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Sample records for psychodynamic psychotherapy stpp

  1. Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP for social phobia into clinical practice: study protocol for a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Leweke Frank

    2011-06-01

    Full Text Available Abstract Background Psychodynamic psychotherapy is frequently applied in the treatment of social phobia. Nevertheless, there has been a lack of studies on the transfer of manualized treatments to routine psychodynamic practice. Our study is the first one to examine the effects of additional training in a manualized Short Term Psychodynamic Psychotherapy (STPP procedure on outcome in routine psychotherapy for social phobia. This study is an extension to a large multi-site RCT (N = 512 comparing the efficacy of STPP to Cognitive-Behavioral Therapy (CBT of Social Phobia. Methods/Design The manualized treatment is designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners will be randomized to training in manualized STPP vs. treatment as usual without a specific training (control condition. We plan to enrol a total of 105 patients (84 completers. Assessments will be conducted before treatment starts, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 months and 12 months after termination of treatment. The primary outcome measure is the Liebowitz Social Anxiety Scale. Remission from social phobia is defined scoring with 30 or less points on this scale. Discussion We will investigate how the treatment can be transferred from a controlled trial into the less structured setting of routine clinical care. This question represents Phase IV of psychotherapy research. It combines the benefits of randomized controlled and naturalistic research. The study is genuinely designed to promote faster and more widespread dissemination of effective interventions. It will answer the questions whether manualized STPP can be implemented into routine outpatient care, whether the new methods improve treatment courses and outcomes and whether treatment effects reached in routine psychotherapeutic treatments are comparable to those of the controlled, strictly manualized treatment of the main study

  2. Transfer of manualized Short Term Psychodynamic Psychotherapy (STPP) for social anxiety disorder into clinical practice: results from a cluster-randomised controlled trial.

    Science.gov (United States)

    Wiltink, Jörg; Ruckes, Christian; Hoyer, Jürgen; Leichsenring, Falk; Joraschky, Peter; Leweke, Frank; Pöhlmann, Karin; Beutel, Manfred E

    2017-03-14

    Despite growing evidence for manualized psychodynamic treatments, there is a lack of studies on their transfer to routine practice. This is the first study to examine the effects of an additional training in manualized Short Term Psychodynamic Psychotherapy (STPP) on the outcome in routine psychotherapy for social anxiety disorder (SAD). The study is an extension to a large RCT comparing STPP to Cognitive-Behavioral Therapy of SAD. The manualized treatment was designed for a time limited approach with 25 individual sessions of STPP over 6 months. Private practitioners were randomized to training in manualized STPP (mSTPP) vs. treatment as usual without a specific training (tauSTPP). A total of 109 patients were enrolled (105 started treatment; 75 completed at least 20 treatment sessions). Assessments were conducted pre-treatment, after 8 and 15 weeks, after 25 treatment sessions, at the end of treatment, 6 and 12 months after termination of treatment. Remission as primary outcome was defined by the Liebowitz-Social-Anxiety-Scale (LSAS) score ≤30. Secondary outcomes were response (at least 31% reduction in LSAS), treatment duration and number of sessions, changes in social anxiety (LSAS, SPAI), depression (BDI), clinical global impression (CGI), and quality of life (EQ-5D). Remission rates of mSTPP (9%) resp. tauSTPP (16%) and also response rates of 33% resp. 28% were comparable between the two treatment approaches as well as treatment duration and number of sessions. Most of the within-group differences (baseline to 25 sessions) indicated moderate to large improvements in both treatments; within-group differences from baseline to 12 months follow-up (LSAS, SPAI, BDI, CGI) were large ranging from d = -0.605 to d = -2.937. Benefits of mSTPP were limited to single outcomes. Findings are discussed with regard to implementation and dissemination of empirically validated treatments in psychodynamic training and practice. SAD patients with a high comorbidity

  3. Spiritually oriented psychodynamic psychotherapy.

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    Shafranske, Edward P

    2009-02-01

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

  4. Psychodynamic psychotherapy as treatment for depression in adolescence.

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    Midgley, Nick; Cregeen, Simon; Hughes, Carol; Rustin, Margaret

    2013-01-01

    This article presents a psychodynamic approach to understanding and treating adolescent depression, based largely on the manual for short-term psychoanalytic psychotherapy (STPP) for adolescents (11-17 years old) with moderate to severe depression, developed for the IMPACT Study from Great Britain. Although the authors make reference to longer-term psychodynamic treatments, the 28-session model (plus 7 sessions of parent/carer work) used in the IMPACT Study informs the psychodynamic approach presented herein. In the course of discussing the analytical framework for depression and the treatment, a single case study is presented throughout to graphically illustrate the clinical course and outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Short-term psychodynamic psychotherapy: review of recent process and outcome studies.

    Science.gov (United States)

    Lewis, Andrew J; Dennerstein, Michelle; Gibbs, Petah M

    2008-06-01

    Short-term psychodynamic psychotherapy (STPP) is a widely practised form of psychological intervention. Given that the Roth and Fonagy (1996) review concluded that there was a lack of confirming evidence for STPP, the current review is focused on studies published between 1996 and 2006 that evaluate the efficacy of STPP. As a result of a systematic literature review, 18 studies were found that met inclusion criteria consistent with those used by Roth and Fonagy (1996) for selection of studies, patient groupings and definition of therapeutic method. In general these studies add to an increasing body of evidence suggesting that STPP can be an effective psychological treatment for individuals experiencing mental health problems. Specifically, for depression STPP can be equal in effects to other psychological treatments and is significantly better than no treatment in the short term. Furthermore, emerging process data indicate that there is a significant relationship between the use of specific psychodynamic therapeutic techniques and the alleviation of depressive symptoms. Increasing evidence has emerged to support STPP as a treatment for generalized anxiety disorder, panic disorder and some personality disorders. There remains limited evidence for the use of STPP treatment for patients with anxiety disorders that relate more to stress. Very limited and inconclusive evidence currently exists to support STPP as a treatment for bipolar disorder, eating disorders and drug dependency. Future research needs to include broader assessment measures, long-term follow up, studies that maintain an identifiable focus, and research that includes a focus on psychotherapy process variables as they interact with outcomes.

  6. Short-term psychodynamic psychotherapy in patients with "male depression" syndrome, hopelessness, and suicide risk: a pilot study.

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    Angeletti, Gloria; Pompili, Maurizio; Innamorati, Marco; Santucci, Chiara; Savoja, Valeria; Goldblatt, Mark; Girardi, Paolo

    2013-01-01

    Objectives and Methods. This was an observational study of the efficacy of short-term psychodynamic psychotherapy (STPP) in a sample of 35 (30 women and 5 men) patients with moderate-to-severe "male depression" (Gotland Scale for Male Depression (GSMD) ≥ 13) comorbid with unipolar mood disorder (dysthymia and major depression) or anxiety disorder. Outcome measures were GSMD and BHS (Beck Hopelessness Scale) score changes from baseline. Results. Patients had a strong response to STPP on the GSMD (estimated mean score change (± SE) = -9.08 ± 2.74; P hopelessness at the baseline (partial r = 0.62; P hopelessness was only marginally reduced by this treatment which points to the need to better understand how STPP can be involved in the reduction of suicide risk.

  7. Multimedia psychodynamic psychotherapy: a preliminary report.

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    Nesci, Domenico Arturo

    2009-05-01

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

  8. A randomized clinical trial of cognitive behavioural therapy versus short-term psychodynamic psychotherapy versus no intervention for patients with hypochondriasis

    DEFF Research Database (Denmark)

    Sørensen, Per; Birket-Smith, M; Wattar, U

    2011-01-01

    Hypochondriasis is common in the clinic and in the community. Cognitive behavioural therapy (CBT) has been found to be effective in previous trials. Psychodynamic psychotherapy is a treatment routinely offered to patients with hypochondriasis in many countries, including Denmark. The aim...... of this study was to test CBT for hypochondriasis in a centre that was not involved in its development and compare both CBT and short-term psychodynamic psychotherapy (STPP) to a waiting-list control and to each other. CBT was modified by including mindfulness and group therapy sessions, reducing the therapist...

  9. Psychodynamic psychotherapy for the depressive syndrome.

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    Cameron, P M

    1989-06-01

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

  10. Psychodynamic Psychotherapy for Children and Adolescents: An Old Friend Revisited

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    Delgado, Sergio V.

    2008-01-01

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

  11. Short-Term Psychodynamic Psychotherapy in Patients with “Male Depression” Syndrome, Hopelessness, and Suicide Risk: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gloria Angeletti

    2013-01-01

    Full Text Available Objectives and Methods. This was an observational study of the efficacy of short-term psychodynamic psychotherapy (STPP in a sample of 35 (30 women and 5 men patients with moderate-to-severe “male depression” (Gotland Scale for Male Depression (GSMD ≥ 13 comorbid with unipolar mood disorder (dysthymia and major depression or anxiety disorder. Outcome measures were GSMD and BHS (Beck Hopelessness Scale score changes from baseline. Results. Patients had a strong response to STPP on the GSMD (estimated mean score change (± SE=−9.08 ± 2.74;P<0.01; partial eta squared  =0.50, but not on the BHS (estimated mean score change (± SE=−0.92 ± 1.55;P=0.57; partial eta squared  =0.03. BHS score changes were significantly associated with GSMD score changes (Pearson's r=0.56; P<0.001, even when controlling for the severity of hopelessness at the baseline (partial r=0.62; P<0.001. Conclusions. STPP proved to be effective in patients suffering from “male depression” although hopelessness was only marginally reduced by this treatment which points to the need to better understand how STPP can be involved in the reduction of suicide risk.

  12. [Psychodynamic psychotherapy and the treatment of pathological gambling].

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    Rosenthal, Richard J

    2008-05-01

    The search for empirically based treatments for pathological gambling is in its infancy, with relatively few clinical trials and an absence of naturalistic studies. Treatment retention of gamblers has been a problem; cognitive-behavioral treatment and pharmacotherapy studies report especially high dropout rates. Psychodynamic approaches, with their emphasis on the therapeutic relationship, and the meaning of the patient's self-destructive and seemingly irrational behaviors, and on obstacles to self-forgiveness, might improve outcome. After a description of psychodynamic psychotherapy, the literature on both short-term and longer therapies is reviewed regarding their efficacy for a variety of disorders. With regard to pathological gambling, the author summarizes the early (1914-1970) psychoanalytic literature then reviews the more recent psychodynamic psychotherapy literature on pathological gambling. A review of the recent psychodynamic psychotherapy literature on pathological gambling failed to disclose a single randomized controlled study of treatment efficacy or effectiveness. However, there are eight positive outcome studies described as multi-modal eclectic; half of those seem to utilize psychodynamic approaches. Two of the more successful programs are described. A review of the outcomes literature for psychodynamic psychotherapy demonstrates efficacy for a variety of disorders sufficient to justify a clinical trial for pathological gambling. Short-term psychodynamic psychotherapy, with its focus on core issues, may be particularly applicable to the pathological gambler's need to avoid or escape intolerable affects and problems. Longer therapies may be needed to modify an avoidant coping style and defenses.

  13. Unique and shared techniques in cognitive-behavioural and short-term psychodynamic psychotherapy: a content analysis of randomised trials on depression

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    Barth, Jürgen; Michlig, Nadja; Munder, Thomas

    2014-01-01

    Randomised controlled trials (RCTs) of psychotherapeutic interventions assume that specific techniques are used in treatments, which are responsible for changes in the client's symptoms. This assumption also holds true for meta-analyses, where evidence for specific interventions and techniques is compiled. However, it has also been argued that different treatments share important techniques and that an upcoming consensus about useful treatment strategies is leading to a greater integration of treatments. This makes assumptions about the effectiveness of specific interventions ingredients questionable if the shared (common) techniques are more often used in interventions than are the unique techniques. This study investigated the unique or shared techniques in RCTs of cognitive-behavioural therapy (CBT) and short-term psychodynamic psychotherapy (STPP). Psychotherapeutic techniques were coded from 42 masked treatment descriptions of RCTs in the field of depression (1979–2010). CBT techniques were often used in studies identified as either CBT or STPP. However, STPP techniques were only used in STPP-identified studies. Empirical clustering of treatment descriptions did not confirm the original distinction of CBT versus STPP, but instead showed substantial heterogeneity within both approaches. Extraction of psychotherapeutic techniques from the treatment descriptions is feasible and could be used as a content-based approach to classify treatments in systematic reviews and meta-analyses. PMID:25750827

  14. Psychodynamic psychotherapy and clomipramine in the treatment of major depression.

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

    2002-05-01

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

  15. Therapeutic alliance and treatment outcome in psychodynamic psychotherapy of depressed breast cancer patients: the same old story or different from other populations?

    Science.gov (United States)

    Leuteritz, Katja; Weißflog, Gregor; Barthel, Yvette; Brähler, Elmar; Zwerenz, Rüdiger; Wiltink, Jörg; Beutel, Manfred E

    2017-11-01

    A good therapeutic alliance is associated with better treatment outcomes in diverse types of psychotherapy and patient populations, but little is known about therapeutic alliance in psychotherapies with cancer patients. This study examines the association of therapeutic alliance and treatment outcome in short term psychodynamic psychotherapy (STPP) for breast cancer patients. Within a randomized controlled trial, 47 completers of STPP could be included in the analyses. The therapeutic alliance was assessed by patients and therapists at treatment termination with the Helping Alliance Questionnaire. Outcome was defined as no diagnosis of depression assessed with Structured Clinical Interview for DSM-IV (SCID-I) and a reduction of the HADS-depression score by at least two points at treatment termination. Patients' alliance ratings were significantly associated with outcome (r = 0.46, p = 0.015), while, in contrast to findings in non-cancer populations, therapists' ratings were unrelated. There was no association between patients' and therapists' ratings of therapeutic alliance. Especially success and working related aspects of patients' alliance scores were associated with outcome. Patients' and therapists' alliance scores were unrelated to any of their baseline characteristics, therapist characteristic or treatment variables. We conclude that therapists should regularly assess the quality of patients' perceived therapeutic alliance in the course of psychotherapy with breast cancer patients to improve psychotherapy outcome. The breast cancer patients' perspective should be actively inquired and considered throughout treatment by therapists. Possible discrepancies between both judgements can be addressed in treatment.

  16. A case study of psychodynamic group psychotherapy for bipolar disorder.

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    Gonzalez, Jodi M; Prihoda, Thomas J

    2007-01-01

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

  17. Supportive psychodynamic psychotherapy versus treatment as usual for first-episode psychosis

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Harder, Susanne; Knudsen, Per

    2012-01-01

    During recent decades, the field of treatment of schizophrenia has lacked empirical, systematic outcome studies that support psychodynamic psychotherapy as an evidence-based intervention for patients with schizophrenia. The Danish schizophrenia project (DNS) compared psychodynamic psychotherapy f.......000) and GAF(symptom) (p = 0.010) significantly favored SPP in combination with TaU over TaU alone. In spite of limitations, this study speaks in favor of including supportive psychodynamic psychotherapy in the treatment for patients with schizophrenic first-episode psychoses....

  18. Cognitive Behavioral Therapy versus Short Psychodynamic Supportive Psychotherapy in the outpatient treatment of depression: a randomized controlled trial

    NARCIS (Netherlands)

    Driesssen, E.; Van Henricus, L.; Schoevers, R.A.; Cuijpers, P.; van Aalst, G.; Don, F.J.; Hendriksen, M.; Kool, S.; Molenaar, P.J.; Peen, J.; Dekker, J.J.M.

    2007-01-01

    Background: Previous research has shown that Short Psychodynamic Supportive Psychotherapy (SPSP) is an effective alternative to pharmacotherapy and combined treatment (SPSP and pharmacotherapy) in the treatment of depressed outpatients. The question remains, however, how Short Psychodynamic

  19. Initial and last manifest dream reports of patients in psychodynamic psychotherapy and combined psychotherapy/pharmacotherapy.

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    Glucksman, Myron L; Kramer, Milton

    2012-12-01

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

  20. 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.

  1. What Works for People with Mental Retardation? Critical Commentary on Cognitive-Behavioral and Psychodynamic Psychotherapy Research.

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    Beail, Nigel

    2003-01-01

    This paper reviews what is known about the effectiveness of the more controversial use of psychodynamic and cognitive-behavioral psychotherapy with people who have mental retardation. It examines self-management approaches (problem solving, anger management, and cognitive therapy) and psychodynamic psychotherapy. The paper concludes that there has…

  2. Examining the therapeutic relationship and confronting resistances in psychodynamic psychotherapy: a certified public accountant case.

    Science.gov (United States)

    Manetta, Christopher T; Gentile, Julie P; Gillig, Paulette Marie

    2011-05-01

    Psychodynamic psychotherapy is effective for a variety of mental health symptoms. This form of psychotherapy uses patient self reflection and self examination, as well as the therapeutic relationship between the patient and psychiatrist, to explore maladaptive coping strategies and relationship patterns of the patient. A thorough understanding of resistance and the core conflictual relationship theme afford the psychiatrist the ability to facilitate this work. In this article, the composite case illustrates some of the psychodynamic psychotherapy techniques that can be employed in a psychotherapy case. In this example, the case is about a certified public accountant that came to treatment because of an acute stressor that put her career goals at risk. An acute episode or event can bring to light chronic and ongoing symptoms, which have had a remitting and relapsing course, and leave the patient unable to compensate on his or her own.

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

    OpenAIRE

    Wiltink, Jörg; Hoyer, Jürgen; Beutel, Manfred E.; Ruckes, Christian; Herpertz, Stephan; Joraschky, Peter; Koranyi, Susan; Michal, Matthias; Nolting, Björn; Pöhlmann, Karin; Salzer, Simone; Strauss, Bernhard; Leibing, Eric; Leichsenring, Falk

    2016-01-01

    OBJECTIVES: 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. RESEARCH DESIGN AND METHODS: 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 treatmen...

  4. Facets of Object Representation: Process and Outcome Over the Course of Psychodynamic Psychotherapy.

    Science.gov (United States)

    Mullin, Anthony S J; Hilsenroth, Mark J; Gold, Jerold; Farber, Barry A

    2018-01-01

    This study explores the effectiveness of psychodynamic psychotherapy in improving facets of object relations (OR) functioning over the course of treatment. The sample consisted of 75 outpatients engaged in short-term dynamic psychotherapy at a university-based psychological services clinic. Facets of OR functioning were assessed at pre- and posttreatment by independent raters using the Social Cognition and Object Relations Scale-Global rating method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011 ; Westen, 1995 ) from in-session patient relational narratives. The Comparative Psychotherapy Process Scale (CPPS; Hilsenroth, Blagys, Ackerman, Bonge, & Blais, 2005 ) was used to assess therapist activity and psychotherapy techniques early in treatment. Independent clinical ratings of OR functioning and psychotherapy technique were conducted and all were found to be in the good to excellent range of reliability. Specific facets of OR functioning improved with medium to large effect changes posttreatment. These adaptive changes were significantly related to the incidence of psychodynamic-interpersonal (PI) techniques. Also, this study identified the role specific psychodynamic techniques had in facilitating change in a number of underlying dimensions of OR. Patient self-reported reliable change in symptomatology and reliable change in facets of OR were significantly related as well. This study highlights the utility of incorporating psychological assessment into psychotherapy practice to assess change at the explicit (symptoms) and implicit (OR) level. Limitations of this study, future research directions, and implications for clinical practice are discussed.

