the negative side effects of drugs. A lasting, positive effect might also prevent many different types of problems in the future.

Group Milieu in systemic and psychodynamic group therapy

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Lau, Marianne Engelbrecht; Kristensen, Ellids

Objectives: A recent meta-analysis also concluded that psychotherapeutic approaches are beneficial for adult with a history of CSA and maintained for at least six months follow-up. The results suggest that different characteristics of therapy moderate the therapeutic outcome. We found in a random......Objectives: A recent meta-analysis also concluded that psychotherapeutic approaches are beneficial for adult with a history of CSA and maintained for at least six months follow-up. The results suggest that different characteristics of therapy moderate the therapeutic outcome. We found...... in a randomized study of systemic versus psychodynamic group therapy, that the short-term outcome for patients who received systemic group psychotherapy was significantly better than the outcome for patients who received psychodynamic group psychotherapy. The current study assessed the group milieu in both groups....... Methods: This randomized prospective study included 106 women: 52 assigned to psychodynamic group psychotherapy and 54 assigned to systemic group psychotherapy. The Group Environment Scale (GES) was filled in the mid phase of therapy and analysed in three dimensions and 10 subscales. Results: The systemic...

Do Patient Characteristics Predict Outcome of Psychodynamic Psychotherapy for Social Anxiety Disorder?

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Jörg Wiltink

Full Text Available Little is known about patient characteristics as predictors for outcome in manualized short term psychodynamic psychotherapy (PDT. No study has addressed which patient variables predict outcome of PDT for social anxiety disorder.In the largest multicenter trial on psychotherapy of social anxiety (SA to date comparing cognitive therapy, PDT and wait list condition N = 230 patients were assigned to receive PDT, of which N = 166 completed treatment. Treatment outcome was assessed based on diverse parameters such as endstate functioning, remission, response, and drop-out. The relationship between patient characteristics (demographic variables, mental co-morbidity, personality, interpersonal problems and outcome was analysed using logistic and linear regressions.Pre-treatment SA predicted up to 39 percent of variance of outcome. Only few additional baseline characteristics predicted better treatment outcome (namely, lower comorbidity and interpersonal problems with a limited proportion of incremental variance (5.5 to 10 percent, while, e.g., shame, self-esteem or harm avoidance did not.We argue that the central importance of pre-treatment symptom severity for predicting outcomes should advocate alternative treatment strategies (e.g. longer treatments, combination of psychotherapy and medication in those who are most disturbed. Given the relatively small amount of variance explained by the other patient characteristics, process variables and patient-therapist interaction should additionally be taken into account in future research.Controlled-trials.com/ISRCTN53517394.

Psicoterapia psicodinâmica e o tratamento do jogo patológico Psychodynamic psychotherapy and the treatment of pathological gambling

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Richard J. Rosenthal

2008-05-01

ão evitativo de comportamento e defesas psicodinâmicas.OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.

Drop-out from a psychodynamic group psychotherapy outpatient unit.

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

2014-11-01

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.

A new model of techniques for concurrent psychodynamic work with parents of child and adolescent psychotherapy patients.

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Novick, Kerry Kelly; Novick, Jack

2013-04-01

To address the neglect of the importance of parent work in the psychodynamic psychotherapy of children and adolescents, the authors present a model of concurrent dynamic parent work that has demonstrated success with patients of all ages. The model includes dual goals for all therapies, addresses the challenge of confidentiality by differentiating privacy and secrecy, and emphasizes the importance of parent work throughout treatment. Copyright © 2013 Elsevier Inc. All rights reserved.

Corrective relational experiences in psychodynamic-interpersonal psychotherapy: Antecedents, types, and consequences.

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Huang, Teresa Chen-Chieh; Hill, Clara E; Strauss, Nicole; Heyman, Michelle; Hussain, Mahum

2016-03-01

In posttherapy interviews with 31 clients who had recently terminated from individual open-ended psychodynamic-interpersonal psychotherapy, 18 reported having had at least 1 corrective relational experience (CRE) during psychotherapy, whereas 13 did not report any CREs. CREs typically occurred in the context of therapeutic relationships that were primarily positive but also had minor difficulties. Therapists typically facilitated CREs by identifying or questioning client behavior patterns and conveying trustworthiness. Corrective shifts for clients typically involved a new understanding of the therapy experience and variantly involved gaining a new understanding of behavior patterns. Consequences generally included improvements in the therapy relationship and intrapersonal well-being. Qualitatively, the 13 non-CRE clients more frequently reported wishing the therapist's theoretical orientation was a better match than did the 18 CRE clients. Quantitatively, the CRE clients rated themselves as having more interpersonal problems at intake on the Inventory of Interpersonal Problems-32 (Barkham, Hardy, & Startup, 1996), had marginally significant improvements in interpersonal functioning over time, rated their therapy alliances higher on the Working Alliance Inventory-Short Revised (Hatcher & Gillaspy, 2006) midtherapy, and rated their therapy alliances higher over time compared with the non-CRE clients. Implications for practice and research are discussed. (c) 2016 APA, all rights reserved).

Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial

Science.gov (United States)

2012-01-01

Background A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. However, there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists. The present article describes the protocol of a study that will examine the relative efficacy, the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for inpatients with unipolar depression. Methods/Design The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions). Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention–to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher. Discussion Despite the large number of studies on treatment of depression

[Initial and extension applications for psychodynamic therapy according to the German Guidelines for Psychotherapy].

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Lieberz, Klaus; Krumm, Bertram; Adamek, Lucie; Mühlig, Stephan

2010-01-01

According to the German Guidelines for Psychotherapy, psychotherapists need the consent of the respective insurance company to commence outpatient therapy. They have two options: (1) To begin a so-called short-term therapy (KZT) for up to 25 sessions--a quick and easy procedure requiring few formal expenses. Afterwards the therapist must provide the reasons for extending the therapy in a formal expert assessment request (extension request). (2) It is also possible to obtain the consent of the insurance company at the beginning of therapy (initial request) for up to 50 sessions (psychodynamic long-term therapy) or even for up to 160 sessions (analytical psychotherapy), both of which require the same expert assessment to be filled out beforehand (LZT). This study examines the initial and extension requests submitted for evaluation for psychodynamic therapies according to the German Guidelines for Psychotherapy. The question is posed as to what influences are important in the selection of therapists for these two types of request. In the context of the MARS study, we evaluated a total of 362 randomly chosen requests submitted between May 2007 and June 2008, 128 of which were initial requests and 234 of which were requests for an extension. The evaluation of the reports proceeded on the basis of a previously developed documentation system with various modules comprising information on the sociodemographics and morbidity of the patients as well as information on the therapists themselves. Further modules are assessed in this review. There were many more requests for an extension submitted than initial requests. Initial requests were preferably made when planning analytical psychotherapy. Patients for whom initial requests were submitted were also distinctly younger. The morbidity of the patients had no noticeable influence on the choice of procedure. In particular, diagnoses that could require crisis intervention were not more common in the requests for an extension

Prediction and moderation of improvement in cognitive-behavioral and psychodynamic psychotherapy for panic disorder.

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Chambless, Dianne L; Milrod, Barbara; Porter, Eliora; Gallop, Robert; McCarthy, Kevin S; Graf, Elizabeth; Rudden, Marie; Sharpless, Brian A; Barber, Jacques P

2017-08-01

To identify variables predicting psychotherapy outcome for panic disorder or indicating which of 2 very different forms of psychotherapy-panic-focused psychodynamic psychotherapy (PFPP) or cognitive-behavioral therapy (CBT)-would be more effective for particular patients. Data were from 161 adults participating in a randomized controlled trial (RCT) including these psychotherapies. Patients included 104 women; 118 patients were White, 33 were Black, and 10 were of other races; 24 were Latino(a). Predictors/moderators measured at baseline or by Session 2 of treatment were used to predict change on the Panic Disorder Severity Scale (PDSS). Higher expectancy for treatment gains (Credibility/Expectancy Questionnaire d = -1.05, CI 95% [-1.50, -0.60]), and later age of onset (d = -0.65, CI 95% [-0.98, -0.32]) were predictive of greater change. Both variables were also significant moderators: patients with low expectancy of improvement improved significantly less in PFPP than their counterparts in CBT, whereas this was not the case for patients with average or high levels of expectancy. When patients had an onset of panic disorder later in life (≥27.5 years old), they fared as well in PFPP as CBT. In contrast, at low and mean levels of onset age, CBT was the more effective treatment. Predictive variables suggest possibly fruitful foci for improvement of treatment outcome. In terms of moderation, CBT was the more consistently effective treatment, but moderators identified some patients who would do as well in PFPP as in CBT, thereby widening empirically supported options for treatment of this disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Assessing Psychodynamic Conflict.

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Simmonds, Joshua; Constantinides, Prometheas; Perry, J Christopher; Drapeau, Martin; Sheptycki, Amanda R

2015-09-01

Psychodynamic psychotherapies suggest that symptomatic relief is provided, in part, with the resolution of psychic conflicts. Clinical researchers have used innovative methods to investigate such phenomenon. This article aims to review the literature on quantitative psychodynamic conflict rating scales. An electronic search of the literature was conducted to retrieve quantitative observer-rated scales used to assess conflict noting each measure's theoretical model, information source, and training and clinical experience required. Scales were also examined for levels of reliability and validity. Five quantitative observer-rated conflict scales were identified. Reliability varied from poor to excellent with each measure demonstrating good validity. However a small number of studies and limited links to current conflict theory suggest further clinical research is needed.

Types of psychotherapy for pathological gamblers.

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Fong, Timothy W

2005-05-01

Several types of psychotherapy are currently used to treat pathological gamblers. These include Gambler's Anonymous, cognitive behavioral therapy, behavioral therapy, psychodynamic therapy, and family therapy. Research into which types of psychotherapy are the most effective for pathological gambling is limited but is a growing area of study. Group therapy, namely Gambler's Anonymous, provides peer support and structure. Cognitive behavior therapy aims to identify and correct cognitive distortions about gambling. Psychodynamic psychotherapy can help recovering gamblers address core conflicts and hidden psychological meanings of gambling. Family therapy is helpful by providing support and education and eliminating enabling behaviors. To date, no single type of psychotherapy has emerged as the most effective form of treatment. As in other addictive disorders, treatment retention of pathological gamblers is highly variable. Understanding the types of psychotherapy that are available for pathological gamblers, as well their underlying principles, will assist clinicians in managing this complex behavioral disorder.

Affect-focused psychodynamic psychotherapy for depression and anxiety through the Internet: a randomized controlled trial

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Robert Johansson

2013-07-01

Full Text Available Background. Psychodynamic psychotherapy is a psychological treatment approach that has a growing empirical base. Research has indicated an association between therapist-facilitated affective experience and outcome in psychodynamic therapy. Affect-phobia therapy (APT, as outlined by McCullough et al., is a psychodynamic treatment that emphasizes a strong focus on expression and experience of affect. This model has neither been evaluated for depression nor anxiety disorders in a randomized controlled trial. While Internet-delivered psychodynamic treatments for depression and generalized anxiety disorder exist, they have not been based on APT. The aim of this randomized controlled trial was to investigate the efficacy of an Internet-based, psychodynamic, guided self-help treatment based on APT for depression and anxiety disorders.Methods. One hundred participants with diagnoses of mood and anxiety disorders participated in a randomized (1:1 ratio controlled trial of an active group versus a control condition. The treatment group received a 10-week, psychodynamic, guided self-help treatment based on APT that was delivered through the Internet. The treatment consisted of eight text-based treatment modules and included therapist contact (9.5 min per client and week, on average in a secure online environment. Participants in the control group also received online therapist support and clinical monitoring of symptoms, but received no treatment modules. Outcome measures were the 9-item Patient Health Questionnaire Depression Scale (PHQ-9 and the 7-item Generalized Anxiety Disorder Scale (GAD-7. Process measures were also included. All measures were administered weekly during the treatment period and at a 7-month follow-up.Results. Mixed models analyses using the full intention-to-treat sample revealed significant interaction effects of group and time on all outcome measures, when comparing treatment to the control group. A large between-group effect size

The Psychotherapy Process with Adolescents: A First Pilot Study and Preliminary Comparisons between Different Therapeutic Modalities Using the "Adolescent Psychotherapy Q-Set"

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Bychkova, Tetyana; Hillman, Saul; Midgley, Nick; Schneider, Celeste

2011-01-01

An innovative methodology is presented for describing the therapeutic processes involved in five types of adolescent treatments: psychoanalysis, psychodynamic psychotherapy, cognitive-behavioural therapy, mentalisation-based treatment and interpersonal psychotherapy. Using the "Adolescent Psychotherapy Q-Set" (APQ), 18 experienced clinicians…

SCL-90-R Symptom Profiles and Outcome of Short-Term Psychodynamic Group Therapy

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

2013-01-01

Abstract Background. Psychodynamic group psychotherapy may not be an optimal treatment for anxiety and agoraphobic symptoms. We explore remission of SCL-90-R Global Severity Index (GSI) and target symptoms in 39 sessions of psychodynamic group therapy. Methods. SCL-90-R “target symptom” profile a...

Women, money, and psychodynamic group psychotherapy.

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Motherwell, Lise

2002-01-01

Developmental concerns and sociocultural expectations may keep female patients and therapists from addressing financial issues openly in group psychotherapy. Interpersonal theory provides a different view of nurturing that may help women leaders deal better with financial discussions in group. This paper includes a review of the literature on group psychotherapy and fees; feminist literature relevant to leadership; money management in group therapy; countertransference; and case examples.

Depressed patients’ preferences for type of psychotherapy: a preliminary study

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Yrondi A

2015-09-01

Full Text Available Antoine Yrondi,1 Julie Rieu,1 Claire Massip,1 Vanina Bongard,2 Laurent Schmitt1 1Department of Psychiatry and Medical Psychology, 2Public Health Service, CHU Toulouse, Toulouse, France Background: The treatment recommendations for depressed patients by the American Psychiatric Association encourage a focus on the patient’s preferences. The focus of this study was the preference of depressed inpatients for the type of psychotherapy. Methods: Twenty-nine subjects of both sexes who were hospitalized with a major depressive episode were interviewed at 5-day intervals with the same questions after the depressive episode resolved, as indicated by a score less than 7 on the Hamilton Depression Rating Scale (HDRS. The selection of items was performed by expert consensus. Results: The supportive psychotherapy scores were the highest, followed by psychodynamic psychotherapy and cognitive behavioral therapy. The two sessions conducted at 5-day intervals showed no significant difference, which reflected the stability of choices and preferences of patients. Conclusion: In this study, the patients preferred supportive psychotherapy as first-line therapy compared to psychodynamic psychotherapy and cognitive behavioral therapy. Keywords: depression, depressive disorder, psychodynamic psychotherap, supportive psychotherapy, cognitive behavioral therapy

Is the residential combined (psychotherapy plus medication) treatment of patients with severe personality disorder effective in terms of suicidality and impulsivity?

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Vaslamatzis, Grigorios; Theodoropoulos, Panayiotis; Vondikaki, Stamatia; Karamanolaki, Hara; MiliaTsanira, Myrto; Gourounti, Kleanthi

2014-02-01

The aim of this study was to compare the effectiveness of combined treatment-medication plus psychodynamic psychotherapy-and psychodynamic psychotherapy alone on the outcome variables of suicidality and impulsivity in a population of adult inpatients with severe personality disorder (SPD). This is a naturalistic-empirical (observational) study under the conditions of clinical practice (an intensive specialized inpatient psychotherapeutic program [SIPP]). The sample consisted of 33 inpatients with SPD who were allocated to two subgroups (groups A and B). The patients in group A received psychodynamic psychotherapy and adjunctive pharmacotherapy, whereas the patients in group B received multimodal psychodynamic psychotherapy only. A statistically significant reduction in suicidality score was observed in the patients in group A, whereas a tendency for significant reduction in impulsivity score was observed in group B after the SIPP termination. Pharmacotherapy combined with multimodal psychodynamic psychotherapy, always within the SIPP, seems more effective in the case of suicidality rather than impulsivity.

When It Comes to Evaluating Psychodynamic Therapy, the Devil Is in the Details

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Anestis, Michael D.; Anestis, Joye C.; Lilienfeld, Scott O.

2011-01-01

Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler. As Shedler noted, some researchers have reflexively and stridently dismissed psychodynamic therapy (PT) as ineffective without granting outcome studies on this modality a fair hearing. We applaud Shedler's efforts to bring PT into the scientific…

The Grandmaternal Transference in Parent-Infant/Child Psychotherapy

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Dugmore, Nicola

2013-01-01

The psychic significance of the figure of the grandmother in psychodynamic psychotherapy has received scant attention. This paper develops the concept of the "grandmaternal transference" in parent-infant psychotherapy and explores its identification, its possible functions and its therapeutic significance. The grandmaternal transference has…

Focus is key: Panic-focused interpretations are associated with symptomatic improvement in panic-focused psychodynamic psychotherapy.

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Keefe, John R; Solomonov, Nili; Derubeis, Robert J; Phillips, Alexander C; Busch, Fredric N; Barber, Jacques P; Chambless, Dianne L; Milrod, Barbara L

2018-04-18

This study examines whether, in panic-focused psychodynamic psychotherapy (PFPP), interpretations of conflicts that underlie anxiety (panic-focused or PF-interpretations) are specifically associated with subsequent panic disorder (PD) symptom improvement, over and above the provision of non-symptom-focused interpretations. Technique use in Sessions 2 and 10 of a 24-session PFPP protocol was assessed for the 65 patients with complete outcome data randomized to PFPP in a two-site trial of psychotherapies for PD. Sessions were rated in 15-min segments for therapists' use of PF-interpretations, non-PF-interpretations, and PF-clarifications. Robust regressions were conducted to examine the relationship between these interventions and symptom change subsequent to the sampled session. Interpersonal problems were examined as a moderator of the relationship of PF-interpretations to symptom change. At Session 10, but not at Session 2, patients who received a higher degree of PF-interpretations experienced greater subsequent improvement in panic symptoms. Non-PF-interpretations were not predictive. Patients with more interpersonal distress benefitted particularly from the use of PF-interpretations at Session 10. By the middle phase of PFPP, panic-focused interpretations may drive subsequent improvements in panic symptoms, especially among patients with higher interpersonal distress. Interpretations of conflict absent a panic focus may not be especially helpful.

Dreaming of you: client and therapist dreams about each other during psychodynamic psychotherapy.

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Hill, Clara E; Knox, Sarah; Crook-Lyon, Rachel E; Hess, Shirley A; Miles, Joe; Spangler, Patricia T; Pudasaini, Sakar

2014-01-01

Our objectives were to describe the frequency of therapists' dreams about their clients and clients' dreams about their therapists, to determine how therapists and clients who had such dreams differed from those who did not have such dreams, whether therapy process and outcome differed for those who had and did not have such dreams, and to describe the content and consequences of these dreams. Thirteen doctoral student therapists conducted psychodynamic psychotherapy with 63 clients in a community clinic. Therapists who had dreams about clients had higher estimated and actual dream recall than did therapists who did not dream about clients. Qualitative analyses indicated that therapists' dreams yielded insights about the therapist, clients, and therapy; therapists used insights in their work with the clients. Among the clients, only two (who were particularly high in attachment anxiety and who feared abandonment from their therapists) reported dreams that were manifestly about their therapists. Therapists-in-training dreamed more about their clients than their clients dreamed about them. Dreams about clients can be used by therapists to understand themselves, clients, and the dynamics of the therapy relationship.

A Psychodynamic Psychologist in Community Psychiatry: 14 Years of Experience

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Tânia Roquette

2013-11-01

Full Text Available This paper aims to critically review the role of a psychodynamic psychologist integrated in a community outpatient clinic of a Psychiatric Department. It describes the characteristics of a psychodynamic intervention that is complementary to the psychiatric approach while sharing a common goal –the suffering patient – and enhancing the knowledge and understanding of several domains like psychopathology, diagnosis, treatment, rehabilitation and integration. Furthermore it describes how the use of Psychological Assessment led to the formulation of specific individual psychotherapies, spanning 14 years of clinical practice. The paper concludes with some considerations regarding the integration of Psychodynamic Psychology in a multidisciplinary mental health team, addressing issues such as the boundaries between technical characteristics, the appropriateness of language to other disciplines and psychodynamic implications of the different features of this clinical setting.

Outcomes of specific interpersonal problems for binge eating disorder: comparing group psychodynamic interpersonal psychotherapy and group cognitive behavioral therapy.

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Tasca, Giorgio A; Balfour, Louise; Presniak, Michelle D; Bissada, Hany

2012-04-01

We assessed whether an attachment-based treatment, Group Psychodynamic Interpersonal Psychotherapy (GPIP) had a greater impact compared to Group Cognitive Behavioral Therapy (GCBT) on Cold/Distant and Intrusive/Needy interpersonal problems. Ninety-five individuals with Binge Eating Disorder (BED) were randomized to GPIP or GCBT and assessed at pre-, post-, and six months post-treatment. Both therapies resulted in a significant decrease in all eight interpersonal problem subscales except the Nonassertive subscale. GPIP resulted in a greater reduction in the Cold/Distant subscale compared to GCBT, but no differences were found for changes in the Intrusive/Needy subscale. GPIP may be most relevant for those with BED who have Cold/Distant interpersonal problems and attachment avoidance.

Psychodynamic Emotional Regulation in View of Wolpe's Desensitization Model.

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Rabinovich, Merav

2016-01-01

The current research belongs to the stream of theoretical integration and establishes a theoretical platform for integrative psychotherapy in anxiety disorders. Qualitative metasynthesis procedures were applied to 40 peer-reviewed psychoanalytic articles involving emotional regulation. The concept of psychodynamic emotional regulation was found to be connected with the categories of desensitization, gradual exposure, containment, and transference. This article presents a model according to which psychoanalytic psychotherapy allows anxiety to be tolerated while following the core principles of systematic desensitization. It is shown that despite the antiresearch image of psychoanalytic psychotherapy, its foundations obey evidence-based principles. The findings imply that anxiety tolerance might be a key goal in which the cumulative wisdom of the different therapies can be used to optimize psychotherapy outcomes.

Types of Psychotherapy for Pathological Gamblers

OpenAIRE

Fong, Timothy W.

2005-01-01

Several types of psychotherapy are currently used to treat pathological gamblers. These include Gambler's Anonymous, cognitive behavioral therapy, behavioral therapy, psychodynamic therapy, and family therapy. Research into which types of psychotherapy are the most effective for pathological gambling is limited but is a growing area of study. Group therapy, namely Gambler's Anonymous, provides peer support and structure. Cognitive behavior therapy aims to identify and correct cognitive distor...

[Psychodynamic hypothesis about suicidality in elderly men].

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Lindner, Reinhard

2010-08-01

Old men are overrepresented in the whole of all suicides. In contrast, only very few elderly men find their way to specialised treatment facilities. Elderly accept psychotherapy more rarely than younger persons. Therefore presentations on the psychodynamics of suicidality in old men are rare and mostly casuistical. By means of a stepwise reconstructable qualitative case comparison of five randomly chosen elderly suicidal men with ideal types of suicidal (younger) men concerning biography, suicidal symptoms and transference, psychodynamic hypothesis of suicidality in elderly men are developed. All patients came into psychotherapy in a specialised academic out-patient clinic for psychodynamic treatment of acute and chronic suicidality. The five elderly suicidal men predominantly were living in long-term, conflictuous sexual relationships and also had ambivalent relationships to their children. Suicidality in old age refers to lifelong existing intrapsychic conflicts, concerning (male) identity, self-esteem and a core conflict between fusion and separation wishes. The body gets a central role in suicidal experiences, being a defensive instance modified by age and/or physical illness, which brings up to consciousness aggressive and envious impulses, but also feelings of emptiness and insecurity, which have to be warded off again by projection into the body. In transference relationships there are on the one hand the regular transference, on the other hand an age specific turned around transference, with their counter transference reactions. The chosen methodological approach serves the systematic finding of hypotheses with a higher degree in evidence than hypotheses generated from single case studies. Georg Thieme Verlag KG Stuttgart - New York.

Innovative Educational Initiatives to Train Psychodynamic Psychiatrists in Underserved Areas of the World.

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Alfonso, César A; Michael, Marco Christian; Elvira, Sylvia Detri; Zakaria, Hazli; Kalayasiri, Rasmon; Adlan, Aida Syarinaz A; Moinalghorabaei, Mahdieh; Lukman, Petrin Redayani; San'ati, Mohammad; Duchonova, Katerina; Sullivan, Timothy B

2018-06-01

Psychodynamic psychiatry remains a challenging subject to teach in underserved areas, where enthusiasm to learn is substantial. Besides logistical and psychiatric workforce shortcomings, sensible cultural adaptations to make psychodynamic psychiatry relevant outside of high-income countries require creative effort. Innovative pedagogical methods that include carefully crafted mentoring and incorporate videoconferencing in combination with site visits can be implemented through international collaborations. Emphasis on mentoring is essential to adequately train future psychodynamic psychotherapy supervisors. Examples of World Psychiatric Association initiatives in countries such as Indonesia, Iran, Malaysia, and Thailand are presented as possible models to emulate elsewhere. Copyright © 2018 Elsevier Inc. All rights reserved.

Clouds and silver linings: training experiences of psychodynamically oriented mental health trainees.

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Rouff, L C

2000-01-01

This paper discusses the experiences of today's psychodynamically oriented mental health trainees. Recent changes in the training environment, such as the increase in managed care, rise in use of psychotropic medication, the waning popularity of psychodynamic thinking, and reduced funding for psychotherapy training, in general, have all affected current trainees' professional development. In particular, trainees struggle with problems of demoralization, professional isolation, and reduced financial opportunities. Advantages that current trainees experience, as well as suggestions for training directors and trainees, will also be discussed.

Treatment of adolescents with depression: the effect of transference interventions in a randomized controlled study of dynamic psychotherapy

OpenAIRE

Ulberg, Randi; Hersoug, Anne Grete; H?glend, Per

2012-01-01

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 psyc...

Working alliance, real relationship, session quality, and client improvement in psychodynamic psychotherapy: A longitudinal actor partner interdependence model.

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Kivlighan, Dennis M; Hill, Clara E; Gelso, Charles J; Baumann, Ellen

2016-03-01

We used the Actor Partner Interdependence Model (APIM; Kashy & Kenny, 2000) to examine the dyadic associations of 74 clients and 23 therapists in their evaluations of working alliance, real relationship, session quality, and client improvement over time in ongoing psychodynamic or interpersonal psychotherapy. There were significant actor effects for both therapists and clients, with the participant's own ratings of working alliance and real relationship independently predicting their own evaluations of session quality. There were significant client partner effects, with clients' working alliance and real relationship independently predicting their therapists' evaluations of session quality. The client partner real relationship effect was stronger in later sessions than in earlier sessions. Therapists' real relationship ratings (partner effect) were a stronger predictor of clients' session quality ratings in later sessions than in earlier sessions. Therapists' working alliance ratings (partner effect) were a stronger predictor of clients' session quality ratings when clients made greater improvement than when clients made lesser improvement. For clients' session outcome ratings, there were complex three-way interactions, such that both Client real relationship and working alliance interacted with client improvement and time in treatment to predict clients' session quality. These findings strongly suggest both individual and partner effects when clients and therapists evaluate psychotherapy process and outcome. Implications for research and practice are discussed. (c) 2016 APA, all rights reserved).

Palmistry, tarot cards, and psychotherapy.

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Pejic, Nicholas G

2008-01-01

The author summarizes his experience with palm and Tarot card readers in New Orleans. The history, practice, and psychodynamics of palmistry and Tarot are explored. It's postulated that these practices are forms of archaic psychotherapy, which employ supportive treatment and placebo. These tactics are used to elicit hope for its clients.

Psicoterapias breves psicodinâmicas: características da produção científica nacional e estrangeira (1980/2003 Brief psychodynamic psychotherapies: Characteristics of national and foreign scientific production (1980/2003

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Elisa Medici Pizão Yoshida

2005-06-01

Full Text Available Apresenta o levantamento de algumas características formais da produção científica para saber quem, onde e o que tem sido indexado nas bases de dados eletrônicas, sob os verbetes: "psicoterapias breves psicodinâmicas" e "psicoterapias psicodinâmicas de tempo limitado". As produções estrangeira e nacional foram cotejadas e críticas apresentadas. A amostra de 534 resumos (1980 a 2003, publicados em bases nacionais e internacionais, indicou que a produção estrangeira foi quantitativamente superior quanto ao número de referências, periódicos científicos e autores. No entanto, a nacional equipara-se em aspectos tais como: média de referência por autor, predomínio de autoria única e adoção de psicoterapias integrativas, em que influências de outras abordagens, que não a psicodinâmica, são identificadas. Nas duas realidades predominaram, ainda, publicações sobre psicoterapias individuais de adultos, veiculadas por periódicos psiquiátricos. Espera-se que com a expansão das bases de dados da psicologia, esta última característica venha a se reverter, ao menos no Brasil.It presents a survey of some formal characteristics of the scientific production with the aim of knowing whom, where, and what have been indexed in electronic databases, under the entry: "brief psychodynamic psychotherapy" and "time-limited psychodynamic psychotherapy". Foreign and national productions were checked and critiques were presented. The sample of 534 abstracts (1980 to 2003, published in Brazil and abroad, indicated that the foreign production was quantitatively superior concerning the number of references, journals and authors. However, the national production compares in some aspects such as: reference average by author, predominance of unique authorship and adoption of integrative psychotherapy, in which influences of other approaches, rather than the psychodynamic, are identified. In the two realities there was a predominance of publications

Effectiveness of short-term psychodynamic group therapy in a public outpatient psychotherapy unit

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

2010-01-01

BACKGROUND: Short-term psychodynamic group therapy in heterogeneous patient groups is common in the public Danish psychiatric system but is in need of evaluation. AIM: To investigate improvement in 39-session psychodynamic group therapy using three criteria: 1) effect size (Cohen's d), 2...... compared with Danish norms. Clinical implications: Patients referred to public outpatient treatment settings may need alternative or longer treatment than 39 sessions of psychodynamic group therapy over 3 months.......) and subscales. Analyses were conducted on the total sample and after exclusion of 32 GSI pre-treatment no-cases. RESULTS: The total sample GSI effect size was 0.74 indicating a moderate to large effect size (ranging from 0.67 in depressed to 0.74 in neurotic and personality disorder patients), which increased...

Therapeutic self-disclosure in integrative psychotherapy: When is this a clinical error?

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Ziv-Beiman, Sharon; Shahar, Golan

2016-09-01

Ascending to prominence in virtually all forms of psychotherapy, therapist self-disclosure (TSD) has recently been identified as a primarily integrative intervention (Ziv-Beiman, 2013). In the present article, we discuss various instances in which using TSD in integrative psychotherapy might constitute a clinical error. First, we briefly review extant theory and empirical research on TSD, followed by our preferred version of integrative psychotherapy (i.e., a version of Wachtel's Cyclical Psychodynamics [Wachtel, 1977, 1997, 2014]), which we title cognitive existential psychodynamics. Next, we provide and discuss three examples in which implementing TSD constitutes a clinical error. In essence, we submit that using TSD constitutes an error when patients, constrained by their representational structures (object relations), experience the subjectivity of the other as impinging, and thus propels them to "react" instead of "emerge." (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Treatment of adolescents with depression: the effect of transference interventions in a randomized controlled study of dynamic psychotherapy

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Ulberg Randi

2012-09-01

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

Treatment of adolescents with depression: the effect of transference interventions in a randomized controlled study of dynamic psychotherapy.

Science.gov (United States)

Ulberg, Randi; Hersoug, Anne Grete; Høglend, Per

2012-09-06

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. 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. 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. Gender personality disorder (PD) and quality of object relations (QOR

Assessing Attachment in Psychotherapy

DEFF Research Database (Denmark)

Talia, Alessandro; Miller-Bottome, Madeleine; Daniel, Sarah I.F.

2017-01-01

The authors present and validate the Patient Attachment Coding System (PACS), a transcript-based instrument that assesses clients' in-session attachment based on any session of psychotherapy, in multiple treatment modalities. One-hundred and sixty clients in different types of psychotherapy...... (cognitive–behavioural, cognitive–behavioural-enhanced, psychodynamic, relational, supportive) and from three different countries were administered the Adult Attachment Interview (AAI) prior to treatment, and one session for each client was rated with the PACS by independent coders. Results indicate strong...... inter-rater reliability, and high convergent validity of the PACS scales and classifications with the AAI. These results present the PACS as a practical alternative to the AAI in psychotherapy research and suggest that clinicians using the PACS can assess clients' attachment status on an ongoing basis...

The early impact of therapeutic alliance in brief psychodynamic psychotherapy O impacto inicial da aliança terapêutica em psicoterapia psicodinâmica breve

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José Alvaro Marques Marcolino

2003-06-01

Full Text Available INTRODCTION: Therapeutic alliance is a key component of the psychotherapeutic process. This study estimated the impact of the therapeutic alliance as measured by CALPAS-P in an individual brief psychodynamic psychotherapy program. METHODS: To study the impact of the therapeutic alliance patients in psychotherapy answered to the CALPAS-P at the first and third session and to the Self-report Questionnaire (SRQ-20, to the Beck Depression Inventory (BDI and to the Hamilton Anxiety Scale at the beginning and at the end of psychotherapy. RESULTS: The study of the impact of the therapeutic alliance in brief psychodynamic psychotherapy showed that higher TUI scores in the first session were significantly associated to the improvement on the BDI. Patients with best scores in the working alliance, measured at the third PWC session had also significant symptomatic changes. DISCUSSION: The study of the impact of the therapeutic alliance in brief psychotherapy indicated that patients who perceived that their therapists had the best capability to understand and to be involved in their issues had best results in reducing depressive symptoms and patients with higher capability to form the working alliance reached the best psychotherapy outcomes.INTRODUÇÃO: A aliança terapêutica é um conceito central do processo psicoterápico. Este estudo avaliou o impacto da aliança terapêutica em um programa de psicoterapia individual psicodinâmica breve. MÉTODO: Para o estudo do impacto da aliança, pacientes em psicoterapia responderam, ao início e ao final de cada psicoterapia, ao Questionário de auto-avaliação (SRQ-20, ao Inventário de Depressão de Beck (BDI e à Escala de Ansiedade de Hamilton. Responderam também a CALPAS-P ao término da primeira e da terceira sessão. RESULTADOS: Os resultados mostraram que os pacientes com uma pontuação mais alta da TUI na primeira sessão tiveram um impacto significativo sobre a mudança da sintomatologia medida

Interpersonal psychotherapy for anorexia nervosa.

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McIntosh, V V; Bulik, C M; McKenzie, J M; Luty, S E; Jordan, J

2000-03-01

This paper outlines the rationale for treating individuals with anorexia nervosa using interpersonal psychotherapy. We review theoretical, empirical, and psychotherapy literature relating to interpersonal functioning in anorexia nervosa. Etiological theories emphasize interpersonal and family dysfunction in the development of anorexia nervosa. Research supports the notion that families of individuals with anorexia nervosa have dysfunctional patterns of communication. The history of treatment for anorexia nervosa emphasizes the need for resolution of interpersonal dysfunction, within the traditions of psychodynamic, family therapy, and multidimensional therapies. Interpersonal psychotherapy is a time-limited psychotherapy based on the notion that regardless of etiology, interpersonal relationships are intertwined with symptomatology. The goals of the therapy are to improve interpersonal functioning and thereby decrease symptomatology. Factors identified as important in the development of anorexia nervosa are readily conceptualized within the interpersonal psychotherapy problem areas of grief, interpersonal disputes, interpersonal deficits, and role transitions. Copyright 2000 by John Wiley & Sons, Inc.

Psychotherapy Integration via Theoretical Unification

Directory of Open Access Journals (Sweden)

Warren W. Tryon

2017-01-01

Full Text Available Meaningful psychotherapy integration requires theoretical unification because psychotherapists can only be expected to treat patients with the same diagnoses similarly if they understand these disorders similarly and if they agree on the mechanisms by which effective treatments work. Tryon (in press has proposed a transtheoretic transdiagnostic psychotherapy based on an Applied Psychological Science (APS clinical orientation, founded on a BioPsychology Network explanatory system that provides sufficient theoretical unification to support meaningful psychotherapy integration. That proposal focused mainly on making a neuroscience argument. This article makes a different argument for theoretical unification and consequently psychotherapy integration. The strength of theories of psychotherapy, like all theory, is to focus on certain topics, goals, and methods. But this strength is also a weakness because it can blind one to alternative perspectives and thereby promote unnecessary competition among therapies. This article provides a broader perspective based on learning and memory that is consistent with the behavioral, cognitive, cognitive-behavioral, psychodynamic, pharmacologic, and Existential/Humanistic/Experiential clinical orientations. It thereby provides a basis for meaningful psychotherapy integration.

A Substance Called Food: Long-Term Psychodynamic Group Treatment for Compulsive Overeating.

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Schwartz, Deborah C; Nickow, Marcia S; Arseneau, Ric; Gisslow, Mary T

2015-07-01

Obesity has proven difficult to treat. Many approaches neglect to address the deep-rooted underlying psychological issues. This paper describes a psychodynamically oriented approach to treating compulsive overeating as an addiction. Common to all addictions is a compulsion to consume a substance or engage in a behavior, a preoccupation with using behavior and rituals, and a lifestyle marked by an inability to manage the behavior and its harmful consequences. The approach represents a shift away from primarily medical models of intervention to integrated models focusing on the psychological underpinnings of obesity. Long-term psychodynamic group psychotherapy is recommended as a primary treatment.

Psychotherapy in Contemporary Psychiatric Practice.

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

2015-06-01

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. 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. 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. 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.

Succession and survival in psychotherapy organizations.

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Khaleelee, Olya

2008-11-01

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.

Integrated cognitive-behavioral and psychodynamic psychotherapy for intimate partner violent men.

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Lawson, David M; Kellam, Melanie; Quinn, Jamie; Malnar, Stevie G

2012-06-01

Intimate partner violence (IPV) continue to have widespread negative effects on victims, children who witness IPV, and perpetrators. Current treatments have proven to be only marginally effective in stopping or reducing IPV by men. The two most prominent treatment approaches are feminist sociocultural and cognitive-behavioral therapy (CBT). The feminist sociocultural approach has been criticized for failing to adequately consider the therapeutic alliance, personality factors, and sole focus on patriarchy as the cause for IPV, whereas CBT has been criticized for failing to attend to motivation issues in treatment protocols. This article reviews the effectiveness of current treatments for partner-violent men, examines relationship and personality variables related to IPV and its treatment, and presents an emerging IPV treatment model that combines CBT and psychodynamic therapy. The article addresses how psychodynamic therapy is integrated into the more content-based elements of CBT. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Comparing Psychodynamic Teaching, Supervision, and Psychotherapy Over Videoconferencing Technology with Chinese Students.

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Gordon, Robert M; Wang, Xiubing; Tune, Jane

2015-12-01

How do experts compare teaching, supervision, and treatment from a psychodynamic perceptive over the Internet with in-person work? Our methodology was based on the expert opinions of 176 teachers, supervisors, and therapists in the China American Psychoanalytic Alliance (CAPA) who use videoconferencing (VCON) with Chinese students. The results from our online survey indicate: (1), The longer teachers teach, the more effective they rate teaching over VCON; (2), Teaching, supervision, and treatment were all rated in the range of "slightly less effective" than in-person, with supervision rated significantly more effective than teaching and treatment over VCON; (3), When doing psychodynamic treatment over VCON the issues of symptom reduction, exploring mental life, working on transference, relational problems, resistance, privacy issues, countertransference, are all equally rated in the range of "slightly less effective" than in-person treatment; (4), The highest significantly rated indications for treatment over VCON are: "To offer high quality treatment to underserved or remote patients" and "When patient is house-bound or travel would be impractical"; and (5), The highest significantly rated contraindication for treatment over VCON is: "Patient needs close observation due to crisis or decompensation." Overall, this survey suggests that VCON teaching, supervision, and treatment from a psychodynamic perceptive is a worthwhile option when considering its unique contribution to extending services where needed.

What hath freud wrought? Current confusion and controversies about the clinical practice of psychoanalysis and psychodynamic psychotherapy.

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Chessick, Richard D

2014-12-01

This article discusses the current state of psychoanalysis and the challenges to the fundamental premises of Freud's psychoanalysis by those who have shifted to relationship or so-called two-person psychologies in our field. The author begins by briefly describing a parallel to the recent history of psychoanalysis in the sudden rise and fall of scholastic philosophy in the 14th century. He then focuses on contemporary attacks on Freud's psychoanalysis as a science, based on the contention by two-person psychologists that free association by the patient and evenly hovering attention by the analyst are actually impossible. He reviews Freud's idea of psychoanalysis, discusses psychodynamic psychotherapy, both conceived as scientific treatment procedures, and describes the current assault on their metapsychological and epistemological foundations. Returning to the parallel between what happened to medieval scholasticism and what has happened to psychoanalysis, he examines why this happened, and the resulting fragmentation of psychoanalytic practice. The article concludes with suggestions for the integration of various schools of psychoanalysis, reminding us of Benjamin Franklin's warning: "We must, indeed, all hang together or, most assuredly, we shall all hang separately."

Psychotherapy in Contemporary Psychiatric Practice

Science.gov (United States)

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

2015-01-01

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

A Neural Systems-Based Neurobiology and Neuropsychiatry Course: Integrating Biology, Psychodynamics, and Psychology in the Psychiatric Curriculum

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Lacy, Timothy; Hughes, John D.

2006-01-01

Objective: Psychotherapy and biological psychiatry remain divided in psychiatry residency curricula. Behavioral neurobiology and neuropsychiatry provide a systems-level framework that allows teachers to integrate biology, psychodynamics, and psychology. Method: The authors detail the underlying assumptions and outline of a neural systems-based…

Group Milieu in systemic and psychodynamic group therapy

DEFF Research Database (Denmark)

Lau, Marianne Engelbrecht

Objectives: A recent meta-analysis also concluded that psychotherapeutic approaches are beneficial for adult with a history of CSA and maintained for at least six months follow-up. The results suggest that different characteristics of therapy moderate the therapeutic outcome. We found in a random......Objectives: A recent meta-analysis also concluded that psychotherapeutic approaches are beneficial for adult with a history of CSA and maintained for at least six months follow-up. The results suggest that different characteristics of therapy moderate the therapeutic outcome. We found....... Methods: This randomized prospective study included 106 women: 52 assigned to psychodynamic group psychotherapy and 54 assigned to systemic group psychotherapy. The Group Environment Scale (GES) was filled in the mid phase of therapy and analysed in three dimensions and 10 subscales. Results: The systemic...... subscales: Cohesion (pLeader support (p=0.001), Expressiveness (p

[Body integrity identity disorder--first success in long-term psychotherapy].

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Thiel, Aylin; Ehni, Franziska J F; Oddo, Silvia; Stirn, Aglaja

2011-07-01

The Body Integrity Identity Disorder (BIID) is a fairly unknown and unexplored psychic illness. Very little cases underwent a psychotherapeutic treatment. We report on the two-and-a-half year psychotherapy with a 37 years old man, who wants an amputation of his two legs. Origin and meaning of the amputation desire were uncovered in psychotherapy. The psychodynamic oriented therapy with cognitive-behavioral elements can be used to develop further treatment approaches. © Georg Thieme Verlag KG Stuttgart · New York.

[Reality of treatment in psychotherapy: Results of a survey of German psychiatric hospitals].

Science.gov (United States)

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

2015-05-01

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.

Is psychodynamic psychotherapy an effective intervention for individuals at ultra-high risk (UHR of psychosis?: a case report

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Paula A. Martins

2012-01-01

Full Text Available OBJECTIVE: To report a case and to discuss the use of psychodynamic psychotherapy (PD-P to treat individuals at ultra-high risk (UHR of psychosis. METHODS: An individual at UHR was followed up for 24 months. The baseline evaluation included a psychiatric interview, the Structured Interview for Prodromal Symptoms (SIPS, the Scale of Prodromal Symptoms (SOPS, and neuropsychological assessment. He underwent weekly sessions of PD-P for 12 months and was followed up for 12 months after the end of PD-P. The evaluations were at baseline, after 6-, 12-, and 24-month follow-up. No medication was prescribed during the 24-month follow-up. RESULTS: The prodromal symptoms remitted. The initial total score on the SIPS/SOPS was 37 points. After the first 12 months of PD-P, there was a reduction to 12 points on the SIPS/SOPS score, which stabilized in the 24-month follow-up. There was also a slight improvement in his performance on the neuropsychological evaluations. CONCLUSION: This case report suggests that PD-P can reduce prodromal symptoms; nevertheless, a better understanding of the specificity and efficacy of PD-P as an option of treatment for UHR individuals is needed.

Changes in prefrontal-limbic function in major depression after 15 months of long-term psychotherapy.

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Anna Buchheim

Full Text Available 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.

Changes in Prefrontal-Limbic Function in Major Depression after 15 Months of Long-Term Psychotherapy

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Buchheim, Anna; Viviani, Roberto; Kessler, Henrik; Kächele, Horst; Cierpka, Manfred; Roth, Gerhard; George, Carol; Kernberg, Otto F.; Bruns, Georg; Taubner, Svenja

2012-01-01

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

With Doug: an Eastern Orthodox--Gestalt framework for pastoral psychotherapy in the armed forces.

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Alexander, David

2013-01-01

In military behavioral healthcare, a short-term, solutions-focused system often privileges cognitive techniques over existential, affective, or psychodynamic approaches to care. Pastoral psychotherapy, which often privileges existential and person-centered care, has the potential to prove a pivotal complement in treating the whole person. This article offers an existential approach to pastoral psychotherapy in the military using integrated concepts and applications from Gestalt Therapy and Eastern Orthodox pastoral care.

Trends in Psychotherapy Training: A National Survey of Psychiatry Residency Training

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Sudak, Donna M.; Goldberg, David A.

2012-01-01

Objective: The authors sought to determine current trends in residency training of psychiatrists. Method: The authors surveyed U.S. general-psychiatry training directors about the amount of didactic training, supervised clinical experience, and numbers of patients treated in the RRC-mandated models of psychotherapy (psychodynamic,…

Psychotherapy Training: Residents' Perceptions and Experiences.

Science.gov (United States)

Kovach, Jessica G; Dubin, William R; Combs, Christopher J

2015-10-01

This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more

Self-reported immature defense style as a predictor of outcome in short-term and long-term psychotherapy.

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Laaksonen, Maarit A; Sirkiä, Carlos; Knekt, Paul; Lindfors, Olavi

2014-07-01

Identification of pretreatment patient characteristics predictive of psychotherapy outcome could help to guide treatment choices. This study evaluates patients' initial level of immature defense style as a predictor of the outcome of short-term versus long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 adult outpatients with mood or anxiety disorder were randomized to individual short-term (psychodynamic or solution-focused) or long-term (psychodynamic) psychotherapy. Their defense style was assessed at baseline using the 88-item Defense Style Questionnaire and classified as low or high around the median value of the respective score. Both specific (Beck Depression Inventory [BDI], Hamilton Depression Rating Scale [HDRS], Symptom Check List Anxiety Scale [SCL-90-Anx], Hamilton Anxiety Rating Scale [HARS]) and global (Symptom Check List Global Severity Index [SCL-90-GSI], Global Assessment of Functioning Scale [GAF]) psychiatric symptoms were measured at baseline and 3-7 times during a 3-year follow-up. Patients with high use of immature defense style experienced greater symptom reduction in long-term than in short-term psychotherapy by the end of the 3-year follow-up (50% vs. 34%). Patients with low use of immature defense style experienced faster symptom reduction in short-term than in long-term psychotherapy during the first year of follow-up (34% vs. 19%). Knowledge of patients' initial level of immature defense style may potentially be utilized in tailoring treatments. Further research on defense styles as outcome predictors in psychotherapies of different types is needed.