  5. Psychoanalytic/Psychodynamic Psychotherapy for Sexually Abused Children and Adolescents: A Systematic Review

    Science.gov (United States)

    Parker, Ben; Turner, William

    2014-01-01

    Objective: To assess the effectiveness of psychoanalytic/psychodynamic psychotherapy for children and adolescents who have been sexually abused. Method: The Cochrane Collaboration's criteria for data synthesis and study quality assessment were used. Electronic bibliographic databases and web searches were used to identify randomized and…

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

    NARCIS (Netherlands)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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...

  9. Guidelines for Individual and Group Psychodynamic Psychotherapy for the Treatment of Persons Diagnosed with Psychosis and/or Schizophrenia.

    Science.gov (United States)

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

    2017-09-01

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

  10. Perceptions of the significant other of the effects of psychodynamic psychotherapy. Implications for thinking about psychodynamic and systemic approaches.

    Science.gov (United States)

    Roberts, J

    1996-01-01

    Clinical suggests that partners of psychotherapy patients often have powerful feelings about the therapy and therapist. The repercussions of psychotherapy on those close to the patient are rarely considered. A small exploratory study was therefore conducted. All patients who had completed at least two months of weekly psychodynamic psychotherapy in 1990 at an out-patient unit of a psychiatric hospital (n = 35) and had a partner with whom they were living at the time of starting therapy (n = 23) were contacted. Eight gave permission for their partner to be contacted directly. All eight partners agreed to participate in a semi-structured interview exploring their perceptions of the effects of the therapy on a number of family relationships. The impact of the process of the study was also investigated by means of a questionnaire sent to all partners some weeks after the interview. Considerable changes were perceived to have taken place in association with therapy affecting not only the relationship between the couple but also their parenting relationship, the children, and at time members of the extended family. Partner's views about the direction of such changes seemed to influence other perceptions about the therapy. The repercussions of individual psychotherapy may well spread extensively within a family. This further blurs the boundary between individual and family therapy, both theoretically and clinically. Research procedures are themselves a major intervention and may have a considerable emotional impact on participants.

  11. Psychoanalytic/psychodynamic psychotherapy for children and adolescents who have been sexually abused.

    Science.gov (United States)

    Parker, Ben; Turner, William

    2013-07-31

    The sexual abuse of children and adolescents is a significant worldwide problem. It is associated with a wide variety of negative psychological, social and physical consequences for the victims. These effects can often be seen immediately following sexual abuse, but they may manifest later on and sometimes only in adult life. There are a number of different interventions aimed at helping children and adolescents who have been sexually abused, and psychoanalytic/psychodynamic psychotherapy has a long-established tradition of being used for such victims. In this review, we set out to find the evidence for its effectiveness specifically in children and adolescents who have been sexually abused. To assess the effectiveness of psychoanalytic/psychodynamic psychotherapy for children and adolescents who have been sexually abused. We searched the following databases in May 2013: CENTRAL, Ovid MEDLINE, Embase, PsycINFO, CINAHL, Sociological Abstracts, Social Science Citation Index, Conference Proceedings Citation Index - Social Science and Humanities, LILACS and WorldCat. We also searched three trials registers, checked the reference lists of relevant studies and contacted known experts. Randomised and quasi-randomised trials comparing psychoanalytic/psychodynamic psychotherapy with treatment as usual or no treatment/waiting list control for children and adolescents up to age of 18 who had experienced sexual abuse at any time prior to the intervention. The review authors (BP and WT) independently screened search results to identify studies that met eligibility criteria. No studies were identified that met the inclusion criteria for this review. There are no randomised and quasi-randomised trials that compare psychoanalytic/psychodynamic therapy with treatment as usual, no treatment or waiting list control for children and adolescents who have been sexually abused. As a result, we cannot draw any conclusions as to the effectiveness of psychoanalytic/psychodynamic

  12. Tracking Functional Brain Changes in Patients with Depression under Psychodynamic Psychotherapy Using Individualized Stimuli

    Science.gov (United States)

    Wiswede, Daniel; Taubner, Svenja; Buchheim, Anna; Münte, Thomas F.; Stasch, Michael; Cierpka, Manfred; Kächele, Horst; Roth, Gerhard; Erhard, Peter; Kessler, Henrik

    2014-01-01

    Objective Neurobiological models of depression posit limbic hyperactivity that should normalize after successful treatment. For psychotherapy, though, brain changes in patients with depression show substantial variability. Two critical issues in relevant studies concern the use of unspecific stimulation experiments and relatively short treatment protocols. Therefore changes in brain reactions to individualized stimuli were studied in patients with depression after eight months of psychodynamic psychotherapy. Methods 18 unmedicated patients with recurrent major depressive disorder were confronted with individualized and clinically derived content in a functional MRI experiment before (T1) and after eight months (T2) of psychodynamic therapy. A control group of 17 healthy subjects was also tested twice without intervention. The experimental stimuli were sentences describing each participant's dysfunctional interpersonal relationship patterns derived from clinical interviews based on Operationalized Psychodynamic Diagnostics (OPD). Results At T1 patients showed enhanced activation compared to controls in several limbic and subcortical regions, including amygdala and basal ganglia, when confronted with OPD sentences. At T2 the differences in brain activity between patients and controls were no longer apparent. Concurrently, patients had improved significantly in depression scores. Conclusions Using ecologically valid stimuli, this study supports the model of limbic hyperactivity in depression that normalizes after treatment. Without a control group of untreated patients measured twice, though, changes in patients' brain activity could also be attributed to other factors than psychodynamic therapy. PMID:25275317

  13. Psychodynamic psychotherapy for complex trauma: targets, focus, applications, and outcomes.

    Science.gov (United States)

    Spermon, Deborah; Darlington, Yvonne; Gibney, Paul

    2010-01-01

    Complex trauma describes that category of severe, chronic interpersonal trauma usually originating in the formative years of a child. In the adult, this can result in global dissociative difficulties across areas of cognitive, affective, somatic, and behavioral functions. Targeting this field of traumatic pathology, this article reviews the contributions and developments within one broad approach: psychodynamic theory and practice. Brief descriptions of aspects of analytical, Jungian, relational, object relations, and attachment therapeutic approaches are given, along with understandings of pathology and the formulation of therapeutic goals. Major practices within client sessions are canvassed and the issues of researching treatment outcomes are discussed.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Samardžić Ljiljana

    2014-01-01

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

  16. Internal Representations of the Therapeutic Relationship Among Adolescents in Psychodynamic Psychotherapy.

    Science.gov (United States)

    Atzil-Slonim, Dana; Tishby, Orya; Shefler, Gaby

    2015-01-01

    This study examined changes in adolescents' internal representations of their relationship with their therapist and the extent to which these changes were related to changes in their representations of their relationship with their parents and to treatment outcomes. Thirty adolescents (aged 15-18 years, 70% women) undergoing psychodynamic psychotherapy participated in relationship anecdote paradigms interviews based on the core conflictual relationship theme method and completed outcome measures at the beginning of treatment and a year later. Adolescents' positive representations of their therapists increased throughout the year of treatment, whereas their negative representations did not change. There was an association between the development of the therapeutic relationship and improvement in the perception of the relationship with parents over the course of therapy. Increases in the level of positive representations and decreases in the level of negative representations of the therapist were associated with greater satisfaction with treatment but not with the other outcome measures. These results support the centrality of the therapeutic relationship in the process of change during adolescents' psychodynamic psychotherapy. The finding that positive representations of the therapist increased throughout treatment but that negative representations remained steady suggests that therapists who treat adolescents should expect and be able to hear adolescent clients' positive and negative internal representations of themselves. Therapists need to realize that although adolescents often experience negative emotions and perceptions in therapy as in other significant relationships, this does not necessarily block the development of positive emotions. The finding that changes in the representations of the therapist are associated with changes in the representations of parents is in line with psychodynamic theory, which posits that psychotherapy facilitates new

  17. The power of subtle interpersonal hostility in psychodynamic psychotherapy: a speech acts analysis.

    Science.gov (United States)

    Anderson, Timothy; Knobloch-Fedders, Lynne M; Stiles, William B; Ordoñez, Tatiana; Heckman, Bernadette D

    2012-01-01

    This study compared participants' speech acts in low-hostile versus moderate-hostile interpersonal episodes in time-limited psychodynamic psychotherapy. Sixty-two cases from the Vanderbilt II psychotherapy project were categorized as low or moderate in interpersonal hostility based on ratings of interpersonal process using Structural Analysis of Social Behavior (Benjamin, 1996). Representative episodes were coded using a taxonomy of speech acts (Stiles, 1992), and speech acts were compared across low- and moderate-hostile episodes. Therapists in moderate-hostility episodes used more interpretations and edifications, and fewer questions and reflections. Patients in moderate-hostility episodes used more disclosures and fewer edifications. Content coding showed that therapist interpretations with a self/intrapsychic self focus were more characteristic of moderate-hostility than low-hostility episodes, whereas the two types of episodes contained similar levels of interpretations focused on the patient's interpersonal relationships and the therapeutic relationship.

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

    Science.gov (United States)

    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.

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

    DEFF Research Database (Denmark)

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

    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....

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

    Science.gov (United States)

    Wiltink, Jörg; Hoyer, Jürgen; Beutel, Manfred E.; Ruckes, Christian; Herpertz, Stephan; Joraschky, Peter; Koranyi, Susan; Michal, Matthias; Nolting, Björn; Pöhlmann, Karin; Salzer, Simone; Strauss, Bernhard

    2016-01-01

    Objectives 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. Research Design and Methods 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. Results 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. Conclusions 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. Trial Registration Controlled-trials.com/ISRCTN53517394 PMID:26785255

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Wiltink, Jörg; Hoyer, Jürgen; Beutel, Manfred E; Ruckes, Christian; Herpertz, Stephan; Joraschky, Peter; Koranyi, Susan; Michal, Matthias; Nolting, Björn; Pöhlmann, Karin; Salzer, Simone; Strauss, Bernhard; Leibing, Eric; Leichsenring, Falk

    2016-01-01

    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.

  3. Psychodynamic change in psychotherapy: cycles of patient-therapist linguistic interactions and interventions.

    Science.gov (United States)

    McCarthy, Kye L; Mergenthaler, Erhard; Schneider, Sven; Grenyer, Brin F S

    2011-11-01

    Psychodynamic change is understood to occur in part through the unique therapeutic relationship developed between therapist and patient, and the subtle cycles of their conversation from relaxed connection to intense experiencing. The Therapeutic Cycles Model (TCM) (Mergenthaler, 1996 ) and Heidelberg Structural Change Scale (HSCS) (OPD Task Force, 2008 ) were used to investigate therapist-patient dynamic processes across 16 sessions of psychotherapy. The TCM identified interventions of the therapist instigating change in emotion-abstraction patterns. Structural personality change was higher in TCM cycles, and differed according to emotion-abstraction patterns. The interventions of the therapist promoted dynamic structural change in the patient. The findings demonstrate for the first time the interconnection between specific types of therapist and patient dialogue that promote deep changes.

  4. Five-Year Follow-Up of Supportive Psychodynamic Psychotherapy in First-Episode Psychosis

    DEFF Research Database (Denmark)

    Harder, Susanne; Køster, Anne; Valbak, Kristian

    2014-01-01

    OBJECTIVES: The long-term outcomes of several approaches to intervention targeting social functioning in schizophrenia are not well documented. Contemporary supportive psychodynamic psychotherapy (SPP) aims to improve social functioning. The aim of the present study was to investigate the long...... up for 5 years (N = 269). The SPP targeted interpersonal relationships, emotion regulation, social cognition, and self-coherence. RESULTS: Significant between-group effects in favor of SPP+ST on social functioning, overall symptoms, and positive psychotic symptoms were found during the period...... of active SPP intervention. These differential effects, however, were not sustained after end of additional SPP at 5-year follow-up. CONCLUSION: The findings are in line with results from other approaches targeting social functioning in schizophrenia and support SPP as a valuable treatment. Further research...

  5. Do therapists' subjective variables impact on psychodynamic psychotherapy outcomes? A systematic literature review.

    Science.gov (United States)

    Lingiardi, Vittorio; Muzi, Laura; Tanzilli, Annalisa; Carone, Nicola

    2017-09-05

    Despite growing attention to the general therapist effects in a wide range of clinical settings, little is known about the individual, cross-situational, and therapy-nonspecific variables that impact on the differential effectiveness of clinicians. The current study is a systematic review of the evidence relating to the influence of therapist's subjective characteristics on outcomes of psychodynamic psychotherapies. A multistage and systematic search of articles published between 1987 and 2017 identified 30 relevant studies, which were organized into 6 areas according to the specific therapist's variable considered. Therapists' interpersonal functioning and skills showed the strongest evidence of a direct effect on treatment outcomes. Furthermore, there were preliminary evidence that therapists' attachment styles, their interpersonal history with caregivers, and their self-concept might affect outcomes through interaction effects with other constructs, such as technical interventions, patient's pathology, and therapeutic alliance. The high variability between studies on therapists' overall reflective or introspective abilities and personality characteristics suggested the need for more systematic research in these areas, whereas therapists' values and attitudes showed small effects on therapeutic outcome. The present review clarifies how a deep examination of the contribution of therapists' subjective characteristics can help elucidate the complex association between relational and technical factors related to the outcome of psychodynamic treatments. Copyright © 2017 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    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, CI95% [-1.50, -0.60]), and later age of onset (d = -0.65, CI95% [-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).

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

  10. Clinical wisdom in psychoanalysis and psychodynamic psychotherapy: a philosophical and qualitative analysis.

    Science.gov (United States)

    Baum-Baicker, Cynthia; Sisti, Dominic A

    2012-01-01

    To precisely define wisdom has been an ongoing task of philosophers for millennia. Investigations into the psychological dimensions of wisdom have revealed several features that make exemplary persons "wise." Contemporary bioethicists took up this concept as they retrieved and adapted Aristotle's intellectual virtue of phronesis for applications in medical contexts. In this article, we build on scholarship in both psychology and medical ethics by providing an account of clinical wisdom qua phronesis in the context of the practice of psychoanalysis and psychodynamic psychotherapy. With the support of qualitative data, we argue that the concept of clinical wisdom in mental healthcare shares several of the key ethical dimensions offered by standard models of phronesis in medical ethics and serves as a useful, albeit overlooked, reference point for a broader development of virtue-based medical ethics. We propose that the features of clinical wisdom are pragmatic skills that include, but are not limited to, an awareness of balance, the acceptance of paradox, and a particular clinical manner that maintains a deep regard for the other. We offer several suggestions for refining training programs and redoubling efforts to provide long-term mentorship opportunities for trainees in clinical mental healthcare in order to cultivate clinical wisdom.

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

    Science.gov (United States)

    Bögels, Susan M; Wijts, Paul; Oort, Frans J; Sallaerts, Steph J M

    2014-05-01

    Comparing the overall and differential effects of psychodynamic psychotherapy (PDT) versus cognitive behavior therapy (CBT) for social anxiety disorder (SAD). Patients with a primary SAD (N = 47) were randomly assigned to PDT (N = 22) or CBT (N = 27). Both PDT and CBT consisted of up to 36 sessions (average PDT 31.4 and CBT 19.8 sessions). Assessments took place at waitlist: pretest, after 12 and 24 weeks for those who received longer treatment: posttest, 3-month and 1-year follow-up. Changes in the main outcome measure self-reported social anxiety composite, as well as in other psychopathology, social skills, negative social beliefs, public self-consciousness, defense mechanisms, personal goals, independent rater's judgments of SAD and general improvement, and approach behavior during an objective test, were analyzed using multilevel analysis. No improvement occurred during waitlist. Treatments were highly efficacious, with large within-subject effect sizes for social anxiety, but no differences between PDT and CBT on general and treatment-specific measures occurred. Remission rates were over 50% and similar for PDT and CBT. Personality disorders did not influence the effects of PDT or CBT. PDT and CBT are both effective approaches for SAD. Further research is needed on the cost-effectiveness of PDT versus CBT, on different lengths PDT, and on patient preferences and their relationship to outcome of PDT versus CBT. © 2014 Wiley Periodicals, Inc.

  12. Varieties of Castration Experience: Relevance to Contemporary Psychoanalysis and Psychodynamic Psychotherapy.

    Science.gov (United States)

    Taylor, Graeme J

    2016-03-01

    Although Freud considered castration to be one of the two major anxieties of human life, the castration complex has been relatively neglected in contemporary psychoanalytic writing and is insufficiently discussed in presentations of clinical cases. This article discusses the relevance of the concept to contemporary psychoanalysis and psychodynamic psychotherapy, in particular the important contributing role of castration conflicts in the pathogenesis of a wide range of clinical symptoms. The author begins by briefly reviewing some classical and contemporary psychoanalytic ideas about castration to show how the concept has broadened and is currently used not only to signify fear of damage to or loss of the genital, but also metaphorically to indicate a threat to or loss of any valued human characteristic or function. He outlines Brenner's distinction between castration anxiety and castration depression, and reviews the role of childhood trauma in intensifying castration conflicts. He then illustrates the clinical application of these ideas by describing aspects of his psychotherapeutic work with three male patients who presented with a variety of symptoms and distressing psychological experiences that were gradually resolved through the analysis of underlying castration anxiety and/or castration depression. Although castration anxiety is frequently intermingled with separation anxiety, the author concludes that with many traumatized patients castration conflicts are in the foreground and the therapist needs to focus on the patient's proneness to humiliation, powerlessness, and shame.

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

    Directory of Open Access Journals (Sweden)

    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

  14. The empirical status of psychodynamic psychotherapy - an update: Bambi's alive and kicking.

    Science.gov (United States)

    Leichsenring, Falk; Leweke, Frank; Klein, Susanne; Steinert, Christiane

    2015-01-01

    The Task Force on Promotion and Dissemination of Psychological Procedures proposed rigorous criteria to define empirically supported psychotherapies. According to these criteria, 2 randomized controlled trials (RCTs) showing efficacy are required for a treatment to be designated as 'efficacious' and 1 RCT for a designation as 'possibly efficacious'. Applying these criteria modified by Chambless and Hollon, this article presents an update on the evidence for psychodynamic therapy (PDT) in specific mental disorders. A systematic search was performed using the criteria by Chambless and Hollon for study selection, as follows: (1) RCT of PDT in adults, (2) use of reliable and valid measures for diagnosis and outcome, (3) use of treatment manuals or manual-like guidelines, (4) adult population treated for specific problems and (5) PDT superior to no treatment, placebo or alternative treatment or equivalent to an established treatment. A total of 39 RCTs were included. Following Chambless and Hollon, PDT can presently be designated as efficacious in major depressive disorder (MDD), social anxiety disorder, borderline and heterogeneous personality disorders, somatoform pain disorder, and anorexia nervosa. For MDD, this also applies to the combination with pharmacotherapy. PDT can be considered as possibly efficacious in dysthymia, complicated grief, panic disorder, generalized anxiety disorder, and substance abuse/dependence. Evidence is lacking for obsessive-compulsive, posttraumatic stress, bipolar and schizophrenia spectrum disorder(s). Evidence has emerged that PDT is efficacious or possibly efficacious in a wide range of common mental disorders. Further research is required for those disorders for which sufficient evidence does not yet exist.

  15. Manualized supportive-expressive psychotherapy versus nonmanualized community-delivered psychodynamic therapy for patients with personality disorders: bridging efficacy and effectiveness.

    Science.gov (United States)

    Vinnars, Bo; Barber, Jacques P; Norén, Kristina; Gallop, Robert; Weinryb, Robert M

    2005-10-01

    Time-limited manualized dynamic psychotherapy was compared with community-delivered psychodynamic therapy for outpatients with personality disorders. In a stratified randomized clinical trial, 156 patients with any personality disorder diagnosis were randomly assigned either to 40 sessions of supportive-expressive psychotherapy (N=80) or to community-delivered psychodynamic therapy (N=76). Assessments were made at intake and 1 and 2 years after intake. Patients were recruited consecutively from two community mental health centers (CMHCs), assessed with the Structural Clinical Interview for DSM-IV Axis II Personality Disorders, and included if they had a diagnosis of any DSM-IV personality disorder. The outcome measures included the presence of a personality disorder diagnosis, personality disorder severity index, level of psychiatric symptoms (SCL-90), Global Assessment of Functioning Scale score, and number of therapy sessions. General mixed-model analysis of variance was used to assess group and time effects. In both treatment conditions, the global level of functioning improved while there were decreases in the prevalence of patients fulfilling criteria for a personality disorder diagnosis, personality disorder severity, and psychiatric symptoms. There was no difference in effect between treatments. During the follow-up period, patients who received supportive-expressive psychotherapy made significantly fewer visits to the CMHCs than the patients who received community-delivered psychodynamic therapy. Manualized supportive-expressive psychotherapy was as effective as nonmanualized community-delivered psychodynamic therapy conducted by experienced dynamic clinicians.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Patients' pre-treatment interpersonal problems as predictors of therapeutic alliance in long-term psychodynamic psychotherapy.

    Science.gov (United States)

    Ollila, Pekka; Knekt, Paul; Heinonen, Erkki; Lindfors, Olavi

    2016-07-30

    Information on how the patient's interpersonal problems predict alliance development during long-term therapy is lacking. The aim of this study was to explore how the patient's pre-treatment interpersonal problems predict the development of alliance in long-term psychotherapy. Altogether 128 adult outpatients experiencing mood or anxiety disorder were assigned to long-term psychodynamic psychotherapy in the Helsinki Psychotherapy Study. The Inventory of Interpersonal Problems (IIP) total score and the eight octant scores, assessed at baseline, were used as predictors. The trajectories of change in patient- and therapist-rated Working Alliance Inventory (WAI) were used as outcome measures at 7, 12, and 36 months of follow-up after baseline. Study of the changes by time showed that the patient-rated alliance was significantly improved by the 36-month follow-up, i.e. the most usual end-point of therapy, in persons with higher pre-treatment level of the IIP total score. Low total IIP score and low to moderate level of hostile type problems showed no slope of improvement of patient-rated alliance during follow-up. The therapist-rated alliance showed a similar course as the patient-rated alliance with the exception of a faster improvement for higher IIP scores. In conclusion, a higher level of patients' interpersonal problems predicted favorable alliance development. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. The efficacy of long-term psychodynamic psychotherapy, fluoxetine and their combination in the outpatient treatment of depression.

    Science.gov (United States)

    Bastos, Andre Goettems; Guimaraes, Luciano Santos Pinto; Trentini, Clarissa Marceli

    2015-01-01

    There are few randomized controlled trials examining the efficacy of long-term psychodynamic psychotherapy (LTPP) in depression treatment. LTPP was compared with fluoxetine treatment and their combination; 272 depressed patients (aged 26-34, 72% with a first episode of depression) were randomized to receive LTPP (one session/week), fluoxetine treatment (20-60 mg/day) or their combination for 24 months. Beck Depression Inventory (BDI) was the outcome measure. The psychotherapy was not manualized and the treatment took place under real-life conditions in an outpatient psychiatric clinic. Intention-to-treat analyses indicated that all the treatments were associated with significant reductions in the BDI scores (mean reduction of 18.88 BDI points). Furthermore, LTPP and combination therapy were more effective in reducing BDI scores than fluoxetine alone (22.08 and 22.04 vs. 12.53 BDI points). LTPP, pharmacological treatment with fluoxetine and their combination are effective in reducing symptoms of patients with moderate depression. LTPP and combined treatment were more effective compared to fluoxetine alone. These findings have implications for patients with depression who may benefit from long-term psychotherapy or combined treatment, or for depressed patients who do not wish to take medications such as fluoxetine.

  19. Use of the adult attachment projective picture system in psychodynamic psychotherapy with a severely traumatized patient.

    Science.gov (United States)

    George, Carol; Buchheim, Anna

    2014-01-01

    The following case study is presented to facilitate an understanding of how the attachment information evident from Adult Attachment Projective Picture System (AAP) assessment can be integrated into a psychodynamic perspective in making therapeutic recommendations that integrate an attachment perspective. The Adult Attachment Projective Picture System (AAP) is a valid representational measure of internal representations of attachment based on the analysis of a set of free response picture stimuli designed to systematically activate the attachment system (George and West, 2012). The AAP provides a fruitful diagnostic tool for psychodynamic-oriented clinicians to identify attachment-based deficits and resources for an individual patient in therapy. This paper considers the use of the AAP with a traumatized patient in an inpatient setting and uses a case study to illustrate the components of the AAP that are particularly relevant to a psychodynamic conceptualization. The paper discusses also attachment-based recommendations for intervention.

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

    Science.gov (United States)

    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).

  1. Internet-delivered psychodynamic psychotherapy in the treatment of social anxiety disorder

    OpenAIRE

    Hesslow, Thomas; Nilsson, Maja; Johansson, R.; Färdig, S.; Jansson, A.; Jonsson, L.; Karlsson, J.; Hesser, H.; Ljótsson, B.; Frederick, R.J.; Lilliengren, Peter; Carlbring, Per; Andersson, Gerhard

    2015-01-01

    Social anxiety disorder is one of the most common mental health disorders. Effective treatments exist, but limited access and high costs causes many sufferers to remain untreated. As not all patients accept the CBTmodel of psychopathology, alternative treatments are desirable. We conducted two studies to help establish the efficacy of a psychodynamic model of guided self-help (IPDT). In the first study (N=72) participants were randomized to either ten weeks of IPDT or a waiting list control c...

  2. Essentials of psychoanalytic process and change: how can we investigate the neural effects of psychodynamic psychotherapy in individualized neuro-imaging?

    OpenAIRE

    Heinz eBoeker; André eRichter; Holger eHimmighoffen; Jutta eErnst; Laura eBohleber; Elena eHofmann; Johannes eVetter; Georg eNorthoff

    2013-01-01

    The paper focuses on the essentials of psychoanalytic process and change and the question of how the neural correlates and mechanisms of psychodynamic psychotherapy can be investigated. The psychoanalytic approach aims at enabling the patient to “remember, repeat, and work through” concerning explicit memory. Moreover, the relationship between analyst and patient establishes a new affective configuration which enables a reconstruction of the implicit memory. If psychic change can be achieved ...

  3. 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

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

    Science.gov (United States)

    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."

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Termination of psychotherapy: the journey of 10 psychoanalytic and psychodynamic therapists.

    Science.gov (United States)

    Fragkiadaki, Evangelia; Strauss, Susan M

    2012-09-01

    Literature on termination originates mainly from clinical and theoretical accounts as well as practitioners' autobiographical reports. There is, however, a paucity of psychological research on termination. The purpose of this study is to examine the process of termination of therapy based on therapists' narratives of experiences of endings with patients. Grounded Theory methodology has been applied in this study in order to conceptualize the process of termination from the therapist's perspective. Ten psychoanalytic and psychodynamic therapists were interviewed for this study. Grounded Theory analysis of the data revealed five central categories: therapist as a person, therapist's awareness of termination, development of therapeutic relationship, working through termination, and the aftermath (post-termination phase). The results offer a Grounded Theory model of the therapist's journey through termination of therapy with patients. Subcategories and their relationships will be explored. Implications for clinical practice, limitations and suggestions for further research will be discussed. © 2011 The British Psychological Society.

  7. The effects of the therapist's disengaged feelings on the in-session process in psychodynamic psychotherapy.

    Science.gov (United States)

    Ulberg, Randi; Amlo, Svein; Hersoug, Anne Grete; Dahl, Hanne-Sofie Johnsen; Høglend, Per

    2014-05-01

    The primary aim of this article was to explore the effects of the therapist's disengaged feelings (i.e., bored, tired of, sleepy, indifferent, aloof) in psychodynamic therapy. The Transference Work Scale was used in combination with the Defense Mechanism Rating Scales and Structural Analyses of Social Behavior to explore the in-session process in 2 therapies with female patients with interpersonal problems. Analyses showed differences in in-session processes (i.e., defense mechanisms; transference work; degree of affiliation and interdependence in the dialogue) and treatment outcome between therapies characterized by a low versus a higher degree of disengaged feelings. Compared to the case with the engaged therapist, the disengaged therapist showed poorer interaction and less response to transference and defense interpretation. When aware of their disengaged feelings, therapists are advised to encourage their patients to discuss the patient-therapist interaction. © 2014 Wiley Periodicals, Inc.

  8. Baseline training in cognitive and psychodynamic psychotherapy during a psychologist training program. Exploring client outcomes in therapies of one or two semesters.

    Science.gov (United States)

    Dennhag, Inga; Armelius, Bengt-Åke

    2012-01-01

    This effectiveness study explored the outcomes of 187 clients seen by 187 students undergoing baseline training in psychotherapy. Clients reduced their symptoms (SCL-90) and increased their positive self-image (SASB introject) during the therapy. Multiple regression analyses showed no differences between the cognitive and the psychodynamic training approaches and no differences between one and two semesters duration of the therapies. However, 2-3% of variance in end states was accounted for by the interaction between the variables, indicating a moderating effect of duration in the two approaches. Outcomes for clients in the cognitive training approach were significantly better with two semesters than with one semester, while there was no such difference in the psychodynamic approach. Consequences for baseline training are discussed.

  9. Change in Attachment Dimensions in Women with Binge-Eating Disorder Following Group Psychodynamic Interpersonal Psychotherapy.

    Science.gov (United States)

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

    2017-01-27

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

  10. Integration in the Psychodynamic Psychotherapy of Severe Personality Disorders: The Conversational Model.

    Science.gov (United States)

    Haliburn, Joan; Stevenson, Janine; Halovic, Shaun

    2017-05-17

    The psychotherapy of commonly occurring severe personality disorders-borderline, narcissistic, avoidant, dependent, obsessive compulsive, and schizoid-presents the therapist with a unique therapeutic challenge, as each personality disorder rarely occurs alone. Integration of what is most useful and what works in each model is being proposed to enable a more successful approach to the diversity of presentations. We describe the conversational model, some outcome research, and descriptive studies to illustrate this. Based in psychoanalytic theory, the conversational model is integrated with trauma theory, findings in memory research, linguistics, neurophysiological data, and, above all, on the observations of clinical experiences. Our emphasis in this article is on the treatment principles, methods, and techniques, along with case examples to illustrate what we mean. Case material is taken from audio recordings for which written informed consent was obtained for presentations and journal articles. Some changes have been made to maintain confidentiality.

  11. Significant change events in psychodynamic psychotherapy: Is cognition or emotion more important?

    Science.gov (United States)

    McCarthy, Kye L; Caputi, Peter; Grenyer, Brin F S

    2017-09-01

    Significant change events are helpful moments within a psychotherapy session that have been shown in previous research to relate strongly to outcome. They are special moments and therefore provide rich data for research into understanding therapeutic process. This study investigated clinical and linguistic features of these helpful moments using and comparing both human ratings and computerized text analysis strategies. Significant change events versus non-event passages were studied within 1195 word blocks of transcribed psychotherapy for 20 participants with diagnoses of comorbid depression and personality disorder. Significant events were determined manually by independent raters using the Helpful Aspects of Therapy (HAT) form linked to the Helpful Aspects of Experiential Therapy Content Analysis System (HAETCAS). Mergenthaler's Therapeutic Cycles Model (TCM)-computerized text analysis, identified significant events via linguistic markers. The Linguistic Inquiry and Word Count (LIWC) differentiated emotional and cognitive components. Significant events included statements reflecting emotional and cognitive awareness and insight, and moments of alliance strengthening. These events were saturated with both positive and negative emotion words, particularly anger and sadness, and more cognitive insight words. Significant moments of psychotherapeutic movement featured high therapeutic alliance. There was evidence of the integration or working through of positive and negative emotional content with cognitive insight - meaning both emotion and cognition were important in these interchanges. This study found that significant events in therapy were characterized by high levels of both emotional and cognitive language, and alliance strengthening. Linguistic analysis methods provide important data on psychotherapeutic processes which can be useful in guiding clinicians and improving treatment outcomes. © 2017 The British Psychological Society.

  12. Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: Results of a randomized controlled trial.

    Science.gov (United States)

    de Roten, Yves; Ambresin, Gilles; Herrera, Fabrice; Fassassi, Sylfa; Fournier, Nicolas; Preisig, Martin; Despland, Jean-Nicolas

    2017-02-01

    For severe and chronic depression, inpatient treatment may be necessary. Current guidelines recommend combined psychological and pharmacological treatments for moderate to severe depression. Results for positive effects of combined treatment for depressed inpatients are still ambiguous. This randomised controlled trial examined the efficacy of adding an intensive and brief psychodynamic psychotherapy (IBPP) to treatment-as-usual (TAU) for inpatients with DSM-IV major depressive episode. The primary outcomes were reduction in depression severity, and response and remission rates at post-treatment, 3-month and 12-month follow-up points. A linear mixed model analysis (N=149) showed a higher reduction in the observer-rated severity of depressive symptoms at each follow-up point for the IBPP condition compared with the TAU condition (post-treatment ES=0.39, 95%CI 0.06-0.71; 3-month ES=0.46, 95%CI 0.14-0.78; 12-month ES=0.32, 95%CI 0.01-0.64). Response rate was superior in the IBPP group compared with the TAU group at all follow-up points (post-treatment OR =2.69, 95%CI 1.18-6.11; 3-month OR=3.47, 95%CI 1.47-8.25; 12-month OR=2.26, 95%CI 1.02-4.97). IBPP patients were more likely to be remitted 3 months (OR=2.82, 95%CI 1.12-7.10) and 12 months (OR=2.93, 95%CI 1.12-7.68) after discharge than TAU patients. Heterogeneous sample with different subtypes of depression and comorbidity. IBPP decreased observer-rated depression severity up to 12 months after the end of treatment. IBPP demonstrated immediate and distant treatment responses as well as substantial remissions at follow-up. IBPP appears to be a valuable adjunct in the treatment of depressed inpatients. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ambresin Gilles

    2012-10-01

    Full Text Available Abstract 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

  14. Essentials of psychoanalytic process and change: How can we investigate the neural effects of psychodynamic psychotherapy in individualized neuro-imaging?

    Directory of Open Access Journals (Sweden)

    Heinz eBoeker

    2013-08-01

    Full Text Available The paper focuses on the essentials of psychoanalytic process and change and the question of how the neural correlates and mechanisms of psychodynamic psychotherapy can be investigated. The psychoanalytic approach aims at enabling the patient to remember, repeat and work through concerning explicit memory. Moreover, the relationship between analyst and patient establishes a new affective configuration which enables a reconstruction of the implicit memory. If psychic change can be achieved it corresponds to neuronal transformation.Individualized neuro-imaging requires controlling and measuring of variables that must be defined. Two main methodological problems can be distinguished: The design problem addresses the issue of how to account for functionally related variables in an experimentally independent way. The translation problem raises the question of how to bridge the gaps between different levels of the concepts presupposed in individualized neuro-imaging (e.g. the personal level of the therapist and the client, the neural level of the brain.An overview of individualized paradigms, which have been used until now is given, including Operationalized Psychodynamic Diagnosis (OPD-2 and the Maladaptive Interpersonal Patterns Q-Start (MIPQS. The development of a new paradigm that will be used in fMRI experiments, the Interpersonal Relationship Picture Set (IRPS, is described. Further perspectives and limitations of this new approach concerning the design and the translation problem are discussed.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.; Aalst, van 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

  17. Effects of treatment duration and severity of depression on the maintenance of gains after cognitive-behavioral and psychodynamic-interpersonal psychotherapy.

    Science.gov (United States)

    Shapiro, D A; Rees, A; Barkham, M; Hardy, G; Reynolds, S; Startup, M

    1995-06-01

    One hundred four clients completed a mailed follow-up 1 year after completing 8 of 16 sessions of treatment, either cognitive-behavioral (CB) or psychodynamic-interpersonal (PI) psychotherapy. Although mean scores on outcome measures at 1 year suggested that gains were, in general, well maintained, only 29% of clients were asymptomatic on all 3 occasions of testing (end of treatment, 3 months and 1 year later) without recourse to further treatment. However, only 11% of those asymptomatic at end of treatment experienced relapse or recurrence of depression, albeit on the limited evidence of just two follow-up assessments. The results of comparisons among treatment conditions at 1 year differed substantially from those obtained earlier: Eight-session PI treatment now appeared less efficacious than the other 3 treatment conditions, and there was now no measurable benefit of 16-session over 8-session CB, irrespective of initial severity of depression. These findings confirm the importance of follow-up in evaluation of psychotherapies for depression.

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

    Directory of Open Access Journals (Sweden)

    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

  19. Treatment disrupting behaviors during psychotherapy of patients with personality disorders: the predictive power of psychodynamic personality diagnosis.

    NARCIS (Netherlands)

    Ingenhoven, T.J.; van den Brink, W.; Passchier, J.; Duivenvoorden, H.J.

    2011-01-01

    Background. Behavioral dyscontrol and violations of treatment contracts are serious clinical problems during psychotherapy, especially in treating patients with personality disorders. However, little is known about predictors of these treatment-interfering phenomena. Objective. To identify

  20. Treatment-Disrupting Behaviors during Psychotherapy of Patients with Personality Disorders: The Predictive Power of Psychodynamic Personality Diagnosis

    NARCIS (Netherlands)

    Ingenhoven, Theo J. M.; van den Brink, Wim; Passchier, Jan; Duivenvoorden, Hugo J.

    2011-01-01

    Background. Behavioral dyscontrol and violations of treatment contracts are serious clinical problems during psychotherapy, especially in treating patients with personality disorders. However, little is known about predictors of these treatment-interfering phenomena. Objective. To identify

  1. INTRANASAL ADMINSITRATION OF OXYTOCIN IN POSTNATAL DEPRESSION: IMPLICATIONS FOR PSYCHODYNAMIC PSYCHOTHERAPY FROM A RANDOMIZED DOUBLE-BLIND PILOT STUDY

    Directory of Open Access Journals (Sweden)

    Andrea eCLARICI

    2015-04-01

    Full Text Available Oxytocin is a neuropeptide that is active in the central nervous system and is generally considered to be involved in prosocial behaviors and feelings. In light of its documented positive effect on maternal behaviour, we designed a study to ascertain whether oxytocin exerts any therapeutic effects on depressive symptoms in women affected by maternal postnatal depression. A group of 16 mothers were recruited in a randomized double-blind study: the women agreed to take part in a brief course of psychoanalytic psychotherapy (12 sessions, once a week while also being administered, during the 12-week period, with a daily dose of intranasal oxytocin (or a placebo. The pre-treatment evaluation also included a personality assessment of the major primary-process emotional command systems described by Panksepp (1998 and a semi-quantitative assessment by the therapist of the mother’s depressive symptoms and on her personality. No significant effect on depressive symptomatology was found following the administration of oxytocin (as compared to a placebo during the period of psychotherapy. Nevertheless, a personality trait evaluation of the mothers, conducted in our overall sample group, showed a decrease in the narcissistic trait only within the group who took oxytocin. The depressive (dysphoric trait was in fact significantly affected by psychotherapy (this effect was only present in the placebo group so it may reflect a positive placebo effect enhancing the favorable influence of psychotherapy on depressive symptoms but not in the presence of oxytocin. Based on these results, we confirm our hypothesis that what is generally defined as postnatal depression may include disturbances of narcissistic affective balance, and oxytocin supplementation can counteract that type of affective disturbance.