Psychotherapy of Mood Disorders

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Picardi, Angelo; Gaetano, Paola

2014-01-01

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. PMID

The dual process of adolescent immigration and relocation: from country to country and from childhood to adolescence--its reflection in psychodynamic psychotherapy.

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Sharabany, Ruth; Israeli, Etziona

2008-01-01

This chapter presents psychological issues and processes in adolescent patients who have also migrated or relocated from one country to another. Theoretical perspectives related to attachment processes illumine both migration and adolescence as changes for which secure bases are most needed, lost, and sometimes rediscovered. The psychodynamic processes underlying the difficulties encountered by such adolescents, and their meaning, are presented. Relationships with parents, which normally go through separation-individuation and renegotiation of the oedipal crisis, both of which are central to adolescence, are disrupted by migration. Migration poses new challenges and choices while identity formation is evolving during adolescence. These include adopting a new identity, embracing and letting go of the old, and accepting and integrating the new. The dual relationship with identity finds expression, for example, in language. Fluctuations in understanding and not understanding the new and the old language represent the ambivalence toward the new and the old. The developmental roller-coaster of adolescence, which involves more intense use of defense mechanisms, is heightened during immigration. Processes of idealization (of parents, therapist, old country, new culture) rapidly fade with the devaluation of the same targets. Mechanisms of splitting between good and bad, as well as massive repression of issues that are too hard to deal with at this crossroad, are profuse. Hopeful fantasies of rebirth are concurrent with despair, depression, and, in some cases, suicidal thoughts and attempts. Excerpts from a case in psychodynamic psychotherapy are presented, focusing on the evolving new balances: integrating the old and the new by maintaining attachments to the one while forming attachments to the other; relinquishing and mourning the lost paradise of childhood, as well as the old country, friends, culture, smells, and tastes; accepting disappointments when the shining new

Integrative Treatment of Personality Disorder. Part I: Psychotherapy.

Science.gov (United States)

Jovanovic, Mirjana Divac; Svrakic, Dragan

2017-03-01

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.

Psychodynamic Treatment of the Criminal Offender: Making the Case for Longer-Term Treatment in a Longer-Term Setting.

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Mulay, Abby L; Kelly, Elspeth; Cain, Nicole M

2017-01-01

In recent years, prisons and jails have become de facto psychiatric hospitals, responsible for the care and treatment of individuals with serious mental illness. Historically, cognitive-behaviorally informed therapeutic approaches have been the treatment of choice among mental health practitioners in correctional settings. However, inmate-clients often present with complex diagnostic issues that are arguably better served by long-term treatment options, such as psychodynamic psychotherapy. We first review the nature of psychotherapy in the correctional setting, as well as treatment barriers and challenges faced by both mental health providers and inmate-clients. We then review treatment studies that examine the efficacy of various therapeutic techniques in correctional/forensic contexts. Finally, we argue that, due to the complex nature of psychopathology, average length of time incarcerated, and treatment issues that arise in this multifaceted and challenging setting, mental health treatment providers should consider providing psychodynamic treatment modalities when working with incarcerated individuals. We also argue that more research is needed to examine the efficacy of these treatment approaches with inmate-clients.

[Adaptation of psychodrama in psychotherapy of patients with anorexia nervosa and bulimia nervosa].

Science.gov (United States)

Izydorczyk, Bernadetta

2011-01-01

The aim of the article was an attempt to present selected theoretical motifs and moreover self experience in the adaptation of elements of psychodrama by Moreno in psychodynamic psychotherapy (individual and group psychotherapy) in a group of people with anorexia and bulimia nervosa. Psychodrama through own creativity, spontaneity and taking action on the "here and now" stage helps to attain and intensify therapeutic aims which concern the consciousness of inner conflict of persons with anorexia and bulimia nervosa, which is translocated on their body.

Attitudes of psychotherapists towards pharmacotherapy in the course of psychotherapy

Directory of Open Access Journals (Sweden)

Sławomir Murawiec

2017-06-01

Full Text Available Background: In contrast to the reality of clinical practice, in which psychotherapy and pharmacotherapy are frequently combined, the attitudes of psychotherapists towards the use of pharmacotherapy in conjunction with psychotherapy have to date been rarely studied. Method: A special questionnaire was designed for the purpose of the study. An electronic format allowing for anonymous online responses was sent to psychotherapists from two selected mental health institutions in Warsaw. The results were analysed statistically. Results: One hundred six psychotherapists returned a completed questionnaire. They were classified into three groups depending on the length of psychotherapeutic practice as well as into groups of  cognitive-behavioural, psychodynamic/psychoanalytic and  systemic/integrative psychotherapists. Although cognitive-behavioural therapists do not treat more patients than therapists of other modalities, they encounter significantly more patients who receive medications (p = 0.001 and the number of their patients receiving combined treatment is  increasing during psychotherapy. The  highest knowledge of  drug names was reported in  the group of psychodynamic/psychoanalytic therapists. Integrative and systemic therapists more often declared their positive attitude towards combining psychotherapy with pharmacotherapy (Chi-squared test, χ2; p = 0.04. Psychotherapists declaring a neutral attitude towards pharmacotherapy – regardless of the therapeutic modality – had generally more patients in therapy than therapists by whom the use of drugs in the course of psychotherapy was perceived positively or negatively (p < 0.05. Conclusions: The use of medications in the course of psychotherapy is a result of an interplay between many factors, including patients’ preferences, psychotherapeutic modality and the age of a psychotherapist.

An empirical analysis of mental state talk and affect regulation in two single-cases of psychodynamic child therapy.

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Halfon, Sibel; Bekar, Ozlem; Gürleyen, Büşra

2017-06-01

Literature has shown the importance of mentalizing techniques in symptom remission and emotional understanding; however, no study to date has looked at the dynamic relations between mental state talk and affect regulation in the psychotherapy process. From a psychodynamic perspective, the emergence of the child's capacity to regulate affect through the therapist's reflection on the child's mental states is a core aspect of treatment. In an empirical investigation of 2 single cases with separation anxiety disorder, who were treated in long-term psychodynamic play therapy informed with mentalization principles, the effect of therapists' and children's use of mental state talk on children's subsequent capacity to regulate affect in play was assessed. One case was a positive outcome case, whereas the other did not show symptomatic improvement at the end of treatment. Children's and therapists' utterances in the sessions were coded using the Coding System for Mental State Talk in Narratives, and children's play was coded by Children's Play Therapy Instrument, which generated an index of children's "affect regulation." Time-series Granger Causality tests showed that even though both therapists' use of mental state talk significantly predicted children's subsequent affect regulation, the association between child's mental state talk and affect regulation was only supported for the child who showed clinically significant symptom reduction. This study provided preliminary support that mental state talk in psychodynamic psychotherapy facilitates emotion regulation in play. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Psychosomatic regularities of psychotic disorders of women in involution (pathogenesis, clinics, psychodynamic psychotherapy

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М. М. Pustovoyt

2017-08-01

Full Text Available The problem of psychotic disorders with onset in the age of involution from broader perspective, guided by modern multidimensional paradigm, was never discussed before. Involutional psychosis is considered as a constellation of the biological changes that are irrefutable in this age period. Certain personality traits and coping strategies can be predisposing to psychotic response, as well as typical features of the “life curve” and external stressors that can run a psychotic reaction. The paper presents the result of our study. This study pays much attention to study of premorbid personality, with emphasis on characteristic features, peculiarities of the emotional reaction and motivation-behavioral area, which completely coincided with characteristics of the narcissistic personality disorder listed in DSM-V (2013. Aim: To explore the psychosomatic pathogenetic connections inherent involutionary psychosis, given pathogenic and pathoplastic impact of premorbid personality structure their syndromic form and dynamics, determine their place on the psychosomatic continuum and develop adequate and pathogenetic justified method of therapy. Methods. Data obtained by the clinical method were confirmed by the results of experimental psychological and neuropsychological researches. Results. Clinical characteristics of psychotic disorders in the patient population showed in the structure of psychosis the existence of two oppositely directed continuums: affective (depressive and delusional. This allows to allocate four main clinical forms of psychosis and their tendency to unite in two clusters that differed each other by the features, and also by their response to therapy and, therefore, by the prognosis. Conclusions: The psychodynamic approach to understanding the involutional psychosis, that was introduced by the author, got natural development in the proposed method of treatment that included complex medication and psychotherapy. The schemes of

Heterogeneity of treatment changes after psychodynamic therapy within a one year follow-up

DEFF Research Database (Denmark)

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

2014-01-01

Naturalistic psychotherapy effect studies commonly report effect sizes for the total sample. However, a previous study of SCL-90 Global Severity Index (GSI) improvement in a large outpatient sample used a cluster analytic strategy and reported clinical relevant outcome trajectories that could...... and agoraphobic symptoms may be less optimally treated in short-term time limited psychodynamic groups. There is an obvious need for diversity of treatment offers, better integration of psycho-social treatment components, and long-term open ended treatment....

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

Science.gov (United States)

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

2017-11-17

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.

The effect of adding psychodynamic therapy to antidepressants in patients with major depressive disorder. A systematic review of randomized clinical trials with meta-analyses and trial sequential analyses.

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Jakobsen, Janus Christian; Hansen, Jane Lindschou; Simonsen, Erik; Gluud, Christian

2012-03-01

Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Psychodynamic therapy may be a treatment option for depression, but the effects have only been limitedly assessed in systematic reviews. Using Cochrane systematic review methodology, we compared the benefits and harms of psychodynamic therapy versus 'no intervention' or sham for major depressive disorder. We accepted any co-intervention, including antidepressants, as long as it was delivered similarly in both intervention groups. Trials were identified by searching the Cochrane Library's CENTRAL, MEDLINE via PubMed, EMBASE, Psychlit, Psyc Info, and Science Citation Index Expanded until February 2010. Two authors independently extracted data. We evaluated risk of bias to control for systematic errors. We conducted trial sequential analysis to control for random errors. We included five trials randomizing a total of 365 participants who all received antidepressants as co-intervention. All trials had high risk of bias. Four trials assessed 'interpersonal psychotherapy' and one trial 'short psychodynamic supportive psychotherapy'. Meta-analysis showed that psychodynamic therapy significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference -3.01 (95% confidence interval -3.98 to -2.03; Ptherapy to antidepressants might benefit depressed patients, but the possible treatment effect measured on the Hamilton Rating Scale for Depression is small. Copyright © 2011 Elsevier B.V. All rights reserved.

Commentary: Coming Full Circle--Psychoanalysis, Psychodynamics, and Forensic Psychiatry.

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Hegarty, Angela M

2015-12-01

Drs. Simopoulos and Cohen argue that knowledge of one's unconscious processes improves the forensic psychiatrist's capacity to manage complex forensic situations and to generate forensic formulations and opinions that are demonstrably more valid and reliable, much like competence in cultural assessment and formulation. In practice, the challenges posed by the application of these principles in forensic settings are far outweighed by the potential benefit. Forensic practice is informed by many specialties. Forensic psychiatrists do not have to complete full training in these disciplines to make use of the knowledge and perspectives they offer. The same may not be true of psychodynamic assessment and formulation. Although much can be learned from supervision, case seminars, conferences, and reading, such knowledge does little to foster awareness of one's unconscious processes that by definition operate outside awareness and thus contribute to the vitiating effect of bias. To date, the only method whereby psychiatrists can effectively come to appreciate their own unconscious processes in action is arguably through their own analysis conducted in the course of training in analysis or psychodynamic psychotherapy. © 2015 American Academy of Psychiatry and the Law.

NICE recommendations for psychotherapy in depression: Of limited clinical utility.

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McQueen, D; Smith, P St John

2015-01-01

In 2009/10 NICE partially updated its guidelines on the treatment and management of depression in adults. Due to methodological shortcomings the recommendations for psychotherapy must be treated with caution. Despite recognising the heterogeneous and comorbid nature of depression, and the limitations of depression as a unitary diagnostic category, NICE treats depression as if it were a unitary entity differentiated only by severity. The guidance ignores important aetiological factors such as trauma, loss and maltreatment, personality and interpersonal difficulties. It excludes the largest naturalistic studies on clinical populations treated in the National Health Service on the grounds that they are observational studies conducted in heterogeneous groups with mixed neurotic disorders. It unquestioningly accepts that the "brand" of psychotherapy has construct validity, and ignores psychotherapy process research indicating significant commonalities, and overlap, between treatment modalities and evidence that individual practitioner effects are larger than the differences between treatment modalities. It fails to consider patient differences and preferences, which are known to influence uptake, completion and response. It takes an exclusively short-term perspective on a chronic relapsing disorder. It does not consider the evidence for longer-term treatments. It is of special concern that NICE misrepresents the findings of its own systematic review by implying that CBT and IPT are superior treatments. NICE's systematic review actually found no evidence of superiority between CBT, IPT, psychodynamic psychotherapy, or counselling. Based on the exclusion of much clinically relevant research demonstrating the effectiveness of psychodynamic psychotherapy and counselling many commentators have alleged a bias towards CBT in the guidance. With regard to service delivery NICE proposes the replacement of psychiatric assessment and individualised treatment plans, with an unproven

A Cognitive-Developmental Model of Emotional Awareness and Its Application to the Practice of Psychotherapy.

Science.gov (United States)

Chhatwal, Jasleen; Lane, Richard D

The ability to be aware of one's own emotional states has been a time-honored ingredient of successful psychodynamic psychotherapy. With the rise of cognitive-behavioral therapy (CBT), however, the utility of experiencing and reflecting upon emotional experience has become less certain, and a quantifiable measure of emotional awareness for clinicians has not been previously available. Several recent advances cast the role of emotional awareness in psychotherapy in a different light: (1) a new theory of change in psychotherapy has been formulated that highlights emotional experience as an important ingredient of change in a variety of modalities; (2) new evidence shows that individual differences in the capacity for emotional awareness predict successful psychotherapeutic outcome in the treatment of panic disorder both by manualized psychodynamic psychotherapy and CBT; and (3) a new online version of the electronic Levels of Emotional Awareness Scale (eLEAS) has been created that can be used with individual patients as a guide to psychotherapy treatment. Here we review evidence of a reliable and valid measure of emotional awareness that has been used in both normative and clinical contexts. The psychotherapeutic treatment of three patients is described to illustrate the clinical manifestations of the different levels of emotional awareness and the ways the eLEAS can be useful in the clinical context, including (1) assessment of the patient's current level of emotional functioning and his or her potential for higher levels of functioning, (2) the targeting of interventions to facilitate functioning at the next level, and (3) a possible marker of treatment progress. These observations suggest that the eLEAS has the potential to be a clinically useful tool that may assist clinicians in guiding psychotherapy treatment.

Informed Consent and Psychotherapy : An Interpretative Phenomenological Analysis of Therapists’ Views.

OpenAIRE

Goddard, Angela; Murray, Craig; Simpson, Jane

2008-01-01

Objectives: To examine the issue of informed consent and how this is translated into clinical psychotherapy practice. Design: A qualitative approach was taken in which interviews were used to produce data. Methods: Nine clinical psychologists with specialist psychodynamic training took part in the research. Participants were interviewed using a semi-structured interview schedule. The interviews were transcribed and the data were analysed using Interpretative Phenomenological Analysis. Results...

Predictive value of object relations for therapeutic alliance and outcome in psychotherapy for depression: an exploratory study

NARCIS (Netherlands)

Van, H.L.; Hendriksen, M.; Schoevers, R.A.; Peen, J.; Abraham, R.A.; Dekker, J.J.M.

2008-01-01

The concept of object relations has been shown to be relevant for the process and outcome of psychodynamic psychotherapies. However, little is known about its relevance for the psychotherapeutic treatment of depression. In this study, we explored the predictive value of object relational functioning

Self-concept and quality of object relations as predictors of outcome in short- and long-term psychotherapy.

Science.gov (United States)

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

2014-01-01

Quality of object relations and self-concept reflect clinically relevant aspects of personality functioning, but their prediction as suitability factors for psychotherapies of different lengths has not been compared. This study compared their prediction on psychiatric symptoms and work ability in short- and long-term psychotherapy. Altogether 326 patients, 20-46 years of age, with mood and/or anxiety disorder, were randomized to short-term (solution-focused or short-term psychodynamic) psychotherapy and long-term psychodynamic psychotherapy. The Quality of Object Relations Scale (QORS) and the Structural Analysis of Social Behavior (SASB) self-concept questionnaire were measured at baseline, and their prediction on outcome during the 3-year follow-up was assessed by the Symptom Check List Global Severity Index and the Anxiety Scale, the Beck Depression Inventory and by the Work Ability Index, Social Adjustment Scale work subscale and the Perceived Psychological Functioning scale. Negative self-concept strongly and self-controlling characteristics modestly predicted better 3-year outcomes in long-term therapy, after faster early gains in short-term therapy. Patients with a more positive or self-emancipating self-concept, or more mature object relations, experienced more extensive benefits after long-term psychotherapy. The importance of length vs. long-term therapy technique on the differences found is not known. Patients with mild to moderate personality pathology, indicated by poor self-concept, seem to benefit more from long-term than short-term psychotherapy, in reducing risk of depression. Long-term therapy may also be indicated for patients with relatively good psychological functioning. More research is needed on the relative importance of these characteristics in comparison with other patient-related factors. © 2013 Published by Elsevier B.V.

Moderation of the Alliance-Outcome Association by Prior Depressive Episodes: Differential Effects in Cognitive-Behavioral Therapy and Short-Term Psychodynamic Supportive Psychotherapy.

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Lorenzo-Luaces, Lorenzo; Driessen, Ellen; DeRubeis, Robert J; Van, Henricus L; Keefe, John R; Hendriksen, Mariëlle; Dekker, Jack

2017-09-01

Prior studies have suggested that the association between the alliance and depression improvement varies as a function of prior history of depression. We sought to replicate these findings and extend them to short-term psychodynamic supportive psychotherapy (SPSP) in a sample of patients who were randomized to one of these treatments and were administered the Helping Alliance Questionnaire (N=282) at Week 5 of treatment. Overall, the alliance was a predictor of symptom change (d=0.33). In SPSP, the alliance was a modest but robust predictor of change, irrespective of prior episodes (d=0.25-0.33). By contrast, in CBT, the effects of the alliance on symptom change were large for patients with 0 prior episodes (d=0.86), moderate for those with 1 prior episode (d=0.49), and small for those with 2+ prior episodes (d=0.12). These findings suggest a complex interaction between patient features and common vs. specific therapy processes. In CBT, the alliance relates to change for patients with less recurrent depression whereas other CBT-specific processes may account for change for patients with more recurrent depression. Copyright © 2016. Published by Elsevier Ltd.

The use of empathy and transference as interventions in psychotherapy with attention deficit hyperactive disorder latency-aged boys.

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Conway, Francine

2014-03-01

Psychodynamic-oriented therapies are uniquely positioned to address the internal experiences of a child whose external presentation is consistent with an Attention Deficit Hyperactivity Disorder (ADHD) diagnosis, an area of treatment intervention that is conspicuously absent from common ADHD treatment modalities. This article presents two psychodynamic psychotherapy treatment interventions that demonstrate (1) the importance of empathy in the therapeutic relationship and (2) the use of transference in psychotherapy with ADHD children. Through the use of case examples, the use of empathy is demonstrated in developing the therapeutic alliance, facilitating the development of the child's reflective capacity on affective states, and organizing the child's affective experiences. The benefits of transference interventions with ADHD children are reviewed, and case examples are provided to demonstrate how the therapist worked with the idealized and mirroring transference. Interventions are presented in the context of Object Relations and Self-Psychology Theories. (c) 2014 APA, all rights reserved.

Using Psychodynamic, Cognitive Behavioral, and Control Mastery Prototypes to Predict Change: A New Look at an Old Paradigm for Long-Term Single-Case Research

Science.gov (United States)

Pole, Nnamdi; Ablon, J. Stuart; O'Connor, Lynn E.

2008-01-01

This article illustrates a method of testing models of change in individual long-term psychotherapy cases. A depressed client was treated with 208 sessions of control mastery therapy (CMT), an unmanualized approach that integrates elements of psychodynamic therapy (PDT) and cognitive behavioral therapy (CBT). Panels of experts developed prototypes…

[The way to proceed in psychotherapy--focusing on the framework of phobias and obsessive-compulsive stories].

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Nishimura, Ryoji

2012-01-01

Compulsion becomes long-term when treatment is commenced with very severe resistance. Patients showing emotional changes are rare compared to those with conversion and phobic disorders. However, most people improve when careful treatment is carried out. Although there are those in whom drug treatment is effective, drug treatment and psychotherapy are concomitantly used in most cases. In this lecture, the characteristics of compulsion were psychodynamically investigated regarding: 1. Central conflict, 2. Defense mechanisms, 3. Condition of love life (including sex life), 4. Growth history, by comparing with phobias. When the life of the inner-self protrudes, obsessive-compulsive patients try to contradict and deny this. The symptoms sometimes directly represent the mental conflict of the person, and sometimes the symptom formation process may be understood to some extent. It is said that such cases are suitable for psychotherapy. Psychodynamic psychotherapy involves regaining the continuity of emotional life divided due to defenses such as negation, reaction formation, and isolation. Meanwhile, the real nature of phobias is avoidance and escape. Therefore, the trick in proceeding with interviews is to lead the phobia patient to areas which they avoid during interviews and areas which they avoid in daily life, and to have the patient enter these fields at times by encouraging them.

Evidens for psykodynamisk psykoterapi

DEFF Research Database (Denmark)

Alberdi, Francisco; Rosenbaum, Bent

2010-01-01

In general, psychodynamic psychotherapy is not considered evidence-based treatment. This review includes recent meta-analyses and review papers. We conclude that evidence in favour of psychodynamic psychotherapy exists for unipolar depression, panic anxiety with and without agoraphobia, social...... phobia, generalised anxiety and post-traumatic stress disorder. For complex mental conditions, long-term psychodynamic psychotherapy shows greater effect than no treatment, standard treatment and short-term psychotherapy. Psychodynamic psychotherapy can be recommended for treatment of specific...

[In-patient psychoanalytical psychotherapy of a 12 year old boy with secondary encopresis].

Science.gov (United States)

Pressel, Christine

2007-01-01

Case report on the in-patient psychoanalytical psychotherapy of a 12 year old boy, who developed a nonorganic encopresis at the age of nine after his mother died. One focal issue is his denial of this loss and the beginning of a process of mourning due to the treatment. The Operationalized Psychodynamic Diagnostics (OPD) for Children and Adolescents are illustrated for this case.

[Integrative parent-infant psychotherapy for early regulatory and relationship disorders].

Science.gov (United States)

Papousek, Mechthild; de Chuquisengo, Ruth Wollwerth

2006-01-01

The author introduces both the concept and practice of Integrative Parent-Infant Psychotherapy (IPI-P), a treatment specifically designed for the most frequent developmental problems and psychological needs of infants and their parents. Based on growing knowledge from interdisciplinary infancy research, both basic and clinical, IPI-P has been developed and practised in the "Munich Interdisciplinary Research and Intervention Program" for early regulatory and relationship disorders since the early nineties. Preverbal parent-infant communication represents both the port of entry into the system and the main focus of diagnostics, developmental counselling, interaction guidance, or psychodynamic psychotherapy of distorted communication and distressed/disordered relationships. The method of videomicroanalysis during video-feedback with the parent has proven particularly efficient--while observing, reliving and working through brief episodes of recorded parent-infant interaction. The author illustrates the diagnostic and therapeutic procedures with excerpts from psychotherapy of a toddler with an age-specific regulatory disorder in the context of severely distressed primary relationships.

Karolinske psychodynamic profile (KAPP)

DEFF Research Database (Denmark)

Mathiesen, Birgit Bork; Søgaard, Ulf

2006-01-01

psykologiske testmetoder, assesment, Karolinska psychodynamic profile (KAPP), psykodynamisk profil......psykologiske testmetoder, assesment, Karolinska psychodynamic profile (KAPP), psykodynamisk profil...

Psychosis and the dynamics of the psychotherapy process

DEFF Research Database (Denmark)

Rosenbaum, Bent; Harder, Susanne

2007-01-01

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 of the 's......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......-subjective process, a therapeutic relationship is disrupted and a therapeutic alliance is not assured. Therapists have to pay particular attention to the empathic aspects of the interaction as they attempt to integrate affects to restore meaning to the inner life of the patient. The psychodynamics of this process...

Adult separation anxiety in treatment nonresponders with anxiety disorders: delineation of the syndrome and exploration of attachment-based psychotherapy and biomarkers.

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Milrod, Barbara; Altemus, Margaret; Gross, Charles; Busch, Fredric; Silver, Gabrielle; Christos, Paul; Stieber, Joshua; Schneier, Franklin

2016-04-01

Clinically significant separation anxiety [SA] has been identified as being common among patients who do not respond to psychiatric interventions, regardless of intervention type (pharmacological or psychotherapeutic), across anxiety and mood disorders. An attachment formation and maintenance domain has been proposed as contributing to anxiety disorders. We therefore directly determined prevalence of SA in a population of adult treatment non-responders suffering from primary anxiety. In these separation anxious nonresponders, we pilot-tested an SA-focused, attachment-based psychotherapy for anxiety, Panic-Focused Psychodynamic Psychotherapy-eXtended Range [PFPP-XR], and assessed whether hypothesized biomarkers of attachment were engaged. We studied separation anxiety [SA] in 46 adults (ages 23-70 [mean 43.9 (14.9)]) with clinically significant anxiety symptoms (Hamilton Anxiety Rating Scale [HARS]≥15), and reporting a history of past non-response to psychotherapy and/or medication treatments. Thirty-seven (80%) had clinically significant symptoms of separation anxiety (Structured Clinical Interview for Separation Anxiety Symptoms [SCI-SAS] score≥8). Five of these subjects completed an open clinical trial of Panic Focused Psychodynamic Psychotherapy eXtended Range [PFPP-XR], a 21-24 session, 12-week manualized attachment-focused anxiolytic psychodynamic psychotherapy for anxiety. Patients improved on "adult threshold" SCI-SAS (current separation anxiety) (p=.016), HARS (p=0.002), and global severity, assessed by the Clinical Global Impression Scale (p=.0006), at treatment termination. Salivary oxytocin levels decreased 67% after treatment (p=.12). There was no significant change in high or low frequency HRV after treatment, but change in high frequency HRV inversely correlated with treatment change in oxytocin (ppsychotherapy, potentially supporting the clinical relevance of attachment dysfunction in this sample. The large decrease in oxytocin levels with

Dispositional optimism as predictor of outcome in short- and long-term psychotherapy.

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Heinonen, Erkki; Heiskanen, Tiia; Lindfors, Olavi; Härkäpää, Kristiina; Knekt, Paul

2017-09-01

Dispositional optimism predicts various beneficial outcomes in somatic health and treatment, but has been little studied in psychotherapy. This study investigated whether an optimistic disposition differentially predicts patients' ability to benefit from short-term versus long-term psychotherapy. A total of 326 adult outpatients with mood and/or anxiety disorder were randomized into short-term (solution-focused or short-term psychodynamic) or long-term psychodynamic therapy and followed up for 3 years. Dispositional optimism was assessed by patients at baseline with the self-rated Life Orientation Test (LOT) questionnaire. Outcome was assessed at baseline and seven times during the follow-up, in terms of depressive (BDI, HDRS), anxiety (SCL-90-ANX, HARS), and general psychiatric symptoms (SCL-90-GSI), all seven follow-up points including patients' self-reports and three including interview-based measures. Lower dispositional optimism predicted faster symptom reduction in short-term than in long-term psychotherapy. Higher optimism predicted equally rapid and eventually greater benefits in long-term, as compared to short-term, psychotherapy. Weaker optimism appeared to predict sustenance of problems early in long-term therapy. Stronger optimism seems to best facilitate engaging in and benefiting from a long-term therapy process. Closer research might clarify the psychological processes responsible for these effects and help fine-tune both briefer and longer interventions to optimize treatment effectiveness for particular patients and their psychological qualities. Weaker dispositional optimism does not appear to inhibit brief therapy from effecting symptomatic recovery. Patients with weaker optimism do not seem to gain added benefits from long-term therapy, but instead may be susceptible to prolonged psychiatric symptoms in the early stages of long-term therapy. © 2016 The British Psychological Society.

Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial.

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Zipfel, Stephan; Wild, Beate; Groß, Gaby; Friederich, Hans-Christoph; Teufel, Martin; Schellberg, Dieter; Giel, Katrin E; de Zwaan, Martina; Dinkel, Andreas; Herpertz, Stephan; Burgmer, Markus; Löwe, Bernd; Tagay, Sefik; von Wietersheim, Jörn; Zeeck, Almut; Schade-Brittinger, Carmen; Schauenburg, Henning; Herzog, Wolfgang

2014-01-11

Psychotherapy is the treatment of choice for patients with anorexia nervosa, although evidence of efficacy is weak. The Anorexia Nervosa Treatment of OutPatients (ANTOP) study aimed to assess the efficacy and safety of two manual-based outpatient treatments for anorexia nervosa--focal psychodynamic therapy and enhanced cognitive behaviour therapy--versus optimised treatment as usual. The ANTOP study is a multicentre, randomised controlled efficacy trial in adults with anorexia nervosa. We recruited patients from ten university hospitals in Germany. Participants were randomly allocated to 10 months of treatment with either focal psychodynamic therapy, enhanced cognitive behaviour therapy, or optimised treatment as usual (including outpatient psychotherapy and structured care from a family doctor). The primary outcome was weight gain, measured as increased body-mass index (BMI) at the end of treatment. A key secondary outcome was rate of recovery (based on a combination of weight gain and eating disorder-specific psychopathology). Analysis was by intention to treat. This trial is registered at http://isrctn.org, number ISRCTN72809357. Of 727 adults screened for inclusion, 242 underwent randomisation: 80 to focal psychodynamic therapy, 80 to enhanced cognitive behaviour therapy, and 82 to optimised treatment as usual. At the end of treatment, 54 patients (22%) were lost to follow-up, and at 12-month follow-up a total of 73 (30%) had dropped out. At the end of treatment, BMI had increased in all study groups (focal psychodynamic therapy 0·73 kg/m(2), enhanced cognitive behaviour therapy 0·93 kg/m(2), optimised treatment as usual 0·69 kg/m(2)); no differences were noted between groups (mean difference between focal psychodynamic therapy and enhanced cognitive behaviour therapy -0·45, 95% CI -0·96 to 0·07; focal psychodynamic therapy vs optimised treatment as usual -0·14, -0·68 to 0·39; enhanced cognitive behaviour therapy vs optimised treatment as usual -0·30

Does interpersonal behavior of psychotherapy trainees differ in private and professional relationships?

OpenAIRE

Fincke, Janna I.; Möller, Heidi; Taubner, Svenja

2015-01-01

Aim: The present study aimed to evaluate the effect of trainees' interpersonal behaviour on Work Involvement (WI) and compared their social behaviour within professional and private relationships as well as between different psychotherapeutic orientations. Methods: The interpersonal scales of the Intrex short-form questionnaire and the Work Involvement Scale (WIS) were used to evaluate two samples of German psychotherapy trainees in psychoanalytic (PA), psychodynamic (PD) and cognitive behavi...

Psychotherapy and Cognitive Behavioral Therapy Supervision in Danish Psychiatry: Training the Next Generation of Psychiatrists.

Science.gov (United States)

Schmidt, Lasse M; Foli-Andersen, Nina J

2017-02-01

Psychotherapy training is mandatory for physicians to qualify as psychiatrists in Denmark. Evidence for the effectiveness of psychotherapy has increased, and psychotherapy is increasingly included in international treatment guidelines. The authors investigated how psychiatrists in training in Denmark evaluate the opportunities to practice psychotherapy in their training and the quality of the supervision they receive in psychotherapy training, particularly for cognitive behavioral therapy (CBT). The authors conducted a survey regarding psychotherapy training and CBT supervision among psychiatrists in training at Danish psychiatric specialist training courses. They investigated respondents' interest and experience in psychotherapy and respondents' views on the relevance and feasibility of performing psychotherapy and receiving supervision in their psychiatry training. Eighty-eight percent of the psychiatrists in training found psychotherapy to be a relevant part of their training; however, 77 % found it difficult to find time to practice psychotherapy and 44 % felt that practicing psychotherapy was a strain on their employer. Thirty-six percent and 53 %, respectively, had difficulties securing psychodynamic and CBT supervision. In CBT supervision, more than 60 % reported supervision that appeared to be below the expected CBT supervision standard and often so much below it might not qualify as CBT supervision. There is a need to focus on how to better integrate psychotherapy and supervision in the Danish psychiatric training program. Good CBT supervision may be lacking, and a way to ensure high-quality supervision is required.

Training in Good Psychiatric Management for Borderline Personality Disorder in Residency: An Aide to Learning Supportive Psychotherapy for Challenging-to-Treat Patients.

Science.gov (United States)

Bernanke, Joel; McCommon, Benjamin

2018-01-01

Given many competing demands, psychotherapy training to competency is difficult during psychiatric residency. Good Psychiatric Management for borderline personality disorder (GPM) offers an evidence-based, simplified, psychodynamically informed framework for the outpatient management of patients with borderline personality disorder, one of the most challenging disorders psychiatric residents must learn to treat. In this article, we provide an overview of GPM, and show that training in GPM meets a requirement for training in supportive psychotherapy; builds on psychodynamic psychotherapy training; and applies to other severe personality disorders, especially narcissistic personality disorder. We describe the interpersonal hypersensitivity model used in GPM as a straightforward way for clinicians to collaborate with patients in organizing approaches to psychoeducation, treatment goals, case management, use of multiple treatment modalities, and safety. A modification of the interpersonal hypersensitivity model that includes intra-personal hypersensitivity can be used to address narcissistic problems often present in borderline personality disorder. We argue that these features make GPM ideally suited for psychiatry residents in treating their most challenging patients, provide clinical examples to illustrate these points, and report the key lessons learned by a psychiatry resident after a year of GPM supervision.

Psychiatry residents and dynamic psychiatry: two narratives, a survey, and some ideas to enhance recruitment.

Science.gov (United States)

Katz, Debra A; Tuttle, Jeffrey P; Housman, Beth T

2011-01-01

Psychiatric residency has undergone a major shift over the past 50 years with increasing emphasis on psychopharmacology evidence-based treatments, and competency-based requirements which has led to concerns that psychodynamic knowledge and skills are in jeopardy. Narratives of two residents who developed strong interest in psychodynamic psychotherapy and psychoanalytic training are presented to illustrate the important influences on their identities as psychodynamically oriented psychiatrists. Results from a recent survey of U.S. residents regarding psychodynamic psychiatry indicate that they value psychodynamic psychotherapy, want to incorporate psychotherapy into their careers as psychiatrists, and strongly endorse personal psychotherapy but view their psychodynamic skills as weak. Recommendations about how to enhance education and interest include (1) building or strengthening relationships with mentors, supervisors, and teachers, (2) emphasizing the importance of psychodynamic understanding of patients whether or not the resident is functioning as a therapist, (3) using psychopharmacology to engage residents in thinking psychodynamically, (4) encouraging personal psychotherapy for residents and helping find ways to make it affordable, (5) utilizing awards, visiting scholars, specialized programs, and distance learning, especially for programs without adequate resources, and (6) encouraging clinicians to become familiar with the research base in psychodynamic psychotherapy to correct biases and misperceptions.

Some comments on the nature and use of the concept of psyche in psychoanalysis and psychodynamic psychotherapy.

Science.gov (United States)

Brookes, Crittenden E

2004-01-01

The term psyche is central to the field of mental health and dysfunction. And yet the term is seldom talked about directly, and is seldom elaborated by the professionals who function under its rubric. This article elaborates this term, and sets forth a definition for the purposes of psychology and psychodynamics as science in the sense of the establishment of psychological knowledge. Psyche is defined in this article as a hypothetical construct, as outlined in the classic article in the theory of psychological science by MacCorquodale and Meehl (1948). Psyche is to be distinguished from the concept of mind, which is identified here as a strictly phenomenological (subjective) concept. Use of psyche in this way allows it to be utilized in descriptions of its dynamics (psychodynamics), as a central concept in a science which utilizes phenomenological (subjective rather than objective) data.

Is training effective? A study of counseling psychology doctoral trainees in a psychodynamic/interpersonal training clinic.

Science.gov (United States)

Hill, Clara E; Baumann, Ellen; Shafran, Naama; Gupta, Shudarshana; Morrison, Ashley; Rojas, Andrés E Pérez; Spangler, Patricia T; Griffin, Shauna; Pappa, Laura; Gelso, Charles J

2015-04-01

We investigated changes over 12 to 42 months in 23 predoctoral trainees during their externship training in a psychodynamic/interpersonal psychotherapy clinic. Over time, trainees increased in client-rated working alliance and real relationship, therapist-rated working alliance, client-rated interpersonal functioning, ability to use helping skills (e.g., challenges, immediacy), higher-order functioning (e.g., conceptualization ability, countertransference management), feelings about themselves as therapists (e.g., more authentic, more self-aware), and understanding about being a therapist (e.g., theoretical orientation, curiosity about client dynamics). In contrast, trainees did not change in engaging clients (return after intake or for at least 8 sessions), judge-rated psychodynamic techniques in third and ninth sessions across clients (although trainees used more cognitive-behavioral techniques over time in third but not ninth sessions), or changes in client-rated symptomatology. Trainees primarily attributed changes to graduate training, individual and group supervision, research participation, and working with clients. Implications for training and research are discussed. (c) 2015 APA, all rights reserved).

The relationship between clients' depression etiological beliefs and psychotherapy orientation preferences, expectations, and credibility beliefs.

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Tompkins, Kelley A; Swift, Joshua K; Rousmaniere, Tony G; Whipple, Jason L

2017-06-01

The purpose of this study was to examine the relationship between clients' etiological beliefs for depression and treatment preferences, credibility beliefs, and outcome expectations for five different depression treatments-behavioral activation, cognitive therapy, interpersonal psychotherapy, pharmacotherapy, and psychodynamic psychotherapy. Adult psychotherapy clients (N = 98) were asked to complete an online survey that included the Reasons for Depression Questionnaire, a brief description of each of the five treatment options, and credibility, expectancy, and preference questions for each option. On average, the participating clients rated pharmacotherapy as significantly less credible, having a lower likelihood of success, and being less preferred than the four types of psychotherapy. In general, interpersonal psychotherapy was also rated more negatively than the other types of psychotherapy. However, these findings depended somewhat on whether the participating client was personally experiencing depression. Credibility beliefs, outcome expectations, and preferences for pharmacotherapy were positively associated with biological beliefs for depression; however, the other hypothesized relationships between etiological beliefs and treatment attitudes were not supported. Although the study is limited based on the specific sample and treatment descriptions that were used, the results may still have implications for psychotherapy research, training, and practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Integrative techniques related to positive processes in psychotherapy.

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Cromer, Thomas D

2013-09-01

This review compiles and evaluates a number of therapist interventions that have been found to significantly contribute to positive psychotherapy processes (i.e., increased alliance, patient engagement/satisfaction, and symptomatic improvement). Four forms of intervention are presented: Affect-focused, Supportive, Exploratory, and Patient-Therapist Interaction. The intention of this review is to link specific interventions to applied practice so that integrative clinicians can potentially use these techniques to improve their clinical work. To this end, there is the inclusion of theory and empirical studies from a range of orientations including Emotionally Focused, Psychodynamic, Client-Centered, Cognitive-Behavioral, Interpersonal, Eclectic, and Motivational Interviewing. Each of the four sections will include the theoretical basis and proposed mechanism of change for the intervention, research that supports its positive impact on psychotherapy processes, and conclude with examples demonstrating its use in actual practice. Clinical implications and considerations regarding the use of these interventions will also be presented. 2013 APA, all rights reserved

“Gold Standards,” Plurality and Monocultures: The Need for Diversity in Psychotherapy

Directory of Open Access Journals (Sweden)

Falk Leichsenring

2018-04-01

Full Text Available For psychotherapy of mental disorders, presently several approaches are available, such as interpersonal, humanistic, systemic, psychodynamic or cognitive behavior therapy (CBT. Pointing to the available evidence, proponents of CBT claim that CBT is the gold standard. Some authors even argue for an integrated CBT-based form of psychotherapy as the only form of psychotherapy. CBT undoubtedly has its strengths and CBT researchers have to be credited for developing and testing treatments for many mental disorders. A critical review, however, shows that the available evidence for the theoretical foundations of CBT, assumed mechanisms of change, quality of studies, and efficacy is not as robust as some researchers claim. Most important, there is no consistent evidence that CBT is more efficacious than other evidence-based approaches. These findings do not justify regarding CBT as the gold standard psychotherapy. They even provide less justification for the idea that the future of psychotherapy lies in one integrated CBT-based form of psychotherapy as the only type of psychotherapy. For the different psychotherapeutic approaches a growing body of evidence is available. These approaches have their strengths because of differences in their respective focus on interpersonal relationships, affects, cognitions, systemic perspectives, experiential, or unconscious processes. Different approaches may be suitable to different patients and therapists. As generally assumed, progress in research results from openness to new ideas and learning from diverse perspectives. Thus, different forms of evidence-based psychotherapy are required. Plurality is the future of psychotherapy, not a uniform “one fits all” approach.

“Gold Standards,” Plurality and Monocultures: The Need for Diversity in Psychotherapy

Science.gov (United States)

Leichsenring, Falk; Abbass, Allan; Hilsenroth, Mark J.; Luyten, Patrick; Munder, Thomas; Rabung, Sven; Steinert, Christiane

2018-01-01

For psychotherapy of mental disorders, presently several approaches are available, such as interpersonal, humanistic, systemic, psychodynamic or cognitive behavior therapy (CBT). Pointing to the available evidence, proponents of CBT claim that CBT is the gold standard. Some authors even argue for an integrated CBT-based form of psychotherapy as the only form of psychotherapy. CBT undoubtedly has its strengths and CBT researchers have to be credited for developing and testing treatments for many mental disorders. A critical review, however, shows that the available evidence for the theoretical foundations of CBT, assumed mechanisms of change, quality of studies, and efficacy is not as robust as some researchers claim. Most important, there is no consistent evidence that CBT is more efficacious than other evidence-based approaches. These findings do not justify regarding CBT as the gold standard psychotherapy. They even provide less justification for the idea that the future of psychotherapy lies in one integrated CBT-based form of psychotherapy as the only type of psychotherapy. For the different psychotherapeutic approaches a growing body of evidence is available. These approaches have their strengths because of differences in their respective focus on interpersonal relationships, affects, cognitions, systemic perspectives, experiential, or unconscious processes. Different approaches may be suitable to different patients and therapists. As generally assumed, progress in research results from openness to new ideas and learning from diverse perspectives. Thus, different forms of evidence-based psychotherapy are required. Plurality is the future of psychotherapy, not a uniform “one fits all” approach. PMID:29740361

Computational psychotherapy research: scaling up the evaluation of patient-provider interactions.

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Imel, Zac E; Steyvers, Mark; Atkins, David C

2015-03-01

In psychotherapy, the patient-provider interaction contains the treatment's active ingredients. However, the technology for analyzing the content of this interaction has not fundamentally changed in decades, limiting both the scale and specificity of psychotherapy research. New methods are required to "scale up" to larger evaluation tasks and "drill down" into the raw linguistic data of patient-therapist interactions. In the current article, we demonstrate the utility of statistical text analysis models called topic models for discovering the underlying linguistic structure in psychotherapy. Topic models identify semantic themes (or topics) in a collection of documents (here, transcripts). We used topic models to summarize and visualize 1,553 psychotherapy and drug therapy (i.e., medication management) transcripts. Results showed that topic models identified clinically relevant content, including affective, relational, and intervention related topics. In addition, topic models learned to identify specific types of therapist statements associated with treatment-related codes (e.g., different treatment approaches, patient-therapist discussions about the therapeutic relationship). Visualizations of semantic similarity across sessions indicate that topic models identify content that discriminates between broad classes of therapy (e.g., cognitive-behavioral therapy vs. psychodynamic therapy). Finally, predictive modeling demonstrated that topic model-derived features can classify therapy type with a high degree of accuracy. Computational psychotherapy research has the potential to scale up the study of psychotherapy to thousands of sessions at a time. We conclude by discussing the implications of computational methods such as topic models for the future of psychotherapy research and practice. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

The role of avoidant and obsessive-compulsive personality disorder traits in matching patients with major depression to cognitive behavioral and psychodynamic therapy: A replication study.

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Kikkert, Martijn J; Driessen, Ellen; Peen, Jaap; Barber, Jacques P; Bockting, Claudi; Schalkwijk, Frans; Dekker, Jeff; Dekker, Jack J M

2016-11-15

Barber and Muenz (1996) reported that cognitive behavior therapy (CBT) was more effective than interpersonal therapy (IPT) for depressed patients with elevated levels of avoidant personality disorder, while IPT was more effective than CBT in patients with elevated levels of obsessive-compulsive personality disorder. These findings may have important clinical implications, but have not yet been replicated. We conducted a study using data from a randomized clinical trial comparing the efficacy of CBT and short-term psychodynamic supportive psychotherapy in the outpatient treatment of depression. We found no evidence indicating that avoidant patients may benefit more from CBT compared to short-term psychodynamic supportive therapy (SPSP). Our results indicate that treatment effect does not depend on the level of avoidance, or obsessive-compulsiveness personality disorders further examine the influence of personality disorders on the effectiveness of CBT or psychodynamic therapy in the treatment of depression. Copyright © 2016 Elsevier B.V. All rights reserved.

Bias Toward Psychodynamic Therapy: Framing the Problem and Working Toward a Solution.

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Plakun, Eric M

2017-09-01

Although psychodynamic therapy (PDT) is an evidence-based intervention for a broad spectrum of psychiatric conditions, there is often notable bias in the way PDT is depicted both in the popular media and in the scientific literature. This has contributed to a negative view of PDT, which hampers both patient access to this treatment and researcher access to funding for further research on PDT. The adverse effects of these distortions and biases are detrimental not only to PDT but also to the overall field of psychotherapy, raising questions about its credibility. Here we summarize current evidence for PDT, describe existing biases, and formulate a set of recommendations to foster a more balanced perspective on PDT.

Predictive value of object relations for therapeutic alliance and outcome in psychotherapy for depression: an exploratory study.

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Van, Henricus L; Hendriksen, Mariëlle; Schoevers, Robert A; Peen, Jaap; Abraham, Robert A; Dekker, Jack

2008-09-01

The concept of object relations has been shown to be relevant for the process and outcome of psychodynamic psychotherapies. However, little is known about its relevance for the psychotherapeutic treatment of depression. In this study, we explored the predictive value of object relational functioning (ORF) for the therapeutic alliance and outcome of short-term psychodynamic supportive psychotherapy in patients with mild to moderately severe depression. The ORF of 81 patients was rated by using the Developmental Profile. The overall maturity of ORF measured at baseline was higher in patients who showed a better treatment response. In multiple regression analysis, the adaptive level of individuation appeared to be specifically predictive of outcome. Patients with a recurrent depression showed less mature levels of ORF, lower adaptive levels and a higher score on the symbiotic level. No association was found between ORF and therapeutic alliance during treatment. In contrast to the single measure of alliance early in therapy, the growth of the alliance was related to outcome. The study indicated the relevance of ORF for depression and established that it is distinctive from the actual therapeutic alliance.