  2. Psychotherapies

    Science.gov (United States)

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

  3. Therapists' professional and personal characteristics as predictors of outcome in long-term psychodynamic psychotherapy and psychoanalysis.

    Science.gov (United States)

    Heinonen, E; Knekt, P; Jääskeläinen, T; Lindfors, O

    2014-06-01

    Whether long-term psychodynamic therapy (LPP) and psychoanalysis (PA) differ from each other and require different therapist qualities has been debated extensively, but rarely investigated empirically. In a quasi-experimental design, LPP was provided for 128 and PA for 41 outpatients, aged 20-46 years and suffering from mood or anxiety disorder, with a 5-year follow-up from start of treatment. Therapies were provided by 58 experienced therapists. Therapist characteristics, measured pre-treatment, were assessed with the Development of Psychotherapists Common Core Questionnaire (DPCCQ). General psychiatric symptoms were assessed as the main outcome measure at baseline and yearly after start of treatment with the Symptom Check List, Global Severity Index (SCL-90-GSI). Professionally less affirming and personally more forceful and less aloof therapists predicted less symptoms in PA than in LPP at the end of the follow-up. A faster symptom reduction in LPP was predicted by a more moderate relational style and work experiences of both skillfulness and difficulties, indicating differences between PA and LPP in the therapy process. Results challenge the benefit of a classically "neutral" psychoanalyst in PA. They also indicate closer examinations of therapy processes within and between the two treatments, which may benefit training and supervision of therapists. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Transdiagnostic, Psychodynamic Web-Based Self-Help Intervention Following Inpatient Psychotherapy: Results of a Feasibility Study and Randomized Controlled Trial.

    Science.gov (United States)

    Zwerenz, Rüdiger; Becker, Jan; Johansson, Robert; Frederick, Ronald J; Andersson, Gerhard; Beutel, Manfred E

    2017-10-16

    Mental disorders have become a major health issue, and a substantial number of afflicted individuals do not get appropriate treatment. Web-based interventions are promising supplementary tools for improving health care for patients with mental disorders, as they can be delivered at low costs and used independently of time and location. Although psychodynamic treatments are used frequently in the face-to-face setting, there has been a paucity of studies on psychodynamic Web-based self-help interventions. The objective of this study was to determine the feasibility and preliminary efficacy of a transdiagnostic affect-focused psychodynamic Web-based self-help intervention designed to increase emotional competence of patients with mental disorders. A total of 82 psychotherapy inpatients with mixed diagnoses were randomized into two groups. Following discharge, the intervention group (IG) got access to a guided version of the intervention for 10 weeks. After a waiting period of 10 weeks, the wait-list control group (WLCG) got access to an unguided version of the intervention. We reported the assessments at the beginning (T0) and at the end of the intervention, resp. the waiting period (T1). The primary outcome was satisfaction with the treatment at T1. Secondary outcome measures included emotional competence, depression, anxiety, and quality of life. Statistical analyses were performed with descriptive statistics (primary outcome) and analysis of covariance; a repeated measurement analysis of variance was used for the secondary outcomes. Effect sizes were calculated using Cohen d and data were analyzed as per protocol, as well as intention-to-treat (ITT). Patients were chronically ill, diagnosed with multiple diagnoses, most frequently with depression (84%, 58/69), anxiety (68%, 47/69), personality disorder (38%, 26/69), and depersonalization-derealization disorder (22%, 15/69). A majority of the patients (86%, 36/42) logged into the program, of which 86% (31

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Psychotherapy of Mood Disorders

    OpenAIRE

    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. Psychothera...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Schauenburg Henning

    2009-04-01

    Full Text Available Abstract 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

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Clinical Holistic Medicine (Mindful Short-Term Psychodynamic Psychotherapy Complimented with Bodywork in the Treatment of Schizophrenia (ICD10-F20/DSM-IV Code 295 and Other Psychotic Mental Diseases

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available Clinical holistic medicine (CHM has developed into a system that can also be helpful with mentally ill patients. CHM therapy supports the patient through a series of emotionally challenging, existential, and healing crises. The patient’s sense of coherence and mental health can be recovered through the process of feeling old repressed emotions, understanding life and self, and finally letting go of negative beliefs and delusions. The Bleuler's triple condition of autism, disturbed thoughts, and disturbed emotions that characterizes the schizophrenic patient can be understood as arising from the early defense of splitting, caused by negative learning from painful childhood traumas that made the patient lose sense of coherence and withdraw from social contact. Self-insight gained through the therapy can allow the patients to take their bodily, mental, and spiritual talents into use. At the end of therapy, the patients are once again living a life of quality centered on their life mission and they relate to other people in a way that systematically creates value. There are a number of challenges meeting the therapist who works with schizophrenic and psychotic patients, from the potential risk of experiencing a patient's violence, to the obligation to contain the most difficult and embarrassing of feelings when the emotional and often also sexual content of the patient’s unconsciousness becomes explicit. There is a long, well-established tradition for treating schizophrenia with psychodynamic therapy, and we have found that the combination of bodywork and psychotherapy can enhance and accelerate the therapy and might improve the treatment rate further.

  15. Bridging the gap between neuroscientific and psychodynamic models in child and adolescent psychiatry.

    Science.gov (United States)

    Protopopescu, Xenia; Gerber, Andrew J

    2013-01-01

    This article provides a selective review of the neuroscience and child-psychoanalytic literature, focusing on areas of significant overlap and emphasizing comprehensive theories in developmental neuroscience and child psychoanalysis with testable mechanisms of action. Topics include molecular biology and genetics findings relevant to psychotherapy research, neuroimaging findings relevant to psychotherapy, brain regions of interest for psychotherapy, neurobiologic changes caused by psychotherapy, use of neuroimaging to predict treatment outcome, and schemas as a bridging concept between psychodynamic and cognitive neuroscience models. The combined efforts of neuroscientists and psychodynamic clinicians and theorists are needed to unravel the mechanisms of human mental functioning. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. The cost-effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorders during a one-year follow-up.

    Science.gov (United States)

    Maljanen, Timo; Paltta, Paivi; Harkanen, Tommi; Virtala, Esa; Lindfors, Olavi; Laaksonen, Maarit A; Knekt, Paul

    2012-03-01

    Mood and anxiety disorders are characterized by a high and increasing prevalence, they cause a lot of costs and human suffering and there are many treatment options with differing costs. The benefits of identifying the treatments with the most favourable cost-effectiveness ratios can be substantial. However, the number of randomized trials where psychological treatments are compared with each other and where economic aspects, too, are taken into account is still relatively small. To compare the cost-effectiveness of two short-term psychotherapies in the treatment of depressive and anxiety disorders during a one-year follow-up. In the Helsinki Psychotherapy Study, 198 patients, who were 20--45 years of age and met DSM-IV criteria for anxiety or mood disorder, were randomized to short-term psychodynamic psychotherapy (SPP) or solution-focused therapy (SFT). Psychiatric symptoms were assessed at baseline and 4 times during the one-year follow-up from the start of therapy using the Beck Depression Inventory and the Symptom Check List Anxiety Scale, and 2 times using the Hamilton Depression Rating Scales and Hamilton Anxiety Rating Scales. Both direct costs (therapy sessions, outpatient visits, medication, inpatient care) and indirect costs (production losses due to work absenteeism, value of neglected household work, lost leisure time and unpaid help received) due to mental disorders were measured. Mean total costs were compared and incremental cost-effectiveness ratios analyzed. According to all 4 psychiatric outcome measures, symptoms of depression and anxiety were reduced statistically significantly in both therapy groups during the one-year follow-up. The relative changes were about the same size according to all four outcome measures. In both groups the reductions took place mainly in the first half of the follow-up. The reductions were somewhat greater with SPP, but the differences between the two groups were small and not statistically significant at any

  17. Advanced psychotherapy training: psychotherapy scholars' track, and the apprenticeship model.

    Science.gov (United States)

    Feinstein, Robert E; Yager, Joel

    2013-07-01

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

  18. Predictors of non-responding in short-term psychodynamic group therapy

    DEFF Research Database (Denmark)

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

    2017-01-01

    Selection for psychotherapy may be improved by identifying predictors of non-responding to treatment, but there are only few studies of non-responding in short-term psychodynamic group therapy. We analyzed potential socio-demographic and clinical predictors in a sample of 239 patients in 39...... to explore before selection of patients to short-term time-limited psychodynamic group therapy....... sessions of psychodynamic group psychotherapy, including self-reported symptoms, personality, and extra-therapeutic events. Non-responding was assessed by the Symptom Check List-90-Revised Global Severity Index (SCL-90-R GSI) according to Jacobson and Truax’s Reliable Change Index. Non...

  19. A Psychodynamic Psychologist in Community Psychiatry: 14 Years of Experience

    Directory of Open Access Journals (Sweden)

    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.

  20. 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

  1. Therapist-rated outcomes in a randomized clinical trial comparing cognitive behavioral therapy and psychodynamic therapy for major depression

    NARCIS (Netherlands)

    Driessen, E.; Van, H.L.; Peen, J.; Don, F.J.; Kool, S.; Westra, D.; Hendriksen, M.; Cuijpers, P.; Twisk, J.W.R.; Dekker, J.J.M.

    2015-01-01

    Background The efficacy of psychodynamic therapy (PDT) for depression is debated due to a paucity of high-quality studies. We compared short psychodynamic supportive psychotherapy (SPSP) to cognitive behavioral therapy (CBT) in a randomized clinical trial. We used therapist-rated outcomes to examine

  2. Attachment and ownership in psychodynamic psychotherapies

    OpenAIRE

    Sebastião Elyseu Jr; Elisa Medici Pizão Yoshida

    2007-01-01

    O objetivo deste artigo foi o de demonstrar como padrões de apego e de posse aparecem na comunicação transferencial de pacientes em psicoterapias psicodinâmicas e como podem orientar as intervenções do terapeuta. Propõe-se que a posse seja compreendida, de forma complementar à teoria do apego de John Bowlby. Apresentam-se as formulações teóricas do apego e da posse, juntamente com limites e especificidades de cada construto. Em relação especificamente à experiência psicológica da posse, propõ...

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

    OpenAIRE

    Jensen, Hans Henrik; Mortensen, Erik L.; Lotz, Martin

    2013-01-01

    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 and GSI remission according to Danish norms were identified in 239 patients and evaluated according to reliable and clinical significant change. Results. Four major groups of target symptom cases (depression, i...

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

    NARCIS (Netherlands)

    Gersons, Berthold P. R.; Schnyder, Ulrich

    2013-01-01

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

  5. [Psychodynamic hypothesis about suicidality in elderly men].

    Science.gov (United States)

    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.

  6. Psychodynamic treatment, training, and supervision using internet-based technologies.

    Science.gov (United States)

    Fishkin, Ralph; Fishkin, Lana; Leli, Ubaldo; Katz, Barbara; Snyder, Elise

    2011-01-01

    For several years, the China American Psychoanalytic Alliance (CAPA) has provided treatment, training, and supervision to Chinese mental health professionals over the Internet. The lack of Chinese analysts and mentors has created an intense demand for psychodynamic psychotherapy training and treatment that CAPA is addressing using Skype™ and other distance communication technologies. This article describes the project, its history, scope, and activities, and the experiences of CAPA teachers and clinicians in exploring and developing the usefulness and power of this very new teaching method. Some particular characteristics of Chinese culture have become apparent as a result of the teaching experience. Aspects of the transference and countertransference that are shaped by the virtual nature of the technology are discussed, using case material. Our hope is that, in helping to train our Chinese students in psychodynamic psychotherapy, they will go on to train future generations of clinicians. This model of teaching and training could also be applied in other underserved areas.

  7. Psychotherapy of mood disorders.

    Science.gov (United States)

    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.

  8. Review of Psychodynamic diagnostics manual (PDM).

    Science.gov (United States)

    Moses, Ira

    2008-03-01

    Reviews the book, Psychodynamic diagnostics manual (PDM) by Alliance of Psychoanalytic Organizations (2006). This volume is divided into three major sections, Part 1--Classification of Adult Mental Heath Disorder, Part 2--Classification of Child and Adolescent Mental Health Disorder, and Part 3--Conceptual and Research Foundations for a Psychodynamically Based Classification System for Mental Health Disorders. Unlike the standard DSM which highlights the patient's presenting symptom (Axis I) with secondary consideration given to an underlying personality disorder (Axis II), the major thesis of classification scheme of this volume is that diagnostic evaluation should provide a more patient centered and a more clinically useful picture of the individual by understanding the symptom(s) through the essential dimensions of the patient's personality and mental functions (interpersonal and cognitive capacities). Part 3, which could stand on its own as a separate volume, is a thorough critique of psychotherapy outcome research in which the authors delineate how major design flaws have derived from "favoring what is measurable over what is meaningful." The authors cogently demonstrate that diagnostic assessment is a continuous effort toward providing individualized and clinically relevant evaluations. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  9. [Integrated psychotherapy for eating disorders].

    Science.gov (United States)

    Tomizawa, O

    1995-01-01

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

  10. Special population - child and adolescent psychotherapy.

    Science.gov (United States)

    Halasz, George

    2017-06-01

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

  11. Trainee Therapists' Views on the Alliance in Psychotherapy and Supervision: A Longitudinal Study

    Science.gov (United States)

    Ybrandt, H.; Sundin, E. C.; Capone, G.

    2016-01-01

    The shape of alliance in psychotherapy and supervision using growth curve modeling was examined for clinically inexperienced trainee therapists, who were engaged in long-term cognitive behavioral--or psychodynamic individual psychotherapy at a Psychology Clinic in Sweden. Trainee therapists rated their view of the alliance with their clients and…

  12. Treatment of music performance anxiety via psychological approaches: a review of selected CBT and psychodynamic literature.

    Science.gov (United States)

    Nagel, Julie J

    2010-12-01

    Performance anxiety, or stage fright, is anxiety aroused about potential mishaps in performance that expose feared inadequacies before an audience and which evoke feelings of embarrassment and humilation. For affected musicians, performance anxiety can be emotionally devastating, as their career choice in music may be terminated or severely compromised. This paper focuses on the cognitive and psychodynamic literature about music performance anxiety, with the emphasis that for treatment "one size does not fit all." It reviews the factors underlying performance anxiety and those factors which can exacerbate the condition in musicians. The two major clinical treatment modalities within contemporary psychology, cognitive behavior therapy (CBT) and psychodynamic treatments, are reviewed. While there are more empirical studies of CBT in various populations in the literature, until recently there was an indifference to empirical research by psychodynamic investigators. However, meta-analyses show strong efficacy for psychodynamic psychotherapy (in various disorders, not specifically music performance anxiety), but also that the benefits of psychodynamic psychotherapy may endure longer and increase with time.

  13. Succession and survival in psychotherapy organizations.

    Science.gov (United States)

    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.

  14. The efficacy of various modalities of psychotherapy for personality disorders: a systematic review of the evidence and clinical recommendations.

    Science.gov (United States)

    Verheul, Roel; Herbrink, Marjolein

    2007-02-01

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

  15. [Short-Term Psychodynamic Therapy in Depression - An Evidence-Based Unified Protocol].

    Science.gov (United States)

    Steinert, Christiane; Schauenburg, Henning; Dinger, Ulrike; Leichsenring, Falk

    2016-01-01

    With a lifetime prevalence of about 17% depression is the most common mental disorder. Psychotherapy is efficacious in the treatment of depression, with no significant differences between different forms of psychotherapies. For psychodynamic therapy (PDT) various models proved to be efficacious in randomized controlled trials (RCTs). As a consequence the evidence for PDT is scattered between different forms or orientations of PDT entailing problems regarding psychotherapy training and the transfer of research into clinical practice. Thus, our aim was to develop a unified protocol for the dynamic treatment of depression that is based on those models of PDT that proved efficacious in randomized controlled trials (RCTs). As a first step we conducted a systematic search of RCTs investigating manualized or manual-based individual psychodynamic therapy for depressive disorders in adults that proved to be efficacious compared to comparison conditions. 11 studies fulfilled our inclusion criteria. In a second step we systematically reviewed the studies with regard to the treatment concepts they had applied. 7 highly consistent treatment components could be identified. We conceptualized them in the form of 7 interrelated treatment modules which constitute the unified psychodynamic protocol for depression. The protocol may enhance the empirical status of PDT and facilitate both psychotherapy training as well as the transfer of research to clinical practice. Through the focused use of techniques that proofed efficacious it is expected to bring more benefit to depressed patients and therefore also have a positive impact on the health care system. © Georg Thieme Verlag KG Stuttgart · New York.

  16. 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...

  17. Driven sexual behavior in bipolar spectrum patients: psychodynamic issues.

    Science.gov (United States)

    Downey, Jennifer I

    2011-01-01

    Recent psychiatric attention to the bipolar spectrum conditions (Bipolar I, Bipolar II, and Bipolar NOS Disorders in the DSM-IV-TR) has revealed that many more individuals are affected by bipolar disorder (BD) than was earlier appreciated. Increased sexual thoughts, impulses, and risk-taking sexual behavior are recognized symptoms of the bipolar conditions when individuals are manic or hypomanic. There is little scientific information on the prevalence of symptoms of driven sexuality in individuals with the less severe forms of BD as well as those individuals with severer forms of the disorder who are recovering or have recovered from an episode of mania or hypomania. This article discusses the use of developmentally oriented psychotherapy for an individual with a bipolar spectrum condition whose symptoms were well controlled on medications except for her driven sexuality. Current concepts in psychodynamic psychotherapy offer a way to understand and treat sexual symptoms in many individuals with less severe or partially treated BD.

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

    Science.gov (United States)

    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…

  19. Comparative study of emotional experiencing in psychodynamic-interpersonal and cognitive-behavioral therapies.

    Science.gov (United States)

    Wiser, S; Goldfried, M R

    1993-10-01

    Despite increased interest in the role of emotion in the process of psychotherapy, we currently lack a valid gauge of its importance in the change process. Significant sessions obtained from 13 experienced psychodynamic-interpersonal and 17 experienced cognitive-behavior therapists were examined to determine the extent of affective exploration and therapists' views of these client states. Results indicate that affective experiencing is present in equivalent amounts in the change sessions of these two orientations. However, therapists' clinical views were dissimilar. Psychodynamic-interpersonal therapists viewed portions containing higher affective experiencing as more critical to the change process, whereas cognitive-behavior therapists viewed lower levels of experiencing as being therapeutically more significant. These findings suggest that, with regard to emotional experiencing, psychodynamic-interpersonal therapists may share common ground with experiential therapists, whereas cognitive-behavior therapists appear to have a unique perspective.

  20. 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

    Directory of Open Access Journals (Sweden)

    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.

  1. Therapist interventions using the Psychodynamic Interventions Rating Scale (PIRS) in dynamic therapy, psychoanalysis and CBT.

    Science.gov (United States)

    Banon, Elisabeth; Perry, John Christopher; Semeniuk, Trent; Bond, Michael; de Roten, Yves; Hersoug, Anne Grete; Despland, Jean-Nicolas

    2013-01-01

    One requirement for psychotherapy research is an accurate assessment of therapeutic interventions across studies. This study compared frequency and depth of therapist interventions from a dynamic perspective across four studies, conducted in four countries, including three treatment arms of psychodynamic psychotherapy, and one each of psychoanalysis and CBT. All studies used the Psychodynamic Intervention Rating Scales (PIRS) to identify 10 interventions from transcribed whole sessions early and later in treatment. The PIRS adequately categorized all interventions, except in CBT (only 91-93% categorized). As hypothesized, interpretations were present in all dynamic therapies and relatively absent in CBT. Proportions of interpretations increased over time. Defense interpretations were more common than transference interpretations, which were most prevalent in psychoanalysis. Depth of interpretations also increased over time. These data can serve as norms for measuring where on the supportive-interpretive continuum a dynamic treatment lies, as well as identify potentially mutative interventions for further process and outcome study.

  2. Forensic psychotherapy.

    Science.gov (United States)

    Riordan, Daniel

    2017-06-01

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

  3. A systematic review and meta-analysis of cognitive behavioral and psychodynamic therapy for depression in Parkinson's disease patients.

    Science.gov (United States)

    Xie, Cheng-Long; Wang, Xiao-Dan; Chen, Jie; Lin, Hua-Zhen; Chen, Yi-He; Pan, Jia-Lin; Wang, Wen-Wen

    2015-06-01

    Numerous practice guidelines have recommended cognitive behavioral therapy (CBT) and psychodynamic therapy as a treatment of choice for depression in Parkinson's disease (PD). However, no recent meta-analysis has examined the effects of brief psychotherapy (which includes both CBT and psychodynamic therapy) for adult depression in PD. We decided to conduct such a systematic review and meta-analysis. We included randomized controlled trials (RCTs) examining the effects of brief psychotherapy compared with control groups, other support nursing, or pharmacotherapy. The quality of included studies was strictly evaluated. Twelve studies including 766 patients met all inclusion criteria. The result showed that brief psychotherapy could evidently improve the HAMD (p depression in PD patients. But one reason to undermine the validity of findings is high clinical heterogeneity and low methodological quality of the included trials.

  4. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  5. Specificity of psychoanalytic hypotheses regarding the onset of adolescent psychoses: an empirical test of a psychodynamic model.

    Science.gov (United States)

    Kutcher, S; Marton, P; Szalai, J; Kennedy, B

    1992-07-01

    The specificity of psychodynamic hypotheses regarding the onset of adolescent psychosis was assessed in a group of rigorously diagnosed psychotic (N = 75) and depressed (N = 53) adolescents. None of the four operationally defined psychodynamic hypotheses purported to be etiologically specific in the onset of adolescent psychotic illness: success and its opportunities; intimacy and its attempts; intent to act autonomously; or involved in insight-oriented psychotherapy was more commonly observed in the psychotic than the depressed group, thereby not supporting the hypotheses. The consequences of this finding are discussed.

  6. Dreams and fantasies in psychodynamic group psychotherapy of psychotic patients.

    Science.gov (United States)

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

    2013-09-01

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

  7. Games children play: board games in psychodynamic psychotherapy.

    Science.gov (United States)

    Bellinson, Jill

    2013-04-01

    Children of latency age have typically outgrown dramatic play but have not yet developed the ability to talk about their thoughts and feelings in therapy; at this stage they often play structured board games, during their own playtime and during therapy sessions. This article discusses ways to use board-game play therapeutically, by watching the way children stretch and bend the rules to display their psychological self-states, and by interpreting their experiences within the play. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Dream analysis in the psychodynamic psychotherapy of borderline patients.

    Science.gov (United States)

    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.

  9. Psychodynamic psychotherapy for complex trauma: targets, focus, applications, and outcomes

    OpenAIRE

    Spermon, Deborah; Darlington, Yvonne; Gibney, Paul

    2010-01-01

    Deborah Spermon1, Yvonne Darlington1, Paul Gibney21School of Social work and Human Services, The University of Queensland, St. Lucia, QLD, Australia; 2Private Practice, Brisbane, QLD, AustraliaAbstract: Complex trauma describes that category of severe, chronic interpersonal trauma usually originating in the formative years of a child. In the adult, this can result in global dissociative difficulties across areas of cognitive, affective, somatic, and behavioral functions. Targeting this field ...

  10. Empirically supported methods of short-term psychodynamic therapy in depression - towards an evidence-based unified protocol.

    Science.gov (United States)

    Leichsenring, Falk; Schauenburg, Henning

    2014-12-01

    There is evidence that psychotherapy is helpful in depressive disorders, with no significant differences between psychotherapies. For psychodynamic therapy (PDT) various models prove to be efficacious. Thus, the evidence for PDT is "scattered" between different forms of PDT, also implying problems in training of psychotherapy and in transferring research to clinical practice. A unified protocol based on empirically-supported methods of PDT in depression may contribute to solve these problems Systematic search for randomized controlled trials fulfilling the following criteria: (a) individual psychodynamic therapy (PDT) of depressive disorders, (b) treatment manuals or manual-like guidelines, (c) PDT proved to be efficacious compared to control conditions, (d) reliable measures for diagnosis and outcome, and (f) adult patients. Fourteen RCTs fulfilled the inclusion criteria. By a systematic review of the applied methods of PDT seven treatment components were identified. A high consistency between components was found. The components were conceptualized in the form of seven interrelated treatment modules. A unified psychodynamic protocol for depression may enhance the empirical status of PDT, facilitate both the training in psychotherapy and the transfer of research to clinical practice and may have an impact on the health care system. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    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.

  12. [The eclectic individual psychotherapy of a dysthymic patient--case study].

    Science.gov (United States)

    Simon, Witold

    2006-01-01

    The article describes the case of eclectic individual psychotherapy of a dysthymic patient. The therapeutic process integrated elements of the following psychotherapeutic approaches: psychodynamic, behavioural-cognitive, systemic, interpersonal, existential and Gestalt. The paper discusses history of treatment, diagnosis of dysthymia, indications for psychotherapy, course of the sessions. Anamnesis, factors contributing to the disorder, triggers and factors sustaining the symptoms, personality factors were also analysed. Therapeutic goals and applied techniques are presented.

  13. The contemporary psychodynamic developmental perspective.

    Science.gov (United States)

    Malberg, Norka T; Mayes, Linda C

    2013-01-01

    Authors address the transformations taking place in the last 25 years in the theory and practice of developmental psychoanalysis. They emphasize the role of attachment theory in this process and its clinical applications to the work with children and families and the social systems supporting them. The article also describes and explores a move toward an integrative and systemic developmental psychodynamic approach and its relevance to today's practitioner. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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.

  15. Containers, mental space and psychodynamics.

    Science.gov (United States)

    Rosenbaum, B; Garfield, D

    1996-12-01

    The concept of the container has a place within cognitive science as well as within psychodynamic theories. Cognitive semantics has shown that many metaphors giving meaning to daily life-events use the container as a basic reference point. Psychoanalytic theory, most notably, Freud's psychosexual developmental model, illustrates how the container of the body results in meaning. Object relations theory in psychoanalysis has shown how patients with borderline personality disorder behave according to the dynamics of container and containment. Both the cognitive and the psychodynamic conceptions of containers are clinically relevant. The fundamental notion of the container leads to an exploration of 'container dynamics' both in cognitive semantics and in psychodynamic work. A model of the cusp may be of help in the description of the dynamics at the border of the container. Furthermore, the descriptions of the patient's communication of emotion and thoughts may involve three interacting dimensions: an effective-perceptual dimension, a phantasy dimension and a socio-interactive dimension. The interaction between these dimensions has implications for dealing with container dynamics and the process of containment.

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

    Directory of Open Access Journals (Sweden)

    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

  17. Psychotherapy in a changing postindustrial society.

    Science.gov (United States)

    Lesse, S

    1987-07-01

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

  18. A neural systems-based neurobiology and neuropsychiatry course: integrating biology, psychodynamics, and psychology in the psychiatric curriculum.

    Science.gov (United States)

    Lacy, Timothy; Hughes, John D

    2006-01-01

    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. The authors detail the underlying assumptions and outline of a neural systems-based neuroscience course they teach at the National Capital Consortium Psychiatry Residency Program. They review course assessment reports and classroom observations. Self-report measures and teacher observations are encouraging. By the end of the course, residents are able to discuss both neurobiological and psychodynamic/psychological concepts of distributed biological neural networks. They verbalize an understanding that psychology is biology, that any distinction is artificial, and that both are valuable. A neuroscience curriculum founded on the underlying principles of behavioral neurobiology and neuropsychiatry is inherently anti-reductionistic and facilitates the acquisition of detailed information as well as critical thinking and cross-disciplinary correlations with psychological theories and psychotherapy.

  19. Psychotherapy for post-traumatic stress disorder in a young rape ...

    African Journals Online (AJOL)

    This paper describes the psychodynamic psychotherapy of a 20-year-old African woman with post-traumatic stress disorder (PTSD). 'Mphumi' entered therapy a year after her father's friend had repeatedly raped her. The paper documents the process of therapy and uses the case material to examine theoretical issues ...

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

    Science.gov (United States)

    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,…

  1. Impact of Cluster C Personality Disorders on Outcomes of Contrasting Brief Psychotherapies for Depression.

    Science.gov (United States)

    Hardy, Gillian E.; And Others

    1995-01-01

    Study compares 27 depressed clients diagnosed with Cluster C personality disorder (PD) with 87 depressed clients without the diagnosis. All clients completed cognitive-behavioral or psychodynamic-interpersonal psychotherapy. Treatment length did not influence outcome for PD clients. PD clients whose depression was also relatively severe showed…

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

    DEFF Research Database (Denmark)

    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...... to phobic anxiety and anxiety patients, patients with interpersonal sensitivity obtained overall the most optimal outcome. The phobic anxiety scale, social network support, and years of school education were independent predictors of GSI remission, and a low anxiety score and absence of phobic anxiety...... and GSI remission according to Danish norms were identified in 239 patients and evaluated according to reliable and clinical significant change. Results. Four major groups of target symptom cases (depression, interpersonal sensitivity, anxiety, and phobic anxiety) covered 95.7% of the sample. As opposite...

  3. The therapeutic alliance in psychodynamic-interpersonal and cognitive-behavioral therapy.

    Science.gov (United States)

    Raue, P J; Goldfried, M R; Barkham, M

    1997-08-01

    The quality of the therapeutic alliance was compared in sessions of psychodynamic-interpersonal and cognitive-behavioral therapy, and the alliance's relationship to various session impacts was investigated. As part of the Sheffield Psychotherapy Project 2 (D. A. Shapiro, M. Barkham, A. Rees, G. E. Hardy, S. Reynolds, & M. Startup, 1994), 57 clients diagnosed with major depression received 16 sessions of either psychodynamic-interpersonal or cognitive-behavioral therapy. Coders used the Working Alliance Inventory to rate 1 high-impact and 1 low-impact session from each client. Results indicated significantly greater alliance scores for cognitive-behavioral therapy sessions on the whole. Also, for the samples as a whole, high-impact sessions were characterized by higher alliance scores than those for low-impact sessions, and alliance was positively related to therapists' ratings of session depth and smoothness and to clients' ratings of mood.

  4. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  5. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  6. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  7. [Anxiety disorders: which psychotherapy for whom?

    Science.gov (United States)

    Ströhle, A; Fydrich, T

    2018-01-30

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

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

    Science.gov (United States)

    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.

  9. Piperine-loaded chitosan-STPP nanoparticles reduce neuronal loss and astrocytes activation in chemical kindling model of epilepsy.

    Science.gov (United States)

    Anissian, Diana; Ghasemi-Kasman, Maryam; Khalili-Fomeshi, Mohsen; Akbari, Atefeh; Hashemian, Mona; Kazemi, Sohrab; Moghadamnia, Ali Akbar

    2017-09-20

    Recent evidence suggests that encapsulation of hydrophobic drugs in biodegradable polymers opens a new horizon in nanomedicine filed. Piperine, a main alkaloid form of black pepper possesses potent anticonvulsant activity. However, the low water solubility of piperine has limited its clinical application. In this study, piperine was loaded on chitosan-sodium tripolyphosphate nanoparticles (CS-STPP NPs) and the effect of piperine NPs on seizures behavior and astrocytes activation was assessed in pentylentetrazol (PTZ)-induced kindling model. Animals have received the daily injection of free piperine or piperine NPs at doses of 5 or 10mg/kg, 10days before PTZ injections and their intraperitoneally (i.p) administration continued until the last PTZ injection. The neuroprotective effects of piperine NPs were evaluated using nissl staining and immunostaining against NeuN. Astrocytes activation was examined by GFAP immunostaining. Behavioral data showed that piperine NPs have inhibited the development of seizure parameters compared to the free piperine groups. In addition, the levels of cell loss and astrocytes activation were reduced in piperine NPs groups. In conclusion, these data suggest that piperine NPs enhance the neuroprotection and ameliorate the astrocytes activation in chemical kindling model of epilepsy. This may provide an effective therapeutic strategy for the treatment of epilepsy disorder. Copyright © 2017. Published by Elsevier B.V.

  10. [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.

  11. A psychodynamic perspective on elections.

    Science.gov (United States)

    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.

  12. The difficult patient: a psychodynamic perspective

    National Research Council Canada - National Science Library

    Woods, Craig D

    2007-01-01

    Managing the "difficult" patient is a challenge all dentists face. This paper describes a psychodynamic model that pictures the dentist-patient relationship as a two-way interaction that involves unconscious processes...

  13. [The contribution of psychotherapy to a therapeutic approach of bipolar disorders that combines psychotherapy and pharmacotherapy].

    Science.gov (United States)

    Spivacow, Miguel Alejo

    2003-01-01

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

  14. Constructing a systems psychodynamic wellness model

    OpenAIRE

    Sanchen Henning; Frans Cilliers

    2012-01-01

    Orientation: The researchers constructed a Systems Psychodynamic Wellness Model (SPWM) by merging theory and concepts from systems psychodynamics and positive psychology. They then refined the model for application in organisations during a Listening Post (LP) that comprised experienced subject experts.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 fo...

  15. The Dream: A Psychodynamically Informative Instrument

    OpenAIRE

    Glucksman, Myron 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 ...

  16. [What place is there for psychotherapy in public psychiatry?].

    Science.gov (United States)

    Kramer, U; Ambresin, G; de Roten, Y; Fassassi, S; Hedjal, A; Herrera, F; Kolly, S; Pomini, V; Preisig, M; Despland, J-N

    2010-09-22

    The question of the place of psychotherapy in psychiatric public care is posed in this article. We will address this question first by presenting two clinical and research programmes which were implemented in a clinical psychiatric unit, section Karl Jaspers (Service of General Psychiatry) of the Department of Psychiatry CHUV, in Lausanne with the collaboration of the University Institute of Psychotherapy. The first one puts forward psychodynamic psychotherapy of depressed inpatients; the clinical programme and the research questions on efficacy of this treatment are discussed. The second focuses on the early treatment of patients with Borderline Personality Disorder, in particular in its research question on the effect of the motive-oriented therapeutic relationship in this process. We conclude by underlining the convergences of the two programmes.

  17. 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

  18. 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.

    Science.gov (United States)

    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.

  19. [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.

  20. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  1. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  2. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  3. 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.

  4. Transference, transference interpretations, and transference-focused psychotherapies.

    Science.gov (United States)

    Levy, Kenneth N; Scala, J Wesley

    2012-09-01

    The concept of transference and the use of transference interpretations in psychotherapy have been highly controversial topics garnering frequent attention both within psychoanalysis and across multiple orientations of psychotherapy. In this article, we review the empirical evidence as it bears on this controversy and discuss the implications of the evidence for psychoanalysis, psychodynamic psychotherapy, and therapy in general. We provide a brief historical and contextual overview, followed by a discussion of the development of the concept of transference. We then discuss the evidence for the concept of transference from basic psychological research and contend that these findings are not only consistent with a social-cognitive and information processing model, but that they may also indicate conflict and defensive processes suggestive of a dynamic transference process model. We continue with a discussion of the evidence for the concept of transference from psychotherapy research and examine process findings relating to the use of transference interpretations and transference-focused psychotherapies. Finally, we present the implications of this emerging evidence for clinical practice. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  5. Educational Psychotherapy of Preschoolers.

    Science.gov (United States)

    Stein, Myron; Ronald, Doris

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

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

    OpenAIRE

    Janna Ida Fincke; Heidi eMöller; Svenja eTaubner

    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...

  7. Dynamic psychiatry and the psychodynamic formulation

    African Journals Online (AJOL)

    relation to his very successful brother. The fact that he will soon have to start his career is also an ongoing stressor. Non-dynamic factors. A family history of depression points towards the likely contribution of genetic factors in the etiology of his depression. Psychodynamic explanation. • Personality structure. “P” is a sensitive ...

  8. Dynamic psychiatry and the psychodynamic formulation

    African Journals Online (AJOL)

    In her book 'An Unquiet Mind' the psychologist Kay Jamison gives a moving ... Department of Psychiatry, University of Pretoria, Weskoppies Hospital, Pretoria, South Africa. Abstract: This ... psychodynamic formulation is unfortunately seldom incorporated in the psychiatric presentation of patients; guidelines are therefore ...

  9. Parents as change agents: a psychodynamic model.

    Science.gov (United States)

    Zacker, J

    1978-10-01

    A treatment model is described by which psychodynamic clinicians can guide parents to become the primary change agents when their child is the identified patient. Three cases are presented where brief treatment, in which guided clinical interventions were largely carried out by the parents, led to sustained improvement in the child. Advantages of the approach and clinical issues regarding tis application are discussed.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Berthold P. R. Gersons

    2013-12-01

    Full Text Available Brief eclectic psychotherapy for PTSD (BEPP is an evidence-based therapeutic approach that combines and integrates elements from psychodynamic, cognitive-behavioral, and directive psychotherapy. Psychoeducation is done jointly with the patient and his or her partner. Exposure, a structured writing task, and memorabilia are used to help patients accessing, feeling and expressing their suppressed emotions related to the traumatic experience. In the domain of meaning stage, patients will learn how they and their view of the world have changed, and that they have become “sadder but wiser”. Much emphasis is put on the vulnerability of human beings. Finally, an individually tailored farewell ritual is done to end treatment, to reunite with loved ones, and to go on with life.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  12. Outcomes of psychotherapy from the perspective of the users.

    Science.gov (United States)

    Valkonen, Jukka; Hanninen, Vilma; Lindfors, Olavi

    2011-03-01

    Psychotherapy is widely held to be an effective means to decrease depression. It seems, however, that not everyone benefits from every kind of therapy, and the relevant outcomes vary from person to person. In this article, the pre-therapy views and post-therapy experiences of 14 users of either long-term psychodynamic psychotherapy or short-term solution-focused therapy are analyzed. The interviewees' personal views about their depression and therapy are approached with the concept of inner narrative. Three "basic stories" or orientations were found: life historical, situational and moral. These offered people different contexts from which to evaluate the outcomes of their therapy. The findings suggest that a person's expectations, hopes and values are worth taking into account to ensure positive therapy outcomes.

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

    Science.gov (United States)

    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.

  14. Constructing a systems psychodynamic wellness model

    Directory of Open Access Journals (Sweden)

    Sanchen Henning

    2012-01-01

    Full Text Available Orientation: The researchers constructed a Systems Psychodynamic Wellness Model (SPWM by merging theory and concepts from systems psychodynamics and positive psychology. They then refined the model for application in organisations during a Listening Post (LP that comprised experienced subject experts.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.