Linguistic measures of the referential process in psychodynamic treatment: the English and Italian versions.

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Mariani, Rachele; Maskit, Bernard; Bucci, Wilma; De Coro, Alessandra

2013-01-01

The referential process is defined in the context of Bucci's multiple code theory as the process by which nonverbal experience is connected to language. The English computerized measures of the referential process, which have been applied in psychotherapy research, include the Weighted Referential Activity Dictionary (WRAD), and measures of Reflection, Affect and Disfluency. This paper presents the development of the Italian version of the IWRAD by modeling Italian texts scored by judges, and shows the application of the IWRAD and other Italian measures in three psychodynamic treatments evaluated for personality change using the Shedler-Westen Assessment Procedure (SWAP-200). Clinical predictions based on applications of the English measures were supported.

Use of interpreters in individual psychotherapy.

Science.gov (United States)

Baxter, H; Cheng, L Y

1996-02-01

This paper was written after one of the authors treated a case by individual therapy using an interpreter, as patient and therapist spoke different languages. There is little literature on this subject, and this paper describes our findings and recommendations for using this approach. A 15-year-old Chinese, Cantonese-speaking in-patient in Hong Kong was treated with individual psychodynamic psychotherapy by an English-speaking Caucasian psychotherapist. The Chinese interpreter attended each session, and therapy was supervised by a bilingual Chinese supervisor. The alternative was to not carry out any therapy, as there was no other therapist available. The patient was treated for a total of 32 sessions. Issues involving language and culture differences between therapist and patient, issues of therapy in a triadic situation involving group dynamics, and specific therapy difficulties raised by the presence of the interpreter are discussed. Therapy was not as effective as hoped, but the patient made some improvements. Finding a suitable interpreter is difficult and their role must be well defined. A bilingual supervisor is also needed to monitor the translation as well as supervising the therapist. Psychotherapy through an interpreter is feasible but not ideal.

A Systematic Review of the Combined Use of Electroconvulsive Therapy and Psychotherapy for Depression

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McClintock, Shawn M.; Brandon, Anna R.; Husain, Mustafa M.; Jarrett, Robin B.

2011-01-01

Objective Electroconvulsive therapy (ECT) is one of the most effective treatments for severe Major Depressive Disorder (MDD). However, after acute phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe MDD and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation. Methods The authors performed two independent searches in PsychInfo (1806 – 2009) and MEDLINE (1948 – 2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of six articles (English language) that mentioned ECT and psychotherapy in the abstract, and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome. Results Although research over the past seven decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes. Conclusions Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special

Evidens for psykodynamisk psykoterapi

DEFF Research Database (Denmark)

Alberdi, Francisco; Rosenbaum, Bent

2010-01-01

phobia, generalised anxiety and post-traumatic stress disorder. For complex mental conditions, long-term psychodynamic psychotherapy shows greater effect than no treatment, standard treatment and short-term psychotherapy. Psychodynamic psychotherapy can be recommended for treatment of specific...

THE NONLINEAR TRAJECTORY OF CHANGE IN PLAY PROFILES OF THREE CHILDREN IN PSYCHODYNAMIC PLAY THERAPY

Directory of Open Access Journals (Sweden)

Sibel Halfon

2016-10-01

Full Text Available Aim: Even though there is substantial evidence that play based therapies produce significant change, the specific play processes in treatment remain unexamined. For that purpose, processes of change in long-term psychodynamic play therapy are assessed through a repeated systematic assessment of three children’s Play Profiles, which reflect patterns of organization among play variables that contribute to play activity in therapy, indicative of the children’s coping strategies, and an expression of their internal world. The main aims of the study are to investigate the kinds of Play Profiles expressed in treatment, and to test whether there is emergence of new and more adaptive Play Profiles using dynamic systems theory as a methodological framework.Methods and Procedures: Each session from the long-term psychodynamic treatment (mean number of sessions = 55 of three 6 year old good outcome cases presenting with Separation Anxiety were recorded, transcribed and coded using items from the Children's Play Therapy Instrument, created to assess the play activity of children in psychotherapy, generating discrete and measurable units of play activity arranged along a continuum of four play profiles: Adaptive, Inhibited, Impulsive, and Disorganized. The play profiles were clustered through K-means Algorithm, generating 7 discrete states characterizing the course of treatment and the transitions between these states were analyzed by Markov Transition Matrix, Recurrence Quantification Analysis (RQA and odds ratios comparing the first and second halves of psychotherapy.Results: The Markov Transitions between the states scaled almost perfectly and also showed the ergodicity of the system meaning that the child can reach any state or shift to another one in play. The RQA and odds ratios showed two trends of change, first concerning the decrease in the use of less adaptive strategies, second regarding the reduction of play interruptions.Conclusions: The

Karolinska Psychodynamic Profile for Sexual Disorders: KAPP-SD. A proposal for a psychodynamic rating scale for sexual disorders.

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Soldati, Lorenzo; Köhl, John; Abraham, Georges; Bianchi Demicheli, Francesco; Wilczek, Alexander

2015-01-01

Our first objective in this paper was to review the literature on psychodynamic rating scales of sexual disorders. Our second objective, based on the findings from our review, was to develop a psychodynamic rating scale for people with sexual disorders: the KAPP-SD. We developed the KAPP-SD by modifying an existing psychodynamic rating scale, which assesses stable modes of mental functioning and character traits, the Karolinska Psychodynamic Profile (KAPP). We removed items 13 and 14 of the KAPP and replaced them with three other items-sexual fantasies, conceptions and role of gender identity, and conceptions and role of sexual orientation. These items are part of the assessment of an individual's sexuality and are used to evaluate a person with a sexual disorder psychodynamically. The KAPP-SD, a modified version of the KAPP, can be found in the Appendix. We developed the KAPP-SD in order to help sex therapists make a rigorous psychodynamic evaluation of persons with sexual disorders, which would give information on the prognosis and on the type of treatment to offer.

Theoretical orientation and therapists' attitudes to important components of therapy: a study based on the valuable elements in psychotherapy questionnaire.

Science.gov (United States)

Larsson, Billy P M; Kaldo, Viktor; Broberg, Anders G

2010-01-01

The authors describe the inception and subsequent testing of a questionnaire on attitudes regarding how psychotherapy ought to be pursued: the Valuable Elements in Psychotherapy Questionnaire (VEP-Q). A sample of 416 Swedish therapists (161 psychodynamic, 93 cognitive, 95 cognitive behavioral, and 67 integrative/eclectic) responded to the 17-item VEP-Q. A factor analysis of these items resulted in three subscales: PDT, CBT, and Common Factor, as validated by analyses of covariance. The internal consistency and test-retest reliability of the scales were excellent. In addition to theoretical orientation, variables such as gender and basic professional training influenced how respondents answered the VEP-Q. The authors conclude that the VEP-Q seems to be an appropriate instrument for describing similarities as well as differences among practitioners of various schools of psychotherapy.

Goethe's anxieties, depressive episodes and (self-)therapeutic strategies: a contribution to method integration in psychotherapy.

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Holm-Hadulla, Rainer M

2013-01-01

In psychiatry and psychotherapy, abstract scientific principles need to be exemplified by narrative case reports to gain practical precision. Goethe was one of the most creative writers, productive scientists, and effective statesmen that ever lived. His descriptions of feelings, emotions, and mental states related to anxieties, depressive episodes, dysthymia, and creativity are unique in their phenomenological precision and richness. His life and work can thus serve as an excellent example enhancing our understanding of the relationship between anxiety, depression and creativity. Furthermore, he described (self-)therapeutic strategies that reinforce and refine modern views. Goethe's self-assessments in his works and letters, and the descriptions by others are analyzed under the perspective of current psychiatric classification. His therapeutic techniques and recommendations are compared with cognitive-behavioral, psychodynamic, and existential psychotherapy to amplify modern concepts of psychotherapy. From a scientific perspective, several distinctive depressive episodes can be diagnosed in Goethe's life. They were characterized by extended depressive moods, lack of drive, and loss of interest and self-esteem combined with social retreat. Goethe displayed diffuse and phobic anxieties as well as dysthymia. His (self-)therapeutic strategies were: (a) the systematic use of helping alliances, (b) behavioral techniques, (c) cognitive reflection on meanings and beliefs, (d) psychodynamic and psychoanalytic remembering, repeating, and working through, and (e) existential striving for self-actualization, social commitment, meaning, and creativity. In Goethe's life, creative incubation, illumination, and elaboration appear to have been associated with psychic instability and dysthymia, sometimes with depressive episodes in a clinical sense. On the one hand, his creative work was triggered by anxieties, dysthymia, and depressive moods. On the other hand, his creativity

[Psychotherapy with a boy with depression following the death of his 2 brothers].

Science.gov (United States)

Zollinger, R

1997-12-01

The author describes the psychotherapy of about 2 1/2 years duration of a 14-year old boy. This psychodynamically oriented psychotherapy dealt with the aftermath of two disasters in his family: The accidental deaths of two older brothers five and four years ago. These events had a lasting effect on the family which negatively interfered with the achievement of developmental tasks in adolescence in the patient. He had erected massive defenses against his own wishes and became withdrawn and depressed. The main issues dealt with in therapy were: (a) The boys fear to step out of his position as the families "child" in consideration of his grieving mother. (b) The boy's difficulty to tolerate and integrate aggressive fantasies and feelings because of his guilt feelings and fear of another loss due to these fantasies and feelings. The working through of conflictual issues in psychotherapy enabled the boy to gain awareness regarding his own needs and wishes, and to find ways to fulfill them. Subsequently, he succeeded in making an adequate professional choice and to go into training for it.

Psychologists conducting Psychotherapy in 2012: current practices and historical trends among Division 29 members.

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Norcross, John C; Rogan, Jessica D

2013-12-01

This study updates three similar investigations conducted in 1981, 1991, and 2001 on APA Division of Psychotherapy members in order to paint a contemporary portrait of psychologists conducting psychotherapy and to chronicle historical trends among Division 29 members. Four hundred twenty-eight psychologists (43% response) completed a questionnaire in 2012 regarding their demographic characteristics, professional activities, theoretical orientations, employment settings, and career experiences. The results point to an increasingly female and aging membership, which continues to be employed primarily in private practices and universities. Psychodynamic (27%), integrative (25%), and cognitive (17%) orientations continue to prevail. Professional activities have remained quite similar across the past 30 years with the exception of declines in projective testing and growth in neuropsychological and health testing. Training and career satisfactions remain high as well.

Towards a taxonomy of common factors in psychotherapy-results of an expert survey.

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Tschacher, Wolfgang; Junghan, Ulrich Martin; Pfammatter, Mario

2014-01-01

How change comes about is hotly debated in psychotherapy research. One camp considers 'non-specific' or 'common factors', shared by different therapy approaches, as essential, whereas researchers of the other camp consider specific techniques as the essential ingredients of change. This controversy, however, suffers from unclear terminology and logical inconsistencies. The Taxonomy Project therefore aims at contributing to the definition and conceptualization of common factors of psychotherapy by analyzing their differential associations to standard techniques. A review identified 22 common factors discussed in psychotherapy research literature. We conducted a survey, in which 68 psychotherapy experts assessed how common factors are implemented by specific techniques. Using hierarchical linear models, we predicted each common factor by techniques and by experts' age, gender and allegiance to a therapy orientation. Common factors differed largely in their relevance for technique implementation. Patient engagement, Affective experiencing and Therapeutic alliance were judged most relevant. Common factors also differed with respect to how well they could be explained by the set of techniques. We present detailed profiles of all common factors by the (positively or negatively) associated techniques. There were indications of a biased taxonomy not covering the embodiment of psychotherapy (expressed by body-centred techniques such as progressive muscle relaxation, biofeedback training and hypnosis). Likewise, common factors did not adequately represent effective psychodynamic and systemic techniques. This taxonomic endeavour is a step towards a clarification of important core constructs of psychotherapy. This article relates standard techniques of psychotherapy (well known to practising therapists) to the change factors/change mechanisms discussed in psychotherapy theory. It gives a short review of the current debate on the mechanisms by which psychotherapy works. We

Psychometric properties of the Helping Alliance Questionnaire-I in psychodynamic psychotherapy for major depression

NARCIS (Netherlands)

Hendriksen, Marielle; Van, Rien; Peen, Jaap; Oudejans, Suzan; Schoevers, Robert; Dekker, Jack

2010-01-01

The psychometric properties of the Helping Alliance Questionnaire-I were analyzed at two times in short-term psychoanalytic supportive psychotherapy for outpatient depression. Exploratory factor analysis conducted in 142 patients generated a model that was confirmed in a different validation sample

The Non-linear Trajectory of Change in Play Profiles of Three Children in Psychodynamic Play Therapy.

Science.gov (United States)

Halfon, Sibel; Çavdar, Alev; Orsucci, Franco; Schiepek, Gunter K; Andreassi, Silvia; Giuliani, Alessandro; de Felice, Giulio

2016-01-01

Aim: Even though there is substantial evidence that play based therapies produce significant change, the specific play processes in treatment remain unexamined. For that purpose, processes of change in long-term psychodynamic play therapy are assessed through a repeated systematic assessment of three children's "play profiles," which reflect patterns of organization among play variables that contribute to play activity in therapy, indicative of the children's coping strategies, and an expression of their internal world. The main aims of the study are to investigate the kinds of play profiles expressed in treatment, and to test whether there is emergence of new and more adaptive play profiles using dynamic systems theory as a methodological framework. Methods and Procedures: Each session from the long-term psychodynamic treatment (mean number of sessions = 55) of three 6-year-old good outcome cases presenting with Separation Anxiety were recorded, transcribed and coded using items from the Children's Play Therapy Instrument (CPTI), created to assess the play activity of children in psychotherapy, generating discrete and measurable units of play activity arranged along a continuum of four play profiles: "Adaptive," "Inhibited," "Impulsive," and "Disorganized." The play profiles were clustered through K -means Algorithm, generating seven discrete states characterizing the course of treatment and the transitions between these states were analyzed by Markov Transition Matrix, Recurrence Quantification Analysis (RQA) and odds ratios comparing the first and second halves of psychotherapy. Results: The Markov Transitions between the states scaled almost perfectly and also showed the ergodicity of the system, meaning that the child can reach any state or shift to another one in play. The RQA and odds ratios showed two trends of change, first concerning the decrease in the use of "less adaptive" strategies, second regarding the reduction of play interruptions. Conclusion

Relationships among alexithymia, therapeutic alliance, and psychotherapy outcome in major depressive disorder.

Science.gov (United States)

Quilty, Lena C; Taylor, Graeme J; McBride, Carolina; Bagby, R Michael

2017-08-01

Previous studies have found that alexithymia predicts process and outcome of psychodynamic psychotherapy across a range of psychiatric disorders. There is preliminary evidence that alexithymia may exert its effects on outcome through the therapist. Other studies have found that alexithymia does not influence outcome of cognitive-behavioral therapy (CBT). The aim of the current study was to investigate the capacity of alexithymia to predict therapist- and patient-rated therapeutic alliance and response to CBT and interpersonal psychotherapy (IPT) for major depressive disorder. A total of 75 adults with major depressive disorder were randomized to receive weekly sessions of manualized individual CBT or IPT for a period of 16 weeks. Pre-treatment alexithymia exhibited a positive direct effect on depression change, and a negative indirect effect on depression change via patient-rated alliance at week 13. There was no mediating role of therapist-rated alliance. Although these findings are preliminary, they suggest that pre-treatment alexithymia has meaningful links to psychotherapy process and outcome, and that nuanced analyses incorporating intervening variables are necessary to elucidate the nature of these links. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Patient preference compared with random allocation in short-term psychodynamic supportive psychotherapy with indicated addition of pharmacotherapy for depression.

NARCIS (Netherlands)

Van, H.L.; Dekker, J.J.M.; Koelen, J.; Kool, S.; van Aalst, G.; Hendriksen, I.J.M.; Peen, J.; Schoevers, R.A.

2009-01-01

Depressed patients randomized to psychotherapy were compared with those who had been chosen for psychotherapy in a treatment algorithm, including addition of an antidepressant in case of early nonresponse. There were no differences between randomized and by-preference patients at baseline in

Attachment theory as a guide to understanding and working with transference and the real relationship in psychotherapy.

Science.gov (United States)

Gelso, Charles J; Palma, Beatriz; Bhatia, Avantika

2013-11-01

Recent decades have witnessed an extraordinary amount of conceptual and empirical work on attachment theory in psychology and psychotherapy. Attachment theory is discussed in the present article as a way of understanding and fostering therapeutic work with 2 other key relationship constructs that have been theorized to be elements of all psychotherapies: client transference and the real relationship existing between the therapist and patient. Fundamental features of attachment, transference, and the real relationship are summarized. Particular emphasis is given to the role of the therapist as a secure base and a safe haven within the real relationship, and to the patient's internal working model as it relates to transference. A case of long-term psychodynamic psychotherapy conducted by the first author is presented to illuminate the 3 main constructs. The case demonstrates both the usefulness of attachment theory and the fact that any single theory cannot explain all of the complex features of a given treatment. © 2013 Wiley Periodicals, Inc.

Behavioral activation in TFP: The role of the treatment contract in transference-focused psychotherapy.

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Yeomans, Frank E; Delaney, Jill C; Levy, Kenneth N

2017-09-01

Transference-focused psychotherapy (TFP) is a manualized evidence-based treatment for borderline and other severe personality disorders that is based on psychoanalytic object relations theory. Similar to other psychodynamic psychotherapies, TFP focuses on changing psychological structures, but also focuses on symptom and behavioral change, particularly the importance of being active (e.g., obtaining a job or involvement in similar activities). In TFP, the establishment of the treatment contract, also known as the treatment frame, is where goals such as work and other activities are agreed upon. The focus on such activities is particularly relevant to the concept of behavioral activation. We provide a clinical vignette to illustrate how TFP utilizes behavioral activation in facilitating treatment outcome both at the behavioral level and at the psychological level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

[Integrative approach in the psychotherapy of borderline personality disorder].

Science.gov (United States)

Kuritárné Szabó, Ildikó

2012-01-01

In the last 20 years six psychotherapy methods have been developed specifically for borderline personality disorder. Solid RCT evidences suggests the efficacy of all the methods. Roughly equivalent improvement was obtained from the different types of psychotherapies. Today we have reached a new phase of the borderline "psychotherapy boom", the integrative approach. According to the integrative treatment advocates we should not choose among these effective treatments but we can incorporate in the therapy all the components that work. The integrative approach uses general factors common to all effective therapies, combined with specific treatment techniques taken from different therapies in order to treat the given patient's psychopathology. These common factors are: coherent framework; attention to strategies for building strong positive alliance and maintaining patient motivation; creating a safe and structured therapeutic environment; clear treatment frame; transparency of the goals and roles; focus upon presenting problems; higher level therapeutic activity; here-and-now focus; and facilitating self-reflection. Treatment focuses on change while maintaining a validating and supportive stance. General strategies can be supplemented by more specific techniques such as cognitive-behavioral interventions for reducing maladaptive behavior, training for developing emotion regulation skills and interpersonal skills coming from dialectical behavior therapy. Methods drawn from psychodynamic approaches can be used for the modification of underlying interpersonal cognitive-emotional schemas.

Clinical process in an integrative psychotherapy for self-wounds.

Science.gov (United States)

Wolfe, Barry E

2013-09-01

In this article, I will briefly describe the clinical process of an integrative psychotherapy for the healing of self-wounds, including its intended interventions and the variability of their application and outcome. Four specific strategies will be considered, including (a) the role of empathy throughout the course of therapy; (b) exposure therapy as a paradigmatic treatment for the treatment of feared thoughts, behavior, and emotions; (c) focusing and other experiential interventions for eliciting self-wounds; and (d) modification and healing of self-wounds with an individualized array of psychodynamic, experiential, and cognitive-behavioral strategies. In addition, we will briefly consider the impact of transference and countertransference on the trajectory of therapy. 2013 APA, all rights reserved

Change in self-esteem predicts depressive symptoms at follow-up after intensive multimodal psychotherapy for major depression.

Science.gov (United States)

Dinger, Ulrike; Ehrenthal, Johannes C; Nikendei, Christoph; Schauenburg, Henning

2017-09-01

Reduced self-esteem is a core symptom of depression, but few studies have investigated within-treatment change of self-esteem as a predictor of long-term outcome in depression. This study investigated change in self-esteem during 8 weeks of multimodal, psychodynamically oriented psychotherapy for 40 depressed patients and tested whether it would predict outcome 6 months after termination. Data was drawn from a randomized clinical pilot trial on day-clinic versus inpatient psychotherapy for depression. Findings supported the association between change in self-esteem and follow-up depression severity, even when controlling for within-treatment symptom change. Change in self-esteem was not related to overall symptoms and interpersonal problems at follow-up. Thus, change in self-esteem may be an important variable in preventing relapse for depression. Self-esteem is related to depressive symptoms and interpersonal problems. Improvement of self-esteem during psychotherapy correlates with improvements of symptoms and interpersonal problems. Change of self-esteem during psychotherapy predicts depressive symptoms 6 months after termination of therapy. When treating depressed patients, psychotherapists should work towards an improvement of self-esteem in order to prevent relapse. Copyright © 2017 John Wiley & Sons, Ltd.

Psychodynamic Movement

DEFF Research Database (Denmark)

Pedersen, Inge Nygaard

2002-01-01

This chapter/article describes the historical development of the disciplin Psychodynamic Movement. The importance of this disciplin for self-experience and for training in developing a therapist identy for the music therapy students are emphasized. Prototypeexercises developed and simplified...

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

2008-01-01

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...

Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis.

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Cristea, Ioana A; Gentili, Claudio; Cotet, Carmen D; Palomba, Daniela; Barbui, Corrado; Cuijpers, Pim

2017-04-01

, 0.09-0.54), suicide (g = 0.44; 95% CI, 0.15-0.74), health service use (g = 0.40; 95% CI, 0.22-0.58), and general psychopathology (g = 0.32; 95% CI, 0.09-0.55), with no differences between design types. There were no significant differences in the odds ratios for treatment retention (1.32; 95% CI, 0.87-2.00 for stand-alone designs and 1.01; 95% CI, 0.55-1.87 for add-on designs). Thirteen trials reported borderline-relevant outcomes at follow-up (g = 0.45; 95% CI, 0.15-0.75). Dialectical behavior therapy (g = 0.34; 95% CI, 0.15-0.53) and psychodynamic approaches (g = 0.41; 95% CI, 0.12-0.69) were the only types of psychotherapies more effective than control interventions. Risk of bias was a significant moderator in subgroup and meta-regression analyses (slope β = -0.16; 95% CI, -0.29 to -0.03; P = .02). Publication bias was persistent, particularly for follow-up. Psychotherapies, most notably dialectical behavior therapy and psychodynamic approaches, are effective for borderline symptoms and related problems. Nonetheless, effects are small, inflated by risk of bias and publication bias, and particularly unstable at follow-up.

I was being myself but being an actor too: the experience of a Black male in interracial psychotherapy.

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Qureshi, Adil

2007-12-01

In recent years, investigators have indicated that the psychotherapy process is of considerable importance in the context of interracial psychotherapy. Despite the interest in the area, minimal research has examined how racial difference impacts the psychotherapy process. This study examines the lived experience of interracial psychodynamic psychotherapy via an in-depth interview with an African-American man who had been in therapy with a European American therapist. This qualitative study utilizes a hermeneutic phenomenological approach, which accepts that understanding is contingent on both sociohistorical situatedness and relational dynamics. The study participant was chosen because of his interest in the area and willingness to explore it in detail with the interviewer. A number of themes emerged, the most salient of which are the multidimensionality of the experience and the 'absent presence' of race in the therapy process. This client's experience was both positive and negative, and in many cases, the same process-related variables contributed both positively and negatively to the client's therapeutic experience. Issues of trust, perceived cultural issues and therapy focus contributed to and detracted from the therapy experience. The depth of the therapy experience was limited by the therapist not explicitly addressing race.

Evidens for psykodynamisk psykoterapi

DEFF Research Database (Denmark)

Alberdi, Francisco; Rosenbaum, Bent

2010-01-01

In general, psychodynamic psychotherapy is not considered evidence-based treatment. This review includes recent meta-analyses and review papers. We conclude that evidence in favour of psychodynamic psychotherapy exists for unipolar depression, panic anxiety with and without agoraphobia, social...

The affective dimension of alliance in transactional analysis psychotherapy

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Roland Johnsson

2010-07-01

Full Text Available The study describes an investigation of the significance of the affective dimension of the therapeutic alliance (Bordin 1979, in a psychodynamic form of transactional analysis therapy after the style of “Redecision therapy” (Goulding & Goulding, 1979. We explored the client’s pattern of affective relationships by use of CCRT (the Core Conflictual Relationship method, Luborsky & Crits-Christoph, 1990, 1998 and examined how the therapist responds to the client’s affective messages (“tests” by use of the Plan Diagnosis method (Weiss & Sampson, 1986. We found that “emotional” aspects play a more decisive role than has been envisioned in the TA redecision method and similar approaches of TA psychotherapy that emphasise contracts, tasks of therapy and a rational approach.

The dream: a psychodynamically informative instrument.

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Glucksman, M L

2001-01-01

The dream is a unique psychodynamically informative instrument for evaluating the subjective correlates of brain activity during REM sleep. These include feelings, percepts, memories, wishes, fantasies, impulses, conflicts, and defenses, as well as images of self and others. Dream analysis can be used in a variety of clinical settings to assist in diagnostic assessment, psychodynamic formulation, evaluation of clinical change, and the management of medically ill patients. Dreams may serve as the initial indicators of transference, resistance, impending crisis, acting-out, conflict resolution, and decision-making. A clinically functional categorization of dreams can facilitate an understanding of psychopathology, psychodynamics, personality structure, and various components of the psychotherapeutic process. Examples of different types of dreams are provided to illustrate their relevance and use in various clinical situations.

Clinical Considerations Regarding Regression in Psychotherapy with Patients with Conversion Disorder.

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Kaplan, Marcia

Regression is a ubiquitous phenomenon in psychodynamic psychotherapy and psychoanalysis, typically part of a reorganization that leads to progression, at least with respect to recruiting elements in the unconscious to consciousness. Regression in patients with conversion disorder (i.e., pseudo-neurological symptoms without an organic basis) is often itself somatic/physical rather than psychic in nature. Psychotherapists working with these patients must be prepared for confusing or frightening forms of regression that should be expected as part of the therapeutic process. In conversion disorder patients with adequate character structure, this regression, when handled effectively by the psychotherapist, ultimately leads to verbalized thoughts and feelings and a gradually strengthening alternative to physically experienced psychic conflict.

Psicoterapia di gruppo ad orientamento psicodinamico: elaborazione teorica e ricerca empirica

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Marie Di Blasi

2012-11-01

Full Text Available This article examines some theoretical and methodological aspects of research in psychodynamic group psychotherapy. Despite the increasing diffusion of therapeutic groups, the small number of researches on psychodynamic group therapy points out methodological difficulties related to research designs, the presence of several variables and the creation of operational indicators. The article examines how the recent constitution of an Italian network focused on psychodynamic group psychotherapy research makes it possible to analyze the results of different national groups and compare theoretical and epistemological assumptions and methodological choices that can make the relationship between psychotherapy and research more consistent.

Clinical Severity as a Moderator of Outcome in Psychodynamic and Dialectical Behavior Therapies for Borderline Personality Disorder.

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Sahin, Zeynep; Vinnars, Bo; Gorman, Bernard S; Wilczek, Alexander; Åsberg, Marie; Barber, Jacques P

2017-12-14

The aim of the present study was to assess the effect of initial level of psychiatric severity on treatment outcome in psychodynamic therapy and dialectical behavior therapy (DBT) for borderline personality disorder (BPD). It was hypothesized that DBT would lead to better outcome for patients with high psychiatric severity, whereas dynamic treatment would lead to better outcome for patients with lower psychiatric severity. Data from the 5th-year follow-up of the Stockholm City Council's and the Karolinska Institute's Psychotherapy Project were used in the present study. A total of 106 female patients diagnosed with BPD with at least 2 past suicide attempts were randomized into object-relational psychotherapy (ORP; based on transference-focused psychotherapy), DBT, and treatment as usual. Patients' baseline global severity index was used as a moderator. Global Assessment of Functioning (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [American Psychiatric Association, 1994]) was used to examine outcome. There was a significant 3-way interaction of Time × Treatment × Severity. Post hoc analyses suggested that patients with lower levels of severity had significantly better outcomes in object-relational psychotherapy. For patients with higher severity, the 3 treatments resulted in similar outcomes in terms of level of functioning. Outcome of treatment for BPD might differ significantly for patients depending on their initial levels of overall psychiatric severity. If our findings are replicated for patients with low severity and supported for a high-severity sample, psychiatric severity can be used as a low-cost and effective tool to match patients with BPD to optimal treatments. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Psychodynamics in medically ill patients.

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Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

2009-01-01

This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

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Tillman, Jane G

2008-01-01

Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach.

Clinical Holistic Medicine (Mindful, Short-Term Psychodynamic Psychotherapy Complemented with Bodywork in the Treatment of Experienced Physical Illness and Chronic Pain

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Søren Ventegodt

2007-01-01

Full Text Available We investigated the treatment effect of psychodynamic short-term therapy complemented with bodywork on patients who presented with physical illness at the Research Clinic for Holistic Medicine in Copenhagen. Psychodynamic short-term therapy was complemented with bodywork (Marion Rosen to help patients confront old emotional pain from childhood trauma(s. Patients were measured with a five-item quality of life and health questionnaire (QOL5, a one-item questionnaire of self-assessed quality of life (QOL1, and four questions on self-rated ability to love and to function sexually, socially, and at work (ability to sustain a full-time job. Most of the patients had chronic pain that could not be alleviated with drugs. Results showed that 31 patients with the experience of being severely physically ill (mostly from chronic pain, in spite of having consulted their own general practitioner, entered the study. The holistic approach and body therapy accelerated the therapy dramatically and no significant side effects were detected. After the intervention, 38.7% did not feel ill (1.73 < NNT < 4.58 (p = 0.05. Psychodynamic short-term therapy complemented with bodywork can help patients. When the patients responded to the therapy, the self-assessed mental health, relationship with partner, ability to work, self-assessed quality of life, relationships in general, measured QOL (with the validated questionnaire QOL5, and life's total state (mean of health, QOL and ability were significantly improved, statistically and clinically. Most importantly, all aspects of life were improved simultaneously, due to induction of Antonovsky-salutogenesis. The patients received in average 20 sessions over 14 months at a cost of 1600 EURO. For the treatment responders, the treatment seemingly provided lasting benefits.

Clinical holistic medicine (mindful, short-term psychodynamic psychotherapy complemented with bodywork) in the treatment of experienced physical illness and chronic pain.

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Ventegodt, Søren; Thegler, Suzette; Andreasen, Tove; Struve, Flemming; Enevoldsen, Lars; Bassaine, Laila; Torp, Margrethe; Merrick, Joav

2007-03-02

We investigated the treatment effect of psychodynamic short-term therapy complemented with bodywork on patients who presented with physical illness at the Research Clinic for Holistic Medicine in Copenhagen. Psychodynamic short-term therapy was complemented with bodywork (Marion Rosen) to help patients confront old emotional pain from childhood trauma(s). Patients were measured with a five-item quality of life and health questionnaire (QOL5), a one-item questionnaire of self-assessed quality of life (QOL1), and four questions on self-rated ability to love and to function sexually, socially, and at work (ability to sustain a full-time job). Most of the patients had chronic pain that could not be alleviated with drugs. Results showed that 31 patients with the experience of being severely physically ill (mostly from chronic pain), in spite of having consulted their own general practitioner, entered the study. The holistic approach and body therapy accelerated the therapy dramatically and no significant side effects were detected. After the intervention, 38.7% did not feel ill (1.73 treatment responders, the treatment seemingly provided lasting benefits.

Borderline or Schizotypal? Differential Psychodynamic Assessment in Severe Personality Disorders.

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VAN Riel, Laura; Ingenhoven, Theo J M; VAN Dam, Quin D; Polak, Marike G; Vollema, Meinte G; Willems, Anne E; Berghuis, Han; VAN Megen, Harold

2017-03-01

Considerable overlap in symptoms between patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) complicates personality diagnostics. Yet very little is known about the level of psychodynamic functioning of both personality disorders. Psychodynamic assessment procedures may specify personality characteristics relevant for differential diagnosis and treatment planning. In this cross-sectional study we explored the differences and similarities in level of personality functioning and psychodynamic features of patients with severe BPD or STPD. In total, 25 patients with BPD and 13 patients with STPD were compared regarding their level of personality functioning (General Assessment of Personality Disorder), current quasipsychotic features (Schizotypal Personality Questionnaire), and psychodynamic functioning [Developmental Profile (DP) interview and Developmental Profile Inventory (DPI) questionnaire]. Both groups of patients showed equally severe impairments in the level of personality functioning and the presence of current quasipsychotic features. As assessed by the DP interview, significant differential psychodynamic patterns were found on the primitive levels of functioning. Moreover, subjects with BPD had significantly higher scores on the adaptive developmental levels. However, the self-questionnaire DPI was not able to elucidate all of these differences. In conclusion, our study found significant differences in psychodynamic functioning between patients with BPD and STPD as assessed with the DP interview. In complicated diagnostic cases, personality assessment by psychodynamic interviewing can enhance subtle but essential differentiation between BPD and STPD.

Clinical Holistic Medicine (Mindful, Short-Term Psychodynamic Psychotherapy Complemented with Bodywork Improves Quality of Life, Health, and Ability by Induction of Antonovsky-Salutogenesis

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Søren Ventegodt

2007-01-01

Full Text Available We had a success rate of treating low, self-assessed, global quality of life (measured by QOL1: How would you assess the quality of your life now? with clinical holistic medicine of 56.4% (95% CI: 42.3–69.7% and calculated from this the Number Needed to Treat (NNT as 1.43–2.36. We found that during treatment, (in average 20 sessions of psychodynamic psychotherapy complemented with bodywork at a cost of 1600 EURO, the patients entered a state of Antonovsky-salutogenesis (holistic, existential healing, which also improved their self-assessed health and general ability one whole step up a 5-point Likert Scale. The treatment responders radically improved their self-assessed physical health (0.6 step, self-assessed mental health (1.6 step, their relation to self (1.2 step, friends (0.3 step, and partner (2.1 step on a 6-step scale, and their ability to love (1.2 step and work (0.8 step, and to function socially (1.0 step and sexually (0.8 step. It seems that treatment with clinical holistic medicine is the cure of choice when the patients (1 present the triad of low quality of life, poor self-assessed physical and/or mental health, and poor ability to function; and (2 are willing to suffer during the therapy by confronting and integrating old emotional problems and trauma(s from the past. For these patients, the treatment provided lasting benefits, without the negative side effects of drugs. A lasting, positive effect might also prevent many different types of problems in the future. The therapy was “mindful” in its focus on existential and spiritual issues.

Girls who cut: treatment in an outpatient psychodynamic psychotherapy practice with adolescent girls and young adult women.

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Ruberman, Louise

2011-01-01

The observation of deficits in the capacity for mature emotional self-regulation in girls who cut is noted in the literature (Daldin, 1990; Novick & Novick, 1991; Nock et al., 2008). The acquisition of the ability to respond in a healthy manner to stress and challenge, either from outside or inside the self is one of the most important tasks of early development; girls who cut have not accomplished this developmental task or are seriously compromised in their efforts to do so. The connection between this observation, the psychosexual developmental antecedents of this deficit, and psychodynamic approaches to treatment are explored in the literature and in case reviews.

Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: A systematic review and network meta-analysis

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Zhou, Xinyu; Hetrick, Sarah E; Cuijpers, Pim; Qin, Bin; Barth, Jürgen; Whittington, Craig J; Cohen, David; Del Giovane, Cinzia; Liu, Yiyun; Michael, Kurt D; Zhang, Yuqing; Weisz, John R; Xie, Peng

2015-01-01

Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N=3805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from −0.47 to −0.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from −0.26 to −1.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy

How to Design and Equip a Mentalization-Based Play Therapy Room.

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Rüth, Ulrich; Holch, Astrid

2018-01-01

Designing and equipping a play therapy room as a differentiated tool in a psychodynamic approach to child psychotherapy is seldom discussed. This article sketches out the equipment and furnishing of a play therapy room to be used for mentalization-based psychodynamic psychotherapy and gives examples of the use of such a room in practice.

Interpersonal processes in psychodynamic-interpersonal and cognitive behavioral group therapy: a systematic case study of two groups.

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Tasca, Giorgio A; Foot, Meredith; Leite, Catherine; Maxwell, Hilary; Balfour, Louise; Bissada, Hany

2011-09-01

This mixed method systematic case study applied an interpersonal stage model of the therapeutic process to examine interpersonal processes among a highly adherent Group Psychodynamic-Interpersonal Psychotherapy (GPIP) therapist and a highly adherent Group Cognitive Behavioral Therapy (GCBT) therapist and their groups of binge eating disordered (BED) patients. This is the first case study to apply the interpersonal stage model of psychotherapy to compare GCBT and GPIP methods and the first to apply the model to group therapy. Early-, middle-, and late-stage transcribed video recordings of sequential interactions among therapists and patients in each of these two time-limited group therapies were analyzed with the Structural Analysis of Social Behavior (SASB). We also provide qualitative presentations of the transcripts from each stage as context for the quantitative analyses. BED patients in both groups achieved positive outcomes for binge eating and depression. Consistent with their treatment model, the GPIP therapist was more autonomy-giving, whereas the GCBT therapist was more controlling/directive. The GPIP therapist and her group had high levels of interpersonal complementary interaction sequences in the early stage followed by lower complementarity in the middle stage. The GCBT therapist and her group showed a high-low-high pattern of complementarity across the three stage of therapy. However, overall the GPIP group had higher levels complementarity than the GCBT group. This mixed method case study of group processes based on an interpersonal stage model of psychotherapy suggested specific therapist behaviors in each modality to maximize positive therapeutic interactions at each stage of group therapy. (c) 2011 APA, all rights reserved.

Induction of apoptosis in HeLa cancer cells by an ultrasonic-mediated synthesis of curcumin-loaded chitosan-alginate-STPP nanoparticles.

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Ahmadi, Fatemeh; Ghasemi-Kasman, Maryam; Ghasemi, Shahram; Gholamitabar Tabari, Maryam; Pourbagher, Roghayeh; Kazemi, Sohrab; Alinejad-Mir, Ali

2017-01-01

Natural herbal compounds have been widely introduced as an alternative therapeutic approach in cancer therapy. Despite potent anticancer activity of curcumin, its clinical application has been limited because of low water solubility and resulting poor bioavailability. In this study, we designed a novel ultrasonic-assisted method for the synthesis of curcumin-loaded chitosan-alginate-sodium tripolyphosphate nanoparticles (CS-ALG-STPP NPs). Furthermore, antitumor effect of curcumin-loaded NPs was evaluated in vitro. Field emission scanning electron microscopy (FE-SEM) and atomic force microscopy (AFM) were used to characterize the properties of NPs. Antitumor activity of curcumin-loaded NPs was assessed by using MTT and quantitative real-time polymerase chain reaction (qRT-PCR). FE-SEM and AFM data revealed the spherical morphology, and the average size of NPs was curcumin-loaded CS-ALG-STPP NPs displayed significant antitumor activity compared with the free curcumin. Gene expression level analyses showed that curcumin NPs significantly increased the apoptotic gene expression. Collectively, our results suggest that curcumin-loaded NPs significantly suppressed proliferation and promoted the induction of apoptosis in human cervical epithelioid carcinoma cancer cells, which might be regarded as an effective alternative strategy for cancer therapy.

Induction of apoptosis in HeLa cancer cells by an ultrasonic-mediated synthesis of curcumin-loaded chitosan–alginate–STPP nanoparticles

Science.gov (United States)

Ahmadi, Fatemeh; Ghasemi-Kasman, Maryam; Ghasemi, Shahram; Gholamitabar Tabari, Maryam; Pourbagher, Roghayeh; Kazemi, Sohrab; Alinejad-Mir, Ali

2017-01-01

Natural herbal compounds have been widely introduced as an alternative therapeutic approach in cancer therapy. Despite potent anticancer activity of curcumin, its clinical application has been limited because of low water solubility and resulting poor bioavailability. In this study, we designed a novel ultrasonic-assisted method for the synthesis of curcumin-loaded chitosan–alginate–sodium tripolyphosphate nanoparticles (CS-ALG-STPP NPs). Furthermore, antitumor effect of curcumin-loaded NPs was evaluated in vitro. Field emission scanning electron microscopy (FE-SEM) and atomic force microscopy (AFM) were used to characterize the properties of NPs. Antitumor activity of curcumin-loaded NPs was assessed by using MTT and quantitative real-time polymerase chain reaction (qRT-PCR). FE-SEM and AFM data revealed the spherical morphology, and the average size of NPs was curcumin-loaded CS-ALG-STPP NPs displayed significant antitumor activity compared with the free curcumin. Gene expression level analyses showed that curcumin NPs significantly increased the apoptotic gene expression. Collectively, our results suggest that curcumin-loaded NPs significantly suppressed proliferation and promoted the induction of apoptosis in human cervical epithelioid carcinoma cancer cells, which might be regarded as an effective alternative strategy for cancer therapy. PMID:29238191

Evidence for the Effectiveness of Jungian Psychotherapy: A Review of Empirical Studies

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Christian Roesler

2013-10-01

Full Text Available Since the 1990s several research projects and empirical studies (process and outcome on Jungian Psychotherapy have been conducted mainly in Germany and Switzerland. Prospective, naturalistic outcome studies and retrospective studies using standardized instruments and health insurance data as well as several qualitative studies of aspects of the psychotherapeutic process will be summarized. The studies are diligently designed and the results are well applicable to the conditions of outpatient practice. All the studies show significant improvements not only on the level of symptoms and interpersonal problems, but also on the level of personality structure and in every day life conduct. These improvements remain stable after completion of therapy over a period of up to six years. Several studies show further improvements after the end of therapy, an effect which psychoanalysis has always claimed. Health insurance data show that, after Jungian therapy, patients reduce health care utilization to a level even below the average of the total population. Results of several studies show that Jungian treatment moves patients from a level of severe symptoms to a level where one can speak of psychological health. These significant changes are reached by Jungian therapy with an average of 90 sessions, which makes Jungian psychotherapy an effective and cost-effective method. Process studies support Jungian theories on psychodynamics and elements of change in the therapeutic process. So finally, Jungian psychotherapy has reached the point where it can be called an empirically proven, effective method.

An Integrative Approach to Treatment-Resistant Obsessive-Compulsive Disorder.

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Woon, Luke Sy-Cherng; Kanapathy, Anita; Zakaria, Hazli; Alfonso, César A

2017-01-01

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

Journeys through the valley of death: multimethod psychological assessment and personality transformation in long-term psychotherapy.

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Finn, Stephen E

2011-03-01

The Psychodynamic Diagnostic Manual (PDM Task Force, 2006) is based on the assumption that an in-depth understanding of clients' underlying emotional, personality, and interpersonal patterns will facilitate their treatment. In this article I show how such an understanding can be achieved through multimethod psychological assessment, and how useful such information can be in long-term psychotherapy with high-achieving, successful clients who struggle with forming and maintaining intimate relationships. Such treatments are extremely difficult, because when these clients attach to their psychotherapists, many of them temporarily become more symptomatic. I illustrate these points with a detailed account of my long-term therapy with a resilient but highly traumatized young man. Repeated use of the Minnesota Multiphasic Personality Disorder-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and Rorschach with my client helped guide us in our work, and also helped create an important therapeutic "opening" into the underlying traumatic material. This and other experiences have convinced me that it is extremely useful for psychologists to have training in both assessment and psychotherapy.

"The Matrix": An allegory of the psychoanalytic journey.

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Mischoulon, David; Beresin, Eugene V

2004-01-01

"The Matrix" has been a huge commercial and critical success and has spawned a series of books and essays exploring the philosophical and religious themes in the story. The authors propose is that "The Matrix" can be interpreted as an allegory for an individual's journey into spiritual and mental health, achieved by overcoming one's intrapsychic conflicts with the help of psychodynamic psychotherapy or psychoanalysis. Neo's story parallels the journey undertaken by the individual who chooses to enter psychotherapy and illustrates several themes of analytic psychotherapy, its benefits, and liabilities. The movie may therefore serve as a teaching tool for psychiatric residents about the goals, functions, and intricacies of psychodynamic psychotherapy.

Amplification of the concept of erroneous meaning in psychodynamic science and in the consulting room.

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Brookes, Crittenden E

2007-01-01

Previous papers dealt with the concept of psyche as that dynamic field which underlies the subjective experience of mind. A new paradigm, psychodynamic science, was suggested for dealing with subjective data. The venue of the psychotherapeutic consulting room is now brought directly into science, expanding the definition of psychotherapy to include both humanistic and scientific elements. Certain concepts were introduced to amplify this new scientific model, including psyche as hypothetical construct, the concept of meaning as replacement for operational validation in scientific investigation, the synonymity of meaning and insight, and the concept of synchronicity, together with the meaning-connected affect of numinosity. The presence of unhealthy anxiety as the conservative ego attempts to preserve its integrity requires a deeper look at the concept of meaning. This leads to a distinction between meaning and erroneous meaning. The main body of this paper amplifies that distinction, and introduces the concept of intolerance of ambiguity in the understanding of erroneous meanings and their connection with human neurosis.

The addiction concept and technology: diagnosis, metaphor, or something else? a psychodynamic point of view.

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Essig, Todd

2012-11-01

Many today suffer from an imbalance between life and life on the screen. When extreme, such as excessive gaming, clinicians retreat to familiar explanations, such as "Internet addiction." But the addiction concept is of limited value, limiting both research and treatment options. This article discusses an alternative. Pathological overuse is seen as a failed solution in which people become entrapped by technology's promise of delivering that which only life can offer, such as the grand adventure simulated in World of Warcraft. A two-part treatment approach of such "simulation entrapment" is described in which both the original problem and the entrapment are treated, the former by traditional psychodynamic psychotherapy and the later by highlighting differences between the technologically mediated experience and traditional experiences of being bodies together. The case of a college student suffering from pathological shame with excessive gaming as the failed solution is offered as an illustration. © 2012 Wiley Periodicals, Inc.

The Role of Theory-Specific Techniques and Therapeutic Alliance in Promoting Positive Outcomes: Integrative Psychotherapy for World Trade Center Responders.

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Haugen, Peter Tejas; Werth, Aditi Sinha; Foster, Alyce Lauren; Owen, Jesse

2016-12-01

World Trade Center responders demonstrate high symptom burden, underscoring the importance of refining treatment approaches for this cohort. One method is examining the impact of therapy techniques on outcomes, and the interactions between technique and alliance on outcomes. This study a) examined the interaction of early treatment techniques on integrative psychotherapy outcomes and b) explored whether associations differed at varying levels of alliance. Twenty-nine adult responders diagnosed with partial or full posttraumatic stress disorder received outpatient psychotherapy and completed weekly measures of alliance, technique, and symptom distress. Analyses indicated significant interactions between 1) alliance and psychodynamic interventions on outcomes and 2) alliance and cognitive behavioral (CB) interventions on outcomes. Clients with high alliance had better outcomes when their therapist used fewer CB techniques. No meaningful differences were found between technique and outcomes for clients with lower alliance. These findings reiterate the critical roles technique and responsiveness to the alliance play in engendering successful outcomes.

Integrative change model in psychotherapy: Perspectives from Indian thought.

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Manickam, L S S

2013-01-01

Different psychotherapeutic approaches claim positive changes in patients as a result of therapy. Explanations related to the change process led to different change models. Some of the change models are experimentally oriented whereas some are theoretical. Apart from the core models of behavioral, psychodynamic, humanistic, cognitive and spiritually oriented models there are specific models, within psychotherapy that explains the change process. Integrative theory of a person as depicted in Indian thought provides a common ground for the integration of various therapies. Integrative model of change based on Indian thought, with specific reference to psychological concepts in Upanishads, Ayurveda, Bhagavad Gita and Yoga are presented. Appropriate psychological tools may be developed in order to help the clinicians to choose the techniques that match the problem and the origin of the dimension. Explorations have to be conducted to develop more techniques that are culturally appropriate and clinically useful. Research has to be initiated to validate the identified concepts.

Does Psychodynamic Environmental Therapy Work?

DEFF Research Database (Denmark)

Nissen, Poul; Hansen, Kim Gabriel

2007-01-01

This article presents the first Danish prospective outcome study of psychodynamic environmental therapy of children in residential treatment with early, serious traumatisation and extential relational disturbances. The study delves beneath the surface and explores the extent to which the children...

CRITICAL REVIEW OF OUTCOME RESEARCH ON INTERPERSONAL PSYCHOTHERAPY FOR ANXIETY DISORDERS

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Markowitz, John C.; Lipsitz, Joshua; Milrod, Barbara L.

2014-01-01

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

The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa - a randomized controlled trial

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Wild, Beate; Friederich, Hans-Christoph; Gross, Gaby; Teufel, Martin; Herzog, Wolfgang; Giel, Katrin E; de Zwaan, Martina; Schauenburg, Henning; Schade-Brittinger, Carmen; Schäfer, Helmut; Zipfel, Stephan

2009-01-01

Background Anorexia nervosa is a serious eating disorder leading to high morbidity and mortality as a result of both malnutrition and suicide. The seriousness of the disorder requires extensive knowledge of effective treatment options. However, evidence for treatment efficacy in this area is remarkably weak. A recent Cochrane review states that there is an urgent need for large, well-designed treatment studies for patients with anorexia nervosa. The aim of this particular multi-centre study is to evaluate the efficacy of two standardized outpatient treatments for patients with anorexia nervosa: focal psychodynamic (FPT) and cognitive behavioural therapy (CBT). Each therapeutic approach is compared to a "treatment-as-usual" control group. Methods/Design 237 patients meeting eligibility criteria are randomly and evenly assigned to the three groups – two intervention groups (CBT and FPT) and one control group. The treatment period for each intervention group is 10 months, consisting of 40 sessions respectively. Body weight, eating disorder related symptoms, and variables of therapeutic alliance are measured during the course of treatment. Psychotherapy sessions are audiotaped for adherence monitoring. The treatment in the control group, both the dosage and type of therapy, is not regulated in the study protocol, but rather reflects the current practice of established outpatient care. The primary outcome measure is the body mass index (BMI) at the end of the treatment (10 months after randomization). Discussion The study design surmounts the disadvantages of previous studies in that it provides a randomized controlled design, a large sample size, adequate inclusion criteria, an adequate treatment protocol, and a clear separation of the treatment conditions in order to avoid contamination. Nevertheless, the study has to deal with difficulties specific to the psychopathology of anorexia nervosa. The treatment protocol allows for dealing with the typically occurring

When and Why Should Mental Health Professionals Offer Traditional Psychodynamic Therapy to Cancer Patients?

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Yuppa, David P; Meyer, Fremonta

2017-05-01

Given the recent studies promoting time-limited manualized therapies in the oncology setting, clinicians may be reluctant to offer traditional psychodynamic therapy to cancer patients. However, there are no studies directly comparing psychodynamic therapy and other therapy modalities in this patient population and no data suggesting harm from psychodynamic approaches. Therefore, it is inappropriate to draw the conclusion that psychodynamic therapy is inferior to manualized therapy from existing evidence. Manualized treatment, such as cognitive behavioral therapy, is generally short term and therefore may reduce the practitioner's own anxiety stemming from exposure to patients facing grave disability and death. However, manualized treatment is not fully effective in specific clinical scenarios. We present a case reflecting these limitations and advocate for a flexible treatment approach incorporating elements of psychodynamic therapy. © 2017 American Medical Association. All Rights Reserved.

Some problems with non-inferiority tests in psychotherapy research: psychodynamic therapies as an example.

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Rief, Winfried; Hofmann, Stefan G

2018-02-14

In virtually every field of medicine, non-inferiority trials and meta-analyses with non-inferiority conclusions are increasingly common. This non-inferiority approach has been frequently used by a group of authors favoring psychodynamic therapies (PDTs), concluding that PDTs are just as effective as cognitive-behavioral therapies (CBT). We focus on these examples to exemplify some problems associated with non-inferiority tests of psychological treatments, although the problems also apply to psychopharmacotherapy research, CBT research, and others. We conclude that non-inferiority trials have specific risks of different types of validity problems, usually favoring an (erroneous) non-inferiority conclusion. Non-inferiority trials require the definition of non-inferiority margins, and currently used thresholds have a tendency to be inflationary, not protecting sufficiently against degradation. The use of non-inferiority approaches can lead to the astonishing result that one single analysis can suggest both, superiority of the comparator (here: CBT) and non-inferiority of the other treatment (here PDT) at the same time. We provide recommendations how to improve the quality of non-inferiority trials, and we recommend to consider them among other criteria when evaluating manuscripts examining non-inferiority trials. If psychotherapeutic families (such as PDT and CBT) differ on the number of investigating trials, and in the fields of clinical applications, and in other validity aspects mentioned above, conclusions about their general non-inferiority are no more than a best guess, typically expressing the favored approach of the lead author.

A Psychodynamic Systems Perspective on Command Relationship during Combat Operations

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2017-06-09

Hasselager, Wilfred Bion, Bent Jorgensen, Defensive Mechanisms, Assumption Groups , Psychodynamic System Theory . 16. SECURITY CLASSIFICATION OF: 17...LITERATURE REVIEW Introduction The purpose of this chapter is to give the reader a detailed overview of the theories used as a foundation for the analysis...conclusion, psychodynamic system theory can be visually represented as the two operating levels of the group with an external boundary to the

Early and sustained dynamic intervention in schizophrenia

DEFF Research Database (Denmark)

Rosenbaum, Bent; Rosenbaum, Bent

2009-01-01

This paper is based on the Danish National Schizophrenia Project manual for psychodynamic individual psychotherapy with persons in states of schizophrenia. The methods for engaging with and treating a patient with schizophrenia in a supportive, psychodynamic way are described....

Commentary on Dinger et al.: Therapist's attachment, interpersonal problems and alliance development over time in inpatient psychotherapy.

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Holmes, Jeremy

2009-09-01

This short article is a commentary on a research study investigating therapist and client attachment styles and their relationship to alliance development in a 12-week psychodynamic psychotherapy program for nonpsychotic inpatients. The relationship is complex; unsurprisingly, securely attached therapists with less distressed clients formed the strongest alliances. A significant proportion of therapists were insecure, almost entirely in the preoccupied or hyperactivating mode. It is argued that collusive relationships between such therapists and similarly overaroused clients may be common. Therapists need both to accommodate to their client's attachment style and to confound it if positive change is to result. Therapist self-scrutiny is likely to be a precondition for such positive outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Integrative psychotherapy.

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Kozarić-Kovacić, Dragica

2008-09-01

The main purposes of the article are to present the history of integration in psychotherapy, the reasons of the development integrative approaches, and the approaches to integration in psychotherapy. Three approaches to integration in psychotherapy exist: theoretical integration, theoretical eclecticism, and common factors in different psychotherapeutic trends. In integrative psychotherapy, the basic epistemology, theory, and clinical practice are based on the phenomenology, field theory, holism, dialogue, and co-creation of dialogue in the therapeutic relationship. The main criticism is that integrative psychotherapy suffers from confusion and many unresolved controversies. It is difficult to theoretically and methodologically define the clinically applied model that is based on such a different epistemological and theoretical presumptions. Integrative psychotherapy is a synthesis of humanistic psychotherapy, object relations theory, and psychoanalytical self psychology. It focuses on the dynamics and potentials of human relationships, with a goal of changing the relations and understanding internal and external resistances. The process of integrative psychotherapy is primarily focused on the developmental-relational model and co-creation of psychotherapeutic relationship as a single interactive event, which is not unilateral, but rather a joint endeavor by both the therapist and the patient/client. The need for a relationship is an important human need and represents a process of attunement that occurs as a response to the need for a relationship, a unique interpersonal contact between two people. If this need is not met, it manifests with the different feelings and various defenses. To meet this need, we need to have another person with whom we can establish a sensitive, attuned relationship. Thus, the therapist becomes this person who tries to supplement what the person did not receive. Neuroscience can be a source of integration through different therapies. We

Observing the determinants of the psychotherapeutic process in depressive disorders. A clinical case study within a psychodynamic approach

Directory of Open Access Journals (Sweden)

Osmano eOasi

2015-04-01

Full Text Available This paper focuses on the relationship between depressive disorders, personality configurations, and mental functioning. A years treatment of a young man with the diagnosis of Depression is presented: the clinical and empirical points of view are described in depth through an assessment at the beginning and at one year after of an oriented psychodynamic psychotherapy. SCID I and II and HAMRS were administered to the patient in assessement phase. In the same phase he filled in BDI-II, and DEQ; the psychotherapist completed SWAP-200. These clinician instruments were used again after one year of the treatment. The PDM point of view is also presented. All sessions are audiotaped: twelve verbatim transcripts were coded with the Defense Mechanisms Rating Scale and CCRT. The results show a decrease in depressive symptoms, a change in some personality configurations, but a substantial invariance of the introjective profile, and a modification in mental functioning.

Therapists' thoughts on therapy: clinicians' perceptions of the therapy processes that distinguish schema, cognitive behavioural and psychodynamic approaches.

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Boterhoven De Haan, Katrina L; Lee, Christopher W

2014-01-01

Debates continue over shared factors in therapy processes between different theoretical orientations. By seeking the opinions of practicing clinicians, this study aimed to elucidate the similarities and differences between cognitive-behavioural (CBT), psychodynamic (PDT), and schema therapy (ST) approaches. Forty-eight practitioners aligning with one of the three approaches were asked to identify crucial processes in their therapy using a modified online version of the Psychotherapy Process Q-set. Distinct differences between each theoretical orientation with few shared common factors were found. A comparison with ratings from previous studies indicated that CBT therapists have not changed over the last 20 years, whereas PDT therapists have changed and the differences appeared consistent with modern PDT theory. The differences between the therapy approaches were consistent with theories underlying each model. PDT therapists valued a neutral relationship, CBT therapists emphasized a didactic interaction, and therapists form a ST orientation placed a greater emphasis on emotional involvement.

Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study

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Amianto Federico

2011-11-01

Full Text Available Abstract Background Individuals affected by severe Borderline Personality Disorder (BPD are often heavy users of Mental Health Services (MHS. Short-term treatments currently used in BPD therapy are useful to target disruptive behaviors but they are less effective in reducing heavy MHS use. Therefore, alternative short-term treatments, less complex than long-term psychodynamic psychotherapies but specifically oriented to BPD core problems, need to be developed to reduce MHS overuse. This study aimed to evaluate the efficacy of adding Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP to Supervised Team Management (STM in BPD treatment compared to STM alone in a naturalistic group of heavy MHS users with BPD. Effectiveness was evaluated 6 times along a two-year follow-up. Methods Thirty-five outpatients who met inclusion criteria were randomly assigned to two treatment groups (STM = 17; SB-APP = 18 and then compared. Clinical Global Impression (CGI and CGI-modified (CGI-M for BPD, Global Assessment of Functioning (GAF, State-Trait Anger Expression Inventory (STAXI, and Symptom Checklist-90 Revised (SCL-90-R were administered at T1, T3, T6, T12, T18 and T24. At T12 the Working Alliance Inventory-Short Form (WAI-S was also completed. At the one-year follow-up, SB-APP group did not receive any additional individual psychological support. MHS team was specifically trained in BPD treatment and had regular supervisions. Results All patients improved on CGI, GAF, and STAXI scores after 6 and 12 months, independently of treatment received. SB-APP group showed better outcome on impulsivity, suicide attempts, chronic feelings of emptiness, and disturbed relationships. We found a good stabilization at the one year follow-up, even after the interruption of brief psychotherapy in the SB-APP group. Conclusions Although STM for BPD applied to heavy MHS users was effective in reducing symptoms and improving their global functioning, adding a time

Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder: a two-year follow-up preliminary randomized study.

Science.gov (United States)

Amianto, Federico; Ferrero, Andrea; Pierò, Andrea; Cairo, Elisabetta; Rocca, Giuseppe; Simonelli, Barbara; Fassina, Simona; Abbate-Daga, Giovanni; Fassino, Secondo

2011-11-21

Individuals affected by severe Borderline Personality Disorder (BPD) are often heavy users of Mental Health Services (MHS). Short-term treatments currently used in BPD therapy are useful to target disruptive behaviors but they are less effective in reducing heavy MHS use. Therefore, alternative short-term treatments, less complex than long-term psychodynamic psychotherapies but specifically oriented to BPD core problems, need to be developed to reduce MHS overuse. This study aimed to evaluate the efficacy of adding Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP) to Supervised Team Management (STM) in BPD treatment compared to STM alone in a naturalistic group of heavy MHS users with BPD. Effectiveness was evaluated 6 times along a two-year follow-up. Thirty-five outpatients who met inclusion criteria were randomly assigned to two treatment groups (STM = 17; SB-APP = 18) and then compared. Clinical Global Impression (CGI) and CGI-modified (CGI-M) for BPD, Global Assessment of Functioning (GAF), State-Trait Anger Expression Inventory (STAXI), and Symptom Checklist-90 Revised (SCL-90-R) were administered at T1, T3, T6, T12, T18 and T24. At T12 the Working Alliance Inventory-Short Form (WAI-S) was also completed. At the one-year follow-up, SB-APP group did not receive any additional individual psychological support. MHS team was specifically trained in BPD treatment and had regular supervisions. All patients improved on CGI, GAF, and STAXI scores after 6 and 12 months, independently of treatment received. SB-APP group showed better outcome on impulsivity, suicide attempts, chronic feelings of emptiness, and disturbed relationships. We found a good stabilization at the one year follow-up, even after the interruption of brief psychotherapy in the SB-APP group. Although STM for BPD applied to heavy MHS users was effective in reducing symptoms and improving their global functioning, adding a time-limited and focused psychotherapy was found to achieve a

Comparing bona fide psychotherapies of depression in adults with two meta-analytical approaches.

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Sarah R Braun

Full Text Available OBJECTIVE: Despite numerous investigations, the question whether all bona fide treatments of depression are equally efficacious in adults has not been sufficiently answered. METHOD: We applied two different meta-analytical techniques (conventional meta-analysis and mixed treatment comparisons. Overall, 53 studies with 3,965 patients, which directly compared two or more bona fide psychotherapies in a randomized trial, were included. Meta-analyses were conducted regarding five different types of outcome measures. Additionally, the influence of possible moderators was examined. RESULTS: Direct comparisons of cognitive behavior therapy, behavior activation therapy, psychodynamic therapy, interpersonal therapy, and supportive therapies versus all other respective treatments indicated that at the end of treatment all treatments but supportive therapies were equally efficacious whereas there was some evidence that supportive therapies were somewhat less efficacious than all other treatments according to patient self-ratings and clinical significance. At follow-up no significant differences were present. Age, gender, comorbid mental disorders, and length of therapy session were found to moderate efficacy. Cognitive behavior therapy was superior in studies where therapy sessions lasted 90 minutes or longer, behavior activation therapy was more efficacious when therapy sessions lasted less than 90 minutes. Mixed treatment comparisons indicated no statistically significant differences in treatment efficacy but some interesting trends. CONCLUSIONS: This study suggests that there might be differential effects of bona fide psychotherapies which should be examined in detail.

Evaluation of Psychoanalytic Oriented Psychotherapy Outcome Using Rorschach and TAT: A Case Study

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Zihniye OKRAY

2017-12-01

Full Text Available Projective techniques especially Rorschach and TAT ( Thematic Apperception Test have a wide variety of assestment areas. These techniques have been used from selection of staff for a appropriate job, giving diagnosis to psychiatric patients, in child services for counseling, selection and evaluation of military personel. Apart from these uses they also have valuable contributions to the efficiency of a certain treatment programs with helping clinicans to evaluate the psychodynamic properties of a client to decide the type, duration and specific issues in the treatment programme (Deabler, 1947, Weiner, 1997, Tunaboylu-İkiz, 2001, 2002, 2010,2011, Anzieu & Chabert, 2011. In this study a case who was treated with psychodynamic oriented psychotherapy for 2 years the outcome of the threapy evaluated with Rorschach and TAT. In the first assestment before the psychothreapy began the Detail responses given by the patient was to much inorder to protect himself from the dangers coming from the real world.The content of the responses also showed the same charasteristic with using the same theme all over the full protocol.Case’s problems around his self-representaion, self, identification- differences between gender and object relations was evaluated with TAT that showed object loss was the main problematic. After 2 years with the termination of the threapy the second evaluation was done. In this second evaluation the case led himself more freely to the test material with less resistance. In the second evaluation; the case’s cognitive processes and using of words are more rich wch represents high cognitive and entellectual capacities. He is less resistant to unconscious material, sexual contents coming up in responses with more intellectual ways. With these two assestment the efficiency of psychodynamic oriented psychothreapy was proved. Although the case’s perception of the real world still contains some aspects of threads the second evaluation

Compulsive buying and binge eating disorder--a case vignettes.

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Marcinko, Darko; Bolanca, Marina; Rudan, Vlasta

2006-12-30

Compulsive buying behaviour has recently received long overdue attention as a clinical issue. Aim of this report is to describe treatment of two female patients diagnosed with compulsive buying disorder in comorbidity with binge eating disorder. In both cases, criteria for diagnosing of other axis I or axis II disorder were not present. Fluvoxamine was used in pharmacotherapy, and psychodynamic psychotherapy as a psychotherapeutical approach. We conclude that fluvoxamine and psychodynamic psychotherapy may be effective in treatment of compulsive buyers in comorbidity with binge eating disorder.

Psychodynamic theory and counseling in predictive testing for Huntington's disease.

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Tassicker, Roslyn J

2005-04-01

This paper revisits psychodynamic theory, which can be applied in predictive testing counseling for Huntington's Disease (HD). Psychodynamic theory has developed from the work of Freud and places importance on early parent-child experiences. The nature of these relationships, or attachments are reflected in adult expectations and relationships. Two significant concepts, identification and fear of abandonment, have been developed and expounded by the psychodynamic theorist, Melanie Klein. The processes of identification and fear of abandonment can become evident in predictive testing counseling and are colored by the client's experience of growing up with a parent affected by Huntington's Disease. In reflecting on family-of-origin experiences, clients can also express implied expectations of the future, and future relationships. Case examples are given to illustrate the dynamic processes of identification and fear of abandonment which may present in the clinical setting. Counselor recognition of these processes can illuminate and inform counseling practice.

Does interpersonal behavior of psychotherapy trainees differ in private and professional relationships?

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Fincke, Janna I; Möller, Heidi; Taubner, Svenja

2015-01-01

The present study aimed to evaluate the effect of trainees' interpersonal behavior on work involvement (WI) and compared their social behavior within professional and private relationships as well as between different psychotherapeutic orientations. The interpersonal scales of the Intrex short-form questionnaire and the Work Involvement Scale (WIS) were used to evaluate two samples of German psychotherapy trainees in psychoanalytic, psychodynamic, and cognitive behavioral therapy training. Trainees from Sample 1 (N = 184) were asked to describe their interpersonal behavior in relation to their patients when filling out the Intrex, whereas trainees from Sample 2 (N = 135) were asked to describe the private relationship with a significant other. Interpersonal affiliation in professional relationships significantly predicted the level of healing involvement, while stress involvement was predicted by interpersonal affiliation and interdependence in trainees' relationships with their patients. Social behavior within professional relationships provided higher correlations with WI than private interpersonal behavior. Significant differences were found between private and professional relation settings in trainees' interpersonal behavior with higher levels of affiliation and interdependence with significant others. Differences between therapeutic orientation and social behavior could only be found when comparing trainees' level of interdependence with the particular relationship setting. Trainees' interpersonal level of affiliation in professional relationships is a predictor for a successful psychotherapeutic development. Vice versa, controlling behavior in professional settings can be understood as a risk factor against psychotherapeutic growth. Both results strengthen an evidence-based approach for competence development during psychotherapy training.

What is the effect on comorbid personality disorder of brief panic-focused psychotherapy in patients with panic disorder?

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Keefe, John R; Milrod, Barbara L; Gallop, Robert; Barber, Jacques P; Chambless, Dianne L

2018-03-01

No studies of psychotherapies for panic disorder (PD) have examined effects on comorbid personality disorders (PersD), yet half such patients have a PersD. In a randomized trial for PD with and without agoraphobia comparing Cognitive-Behavioral Therapy (CBT) and Panic-Focused Psychodynamic Psychotherapy (PFPP), PersD was assessed pre-to-post treatment with the Structured Clinical Interview for the Diagnosis of Axis-II Disorders (SCID-II). For patients completing therapy (n = 118, 54 with PersD), covariance between panic and SCID-II criteria improvements was analyzed. SCID-II diagnostic remission and recovery were evaluated. Comparative efficacy of PFPP versus CBT for improving PersD was analyzed both for the average patient, and as a function of PersD severity. 37 and 17% of PersD patients experienced diagnostic PersD remission and recovery, respectively. Larger reductions in PersD were related to more panic improvement, with a modest effect size (r = 0.28). Although there was no difference between treatments in their ability to improve PersD for the average patient (d = 0.01), patients meeting more PersD criteria did better in PFPP compared to CBT (P = .007), with PFPP being significantly superior at 11 criteria and above (d = 0.66; 3 more criteria lost). PersD presenting in the context of primary PD rarely resolves during psychotherapies focused on PD, and change in PersD only moderately tracks panic improvements, indicating non-overlap of the constructs. Patients receiving panic-focused psychotherapies may require additional treatment for their PersD. PFPP may be superior at improving severe PersD, but replication of this finding is required. © 2017 Wiley Periodicals, Inc.

A child's nightmare. Mum comes and comforts her child. Attachment evaluation as a guide in the assessment and treatment in a clinical case study

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Silvia eSalcuni

2014-08-01

Full Text Available There is a gap between proposed theoretical attachment theory frameworks, measures of attachment in the assessment phase and their relationship with changes in outcome after a psychodynamic oriented psychotherapy. Based on a clinical case study of a young woman with Panic Attack Disorder, this paper examined psychotherapy outcome findings comparing initial and post-treatment assessments, according to the mental functioning in S and M-axis of the Psychodynamic Diagnostic Manual (PDM. Treatment planning and post-treatment changes were described with the main aim to illustrate from a clinical point of view why a psycho-dynamic approach, with specific attention to an attachment theory stance, was considered the treatment of choice for this patient. The Symptom Check List 90 Revised (SCL-90-R and the Shedler-Westen Assessment Procedure (SWAP–200 were administered to detect patient’s symptomatic perception and clinician’s diagnostic points of view, respectively; the Adult Attachment Interview (AAI and the Adult Attachment Projective Picture System (AAP were also administered as to pay attention to patient’s unconscious internal organization and changes in defense processes. A qualitative description of how the treatment unfolded was included. Findings highlight the important contribution of attachment theory in a 22-month psychodynamic psychotherapy framework, promoting resolution of patient’s symptoms and adjustment.

Integrative Psychotherapy ‘Revisited’

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Marye O’Reilly-Knapp

2017-02-01

Full Text Available This article revisits aspects of the theory and methods of Integrative Psychotherapy as written and discussed by Richard G. Erskine, PhD and others. A case study demonstrates the use of Integrative Psychotherapy as the basis for therapeutic interventions that allow the client to interpret early experiences of relational failures, via a relationally based psychotherapy. Revisiting the theory and methods of Integrative Psychotherapy served to further validate the core of IP and its value as a cohesive and comprehensive psychotherapy.

[Inpatient psychotherapy].

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Spitzer, C; Rullkötter, N; Dally, A

2016-01-01

In German-speaking countries inpatient psychotherapy plays a major role in the mental healthcare system. Due to its characteristic features, i. e. multiprofessionalism, multimodality and method integration, the inpatient approach represents a unique and independent type of psychotherapy. In order to be helpful, the manifold verbal and non-verbal methods need to be embedded into an overall treatment plan. Additionally, the therapeutic milieu of the hospital represents an important effective factor and its organization requires a more active construction. The indications for inpatient psychotherapy are not only based on the mental disorder but also on illness, setting and healthcare system-related criteria. In integrative concepts, the multiprofessional team is a key component with many functions. The effectiveness of psychotherapeutic hospital treatment has been proven by meta-analysis studies; however, 20-30% of patients do not benefit from inpatient psychotherapy and almost 13% drop-out prematurely.

Does interpersonal behaviour of psychotherapy trainees differ in private and professional relationships?

Directory of Open Access Journals (Sweden)

Janna Ida Fincke

2015-06-01

Full Text Available Aim: The present study aimed to evaluate the effect of trainees' interpersonal behaviour on Work Involvement (WI and compared their social behaviour within professional and private relationships as well as between different psychotherapeutic orientations. Methods: The interpersonal scales of the Intrex short-form questionnaire and the Work Involvement Scale (WIS were used to evaluate two samples of German psychotherapy trainees in psychoanalytic (PA, psychodynamic (PD and cognitive behavioural therapy (CBT training. Trainees from sample 1 (N = 184 were asked to describe their interpersonal behaviour in relation to their patients when filling out the Intrex, whereas trainees from sample 2 (N = 135 were asked to describe the private relationship with a significant other. Results: Interpersonal affiliation in professional relationships significantly predicted the level of Healing Involvement (HI, while Stress Involvement (SI was predicted by interpersonal affiliation and interdependence in trainees' relationships with their patients. Social behaviour within professional relationships provided higher correlations with WI than private interpersonal behaviour. Significant differences were found between private and professional relation settings in trainees’ interpersonal behaviour with higher levels of affiliation and interdependence with significant others. Differences between therapeutic orientation and social behaviour could only be found when comparing trainees' level of interdependence with the particular relationship setting. Conclusion: Trainees' interpersonal level of affiliation in professional relationships is a predictor for a successful psychotherapeutic development. Vice versa, controlling behaviour in professional settings can be understood as a risk factor against psychotherapeutic growth. Both results strengthen an evidence-based approach for competence development during psychotherapy training.

Integrative Psychotherapy ‘Revisited’

OpenAIRE

Marye O’Reilly-Knapp

2017-01-01

This article revisits aspects of the theory and methods of Integrative Psychotherapy as written and discussed by Richard G. Erskine, PhD and others. A case study demonstrates the use of Integrative Psychotherapy as the basis for therapeutic interventions that allow the client to interpret early experiences of relational failures, via a relationally based psychotherapy. Revisiting the theory and methods of Integrative Psychotherapy served to further validate the core of IP and its value as a ...

Early Intervention for Borderline Personality Disorder: Psychodynamic Therapy in Adolescents.

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Salzer, Simone; Cropp, Carola; Streeck-Fischer, Annette

2014-01-01

Borderline personality disorder (BPD) should be understood as a disorder of development (Streeck-Fischer 2008, 2013) that has its first manifestation in late childhood and adolescence. There are only few treatment studies of adolescents meeting the diagnostic criteria of borderline personality disorder, although early interventions for these patients are urgently needed (see Chanen & McCutcheon 2013). We examined the effectiveness of an inpatient psychodynamic therapy (PDT). Twenty-eight adolescents fulfilling the DSM-IV diagnostic criteria of borderline personality disorder were treated with psychodynamic therapy. The mean duration of treatment was 29.87 weeks (SD = 15.88). Outcomes were remission rates, GAF, GSI, SDQ, IIP and BPI scores. Assessments were made at admission and after treatment. Pre-post comparisons and comparisons with normative data were conducted. At the end of treatment 39.29% of the patients were remitted. We found significant improvements for the GAF, GSI, SDQ, IIP (all p0.001) and the BPI (p = 0.006). These clinically relevant improvements demonstrate the effectiveness of psychodynamic therapy in adolescents with borderline personality disorder and stress the usefulness of an early intervention for these patients.

Psychotherapy And Phenomenology

African Journals Online (AJOL)

denise

psychology and psychotherapy since its beginnings. ... accountability of psychological meaning are ... the whole of human being as entirely representative ..... approaches and range across the areas of personality psychology, psychotherapy, ...

Existentially informed HIV-related psychotherapy.

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Farber, Eugene W

2009-09-01

This article describes an existentially informed approach to conducting psychotherapy with individuals living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Uses of existential concepts to guide a holistic conceptualization of the individual and illuminate core existential concerns and dilemmas in confronting HIV-related challenges are delineated. Applications of existential ideas regarding psychotherapy process and technique in HIV-related psychotherapy also are illustrated. It is concluded that existential psychotherapy offers a conceptual framework that is especially well suited to the work of psychotherapy with individuals living with HIV disease, although the approach has received only limited attention in the HIV-related psychotherapy literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Psychotherapy for cancer patients.

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Chong Guan, Ng; Mohamed, Salina; Kian Tiah, Lai; Kar Mun, Teoh; Sulaiman, Ahmad Hatim; Zainal, Nor Zuraida

2016-07-01

Objective Psychotherapy is a common non-pharmacological approach to help cancer patients in their psychological distress. The benefit of psychotherapies was documented, but the types of psychotherapies proposed are varied. Given that the previous literature review was a decade ago and no quantitative analysis was done on this topic, we again critically and systematically reviewed all published trials on psychotherapy in cancer patients. Method We identified 17 clinical trials on six types of psychotherapy for cancer patients by searching PubMed and EMBASE. Result There were four trials involved adjunct psychological therapy which were included in quantitative analysis. Each trial demonstrated that psychotherapy improved the quality of life and coping in cancer patients. There was also a reduction in distress, anxiety, and depression after a psychological intervention. However, the number and quality of clinical trials for each type of psychotherapy were poor. The meta-analysis of the four trials involved adjunct psychological therapy showed no significant change in depression, with only significant short-term improvement in anxiety but not up to a year-the standardized mean differences were -0.37 (95% confidence interval (CI) = -0.57, -0.16) at 2 months, -0.21 (95% CI = -0.42, -0.01) at 4 months, and 0.03 (95 % CI = -0.19, 0.24) at 12 months. Conclusion The evidence on the efficacy of psychotherapy in cancer patients is unsatisfactory. There is a need for more rigorous and well-designed clinical trials on this topic.

Neuroimaging for psychotherapy research: current trends.

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Weingarten, Carol P; Strauman, Timothy J

2015-01-01

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. 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. We summarize findings from neuroimaging studies of psychotherapy outcome, including treatment for depression, obsessive compulsive disorder (OCD), and schizophrenia. 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.

Group psychotherapy for parents of patients with schizophrenia.

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Gruber, Ema N; Kajević, Milka; Agius, Mark; Martić-Biocina, Sanja

2006-11-01

During a four-month period, the authors provided group psychotherapy combining psychodynamic, supportive and psycho-educational approaches. The aim was to investigate whether this approach would enable parents of patients with schizophrenia to re-establish their psychic balance and the balance of the whole family system by reducing high expressed emotion. The following tools were administered: a socio-cultural questionnaire, MMPI and PIE psychological tests and two questionnaires for group evaluation. The socio-cultural questionnaire showed that the group of parents is heterogeneous. MMPI profiles showed truthful answers and well organized thinking; there were no psychopathological symptoms. The PIE test showed increased dimensions of sociability and trust. The dimensions of fear, sorrow and anger were decreased. Combinations of primary emotions (marked sociability and high self-protection) show that the parents are cautious, responsible and tend to feel guilt. The parents evaluated the group work as interesting and helpful and the group as a place where the parents can overcome the stigma of the disease that affects them, get information, find help and friends and find a way out of their social isolation. This combined approach changes the emotional profile of parents, reduces high expressed emotions (fear, sorrow and anger) in parents and helps re-establish their psychic balance and the balance of the whole family system.

Induction of apoptosis in HeLa cancer cells by an ultrasonic-mediated synthesis of curcumin-loaded chitosan–alginate–STPP nanoparticles

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Ahmadi F

2017-11-01

Full Text Available Fatemeh Ahmadi,1 Maryam Ghasemi-Kasman,2,3 Shahram Ghasemi,4 Maryam Gholamitabar Tabari,5 Roghayeh Pourbagher,2 Sohrab Kazemi,6 Ali Alinejad-Mir7 1Student Research Committee, Babol University of Medical Sciences, 2Cellular and Molecular Biology Research Center, 3Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran; 4Faculty of Chemistry, University of Mazandaran, Babolsar, Iran; 5Infertility and Health Reproductive Research Center, Health Research Institute, 6Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran; 7Department of Chemical Engineering, University of Mazandaran, Babolsar, Iran Abstract: Natural herbal compounds have been widely introduced as an alternative therapeutic approach in cancer therapy. Despite potent anticancer activity of curcumin, its clinical application has been limited because of low water solubility and resulting poor bioavailability. In this study, we designed a novel ultrasonic-assisted method for the synthesis of curcumin-loaded chitosan–alginate–sodium tripolyphosphate nanoparticles (CS-ALG-STPP NPs. Furthermore, antitumor effect of curcumin-loaded NPs was evaluated in vitro. Field emission scanning electron microscopy (FE-SEM and atomic force microscopy (AFM were used to characterize the properties of NPs. Antitumor activity of curcumin-loaded NPs was assessed by using MTT and quantitative real-time polymerase chain reaction (qRT-PCR. FE-SEM and AFM data revealed the spherical morphology, and the average size of NPs was <50 nm. In vitro cytotoxicity assay suggested that curcumin-loaded CS-ALG-STPP NPs displayed significant antitumor activity compared with the free curcumin. Gene expression level analyses showed that curcumin NPs significantly increased the apoptotic gene expression. Collectively, our results suggest that curcumin-loaded NPs significantly suppressed proliferation and promoted the induction of

Reduction of suicidal ideation in patients undergoing psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders and their neurotic personality traits measured before the hospitalization.

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

2015-01-01

Analysis of associations between initial neurotic personality traits and subsequent reduction of suicidal ideation (SI) - or lack of such reduction - obtained until the end of hospitalization in patients who underwent the course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men hospitalized in the day-hospital due to neurotic, behavioral and personality disorders between 2005-2013. At the stage of qualification 134 women and 80 men reported SI, of whom subsequently 84.3% and 77.5% respectively improved. Women with prominent Tendency to risk-taking (p=0.002) and Impulsiveness (p=0.038) constituted subgroups with decreased chances of improvement in terms of SI, while men with prominently elevated level of Envy (p=0.041) and women who seemed to have difficulties in expressing anger adequately (ppsychotherapy. Thus, those subgroups require special attention and diligent selection of therapeutic methods. Also, it is probable that focusing therapy at the above-mentioned personality components may increase effectiveness of SI treatment. Reducing SI during psychotherapy appears to be highly effective especially in women with difficulties in expressing anger adequately and in men with prominently elevated level of Envy, which suggests adequacy of this treatment choice and of targeting those difficulties during psychotherapy.

Mixed methods in psychotherapy research: A review of method(ology) integration in psychotherapy science.

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Bartholomew, Theodore T; Lockard, Allison J

2018-06-13

Mixed methods can foster depth and breadth in psychological research. However, its use remains in development in psychotherapy research. Our purpose was to review the use of mixed methods in psychotherapy research. Thirty-one studies were identified via the PRISMA systematic review method. Using Creswell & Plano Clark's typologies to identify design characteristics, we assessed each study for rigor and how each used mixed methods. Key features of mixed methods designs and these common patterns were identified: (a) integration of clients' perceptions via mixing; (b) understanding group psychotherapy; (c) integrating methods with cases and small samples; (d) analyzing clinical data as qualitative data; and (e) exploring cultural identities in psychotherapy through mixed methods. The review is discussed with respect to the value of integrating multiple data in single studies to enhance psychotherapy research. © 2018 Wiley Periodicals, Inc.

The prediction of the level of personality organization on reduction of psychiatric symptoms and improvement of work ability in short- versus long-term psychotherapies during a 5-year follow-up.

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

2017-09-01

How level of personality organization (LPO) predicts psychiatric symptoms and work ability in short- versus long-term psychotherapies is poorly known. We investigated the importance of the LPO on the benefits of short-term versus long-term psychotherapies. A cohort study based on 326 outpatients with mood or anxiety disorder was allocated to long-term (LPP) and short-term (SPP) psychodynamic psychotherapy, and solution-focused therapy (SFT). The LPO was assessed by interview at baseline and categorized into neuroses and higher level borderline. Outcome was assessed at baseline and 4-9 times during a 5-year follow-up, using self-report and interview-based measures of symptoms and work ability. For patients receiving SPP, improvement in work ability, symptom reduction, and the remission rate were more considerable in patients with neuroses than in higher level borderline patients, whereas LPP or SFT showed no notable differences in effectiveness in the two LPO groups. In patients with neuroses, improvement was more considerable in the short-term therapy groups during the first year of follow-up, and in higher level borderline patients LPP was more effective after 3 years of follow-up. The remission rate, defined as both symptom reduction and lack of auxiliary treatment, was higher in LPP than in SPP for both the LPO groups considered. In neuroses, short-term psychotherapy was associated with a more rapid reduction of symptoms and increase in work ability, whereas LPP was more effective for longer follow-ups in both LPO groups. Further large-scale studies are needed. Level of personality organization is relevant for selection between short- and long-term psychotherapies. Short-term therapy gives faster benefits for neurotic patients but not for patients with higher level borderline personality organization. Sustained remission from symptoms is more probable after long-term than short-term therapy. © 2016 The British Psychological Society.

Ethical reflection and psychotherapy.

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Vyskocilová, Jana; Prasko, Jan

2013-01-01

Theories of ethics and ethical reflection may be applied to both theory and practice in psychotherapy. There is a natural affinity between ethics and psychotherapy. Psychotherapy practice is concerned with human problems, dilemmas and emotions related to both one's own and other people's values. Ethics is also concerned with dilemmas in human thinking and with how these dilemmas reflect other individuals' values. Philosophical reflection itself is not a sufficient basis for the ethics of psychotherapy but it may aid in exploring attitudes related to psychotherapy, psychiatry and health care. PubMed, Web of Science and Scopus databases were searched for articles containing the keywords "psychotherapy", "ethics", "therapeutic relationship" and "supervision". The search was conducted by repeating the terms in various combinations without language or time restrictions. Also included were data from monographs cited in reviews. The resulting text is a review with conclusions concerning ethical aspects of psychotherapy. The ability to behave altruistically, sense for justice and reciprocity and mutual help are likely to be genetically determined as dispositions to be later developed by upbringing or to be formed or deformed by upbringing. Early experiences lead to formation of ethical attitudes which are internalized and then applied to both one's own and other people's behavior. Altruistic behavior has a strong impact on an individual's health and its acceptance may positively influence the pathophysiological mechanisms underlying numerous diseases. Ethical theory and reflection, however, may be applied to both theory and practice of psychotherapy in a conscious, targeted and thoughtful manner. In everyday practice, psychotherapists and organizations must necessarily deal with conscious conflicts between therapeutic possibilities, clients' wishes, their own as well as clients' ideas and the real world. Understanding one's own motives in therapy is one of the aims of a

Group Psychotherapy in Italy.

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Giannone, Francesca; Giordano, Cecilia; Di Blasi, Maria

2015-10-01

This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.

Autoethnography and Psychodynamics in Interrelational Spaces of the Research Process

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Dybbroe, Betina; Hansson, Birgitte

2012-01-01

This article takes the stance that the subjectivity of the researcher is an integral part of the research process. It should be studied as a key to understanding the interrelational processes of meaning in an interview situation. The article demonstrates how the subjectivity of the researcher can...... be made accessible methodologically and methodically by combining a psychodynamic approach with an autoethnographic approach. The methodical question is therefore how the researcher can conduct introspection and at the same time reflect upon and analyse the central object of investigation. The approach...... is psychoanalytically informed, but autoethnography became the actual vehicle for moving beyond reflections on the psychodynamics represented in the texts. The researcher ventured into an introspection of not only the texts, but also her own feelings, fantasies, and bodily experiences at the time of the interview...

Constructing a systems psychodynamic wellness model

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Sanchen Henning

2012-03-01

Research purpose: The purpose of the research was to construct and refine the SPWM in order to understand psychological wellness at the individual, group and organisational levels. Motivation for the study: There is no psychological wellness model that integrates the principles of systems psychodynamics and positive psychology. Systems psychodynamics traditionally focuses on so-called negative behaviour whilst positive psychology tends to idealise positive behaviour. This research tried to merge these views in order to apply them to individual, group and organisational behaviour. Research design, approach and method: The researchers used qualitative, descriptive and conceptual research. They conducted an in-depth literature study to construct the model. They then refined it using the LP. Main findings: The researchers identified 39 themes. They categorised them into three different levels. Three first-level themes emerged as the highest level of integration: identity, hope and love. The nine second-level themes each consisted of three more themes. They were less complex and abstract than the first-level themes. The least complex 27 third-level themes followed. Practical/managerial implications: One can apply the SPWM as a qualitative diagnostic tool for understanding individual, group and organisational wellness and for consulting on systemic wellness. Contribution/value-add: The SPWM offers a model for understanding individual, group and organisational wellness and for consulting on systemic wellness.

Reviving and Refining Psychodynamic Interpretation of the Wechsler Intelligence Tests: The Verbal Comprehension Subtests.

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Bram, Anthony D

2017-01-01

The Wechsler intelligence tests (currently Wechsler, 2008 , 2014) have traditionally been part of the multimethod test battery favored by psychodynamically oriented assessors. In this tradition, assessors have used Wechsler data to make inferences about personality that transcend cognition. Recent trends in clinical psychology, however, have deemphasized this psychodynamic way of working. In this article, I make a conceptual and clinical case for reviving and refining a psychodynamic approach to inference making about personality using the Wechsler Verbal Comprehension subtests. Specifically, I (a) describe the psychological and environmental conditions sampled by the Wechsler tests, (b) discuss the Wechsler tests conceptually in terms of assessing vulnerability to breakdowns in adaptive defensive functioning, (c) review a general framework for inference making, and (d) offer considerations for and illustrate pragmatic application of the Verbal Comprehension subtests data to make inferences that help answer referral questions and have important treatment implications.

Evidence-Based Psychotherapy: Advantages and Challenges.

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Cook, Sarah C; Schwartz, Ann C; Kaslow, Nadine J

2017-07-01

Evidence-based psychotherapies have been shown to be efficacious and cost-effective for a wide range of psychiatric conditions. Psychiatric disorders are prevalent worldwide and associated with high rates of disease burden, as well as elevated rates of co-occurrence with medical disorders, which has led to an increased focus on the need for evidence-based psychotherapies. This chapter focuses on the current state of evidence-based psychotherapy. The strengths and challenges of evidence-based psychotherapy are discussed, as well as misperceptions regarding the approach that may discourage and limit its use. In addition, we review various factors associated with the optimal implementation and application of evidence-based psychotherapies. Lastly, suggestions are provided on ways to advance the evidence-based psychotherapy movement to become truly integrated into practice.

Money and sentiment: a psychodynamic approach to behavioral finance.

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Mohacsy, Ildiko; Lefer, Heidi

2007-01-01

This article tackles one of the timeliest issues for both practitioners and patients today: sentiment, psychodynamics, and the stock market. Economic bubbles and crashes have occurred regularly through history -- from Holland's 17th century tulip mania, to America's 19th century railway mania, to the 1990s high-tech obsession. Though most investors regard themselves as investing rationally, few do. Instead they react collectively, buying high and selling low in crowds. Being subject to the illusion of control, they follow regressive behavior patterns and irrational, wishful thinking. They are victimized by their own emotions of hope, fear, and uncertainty. Crises happen often in economics. Indeed, the market itself may be quantified as a conglomeration of human sentiment. The relationship between magical thinking and the pictorial language of the market will be explored. Psychodynamic conceptualizations about risk and speculation are discussed, as are the interplay of affects versus judgment, rational thinking, and the knowledge of one's own capacity for stress tolerance.

Introduction: attachment theory and psychotherapy.

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Levy, Kenneth N

2013-11-01

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.

Integration in psychotherapy: Reasons and challenges.

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Fernández-Álvarez, Héctor; Consoli, Andrés J; Gómez, Beatriz

2016-11-01

Although integration has been formally influencing the field of psychotherapy since the 1930s, its impact gained significant momentum during the 1980s. Practical, theoretical, and scientific reasons help to explain the growing influence of integration in psychotherapy. The field of psychotherapy is characterized by many challenges which integration may change into meaningful opportunities. Nonetheless, many obstacles remain when seeking to advance integration. To appreciate the strength of integration in psychotherapy we describe an integrative, comprehensive approach to service delivery, research, and training. We then discuss the role of integration in the future of psychotherapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Making Psychotherapy Great Again?

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Plakun, Eric M

2017-05-01

Psychotherapy never stopped being as "great" as other treatments. This column explores the evidence base for both psychotherapy and medications, using depression as a specific example. The limitations are comparable for psychotherapy and medication, with much of the evidence based on small degrees of "statistically significant" rather than "clinically meaningful" change. Our field's biomedical emphasis leads to a false assumption that most patients present with single disorders, when comorbidity is the rule rather than the exception. This false assumption contributes to limitations in the evidence base and in our ability to treat patients optimally.

Psychodynamic Therapy and Intellectual Disabilities: Dealing with Challenging Behaviour.

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Berry, Paul

2003-01-01

Four case studies concerning long-term psychodynamic treatment of German individuals with intellectual disabilities are presented: an aggressive young man with a mild intellectual disability; a young man with multiple disabilities with destructive behavior; a withdrawn young woman with self-destructive behavior; and a young man with autism with…

Working with boundaries in systems psychodynamic consulting

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Henk Struwig

2012-03-01

Research purpose: The purpose of the research was to produce a set of theoretical assumptions about organisational boundaries and boundary management in organisations and, from these, to develop a set of hypotheses as a thinking framework for practising consulting psychologists when they work with boundaries from a systems psychodynamic stance. Motivation for the study: The researcher used the belief that organisational boundaries reflect the essence of organisations. Consulting to boundary managers could facilitate a deep understanding of organisational dynamics. Research design, approach and method: The researcher followed a case study design. He used systems psychodynamic discourse analysis. It led to six working hypotheses. Main findings: The primary task of boundary management is to hold the polarities of integration and differentiation and not allow the system to become fragmented or overly integrated. Boundary management is a primary task and an ongoing activity of entire organisations. Practical/managerial implications: Organisations should work actively at effective boundary management and at balancing integration and differentiation. Leaders should become aware of how effective boundary management leads to good holding environments that, in turn, lead to containing difficult emotions in organisations. Contribution/value-add: The researcher provided a boundary-consulting framework in order to assist consultants to balance the conceptual with the practical when they consult.

Characteristics and experience of the patient in psychotherapy and the psychotherapy's effectiveness. A structural approach.