  15. A psychodynamic model of panic disorder.

    Science.gov (United States)

    Shear, M K; Cooper, A M; Klerman, G L; Busch, F N; Shapiro, T

    1993-06-01

    Current psychiatric research on panic disorder and its treatment are heavily influenced by neurobiological and cognitive-behavioral models rather than psychodynamic propositions, and psychodynamic treatment is generally considered to be of little benefit in amelioration of symptoms. However, because neither of the current models fully explains the clinical psychopathology, etiology, or pathogenesis of panic disorder, there is a need for further model building. The authors suggest that a psychodynamic approach may add to the understanding of patients with panic disorder. They base their psychodynamic formulation on pilot interviews with nine patients with panic disorder, published reports of psychological characteristics of patients with panic disorder, and data from infant and animal research on temperament. Interview results included the following: 1) all of the patients described themselves as fearful, nervous, or shy as children, 2) they remembered their parents as angry, frightening, critical, or controlling, 3) they frequently indicated discomfort with aggression, 4) most described chronic feelings of low self-esteem, 5) their spouses were characterized as passive, kind, and nonaggressive, and 6) stressors associated with frustration and resentment preceded the onset of panic. The authors propose a model in which inborn neurophysiological irritability predisposes to early fearfulness. Exposure to parental behaviors that augment fearfulness results in disturbances in object relations and persistence of conflicts between dependence and independence, which predispose to fears of feeling trapped, suffocated, and unable to escape and/or feeling alone and unable to get help. Catastrophic fears of helplessness in the face of suffocation or abandonment are easily accessible.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. [Bioethics and psychotherapy: which moral assumptions sustain psychotherapeutical acts?].

    Science.gov (United States)

    Figueroa, Gustavo

    2004-02-01

    Since about 1970 biomedical ethics crystallized into a full-fledged discipline. The so called "ethical turn" is a fundamental conceptual challenge for the field of medicine and has generated heated controversy. Today, the ancient psychotherapeutic framework is under the severest strain in its long history. To review the relationship between psychotherapy and the conceptual shift in moral theory. To forge a new model for the patient-physician relationship, speech acts and nature of man derived from a "pragmatic turn" of bioethics. Research findings suggest that behavior, cognitive and psychodynamic psychotherapies are speech-acts constituted by a hierarchy of subordinate acts distributed on three levels: the level of the locutionary act, the act of saying; the level of the illocutionary act (or force), what we do in saying and the level of the perlocutionary act, what we provoke by the fact that we speak. Advances in linguistic research have led to a more sophisticated understanding of how psychotherapy affects ethical issues. These developments point towards a new era of psychotherapeutical theory and practice in which specific modes of psychotherapy can be designed to target specific dilemmas of medical ethics.

  17. Working with boundaries in systems psychodynamic consulting

    Directory of Open Access Journals (Sweden)

    Henk Struwig

    2012-01-01

    Full Text Available Orientation: The researcher described the systems psychodynamics of boundary management in organisations. The data showed how effective boundary management leads to good holding environments that, in turn, lead to containing difficult emotions.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.

  18. [Psychotherapy and efficacy].

    Science.gov (United States)

    Papp, Barbara; Péley, Bernadette

    2015-01-25

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

  19. The effectiveness of short- and long-term psychotherapy on personality functioning during a 5-year follow-up.

    Science.gov (United States)

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

    2015-03-01

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

  20. 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

  1. Transference-focused psychotherapy with former child soldiers: meeting the murderous self.

    Science.gov (United States)

    Draijer, Nel; Van Zon, Pauline

    2013-01-01

    This article describes the application of transference-focused psychotherapy (TFP) to the treatment of former child soldiers suffering from dissociative identity disorder. It focuses on the problems with aggression faced in psychotherapy. TFP provides a psychodynamic, object relations model to understand the aggression arising in psychotherapy, focusing on the transference and countertransference in the here and now of the therapeutic relationship. Aggression is considered an essential and vital inner dynamic aimed at autonomy, distancing, and the prevention of injury and dependency. In extremely traumatized patients there may be aggressive and oppressive inner parts that want total control-identifying with childhood aggressors-thus avoiding vulnerability. According to TFP it is vital that this aggression is addressed as belonging to the patients themselves in order to reach some form of integration, balance, and health. This is illustrated in a case description.

  2. Psychotherapy and Phenomenology

    African Journals Online (AJOL)

    denise

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

  3. The Play of Psychotherapy

    Science.gov (United States)

    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…

  4. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  5. Splitting and Projection: Drawing on Psychodynamics in Educational Psychology Practice

    Science.gov (United States)

    Pellegrini, Dario W.

    2010-01-01

    This paper reflects the author's journey into an area of psychology which is not dominant in Educational Psychology discourse, namely psychodynamic psychology. Two psychodynamic mechanisms, namely splitting and projection are explained, and then the author describes and critiques how these mechanisms have proved useful in his practice. Two case…

  6. Clinical Perspective Psychodynamic aspects of suicidal risk in ...

    African Journals Online (AJOL)

    Two cases of attempted suicide by adolescents, following the separation from an idealised first sexual partner, are presented to illustrate psychodynamic issues often overlooked in clinical assessment. Absent fathers and father figures and other psychodynamic issues are explored. Journal of Child and Adolescent Mental ...

  7. Dynamic psychiatry and the psychodynamic formulation | Böhmer ...

    African Journals Online (AJOL)

    This article aims to describe the difference between descriptive and dynamic psychiatry. As part of the latter every psychiatrist should be able to construct a psychodynamic formulation. A psychodynamic formulation, an indication of psychological mindedness, helps the psychiatrist to recognize the unique, personal aspects ...

  8. Teaching psychodynamic therapy to hardworking psychiatric residents.

    Science.gov (United States)

    Ingram, Douglas H

    2006-01-01

    In practice, the classroom teaching of sequentially developing elements of theory and practice in psychodynamic psychiatry to hardworking residents can founder on residents' frequent absences, on-call pages, late arrivals, and early departures. These obstacles can be partially overcome by focusing narrowly on topics that can be explored within the length of a single lecture. Introduction to dynamic psychiatry can be accomplished in this teaching milieu through application of pedagogical techniques of humor, sharply delineated case material, surprise, group participation, demonstrated immediacy of application, theater, and an avoidance of arcane terminology or nuanced theoretical differences.

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

    Science.gov (United States)

    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

  10. The Effect of Abuse History on Adolescent Patients with Feeding and Eating Disorders Treated through Psychodynamic Therapy: Comorbidities and Outcome.

    Science.gov (United States)

    Strangio, Annamaria M; Rinaldi, Lucio; Monniello, Gianluigi; Sisti, Leuconoe Grazia; de Waure, Chiara; Janiri, Luigi

    2017-01-01

    The first aim of our study was to compare the characteristics and comorbidities of patients with eating disorders between those who suffered from a childhood abuse and those who did not. Our second aim was to analyze the differences in the outcome of the psychodynamic therapy between abused and not abused patients. Twenty-six adolescent patients with eating disorders were assessed. Adolescent were evaluated by a single expert psychiatrist by checklists and questionnaires: EDI 3, SCL 90, BIS11, Dissociative Experiences Scale, Global Assessment of Functioning, SCID II, and CTQ-Self control (SF). According to the results of CTQ-SF (cut-off ≥ 8), patients were divided into two groups: those who had experienced a history of abuse and those who had not. They underwent a psychodynamic psychotherapy and were assessed again after 12 months. Eleven patients (42.3%) had a history of abuse according to CTQ score. No significant differences were found in abused and not abused patients in their demographic, clinical, and comorbid characteristics (sex, age, type of eating disorder, comorbid impulse control, personality, and addictive disorders). Abused patients showed a significantly higher score in many scale. The psychotherapeutic intervention in patients with a history of abuse resulted only in a significant decrease in symptom checklist-90 (SCL-90) psychoticism dimension (p dimensions, the SCL-90 Global Severity Index, the Eating Disorder Inventory-3 interceptive deficits, and the dissociative experience scale. Regarding the first aim of our study, we proved that history of abuse is not significantly related to patient comorbidities. Regarding our second aim, history of abuse was related to patient improvement only for psychotic symptoms; whereas patients who had not experienced an abuse improved in a variety of symptoms. Thus, abuse history can be considered as a negative prognostic factor for patients with eating disorders undergoing dynamic psychotherapy. However

  11. What has happened to the practice of short term dynamic psychotherapy in Australia's mental health services? A multidisciplinary training programme in Western Sydney.

    Science.gov (United States)

    Haliburn, Joan; Baker, Ashley

    2014-10-01

    Short term psychodynamic psychotherapies have been markedly phased out of Australia's mental health services. This paper aims to describe the successful introduction of a Conversational Model of Short Term Intensive Psychodynamic Psychotherapy into a public health service in an attempt to revive its practice. A brief review of relevant papers in the Royal Australian & New Zealand College of Psychiatrists journals since 1980 gives a background to the decline of dynamic psychotherapy in Australia. The development of a Conversational Model of Short Term Intensive Psychodynamic Psychotherapy in the author's private practice over 20 years, and its introduction into a hospital-based training programme are described. A structured programme by scholarship has been offered yearly since 2011 to 10 multidisciplinary mental health clinicians of the Western Sydney Health District. Trainees see two patients from their own service. Over three years, 29 trainees have treated 57 patients with weekly supervision provided. The model has been easily learned. Trainees report a sense of re-invigoration, refinement of existing skills and acquisition of new skills. Resolution of problems in a significant number of patients is noted and improvement and satisfaction reported by others. A valuable service is provided and research is underway. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  12. Social support as a predictor of the outcome of depressive and anxiety disorder in short-term and long-term psychotherapy.

    Science.gov (United States)

    Lindfors, Olavi; Ojanen, Sakari; Jääskeläinen, Tuija; Knekt, Paul

    2014-04-30

    Social support is known to be important for well-being of individuals, but it is not clear how it predicts psychotherapy outcome in patients suffering from depressive or anxiety disorders. The aim of the present study was to study the prediction of social support on the outcome of short-term and long-term psychotherapy. In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term psychotherapy (short-term psychodynamic or solution-focused) or long-term psychodynamic psychotherapy. The level of social support at baseline was assessed using the Brief Inventory of Social Support and Integration (BISSI). Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and four times during a 3-year follow-up. Patients with a high level of social support before treatment benefitted more from long-term than short-term therapy at the 3-year follow-up, whereas patients with a low level of social support experienced no such benefit. Pretreatment social support seems to predict differentially short- and long-term psychotherapy and thus needs to be acknowledged when evaluating patient's resources and treatment options. More research is needed to verify these findings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  14. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  15. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  16. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  17. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  18. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  19. Student Attitudes Toward Psychotherapy

    Science.gov (United States)

    Farber, Barry A.; Geller, Jesse D.

    1977-01-01

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

  20. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  1. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  2. Operationalized Psychodynamic Diagnosis as an instrument to transfer psychodynamic constructs into neuroscience

    Directory of Open Access Journals (Sweden)

    Henrik eKessler

    2013-10-01

    Full Text Available This theoretical article makes a contribution to the field of psychoanalytically informed neuroscience. First, central characteristics of psychoanalysis and neuroscience are briefly described leading into three epistemic dichotomies. Neuroscience versus psychoanalysis display almost opposing methodological approaches (reduction vs. expansion, test quality emphases (reliability vs. validity and meaning of results (correlation vs. explanation. The critical point is to reach an intermediate level: in neuroscience an adequate position integrating both aspects – objective and subjective – of dual-aspect monism, and in psychoanalysis the appropriate level for the scientific investigation of its central concepts. As a suggestion to reach that level in both fields the system of Operationalized Psychodynamic Diagnosis (OPD; OPD Task Force, 2008 is presented. Combining aspects of both fields, expansion and reduction as well as reliability and validity, OPD could be a fruitful tool to transfer psychodynamic constructs into neuroscience. The article closes with a short description of recent applications of OPD in neuroscience.

  3. Public anxiety and health policy: A psychodynamic perspective

    OpenAIRE

    Walsh, Kenneth; Campbell, Steven; Ashby, Michael; Procter, Susan

    2016-01-01

    In this article, we explore how the application of organizational psychodynamic theories might improve the understanding of unconscious forces influencing apparently rational and evidence-based processes such as the generation and implementation of health policy. There is a growing body of literature using psychodynamic theories to explore discontinuities in policy-making and the containment of anxiety in organizations. In this article, we focus on the dyadic relationship between policy forma...

  4. Psychotherapies for Children and Adolescents

    Science.gov (United States)

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

  5. Assessing Attachment in Psychotherapy: Validation of the Patient Attachment Coding System (PACS).

    Science.gov (United States)

    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 by monitoring clients' verbal activity. These results also provide information regarding the ways in which differences in attachment status play out in therapy sessions and further the study of attachment in psychotherapy from a pre-treatment client factor to a process variable. Copyright © 2015 John Wiley & Sons, Ltd. The Patient Attachment Coding System is a valid measure of attachment that can classify clients' attachment based on any single psychotherapy transcript, in many therapeutic modalities Client differences in attachment manifest in part independently of the therapist's contributions Client adult attachment patterns are likely to affect psychotherapeutic processes. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Effectiveness of intensive psychotherapy in a day hospital evaluated with Neurotic Personality Inventory KON-2006.

    Science.gov (United States)

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

    2015-01-01

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

  7. [Future psychotherapists? Vocational plans and motivation for choosing psychotherapy as a career in german psychology students].

    Science.gov (United States)

    Glaesmer, Heide; Spangenberg, Lena; Sonntag, Astrid; Brähler, Elmar; Strauss, Bernhard

    2010-12-01

    in Germany psychology students can be seen as the major personal resource in psychotherapy. Nevertheless there are few studies on their vocational plans and their interest in psychotherapeutic training. 480 psychology students completed a self-developed questionnaire on their career expectations. 90% of respondents report interest in clinical work and psychotherapeutic training. Most frequently they mention improving therapeutic competencies and career options as pros and current training requirements as cons. Their theoretical orientation (38% behaviour therapy, 19% psychodynamic therapy) is associated with their psychotherapeutic knowledge, study conditions and respondent's characteristics. psychology students consider working and training conditions for psychologists and psychotherapists, when thinking about their future career.

  8. 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......-term psychotherapy reflect change in symptomatic state. The MCMI-II Base Rate cut-off points probably include too many patients, justifying the introduction of new scoring procedures in the MCMI-III....

  9. 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.

  10. Introduction: attachment theory and psychotherapy.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  13. Group Psychotherapy in Iceland.

    Science.gov (United States)

    Ívarsson, Ómar

    2015-10-01

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

  14. 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).

  15. 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.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    ) statistically reliable improvement, and 3) clinical significant change (CSC). METHODS: Pre-post treatment naturalistic design based on 236 outpatients with diagnoses of mood (9.7%), neurotic (50.8%), and personality disorders (39.4%). Symptom change was evaluated on the SCL-90-R Global Severity Index (GSI......) 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...... to 1.02 after exclusion of pre-treatment no-cases (ranging from 0.98 to 1.11 in depressed and personality disorder patients, respectively). However, in the GSI pre-treatment case sample, 43.1% were unchanged or deteriorated, 27% reliably improved and 29.9% obtained CSC status (ranging from 23...

  17. The brain's shared circuits of interpersonal understanding: implications for psychoanalysis and psychodynamic psychotherapy.

    Science.gov (United States)

    Pally, Regina

    2010-01-01

    Social Neuroscience maintains that human survival depends on interpersonal relations, and that shared circuits evolved to enhance our ability to interact with and understand other people. Shared circuits operate by re-creating the Other’s experience in the same brain regions used for Self experience. The interpersonal understanding made possible by shared circuits is, for the most part, outside conscious awareness and plays a role in the transference-counter transference interaction. The brain mechanisms of shared circuits are presented and clinical vignettes illustrate the use of the concept of shared circuits in the clinical setting.

  18. Helping alliance and outcome in psychotherapy: what predicts what in routine outpatient treatment?

    Science.gov (United States)

    Puschner, Bernd; Wolf, Markus; Kraft, Susanne

    2008-03-01

    This naturalistic longitudinal study analyzed the reciprocal dependency of the helping alliance and symptom outcome over the course of mid- and long-term outpatient psychotherapy as practiced in routine care in Germany. Patient-rated helping alliance and symptom distress were assessed repeatedly over a 2-year period in a sample of 259 outpatients in psychodynamic, cognitive-behavioral, and psychoanalytic psychotherapy. Hierarchical linear models showed that initial symptom distress negatively predicted subsequent quality of the helping alliance but not vice versa. Only initial symptom distress affected symptom status at the last treatment session. These results raise doubts about the helping alliance being a strong predictor of outcome and indicate that other patient and therapist variables might be more important for treatment success.

  19. [Systemic-psychodynamic model for family evaluation].

    Science.gov (United States)

    Salinas, J L; Pérez, M P; Viniegra, L; Armando Barriguete, J; Casillas, J; Valencia, A

    1992-01-01

    In this paper a family evaluation instrument called systemic-psychodynamic family evaluation model is described. Also, the second stage of the validation study of this instrument is presented (which deals with the inter-observers variation). Twenty families were studied. They were assessed always by the same interviewers designated as experts. They are all family therapy specialists and their assessment was used as the evaluation reference standard or "gold standard". The observers were psychiatrists without previous training in family therapy. For the purpose of the interview, both experts and observers were blind to the medical diagnosis of the patients. During the first stage of the validation study the observers did not have a reference guide which resulted in a low concordance rating. For the second stage, a 177 item guide was used and a considerable increase in the concordance rating was observed. Validation studies like the one used here are of considerable value to increase the reliability and further utilisation of evaluation instruments of this type.

  20. The psychodynamic determinants of Moses and Monotheism.

    Science.gov (United States)

    Wallace, E R

    1977-02-01

    Many writers have commented on the lack of Freud's usual level of logic and powers of persuasion in Moses and Monotheism. The majority attribute it to the significance of dynamic determinants in Freud himself--most notably, identification with Moses. Fromm (1972) says "one must assume that Freud's preoccupation with Moses was rooted in the deep unconscious identification with him" (p. 79). Unfortunately, the situation is much more complex. Although many pertinent observations have been made, what is needed is a detailed dissection of the text, a correlation with elements from Freud's personal life, and an overall psychoanalytic synthesis of the data. This paper makes a beginning in that direction, incorporating the ideas of other investigators with those of the author--but it is hoped that much more detailed analysis and biographical correlation will follow. There is a wealth of information about Freud in Moses and Monotheism and no one paper will exhaust it. In this examination no attempt will be made to evaluate Moses and Monotheism for its literary, psychohistorical, or scientific merit. The focus is on the psychodynamic determinants of Freud's essay.

  1. "Psychotherapy" Versus "Treatment"

    Science.gov (United States)

    Arkowitz, Hal

    2005-01-01

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

  2. Art Therapy Verses Psychotherapy

    Science.gov (United States)

    Del Giacco, Maureen

    2009-01-01

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

  3. Psychotherapy for Suicidal Clients.

    Science.gov (United States)

    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)

  4. Borderline Personality Disorder: Psychotherapy

    Medline Plus

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

  5. Piaget and psychotherapy.

    Science.gov (United States)

    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.

  6. 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…

  7. Psychotherapy and Women's Liberation

    Science.gov (United States)

    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)

  8. What Makes Psychotherapy Humanistic?

    Science.gov (United States)

    Tisdale, John R.