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Szymańska, Agnieszka; Dobrenko, Kamila; Grzesiuk, Lidia

2017-08-29

The study concerns the relationship between three groups of variables presenting the patient's perspective: (1) "patient's characteristics" before psychotherapy, including "expectations of the therapy"; (2) "experience in the therapy", including the "psychotherapeutic relationship"; and (3) "assessment of the direct effectiveness of the psychotherapy". Data from the literature are the basis for predicting relationships between all of these variables. Measurement of the variables was conducted using a follow-up survey. The survey was sent to a total of 1,210 former patients of the Academic Center for Psychotherapy (AOP) in which the therapy is conducted mainly with the students and employees of the University of Warsaw. Responses were received from 276 people. 55% of the respondents were women and 45% were men, under 30 years of age. The analyses were performed using structural equations. Two models emerged from an analysis of the relationship between the three above-mentioned groups of variables. One concerns the relationship between (1) the patient's characteristics (2) the course of psychotherapy, in which -from the perspective of the patient - there is a good relationship with the psychotherapist and (3) psychotherapy is effective. The second model refers to (2) the patient's experience of poor psychotherapeutic relationship and (3) ineffective psychotherapy. Patient's expectations of the psychotherapy (especially "the expectation of support") proved to be important moderating variablesin the models-among the characteristics of the patient. The mathematical model also revealed strong correlation of variables measuring "the relationship with the psychotherapist" and "therapeutic interventions".

Clinical Holistic Medicine (Mindful, Short-Term Psychodynamic Psychotherapy Complemented with Bodywork in the Treatment of Experienced Impaired Sexual Functioning

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Søren Ventegodt

2007-01-01

Full Text Available In this clinical follow-up study, we examined the effect of clinical holistic medicine (psychodynamic short-term therapy complemented with bodywork on patients with poor self-assessed sexual functioning and found that this problem could be solved in 41.67% of the patients ((95% CI: 27.61–56.7%; 1.75 < NNT < 3.62, p = 0.05. The bodywork was inspired by the Marion Rosen method and helped the patients to confront painful emotions from childhood trauma(s, and thus accelerated and deepened the therapy. The goal of therapy was the healing of the whole life of the patient through Antonovsky-salutogenesis. In this process, rehabilitation of the character and purpose of life of the patient was essential, and assisted the patient to recover his or her sense of coherence (existential coherence. We conclude that clinical holistic medicine is the treatment of choice if the patient is ready to explore and assume responsibility for his or her existence (true self, and willing to struggle emotionally in the therapy to reach this important goal. When the patient heals existentially, quality of life, health, and ability to function in general are improved at the same time. The therapy was “mindful” in its focus on existential and spiritual issues. The patients received in average 14.8 sessions at the cost of 1,188 EURO.

Psychotherapy Versus Pharmacotherapy of Depression: What's the Evidence?

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Leichsenring, Falk; Steinert, Christiane; Hoyer, Jürgen

Depression may be treated by psychotherapy or pharmacotherapy or their combination. There is an ongoing debate whether one of these approaches is possibly superior. A recent meta-analysis reported results in favour of pharmacotherapy. Individual studies and meta-analyses on the comparative efficacy of psychotherapy vs. pharmacotherapy were reviewed. Evidence suggests that psychotherapy and pharmacotherapy are equally efficacious in the short-term, but psychotherapy is superior in the long-term. For the recently stated hypothesis that pharmacotherapy is superior to psychotherapy in studies without a pill placebo condition, which implies equally including a positive expectancy effect for both pharmacotherapy and psychotherapy no evidence was found. Depression may be treated by psychotherapy or pharmacotherapy with equivalent results in the short-term and advantages for psychotherapy in the long-term. As the rates of response and remission are still limited in both treatments, further improvement of treatments is required.

Comparing Treatment Outcome of Guided Imagery and Music and Psychodynamic Imaginative Trauma Therapy for Women with Complex PTSD

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Maack, Carola

2013-01-01

To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery and M....... Participants treated with GIM showed significantly better outcome in all measurements than participants treated with PITT. This indicates that the use of music is beneficial for women with Complex PTSD treated with psychodynamic trauma therapy.......To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery...... and Music (GIM), another group received 50 hours of outpatient trauma therapy with Psychodynamic Imaginative Trauma Therapy (PITT). The third group was a waiting-list control group of women who had to wait at least nine months for therapy. The participants filled out questionnaires measuring symptoms...

Informed consent in psychotherapy.

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Beahrs, J O; Gutheil, T G

2001-01-01

The authors sought a rational approach to implementing informed consent within the practice of psychotherapy. The history of informed consent in psychotherapy was reviewed to define a common synthesis that maximizes the potential benefits and minimizes the potential hazards. The benefits of informed consent in psychotherapy include fostering a positive treatment outcome through enhancing patient autonomy, responsibility, and self-therapeutic activity; lessening the risks of regressive effects and therapist liability; and helping the practice of psychotherapy extend beyond particular parochialisms by providing checks and balances on therapist judgments. The hazards include the unpredictability of interactional outcomes and the possibilities of replacing positive expectancy with negative suggestion, replacing a therapeutic alliance with a legalistic stance, and misimplying that patients are passive recipients. Practical implementation of informed consent in psychotherapy must balance such tensions in service of optimal treatment. As a guiding principle, the authors recommend that psychotherapists convey to a prospective patient information that is material to the particular patient's decision. The level of detail needed in informed consent discussions varies directly with the cost and risks of the proposed treatment, the presence of viable alternatives and their relative grounding in scientific data and professional acceptance, and the presence of significant controversy. Unresolved is the question of how to address problematic or controversial psychotherapeutic trends that temporarily enjoy wide professional support.

The Play of Psychotherapy

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Marks-Tarlow, Terry

2012-01-01

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…

Treatment of patients with first-episode psychosis: two-year outcome data from the Danish National Schizophrenia Project

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Rosenbaum, Bent; Valbak, Kristian; Harder, Susanne

2006-01-01

First episode psychosis interventions have been in focus in the last two decades in an attempt to improve the course and outcome of schizophrenic disorders. The Danish National Schizophrenia Project began in 1997 its intake of patients, aged 16-35, with a first psychotic episode of a schizophrenic...... psychodynamic psychotherapy as a supplement to treatment as usual", "integrated, assertive, psychosocial and educational treatment programme", or "treatment as usual". Data on symptoms and social function and sociodemographic data were obtained at inclusion, and at year 1 and 2. The three sub-cohorts did...... patients in the treatment-as-usual group. Improvement in the intervention groups continued into the second year. Patients receiving integrated assertive treatment faired better than those being treated with the less intensive method of supportive psychodynamic psychotherapy, and the latter group improved...

Advances in Psychotherapy for Depressed Older Adults.

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Raue, Patrick J; McGovern, Amanda R; Kiosses, Dimitris N; Sirey, Jo Anne

2017-09-01

We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk. Growing evidence supports the feasibility, acceptability, and effectiveness of psychotherapy modified for a variety of health care and social service settings. Research supports the benefits of selecting the type of psychotherapy based on a comprehensive assessment of the older adult's psychiatric, medical, functional, and cognitive status, and tailoring psychotherapy to the settings in which older depressed adults are most likely to present.

Cognitive Behavioral Psychotherapies: History and Development

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M. Hakan Türkçapar

2012-03-01

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.

PSYCHOTHERAPY WITH THE PARENT EGO STATE

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Maruša Zaletel

2012-06-01

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.

Psicoterapia psicodinâmica em grupo para fobia social generalizada Psychodynamic group treatment for generalized social phobia

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Daniela Zippin Knijnik

2004-06-01

Full Text Available OBJETIVOS: O objetivo deste estudo é verificar a efetividade do tratamento psicodinâmico em grupo de pacientes com fobia social generalizada. MÉTODOS: 30 pacientes foram incluídos em um estudo randomizado, simples-cego, comparando Terapia Psicodinâmica de Grupo (TPG com um Grupo de Controle Placebo com Credibilidade (CPC. A TPG foi conduzida em 12 sessões de terapia de orientação psicodinâmica em grupo. Os pacientes do grupo controle receberam um pacote de aulas-discussões e tratamento de apoio por 12 semanas, que foi comparado à TPG. Todos os participantes preencheram a Escala de Liebowitz para Ansiedade Social (LSAS, a Escala Hamilton de Ansiedade (HAM-A e a Escala de Impressão Clínica Global (CGI, na entrevista inicial e na 12ª semana de tratamento. Os dados foram analisados com uma ANOVA de medidas repetidas. Pacientes em vigência de tratamento farmacológico ou psicoterápico foram excluídos. RESULTADOS: Ambos os grupos apresentaram melhora na maioria das medidas. Na LSAS, os pacientes da TPG obtiveram melhora superior aos do grupo controle, ao cabo de 12 semanas (F1,28=4.84, p=0.036. Nas medidas basais dos sujeitos que completaram o estudo, não houve diferença entre os grupos em variáveis demográficas e de desfecho. CONCLUSÃO: Neste estudo, a TPG foi superior ao tratamento placebo com credibilidade no tratamento da fobia social generalizada, em um ensaio clínico randomizado, simples-cego, de 12 semanas.OBJECTIVES: The aim of this study is to assess the effectiveness of psychodynamic group therapy in patients with generalized social phobia. METHODS: Thirty patients were included in a randomized single-blind clinical trial comparing psychodynamic group treatment (PGT with a credible placebo control group (CPC. PGT was carried out within a 12-session psychodynamically-oriented group psychotherapy. Control patients received a treatment package of lecture-discussion and support group for 12 weeks which was compared to PGT

Child Psychotherapy Dropout: An Empirical Research Review

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Deakin, Elisabeth; Gastaud, Marina; Nunes, Maria Lucia Tiellet

2012-01-01

This study aims to discuss the most recent data about child psychotherapy dropout, especially child psychoanalytical psychotherapy. The authors also try to offer some possible alternatives to prevent such a phenomenon. The definition of "child psychotherapy dropout" is extensively discussed. The goal has been to attempt to create a standardised…

Review of Self-disclosure in psychotherapy.

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Hamilton, Rachel A; Del Castillo, Darren M; Stiles, William B

2007-09-01

Reviews the book, Self-disclosure in psychotherapy by Barry A. Farber (see record 2006-11792-000). At one point or another, most therapists have wondered how much their patients are telling them and wrestled with how much they should reveal themselves to their patients. This book aims to provide an integrative and up-to-date review of the literature that has addressed these kinds of questions. By looking at patient, therapist, supervisee, and supervisor self-disclosure, Farber attempts to show both common and unique aspects of self-disclosure across the different parties involved in psychotherapy. Work from historical, clinical, research, and cultural perspectives comes together to provide readers with a multifaceted view of self-disclosure in psychotherapy. This book will be of interest to therapists, researchers, psychotherapy supervisors, and therapists-in-training. Farber's discussion of self-disclosure offers a nuanced perspective on the dilemmas involved in the psychotherapy process. By highlighting the features of self-disclosure across patients, therapists, supervisees, and supervisors, Farber enriches understanding of the phenomenon and encourages empathy for the perspectives of those in other psychotherapy roles. We believe that Farber has successfully synthesized work from various perspectives to create an illuminating review of self-disclosure in psychotherapy. The book condenses a broad range of literature into clearly organized and digestible chapters. The integration of research and theory with clinical vignettes, quotations from books and movies, and popular song lyrics make this work an unusually engaging and accessible read. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Piaget and psychotherapy.

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Friedman, T L

1978-04-01

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.

Cognitive Behavioral Psychotherapies: History and Development

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M. Hakan Türkçapar

2012-04-01

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

Naikan psychotherapy for alcohol dependence syndrome

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堀井, 茂男

1987-01-01

To evaluate the therapeutic effect of Naikan psychotherapy for alcohol dependence syndrome, a comparison was made between 31 patients who were treated with Naikan psychotherapy (Naikan group) and 34 patients who were not treated with Naikan psychotherapy (non-Naikan group) on the following profiles : general characteristics, social adaptation occuring 6 months to 2 years 6 months after discharge (short-term follow-up) and social adaptation occuring 3 years 5 months to 5 years 5 months after d...

Three Psychotherapies Examined: Ellis, Rogers, Perls

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Stoten, J.; Goos, W.

1974-01-01

This study uses Bales' Interaction Process Analysis (I. P. A.) to identify significant process elements in counselling and psychotherapy. For this purpose, the film "Three Approaches to Psychotherapy" was analysed. (Editor)

Psychodynamic Milieu-Therapy and Changes in Personality--What Is the Connection?

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Heede, Tine; Runge, Hanne; Storebo, Ole Jakob; Rowley, Eva; Hansen, Kim Gabriel

2009-01-01

This article refers to the results of a prospective effect evaluation study of three psychodynamic milieu-therapeutic institutions for children, which included cognitive and projective testing. After introducing milieu-therapy and explaining its roots in psychoanalytic and developmental thinking, the specific results of the research evaluation are…

Frontolimbic neural circuit changes in emotional processing and inhibitory control associated with clinical improvement following transference-focused psychotherapy in borderline personality disorder.

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Perez, David L; Vago, David R; Pan, Hong; Root, James; Tuescher, Oliver; Fuchs, Benjamin H; Leung, Lorene; Epstein, Jane; Cain, Nicole M; Clarkin, John F; Lenzenweger, Mark F; Kernberg, Otto F; Levy, Kenneth N; Silbersweig, David A; Stern, Emily

2016-01-01

Borderline personality disorder (BPD) is characterized by self-regulation deficits, including impulsivity and affective lability. Transference-focused psychotherapy (TFP) is an evidence-based treatment proven to reduce symptoms across multiple cognitive-emotional domains in BPD. This pilot study aimed to investigate neural activation associated with, and predictive of, clinical improvement in emotional and behavioral regulation in BPD following TFP. BPD subjects (n = 10) were scanned pre- and post-TFP treatment using a within-subjects design. A disorder-specific emotional-linguistic go/no-go functional magnetic resonance imaging paradigm was used to probe the interaction between negative emotional processing and inhibitory control. Analyses demonstrated significant treatment-related effects with relative increased dorsal prefrontal (dorsal anterior cingulate, dorsolateral prefrontal, and frontopolar cortices) activation, and relative decreased ventrolateral prefrontal cortex and hippocampal activation following treatment. Clinical improvement in constraint correlated positively with relative increased left dorsal anterior cingulate cortex activation. Clinical improvement in affective lability correlated positively with left posterior-medial orbitofrontal cortex/ventral striatum activation, and negatively with right amygdala/parahippocampal activation. Post-treatment improvements in constraint were predicted by pre-treatment right dorsal anterior cingulate cortex hypoactivation, and pre-treatment left posterior-medial orbitofrontal cortex/ventral striatum hypoactivation predicted improvements in affective lability. These preliminary findings demonstrate potential TFP-associated alterations in frontolimbic circuitry and begin to identify neural mechanisms associated with a psychodynamically oriented psychotherapy. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

A psychodynamic model of behavior after acute central nervous system damage.

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Groswasser, Z; Stern, M J

1998-02-01

This article describes a conceptual psychodynamic model for understanding the neurobehavioral manifestations of acute central nervous system damage (ACNSD) displayed by patients during the rehabilitation process. According to the proposed model, patientsO behavioral responses are viewed as their only means of emotional expression and therefore may not be considered entirely abnormal when viewed from the perspective of patientsO interpersonal contexts. An improved understanding of the dynamic processes through which recovering patients with ACNSD journey may lead to better interaction between the patient and the therapeutic environment, the interdisciplinary team, and family members. Combining this proposed psychodynamic model with an emerging understanding of the neurobehavioral foundations of aggression and depression may also lead to a more rational approach to intervention with various psychopharmacologic agents. During the rehabilitation process, understanding patients' cognitive deficits, motivational drives, and emotional needs and proper implementation of medical and environmental treatment can ultimately lead to a better psychosocial outcome.

Cognitive Behavioral Analysis System of Psychotherapy as group psychotherapy for chronically depressed inpatients: a naturalistic multicenter feasibility trial.

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Sabaß, Lena; Padberg, Frank; Normann, Claus; Engel, Vera; Konrad, Carsten; Helmle, Kristina; Jobst, Andrea; Worlitz, Andrew; Brakemeier, Eva-Lotta

2017-09-27

The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is a relatively new approach in the treatment of chronic depression (CD). Adapted as group psychotherapy for inpatients, CBASP is attracting increasing attention. In this naturalistic multicenter trial, we investigated its feasibility after 10 sessions of CBASP group therapy over a treatment time of at least 5 to a maximum of 10 weeks. Treatment outcome was additionally assessed. Across four centers, 116 inpatients with CD (DSM-IV-TR) attended CBASP group psychotherapy. Feasibility was focused on acceptance, and evaluated for patients and therapists after five (t1) and ten sessions (t2) of group psychotherapy. Observer- and self-rating scales (Hamilton Depression Rating Scale-24 items, HDRS 24 ; Beck Depression Inventory-II, BDI-II; World Health Organization Quality of Life assessment, WHOQOL-BREF) were applied before group psychotherapy (t0) and at t2. Dropouts were low (10.3%). Patients' evaluation improved significantly from t1 to t2 with a medium effect size (d = 0.60). Most of the patients stated that the group had enriched their treatment (75.3%), that the size (74.3%) and duration (72.5%) were 'optimal' and 37.3% wished for a higher frequency. Patients gave CBASP group psychotherapy an overall grade of 2 ('good'). Therapists' evaluation was positive throughout, except for size of the group. Outcome scores of HDRS 24 , BDI-II, and WHOQOL-BREF were significantly reduced from t0 to t2 with medium to large effect sizes (d = 1.48; d = 1.11; d = 0.67). In this naturalistic open-label trial, CBASP, when applied as inpatient group psychotherapy, was well accepted by patients and therapists. The results point towards a clinically meaningful effect of inpatient treatment with CBASP group psychotherapy on depression and quality of life. Other potential factors that could have promoted symptom change were discussed. A future controlled study could investigate the safety and efficacy of CBASP

Psychotherapy Outcome Research: Issues and Questions.

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Shean, Glenn

2016-03-01

Emphasis on identifying evidence-based therapies (EBTs) has increased markedly. Lists of EBTs are the rationale for recommendations for how psychotherapy provider training programs should be evaluated, professional competence assessed, and licensure and reimbursement policies structured. There are however methodological concerns that limit the external validity of EBTs. Among the most salient is the circularity inherent in randomized control trials (RCTs) of psychotherapy that constrains the manner in which the psychological problems are defined, psychotherapy can be practiced, and change evaluated. RCT studies favor therapies that focus of specific symptoms and can be described in a manual, administered reliably across patients, completed in relatively few sessions, and involve short-term evaluations of outcome. The epistemological assumptions of a natural science approach to psychotherapy research limit how studies are conducted and assessed in ways that that advantage symptom-focused approaches and disadvantage those approaches that seek to bring broad recovery-based changes. Research methods that are not limited to RCTs and include methodology to minimize the effects of "therapist allegiance" are necessary for valid evaluations of therapeutic approaches that seek to facilitate changes that are broader than symptom reduction. Recent proposals to adopt policies that dictate training, credentialing, and reimbursement based on lists of EBTs unduly limit how psychotherapy can be conceptualized and practiced, and are not in the best interests of the profession or of individuals seeking psychotherapy services.

Individual Psychotherapy and Changes in Self-Experience in Schizophrenia: A Qualitative Comparison of Patients in Metacognitively Focused and Supportive Psychotherapy.

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Lysaker, Paul H; Kukla, Marina; Belanger, Elizabeth; White, Dominique A; Buck, Kelly D; Luther, Lauren; Firmin, Ruth L; Leonhardt, Bethany

2015-01-01

Deficits in metacognition, or the ability to form complex ideas about self and others, may be a root cause of dysfunction in schizophrenia. Accordingly, forms of psychotherapy have been proposed to address metacognitive deficits. This study explored whether metacognitively focused individual psychotherapy can affect self-experience by conducting narrative interviews of patients with a schizophrenia spectrum disorder enrolled in either metacognitively oriented psychotherapy (n = 12) or supportive psychotherapy (n = 13) in a naturalistic setting. Participants in both groups completed a narrative interview consisting of questions that focused on perceptions and process of psychotherapy and its impact on outcomes. Interviews were audiotaped, transcribed, and coded using an inductive process informed by grounded theory. Qualitative analyses revealed all participants reported psychotherapy led to improvements in self-esteem and the ability to think more clearly and set meaningful goals. The group receiving metacognitively oriented therapy, in contrast to those receiving supportive therapy, reported being able to integrate their current experiences into the larger narratives of their lives and an increased experience of sense of agency and the ability to understand and manage pain. Results provide evidence that metacognitively oriented psychotherapy may promote subjective forms of recovery.

Personality disorder moderates outcome in short- and long-term group analytic psychotherapy: A randomized clinical trial.

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

2015-06-01

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 ClinicalTrials.gov 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

INTEGRATIVE PSYCHOTHERAPY AND MINDFULNESS: THE CASE OF SARA

OpenAIRE

Mihael Černetič

2015-01-01

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 ana...

Clinical Holistic Medicine: Avoiding the Freudian Trap of Sexual Transference and Countertransference in Psychodynamic Therapy

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Søren Ventegodt

2008-01-01

Full Text Available Sexual transference and countertransference can make therapy slow and inefficient when libidinous gratification becomes more important for both the patient and the therapist than real therapeutic progress. Sexual transference is normal when working with a patient's repressed sexuality, but the therapeutic rule of not touching often hinders the integration of sexual traumas, as this needs physical holding. So the patient is often left with sexual, Oedipal energies projected onto the therapist as an “idealized father” figure. The strong and lasting sexual desire for the therapist without any healing taking place can prolong therapy for many years, as it often does in psychodynamic psychotherapy and psychoanalysis. We call this problem “Freud's Trap”. Freud used intimate bodywork, such as massage, in the beginning of his career, but stopped, presumably for moral and political reasons. In the tradition of psychoanalysis, touch is therefore not allowed. Recent research in clinical holistic medicine (CHM, salutogenesis, and sexual healing has shown that touch and bodywork (an integral part of medicine since Hippocrates are as important for healing as conversational therapy. CHM allows the patient to regress spontaneously to early sexual and emotional traumas, and to heal the deep wounds on body, soul, and sexual character from arrested psychosexual development. CHM treats sexuality in therapy more as the patient’s internal affair (i.e., energy work and less as a thing going on between the patient and the therapist (i.e., transference. This accelerates healing, and reduces sexual transference and the need for mourning at the end of therapy.

Clinical holistic medicine: avoiding the Freudian trap of sexual transference and countertransference in psychodynamic therapy.

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Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2008-04-14

Sexual transference and countertransference can make therapy slow and inefficient when libidinous gratification becomes more important for both the patient and the therapist than real therapeutic progress. Sexual transference is normal when working with a patient's repressed sexuality, but the therapeutic rule of not touching often hinders the integration of sexual traumas, as this needs physical holding. So the patient is often left with sexual, Oedipal energies projected onto the therapist as an "idealized father" figure. The strong and lasting sexual desire for the therapist without any healing taking place can prolong therapy for many years, as it often does in psychodynamic psychotherapy and psychoanalysis. We call this problem "Freud's Trap". Freud used intimate bodywork, such as massage, in the beginning of his career, but stopped, presumably for moral and political reasons. In the tradition of psychoanalysis, touch is therefore not allowed. Recent research in clinical holistic medicine (CHM), salutogenesis, and sexual healing has shown that touch and bodywork (an integral part of medicine since Hippocrates) are as important for healing as conversational therapy. CHM allows the patient to regress spontaneously to early sexual and emotional traumas, and to heal the deep wounds on body, soul, and sexual character from arrested psychosexual development. CHM treats sexuality in therapy more as the patient's internal affair (i.e., energy work) and less as a thing going on between the patient and the therapist (i.e., transference). This accelerates healing, and reduces sexual transference and the need for mourning at the end of therapy.

Clinical Holistic Medicine: Avoiding the Freudian Trap of Sexual Transference and Countertransference in Psychodynamic Therapy

Science.gov (United States)

Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2008-01-01

Sexual transference and countertransference can make therapy slow and inefficient when libidinous gratification becomes more important for both the patient and the therapist than real therapeutic progress. Sexual transference is normal when working with a patient's repressed sexuality, but the therapeutic rule of not touching often hinders the integration of sexual traumas, as this needs physical holding. So the patient is often left with sexual, Oedipal energies projected onto the therapist as an “idealized father” figure. The strong and lasting sexual desire for the therapist without any healing taking place can prolong therapy for many years, as it often does in psychodynamic psychotherapy and psychoanalysis. We call this problem “Freud's Trap”. Freud used intimate bodywork, such as massage, in the beginning of his career, but stopped, presumably for moral and political reasons. In the tradition of psychoanalysis, touch is therefore not allowed. Recent research in clinical holistic medicine (CHM), salutogenesis, and sexual healing has shown that touch and bodywork (an integral part of medicine since Hippocrates) are as important for healing as conversational therapy. CHM allows the patient to regress spontaneously to early sexual and emotional traumas, and to heal the deep wounds on body, soul, and sexual character from arrested psychosexual development. CHM treats sexuality in therapy more as the patient’s internal affair (i.e., energy work) and less as a thing going on between the patient and the therapist (i.e., transference). This accelerates healing, and reduces sexual transference and the need for mourning at the end of therapy. PMID:18454245

Clinical Holistic Medicine: Teaching Orgasm for Females with Chronic Anorgasmia using the Betty Dodson Method

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Struck, Pia; Ventegodt, Søren

2008-01-01

The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 × 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the “sexological examination”). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the “orgasm course for anorgasmic women”; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient. PMID:18836654

Clinical Holistic Medicine: Teaching Orgasm for Females with Chronic Anorgasmia using the Betty Dodson Method

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Pia Struck

2008-01-01

Full Text Available The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM. The patients received 3 × 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP and complementary medicine (CAM bodywork, manual sexology similar to the “sexological examination”. The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years with chronic anorgasmia (for 12 years on average who were participating in the “orgasm course for anorgasmic women”; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93% had an orgasm during therapy, witnessed by the therapist, and 35 patients (7% did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

A psychodynamic perspective on elections.

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Clemens, Norman A

2010-11-01

In a democracy, elections are the way in which the collective thought processes of the voters arrive at a decision to direct their government. The author explores how the individual voter assesses and resolves many conflicting internal and external forces to arrive at a vote. The midterm elections of 2010 illustrate the parallel between individual resolution of conflicting forces and the process of a campaign leading to the outcome of an election. The psychodynamic concepts of conflict and compromise, affects, aggression, unconscious forces, mechanisms of defense, superego, and the ego's integrative functions are evident in both the individual voter and the collective electoral process. The author expresses concern about the historical vulnerability of democracies and the unbalancing effect of allowing limitless infusion of anonymous corporate money to pour into campaigns.

Power Politics of Family Psychotherapy.

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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,…

How Do Trainees Choose Their First Psychotherapy Training? The Case of Training in Psychotherapy Integration

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Plchová, Romana; Hytych, Roman; Rihácek, Tomáš; Roubal, Jan; Vybíral, Zbynek

2016-01-01

Future trainees go through difficult decision-making processes when starting their first psychotherapy training. The choice of training in psychotherapy integration is a specific type of this process. In this study, qualitative data were obtained from the motivational letters, in-depth semi-structured interviews and e-mail questionnaires of 26…

Treatment preferences of psychotherapy patients with chronic PTSD.

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Markowitz, John C; Meehan, Kevin B; Petkova, Eva; Zhao, Yihong; Van Meter, Page E; Neria, Yuval; Pessin, Hayley; Nazia, Yasmin

2016-03-01

Patient treatment preference may moderate treatment effect in major depressive disorder (MDD) studies. Little research has addressed preference in posttraumatic stress disorder (PTSD); almost none has assessed actual patients' PTSD psychotherapy preferences. From a 14-week trial of chronic PTSD comparing prolonged exposure, relaxation therapy, and interpersonal psychotherapy, we report treatment preferences of the 110 randomized patients, explore preference correlates, and assess effects on treatment outcome. Patients recruited between 2008 and 2013 with chronic DSM-IV PTSD (Clinician-Administered PTSD Scale [CAPS] score ≥ 50) received balanced, scripted psychotherapy descriptions prerandomization and indicated their preferences. Analyses assessed relationships of treatment attitudes to demographic and clinical factors. We hypothesized that patients randomized to preferred treatments would have better outcomes, and to unwanted treatment worse outcomes. Eighty-seven patients (79%) voiced treatment preferences or disinclinations: 29 (26%) preferred prolonged exposure, 29 (26%) preferred relaxation therapy, and 56 (50%) preferred interpersonal psychotherapy (Cochran Q = 18.46, P psychotherapy (Cochran Q = 22.71, P psychotherapy preferences to outcome. Despite explanations emphasizing prolonged exposure's greater empirical support, patients significantly preferred interpersonal psychotherapy. Preference subtly affected psychotherapy outcome; depression appeared an important moderator of the effect of unwanted treatment on outcome. Potential biases to avoid in future research are discussed. ClinicalTrials.gov identifier: NCT00739765. © Copyright 2015 Physicians Postgraduate Press, Inc.

Tavistock Adult Depression Study (TADS: a randomised controlled trial of psychoanalytic psychotherapy for treatment-resistant/treatment-refractory forms of depression

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Taylor David

2012-07-01

Full Text Available Abstract Background Long-term forms of depression represent a significant mental health problem for which there is a lack of effective evidence-based treatment. This study aims to produce findings about the effectiveness of psychoanalytic psychotherapy in patients with treatment-resistant/treatment-refractory depression and to deepen the understanding of this complex form of depression. Methods/Design INDEX GROUP: Patients with treatment resistant/treatment refractory depression. DEFINITION & INCLUSION CRITERIA: Current major depressive disorder, 2 years history of depression, a minimum of two failed treatment attempts, ≥14 on the HRSD or ≥21 on the BDI-II, plus complex personality and/or psycho-social difficulties. EXCLUSION CRITERIA: Moderate or severe learning disability, psychotic illness, bipolar disorder, substance dependency or receipt of test intervention in the previous two years. DESIGN: Pragmatic, randomised controlled trial with qualitative and clinical components. TEST INTERVENTION: 18 months of weekly psychoanalytic psychotherapy, manualised and fidelity-assessed using the Psychotherapy Process Q-Sort. CONTROL CONDITION: Treatment as usual, managed by the referring practitioner. RECRUITMENT: GP referrals from primary care. RCT MAIN OUTCOME: HRSD (with ≤14 as remission. SECONDARY OUTCOMES: depression severity (BDI-II, degree of co-morbid disorders Axis-I and Axis-II (SCID-I and SCID-II-PQ, quality of life and functioning (GAF, CORE, Q-les-Q, object relations (PROQ2a, Cost-effectiveness analysis (CSRI and GP medical records. FOLLOW-UP: 2 years. Plus: a. Qualitative study of participants’ and therapists’ problem formulation, experience of treatment and of participation in trial. (b Narrative data from semi-structured pre/post psychodynamic interviews to produce prototypes of responders and non-responders. (c Clinical case-studies of sub-types of TRD and of change. Discussion TRD needs complex, long-term intervention and

Psychotherapies for adult depression: recent developments.

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Cuijpers, Pim

2015-01-01

Much has been learned from the 400 randomized trials on psychotherapies for adult depression that have been conducted, but much is also still unknown. In this study some recent attempts to further reduce the disease burden of depression through psychotherapies are reviewed. In the past, many new psychotherapies have promised to be more effective than existing treatments, usually without success. We describe recent research on two new therapies, acceptance and commitment therapy and cognitive bias modification, and conclude that both have also not shown to be more effective than existing therapies. A growing number of studies have also focused on therapies that may be successful in further reducing the disease burden, such as treatments for chronic depression and relapse prevention. Other studies are aimed at scaling up psychological services, such as the training of lay health counselors in low-income and middle-income countries, telephone-based, and internet-based therapies. Psychotherapies are essential tools in the treatment of adult depression. Randomized trials have shown that these treatments are effective, and by focusing on key issues, such as chronic depression, relapse, and scaling them up, psychotherapies contribute more and more to the reduction of the disease burden of depression.

INTEGRATIVE PSYCHOTHERAPY AND MINDFULNESS: THE CASE OF SARA

Directory of Open Access Journals (Sweden)

Mihael Černetič

2015-02-01

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.

Brief Psychotherapy for Posttraumatic Stress Disorders.

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Brom, Daniel; And Others

1989-01-01

Examined the effectiveness of psychotherapeutic methods for the treatment of posttraumatic stress disorders. Compared trauma desensitization, hypnotherapy, psychodynamic therapy and control condition for 112 persons suffering from serious disorders resulting from traumatic events in the past 5 years. Results indicated that treated cases were…

Spiritually and religiously integrated group psychotherapy

DEFF Research Database (Denmark)

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

2013-01-01

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...... for spiritually or religiously integrated group psychotherapy and conducting research in this field are propounded....

Followership's experiences of organisational leadership: A systems psychodynamic perspective

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Henk Greyvenstein

2012-03-01

Research purpose: The purpose of the research was to describe followership’s experiences of organisational leadership from a systems psychodynamic perspective. Motivation for the study: Organisational leadership is under tremendous pressure to perform and often under attack, especially if they do not appear to be caring and supportive. The research was planned to better understand the unconscious nature of this phenomenon. Research design, approach and method: Qualitative, descriptive research was used. Data was collected through psychodynamic Listening Posts and analysed using discourse analysis. Working hypotheses were formulated per theme and integrated into the research hypothesis. Main findings: Six themes manifested, namely a negative leadership view; idealisation of the past and blaming the present; obsession with race and gender; constantly changing identity; unfinished business and the future; and cope and hope. Practical/managerial implications: Leadership seem to focus more on business than followership issues which leads to followers feeling disregarded and de-authorised. As a result followers withhold authorisation from leadership which may be instrumental in leaderships’ difficulties to manage change and transformation effectively. Leadership development needs to incorporate the self-authorisation of leaders as well as the invitation of authorisation by leaders. Contribution/value-add: The data would be useful to leadership towards understanding, repairing and optimising their relationships and organisational impact through people.

Schema therapy for aggressive offenders with personality disorders

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Keulen-de Vos, M.; Bernstein, D.P.; Arntz, A.; Tafrate, R.C.; Mitchell, D.

2014-01-01

Schema therapy (ST) is increasingly used in personality-disordered (PD) patients. ST is an integrative psychotherapy that blends elements of cognitive-behavioral, psychodynamic and experiential approaches. The key concepts in ST are early maladaptive schemas, (dysfunctional) coping styles and schema

Viewing the Disney Movie Frozen through a Psychodynamic Lens.

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Kowalski, Christopher; Bhalla, Ruchi

2015-10-14

The Disney movie Frozen is the fifth highest grossing movie of all time. In order to better understand this phenomenon and to hypothesize as to why the movie resonated so strongly with audiences, we have interpreted the movie using psychodynamic theory. We pay particular attention to the themes of puberty, adolescence and sibling relationships and discuss examples of ego defenses that are employed by the lead character in relation to these concepts.

Psychodynamics in child psychiatry in Sweden, 1945-85: from political vision to treatment ideology.

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Nelson, Karin Zetterqvist; Sandin, Bengt

2013-09-01

In this article, changing treatment ideologies and policies in child psychiatric outpatient services in Sweden from 1945 to 1985 are examined. The aim is to discuss the role played by psychoanalytic and psychodynamic thinking in this process of change. When mental health services for children were introduced in the mid-1940s, psychoanalytic thinking was intertwined with the social democratic vision of the Swedish welfare state in which children symbolized the future. In practice, however, treatment ideology was initially less influenced by psychoanalytic thinking. From the early 1960s, child psychiatric services expanded and the number of units increased. By then, the political vision had disappeared, but a treatment ideology began to evolve based on psychodynamic theories, which became dominant in the 1970s.

Applied philosophy and psychotherapy: Heraclitus as case study

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Johann Beukes

2002-10-01

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.

[Psychanalitic psychotherapy: practice and indications in the aged].

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Claudel, Bertrand

2004-09-01

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.

[Method of existence analytic psychotherapy].

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Längle, A

1990-01-01

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.

Psychotherapy: a profile of current occupational therapy practice in Ontario.

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Moll, Sandra E; Tryssenaar, Joyce; Good, Colleen R; Detwiler, Lisa M

2013-12-01

Psychotherapy can be an important part of psychosocial occupational therapy practice; however, it requires specialized training to achieve and maintain competence. Regulation varies by province, and in Ontario, occupational therapists were recently authorized to perform psychotherapy. The purpose of this study was to explore the psychotherapy practice, training, and support needs of Ontario occupational therapists. An online survey was sent to occupational therapists who had clients with mental health or chronic pain issues, asking about their expertise and support needs in relation to nine psychotherapy approaches. Of the 331 therapists who responded, there were variations in the nature and frequency of psychotherapy practice. Experienced therapists in outpatient settings were more likely to practice psychotherapy, and cognitive-behaviour therapy, motivational interviewing, and mindfulness were the most common approaches. Supervision and training varied, with many therapists interested in occupational therapy-specific training. Recommendations for a framework of support include education about the nature of psychotherapy, training and supervision guidelines, and advocacy for occupational therapy and psychotherapy.

Zone of proximal development (ZPD) as an ability to play in psychotherapy: a theory-building case study of very brief therapy.

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Zonzi, Anna; Barkham, Michael; Hardy, Gillian E; Llewelyn, Susan P; Stiles, William B; Leiman, Mikael

2014-12-01

This theory-building case study examined the zone of proximal development (ZPD) in psychotherapy within the assimilation model. Theoretically, the ZPD is the segment of the continuum of therapeutic development within which assimilation of problematic experiences can take place. Work within a problem's current ZPD may be manifested as a Winnicottian ability to play, that is, an ability to adopt a flexible reflexive stance to the presenting problem and be involved in joint examination of possible alternatives. Play may be recognized in the client's receptivity to and creative use of the therapist's formulations of the presenting problems. A case was selected from a comparative clinical trial of two very brief psychotherapies for mild to moderate depression, the Two-Plus-One Project (Barkham, Shapiro, Hardy, & Rees, 1999, J. Consult. Clin. Psychol., 67, 201). Martha, a woman in her late forties, received two sessions of psychodynamic-interpersonal therapy 1 week apart and a follow-up ('plus one') session approximately 3 months later. Dialogical sequence analysis was used to analyse the transcripts of the three sessions. The analysis revealed Martha's problematic action pattern, which remained unchanged throughout the three sessions. Her ability to use and elaborate the therapist's formulations depended on the referential object that the therapist addressed; in particular, she seemed unable to play with the therapist's formulations of her more problematic experiences. The case helped elucidate how the ZPD is content dependent. Winnicott's conception of playing emphasizes the quality of client response as an indicator of this content sensitivity. Differing breadths of major problems' ZPD, manifested as differing abilities to play with therapists' formulations may explain why some clients improve in psychotherapy while some do not. Accessing very problematic content may be very difficult even though the client's ability to mentalize other material appears ordinary

O impacto inicial da aliança terapêutica em psicoterapia psicodinâmica breve

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Marcolino, José Alvaro Marques; Iacoponi, Eduardo

2003-01-01

INTRODCTION: Therapeutic alliance is a key component of the psychotherapeutic process. This study estimated the impact of the therapeutic alliance as measured by CALPAS-P in an individual brief psychodynamic psychotherapy program. METHODS: To study the impact of the therapeutic alliance patients in psychotherapy answered to the CALPAS-P at the first and third session and to the Self-report Questionnaire (SRQ-20), to the Beck Depression Inventory (BDI) and to the Hamilton Anxiety Scale at the ...

Psychological experiences in South African society before the 2010 FIFA World Cup from the systems psychodynamic and positive psychology perspectives

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Pieter Koortzen

2012-05-01

Research purpose: The objective of this study was to analyse and describe the psychological experiences of South Africans before the 2010 FIFA World Cup. Research design, approach and method: The researchers conducted the study from the systems psychodynamic and positive psychology perspectives. The study comprised a qualitative, explorative and social phenomenological study. The researchers conducted interviews with a wide range of their colleagues and clients. Main findings: The results seemed to indicate that South Africans had had a number of positive and negative experiences before the 2010 FIFA World Cup. Practical/managerial implications: The researchers presented the findings as a number of systems psychodynamic and positive psychology themes. Contribution/value-add: This study presents original research that contributes valuable new knowledge to the positive psychology and systems psychodynamic perspectives.

Interpersonal learning is associated with improved self-esteem in group psychotherapy for women with binge eating disorder.

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

2014-03-01

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.

Review: Mäder, Maya (2017: Selbsterfahrung in der Psychotherapie (Self experience in Psychotherapy, Die Bedeutung für den Kompetenzerwerb in der Aus- und Weiterbildung zum transaktionalytischen Psychotherapeuten (The significance for getting competence in training of transactional psychotherapy Münster: Waxmann

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Günther Mohr

2017-07-01

Full Text Available Review: Mäder, Maya (2017: Selbsterfahrung in der Psychotherapie (Self experience in Psychotherapy, Die Bedeutung für den Kompetenzerwerb in der Aus- und Weiterbildung zum transaktionalytischen Psychotherapeuten (The significance for getting competence in training of transactional psychotherapy Münster: Waxmann   Citation - APA format: Mohr, G. (2017. Review: Mäder, Maya (2017: Selbsterfahrung in der Psychotherapie (Self experience in Psychotherapy, Die Bedeutung für den Kompetenzerwerb in der Aus- und Weiterbildung zum transaktionalytischen Psychotherapeuten (The significance for getting competence in training of transactional psychotherapy Münster: Waxmann. International Journal of Transactional Analysis Research & Practice, 8(2, 49-50.

Integrative dimensions of psychotherapy training.

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Greben, Daniel H

2004-04-01

This paper investigates the influence of integrative factors on psychotherapy education. The broad relevance of integrative psychotherapy to residency training and continuing mental health education is discussed. Following a review of the existing literature on the education of integrative psychotherapists, the article systematically examines the integrative and pedagogic issues to be considered in planning psychotherapy training informed by integrative principles. The integrative issues are organized into 5 categories: attitudinal set, knowledge base, clinical techniques and skills, developmental tasks and challenges, and systemic institutional factors. The educational issues can be divided into 4 categories: content, format and process, sequence, and faculty development. Brief descriptions of actual educational interventions illustrate the implementation of such ideas. Specific recommendations are made regarding the development of integrative educational initiatives and future study of unresolved questions.

Moral Dilemmas and Existential Issues Encountered Both in Psychotherapy and Philosophical Counseling Practices

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Beatrice A. Popescu

2015-08-01

Full Text Available This paper stems from clinical observations and empirical data collected in the therapy room over six years. It investigates the relationship between psychotherapy and philosophical counseling, proposing an integrative model of counseling. During cognitive behavior therapy sessions with clients who turn to therapy in order to solve their clinical issues, the author noticed that behind most of the invalidating symptoms classified by the DSM-5 as depression, anxiety, hypochondriac and phobic complaints, usually lies a lack of existential meaning or existential scope and clients are also tormented by moral dilemmas. Following the anamnestic interview and the psychological evaluation, rarely the depression or anxiety diagnosed on Axis I is purely just a sum of invalidating symptoms, which may disappear if treated symptomatically. When applying the Sentence Completion Test, an 80 items test of psychodynamic origin and high-face validity, most of the clients report an entire plethora of conscious or unconscious motivations, distorted cognitions or irrational thinking but also grave existential themes such as scope or meaning of life, professional identity, fear of death, solitude and loneliness, freedom of choice and liberty. Same issues are approached in the philosophical counseling practice, but no systematic research has been done yet in the field. Future research and investigation is needed in order to assess the importance of moral dilemmas and existential issues in both practices.

Moral Dilemmas and Existential Issues Encountered Both in Psychotherapy and Philosophical Counseling Practices.

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Popescu, Beatrice A

2015-08-01

This paper stems from clinical observations and empirical data collected in the therapy room over six years. It investigates the relationship between psychotherapy and philosophical counseling, proposing an integrative model of counseling. During cognitive behavior therapy sessions with clients who turn to therapy in order to solve their clinical issues, the author noticed that behind most of the invalidating symptoms classified by the DSM-5 as depression, anxiety, hypochondriac and phobic complaints, usually lies a lack of existential meaning or existential scope and clients are also tormented by moral dilemmas. Following the anamnestic interview and the psychological evaluation, rarely the depression or anxiety diagnosed on Axis I is purely just a sum of invalidating symptoms, which may disappear if treated symptomatically. When applying the Sentence Completion Test, an 80 items test of psychodynamic origin and high-face validity, most of the clients report an entire plethora of conscious or unconscious motivations, distorted cognitions or irrational thinking but also grave existential themes such as scope or meaning of life, professional identity, fear of death, solitude and loneliness, freedom of choice and liberty. Same issues are approached in the philosophical counseling practice, but no systematic research has been done yet in the field. Future research and investigation is needed in order to assess the importance of moral dilemmas and existential issues in both practices.

[Summary: Scientific evaluation of EMDR psychotherapy].

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Haour, F; de Beaurepaire, C

2016-06-01

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.

Using Psychodynamic Interaction as a Valuable Source of Information in Social Research

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Schmidt, Camilla

2012-01-01

This article will address the issue of using understandings of psychodynamic interrelations as a means to grasp how social and cultural dynamics are processed individually and collectively in narratives. I apply the two theoretically distinct concepts of inter- and intrasubjectivity to gain insight into how social and cultural dynamics are…

Ayurvedic concepts related to psychotherapy.

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

2013-01-01

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.

Empathy deficit in antisocial personality disorder: a psychodynamic formulation.

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Malancharuvil, Joseph M

2012-09-01

Empathic difficulty is a highly consequential characteristic of antisocial personality structure. The origin, maintenance, and possible resolution of this profound deficit are not very clear. While reconstructing empathic ability is of primary importance in the treatment of antisocial personality, not many proven procedures are in evidence. In this article, the author offers a psychodynamic formulation of the origin, character, and maintenance of the empathic deficiency in antisocial personality. The author discusses some of the treatment implications from this dynamic formulation.

Looking Weakly in All the Wrong Places? Comment on Shapiro et al. (1994).

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Norcross, John C.; Rossi, Joseph S.

1994-01-01

Commends Shapiro et al.'s (this issue) article comparing psychodynamic-interpersonal therapy with cognitive-behavioral therapy in treating depression. Questions uncritical support of equivalent outcomes conclusion and implicit rejection of differential efficacy among psychotherapies as function of patient variables. Contends that Shapiro et al.…

Group Analytic Psychotherapy in Brazil.

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Penna, Carla; Castanho, Pablo

2015-10-01

Group analytic practice in Brazil began quite early. Highly influenced by the Argentinean Pichon-Rivière, it enjoyed a major development from the 1950s to the early 1980s. Beginning in the 1970s, different factors undermined its development and eventually led to its steep decline. From the mid 1980s on, the number of people looking for either group analytic psychotherapy or group analytic training decreased considerably. Group analytic psychotherapy societies struggled to survive and most of them had to close their doors in the 1990s and the following decade. Psychiatric reform and the new public health system have stimulated a new demand for groups in Brazil. Developments in the public and not-for-profit sectors, combined with theoretical and practical research in universities, present promising new perspectives for group analytic psychotherapy in Brazil nowadays.

Multicultural approaches in psychotherapy: A rejoinder.