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

  9. Psychodynamics of hypersexuality in children and adolescents with bipolar disorder.

    Science.gov (United States)

    Adelson, Stewart

    2010-01-01

    It has recently become evident that bipolar disorder exists in children and adolescents. The criteria for making the diagnosis of juvenile bipolar disorder (JBD) are in the process of being proposed for the fifth edition of the Diagnostic and Statistical Manual (DSM-V). In adults, a criterion for bipolar disorder is excessive involvement in pleasurable activities including hypersexuality. Recently, some clinicians and researchers have suggested that hypersexuality be included as a criterion for JBD as well. Although abnormal sexuality has been reported to be present in some youth thought to have JBD, the reason for this association is not yet clear. Hypersexuality may be primary and intrinsic to bipolar disorder in youth, secondary and associated with it as the result of psychosocial influences or psychodynamic factors, or due to general aggression and disruptive behavior. Not only have developmental psychosocial factors that may influence sexuality in children and adolescence not been fully investigated, but psychodynamic influences have been omitted from modern etiological constructs as well. This report discusses the importance of psychosocial and psychodynamic influences on the sexual experience and activity of bipolar children. It is proposed that a developmental, psychodynamically informed model is helpful in understanding sexuality in children and adolescents with bipolar disorder. It is also suggested that assessment of psychosocial and psychodynamic influences on the sexuality of bipolar children is necessary in order to adequately assess whether hypersexuality should be a criterion of bipolar disorder in youth.

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

    Science.gov (United States)

    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.

  11. 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

  12. 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...... of the 'self' from the 'world which results in changed abilities in inter-subjective relating to oneself and others. This understanding has led to guidelines for psychotherapists who engage in treatment of psychoses and these are summarized in this article. As a result of the disturbance in the inter......-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...

  13. Narrative and psychotherapy--the phenomenology of healing.

    Science.gov (United States)

    Mishara, A L

    1995-01-01

    In part I, I presented some results of empirical research on mind/body relationship: writing about traumatic experiences brings about improved psychological and physiological health. One important factor of healing in psychotherapy is thereby isolated empirically. In part II, it was shown that the cognitive science explanation of these findings, however, is based on categories deriving from common sense and is insufficient. Phenomenological method can serve as a form of criticism of the assumptions shared by most contemporary approaches to the human mind and brain in psychology, psychiatry, and medicine (e. g. cognitive, psychodynamic, behavioral, and biological). In part III, I presented research and concepts developed in the phenomenological tradition that have bearing on the problem of the healing factor in narrative acts (in writing and speech), including the "talking cure" of psychoanalysis and psychotherapy. I described the problem of the unconscious in narrative acts from the phenomenological point of view and provide an alternative explanation for their healing effects. In short, the way we overcome painful and traumatic experiences is not seen in terms of the cognitive theory in which a painful feeling is "translated" into a cognitive or linguistic representation that organizes it. Such a theory objectifies the human subject. Healing through narration and "opening up," involves an existential act of self-transcendence of an embodied person who organizes his/her experience in time.

  14. Outcome in psychotherapy: the past and important advances.

    Science.gov (United States)

    Lambert, Michael J

    2013-03-01

    Fifty years after the 1963 debate between Strupp and Eysenck, as recorded in their articles in Psychotherapy, it is clear that Eysenck overstated the case against psychoanalysis and dynamic psychotherapy (Bergin, 1971), while inflating the magnitude of improvement in untreated individuals (Lambert, 1976). Eysenck was probably correct about the beneficial effects of behavior therapies, but did not foresee that behavior therapy would be supplanted by cognitive behavior therapies (CBT) and eclectic mixtures of CBT that incorporate elements of eastern religion, humanistic interventions, and psychodynamic constructs. Fortunately, most of the treatments that have been tested in rigorous investigations have been found to be effective, but few have distinguished themselves as uniquely superior. Many of the problems of how to measure the effects of treatment have been solved and suggest that about two thirds of treated individuals improve or recover. This leaves a sizable portion of nonresponding individuals, but emerging methods involving in tracking treatment response are being used to decrease deterioration and enhance positive outcomes.

  15. 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

    2008-04-14

    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.

  16. Sacrifice: psychodynamic, cultural and clinical aspects.

    Science.gov (United States)

    Akhtar, Salman; Varma, Archana

    2012-06-01

    Noting that the topic of sacrifice has remained largely unaddressed in psychoanalytic literature, the authors offer a discussion of it. Their elucidation of sacrifice opens with the definition and etymology of the word and moves on to the place of sacrifice in various religious traditions. They then summarize Freud's views on the topic and suggest that the subsequent analytic contributions have gone in three directions: the first extends and modifies Freud's proposal of triadic-hostile origins of sacrifice, the second locates such origins in dyadic and loving relations, and the third seeks to synthesize the foregoing trends. The authors then delineate the triad of altruism, masochism, and narcissism that underlie sacrifice. They propose that a spectrum of phenomena, ranging from healthy to pathological, is subsumed under the rubric of sacrifice. They also discuss the significance of such ideas to the conduct of psychotherapy and psychoanalysis.

  17. Approche communicative et psychotherapie (The Communicative Approach and Psychotherapy).

    Science.gov (United States)

    Perramond, Daniel B.

    1986-01-01

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

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

    Science.gov (United States)

    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.

  19. Constructivism and psychotherapy.

    Science.gov (United States)

    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.

  20. A STUDY DEMONSTRATING EFFICACY OF A PSYCHOANALYTIC PSYCHOTHERAPY FOR PANIC DISORDER: IMPLICATIONS FOR PSYCHOANALYTIC RESEARCH, THEORY, AND PRACTICE

    Science.gov (United States)

    Busch, Fredric N.; Milrod, Barbara L.; Sandberg, Larry S.

    2013-01-01

    Systematic research on psychoanalytic treatments has been limited by several factors, including a belief that clinical experience can demonstrate the effectiveness of psychoanalysis, rendering systematic research unnecessary, the view that psychoanalytic research would be difficult or impossible to accomplish, and a concern that research would distort the treatment being delivered. In recent years, however, many psychoanalysts have recognized the necessity of research in order to obtain a more balanced assessment of the role of psychodynamic psychotherapy and psychoanalysis in a contemporary treatment armamentarium, as well as to allow appropriate evaluation and potentially greater acceptance by the broader mental health and medical communities. In this context, studies were conducted of a psychodynamic treatment, Panic-Focused Psycho-dynamic Psychotherapy (PFPP), initially in an open trial and then in a randomized controlled trial (RCT) in comparison with a less active treatment, Applied Relaxation Training (ART; Cerny et al. 1984), for adults with primary DSM-IV panic disorder. The results of the RCT demonstrated the efficacy of PFPP in treating panic disorder, and also demonstrated that a psychoanalytic treatment can be systematically evaluated in a mode consistent with the principles of evidence-based medicine. Two specific features of the methodology, the development of the treatment manual and the operationalization of the adherence instrument, both core building blocks of contemporary psychotherapy outcome research, and their implications for psychoanalytic research are discussed in greater depth. The theoretical, clinical, and educational implications of the PFPP studies are elaborated, and suggestions are made for pursuing further outcome research of psychoanalytic treatments. PMID:19270248

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

    Science.gov (United States)

    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.

  2. A psychodynamic understanding of trauma and adolescence - A ...

    African Journals Online (AJOL)

    ... guilt and difficulties with trust, intimacy and safety. This approach highlights the subjective experience of unexpected violence-induced trauma that overwhelms the ego and produces a state of helplessness. Psychodynamic phenomena, such as regression, defenses and the inner world of the adolescent are discussed in ...

  3. Psychodynamics of suicide, with particular reference to the young.

    Science.gov (United States)

    Hendin, H

    1991-09-01

    The article reviews the literature on the psychodynamics of suicide, focusing on factors that will help in evaluating and treating the young suicidal patient. Articles published in refereed journals and books and book chapters based on such articles are the source of most of the material. Articles that first brought a new finding to notice are given preference. Methodological limitations and contradictions with the data of other studies are pointed out. The psychodynamic meaning of suicide for a patient derives from both affective and cognitive components. Rage, hopelessness, despair, and guilt are important affective states in which young patients commit suicide. The meanings of suicide can be usefully organized around the conscious (cognitive) and unconscious meanings given to death by the suicidal patient: death as reunion, death as rebirth, death as retaliatory abandonment, death as revenge, and death as self-punishment or atonement. Knowledge of the psychodynamics helps to distinguish which patients with any given diagnosis are at risk for suicide. Such knowledge is essential to the psychotherapeutic treatment of the young suicidal patient. Topics for future research include the role of anxiety in suicide; the capacity to bear hopelessness, rage, and other unpleasant affects without regression; the use of particular defense mechanisms in distinguishing the risk of either suicidal or violent behavior; and the relation of specific psychodynamic conflicts seen in suicidal patients to particular psychiatric diagnoses.

  4. The Psychodynamics of Mindlessness and Dissent in Small Groups.

    Science.gov (United States)

    Elmes, Michael B.; Gemmill, Gary

    1990-01-01

    Uses psychodynamic perspective to explore tendency of small groups to regress to group mindlessness, where critical thinking is sluggish and individual differences are suppressed. Discusses dynamics of small group mindlessness and the emergence of dissenter role. Suggests ways of enhancing group mindfulness. (Author/TE)

  5. [Review of several different forms of psychotherapy in treatment of depression].

    Science.gov (United States)

    Zogg, W

    2000-02-01

    The present article endeavours to introduce, in a concise form, selected forms of psychotherapy for the treatment of depressions. In particular behaviour therapy (BT), cognitive therapy (CT), interpersonal psychotherapy (IPT) and a psychoanalytically oriented and inspired therapy, subsequently named psychodynamic therapy (PT), are described. The attempt to offer a brief presentation of these treatment methods follows essentially the descriptions of Elizabeth Schramm in her book "Interpersonelle Psychotherapie". We thank the author for giving her kind consent to our publication. Our main concern is to enable the reader to recognize the essential characteristics and differences between these treatment forms, so that he can give the depressive patient advice on the choice of an adequate treatment. The first three brief psychotherapies have been developed specifically for the treatment of depressions. The psychodynamically (psychoanalytically) oriented approach is the most frequently used. CT, BT and IPT in particular have in common that they offer a temporally limited, clearly structured treatment programme in the sense of a manual, and are thus teachable and conveyable and efficient with respect to costs. We would point out, however, that combinations between the different treatment forms are possible and that a strict distinction between the separate methods is chiefly of didactic value. Essential to all treatment methods is the empathic and supporting relation to the patient. The therapist should play an active role and should convey the hope that the patient can be helped. All the described treatment forms are suited for the treatment of light to moderately severe depressions, with or without concomitant psychopharmacological therapy. In psychodynamic therapy the tendency is to dispense with medication, whereas CB, CT and IPT tend to integrate the use of psychoactive drugs in their treatment schedules. In our opinion psychopharmacological treatment should on no

  6. Power Politics of Family Psychotherapy.

    Science.gov (United States)

    Whitaker, Carl A.

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

  7. Social Psychotherapy in Brazil.

    Science.gov (United States)

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

    2015-10-01

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

  8. Of God and Psychotherapy.

    Science.gov (United States)

    Karasu, T Byram

    2015-01-01

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

  9. Autoethnography and Psychodynamics in Interrelational Spaces of the Research Process

    DEFF Research Database (Denmark)

    Dybbroe, Betina; Hansson, Birgitte

    2012-01-01

    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......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...... 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...

  10. Psychodynamic personality profile in first-episode severe mental disorders.

    Science.gov (United States)

    Heikkilä, J; Karlsson, H; Taiminen, T; Lauerma, H; Ilonen, T; Leinonen, K-M; Wallenius, E; Virtanen, H; Heinimaa, M; Kaljonen, A; Salokangas, R K R

    2004-03-01

    The aim of this study was to relate measures of psychoanalytically derived personality traits to descriptive diagnosis and psychopathology in severe mental disorders. Sixty-one consecutive first-episode patients with schizophrenia, bipolar disorder and severe major depression were interviewed. Personality traits were assessed with the Karolinska Psychodynamic Profile (KAPP) and compared with the DSM-IV diagnosis and symptom clusters derived from the BPRS. There were no marked differences in personality traits between the three diagnostic groups, between schizophrenia and affective disorders or between psychotic and non-psychotic illness. However, personality traits had significant associations with symptoms, especially with the emotional retardation cluster. Our findings do not support the hypothesis that severe mental disorders would differ from each other in terms of long-standing psychodynamic personality profiles. Certain dysfunctional personality traits may predict especially negative emotional symptoms and possibly also predispose a person to them.

  11. Viewing the Disney Movie Frozen through a Psychodynamic Lens.

    Science.gov (United States)

    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.

  12. Empathy deficit in antisocial personality disorder: a psychodynamic formulation.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  14. 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.

  15. Evidence for the effectiveness of jungian psychotherapy: a review of empirical studies.

    Science.gov (United States)

    Roesler, Christian

    2013-12-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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.

  18. What is the role of psychotherapy in the treatment of bipolar disorder?

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

    1998-01-01

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

  19. [Emotional stress psychotherapy].

    Science.gov (United States)

    Rozhnov, V E

    1989-01-01

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

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

    Science.gov (United States)

    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

  1. 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. 

  2. Motivating Institutionalized Adolescents for Psychotherapy.

    Science.gov (United States)

    Ranieri, Daniel J.

    1984-01-01

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

  3. PSYCHOTHERAPY SUPPORT ON SCIZOPHRENIA

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    Widyawati Suhendro

    2013-12-01

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

  4. 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.

  5. Systems-Psychodynamics in Schools: A Framework for EPs Undertaking Organisational Consultancy

    Science.gov (United States)

    Eloquin, Xavier

    2016-01-01

    This article considers how a framework for understanding group and organisational behaviour, systems-psychodynamics, can be utilised by educational psychologists taking up an organisational consultancy role to work with schools as whole systems. It outlines the three main theories that constitute a systems-psychodynamic perspective and considers…

  6. The center core in ego state therapy and other hypnotically facilitated psychotherapies.

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    Frederick, Claire

    2013-07-01

    Center core phenomena have been utilized in the practice of ego state therapy and other forms of hypnotically facilitated psychotherapy for nearly 40 years. Despite the frequency with which they are employed, many confusions, contradictions, and questions remain concerning them. In this article relevant center core phenomena literature is reviewed and an essential differentiation between two different kinds of center core phenomena is clarified. Psychodynamic explanations are offered for the therapeutic benefits of archetypal center core experiences such as inner strength and inner wisdom. The information provided offers clinicians a sturdier platform from which to decide whether to incorporate center core experiences into clinical practice. The persistent question of whether center core phenomena are ego states is revisited and addressed.

  7. Ego-structuring psychotherapy.

    Science.gov (United States)

    Villemoes, Palle

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Henk Greyvenstein

    2012-01-01

    Full Text Available Orientation: Followers’ experiences of leadership in their organisations were qualitatively explored and described from a systems psychodynamic perspective. The findings revealed a very negative view on how leadership treats followership, and that leadership is seen as inconsistent.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.

  9. Executive coaching in diversity from the systems psychodynamic perspective

    Directory of Open Access Journals (Sweden)

    Lerato Motsoaledi

    2012-01-01

    Full Text Available Orientation: The researcher applied role analysis from the systems psychodynamic perspective to executives in state departments to improve their awareness of the unconscious diversity dynamics that affect their roles.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.

  10. Psychogenic voice disorders in performers: a psychodynamic model.

    Science.gov (United States)

    Rubin, John S; Greenberg, Maurice

    2002-12-01

    Psychogenic voice disorders are not infrequently encountered in the busy voice clinic. A clinician-friendly psychodynamic model and a multidisciplinary management approach are presented which have proven helpful for our voice team and our patients. In essence the formulation revolves around an "event" occurring, which may be either organic or psychological in nature. The ensuing dysphonia then leads to emotional consequences which in turn have physical consequences on the vocal tract. The situation can become reinforcing and illness behaviors develop. Elucidating this event/process to the patient improves the likelihood of a successful long-term outcome. The diagnostic and management roles of the various team members are discussed.

  11. Psychodynamic Factors Behind Online Social Networking and its Excessive Use.

    Science.gov (United States)

    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.

  12. Conducting psychotherapy with an interpreter.

    Science.gov (United States)

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

    2015-06-01

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

  13. [Method of existence analytic psychotherapy].

    Science.gov (United States)

    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.

  14. [Psychology and psychotherapy in bipolar disorder].

    Science.gov (United States)

    Kupka, R W; de Been, D

    2006-01-01

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

  15. Short-term residential psychotherapy: psychotherapy in a nutshell.

    Science.gov (United States)

    Bolten, M P

    1984-01-01

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

  16. A systems psychodynamic description of organisational bullying experiences

    Directory of Open Access Journals (Sweden)

    Frans Cilliers

    2012-01-01

    Full Text Available Orientation: Organisational bullying experiences manifest themselves as an intense unconscious systemic dynamic involving the bully, the victim and the organisational culture. The relatedness between the objects is characterised by valences and mutual defence mechanisms such as splitting, projection and projective identification.Research purpose: The purpose of this research was to describe organisational bullying experiences from the system psychodynamic perspective.Motivation for the study: Individual psychology tends to simplify organisational bullying by focussing on the bully’s symptomatic behaviour. Systems psychodynamic thinking focuses on the behavioural dynamics in the relationship between the bully and victim, and the relatedness of both with the organisational system.Research design, approach and method: Qualitative and descriptive research, using six participants as case studies, was undertaken. Data was gathered through Free Association Narrative Interviewing and analysed using discourse analysis.Main findings: Three themes manifested themselves, namely, snakes and hyenas, a complex interconnected dyad, and the institutionalisation of bullying. The research hypothesis integrating these three themes was presented.Practical/managerial implications: In resolving organisational bullying Industrial Organisational psychologists need to pursue this phenomenon not only in terms of its symptoms, but in a holistic, systemic and role related manner addressing all of its parts.Contribution/value-add: The systemic understanding of organisational bullying implies the complexity of studying the behaviour of all parts – the bully, the victim, their dyadic relationship as well as how bullying is institutionalised in the organisational setting, climate and culture.

  17. The systems psychodynamic experiences of organisational transformation amongst support staff

    Directory of Open Access Journals (Sweden)

    Martin Steyn

    2016-04-01

    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.

  18. Eating disorders and attachment: a contemporary psychodynamic perspective.

    Science.gov (United States)

    Tasca, Giorgio A; Balfour, Louise

    2014-06-01

    A contemporary psychodynamic framework can add much to our understanding of eating disorders. Eating disorders are associated with complex comorbidities, high levels of mortality, and therapist countertransferences that can complicate psychological treatments. Mainstream models currently focus on cognitive, biological, or cultural factors to the near exclusion of attachment functioning, and the individual's dynamics. As such, standard models appear to exclude person-centred and developmental considerations when providing treatments. In this article, we describe a contemporary psychodynamic model that understands eating disorder symptoms as a consequence of vulnerability to social pressures to be thin and biological predispositions to body weight. Individual vulnerabilities are rooted in unmet attachment needs causing negative affect, and subsequent maladaptive defenses and eating disorder symptoms as a means of coping. We describe how this model can inform transdiagnostic eating disorder treatment that focuses on symptoms as well as specific attachment functions including: interpersonal style, affect regulation, reflective functioning, and coherence of mind. Two clinical examples are presented to illustrate case formulations and psychological treatments informed by these conceptualizations.