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

2010-12-20

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 authors challenge the wisdom of exploring MCCs in psychotherapy research and provide a different framework to understand therapists' multicultural effectiveness with clients based on their cultural race/ethnicity. Additionally, the concept of therapists' multicultural orientation or approach is introduced to illuminate the process of aligning with clients about salient cultural issues in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Large-group psychodynamics and massive violence

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Vamik D. Volkan

2006-06-01

Full Text Available Beginning with Freud, psychoanalytic theories concerning large groups have mainly focused on individuals' perceptions of what their large groups psychologically mean to them. This chapter examines some aspects of large-group psychology in its own right and studies psychodynamics of ethnic, national, religious or ideological groups, the membership of which originates in childhood. I will compare the mourning process in individuals with the mourning process in large groups to illustrate why we need to study large-group psychology as a subject in itself. As part of this discussion I will also describe signs and symptoms of large-group regression. When there is a threat against a large-group's identity, massive violence may be initiated and this violence in turn, has an obvious impact on public health.

Group Supervision in Psychotherapy. Main Findings from a Swedish Research Project on Psychotherapy Supervision in a Group Format

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Ogren, Marie-Louise; Sundin, Eva C.

2009-01-01

Psychotherapy supervision is considered crucial for psychotherapists in training. During the last decades, group supervision has been a frequently used format in many countries. Until recently, very few studies had evaluated the small-group format for training of beginner psychotherapists and psychotherapy supervisors. This article aims to…

Integration of the cognitive and the psychodynamic unconscious.

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Epstein, S

1994-08-01

Cognitive-experiential self-theory integrates the cognitive and the psychodynamic unconscious by assuming the existence of two parallel, interacting modes of information processing: a rational system and an emotionally driven experiential system. Support for the theory is provided by the convergence of a wide variety of theoretical positions on two similar processing modes; by real-life phenomena--such as conflicts between the heart and the head; the appeal of concrete, imagistic, and narrative representations; superstitious thinking; and the ubiquity of religion throughout recorded history--and by laboratory research, including the prediction of new phenomena in heuristic reasoning.

Gratitude in cognitive psychotherapy

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Natalia C. Moyano

2015-08-01

Full Text Available Gratitude is a cognitive-affective state caused by the recognition that one has received a benefit from an external agent, due to the good intentions of this agent. Despite the evidence that associate gratitude with subjective well being, psychological well being, physical health and copping with stressful events, it is not enough taken in consideration in an academic level and in its interaction with psychotherapy instruments as well. In this article, the central concepts and information provided by the research are revised, intending to analyze possible ways to include gratitude into Cognitive Psychotherapy. 

Culture and demoralization in psychotherapy.

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de Figueiredo, John M; Gostoli, Sara

2013-01-01

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 �

CASE STUDIES IN INTEGRATIVE PSYCHOTHERAPY PART 2 (EDITORIAL

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Gregor Žvelc

2013-05-01

Full Text Available Announcement of the special issue of the International Journal of Integrative Psychotherapy, which is dedicated to the exploration and discussion of an integrative psychotherapy case study.

College Students' Therapy Preferences: The Role of Psychological Mindedness

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Price, Jennifer L.

2016-01-01

The current study examined expectations and preferences of psychotherapy approach in 225 college students. Psychodynamic-interpersonal (PI) techniques were generally favored over cognitive-behavioral (CB) techniques both in expectations of what is characteristic of a typical therapy session and perceived helpfulness. There was no difference in…

PERSONALITY THEORY IN INTEGRATIVE PERSONALITY-ORIENTED RECONSTRUCTIVE PSYCHOTHERAPY

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V I Kurpatov

2010-01-01

approaches. V.N. Myasishchev's theory of personality relations in association with its universality, as well as pathogenetic psychotherapy may be the basis for the integration of other methods of psychotherapy

Interpersonal Psychotherapy: Past, Present and Future

OpenAIRE

Markowitz, John C.; Weissman, Myrna M.

2012-01-01

The authors briefly describe the origins, theory, and development of interpersonal psychotherapy: its roots in clinical outcome research, its spread from major depression to other psychiatric disorders and its increasing dissemination as an empirically validated clinical intervention included in treatment guidelines. They attempt to forecast research, organizational and training issues the growing interpersonal psychotherapy community may face in the future.

[Psychotherapy of depression in old age].

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Wächtler, C

2013-02-01

Depression in old age is common and also dangerous due to somatic comorbidity and suicide; however, it is often not recognized and not adequately treated. Psychotherapy is almost never offered to the elderly. However, clinical experience, single-case studies and some controlled trials show effectiveness--at least to the age of 75. The psychotherapist must be aware of unusual transference and countertransference between a younger therapist and elderly patient. Psychotherapy in old age requires some modifications, especially concerning special interest in biography and history, strong empathy, "container function", and focusing. In the future, psychotherapy for the elderly should be both investigated and educated more. In addition, it is hoped that psychotherapists offer to treat elderly people with depression and that more older patients accept this professional help.

An integrative relational point of view.

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Wachtel, Paul L

2014-09-01

This article, part of a special section on the Relational Foundations of Psychotherapy, describes a particular relational approach called cyclical psychodynamics. Cyclical psychodynamics is rooted both in the relational perspective in psychoanalysis and in an integrative melding of psychodynamic, cognitive-behavioral, systemic, and experiential points of view. Central to its theoretical structure is a focus on the vicious and virtuous circles that perpetuate (or contribute to changing) personality patterns that may have originated in childhood but that persist because they often generate the very feedback from others that is necessary to keep them going. As a consequence of this latter focus, the relational foundation of cyclical psychodynamic therapy addresses in equal and dynamically reciprocal fashion both the therapeutic relationship in the consulting room and the key relationships outside the consulting room that play an essential role in the maintenance or change of the problematic patterns the person has come to therapy to work on. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Metaphor in Psychotherapy

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Nergis Lapsekili

2014-08-01

Full Text Available A metaphor is a figüre of speech in which a word or phrase is applied to an object or an action that it does not literally denote in order to imply a resemblence. Metaphor has been an essential feature of human communication from time immemorial: fairy tales, parables, provers are all examples of metaphor. Human beings regularly use metaphors to communicate with each other, so it is reasonable to expect this figüre of speech to have a place in the process of communication we call psychotherapy. As well as carefully planned and developed majör metaphoric stories to achieve specific therapeutic goals, anectodes, similes, analogies, parables and other brief metaphorical statements, relationship metaphors, tasks with metaphorical meanings, objects can be used with their metaphorican meaning in psychotherapy. Stories when properly constucted and told, are usually more interesting than straight expositions of the points one wishws to make. Of course it is possible to construct boring stories or to tell good stories in a boring way. But well thought out and well narrated stories, told in the right context ca inspire people to undertake tasks and think about things they would not have considered before. Stories, because they deal indirectly with issues and have meanings that are in varying degrees veiled, tend to be less threatening and confronting than direct statements. Listeners are free to take stories at their face value, if their implicit meaning is unacceptable to them at the time. And this result will not damage the existing therapist-client rapport. Suggesting solutions to problems, helping people to recognize themselves, increasing motivation, reframing and redefining problems, reminding subjects of their own resources are all the benefits of clinical uses of metaphors in psychotherapy. In this text, the description of metaphor and usage of metaphor in psychotherapy will be reviewed with samples. [JCBPR 2014; 3(2.000: 116-125

Executive coaching in diversity from the systems psychodynamic perspective

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Lerato Motsoaledi

2012-03-01

Research purpose: The purpose of this research was to describe the application of systems psychodynamic role analysis and to determine its trustworthiness in assisting executives to work effectively with conscious and unconscious diversity dynamics in their organisations. Motivation for the study: Executives generally struggle to understand the deeper meaning of diversity behaviour that manifests inside and around them, leading to conflict. Without understanding the unconscious meaning of the behaviour, organisations founder easily. Awareness of below-the-surface behaviour leads to insight and taking responsibility for diversity-related behaviours. Research design, approach and method: The researcher coached six executives in South African state departments over a period of 10 months. The coaching addressed and analysed the executives’ organisational roles. She analysed the data using discourse analysis. Main findings: Themes relating to the diversity dynamics of gender, race, ethnicity, authority, disability, language, age, de-authorisation of diversity work and the coaching process emerged. The coaching assisted the executives to gain insights into below-the-surface diversity dynamics, to address diversity in a sustained manner and to take up their organisational roles more effectively. Practical/managerial implications: Coached executives will have a more objective and dynamic experience of diversity issues that manifest in organisations, between colleagues and within themselves. Contribution/value-add: Executive coaching from a systems psychodynamic perspective displays trustworthiness in improving participants’ diversity awareness, especially with regard to gender, race, ethnicity and authorisation.

Using Psychodynamic Interaction as a Valuable Source of Information in Social Research

DEFF Research Database (Denmark)

Schmidt, Camilla

2012-01-01

This article will address the issue of using understandings of psychodynamic interrelations as a means to grasp how social and cultural dynamics are processed individually and collectively in narratives. I apply the two theoretically distinct concepts of inter- and intrasubjectivity to gain insight...... are valuable sources of information in understanding the process of becoming a social educator....

Consequences of Psychotherapy Clients' Mental Health Ideology.

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Milling, Len; Kirsch, Irving

Current theoretical approaches to understanding emotional difficulties are dominated by the medical model of mental illness, which assumes that emotional dysfunction can be viewed the same way as physical dysfunction. To examine the relationship between psychotherapy clients' beliefs about the medical model of psychotherapy and their behavior…

Book Review Psychotherapy and Phenomenology By Ian Rory ...

African Journals Online (AJOL)

Book Review Psychotherapy and Phenomenology By Ian Rory Owen (2006) ... Psychotherapy and Phenomenology: On Freud, Husserl and Heidegger. New York: iUniverse. Soft Cover (352 ... AJOL African Journals Online. HOW TO USE ...

[Systemic therapies--a contribution to psychotherapy integration].

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Schiepek, Günter

2012-06-01

Some converging lines from neuroscience, neurobiological psychotherapy research, process-outcome-research, internet-based change monitoring and the systems and complexity sciences actually allow for an open and generic definition of systemic therapies. The "family" of systemic therapies as designed here is not restricted to the field of psychotherapy. It is a scientifically founded and engaged, bio-psycho-social multi-level approach to a common or integrative psychotherapy, not restricted to a psychotherapeutic confession or exclusively to family or couples therapy. A core element of systemic therapy is the support of self-organizing processes and the use of data-driven feedback tools. The conclusion goes to a modified concept of evidence-based practice and, vice versa, practice-based evidence, to an integration of the medical model and the common factors model into a self-organization theory of human change processes, and to a list of criteria for scientifically based practice in psychotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical holistic medicine: teaching orgasm for females with chronic anorgasmia using the Betty Dodson method.

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Struck, Pia; Ventegodt, Søren

2008-09-21

The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 "e 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the inverted exclamation mark section signsexological examination inverted exclamation mark ). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the inverted exclamation mark section signorgasm course for anorgasmic women inverted exclamation mark ; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

Moderating Effects of Alexithymia on Associations between the Therapeutic Alliance and the Outcome of Brief Psychodynamic-Interpersonal Psychotherapy for Multisomatoform Disorder.

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Probst, Thomas; Sattel, Heribert; Gündel, Harald; Henningsen, Peter; Kruse, Johannes; Schneider, Gudrun; Lahmann, Claas

2017-01-01

This secondary analysis of a trial on brief psychodynamic-interpersonal therapy (PIT) for patients with multisomatoform disorder investigated whether alexithymia moderates the associations between the therapeutic alliance and the outcome of PIT and whether moderating effects of alexithymia remain significant when controlling for depression. Eighty-three patients with multisomatoform disorder receiving PIT were statistically analyzed. Moderation analyses were performed with the SPSS macro PROCESS. The primary outcome (Y), self-reported physical quality of life at 9-month after the end of PIT, was measured with the physical component summary (PCS) of the SF-36 Health Survey. The potential moderator (M) alexithymia was operationalized with the Toronto Alexithymia Scale (TAS-20) at pre-treatment and the predictor (X) the therapeutic alliance was rated by both patients and therapists via the Helping Alliance Questionnaire (HAQ) at the end of PIT. Moreover, the PCS at pre-treatment functioned as covariate in all moderation models. When the patients' alliance ratings were analyzed, alexithymia did not moderate associations between the alliance and the outcome. When the therapists' alliance ratings were evaluated, alexithymia moderated the relationship between the alliance and the outcome ( p  moderating effect of alexithymia was, however, not statistically significant anymore when adding the pre-treatment depression scores (PHQ-9) as a covariate to the moderation model. The results underline the importance of a good therapists' view of the alliance when treating alexithymic patients and highlight the complex interaction between alexithymia and depression. Future studies are needed to extend the scope of research regarding which psychotherapeutic mechanisms of change are beneficial for which patients.

Is Exposure Necessary? A Randomized Clinical Trial of Interpersonal Psychotherapy for PTSD

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Markowitz, John C.; Petkova, Eva; Neria, Yuval; Van Meter, Page E.; Zhao, Yihong; Hembree, Elizabeth; Lovell, Karina; Biyanova, Tatyana; Marshall, Randall D.

2015-01-01

Background Exposure to trauma reminders has been considered imperative in psychotherapy for posttraumatic stress disorder (PTSD). No treatment benefits all patients, however. We tested Interpersonal Psychotherapy, which has demonstrated antidepressant efficacy and showed promise in pilot PTSD research, as a non-exposure-based, non-cognitive behavioral PTSD treatment. Methods A randomized, fourteen-week trial compared Interpersonal Psychotherapy; Prolonged Exposure, an exposure-based exemplar; and Relaxation Therapy, an active control psychotherapy. Subjects were 110 unmedicated patients having DSM-IV chronic PTSD and Clinician-Administered PTSD Scale (CAPS) score >50. Randomization stratified for comorbid major depression. We hypothesized Interpersonal Psychotherapy would be no more than minimally inferior (CAPS difference 30% CAPS improvement) were: Interpersonal Psychotherapy 63%, Prolonged Exposure 47%, Relaxation Therapy 38% (n.s.). Interpersonal psychotherapy and Prolonged Exposure CAPS outcome differed by 5.5 points (n.s.); the null hypothesis of more than minimal Interpersonal Psychotherapy inferiority was rejected (p=0.035). Patients with comorbid major depression dropped out from Prolonged Exposure nine times more than non-depressed Prolonged Exposure patients. Interpersonal Psychotherapy and Prolonged Exposure improved quality of life and social functioning more than Relaxation Therapy. Conclusions This first controlled study of individual Interpersonal Psychotherapy for PTSD demonstrated non-inferiority to the “gold standard” PTSD treatment. Interpersonal Psychotherapy had (non-significantly) lower attrition and higher response rates than Prolonged Exposure. Contradicting a widespread clinical belief, PTSD treatment may not require cognitive behavioral exposure to trauma reminders. Moreover, as differential therapeutics, patients with comorbid major depression may fare better in Interpersonal Psychotherapy than Prolonged Exposure. PMID:25677355

Shopping around for Theories for Counseling Psychology Practice: Reaction

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Hill, Clara E.

2012-01-01

Three psychotherapy theories are summarized and critiqued for their applicability to counseling psychology. The lack of attention to psychodynamic and experiential theories in the special section and the lack of theorizing by counseling psychologists in general are lamented. A plea is made for encouraging counseling psychologists to construct more…

THE FEMINIST APPROACH TO PSYCHOTHERAPY INTEGRATION

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Lorena Božac Deležan

2011-12-01

Full Text Available The goal of Integrative Psychotherapy is to establish full inner and external contact (Moursund & Erskine, 2004. The most important goal in feminist therapy is the transformation of an individual as well as the transformation of the society as a whole (Herlihy & Corey, 2004. In my work I attempt to integrate both: to help the client establish inner and external contact, but also help him/her to become aware and recognize inner messages connected with his/her gender and replace them with constructive beliefs of his/her own, as well as for him/her to learn, regardless of his/her gender, to trust his/her intuition and experience. In this article I present my approach to integration in psychotherapy and the way I use feminist principles in Integrative Psychotherapy.

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, ...

Reduction of suicidal ideation in patients undergoing psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders and neurotic symptoms reported by them before the hospitalization.

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

2015-01-01

Analysis of associations between symptoms reported before the beginning of the hospitalization and reduction of suicidal ideation - or its lack - obtained until the end of the hospitalization in patients of the day hospital for the treatment of neurotic and behavioral disorders. Symptoms Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated with intensive integrative psychotherapy with predominance of psychodynamic approach in the day hospital due to neurotic, behavioral and personality disorders between 2005-2013. Percentages of patients reporting SI initially and at the end of the treatment were 29.1% and 10.2% respectively in women and 36.5% and 13.7% in men. The improvement in terms of initially reported SI was obtained by 84.3% of women and 77.5% of men. Among patients, those initially reporting SI were characterized by greater intensity of neurotic symptoms (ppsychotherapy. As such, those subgroups of women require special attention and diligent selection of the therapeutic methods.

Promoting Efficacy Research on Functional Analytic Psychotherapy

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Maitland, Daniel W. M.; Gaynor, Scott T.

2012-01-01

Functional Analytic Psychotherapy (FAP) is a form of therapy grounded in behavioral principles that utilizes therapist reactions to shape target behavior. Despite a growing literature base, there is a paucity of research to establish the efficacy of FAP. As a general approach to psychotherapy, and how the therapeutic relationship produces change,…

Characteristics of Patients Involved in Psychotherapy in Bosnia and Herzegovina

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Sabina Alispahić

2014-04-01

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.

Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol.

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Pepping, Christopher A; Lyons, Anthony; Morris, Eric M J

2018-03-01

Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from LGBT clients following the training. Therapists also displayed reductions in homo-negativity and trans-negativity. Therapists' characteristics did not influence the extent to which they benefited from training. Specifically, years of clinical experience, therapist religiosity, and therapist psychological flexibility were unrelated to changes in attitudes, knowledge, and skills. The results of this study clearly suggest that providing training in LGBT-affirmative psychotherapy can enhance therapists' attitudes, knowledge, and skills. Of particular importance is that the benefits associated with such training appear to hold regardless of therapists' characteristics. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Applications of Mindfulness in Psychotherapy – Contemporary Dilemmas

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Borut ŠKODLAR

2016-08-01

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.

Establishing psychiatric registrars' competence in psychotherapy: a portfolio based model.

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Naidu, T; Ramlall, S

2008-11-01

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.

Bentuhua: culturing psychotherapy in postsocialist China.

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Zhang, Li

2014-06-01

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.

Deconstructing Risk Management in Psychotherapy Supervision.

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Kroll, Jerome; Radden, Jennifer

2017-12-01

In the ongoing controversy over how much regulation and standardization to impose on clinical practice and research, it is not surprising that the activity of psychotherapy supervision should be swept up in the drive for uniformity. The managers amongst us want to regulate and institutionalize all aspects of practice. In opposition, many clinicians resist the relentless march toward the safety of uniformity travel alongside managerial imposition of regulations. Psychotherapy supervision's method of a close apprenticeship relationship between supervisor and trainee and its focus on the process and ethics of professional interaction stand at the humanistic core of what is otherwise becoming an increasingly mechanistic model of providing care to persons with mental illness. Our commentary picks up on these themes as it reviews the work by Mehrtens et al about strengthening awareness of liability in psychiatry residency training programs. We argue that the practice of psychiatry is overburdened by documentation requirements. In imposing further record-keeping on psychotherapy supervision, we lose much more than we gain. We recommend that the supervisory process focus on the characterological virtues essential to functioning as an ethical therapist. We also argue that self-protective rules place restraints on possibilities for imaginative insights and innovations in psychotherapy. © 2017 American Academy of Psychiatry and the Law.

Narrative research in psychotherapy: a critical review.

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Avdi, Evrinomy; Georgaca, Eugenie

2007-09-01

This paper is a review of studies which utilise the notion of narrative to analyse psychotherapy. Its purpose is to systematically present this diverse field of research, to highlight common themes and divergences between different strands and to further the development and integration of narrative research in psychotherapy. The paper reviews studies which employ an applied textual analysis of narratives produced in the context of psychotherapy. Criteria for inclusion of studies are, firstly, the analysis of therapeutic and therapy-related texts and, secondly, the adoption of a narrative psychological perspective. The studies were examined on the basis of the notion of narrative they employ and the aspects of client narratives they focus on, and were grouped accordingly in the review. The majority of the studies reviewed assume a constructivist approach to narrative, adopt a representational view of language, focus primarily on client micro-narratives and relate to cognitive-constructivist and process-experiential psychotherapeutic approaches. A smaller group of studies assume a social constructionist approach to narrative and a functional view of language, focus on micro-narratives, highlight the interactional and wider social aspects of narrative and relate to postmodern trends in psychotherapy. The range of conceptualisations of narrative in the studies reviewed, from a representational psychological view to a constructionist social view, reflects tensions within narrative psychology itself. Moreover, two trends can be discerned in the field reviewed, narrative analysis of therapy, which draws from narrative theory and utilises the analytic approaches of narrative research to study psychotherapy, and analyses of narrative in therapy, which study client narratives using non-narrative qualitative methods. Finally, the paper highlights the need for integration of this diverse field of research and urges for the development of narrative studies of psychotherapy

New parity, same old attitude towards psychotherapy?

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Clemens, Norman A

2010-03-01

Full parity of health insurance benefits for treatment of mental illness, including substance use disorders, is a major achievement. However, the newly-published regulations implementing the legislation strongly endorse aggressive managed care as a way of containing costs for the new equality of coverage. Reductions in "very long episodes of out-patient care," hospitalization, and provider fees, along with increased utilization, are singled out as achievements of managed care. Medical appropriateness as defined by expert medical panels is to be the basis of authorizing care, though clinicians are familiar with a history of insurance companies' application of "medical necessity" to their own advantage. The regulations do not single out psychotherapy for attention, but long-term psychotherapy geared to the needs of each patient appears to be at risk. The author recommends that the mental health professions strongly advocate for the growing evidence base for psychotherapy including long-term therapy for complex mental disorders; respect for the structure and process of psychotherapy individualized to patients' needs; awareness of the costs of aggressive managed care in terms of money, time, administrative burden, and interference with the therapy; and recognition of the extensive training and experience required to provide psychotherapy as well as the stresses and demands of the work. Parity in out-of-network benefits could lead to aggressive management of care given by non-network practitioners. Since a large percentage of psychiatrists and other mental health professionals stay out of networks, implementation of parity for out-of-network providers will have to be done in a way that respects the conditions under which they would be willing and able to provide services, especially psychotherapy, to insured patients. The shortage of psychiatrists makes this an important access issue for the insured population in need of care.

Technology-enhanced human interaction in psychotherapy.

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

2017-07-01

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).

[Body-centered psychotherapy IKP (Institute of Body-Centered Psychotherapy): holistic psychotherapy].

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Maurer-Groeli, Y

1996-03-01

Body centered Psychotherapy IKP is treated in this article under the aspect of a holistic approach. First the theory and the system of science are summarised and shown as to which amount they are changing concerning knowledge of details and wholeness. It is pointed out that the actual paradigma "to the depth" has to be completed by that of "wideness". The way of holistic-multirelational thinking, stating a diagnosis and doing therapy is demonstrated along a case study going on at the background of a therapeutic encounter-relationship which is emotionally warm (Gestalt-approach).

The psychodynamics of borderline psychopathology.

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Corradi, Richard B

2015-01-01

The concept of borderline personality disorder (BPD) remains problematic despite psychiatrists' general familiarity with its DSM diagnostic criteria. The diagnosis of BPD is frequently based simply on the DSM checklist of traits and symptoms without knowledge of their origins or significance. Misdiagnosis is common, as is lack of recognition of the full complexity of this severe personality disorder and the nature of the vulnerabilities that underlie its myriad forms of pathology. The stresses of ordinary life are often too much for people with BPD. Knowledge of the nature and origins of their stress points, such as their great fear of loss or rejection, is necessary for adequate diagnosis and treatment. The author addresses how signature features of the disorder relate to psychosocial development, how they correlate with failed developmental milestones, and how they can be understood psychodynamically. This is essential knowledge for psychotherapists because the pathological interpersonal relationships of the borderline patient will be repeated and acted out in the transference, whatever the modality or intensity of treatment.

Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive-behavioural therapy in out-patients with anorexia nervosa.

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Egger, N; Wild, B; Zipfel, S; Junne, F; Konnopka, A; Schmidt, U; de Zwaan, M; Herpertz, S; Zeeck, A; Löwe, B; von Wietersheim, J; Tagay, S; Burgmer, M; Dinkel, A; Herzog, W; König, H-H

2016-12-01

Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive-behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN. The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost-utility and assumptions underlying the base case were investigated in exploratory analyses. Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends. Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.

Lost in Transition: Examining Transitions in Psychotherapy Training.

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Tan, Adrienne; Philipp, Diane; Malat, Jan; Feder, Victor; Kulkarni, Chetana; Lawson, Andrea; So, Vivien; Ravitz, Paula

2015-10-01

Disruptions are inevitable during psychiatry residency training and can affect resident learning and patient care. This exploratory study examined the nature and impact of transitions in psychotherapy training. PGY2-5 residents (45/150; 30% response rate) and psychotherapy supervisors (46/247; 18.6% response rate) were surveyed about transitional events during residency training in psychotherapy. Supervisors and residents ranked the frequency of occurrence of transitional events and their impact very similarly, as well as the "feed forward" items when transitioning to a new supervisor. Residents feeling confused or overwhelmed with the balancing of learning differing models with differing levels of comfort or knowledge was ranked as the issue that occurred most frequently by both supervisors and residents. This study highlights issues that arise at transitions during psychotherapy training in psychiatry residency. Strategies for managing these periods are discussed, with a focus on resident learning and improved continuity of patient care.

Psychodynamic Factors Behind Online Social Networking and its Excessive Use.

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Li, Thomas Cheuk Wing

2016-03-01

This article discusses the psychodynamic factors behind the popularity of one form of Internet activity, online social networking (SN). It views online SN as an extension of the social self, organized in a way that is more controllable than real life relating. The SN platforms reward its users with reassuring surfaces and novel self-object experiences while at the same time induces much anxiety. The addictive quality of online SN is understood in the context of collapse of dialectical space and the defensive use of this technology.

Competency in integrative psychotherapy: perspectives on training and supervision.

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Boswell, James F; Nelson, Dana L; Nordberg, Samuel S; McAleavey, Andrew A; Castonguay, Louis G

2010-03-01

Increasingly, many psychotherapists identify with an integrative approach to psychotherapy. In recent years, more attention has been directed toward the operationalization and evaluation of competence in professional psychology and health care service delivery. Aspects of integrative psychotherapy competency may differ from competency in other psychotherapy orientations, although convergence is more often the case. Despite the potential differences, there exist very few formal training programs or guidelines to systematically guide clinicians in developing a competent integrative practice. This paper attempts to distill the essential elements of competent integrative psychotherapy practice and focuses on how these might be developed in training and supervision. We address most of these complex issues from a specific integrative perspective: principle-based assimilative integration. PsycINFO Database Record (c) 2010 APA, all rights reserved

Psychotherapy Utilization Among Rural and Urban Veterans From 2007 to 2010.

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Mott, Juliette M; Grubbs, Kathleen M; Sansgiry, Shubhada; Fortney, John C; Cully, Jeffrey A

2015-01-01

This study evaluated change in rural and urban veterans' psychotherapy use during a period of widespread effort within the Veterans Health Administration (VHA) to engage rural veterans in mental health care. National VHA administrative databases were queried for patients receiving a new diagnosis of depression, anxiety, or posttraumatic stress disorder in fiscal years (FY) 2007 and 2010. Using the US Department of Agriculture Rural-Urban Continuum Codes, we identified urban (FY 2007: n = 192,347; FY 2010: n = 231,471) and rural (FY 2007: n = 72,923; FY 2010: n = 81,905) veterans. Veterans' psychotherapy use during the 12 months following diagnosis was assessed. From FY 2007 to 2010, the proportion of veterans receiving any psychotherapy increased from 17% to 22% for rural veterans and 24% to 28% for urban veterans. Rural veterans were less likely to receive psychotherapy across both fiscal years; however, the magnitude of this disparity decreased significantly from 2007 (odds ratio [OR] = 1.51) to 2010 (OR = 1.41). Similarly, although urban veterans received more psychotherapy sessions, urban-rural disparities in the receipt of 8 or more psychotherapy sessions decreased over the study period (2007: OR = 2.32; 2010: OR = 1.69). Rural and urban veterans are increasingly making use of psychotherapy, and rural-urban gaps in psychotherapy use are shrinking. These improvements suggest that recent VHA efforts to engage rural veterans in care have been successful at reducing differences between rural and urban veterans with respect to access and engagement in psychotherapy. © 2014 National Rural Health Association.

NONVERBAL STORIES: THE BODY IN PSYCHOTHERAPY

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Richard G. Erskine

2014-11-01

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.

Psicoterapia breve psicodinâmica preventiva: pesquisa exploratória de resultados e acompanhamento Psicoterapia breve psicodinamica preventiva: pesquisa exploratoria de resultados y acompañamiento Brief preventive psychodynamic psychotherapy: exploratory research on results and follow-up

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Tales Vilela Santeiro

2008-12-01

follow-up.Systematic studies on Psychotherapy processes, even of a prevention kind, are scarce in Brazilian clinic-schools. Current proposal focuses Brief Psychodynamic Psychotherapy (BPP conducted by students in a clinic-school context. Depression, anxiety degrees and neuroticism in first-year volunteer students of the Psychology undergraduate course (N=6 are evaluated at the start, end and six months after BPP ending (follow-up. Depression and Anxiety Beck Scales (BDI/BAI and the Emotional/Neuroticism Adjustment were employed. The weekly sessions, a total of 10, were recorded in audio and observed in a room provided with unidirectional mirror. As a rule, changes, occurring in analyzed variables, were more evident from the start to the 10th session and when BDI and BAI Scales were used as measurements. Eventual gains at the end have not always been kept in follow-up.

Reflections on Individual Psychotherapy with University Students: What Seems to Work

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Pinkerton, Rolffs; Talley, Joseph E.; Cooper, Stacie L.

2009-01-01

The authors offer reflections on what seems to work in individual psychotherapy with university students. Discussion centers around the topics of triage and disposition, referral, crisis intervention, stress management, open-ended psychotherapy, extratherapeutic factors, and the psychotherapy relationship. These observations are not intended to be…

Psychotherapy use in bipolar disorder: Association with functioning and illness severity.

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Sylvia, Louisa G; Thase, Michael E; Reilly-Harrington, Noreen A; Salcedo, Stephanie; Brody, Benjamin; Kinrys, Gustavo; Kemp, David; Shelton, Richard C; McElroy, Susan L; Kocsis, James H; Bobo, William V; Kamali, Masoud; McInnis, Melvin; Friedman, Edward; Tohen, Mauricio; Bowden, Charles L; Ketter, Terence A; Singh, Vivek; Calabrese, Joseph; Nierenberg, Andrew A; Rabideau, Dustin J; Elson, Constance M; Deckersbach, Thilo

2015-05-01

This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups. Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants. These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The influence of psychotherapy on marriage typology

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Staniszewski Mirosław

2016-07-01

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.

HELPFUL ASPECTS OF THE THERAPEUTIC RELATIONSHIP IN INTEGRATIVE PSYCHOTHERAPY

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Karmen Urška Modic

2015-12-01

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.

The systems psychodynamic experiences of organisational transformation amongst support staff

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Martin Steyn

2016-10-01

Full Text Available Orientation: The unconscious impact of organisational transformation is often neglected and even denied. This research revealed the manifestation and impact of high levels and different forms of anxiety experienced by employees during transformation. Research objective: The objective was to study and describe the manifesting systems psychodynamic behaviour amongst support staff during organisational transformation. Motivation for the study: Organisational transformation is mostly researched from a leadership viewpoint. Little research data are available on the experiences of support staff on the receiving end of decisions about and implementation of transformation. Research design, approach and method: A qualitative approach within the phenomenological hermeneutic interpretive stance was used. The research was set in a government organisation. A semi-structured interview with four conveniently and purposefully chosen support staff members was thematically analysed using systems psychodynamics as theoretical paradigm. Main findings: Four themes manifested, namely de-authorisation and detachment, being bullied and seduced by leadership, the organisation in the mind as incompetent, and a dangerous and persecutory system. In the discussion, the basic assumptions and relevant constructs are interpreted. Practical implications: Understanding the transformation experiences of support staff could assist the industrial psychologist to facilitate appropriate support in coaching more junior staff towards increasing wellness and work performance. Contribution: Organisational transformation is highlighted as an anxiety provoking experience especially on the lower levels of the organisation. Its potentially deep and complex psychological impact could possibly derail parts of the system if not managed in a psychologically contained manner.

The Therapy Process Observational Coding System for Child Psychotherapy Strategies Scale

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McLeod, Bryce D.; Weisz, John R.

2010-01-01

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…

Ethics and aims in psychotherapy: a contribution from Kant.

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Callender, J S

1998-08-01

Psychotherapy is an activity which takes many forms and which has many aims. The present paper argues that it can be viewed as a form of moral suasion. Kant's concepts of free will and ethics are described and these are then applied to the processes and outcome of psychotherapy. It is argued that his ideas, by linking rationality, free will and ethics into a single philosophical system, offer a valuable theoretical framework for thinking about aims and ethical issues in psychotherapy.

DYNAMICS OF THE ANXIETY DISORDERS IN THE COURSE OF SHORT-TERM PSYCHOTHERAPY

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T.N. Hmylova

2008-06-01

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.

Use of Psychotherapy by Rural and Urban Veterans

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Cully, Jeffrey A.; Jameson, John P.; Phillips, Laura L.; Kunik, Mark E.; Fortney, John C.

2010-01-01

Purpose: To examine whether differences exist between rural and urban veterans in terms of initiation of psychotherapy, delay in time from diagnosis to treatment, and dose of psychotherapy sessions. Methods: Using a longitudinal cohort of veterans obtained from national Veterans Affairs databases (October 2003 through September 2004), we extracted…

Treating the emotional and motivational inhibition of highly gifted underachievers with music psychotherapy: Meta-analysis of an evaluation study based on a sequential design.

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Schiltz, L

The psychological and neuropsychological characteristics of gifted children and adolescents are analysed, as well as the emotional and behavioural risks linked to this condition. A prospective follow-up study of N=93 highly gifted students suffering from school failure at the beginning of adolescence was implemented. They were treated with an integrated form of music psychotherapy and verbal psychotherapy in 5 separate groups. The methodology of treatment combined active musical improvisation with the writing of stories or the production of drawings under musical induction, followed by verbal elaboration in the cognitive-psychodynamic psychotherapeutic tradition. The evaluation was based on a mixed-methods design, combining psychometric scales, projective tests and expressive tests. Comparative pretest-posttest, correlational and multidimensional analyses were computed, using non-parametric statistical procedures adapted to small samples and data belonging to a mixed level of measurement. We present a meta-analysis of the confirmatory results in 5 subgroups. There was a significant increase in the capacity of concentration, the capacity of imaginary and symbolic elaboration, the pictorial and literary creativity, self-esteem, the quality of coping strategies, as well as in school marks. There was a significant decrease in defensive functioning and in embitterment and resignation. The latent dimensions extracted with Optimal Scaling procedures from the correlational matrixes of the Delta values of TAT and TSD-Z were meaningful at the light of the state-of-the-arts. The results of the study confirm a prior theoretical modelization coming out of the preparatory stage of the research project. They are interpreted at the light of recent findings in developmental and clinical psychology of adolescence and they open many tracks for future research.

Obstacles to early career psychiatrists practicing psychotherapy.

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

2014-09-01

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.

Review of Psychoanalytic Psychotherapy: A Practitioner's Guide.

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Papouchis, Nicholas

2006-01-01

Reviews the book, Psychoanalytic Psychotherapy: A Practitioner's Guide by Nancy McWilliams (see record 2004-16060-000). Nancy McWilliams' book on analytic therapy is her latest contribution to the training needs of young clinicians. The book is organized into chapters that address fundamental issues clinical trainees typically face as they work with patients. To establish the context for describing psychoanalytic work, the first chapter defines what she means by psychoanalytic therapy. The three chapters that follow address what McWilliams means by a psychoanalytic sensibility: how the therapist may be prepared for doing therapy and how the client may be prepared for the experience of psychoanalytic psychotherapy. The next three chapters address the maintenance of boundaries and basic therapy processes. Two case examples follow in chapters eight and nine, and each example is a richly evocative description of the complexity of psychoanalytic psychotherapy. The last three chapters of the book deal with the ancillary lessons of psychoanalytic therapy, the occupational hazards and gratifications of the work, and a final chapter on self-care. This is an excellent book, but it should be read together with other texts on psychoanalytic psychotherapy that describe the treatment process systematically in more technical terms. This is a book written for clinicians in training or for experienced clinicians to use in working with clinical trainees. In this sense, Nancy McWilliams has more than achieved her goal of writing a book that will introduce clinical trainees to the psychoanalytic sensibility of doing psychoanalytic psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

A Psychodynamic Perspective of Workplace Bullying: Containment, Boundaries and a Futile Search for Recognition

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White, Sheila

2004-01-01

This paper presents a psychodynamic perspective of workplace bullying. It focuses on two related psychoanalytical concepts, containment and boundaries. The life cycle theory of bullying builds on these concepts and describes in-depth the evolving relationship between a bully and a victim. The search for recognition by the bully and victim proves…

A New Language for Child Psychotherapy: A Response to Jerald Kay

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Clark, James J.; Borden, William

2009-01-01

Jerald Kay's article in this issue reviews important research in the areas of adult psychotherapy and neuroscience, and their implications for child psychotherapy. We respond by exploring some of the strengths and limitations of these lines of research and their implications for child psychotherapy development and research. The paper closes with…

[Undesired treatment effects in behavior group therapy: Frequency and spectrum].

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Linden, M; Walter, M; Fritz, K; Muschalla, B

2015-11-01

Psychotherapy not only has positive but also negative effects, which is especially true for group psychotherapy due to psychodynamic and interactional processes. Using the UE-G questionnaire 71 patients who participated in cognitive behavioral group psychotherapy reported on negative experiences in the context of the group therapy. The answers were then validated in a qualitative interview. Of the patients 98.6% reported about at least one negative experience and 43.7% about severe or extremely severe negative experiences. Most prominent was the induction of hopelessness and demoralization by what patients saw and heard from other patients in the group. Burdensome and therefore undesired treatment effects are regularly seen in group psychotherapy, because of treatment or patient related factors. In any case they must be taken into account during treatment, in the training of group psychotherapists and in quality control.

Medical psychotherapy of schizophrenia--a dynamic/supportive approach.

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Corradi, Richard B

2004-01-01

Split psychiatric treatment-a psychiatrist prescribing medication while a nonphysician provides or coordinates psychosocial treatments-is common practice, especially in the managed care setting. This influence, along with a focus on the biology of mental illness, has shifted the emphasis in psychiatric education and practice away from psychotherapy. In particular, "psychotherapy" of schizophrenia has gotten short shrift. Since our drugs for schizophrenia do not cure, but only ameliorate, it would be unfortunate if psychiatrists were to become marginalized in a largely prescriptive role. This paper discusses medical psychotherapy of schizophrenia-an integrated treatment in which the psychiatrist provides the comprehensive care that such a chronic biopsychosocial illness requires.

Attachment style and readiness for psychotherapy among psychiatric outpatients.

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Kealy, David; Tsai, Michelle; Ogrodniczuk, John S

2017-06-01

Ninety-two adults attending outpatient mental health services completed measures of attachment style and readiness to engage in psychotherapy. Correlation and linear regression analyses found anxious attachment to be positively associated with treatment-seeking distress and found avoidant attachment to be negatively associated with openness to personal disclosure in the therapy relationship. Insecure attachment may influence prospective patients' readiness for psychotherapy. Patients with an avoidant attachment style may need assistance in preparing for the relational aspects of psychotherapy. © 2016 The British Psychological Society.

Therapy 101: A Psychotherapy Curriculum for Medical Students

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Aboul-Fotouh, Frieda; Asghar-Ali, Ali Abbas

2010-01-01

Objective: This pilot project, designed and taught by a resident, created a curriculum to introduce medical students to the practice of psychotherapy. Medical students who are knowledgeable about psychotherapy can become physicians who are able to refer patients to psychotherapeutic treatments. A search of the literature did not identify a…

Internet-mediated psychotherapy: Are we ready for the ethical challenges?

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Satalkar, Priya; Shrivastava, Shivanshu; Desousa, Avinash

2015-01-01

Advances in information and communication technology have facilitated the development of online psychotherapy. This form of psychotherapy would provide the developing world with better access to professional mental healthcare services. At the same time, it is prudent to carefully consider the various ethical, legal and regulatory issues involved in online psychotherapy. This paper highlights the major ethical issues involved in the use of online psychotherapy, whether conducted via e-mail, chat rooms or interactive video, and identifies practical solutions for the ethical dilemmas that exist. Many authors and organisations have expressed their opinions on the subject, but no consensus has evolved. The advice offered to psychologists is mostly skewed and the scarcity of literature available to those considering expanding their practice to include online psychotherapy is certainly a source of vexation. While reviewing the existing literature, this paper seeks to describe and discuss the major ethical issues in this area, particularly in India, but many of these issues will be equally applicable to any developing world settings.

Psychotherapy, consciousness, and brain plasticity

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Daniel eCollerton

2013-09-01

Full Text Available Purely psychological treatments for emotional distress produce lasting, measureable, and reproducible changes in cognitive and emotional consciousness and brain function. How these changes come about illustrates the interplay between brain and consciousness. Studies of the effects of psychotherapy highlight the holistic nature of consciousness. Pre and post treatment functional Magnetic Resonance Imaging localises the brain changes following psychotherapy to frontal, cingulate, and limbic circuits, but emphasise that these areas support a wide range of conscious experiences. Multivoxel Pattern Analysis of distributed changes in function across these brain areas may be able to provide the ability to distinguish between different states of consciousness.

Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

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Staats, H

2005-01-01

Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

Moderating Effects of Alexithymia on Associations between the Therapeutic Alliance and the Outcome of Brief Psychodynamic-Interpersonal Psychotherapy for Multisomatoform Disorder

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Thomas Probst

2017-12-01

Full Text Available This secondary analysis of a trial on brief psychodynamic-interpersonal therapy (PIT for patients with multisomatoform disorder investigated whether alexithymia moderates the associations between the therapeutic alliance and the outcome of PIT and whether moderating effects of alexithymia remain significant when controlling for depression. Eighty-three patients with multisomatoform disorder receiving PIT were statistically analyzed. Moderation analyses were performed with the SPSS macro PROCESS. The primary outcome (Y, self-reported physical quality of life at 9-month after the end of PIT, was measured with the physical component summary (PCS of the SF-36 Health Survey. The potential moderator (M alexithymia was operationalized with the Toronto Alexithymia Scale (TAS-20 at pre-treatment and the predictor (X the therapeutic alliance was rated by both patients and therapists via the Helping Alliance Questionnaire (HAQ at the end of PIT. Moreover, the PCS at pre-treatment functioned as covariate in all moderation models. When the patients’ alliance ratings were analyzed, alexithymia did not moderate associations between the alliance and the outcome. When the therapists’ alliance ratings were evaluated, alexithymia moderated the relationship between the alliance and the outcome (p < 0.05: a stronger alliance in the therapists’ perspective was beneficial for the outcome only for patients scoring above 61 on the TAS-20. This moderating effect of alexithymia was, however, not statistically significant anymore when adding the pre-treatment depression scores (PHQ-9 as a covariate to the moderation model. The results underline the importance of a good therapists’ view of the alliance when treating alexithymic patients and highlight the complex interaction between alexithymia and depression. Future studies are needed to extend the scope of research regarding which psychotherapeutic mechanisms of change are beneficial for which patients.

How I Have Changed Over Time as a Psychotherapist.

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Messer, Stanley B

2015-11-01

Reflecting on my career as a psychotherapist has led me to consider 3 major areas that have affected the way I practice, namely, assimilative integration, the visions of reality, and brief psychodynamic therapy. Although starting out as a traditional psychoanalytic therapist, I became more integrative as I was exposed to other approaches and to patients with a variety of needs. As a result I developed a mode of integration, which I call assimilative. After applying the literary genres of tragedy, comedy, romance, and irony to psychoanalytic, behavioral, and humanistic psychotherapies, I found that they also could be used to describe any patient's multiple facets and psychological challenges. I demonstrate here how such visions helped in the treatment of a case of bipolar disorder. Upon recognizing the need for briefer forms of treatment, I developed an interest in conducting, conceptualizing, and researching brief psychodynamic therapy. I conclude the article by answering questions posed by the editors regarding how I have changed over time in conducting psychotherapy. © 2015 Wiley Periodicals, Inc.

Predictors of response in the treatment of moderate depression

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Andre G. Bastos

Full Text Available Objective: To identify neurocognitive and sociodemographic variables that could be associated with clinical response to three modalities of treatment for depression, as well as variables that predicted superior response to one treatment over the others. Method: The present study derives from a research project in which depressed patients (n=272 received one of three treatments – long-term psychodynamic psychotherapy (n=90, fluoxetine therapy (n=91, or a combination thereof (n=91 – over a 24-month period. Results: Sociodemographic variables were not found to be predictive. Six predictive neurocognitive variables were identified: three prognostic variables related to working memory and abstract reasoning; one prescriptive variable related to working memory; and two variables found to be moderators. Conclusions: The results of this study indicate subgroups of patients who might benefit from specific therapeutic strategies and subgroups that seem to respond well to long-term psychodynamic psychotherapy and combined therapy. The moderators found suggest that abstract reasoning and processing speed may influence the magnitude and/or direction of clinical improvement.

Effects of trauma-focused psychotherapy upon war refugees.

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Kruse, Johannes; Joksimovic, Ljiljana; Cavka, Majda; Wöller, Wolfgang; Schmitz, Norbert

2009-12-01

The aim of this study is to evaluate the effects of a trauma-focused psychotherapy upon war refugees from Bosnia. Seventy refugees who met the criteria for posttraumatic stress disorder (PTSD) and somatoform disorders were included. The first 35 refugees were offered psychotherapy and the following 35 refugees received usual care. Outcome variables were changes in self-reported PTSD symptoms, psychological symptoms, and health status. At 12-month follow-up, participants in the intervention group reported significantly lower scores on the PTSD scale and the measure of psychological symptoms than the comparison group participants. Our results suggest that psychotherapy reduces symptoms of PTSD and somatoform disorders among war refugees even in the presence of insecure residence status.

[Utilization of self-help groups and psychotherapy after psychosomatic-psychotherapeutic in-patient treatment].

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Höflich, Anke; Matzat, Jürgen; Meyer, Friedhelm; Knickenberg, Rudolf J; Bleichner, Franz; Merkle, Wolfgang; Reimer, Christian; Franke, Wolfram; Beutel, Manfred E

2007-05-01

Until now little is known about the role of participation in self-help groups alone or combined with psychotherapy in post-in-patient care. In the present study 2933 patients were questioned about their experience of self-help groups and psychotherapy after discharge from a clinic for psychosomatic medicine and psychotherapy. Nearly 8 % of them utilized self-help groups (mostly combined with out-patient psychotherapy), and altogether 68 % out-patient psychotherapy following in-patient treatment. Patients without out-patient treatment were psychologically less burdened and had better resources than participants of self-help groups or psychotherapy. Self-help group members differed from patients in out-patient psychotherapy by expressing a more positive opinion of groupwork and higher openness to new experiences. Additionly, they had discussed the topic of self-help groups more frequently with their therapists. This may be a starting-point for promoting more self-help activities of patients in the future.

Changes in neurotic personality profile associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

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

2015-01-01

Analysis of associations between changes in neurotic personality profile and reductionof suicidal ideation (SI) - or lack of such reduction - defined as its elimination or reduction of its intensity in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men treated due to neurotic, behavioral or personality disorders in a day hospital between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. Patients who improved in terms of SI obtained significantly greater reduction of global neurotic personality disintegration (neuroticism) than others (ppsychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism) and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

Redefining Outcome Measurement: A Model for Brief Psychotherapy.

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McGuinty, Everett; Nelson, John; Carlson, Alain; Crowther, Eric; Bednar, Dina; Foroughe, Mirisse

2016-05-01

The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The

Is It All about the Higher Dose? Why Psychoanalytic Therapy Is an Effective Treatment for Major Depression.

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Zimmermann, Johannes; Löffler-Stastka, Henriette; Huber, Dorothea; Klug, Günther; Alhabbo, Sarah; Bock, Astrid; Benecke, Cord

2015-01-01

Empirical evidence for the effectiveness of long-term psychodynamic psychotherapy (LTPP) in patients with mood disorders is growing. However, it is unclear whether the effectiveness of LTPP is due to distinctive features of psychodynamic/psychoanalytic techniques or to a higher number of sessions. We tested these rival hypotheses in a quasi-experimental study comparing psychoanalytic therapy (i.e., high-dose LTPP) with psychodynamic therapy (i.e., low-dose LTPP) and cognitive-behavioural therapy (CBT) for depression. Analyses were based on a subsample of 77 subjects, with 27 receiving psychoanalytic therapy, 26 receiving psychodynamic therapy and 24 receiving CBT. Depressive symptoms, interpersonal problems and introject affiliation were assessed prior to treatment, after treatment and at the 1-, 2- and 3-year follow-ups. Psychoanalytic techniques were assessed from three audiotaped middle sessions per treatment using the Psychotherapy Process Q-Set. Subjects receiving psychoanalytic therapy reported having fewer interpersonal problems, treated themselves in a more affiliative way directly after treatment and tended to improve in depressive symptoms and interpersonal problems during follow-up as compared with patients receiving psychodynamic therapy and/or CBT. Multilevel mediation analyses suggested that post-treatment differences in interpersonal problems and introject affiliation were mediated by the higher number of sessions, and follow-up differences in depressive symptoms were mediated by the more pronounced application of psychoanalytic techniques. We also found some evidence for indirect treatment effects via psychoanalytic techniques on changes in introject affiliation during follow-up. These results provide support for the prediction that both a high dose and the application of psychoanalytic techniques facilitate therapeutic change in patients with major depression. Psychoanalytic therapy is an effective treatment for major depression, especially in the

A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy.

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Berghout, Caspar C; Zevalkink, Jolien; Hakkaart-van Roijen, Leona

2010-01-01

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.

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

2015-10-01

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. 

Psychotherapy in psychiatry: the current situation and future directions in Germany.

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Schnell, Knut; Herpertz, Sabine C

2011-11-01

The aim of this article is to review how psychotherapy is dispensed to patients in psychiatric treatment and to render the future perspectives of psychotherapy in psychiatric outpatient and inpatient care in Germany. We demonstrate that--according to the currently available data about healthcare providers, allocation of financial resources and curricular regulations--the presently used definition of the term "psychotherapy" is ambiguous. One major problem for the application of psychotherapy in psychiatry is obviously constituted by the dominance of the major guideline therapies ("Richtlinienverfahren") within psychiatric services. Here, guideline therapies do not meet the needs of a significant proportion of acutely, severely and/or chronically ill psychiatric patients and restrain the application of scientifically approved, disorder-oriented and context compliant interventions in psychiatric practice. As a future perspective, we suggest that the training of psychiatrists should impart profound interpersonal skills and provide the competence to offer psychotherapy within a multimodal, modular, and flexible treatment plan on the background of the self-conception of psychiatry as a medical discipline. Moreover, future concepts of psychiatric psychotherapy should promote an evidence-based selection and application of scientifically approved, disorder-oriented, and integrative treatment methods, which are available in growing number.

Psychotherapy for Suicidal Clients.

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Lester, David

1994-01-01

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)

Using Media to Teach How Not to Do Psychotherapy

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Gabbard, Glen; Horowitz, Mardi

2010-01-01

Objective: This article describes how using media depictions of psychotherapy may help in teaching psychiatric residents. Methods: Using the HBO series "In Treatment" as a model, the authors suggest how boundary transgressions and technical errors may inform residents about optimal psychotherapeutic approaches. Results: The psychotherapy vignettes…

Conceptual Frame for Selecting Individual Psychotherapy in the Schools

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Hughes, Tammy L.; Theodore, Lea A.

2009-01-01

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…

Advancing psychotherapy and evidence-based psychological interventions.

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Emmelkamp, Paul M G; David, Daniel; Beckers, Tom; Muris, Peter; Cuijpers, Pim; Lutz, Wolfgang; Andersson, Gerhard; Araya, Ricardo; Banos Rivera, Rosa M; Barkham, Michael; Berking, Matthias; Berger, Thomas; Botella, Christina; Carlbring, Per; Colom, Francesc; Essau, Cecilia; Hermans, Dirk; Hofmann, Stefan G; Knappe, Susanne; Ollendick, Thomas H; Raes, Filip; Rief, Winfried; Riper, Heleen; Van Der Oord, Saskia; Vervliet, Bram

2014-01-01

Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom-based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state-of-the-art in psychotherapy treatment research, "component analyses" aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large-scale public health strategies and treatments that can be applied to more patients in a simpler and cost-effective way. Increased research on efficacy and moderators of Internet-based treatments and e-mental health tools (e.g. to support

[Publicly funded programs of psychotherapy in Australia and England].

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Vasiliadis, Helen-Maria; Dezetter, Anne

Quebec's HealthCommissioner on the performance of the health system clearly highlighted gaps in the collaboration between primary care physicians and mental health specialists, decreased accessibility and inequity in access to effective mental health services such as psychotherapy.Objectives The aim of this article was to describe the implementation of two publicly funded programs of psychotherapy in Australia and England with similar gatekeeper systems to the one in Quebec.Findings Following the Access to Allied Psychological Services (ATAPS) program introduced in Australia in 2003, one of the most important initiatives from the Council of Australian Governments' National Action Plan on Mental Health 2006-2011 was the Better Access Initiative which commenced in 2006. The plan included AUD1.2 billion in funding for integrating and improving the mental health care system. The purpose of Better Access was to improve the treatment and management of mental illnesses and increasing community access to mental health professionals and providing more affordable mental health care. GPs were encouraged to work more closely with mental health professionals. Under this program, these professionals are able to provide mental health services on a fee-for-service basis subsidized through Medicare. Access to psychological therapies is provided through private providers, rather than through fund holding arrangements. As of 2009 in Australia, 2 million people (1 in 11) had received over 11.2 million subsidized mental health services. A recent study showed clinical improvements in patients with depression associated with Better Access, concluding that the program is meeting previously unmet mental health needs.In the case of England, the IAPT - Improving Access to psychological Therapies-program enabled primary care trusts (PCTs) to implement evidence-based psychological therapies as recommended by National Institute for Health and Clinical Excellence for people suffering from

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 ...

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.

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Meganck, Reitske; Desmet, Mattias; Bockting, Claudi; 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

2017-03-14

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 are considered crucial in understanding outcome, they have received limited research attention. This trial aims at investigating the interaction between therapeutic approach (pre-structured versus explorative) and the personality style of patients (dependent versus self-critical), which is considered a core underlying dimension of depressive pathology. This study is a pragmatic stratified (dependent and self-critical patients) parallel trial with equal randomization (allocation 1:1) conducted in Flanders, Belgium. One hundred and four patients will be recruited and randomized to either 16-20 sessions of cognitive behavioral therapy for depression (pre-structured approach) or 16-20 sessions of short-term psychodynamic psychotherapy for depression (explorative approach) conducted by trained psychotherapists in private practices. The primary outcome is the severity of depression as measured by the Hamilton Rating Scale for Depression at completion of therapy. Secondary outcome measures include self-reported depressive and other symptoms, interpersonal functioning, idiosyncratic complaints, and the presence of the diagnosis of depression. Additional measures include biological measures, narrative material (sessions, interviews), and health care costs. This trial presents the test of an often-described, yet hardly investigated interaction between important personality dimensions and therapeutic approach in the treatment of depression. Results could inform therapists on how to match psychotherapeutic treatments to specific personality characteristics of their patients. Isrctn.com, ISRCTN17130982 . Registered on 2 February 2015.

Psychotherapy and Women's Liberation

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Holroyd, Jean

1976-01-01

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)

[The Application of Body-Mind-Spirit Integrated Psychotherapy in Nursing Practice].

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Hsiao, Fei-Hsiu

2017-06-01

Body-mind-spirit integrated psychotherapy reflects the core value of nursing by emphasizing the inseparable concept of body, mind, and spirit and caring for the holistic needs of the patient. Body-mind-spirit integrated psychotherapy was developed based on Western psychotherapy (positive psychology and forgiveness therapy), traditional Chinese medicine, and the Eastern philosophies of Buddhism, Taoism, and Confucianism. The present paper describes the holistic concepts that underpin this therapeutic approach. Physical health is sustained through proper nutrition, physical relaxation, and harmonized breathing; psychological well-being helps maintain inner peace and harmony in interpersonal relationships; and spiritual well-being helps develop an optimistic and meaningful life. We report on several cases in which body-mind-spirit integrated psychotherapy was applied to the care of clients with depressive disorders and of breast cancer survivors and their partners as well as the related efficacy of this intervention in these cases. Finally, we discuss the potential for culturally-enriched psychotherapy to help clients transform illness suffering into life-growth experiences.

Benefits of Combining Massage Therapy with Group Interpersonal Psychotherapy in Prenatally Depressed Women

OpenAIRE

Field, Tiffany; Deeds, Osvelia; Diego, Miguel; Hernandez-Reif, Maria; Gauler, Andy; Sullivan, Susan; Wilson, Donna; Nearing, Graciela

2009-01-01

One hundred twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy. The group Interpersonal Psychotherapy (one hour sessions) and massage therapy (30 minute sessions) were held once per week for six weeks. The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater perce...

[Psychoanalysis and psychoanalytic oriented psychotherapy: differences and similarities].

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Rössler-Schülein, Hemma; Löffler-Stastka, Henriette

2013-01-01

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.

Research on psychotherapy integration: building on the past, looking to the future.

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Castonguay, Louis G; Eubanks, Catherine F; Goldfried, Marvin R; Muran, J Christopher; Lutz, Wolfgang

2015-01-01

Integration has become an important and influential movement within psychotherapy practice, reflected by the fact that many treatment providers now identify as integrative. However, integration has not had as great an influence on psychotherapy research. The goal of this paper is to highlight the growing body of research on psychotherapy integration, and to identify future directions for research that may strengthen the integration movement as well as the field of psychotherapy as a whole. We first summarize the past 25 years of research on integration, with a focus on four approaches to integration: theoretical integration, technical eclectic, common factors, and assimilative integration. Next, we identify directions of research within these four areas that could strengthen and support integrative practice. We then propose ways in which the perspective of integrationists could contribute to psychotherapy research in the critical areas of harmful effects, therapist effects, practice-oriented research, and training. We end this paper by suggesting that a greater collaboration between integrationists and psychotherapy researchers will help to create a unified landscape of knowledge and action that will benefit all participants and advance the field.

Meaning in life in psychotherapy: The perspective of experienced psychotherapists.

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

2017-07-01

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.

Investigating Psychometric Properties of the Persian Version of Positive Psychotherapy Inventory

Directory of Open Access Journals (Sweden)

Z Ghorbani

2015-08-01

Full Text Available The purpose of the study was to investigate psychometric properties of the Persian version of positive psychotherapy inventory in university students. Research method was descriptive, correlational type. The sample of the study consist of 432 MS and PhD students, 225 female and 207 male, aged between 23 to 45 of state universities of Tehran who were selected through multi-stage random sampling. To study reliability, convergent and structural validity of instrument the sample group completed, positive psychotherapy inventory (Rashid and Oxford Happiness Inventory (Argyle and Hills. To investigating the reliability Cronbach alpha and test- retest method, and for validity of instrument structural validity exploratory factor analysis method and convergent validity were used. Results showed the total internal consistency of positive psychotherapy inventory was 0.80 and subscales internal consistency was between 0.80 to 0.92 respectively. In addition test-retest reliability coefficient was 0.70 for total inventory and between 0.63 to 0.73 for the subscales. Also the correlation coefficients between positive psychotherapy inventory and oxford happiness inventory were 0.73, which indicated a satisfactory convergent validity for positive psychotherapy inventory. Confirmatory factor analysis results showed three factors model of positive psychotherapy inventory in the Iranian sample. These three factors explained 79.99 variance of total inventory.

Interpersonal psychotherapy (IPT) in major depressive disorder.

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Brakemeier, Eva-Lotta; Frase, Lukas

2012-11-01

In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.

Design challenges in transdiagnostic psychotherapy research: Comparing Transdiagnostic Behavior Therapy (TBT) to existing evidence-based psychotherapy in veterans with affective disorders.

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Gros, Daniel F

2015-07-01

To address the limitations of disorder-specific approaches, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. However, the recruitment of multiple diagnoses presents many challenges to the traditional design of psychotherapy randomized controlled trials (RCTs). The goal of the manuscript is to present the challenges and rationale for designing a RCT for transdiagnostic treatment to inform and aid in the development of future investigations. A recently funded and ongoing RCT for Transdiagnostic Behavior Therapy (TBT) is used as an example to discuss the related design challenges. The TBT study involves the recruitment of 96 veteran participants with any of the following eight principal diagnoses: posttraumatic stress disorder, panic disorder, social anxiety disorder, obsessive compulsive disorder, generalized anxiety disorder, specific phobia, major depressive disorder, or persistent depressive disorder. Within the TBT study, participants will complete a semi-structured diagnostic interview and a series of transdiagnostic self-report measures to determine eligibility and assess baseline symptomatology. Qualifying participants will be randomized to TBT or control psychotherapy. Additional assessments will be completed at post-treatment and 6-month follow-up. Due to the transdiagnostic nature of the sample, adjustments to the recruitment and randomization procedures, selection of measures, selection of control psychotherapy, and analysis plan were required. These adjustments have implications to future trials on transdiagnostic psychotherapy protocols as well as future research in line with the transdiagnostic focus of the National Institute of Mental Health's Research Domain Criteria (RDoC) funding strategy. Published by Elsevier Inc.

Social Problem Solving and Depressive Symptoms over Time: A Randomized Clinical Trial of Cognitive-Behavioral Analysis System of Psychotherapy, Brief Supportive Psychotherapy, and Pharmacotherapy

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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.

2011-01-01

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…

Psicodinâmica do adolescente envolvido com drogas Psychodynamic of the adolescent involved with drugs

Directory of Open Access Journals (Sweden)

Felix Kessler

2003-04-01

Full Text Available O uso e o abuso de drogas pelos adolescentes é cada vez mais prevalente e traz desdobramentos sérios nos vários níveis de seu desenvolvimento e na sua família. O presente trabalho aborda as pesquisas no campo epidemiológico sobre fatores de proteção e de risco para o uso de drogas entre os jovens, que demonstram que fracassos tanto pessoais como familiares, além de eventos estressores durante a vida, estão mais associados com o uso de drogas. No entanto, a presença dos pais, a motivação pessoal e o monitoramento do adolescente, estão associados com o não uso. São descritos os principais estudos prospectivos já realizados nessa área. Em seguida, à luz do pensamento de diversos autores como H. Kohut, J. McDougall, H. Rosenfeld, C. Olievenstein, Khantzian, entre outros, apresentam-se teorias psicodinâmicas relacionadas ao problema das adições e sua evolução ao longo dos anos dentro do paradigma psicanalítico. A aplicação das técnicas baseadas nos modelos psicoterápicos de orientação analítica, em dependentes químicos, é também discutida.Drug abuse amongst adolescents is becoming increasingly prevalent placing serious consequences in their development and their relationship with family and society. The present paper discloses some epidemiological data on protectors and risk factors for drug abuse in this population demonstrating that personal and family stressors during early life are associated with drug abuse. On the other hand, engaged parents, personal motivation and constant monitoring are associated with avoidance of drugs. Major prospective studies in this field are also reviewed. Psychodynamic theories related to addiction and their evolution through the thoughts of authors such as H. Kohut, J. McDougall, H. Rosenfeld, C. Olievenstein, Khantzian, are analyzed. The application of the thecnics based on psychoanalytic psychotherapy in chemical dependents is also discussed.

Clients' and therapists' stories about psychotherapy.

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Adler, Jonathan M

2013-12-01

This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. © 2012 Wiley Periodicals, Inc.

The role of identification in dynamic psychiatry and psychotherapy.

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Corradi, Richard B

2011-01-01

Identification-a psychic process in which a person takes on characteristics of another-is a concept important to the understanding of human nature. It plays an important role in how our personalities develop, in our ability to deal with life's stresses, and in how we interact with other people. Knowledge of its manifestations is essential to dynamic psychiatry and to its applications in psychotherapy. This article defines identification and reviews its role in development and as a defense. It discusses its role in the psychopathology of disorders commonly encountered in psychotherapy practice-depression and anxiety states reactive to losses in life, and borderline states. Clinical vignettes illustrate how identification functions in these conditions, and also how identifications reveal themselves in the transference and are utilized in psychotherapy. A teaching vignette illustrates how important it is that residents learning the art of psychotherapy appreciate the therapeutic potential of identification. The article maintains that, although it often goes unrecognized, identification with the therapist is one of the most effective therapeutic devices in the transference.

The Theory and Art of Child Psychotherapy: A Corrective Developmental Approach.

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Friedman, Robert

2017-10-01

The history of child psychotherapy is sketched from the psychoanalytic pioneers Anna Freud and Melanie Klein to the popular "nondirective" approach of Virginia Axline. The author's approach to child psychotherapy, based on contemporary psychoanalytic theories, allows the therapist to play any parental role that helps to repair developmental deficiencies and conflicts. These include nurturing, supporting, mirroring, role modeling, challenging, and limit setting. Following Winnicott, psychotherapy is conceived as a play space in which therapist and child are both spontaneous. The value of interpretation and insight in child therapy is discussed. There follows a more detailed discussion of three major problem areas in child psychotherapy: handling anger and hostile aggression; handling issues related to sexuality; and handling narcissistic issues of inferiority and shame.

Psychotherapy for chronic major depression and dysthymia: A meta analysis.

NARCIS (Netherlands)

Cuijpers, P.; Straten, van A.; Schuurmans, J.; Oppen, van P.C.; Hollon, S.D.; Andersson, G.

2009-01-01

Abstract Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic

Winifred Rushforth and the Davidson Clinic for Medical Psychotherapy: a case study in the overlap of psychotherapy, Christianity and New Age spirituality.

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Miller, Gavin

2015-09-01

The activities of both Winifred Rushforth (1885-1983), and the Edinburgh-based Davidson Clinic for Medical Psychotherapy (1941-73) which she directed, exemplify and elaborate the overlap in Scotland of religious discourses and practices with psychoanalytic psychotherapy. Even as post-war secularization began to affect Scottish culture and society, Rushforth and the Davidson Clinic attempted to renew the biographical discourses of Christianity using the idioms and practices of psychoanalytic psychotherapy. Furthermore, alongside these Christian-inflected activities, Rushforth promoted a psychoanalytically-informed New Age spirituality. This parallel mode of belief and practice drew on Christian life-narrative patterns, preserving them within psychoanalytic forms grafted onto a vitalist worldview informed by the work of Pierre Teilhard de Chardin. © The Author(s) 2015.

Psychodynamic therapy from the perspective of self-organization. a concept of change and a methodological approach for empirical examination.

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Gumz, Antje; Geyer, Michael; Brähler, Elmar

2014-01-01

Observations from therapeutic practice and a series of empirical findings, for example, those on discontinuous change in psychotherapeutic processes, suggest modelling the therapeutic process as a self-organizing system with stable and critical instable phases and abrupt transitions. Here, a concept of psychotherapeutic change is presented that applies self-organization theory to psychodynamic principles. The authors explain the observations and considerations that form the basis of the concept and present some connections with existing findings and concepts. On the basis of this model, they generated two hypotheses regarding the co-occurrence of instability and discontinuous change and the degree of synchrony between the therapist and patient. A study design to test these hypotheses was developed and applied to a single case (psychodynamic therapy). After each session, patient and therapist rated their interaction. A measure of instability was calculated across the resulting time series. Sequences of destabilization were observed. On the basis of points of extreme instability, the process was divided into phases. Local instability maxima were accompanied by significant discontinuous change. Destabilization was highly synchronous in therapist and patient ratings. The authors discussed the concept and the methodological procedure. The approach enables the operationalization of crises and to empirically assess the significance of critical phases and developments within the therapeutic relationship. We present a concept of change that applies self-organization theory to psychodynamic therapy. We empirically tested the hypotheses formulated in the concept based on an extract of 125 long-term psychodynamic therapy sessions. We continuously monitored the therapeutic interaction and calculated a measure of the instability of the assessments. We identified several sequences of stable and unstable episodes. Episodes of high instability were accompanied by discontinuous

The ethics of providing hope in psychotherapy.

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Dembo, Justine Sarah; Clemens, Norman A

2013-07-01

The instillation of hope is a common factor in most psychotherapies. A considerable literature exists on the ethics of providing false or positively biased hope in non-psychiatric medical settings, and ethicists have generally concluded that this practice is unethical. However, the literature on the ethics of encouraging hope in psychotherapy, especially in the case of treatment-resistant mental illness, is sparse. The author explores two clinical cases with the intention of examining the nature of hope, false hope, positive illusions, and denial, as they relate to our definitions of mental health and psychotherapy. The cases highlight the ethics of balancing an acknowledgment of likely treatment futility with a desire to hope. Clinical psychological studies on depressive realism and optimistic bias indicate that some degree of positive bias, referred to by some authors as "the optimal margin of illusion," is in fact necessary to promote what we define as "good mental health;" conversely, stark realism is correlated with mild to moderate depression. An examination of the existential literature, including Ernest Becker's work, The Denial of Death, indicates that without the defense mechanism of denial, human beings tend to experience paralytic despair as a result of being fallible, mortal creatures in a frightening world. The combination of these diverse bodies of literature, along with the surprising outcomes of our case examples, leads to an unexpected conclusion: it may occasionally be ethical to encourage some degree of optimistic bias, and perhaps even positive illusion, when treating patients in psychotherapy.

Serious Games for Psychotherapy: A Systematic Review.

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Eichenberg, Christiane; Schott, Markus

2017-06-01

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.

Exploring the meaning of trauma in the South African Police Service: A systems psychodynamic perspective

Directory of Open Access Journals (Sweden)

Marna Young

2012-01-01

Full Text Available Orientation: This study explores individual stories of trauma and their dissonance with the official, dominant discourse on trauma in the South African Police Service (SAPS from a systems psychodynamic perspective.Research purpose: The purpose of the research was, firstly, to explore how trauma experienced by South African Police Service members is constructed or ‘talked about’ and made sense of. Questions and issues that are considered relevant to the primary purpose are: which aspects of the working environment do members consider to be the most stressful, traumatic and difficult to cope with, and what is the effect of the change and transition processes on members’ working experiences?Motivation for the study: The authors set out to explore the role of systems psychodynamics in the experience of trauma and stress in the SAPS.Research design, approach and method: Through this qualitative, explorative, social phenomenological study, contributing circumstances and processes are included as additional discourses in an attempt to deepen understanding. The epistemology viewpoint of the study is found in the social constructionism and the data comprise 15 essays by members of the SAPS, all of which have been analysed from the perspective of systems psychodynamics.Main findings: Although the effect of trauma on police officers can never be negated, the way in which they deal with trauma seems to be different from what was initially believed. Further, their experience of stress is not solely the result of traumatic experiences but rather the result of traumatic experiences and systems psychodynamics operating within their organisation – which includes both organisational stressors or dynamics and transformation dynamics.Practical/managerial implications: The history of psychological trauma indicates that constructions of traumatic stress are strongly related to cultural, social and political circumstances. Current psychoanalytic thinking

Psychotherapy for neurologists.

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Hobday, Gabrielle S; Gabbard, Glen O

2009-07-01

Psychotherapy has traditionally been regarded as the purview of psychiatry rather than neurology. Yet, the doctor-patient relationship is fundamental to both specialties, and the principles that derive from psychotherapy theory and practice apply to that relationship regardless of the specialty. It is common knowledge that a large proportion of patients seen in the context of the practice of medicine have some kind of emotional disturbance. Moreover, patients with organic disease may also have significant emotional difficulties that complicate both the primary illness and its treatment. This experience inevitably has drawn attention to the need for the nonpsychiatric physician to have an understanding and proficiency in psychiatric diagnosis and psychotherapeutic principles. In this article, we consider basic psychotherapeutic principles that are useful in the everyday practice of neurologists and other nonpsychiatric physicians. These skills are important not only for practical reasons, but also because responsiveness to their emotional distress is essential to maintain empathy and caring as cornerstones of the art of medicine. With the use of clinical examples to illustrate these principles, we hope that readers can apply them to their own clinical experiences.

Psychotherapy for chronic major depression and dysthymia: A meta analysis

NARCIS (Netherlands)

Cuijpers, P.; van Straten, A.; Schuurmans, J.; van Oppen, P.C.; Hollon, S.D.; Andersson, G.

2010-01-01

Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic depression and

Psychotherapy for chronic major depression and dysthymia: A meta analysis.

NARCIS (Netherlands)

Cuijpers, P.; van Straten, A.; Schuurmans, J.; van Oppen, P.C.; Hollon, S.D.; Andersson, G.

2009-01-01

Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic depression and

The self is an illusion: a conceptual framework for psychotherapy.

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Stankevicius, Steve

2017-06-01

To explain the illusory nature of the self and explore its implications for psychotherapy. Our usual experience of the self is an illusion. Rather than a discrete entity, it is a network of processes that maintains apparent irreducible unity via alterations of perceptions, beliefs, intentions and memories. By providing an efficient summary of an individual and its surroundings, the self-illusion allows one to predict, experience and interact with the world efficiently. Targeting mechanisms that preserve the self-illusion could provide a focus for psychotherapy. Viewing the self as a complex network offers a valuable conceptual framework for psychotherapy.

Psychotherapies for Children and Adolescents

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... in intentionally self-harmful behaviors, or have Borderline Personality Disorder. DBT emphasizes taking responsibility for one's problems and ... is a form of psychotherapy where there are multiple patients led by one or more therapists. It ...

Hypnotic Psychotherapy with Sex Offenders

Science.gov (United States)

Moseley, Sullivan; Briggs, Wanda P.; Magnus, Virginia

2005-01-01

The authors review the literature on the prevalence of sex offenders; multiple treatment modalities; and implications of the use of hypnotic psychotherapy, coupled with cognitive behavioral treatment programs, for treating sex offenders. (Contains 2 tables.)

Mobile Phone-Based Mood Ratings Prospectively Predict Psychotherapy Attendance.

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Bruehlman-Senecal, Emma; Aguilera, Adrian; Schueller, Stephen M

2017-09-01

Psychotherapy nonattendance is a costly and pervasive problem. While prior research has identified stable patient-level predictors of attendance, far less is known about dynamic (i.e., time-varying) factors. Identifying dynamic predictors can clarify how clinical states relate to psychotherapy attendance and inform effective "just-in-time" interventions to promote attendance. The present study examines whether daily mood, as measured by responses to automated mobile phone-based text messages, prospectively predicts attendance in group cognitive-behavioral therapy (CBT) for depression. Fifty-six Spanish-speaking Latino patients with elevated depressive symptoms (46 women, mean age=50.92years, SD=10.90years), enrolled in a manualized program of group CBT, received daily automated mood-monitoring text messages. Patients' daily mood ratings, message response rate, and delay in responding were recorded. Patients' self-reported mood the day prior to a scheduled psychotherapy session significantly predicted attendance, even after controlling for patients' prior attendance history and age (OR=1.33, 95% CI [1.04, 1.70], p=.02). Positive mood corresponded to a greater likelihood of attendance. Our results demonstrate the clinical utility of automated mood-monitoring text messages in predicting attendance. These results underscore the value of text messaging, and other mobile technologies, as adjuncts to psychotherapy. Future work should explore the use of such monitoring to guide interventions to increase attendance, and ultimately the efficacy of psychotherapy. Copyright © 2017. Published by Elsevier Ltd.

Individual Psychotherapy ("Talking Therapy"): A Survey of Attitudes among Residents & Specialists in Psychiatry, Israel 2010-2011.

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Levi Shachar, Orit; Mendlovic, Shlomo; Hertzberg, Libi; Baruch, Yehuda; Lurie, Ido

2016-01-01

Individual psychotherapy is an efficient tool and an integral part of psychiatric treatment. However, its status among psychiatrists in Israel has never been explored. To explore and map the attitudes of psychiatrists in Israel regarding psychotherapy and psychotherapy training during residency, with comparisons between residents vs. specialists, peripheral vs. central institutions and mental health vs. medical centers. We conducted a cross-sectional survey to examine the attitudes toward individual psychotherapy. The questionnaire was delivered via email and direct approach to psychiatrists in Israel. The survey was completed by 229 of 1,502 registered psychiatrists (15.3%). While 96% (n=218) had positive attitudes towards psychotherapy, 93.1% (n=215) thought psychotherapy was less available than pharmacotherapy. Psychiatrists from peripheral institutions prefer cognitive behavioral therapy, while psychiatrists from central institutions prefer dynamic psychotherapy. Psychiatrists from mental health centers use more dynamic psychotherapy compared to psychiatrists from medical centers. The number of dynamic psychotherapy treatments psychiatrists delivered during their residencies has been decreasing over time, meaning residents today deliver fewer dynamic psychotherapy treatments compared to the number of treatments specialists delivered during their residencies. Additionally, 97.4% (n=225) believed psychotherapy training should be included in the psychiatric residency and 87.3% thought that the training should be improved to a great extent. The survey demonstrates mixed but overall positive attitudes towards psychotherapy among psychiatrists in Israel. The findings should be taken into consideration by psychiatrists who design the residency program and by policy makers who are in charge of the mental health reform in Israel, or the psychotherapy usage and therapeutic potential may diminish, as has happened in other countries.

Curcumin-loaded chitosan-alginate-STPP nanoparticles ameliorate memory deficits and reduce glial activation in pentylenetetrazol-induced kindling model of epilepsy.

Science.gov (United States)

Hashemian, Mona; Anissian, Diana; Ghasemi-Kasman, Maryam; Akbari, Atefeh; Khalili-Fomeshi, Mohsen; Ghasemi, Shahram; Ahmadi, Fatemeh; Moghadamnia, Ali Akbar; Ebrahimpour, Anahita

2017-10-03

Despite several beneficial effects of curcumin, its medical application has been hampered due to low water solubility. To improve the aqueous solubility of curcumin, it has been loaded on chitosan (CS)-alginate (ALG) - sodium tripolyphosphate (STPP) nanoparticles (NPs). Then, the effect of curcumin NPs on memory improvement and glial activation was investigated in pentylenetetrazol (PTZ)-induced kindling model. Male NMRI mice have received the daily injection of curcumin NPs at dose of 12.5 or 25mg/kg. All interventions were injected intraperitoneally (i.p), 10days before PTZ administration and the injections were continued until 1h before each PTZ injection. Spatial learning and memory was evaluated using Morris water maze test after the 7th PTZ injection. Animals have received 10 injections of PTZ and then, brain tissues were removed for histological evaluation. Nissl staining was used to determine the level of cell death in hippocampus and immunostaining method was performed against NeuN and GFAP/Iba1 for assessment of neuronal density and glial activation respectively. Behavioral results showed that curcumin NPs exhibit anticonvulsant activity and prevent cognitive impairment in fully kindled animals. The level of cell death and glial activation reduced in animals which have received curcumin NPs compared to those received free curcumin. To conclude, these findings suggest that curcumin NPs effectively ameliorate memory impairment and attenuate the level of activated glial cells in a mice model of chronic epilepsy. Copyright © 2017. Published by Elsevier Inc.

Individual psychotherapy for schizophrenia: trends and developments in the wake of the recovery movement

Directory of Open Access Journals (Sweden)

Hamm JA

2013-08-01

Full Text Available Jay A Hamm,1 Ilanit Hasson-Ohayon,2 Marina Kukla,3 Paul H Lysaker11Richard L Roudebush VA Medical Center, Department of Psychiatry, Indianapolis, IN, USA; 2Bar-Ilan University, Department of Psychology, Ramat Gan, Israel; 3Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice, Richard L Roudebush VA Medical Center, Indianapolis, IN, USAAbstract: Although the role and relative prominence of psychotherapy in the treatment of schizophrenia has fluctuated over time, an analysis of the history of psychotherapy for schizophrenia, focusing on findings from the recovery movement, reveals recent trends including the emergence of the development of integrative psychotherapy approaches. The authors suggest that the recovery movement has revealed limitations in traditional approaches to psychotherapy, and has provided opportunities for integrative approaches to emerge as a mechanism for promoting recovery in persons with schizophrenia. Five approaches to integrative psychotherapy for persons with schizophrenia are presented, and a shared conceptual framework that allows these five approaches to be compatible with one another is proposed. The conceptual framework is consistent with theories of recovery and emphasizes interpersonal attachment, personal narrative, and metacognitive processes. Implications for future research on integrative psychotherapy are considered.Keywords: schizophrenia, psychotherapy, recovery, metacognition, psychosis, integrative psychotherapy

Individual psychotherapy for schizophrenia: trends and developments in the wake of the recovery movement.

Science.gov (United States)

Hamm, Jay A; Hasson-Ohayon, Ilanit; Kukla, Marina; Lysaker, Paul H

2013-01-01

Although the role and relative prominence of psychotherapy in the treatment of schizophrenia has fluctuated over time, an analysis of the history of psychotherapy for schizophrenia, focusing on findings from the recovery movement, reveals recent trends including the emergence of the development of integrative psychotherapy approaches. The authors suggest that the recovery movement has revealed limitations in traditional approaches to psychotherapy, and has provided opportunities for integrative approaches to emerge as a mechanism for promoting recovery in persons with schizophrenia. Five approaches to integrative psychotherapy for persons with schizophrenia are presented, and a shared conceptual framework that allows these five approaches to be compatible with one another is proposed. The conceptual framework is consistent with theories of recovery and emphasizes interpersonal attachment, personal narrative, and metacognitive processes. Implications for future research on integrative psychotherapy are considered.

Individual psychotherapy for schizophrenia: trends and developments in the wake of the recovery movement

Science.gov (United States)

Hamm, Jay A; Hasson-Ohayon, Ilanit; Kukla, Marina; Lysaker, Paul H

2013-01-01

Although the role and relative prominence of psychotherapy in the treatment of schizophrenia has fluctuated over time, an analysis of the history of psychotherapy for schizophrenia, focusing on findings from the recovery movement, reveals recent trends including the emergence of the development of integrative psychotherapy approaches. The authors suggest that the recovery movement has revealed limitations in traditional approaches to psychotherapy, and has provided opportunities for integrative approaches to emerge as a mechanism for promoting recovery in persons with schizophrenia. Five approaches to integrative psychotherapy for persons with schizophrenia are presented, and a shared conceptual framework that allows these five approaches to be compatible with one another is proposed. The conceptual framework is consistent with theories of recovery and emphasizes interpersonal attachment, personal narrative, and metacognitive processes. Implications for future research on integrative psychotherapy are considered. PMID:23950665

Training Psychiatry Residents in Psychotherapy: The Role of Manualized Treatments.

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Pagano, Joshua; Kyle, Brandon N; Johnson, Toni L; Saeed, Sy Atezaz

2017-06-01

Evidence-based treatment and manualized psychotherapy have a recent but rich history. As interest and research have progressed, defining the role of treatment manuals in resident training and clinical practice has become more important. Although there is not a universal definition of treatment manual, most clinicians and researchers agree that treatment manuals are an essential piece of evidence-based therapy, and that despite several limitations, they offer advantages in training residents in psychotherapy. Requirements for resident training in psychotherapy have changed over the years, and treatment manuals offer a simple and straightforward way to meet training requirements. In a search limited to only depression, two treatment manuals emerged with the support of research regarding both clinical practice and resident training. In looking toward the future, it will be important for clinicians to remain updated on further advances in evidence based manualized treatment as a tool for training residents in psychotherapy, including recent developments in online and smartphone based treatments.

[New Paradigms? Current Trends within National and International Psychotherapy Research].

Science.gov (United States)

Strauß, Bernhard

2015-09-01

This article is devoted to the question which paradigms currently determine psychotherapy and psychotherapy research, and if there are indicators of paradigm changes in this field. The question of the efficacy and effectiveness (including the effectiveness of a transfer of psychotherapeutic knowledge to service) is specifically focussed as well as the question of the central therapeutic factors and the significance of the person of the therapist. It is argued that there are really some signals of a paradigm switch, with a turn away from controlled outcome research, representing only a minor part of patients in need of psychotherapy, towards a more specific process oriented research, also considering differential effects of the therapist. The most prominent indicator of a paradigm change is reflected by an increasing influence of patient oriented psychotherapy research which - consequently - should also be supported by the insurances as well as the funding organisations. © Georg Thieme Verlag KG Stuttgart · New York.

Qualitative psychotherapy research: the journey so far and future directions.

Science.gov (United States)

Levitt, Heidi M

2015-03-01

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).

The cost-effectiveness of psychotherapy for the major psychiatric diagnoses.

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Lazar, Susan G

2014-09-01

Psychotherapy is an effective and often highly cost-effective medical intervention for many serious psychiatric conditions. Psychotherapy can also lead to savings in other medical and societal costs. It is at times the firstline and most important treatment and at other times augments the efficacy of psychotropic medication. Many patients are in need of more prolonged and intensive psychotherapy, including those with personality disorders and those with chronic complex psychiatric conditions often with severe anxiety and depression. Many patients with serious and complex psychiatric illness have experienced severe early life trauma in an atmosphere in which family members or caretakers themselves have serious psychiatric disorders. Children and adolescents with learning disabilities and those with severe psychiatric disorders can also require more than brief treatment. Other diagnostic groups for whom psychotherapy is effective and cost-effective include patients with schizophrenia, anxiety disorders (including posttraumatic stress disorder), depression, and substance abuse. In addition, psychotherapy for the medically ill with concomitant psychiatric illness often lowers medical costs, improves recovery from medical illness, and at times even prolongs life compared to similar patients not given psychotherapy. While "cost-effective" treatments can yield savings in healthcare costs, disability claims, and other societal costs, "cost-effective" by no means translates to "cheap" but instead describes treatments that are clinically effective and provided at a cost that is considered reasonable given the benefit they provide, even if the treatments increase direct expenses. In the current insurance climate in which Mental Health Parity is the law, insurers nonetheless often use their own non-research and non-clinically based medical necessity guidelines to subvert it and limit access to appropriate psychotherapeutic treatments. Many patients, especially those who need

Personality Theory and Psychotherapy

Science.gov (United States)

Fagan, Joen; And Others

1974-01-01

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…

[The significance of psychodynamic relationship factors for psychopathogenesis in childhood Nazi persecution].

Science.gov (United States)

Bunk, D; Eggers, C

1993-02-01

This study focuses on psychiatric disorders following extreme traumatisation experienced by children born during the Holocaust in World War II. According to numerous epidemiological investigations and case studies on survivors who lived through the Holocaust as children or in adulthood, these traumatic experiences are associated with a higher risk for various psychiatric disturbances during the entire life span. Besides the extreme psychological and physical distress during persecution and following traumatisation (parent-child-separation, discrimination while living in other countries) the coping with the trauma and the development of autonomy and ego-strength is additionally impaired by the specific psychodynamics of families with psychologically altered and disturbed parents. What sort of psychodynamic parent-child relationships developed during traumatisation and after the war in subjects currently suffering from chronic impairment of mental health? Retrospective analysis of 22 cases with applications for pensions of invalids evaluated by diagnostic categories. The implicit pressure on the children to be sensitive to the needs of their deprived parents places a sense of guilt on their attempts to develop autonomy. The parents were experienced as restrictive or overprotective on the one hand or liable to be rejected or to be intolerant on the other. The suffering and trauma continues to be perceived in family communication to the extent that coping with loss of relatives and the development of independence are impaired. The results are discussed critically in terms of current procedures for expertise on pension applications.

Interpersonal Psychotherapy for Depressed Adolescents (IPT-A): A Case Illustration

Science.gov (United States)

Hall, Elisabeth Baerg; Mufson, Laura

2009-01-01

This article describes the treatment of a depressed adolescent (15 years of age) boy using Interpersonal Psychotherapy for depressed adolescents (IPT-A). IPT-A is an empirically supported psychosocial intervention for adolescents suffering from a depressive episode. It is delivered as an individual psychotherapy with a minimum of parental…

[Psychotherapy research in the German-speaking community--a bibliometric analysis of three journals].

Science.gov (United States)

Petermann, Franz; Schüssler, Gerhard

2010-01-01

Psychotherapy research has often been considered a neglected topic in clinical psychology, psychosomatic medicine, and psychiatry because of its massive organizational and financial demands. However, it is unclear whether this assumption actually reflects the research activities in the field. We conducted a bibliometric analysis of the annual volumes for 2008 and 2009 of three clinical journals published in German. All publications referring to facets of psychotherapy research were analysed. About 30% of the publications dealt with issues of psychotherapy research. Outcome and process studies were about equally distributed. Process research frequently focused on patient variables as outcome predictors. Outcome studies most often presented effectiveness studies with rather small sample sizes. Psychotherapy research is a well-represented and multifaceted field in the German speaking research community. However, the traditional distinction between efficacy and process research among the various schools of psychotherapy research may be hampering further developments in this branch. The government-funded research networks may turn out to be promising approaches to overcoming some of the obstacles of classic psychotherapy research.

[Attitudes towards psychotherapy in South Korea and Germany : A cross-cultural comparative study].

Science.gov (United States)

Schulz, W; Shin, M A; Schmid-Ott, G

2018-01-01

Due to the relatively recent introduction of psychotherapy in South Korea and against the background of collectivist and Confucian values, it has been suggested that South Koreans harbor more negative attitudes towards psychotherapy compared to Germans and that the social acceptance of psychotherapy is lower. We compared the attitudes of 99 women from South Korea with 98 German women using the questionnaire on attitudes towards psychotherapeutic treatment (FEP). For the study of the South Korean women we translated the questionnaire into the Korean language. The results of the psychometric analysis suggest that the Korean version of the FEP is of acceptable quality. South Korean women reported a significantly more negative attitude towards psychotherapy compared to German women. Furthermore, South Korean women anticipated a more skeptical social attitude towards psychotherapy compared to Germans. The presented results suggest the relevance of cultural imprinting in psychotherapy. They are discussed with respect to culture-specific self-concepts, concepts of disease and healing expectations and the increase of individualistic values in the Korean society.

Counselling/psychotherapy and older people in medical settings.

OpenAIRE

Trethewey-Spurgeon, Celia.

2004-01-01

This study explores the nature of the need for counselling/psychotherapy for older people who suffer a debilitating physical injury or illness. This topic is investigated within a medical setting where the emphasis is on physical rehabilitation. The relevance of this inquiry is highlighted by the paucity of literature about the individual impact of such an event and the need for counselling/psychotherapy in these situations. Theories, on the ageing process, the body, and the self, are used to...

Psychotherapy, psychopathology, research and practice: pathways of connections and integration.

Science.gov (United States)

Castonguay, Louis G

2011-03-01

This paper describes three pathways of connections between different communities of knowledge seekers: integration of psychotherapeutic approaches, integration of psychotherapy and psychopathology, and integration of science and practice. Some of the issues discussed involve the delineation and investigation of common factors (e.g., principles of change), improvement of major forms of psychotherapy, clinical implications of psychopathology research, as well as current and future directions related to practice-research networks. The aim of this paper is to suggest that building bridges across theoretical orientations, scientific fields, professional experiences, and epistemological views may be a fruitful strategy to improve our understanding and the impact of psychotherapy.

Exploring Psychotherapy Clients' Independent Strategies for Change While in Therapy

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Mackrill, Thomas

2008-01-01

Psychotherapy research usually describes how client change is caused by therapist interventions. This article describes how clients change by continuing to use and revising the strategies for change that they bring with them when they first enter therapy. This article presents data from a qualitative diary study of psychotherapy. Three cases…

Internet-based affect-focused psychodynamic therapy for social anxiety disorder: A randomized controlled trial with 2-year follow-up.

Science.gov (United States)

Johansson, Robert; Hesslow, Thomas; Ljótsson, Brjánn; Jansson, Angelica; Jonsson, Lina; Färdig, Smilla; Karlsson, Josefine; Hesser, Hugo; Frederick, Ronald J; Lilliengren, Peter; Carlbring, Per; Andersson, Gerhard

2017-12-01

Social anxiety disorder (SAD) is associated with considerable individual suffering and societal costs. Although there is ample evidence for the efficacy of cognitive behavior therapy, recent studies suggest psychodynamic therapy may also be effective in treating SAD. Furthermore, Internet-based psychodynamic therapy (IPDT) has shown promising results for addressing mixed depression and anxiety disorders. However, no study has yet investigated the effects of IPDT specifically for SAD. This paper describes a randomized controlled trial testing the efficacy of a 10-week, affect-focused IPDT protocol for SAD, compared with a wait-list control group. Long-term effects were also estimated by collecting follow-up data, 6, 12, and 24 months after the end of therapy. A total of 72 individuals meeting diagnostic criteria for DSM-IV social anxiety disorder were included. The primary outcome was the self-report version of Liebowitz Social Anxiety Scale. Mixed model analyses using the full intention-to-treat sample revealed a significant interaction effect of group and time, suggesting a larger effect in the treatment group than in the wait-list control. A between-group effect size Cohen's d = 1.05 (95% [CI]: [0.62, 1.53]) was observed at termination. Treatment gains were maintained at the 2-year follow-up, as symptom levels in the treated group continued to decrease significantly. The findings suggest that Internet-based affect-focused psychodynamic therapy is a promising treatment for social anxiety disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Humor and creativity in psychotherapy

Directory of Open Access Journals (Sweden)

Javier Martín Camacho

2015-09-01

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. 

Self-critical perfectionism, dependency, and symptomatic distress in patients with personality disorder during hospitalization-based psychodynamic treatment: A parallel process growth modeling approach.

Science.gov (United States)

Lowyck, Benedicte; Luyten, Patrick; Vermote, Rudi; Verhaest, Yannic; Vansteelandt, Kristof

2017-07-01

There is growing evidence for the efficacy and effectiveness of psychotherapy in patients with personality disorder (PD), but very little is known about the factors underlying these effects. Two-polarities models of personality development provide an empirically supported approach to studying therapeutic change. Briefly, these models argue that personality pathology is characterized by an imbalance between development of the capacity for self-definition and for relatedness, with an exaggerated emphasis on issues regarding self-definition and relatedness being expressed in high levels of self-critical perfectionism (SCP) and dependency, respectively. This study used data from a study of 111 patients with PD who received long-term hospitalization-based psychodynamic treatment to investigate whether (a) treatment was related to changes in SCP, dependency, and symptomatic distress; (b) these changes could be explained by pretreatment levels of SCP, dependency, and/or symptomatic distress; and (c) changes in these personality dimensions over time were associated with symptomatic improvement. SCP, dependency, and symptomatic distress were assessed at admission (baseline), at 12 and 24 weeks into treatment, and at discharge. Parallel process multilevel growth modeling showed that (a) treatment was associated with a significant decrease in levels of SCP, dependency, and symptomatic distress, whereas (b) pretreatment levels of each of these three factors did not predict the decreases observed, and (c) changes in SCP, but not dependency, were associated with the rate of decrease in symptomatic distress over time. Implications of these findings for our understanding of therapeutic change in the treatment of PD are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Psychiatric Residents' Views of Quality of Psychotherapy Training and Psychotherapy Competencies: A Multisite Survey

Science.gov (United States)

Calabrese, Christina; Sciolla, Andres; Zisook, Sidney; Bitner, Robin; Tuttle, Jeffrey; Dunn, Laura B.

2010-01-01

Objective: Few studies of residents' attitudes toward psychotherapy training exist. The authors examined residents' perceptions of the quality of their training, support for training, their own competence levels, and associations between self-perceived competence and perceptions of the training environment. Methods: An anonymous, web-based…

The effect of medical comorbidities on male and female Veterans' use of psychotherapy for PTSD.

Science.gov (United States)

Breland, Jessica Y; Greenbaum, Mark A; Zulman, Donna M; Rosen, Craig S

2015-04-01

Posttraumatic stress disorder (PTSD) is associated with an increased risk for medical comorbidities that may prevent participation in psychotherapy. The present study investigated whether medical comorbidities were associated with lower initiation rates and fewer psychotherapy visits for PTSD. Because women are more likely to initiate psychotherapy after traumatic events, we also assessed whether relationships were weaker among women. Veterans (N=482, 47% women) recently diagnosed with PTSD completed a survey assessing demographics, mood, functional status, and interest in treatment. Data on medical comorbidities, psychotherapy visits, antidepressant prescriptions, and service connection were assessed longitudinally through administrative files. Logistic and negative binomial regressions assessed associations between number of medical comorbidities in the 2 years before the survey and the initiation and number of psychotherapy visits for PTSD in the year after the survey. All analyses were stratified by sex and controlled for survey and administrative variables. The relationship between medical comorbidities and number of psychotherapy visits was stronger among women than among men. A greater number of medical comorbidities was associated with significantly fewer psychotherapy visits in the total sample [incidence rate ratio: 0.91; 95% confidence interval (CI): 0.83, 1.00] and among women (incidence rate ratio: 0.87; 95% CI: 0.77, 0.99), but not among men (95% CI: 0.75, 1.01). Medical comorbidities were not associated with the initiation of psychotherapy among men or women. Addressing medical comorbidities may help individuals remain in psychotherapy for PTSD. Medical comorbidities may play a larger role in the number of psychotherapy visits among women than men.

Internet and video technology in psychotherapy supervision and training.

Science.gov (United States)

Wolf, Abraham W

2011-06-01

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.

Solicited Diary Studies of Psychotherapy in Qualitative Research - Pros and Cons

DEFF Research Database (Denmark)

Mackrill, Thomas

2008-01-01

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...

[Meaning in life and mental health: personal meaning systems of psychotherapists and psychotherapy patients].

Science.gov (United States)

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

2010-01-01

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.

Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children.

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Swartz, Holly A; Cyranowski, Jill M; Cheng, Yu; Zuckoff, Allan; Brent, David A; Markowitz, John C; Martin, Stacy; Amole, Marlissa C; Ritchey, Fiona; Frank, Ellen

2016-06-01

Two-generation studies demonstrate that treating maternal depression benefits school-age children. Although mothers prefer psychotherapy to medication, little is known about how psychotherapy for maternal depression affects offspring, especially in very high-risk families in which both mothers and children concurrently meet syndromal criteria for psychiatric disorders. This trial evaluated the effects of 2 brief psychotherapies for maternal depression on very high-risk families. Mothers with major depressive disorder were randomly assigned to 9 sessions of either brief interpersonal psychotherapy for mothers (IPT-MOMS; n = 85) or brief supportive psychotherapy (BSP; n = 83). Independent assessors evaluated mothers and their children, ages 7 to 18 years, diagnosed with at least 1 internalizing disorder, every 3 months over the course of 1 year. Symptoms and functioning of mothers and children improved significantly over time, with no between-group differences. However, children of mothers assigned to BSP had more outpatient mental health visits and were more likely to receive antidepressant medication. Mothers reported greater satisfaction with IPT-MOMS than BSP. Improvement in mothers' depressive symptoms was associated with improvement in child functioning in time-lagged fashion, with children improving 3 to 6 months after mothers improved. Antidepressant medication use and number of mental health visits received by children did not affect outcomes. IPT-MOMS and BSP demonstrated comparable beneficial effects on maternal depression. Children's functioning improved following maternal improvement, independent of youths' treatment. Children of mothers randomized to IPT-MOMS, compared with BSP, achieved comparable outcomes despite less follow-up treatment. Observation of lagged association between maternal improvement and change in child functioning should influence treatment planning for families. Clinical trial registration information-Psychotherapy for Depressed

Research on Psychotherapy Integration: Recommendations and Conclusions from an NIMH Workshop.

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Wolfe, Barry E.; Goldfried, Marvin R.

1988-01-01

Describes National Institute of Mental Health (NIMH) workshop (March 1986) which invited 14 psychotherapy researchers to consider key issues associated with psychotherapy integration. Discusses recommendations developed to initiate a research program encompassing conceptual clarification, efficacy studies of systematic eclectic therapies, the role…

Place of psychotherapy in psychology movement toward cognitivism

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Todorović Milorad V.

2015-01-01

Full Text Available Psychology striving to make us more aware of our own nature dominantly, if not exclusively, is realized through psychotherapy. Psychotherapy as a praxis of psychology, which only follows the psychological theory and without it we can hardly call it that, is largely dependent on the prevailing social trends and the dominant form of pathology that can occur in them. That theoretical aspects of many forms of pathology are not completely understood and not give the right to cancel the search for the unconscious forces that determine the subject. Dominant tendencies in contemporary psychology not only do not favor psychotherapy, but are directly aimed against it. At least against that psychotherapy which is based on the split subject, the interior space in which the physical and perceptual sensations, moral rules, mood depression and everything else that we call 'mental'. The great danger that is above psycho­therapy activity comes by pharmacology and cognitivism (lat. Cognitio 'knowledge' and the intellectual soul. Equating the mind and the brain makes psychotherapy unnecessary in relation to the pharmacology whose power impact becomes decisive on each deviation and every suffering. The fact that in the psychology shortens the long and uncertain path of mental knowledge that does not correspond to the nature of 'psychological' seems to be replaced by those efforts which are only concerned with the question of science. The fact that there is no comprehensive theory of emotions that can not be resolved by cognitivism which is opposite to emotional. Rorty's cynicism towards such efforts, which emphasize that the spirit is the same as that stimulate the brain and that the theorem symphonies and excreted in the same way that the spleen is excreted dark juices (Rorty 1990: 54 exhorts the psychology of the fact that instead of being which has a spirit, that is different from the 'physical body', 'matter', the central nervous system, has been the

Multiple attachments and group psychotherapy: implications for college counseling centers.

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Marmarosh, Cheri L

2009-10-01

A large body of literature has supported the application of attachment theory to the understanding of college student development and the process of individual psychotherapy. Despite group treatment being one of the major methods of intervention in college counseling centers, there has been very little research guided by attachment theory that has been applied to the area of group psychotherapy. Many current assessment instruments used in college counseling centers can be supported with attachment theory, and many group therapy interventions are aimed at facilitating secure working models of self, other, and groups. This paper explores the importance of personal and group attachments in group psychotherapy and specifically addresses implications for clinical training and research in university counseling centers.

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.

Believing is seeing: an evolving research program on patients' psychotherapy expectations.

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Constantino, Michael J

2012-01-01

In this article I discuss one facet of my evolving research program focused on patients' psychotherapy-related expectations. Although generally considered a common psychotherapeutic factor, expectations have been historically undervalued conceptually, empirically, and clinically. Attempting to somewhat redress this slight, I will (a) define the various forms of patients' psychotherapy-related expectations, (b) present relevant findings from research that my colleagues, students, and I have conducted, (c) summarize an integrative psychotherapy approach that underscores expectations as an explanatory construct for patients' corrective experiences, and (d) highlight future research directions for increasing our understanding of the nature and functions of the expectancy construct.

A comparative trial of psychotherapy and pharmacotherapy for "pure" dysthymic patients.

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Markowitz, John C; Kocsis, James H; Bleiberg, Kathryn L; Christos, Paul J; Sacks, Michael

2005-12-01

Psychotherapy of "pure" dysthymic disorder remains understudied. This article reports outcomes of an acute randomized trial of 94 subjects treated for 16 weeks with either interpersonal psychotherapy (IPT), brief supportive psychotherapy (BSP), sertraline, or sertraline plus IPT. Recruited by clinical referral and advertising, subjects met DSM-IV criteria for early onset dysthymic disorder, with no episode of major depression in the prior six months. They were randomly assigned to one of four 16-week treatments, with options for crossover or continuation treatment. Results were analyzed from the intention-to-treat sample by ANCOVA, controlling for baseline depressive severity. Subjects improved in all conditions over time, with the cells including sertraline pharmacotherapy showing superiority over psychotherapy alone for response and remission. Response rates were 58% for sertraline alone, 57% for combined treatment, 35% for IPT, and 31% for BSP. The study was underpowered and may have employed too "active" a control condition. Follow-up data were unobtainable. In this acute trial for "pure" dysthymic disorder, sertraline with or without IPT showed advantages relative to IPT and BSP. Methodological difficulties may have limited differential outcome findings. This study bolsters a small but growing literature on the treatment of dysthymic disorder, suggesting that pharmacotherapy may acutely benefit patients more than psychotherapy.

The Arts, Crafts, and Sciences of Psychotherapy.

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Benjamin, Lorna Smith

2015-11-01

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.

Social Problem Solving and Depressive Symptoms Over Time: A Randomized Clinical Trial of Cognitive Behavioral Analysis System of Psychotherapy, Brief Supportive Psychotherapy, and Pharmacotherapy

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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.

2011-01-01

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 chronically depressed patients who failed to fully respond to an initial trial of pharmacotherapy (Kocsis et al., 2009). Method Participants with chronic depression (n = 491) received Cognitive Behavioral Analysis System of Psychotherapy (CBASP), which emphasizes interpersonal problem-solving, plus medication; Brief Supportive Psychotherapy (BSP) plus medication; or medication alone for 12 weeks. Results CBASP plus pharmacotherapy was associated with significantly greater improvement in social problem solving than BSP plus pharmacotherapy, and a trend for greater improvement in problem solving than pharmacotherapy alone. In addition, change in social problem solving predicted subsequent change in depressive symptoms over time. However, the magnitude of the associations between changes in social problem solving and subsequent depressive symptoms did not differ across treatment conditions. Conclusions It does not appear that improved social problem solving is a mechanism that uniquely distinguishes CBASP from other treatment approaches. PMID:21500885

Effectiveness of Psychotherapy in Personality Disorders Not Otherwise Specified: A Comparison of Different Treatment Modalities.

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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

2015-01-01

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

Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science.

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Lane, Richard D; Ryan, Lee; Nadel, Lynn; Greenberg, Leslie

2015-01-01

Since Freud, clinicians have understood that disturbing memories contribute to psychopathology and that new emotional experiences contribute to therapeutic change. Yet, controversy remains about what is truly essential to bring about psychotherapeutic change. Mounting evidence from empirical studies suggests that emotional arousal is a key ingredient in therapeutic change in many modalities. In addition, memory seems to play an important role but there is a lack of consensus on the role of understanding what happened in the past in bringing about therapeutic change. The core idea of this paper is that therapeutic change in a variety of modalities, including behavioral therapy, cognitive-behavioral therapy, emotion-focused therapy, and psychodynamic psychotherapy, results from the updating of prior emotional memories through a process of reconsolidation that incorporates new emotional experiences. We present an integrated memory model with three interactive components - autobiographical (event) memories, semantic structures, and emotional responses - supported by emerging evidence from cognitive neuroscience on implicit and explicit emotion, implicit and explicit memory, emotion-memory interactions, memory reconsolidation, and the relationship between autobiographical and semantic memory. We propose that the essential ingredients of therapeutic change include: (1) reactivating old memories; (2) engaging in new emotional experiences that are incorporated into these reactivated memories via the process of reconsolidation; and (3) reinforcing the integrated memory structure by practicing a new way of behaving and experiencing the world in a variety of contexts. The implications of this new, neurobiologically grounded synthesis for research, clinical practice, and teaching are discussed.

Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: a systematic overview of meta-analyses.

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Huhn, Maximilian; Tardy, Magdolna; Spineli, Loukia Maria; Kissling, Werner; Förstl, Hans; Pitschel-Walz, Gabriele; Leucht, Claudia; Samara, Myrto; Dold, Markus; Davis, John M; Leucht, Stefan

2014-06-01

There is debate about the effectiveness of psychiatric treatments and whether pharmacotherapy or psychotherapy should be primarily used. To perform a systematic overview on the efficacy of pharmacotherapies and psychotherapies for major psychiatric disorders and to compare the quality of pharmacotherapy and psychotherapy trials. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library (April 2012, with no time or language limit) for systematic reviews on pharmacotherapy or psychotherapy vs placebo, pharmacotherapy vs psychotherapy, and their combination vs either modality alone. Two reviewers independently selected the meta-analyses and extracted efficacy effect sizes. We assessed the quality of the individual trials included in the pharmacotherapy and psychotherapy meta-analyses with the Cochrane risk of bias tool. The search yielded 45,233 results. We included 61 meta-analyses on 21 psychiatric disorders, which contained 852 individual trials and 137,126 participants. The mean effect size of the meta-analyses was medium (mean, 0.50; 95% CI, 0.41-0.59). Effect sizes of psychotherapies vs placebo tended to be higher than those of medication, but direct comparisons, albeit usually based on few trials, did not reveal consistent differences. Individual pharmacotherapy trials were more likely to have large sample sizes, blinding, control groups, and intention-to-treat analyses. In contrast, psychotherapy trials had lower dropout rates and provided follow-up data. In psychotherapy studies, wait-list designs showed larger effects than did comparisons with placebo. Many pharmacotherapies and psychotherapies are effective, but there is a lot of room for improvement. Because of the multiple differences in the methods used in pharmacotherapy and psychotherapy trials, indirect comparisons of their effect sizes compared with placebo or no treatment are problematic. Well-designed direct comparisons, which are scarce, need public funding. Because patients often benefit

Practice Study Outpatient Psychotherapy - Switzerland (PAP-S) : Study design and feasibility (Revised edition)

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Wyl, Agnes von; Crameri, Aureliano; Koemeda, Margit; Tschuschke, Volker; Schulthess, Peter

2016-01-01

Revised edition of Von Wyl, A., Crameri, A., Koemeda, M., Tschuchke, V. & Schulthess, P. (2013). The PAP-S (Practice of Ambulant Psychotherapy-Study), Switzerland: Study Design and Feasibility. Zurich University of Applied Sciences, Zurich. The original article was published in German: von Wyl, A., Crameri, A., Koemeda, M., Tschuschke, V. & Schulthess, P. (2013). Praxisstudie ambulante Psychotherapie Schweiz (PAP-S): Studiendesign und Machbarkeit. Psychotherapie-Wissenschaft, 1, 6-22; op...

Psychosis and the dynamics of the psychotherapy process

DEFF Research Database (Denmark)

Rosenbaum, Bent; Harder, Susanne

2007-01-01

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 of the 's......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...

Changes in intensity of neurotic symptoms associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

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

2017-06-18

Analysis of associations between changes in the intensity of neurotic symptoms and reduction of suicidal ideation (SI) or lack of SI reduction, in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in a day hospital. Symptom Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated in the psychotherapeutic day hospital due to neurotic, behavioral or personality disorders between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. The reduction of neurotic symptoms intensity was greater in patients of both genders who improved in terms of SI than in those who did not. This referred to global intensity of neurotic symptoms (OWK coefficient) in both genders (ppsychotherapy as a treatment method that leads to improvement in terms of both SI and neurotic symptoms. This suggests that the applied therapy may be effective in preventing suicidality in this group of patients. The observed associations also point in favor of hypothesis on similarities in etiopathogenesis of and partly identical personality-related factors predisposing to SI and neurotic disorders.

Culturally Adapted Psychotherapy and the Legitimacy of Myth: A Multilevel Model, Direct Comparison Meta-Analysis

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Benish, Steven G.

2010-01-01

Culturally adapted psychotherapy has potential to improve psychotherapy outcomes for ethnic and racial minorities and solve a decades-long conundrum that alteration of specific ingredients does not improve psychotherapy outcomes. Adaptation of the cultural explanation of illness, known as the anthropological Myth in universal healing practices…

Psychotherapy research needs theory. Outline for an epistemology of the clinical exchange.

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Salvatore, Sergio

2011-09-01

This paper provides an analysis of a basic assumption grounding the clinical research: the ontological autonomy of psychotherapy-based on the idea that the clinical exchange is sufficiently distinguished from other social objects (i.e. exchange between teacher and pupils, or between buyer and seller, or interaction during dinner, and so forth). A criticism of such an assumption is discussed together with the proposal of a different epistemological interpretation, based on the distinction between communicative dynamics and the process of psychotherapy-psychotherapy is a goal-oriented process based on the general dynamics of human communication. Theoretical and methodological implications are drawn from such a view: It allows further sources of knowledge to be integrated within clinical research (i.e. those coming from other domains of analysis of human communication); it also enables a more abstract definition of the psychotherapy process to be developed, leading to innovative views of classical critical issues, like the specific-nonspecific debate. The final part of the paper is devoted to presenting a model of human communication--the Semiotic Dialogical Dialectic Theory--which is meant as the framework for the analysis of psychotherapy.

Efficacy of group psychotherapy for social anxiety disorder: A meta-analysis of randomized-controlled trials.

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Barkowski, Sarah; Schwartze, Dominique; Strauss, Bernhard; Burlingame, Gary M; Barth, Jürgen; Rosendahl, Jenny

2016-04-01

Group psychotherapy for social anxiety disorder (SAD) is an established treatment supported by findings from primary studies and earlier meta-analyses. However, a comprehensive summary of the recent evidence is still pending. This meta-analysis investigates the efficacy of group psychotherapy for adult patients with SAD. A literature search identified 36 randomized-controlled trials examining 2171 patients. Available studies used mainly cognitive-behavioral group therapies (CBGT); therefore, quantitative analyses were done for CBGT. Medium to large positive effects emerged for wait list-controlled trials for specific symptomatology: g=0.84, 95% CI [0.72; 0.97] and general psychopathology: g=0.62, 95% CI [0.36; 0.89]. Group psychotherapy was also superior to common factor control conditions in alleviating symptoms of SAD, but not in improving general psychopathology. No differences appeared for direct comparisons of group psychotherapy and individual psychotherapy or pharmacotherapy. Hence, group psychotherapy for SAD is an efficacious treatment, equivalent to other treatment formats. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study

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Costa Elisabeth Maria Sene

2006-01-01

Full Text Available OBJETIVE: Recent literature has highlighted the role of psychotherapy in the treatment of major depressive disorder. Combined therapies comprising both psychotherapy and pharmacotherapy have presented the best results. Although several kinds of psychotherapies have been studied in the treatment of depressive disorders, there remains a lack of data on psychodramatic psychotherapy in the treatment of major depressive disorder. The objective of this study was to evaluate the impact of psychodramatic psychotherapy (in a sample of major depressive disorder patients. METHOD: This is an open, naturalistic, controlled, non-randomized study. Twenty major depressive disorder patients (according to the DSM-IV criteria, under pharmacological treatment for depression, with Hamilton Depression Scale total scores between 7 and 20 (mild to moderate depression, were divided into two groups. Patients in the psychotherapeutic group took part in 4 individual and 24 structured psychodramatic group sessions, whilst subjects in the control group did not participate in this psychodramatic psychotherapy. Both groups were evaluated with the Social Adjustment Scale - Self Report and the Hamilton Depression Scale. RESULTS: Psychotherapeutic group patients showed a significant improvement according to the Social Adjustment Scale - Self Report and the Hamilton Depression Scale scores at endpoint, compared to those of the control group. CONCLUSIONS: Results suggest that individual and group psychodramatic psychotherapy, associated to pharmacological treatment, provides good clinical benefits in the treatment of major depressive disorder.

History of Division 29, 1993-2013: another 20 years of psychotherapy.

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Williams, Elizabeth Nutt; Barnett, Jeffrey E; Canter, Mathilda B

2013-03-01

The history of Division 29 (Psychotherapy) of the American Psychological Association (APA) from 1993 to 2013 is reviewed. The 20 years of history can be traced via the Division's primary publications (the journal Psychotherapy and its newsletter Psychotherapy Bulletin) as well as the history of those who have served leadership roles in the Division and have won Divisional awards. Several recurring themes emerge related to the Division's articulations of its own identity, the Division's advocacy efforts vis-à-vis the profession and the APA, and the work of the Division on behalf of major social issues (such as disaster relief and the nation's health care).

Emerging and continuing trends in psychotherapy: views from an editor's eye.

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Gelso, Charles J

2011-06-01

It is proposed that six major trends in psychotherapy have continued or emerged over the course of the author's editorship of Psychotherapy, the past seven years. These trends are (a) the increasing integration of techniques and the therapeutic relationship; (b) increasing focus on theoretical integration; (c) increasing efforts at research-practice integration; (d) increases in more specific, integrative reviews; (e) integration of biological, neuroscience understandings; and (f) integration of diversity and cultural considerations into psychotherapy. Each trend is described and its impact on the field is discussed. Cautions about each trend are also noted. The six trends are discussed in the context of integration.

Modern tendencies in psychotherapy: The specialisation of practice and knowledge integration

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Gavrilov-Jerković Vesna

2003-01-01

Full Text Available The paper considers chronological and theoretical development of psychotherapy with the aim of formulating psychotherapeutic paradigm as an expression of scientific improvement in this field, as well as methodological and empirical assumption of integrative models in the psychotherapy. Special attention is paid to the phenomena that have characterised the field of psychotherapy in recent time, such as, on one hand, the emphasis on the increased need for the empirical evaluation of practice and accompanied trend regarding specialisation, and, on the other hand, the strengthening of the trend towards defining and researching general change mechanisms from wider, more integrative and transtheoretical perspective.

Team building from a psychodynamic perspective

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F. v. N. Cilliers

2000-06-01

Full Text Available The aim of this research is to measure the impact of a psychodynamic, Tavistock stance, team building event. Its task is to provide opportunities for learning about team behaviour and dynamics. Consultants offer interpretations in the form of working hypotheses about what is happening in the here-and-now. This refers to the basic assumptions (dependency, fight/flight, pairing and its relevant dynamic concepts. Post measured, qualitative research findings, indicate an increase in knowledge about the teams unconscious behaviour, a realisation of own identity, boundaries, potential and a strong sense of empowerment to act collectively in problem solving. Opsomming Die doel van die navorsing is om die impak van'n psigodinamiese, Tavistock beskouing, spanbou gebeurtems, te meet. Die taak is om leergeleenthede beskikbaar te stel oor eie spangedrag en -dinamika. Konsultantc bicd interpretasies aan in die vorm van werkshipoteses oor die gebeure in die hier-en-nou. Dit verwys na die basiese aannames (afhanklikheid, veg/vlug, afparing en die relevante dinamiese konsepte. Post-gemete, kwalitatiewe navorsingsresultate, dui op n toename in kennis oor die span se onbewuste gedrag, n beset van eie identiteit, grense, potensiaal en 'n sterk sin van bemagtiging om op 'n kollektiewe wyse op te tree in probleemoplossing.

Parent-Infant Psychotherapy and Postpartum Depression: The Fathers Participation

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Milena da Rosa Silva

2013-05-01

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.

Content Coding of Psychotherapy Transcripts Using Labeled Topic Models.

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Gaut, Garren; Steyvers, Mark; Imel, Zac E; Atkins, David C; Smyth, Padhraic

2017-03-01

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.

Psychotherapy via Videoconferencing: A Review

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Simpson, Susan

2009-01-01

Research into the use of videoconferencing for clinical purposes, in particular psychotherapy, is gradually expanding. A number of case studies and case series have suggested that videoconferencing can be clinically effective and acceptable to patients. Nevertheless, there is a lack of methodologically rigorous studies with adequate sample sizes…

Dream analysis in the psychodynamic psychotherapy of borderline patients.

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Stone, Michael H

2012-06-01

Despite Freud's dictum that dreams are the royal road to the unconscious, the use of dream analysis by therapists working with Borderline Personality Disorder and other severe psychiatric conditions has in the past two decades has fallen into a state of decline, if not outright neglect. The reasons why are not altogether clear, though some have said that the growing popularity of ego psychology and other movements in the domain of psychoanalysis have perhaps pushed dream analysis to one side. To me this marginalization seems unjustified. I hope to demonstrate in this article the enduring utility of dream analysis in working with the more severely disordered patients, with the aim of revivifying its application--and its efficacy--in our work with such patients.

Psychiatric and psychotherapeutic literacy: attitudes to, and knowledge of, psychotherapy.

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Furnham, Adrian

2009-11-01

Whereas there is now a rapidly emerging literature on psychiatric literacy (Jorm, 2000), there is much less work on the public's knowledge of, and beliefs about the purpose of, and processes involved in, psychotherapy. This study looked at what lay people think happens during psychotherapy; what the processes and aims are; and the aetiology, treatment and prognosis for a mood and psychotic (bipolar, schizophrenia) and two neurotic (depression, obsessive-compulsive) disorders. In total 185 British adults, recruited by a market research company, completed a four-part questionnaire, lasting about 20 minutes. Participants were generally very positive about psychotherapy believing the experience to be highly beneficial. Schizophrenia was seen to have a biological basis; depression and bipolar disorder were perceived to have family, work and other stress-related causal issues; obsessive-compulsive disorder was seen to be caused by stress and family-related issues. Participants thought psychotherapy a very effective treatment but drug treatments more effective for schizophrenia and bipolar disorder. 'Talking it over' was judged highly relevant, specifically to depression. Participants believed that depression had a good chance of cure, and remission, but that neither schizophrenia nor bipolar disorder had much chance of an effective cure. Lay people show a curious pattern on insight, ignorance and naivety with regard to the cause and cure of mental disorders. They appear to have a modestly realistic but somewhat naive view of the process and efficacy of psychotherapy. This may influence how they react to their own and others' mental illness. It has clear implications for education in psychiatric literacy.

The many secure knowledge bases of psychotherapy.

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Bergner, Raymond M

2006-01-01

Psychotherapeutic practice, while it has benefited greatly from scientific research, rests on many further secure epistemic foundations. In the present article, this thesis is argued in two stages. First, a brief review of some elementary epistemological findings is presented. In this review, the generally acknowledged degree of certainty attributed to different knowledge sources, and thus the confidence with which we may believe and act upon them, are recounted. Second, an extended analysis of the ways in which each of these knowledge sources enter into the practice of psychotherapy is developed. In the end, what is proffered here is a demonstration that well conducted psychotherapy is an activity whose judgments and decisions rest on many secure foundations.

Constructivism and psychotherapy.

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Mahoney, Michael J; Granvold, Donald K

2005-06-01

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.

From classical to eclectic psychodrama: conceptual similarities between psychodrama and psychodynamic and interpersonal group treatments.

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Kipper, David A; Matsumoto, Mia

2002-01-01

A study was conducted to explore the hypothesis that contemporary U.S. psychodramatists evince a shift from strict adherence to the conceptual frame of reference espoused by classical psychodrama toward a degree of sharing concepts with those valued by psychodynamic and interpersonal group therapists. Sixty-two senior psychodramatists ranked a form comprised of 44 concepts. Their rankings were compared to the results of a study by Dies (1992). In general, the results supported the hypothesis.

[Need of specific criteria for psychotherapy referral in the public health system: A proposal].

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García-Haro, J; Fernández-Briz, N

2015-01-01

This study discusses the need of specific criteria for psychotherapy referral in the public services. the use of psychotherapy as a supplement to traditional medication, and its comparison with informal methods of support, has been questioned. This study proposes the establishment of basic criteria for the integration of psychotherapy, based on an analysis of the conditions that allow it to function. It thus aims to contribute to improving the reputation and the practice conditions of psychotherapy in the public health system. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Kleptomania and Potential Exacerbating Factors: A Review and Case Report

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Talih, Farid Ramzi

2011-01-01

Kleptomania is an impulse control disorder that can cause significant impairment and serious consequences. Often, the condition is kept secret by the patient, and usually help is sought only when confronted by the legal consequences of the impulsive behaviors. Historically, kleptomania has been viewed from a psychodynamic perspective, and the mainstay of treatment has been psychotherapy. Recently, attempts to explain kleptomania within a neuropsychiatric paradigm have highlighted the possible...

Synchrony in Psychotherapy: A Review and an Integrative Framework for the Therapeutic Alliance

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Koole, Sander L.; Tschacher, Wolfgang

2016-01-01

During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship– or alliance– and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in the coupling of patient and therapist’s brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another’s internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients’ emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains. PMID:27378968

Synchrony in Psychotherapy: A Review and an Integrative Framework for the Therapeutic Alliance.

Science.gov (United States)

Koole, Sander L; Tschacher, Wolfgang

2016-01-01

During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship- or alliance- and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in the coupling of patient and therapist's brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another's internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients' emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains.

RELATIONAL GROUP PSYCHOTHERAPY: THE HEALING OF STRESS, NEGLECT AND TRAUMA

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Richard G. Erskine

2010-01-01

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.

Playing off the beat: Applying the jazz paradigm to psychotherapy.

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Johnson, David Read

2018-02-01

A jazz paradigm is applied to traditional psychotherapy practice, illuminating the links between psychotherapy and the Romantic aesthetic tradition, primarily in the centrality of concepts such as attunement. Modernist disruptions of realism during the early 20 th century, such as jazz, elaborated dissonant and improvisational artistic impulses that brought new vitality to their art forms. The psychotherapeutic relationship also has potential avenues for multilevel and discrepant communication that open possibilities of freedom. However, the limitations imposed by the single channel nature of comprehended language, compared with the capacity of artistic media to express multiple sensory information simultaneously, remain the most significant obstacle to dimensionalizing the psychotherapeutic dialogue. Psychotherapy may have much to gain from embracing some of the concepts underlying the jazz aesthetic. © 2018 Wiley Periodicals, Inc.

Gestalt Therapy: Student Perceptions of Fritz Perls in "Three Approaches to Psychotherapy"

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Reilly, Joe; Jacobus, Veronica

2009-01-01

The "Three Approaches to Psychotherapy" ("TAP") videotape series introduces students to three major schools of psychotherapy: client-centered therapy, Gestalt therapy, and rational-emotive therapy. A sample of undergraduate students viewed the "TAP" series. The students were surveyed about their observations of…

Psychotherapy

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Sansone, Lori A.

2009-01-01

Clinicians have a number of treatment options for dealing with the emotional ills of patients, including psychoeducation, psychotherapy, and pharmacotherapy. However, after years of experience in the clinical field, we have recognized that these treatment options may not be sufficient to adequately address the problems of some patients. We have found that adding a metaphysical/spiritual component may be helpful, particularly for those patients with histories of childhood trauma. In this edition of The Interface, we discuss four metaphysical techniques for facilitating patient healing—1) refocusing on the present, 2) reframing adversity, 3) practicing surrender, and 4) meditation. These approaches can be mutually integrated and compliment a psychological treatment in either the psychiatric or primary care setting, regardless of whether or not the patient has formal religious beliefs. PMID:20104289

Social phobia in developmental period: From theory to therapy

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Kolar Dušan

2005-01-01

Full Text Available The contemporary integrative theoretical and therapeutic concepts of social phobia in developmental period have been presented in the study. Besides current neurobiological theories, a very important hypothesis about behavioral inhibition has been represented as a predisposition of social phobia. The cognitive-behavioral theories of social phobia are dominant among psychological theories. The integrative concept of social phobia is the most realistic approach to this disorder and the bridge between biological and psychological theories. The interaction between biological and psychological etiological factors is represented through different therapeutical approaches to social phobia. Therapy of social phobia is integrative and involves different therapeutical modalities in different phases of therapy. In integrative psychotherapy, we use cognitive-behavioral therapy, dynamic oriented supportive psychotherapy, psychodynamic psychotherapy and phenomenological-existential psychotherapy. The cognitive-behavioral therapy yields the best results. The medicaments in use are the following: selective serotonin reuptake inhibitors, mono-amine oxidase inhibitors, high-potency benzodiazepines, new antiepileptic drugs and rarely (3-blockers. The combination of integrative psychotherapy and pharmacotherapy is the most optimal therapeutic approach to social phobia. This integrative and to patient adapted treatment will produce the best results in management of children's and adolescent's social phobia.

Psychotherapy: Adaptation or Walking Together? (A Roadside Conversation

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Nina Bychkova

2011-02-01

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. 

Psychotherapy role expectations and experiences - discrepancy and therapeutic alliance among patients with substance use disorders.

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Frankl, My; Philips, Björn; Wennberg, Peter

2014-12-01

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

Resistances in the first session of psychodrama psychotherapy group with adults.

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Drakulić, Aleksandra Mindoljević

2010-06-01

Resistance refers to all types of behaviour that oppose the exploration processes in the therapeutic process and inhibit work. Very common types of resistances, such as forgetting the time of session, being late, non-payment of sessions and such are found in every type of psychotherapy, including psychodrama psychotherapy. The attempt to break resistance in order to evoke changes could be dangerous as it represents the necessary defence mechanism and it is also a vital element of the person's functioning in therapy. In psychodrama, which is a type of action method of group psychotherapy, resistance can manifest through continuous verbalization of problems, in not wanting to act out the problem, the protagonist's typical non-verbal message or the most obvious manifestation: the absence of the protagonist. This paper will be on the typical resistance which the therapist has noticed during the first session of psychodrama psychotherapy, with a small group of adult clients. As the group was young and with undeveloped cohesiveness, resistance represented a certain balancing power for maintaining mental homeostasis of the group.

Can Independent Judges Recognize Different Psychotherapies? An Experience with Manual-Guided Therapies.

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Luborsky, Lester; And Others

1982-01-01

Tested whether independent judges could recognize three different manual-guided psychotherapies, drug counseling, supportive-expressive psychotherapy, and cognitive-behavioral using a special rating form containing scales for the characteristic aspects of each type. Results indicated that manual-guided therapies can be reliably recognized.…

[On the present situation in psychotherapy and its implications - A critical analysis of the facts].

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Tschuschke, Volker; Freyberger, Harald J

2015-01-01

The currently dominating research paradigm in evidence-based medicine is expounded and discussed regarding the problems deduced from so-called empirically supported treatments (EST) in psychology and psychotherapy. Prevalent political and economic as well as ideological backgrounds influence the present dominance of the medical model in psychotherapy by implementing the randomized-controlled research design as the standard in the field. It has been demonstrated that randomized controlled trials (RCTs) are inadequate in psychotherapy research, not the least because of the high complexity of the psychotherapy and the relatively weak role of the treatment concept in the change process itself. All major meta-analyses show that the Dodo bird verdict is still alive, thereby demonstrating that the medical model in psychotherapy with its RCT paradigm cannot explain the equivalence paradox. The medical model is inappropriate, so that the contextual model is proposed as an alternative. Extensive process-outcome research is suggested as the only viable and reasonable way to identify highly complex interactions between the many factors regularly involved in change processes in psychotherapy.

Psychotherapy: from exorcism to cognitive theories

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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.

Integrative Problem-Centered Therapy: Toward the Synthesis of Family and Individual Psychotherapies.

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Pinsof, William M.

1983-01-01

Presents an overview of the Integrative Problem-Centered Therapy (IPCT) Model, and describes its core principles and premises, and basic methodological steps. The IPCT provides a technique for applying individual and family therapy and behavioral, communicational, and psychodynamic orientations to client problems. Its goal is to create efficient…

Elevated midbrain serotonin transporter availability in mixed mania: a case report

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Kuikka Jyrki

2004-09-01

Full Text Available Abstract Background Results obtained from brain imaging studies indicate that serotonin transporter (SERT and dopamine transporter (DAT densities are altered in major depression. However, no such studies have been published on current mania or hypomania. Case presentation In this single photon emission computed tomography (SPECT study with [123I]nor-β-CIT we present a case with simultaneous symptoms of major depression and hypomania. She had an elevated serotonin transporter availability (SERT in the midbrain and elevated dopamine transporter availability (DAT in the striatum, which normalised in a one-year follow-up period during which she received eight months of psychodynamic psychotherapy. Conclusions To our knowledge, this is the first report on SERT and DAT associated with mania. In our case the availability of both SERT in the midbrain and DAT in the striatum were elevated at baseline and declined during psychotherapy, while the SERT and DAT of the depressed controls increased during psychotherapy. Symptoms of hypomania in the case were alleviated during psychotherapy. Clinical recovery was also reflected in the Hamilton Depression Rating Scale (HDRS scores.

Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial.

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Wong, Y Joel; Owen, Jesse; Gabana, Nicole T; Brown, Joshua W; McInnis, Sydney; Toth, Paul; Gilman, Lynn

2018-03-01

Although the past decade has witnessed growing research interest in positive psychological interventions (PPIs), their potential as adjunctive interventions for psychotherapy remains relatively unexplored. Therefore, this article expands the frontiers of PPI research by reporting the first randomized controlled trial to test a gratitude writing adjunctive intervention for psychotherapy clients. Participants were 293 adults seeking university-based psychotherapy services. Participants were randomly assigned to one of three conditions: (a) control (psychotherapy only), (b) a psychotherapy plus expressive writing, and (c) a psychotherapy plus gratitude writing. Participants in the gratitude condition wrote letters expressing gratitude to others, whereas those in the expressive writing condition wrote about their deepest thoughts and feelings about stressful experiences. About 4 weeks as well as 12 weeks after the conclusion of the writing intervention, participants in the gratitude condition reported significantly better mental health than those in the expressive and control conditions, whereas those in the expressive and control conditions did not differ significantly. Moreover, lower proportions of negative emotion words in participants' writing mediated the positive effect of condition (gratitude versus expressive writing) on mental health. These findings are discussed in light of the use of gratitude interventions as adjunctive interventions for psychotherapy clients.

Art/expressive therapies and psychodynamics of parent-child relationship in concept of sophrology and psychosocial oncology

OpenAIRE

Miholić, Damir; Prstačić, Miroslav; Martinec, Renata

2014-01-01

Aim: The main aim of this research includes the analysis of the psychodynamics of the changes in the experience of the child and in the parent-child relationship, during the complementary application and supporting creative art/expressive therapy in pediatric oncology, especially in connection with the modern concepts of psychosocial oncology, sophrology, education and rehabilitation sciences. Method: According to initial hypothesis application of complementary and creative art/expressive ...

Psychodynamic treatment of depressed adolescents.

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Bemporad, J R

1988-09-01

Depression may be conceptualized as the response to the loss of meaning or satisfaction sufficient to affect the individual's optimal view of the self. At each stage of the life cycle, the failure to achieve developmental tasks threatens the concept of the self, producing a phase-specific vulnerability to depression. Adolescence presents particular stresses by forcing the youngster to relinquish the relative familiarity and security of a childhood psychosocial role and create a sense of self independent of family, without childhood denial mechanisms, and of value to a new peer culture. Most individuals experience a sense of loss, confusion, apprehension, and dysphoria during this difficult period of transition. Many who seek psychotherapy require only a secure holding environment that will support their self-esteem as they create new avenues of worth and satisfaction. A few, however, are so hampered by psychosocial limitations that they cannot master this developmental passage without more extensive therapeutic assistance.

[Psychotherapies for the Treatment of Phantom Limb Pain].

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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.

Current Perspective on MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder

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Thal, Sascha B.; Lommen, Miriam J.J.

2018-01-01

The present paper discusses the current literature with regard to substance-assisted psychotherapy with Methylenedioxymethamphetamine (MDMA) for posttraumatic stress disorder (PTSD). The aim of the paper is to give a comprehensive overview of the development from MDMA’s early application in psychotherapy to its present and future role in the treatment of PTSD. It is further attempted to increase the attention for MDMA’s therapeutic potential by providing a thorough depiction of the scientific...

Nonverbal Synchrony in Psychotherapy: Coordinated Body Movement Reflects Relationship Quality and Outcome

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Ramseyer, Fabian; Tschacher, Wolfgang

2011-01-01

Objective: The authors quantified nonverbal synchrony--the coordination of patient's and therapist's movement--in a random sample of same-sex psychotherapy dyads. The authors contrasted nonverbal synchrony in these dyads with a control condition and assessed its association with session-level and overall psychotherapy outcome. Method: Using an…

[Multiprofessional inpatient psychotherapy of depression in old age].

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

2017-11-01

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.

Psychotherapy with people with developmental disabilities

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Barbara Zafošnik

2011-08-01

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.

Looking back, looking forward: A historical reflection on psychotherapy process research.

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Knobloch-Fedders, Lynne M; Elkin, Irene; Kiesler, Donald J

2015-01-01

In 1983, a group of 14 prominent psychotherapy process researchers attended a workshop sponsored by the US National Institute of Mental Health. Although the previous decade had seen a marked emphasis on psychotherapy outcome research, there had also been several major advances in the field of process research. The goals of the workshop were to review the current state of the field, address methodological and conceptual issues, and provide recommendations to advance scholarship in this area. In this paper, we summarize the major themes of the workshop and consider the degree to which its recommendations have come to fruition via subsequent developments in the field. Although 30 years have passed since the workshop was held, its insights remain highly relevant to psychotherapy process research today.

Fundamental dilemmas in contemporary psychotherapy: a transtheoretical concept.

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Scaturo, Douglas J

2002-01-01

The transtheoretical nature of fundamental dilemmas in contemporary psychotherapy is explored. The basic distinction between technical and ethical dilemmas in clinical practice is discussed, as well as the ramifications for the psychotherapist. Clinical dilemmas identified by survey research studies and interviews with master psychotherapists are reviewed. In addition to dilemmas relevant to circumscribed areas of psychotherapy, such as brief therapy, managed mental health care, sexual questions, feminist therapy, dilemmas fundamental to the psychotherapeutic process as a whole are examined. Finally, clinical examples are provided that include such issues as hospitalization of the suicidal patient, dealing with known contraindications, treating the intractable patient, and self-care of the psychotherapist.

Efficacy and enlightenment: LSD psychotherapy and the Drug Amendments of 1962.

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Oram, Matthew

2014-04-01

The decline in therapeutic research with lysergic acid diethylamide (LSD) in the United States over the course of the 1960s has commonly been attributed to the growing controversy surrounding its recreational use. However, research difficulties played an equal role in LSD psychotherapy's demise, as they frustrated researchers' efforts to clearly establish the efficacy of treatment. Once the Kefauver Harris Drug Amendments of 1962 introduced the requirement that proof of efficacy be established through controlled clinical trials before a drug could be approved to market, the value of clinical research became increasingly dependent on the scientific rigor of the trial's design. LSD psychotherapy's complex method of utilizing drug effects to catalyze a psychological treatment clashed with the controlled trial methodology on both theoretical and practical levels, making proof of efficacy difficult to obtain. Through a close examination of clinical trials performed after 1962, this article explores how the new emphasis on controlled clinical trials frustrated the progress of LSD psychotherapy research by focusing researchers' attention on trial design to the detriment of their therapeutic method. This analysis provides a new perspective on the death of LSD psychotherapy and explores the implications of the Drug Amendments of 1962.

Implications of RDoC for the research and practice of psychotherapy.

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Hershenberg, Rachel; Goldfried, Marvin R

2015-03-01

The field of psychotherapy is at an important juncture. Recent changes in the field include (a) the skeptical reception of the fifth edition of the Diagnostic and Statistical Manual and (b) NIMH's prioritization of an alternative classification system to guide translational and intervention research. Moreover, (c) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis. Thus, psychological research as it relates to the practice of psychotherapy is at a crossroads. In this article, we provide a brief overview of several generations of psychotherapy outcome research, including the consequences that followed in the 1980s as psychotherapy research moved toward randomized controlled trials for clinical disorders. We delineate the inherent strengths and limitations of this movement and address how the NIMH has recently responded with the Research Domain Criteria (RDoC). We then address philosophical and practical implications of the emphasis on a neuroscientific conceptualization of psychological problems. Finally, we discuss opportunities for a next generation of convergent science that incorporates, rather than replaces, psychosocial variables across stages of translational research and treatment development. Copyright © 2014. Published by Elsevier Ltd.

Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers.

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Myers Virtue, Shannon; Manne, Sharon L; Darabos, Kathleen; Heckman, Carolyn J; Ozga, Melissa; Kissane, David; Rubin, Stephen; Rosenblum, Norman

2015-09-01

The aim of this study was to describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotion episodes during early and later sessions was associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention and a supportive counseling intervention, for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy sessions for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = 0.02). A higher number of emotion episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p psychotherapy among women diagnosed with gynecological cancer. Copyright © 2014 John Wiley & Sons, Ltd.

‘You have to keep your head on your shoulders’: A systems psychodynamic perspective on women leaders

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Claude-Helene Mayer

2018-03-01

Full Text Available Background:Women leaders within Higher Education Institutions (HEIs in South Africa have increased in numbers over the past years and they have changed the dynamics in these institutions. Yet, it is a subject that has hardly been explored from the perspective of women leaders. Aim:The aim of this study is to explore the experiences of women leaders in HEIs from a systems psychodynamic perspective using the conflict, identity, boundaries, authority, roles, task (CIBART model, a well-researched model to analyse systems psychodynamics and to gain a deeper understanding of (unconscious dynamics within organisations. Methods:This qualitative study is based on Dilthey‘s modern hermeneutics. Interviews were conducted with 23 women leaders from the Higher Education Resource Services South Africa, network across 8 HEIs. Observations were conducted in one organisation to support the data analysis and interpretation. Data were analysed through content analysis. Findings:Findings show that women leaders re-evaluate and reconstruct themselves constantly within organisations. This continuous re-evaluation and reconstruction become visible through the constructs of the CIBART model. The findings reveal deeper insights into systems psychodynamics, which considers anxiety within the system where women leaders seem to contain such anxiety by mobilising specific defence mechanisms. Certain diversity markers, such as race, gender, mother tongue, position within the organisation and generational belonging play a role in creating the dynamics. Women leaders’ experience of de-authorisation and role confusion impacts significantly on women leadership and their action towards ownership. Practical implications: The study provides new, valuable and context-specific insights into women leadership seen through the lens of the CIBART model, highlighting unconscious dynamics that need practical attention in the HEIs to empower women leaders for gender-specific leadership

Use of psychotherapy in a representative adult community sample in São Paulo, Brazil

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Blay, Sergio L.; Fillenbaum, Gerda G.; da Silva, Paula Freitas R.; Peluso, Erica T.

2014-01-01

Little is known about the use of psychotherapy to treat common mental disorders in a major city in a middle income country. Data come from in-home interviews with a stratified random sample of 2,000 community residents age 18–65 in the city of São Paulo, Brazil. The information obtained included sociodemographic characteristics; psychotropic drugs; mental status; and lifetime, previous 12 months, and current use of psychotherapy. Logistic regression was used to examine determinants of use of psychotherapy. Of the sample, 22.7% met General Health Questionnaire-12 criteria for common mental disorders. Lifetime, previous 12 months, and current use of psychotherapy were reported by 14.6%, 4.6%, and 2.3% of the sample respectively. Users were typically women, more educated, higher income, not married, unemployed, with common mental disorders. Further analysis found that 47% (with higher education and income) paid out-of-pocket, and 53% used psychotropic medication. Psychotherapy does not appear to be the preferred treatment for common mental disorders. PMID:25118139

Psychotherapy in Argentina: a clinical case from an integrative perspective.

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Gómez, Beatriz