  19. [THE MANIC DEPRESSIVE DISEASE: PSYCHODYNAMICS ASPECTS AND AFFECTIVE SYNTONY].

    Science.gov (United States)

    Widakowich, Christian

    2015-01-01

    In a time when manic-depressive disease became bipolar disorder, and it is conceptualized and treated almost as a fully medical illness, such as epilepsy, we found worth returning to some psychodynamic aspects underlying this condition. Conventionally, we depart from the concept of melancholy, to introduce in a second time, the mania, as a liberating solution of the depression. To Abraham (1912), mania is the liberation from suffering imposed by the reality principle For Freud (1915), mania becomes a leak from the ego face a tyrannical superego (the encounter of ego and the ego ideal). Klein (1934) explains that the mania serves to counter the depressive position and thus avoid the guilt inside of ego. For Racamier (1979), mania is clearly a frantic negation of the anguish and emotional suffering. Today, some authors as Chabot and Husain try to define the manic depression organization, with the help of projective tests. This personality structure would be between psychosis and borderline. An axial element of this structure is the research for an affective symbiosis with each other. These concept, strongly resemble the "syntony", from Bleuler. We trace the evolution of manic depression from a psychodynamic and structural point of view, with particular interesting in the concept of syntony.

  20. Neuroimaging for psychotherapy research: Current trends

    Science.gov (United States)

    WEINGARTEN, CAROL P.; STRAUMAN, TIMOTHY J.

    2014-01-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  3. The current status of psychotherapy

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2017-11-03

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

  5. Culture and demoralization in psychotherapy.

    Science.gov (United States)

    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

  6. Ayurvedic concepts related to psychotherapy.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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 was the only MCMI personality scale showing significant change when the SCL-90-R Depression change score was included as a covariate. Splitting patients into those with and without personality disorders did not change the results. Observed changes on MCMI-II personality disorder scales in short-term psychotherapy reflect change in symptomatic state. The MCMI-II Base Rate cut-off points probably include too many patients, justifying the introduction of new scoring procedures in the MCMI-III.

  8. The enduring effects of psychodynamic treatments vis-a-vis alternative treatments: A multilevel longitudinal meta-analysis

    Science.gov (United States)

    Kivlighan, D. Martin, III

    Although evidence suggests that the benefits of psychodynamic treatments are sustained over time, presently it is unclear whether these sustained benefits are superior to non-psychodynamic treatments. Additionally, the extant literature comparing the sustained benefits of psychodynamic treatments compared to alternative treatments is limited with methodological shortcomings. The purpose of the current study was to conduct a rigorous test of the growth of the benefits of psychodynamic treatments relative to alternative treatments across distinct domains of change (i.e., all outcome measures, targeted outcome measures, non-targeted outcome measures, and personality outcome measures). To do so, the study employed strict inclusion criteria to identify randomized clinical trials that directly compared at least one bona fide psychodynamic treatment and one bona fide non-psychodynamic treatment. Hierarchical linear modeling (Raudenbush, Bryk, Cheong & Congdon, du Toit, 2011) was used to longitudinally model the impact of psychodynamic treatments compared to non-psychodynamic treatments at post-treatment and to compare the growth (i.e., slope) of effects beyond treatment completion. Findings from the present meta-analysis indicated that psychodynamic treatments and non-psychodynamic treatments were equally efficacious at post-treatment and at follow-up for combined outcomes ( k = 20), targeted outcomes (k =19), non-targeted outcomes (k =17), and personality outcomes (k =6). Clinical implications, directions for future research, and limitations are discussed.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. CRITICAL REVIEW OF OUTCOME RESEARCH ON INTERPERSONAL PSYCHOTHERAPY FOR ANXIETY DISORDERS

    Science.gov (United States)

    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

  12. Critical review of outcome research on interpersonal psychotherapy for anxiety disorders.

    Science.gov (United States)

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

    2014-04-01

    Interpersonal psychotherapy (IPT) has demonstrated efficacy in treating mood and eating disorders. This article critically reviews outcome research testing IPT for anxiety disorders, a diagnostic area where cognitive behavioral therapy (CBT) has dominated research and treatment. A literature search identified six open and five controlled trials of IPT for social anxiety disorder (SAD), panic disorder, and posttraumatic stress disorder. Studies were generally small, underpowered, and sometimes methodologically compromised. Nonetheless, minimally adapted from its standard depression strategies, IPT for anxiety disorders yielded positive results in open trials for the three diagnoses. In controlled trials, IPT fared better than waiting list (N = 2), was equipotent to supportive psychodynamic psychotherapy (N = 1), but less efficacious than CBT for SAD (N = 1), and CBT for panic disorder (N = 1) in a methodologically complicated study. IPT equaled CBT in a group residential format (N = 1). IPT shows some promise for anxiety disorders but has thus far shown no advantages in controlled trials relative to other therapies. Methodological and ecological issues have complicated testing of IPT for anxiety disorders, clouding some findings. The authors discuss difficulties of conducting non-CBT research in a CBT-dominated area, investigator bias, and the probable need to further modify IPT for anxiety disorders. Untested therapies deserve the fairest possible testing. © 2014 Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2015-01-01

    Aim: 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. 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, 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. Results: 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. Conclusion: 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. PMID:26106347

  14. 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.

  15. Assessing psychopathology from a structural perspective: A psychodynamic model.

    Science.gov (United States)

    Trimboli, Frank; Marshall, Rycke L; Keenan, Charles W

    2013-01-01

    This article presents a guide for conceptualizing psychological difficulties across the broad spectrum of personality and symptom disorders. A psychodynamic model is used to organize these disorders along a structural continuum of severity. The authors propose that seven key indices of personality functioning be evaluated: cognition, affect, self-object relations, interpersonal relations, defenses, superego functioning, and primary dynamics. The results are then employed to determine where the patient should be placed along a continuum of nine diagnostic categories of ego development and their associated disorders. These include "normal," neurotic trait, and neurotic symptom organization; high-, mid-, and low-level borderline organization; and affective, cognitive-affective, and cognitive psychotic organization. An accurate evaluation of the seven variables will permit a more precise formulation of the nature and severity of the patient's difficulties, which will hopefully result in more accurate and appropriate treatment planning. Examples of the application of this model to a common symptom complaint are provided.

  16. [Psychodynamic consequences of a family history with psychiatric disorders].

    Science.gov (United States)

    Bouwkamp, C G; den Berg, M P Lambregtse-Van; Kievit, A J A; Kushner, S A

    A positive family history for psychiatric disorders is the most important risk indicator for developing psychopathology. Often, the psychological consequences of a positive family history are insufficiently acknowledged. AIM: To provide insight into the psychodynamics of children who grow up in a family with psychopathology, such as psychosis, to demonstrate how these effects can last a lifetime, and to suggest ways in which such effects might be prevented. METHOD: We review the relevant literature, discuss theoretical concepts, and make clinical recommendations. RESULTS: Parental psychopathology, including psychosis, can have a strong and lasting influence on the child's identity and sense of self. CONCLUSION: A positive family history for psychiatric disorders has the potential to seriously disrupt the normal development of identity and sense of self. Various types of psychosocial interventions might be able to reduce these harmful effects.

  17. Clinical Case Studies in Psychoanalytic and Psychodynamic Treatment

    Science.gov (United States)

    Willemsen, Jochem; Della Rosa, Elena; Kegerreis, Sue

    2017-01-01

    This manuscript provides a review of the clinical case study within the field of psychoanalytic and psychodynamic treatment. The method has been contested for methodological reasons and because it would contribute to theoretical pluralism in the field. We summarize how the case study method is being applied in different schools of psychoanalysis, and we clarify the unique strengths of this method and areas for improvement. Finally, based on the literature and on our own experience with case study research, we come to formulate nine guidelines for future case study authors: (1) basic information to include, (2) clarification of the motivation to select a particular patient, (3) information about informed consent and disguise, (4) patient background and context of referral or self-referral, (5) patient's narrative, therapist's observations and interpretations, (6) interpretative heuristics, (7) reflexivity and counter-transference, (8) leaving room for interpretation, and (9) answering the research question, and comparison with other cases. PMID:28210235

  18. The relationship between transformational leadership psychodynamic attributes, behaviour and effectiveness: towards authentic leadership

    OpenAIRE

    2012-01-01

    D.Comm. The globalisation of the South African economy since 1994 has emphasised the need for a new form of leadership, with specific emphasis on authentic and transformational leadership. By understanding the psychodynamic aspects that drive the transformational leader organisations will be able to identify and develop transformational leaders. A real need exists to understand the psychodynamic attributes of transformational leaders and how these attributes affect their behaviour and effe...

  19. The beneficial demands of conducting psychotherapy.

    Science.gov (United States)

    Hayes, Jeffrey A

    2014-08-01

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

  20. Attachment, ethology and adult psychotherapy.

    Science.gov (United States)

    Sable, Pat

    2004-03-01

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

  1. Implementing Dynamic Assessments in Psychotherapy.

    Science.gov (United States)

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

    2016-08-01

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

  2. [Problems of bilinguism in psychotherapy].

    Science.gov (United States)

    Fadda, S; Müller, C

    1978-01-01

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

  3. Personal construct psychotherapy of addictions.

    Science.gov (United States)

    Klion, R E; Pfenninger, D T

    1997-01-01

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

  4. Interpersonal Psychotherapy for Postnatal Anxiety Disorder.

    Science.gov (United States)

    Chung, J P Y

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  6. The systems psychodynamic leadership coaching experiences of nursing managers

    Directory of Open Access Journals (Sweden)

    Landa Terblanche

    2010-03-01

    Full Text Available The mostly linear and mechanistic nature of the nursing manager role is rapidly becoming more dynamic and systemic. The change involves task and people management within a constantly changing organisational identity, taking up multiple leadership roles, having to authorise oneself and others in a complex matrix system, and managing conscious and unconscious psychological boundaries within and between conflicting systems. The aim of this study was to describe the systems psychodynamic learning experiences of nursing managers during leadership coaching. The coaching task was to provide learning opportunities to the individual leader, towards gaining insight into conscious and unconscious leadership dynamics in terms of anxiety, task, role, authorisation, boundaries and identity. A qualitative research design was used. Six nursing managers attended ten leadership coaching sessions over ten weeks. Field notes and reflective essays were analysed using systems psychodynamic discourse analysis. The findings indicated clarity and authorisation in the participants’ primary task and normative roles; anxiety and de-authorisation in their experiential and phenomenal roles; anxiety in boundary management related to the misuse of power by others; and the continuous exploration of their leadership role identity towards achieving integration. Participants’ learning experiences were evaluated in terms of criteria for organisational learning, after which a general hypothesis was formulated.

    Opsomming

    Die meestal liniêre en meganistiese aard van die verpleegbestuursrol is vinnig besig om na ’n meer dinamiese en sistemiese rol te verander. Die verandering behels taak- en mensbestuur binne 'n steeds veranderende organisasie-identiteit, waar 'n verskeidenheid rolle opgeneem word, die self en ander in 'n komplekse matrikssisteem bemagtig word, en waartydens bewuste en onbewuste sielkundige grense in en tussen botsende sisteme bestuur

  7. Leadership Development From A Systems Psychodynamic Consultancy Stance

    Directory of Open Access Journals (Sweden)

    W. J. De Jager

    2003-11-01

    Full Text Available This research aims to measure the impact of a leadership development programme presented from the systems psychodynamic stance. The aim was to develop psychoanalytically informed change leaders to lead change and transformation in the continuously changing and transforming New Economy network organisation. In order to do this, a group relations training programme was presented for 30 leaders. Qualitative assessment using grounded theory during post-intervention focus groups interviewing indicated the group’s awareness of psychodynamic leadership behaviour such as the regression towards frequent pathological leadership personality characteristics, regression towards unconscious group- and organizational processes such as the basic assumption group, the covert coalition and socially structured defense systems against change and transformation. Insight was also gained in the new leadership role and the taking up of personal authority in the network organisation that needs to function as a systemic whole. Limitations in the study are noted and Recommendations are made to enhance change leader skills for leadership in the New Economy network organisation. OpsommingHierdie navorsing poog om die impak van ‘n leierskapsontwikkelingsprogram wat aangebied is vanuit die sistemiese psigodinamiese perspektief, te evalueer. Die doel was om psigoanalitiese ingeligte leiers te ontwikkel om verandering en transformasie in die gedurige veranderende en transformerende Nuwe Ekonomie netwerk organisasie, te lei. Ten einde dit te bolwerk is. ‘n Groep -verhoudinge-opleidingsprogram is aangebied vir 30 leiers. Kwalitatiewe evaluasie deur van begrondingsteorie gebruik te maak gedurende, die post-intervensie fokus groepe het ‘n groepbewustheid aangedui van psigodinamiese leierskapgedrag soos die regressie na dikwelse patologiese leierskapspersoonlikheidskenmerke, regressie in onbewustelike groep- en organisatoriese prosesse soos die basiese aanname-groep, die

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

    Science.gov (United States)

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

    2017-12-06

    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.

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

    African Journals Online (AJOL)

    QuickSilver

    2003-05-20

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

  10. 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, ...

  11. Treatment resistance and psychodynamic psychiatry: concepts psychiatry needs from psychoanalysis.

    Science.gov (United States)

    Plakun, Eric

    2012-06-01

    Over the last 30 years psychiatry and psychoanalysis have moved in substantially divergent directions. Psychiatry has become rich in methodology but conceptually limited, with a drift toward biological reductionism. Psychoanalysis has remained relatively limited in methodology, but conceptually rich. The rich methodology of psychiatry has led to major contributions in discovering gene by environment interactions, the importance of early adversity, and to recognition of the serious problem posed by treatment resistance. However, psychiatry's biologically reductionistic conceptual focus interferes with the development of a nuanced clinical perspective based on emerging knowledge that might help more treatment resistant patients become treatment responders. This article argues that recognition of the problem of treatment resistance in psychiatry creates a need for it to reconnect with the conceptual richness of psychoanalysis in order to improve patient care. Psychodynamic psychiatry is defined as the relevant intersection of psychiatry and psychoanalysis where this reconnection can occur. I will suggest selected aspects of psychoanalysis that are especially relevant to psychiatry in improving outcomes in work with treatment resistant patients.

  12. A developmental-psychodynamic model for diabetic control.

    Science.gov (United States)

    Viederman, M; Hymowitz, P

    1988-01-01

    This paper elaborates a psychodynamic-developmental model as a framework for understanding the wide range of adaptive and maladaptive responses to the self-care requirements of diabetes. Early life experience participates with other factors in influencing the ease with which diabetics implement diabetic control. This model emphasizes the importance of the mother-child interaction during the second phase of development, the toddler phase, at which time the child begins to establish a sense of autonomy and control over his own body and its functions, with bowel training viewed as a paradigm for body control. It is postulated that certain types of mothers such as controlling-intrusive mothers, overprotective mothers, or guilty, indifferent, or rejecting mothers create problems for the child related to the development of autonomy and the sense of comfortable and pleasurable control over his bodily functions. Conflicts generated during this period are reactivated with the onset of diabetes and lead to difficulty in implementing control. In some situations where conflicts with the caretaker figure were predominantly limited to aspects of control, trusting relations acted as a substrate for change and improvement in control in a supportive medical environment. Specific management recommendations based upon this model are presented.

  13. Synchrony in Dyadic Psychotherapy Sessions

    Science.gov (United States)

    Ramseyer, Fabian; Tschacher, Wolfgang

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

  14. Psychotherapy in the aesthetic attitude.

    Science.gov (United States)

    Beebe, John

    2010-04-01

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

  15. The Subject in Cognitive Psychotherapy

    Directory of Open Access Journals (Sweden)

    Isabel Caro-Gabalda

    2015-05-01

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

  16. [New directions for psychotherapy research: an evaluation of a research protocol and a methodological and technical framework proposal].

    Science.gov (United States)

    Briffault, X; Thurin, M; Lapeyronnie, B; Thurin, J-M

    2007-12-01

    A recent report of the French research institute INSERM, based on a comprehensive review of the work done on the evaluation of psychotherapies Psychothérapies: trois approches évaluées, has shown the lack of research in France on this topic, notably in psychodynamic psychotherapy. The development of such research is needed. The first part of the paper deals with the limits of the third generation of studies on psychotherapy (medical model, use of RCT, DSM...) on which the INSERM report is based and reviews the existing propositions for a fourth generation of research in the field. METHODOLOGICAL FINDINGS: In the second part, a process-outcome research protocol developed by the authors, according to these new proposals as well as several on-going researches [J Clin Psychol, 27 2 (1998) 217-26, J Pragm Case Stud 3 (2000)(2), Arch Gen Psychiatry 59 (2002) 505-10, Psychother Res 12 3 (2002) 251-72 and Br J Psychiatry 165 (1994) 4-8] is presented. The proposed methodology is based on controlled single case studies. Quantitative and qualitative data are associated for the definition of the diagnosis, as well as initial, intermediate and final measures. Process analysis is used to describe the main characteristics of the on-going psychotherapy at different moments in time. It is thus possible to gain access to what is really done during the therapy and not only to what is supposed to be done, based on a manual or even on the name of the theory used by the therapist. This methodology was tested during a one-year pilot study, in true conditions of psychotherapy with outpatients. The different phases of the analysis are presented: several tools dedicated to the observation, formalisation and data analysis are integrated in a coherent iterative process during the whole therapy. The interests and limits of each tool (ESM, DSM, PPQS, Hoglend, CORE...) are described together with the first results of the pilot study. The overall architecture of a database designed to collect

  17. Predictors of discharge in child psychoanalytic psychotherapy

    Directory of Open Access Journals (Sweden)

    Izabel Cristina Paez

    2015-06-01

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

  18. Effectiveness of routine psychotherapy: Method matters.

    Science.gov (United States)

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

    2017-11-02

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

  19. Long-term course in female survivors of childhood abuse after psychodynamically oriented, trauma-specific inpatient treatment: a naturalistic two-year follow-up.

    Science.gov (United States)

    Lampe, Astrid; Hofmann, Peter; Gast, Ursula; Reddemann, Luise; Schüßler, Gerhard

    2014-01-01

    This study examined the long-term course of 43 female survivors of childhood abuse after receiving inpatient treatment based on psychodynamic-orientated trauma therapy. Data on symptom load was assessed at admission, discharge and two-year follow-up. Further information on post-discharge treatment and life events in the follow-up period was collected. At two-year follow-up global symptom load (GSI), PTSD, depression (d = 0.43-0.57) and self-soothing ability (d = 0.72) were significantly improved compared to the admission status with no change in dissociative symptoms. 40% of the sample showed good long-term outcome (clinical significant change, GSI) with a significant reduction in depressive, dissociative and by trend in PTSD symptoms. There were no group differences in the amount of stressful life-events and treatment in the follow-up period. Patients with good outcome showed more previous inpatient treatment. Inpatient treatment leads to a significant symptom reduction in women with severe childhood abuse. The treatment effects remain stable for two years under further outpatient psychotherapy.

  20. [Effect of using an interpreter in psychotherapy].

    Science.gov (United States)

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

    2017-05-22

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

  1. Psychodynamic experience enhances recognition of hidden childhood trauma.

    Directory of Open Access Journals (Sweden)

    David Cohen

    Full Text Available BACKGROUND: Experimental psychology has only recently provided supporting evidence for Freud's and Janet's description of unconscious phenomena. Here, we aimed to assess whether specific abilities, such as personal psychodynamic experience, enhance the ability to recognize unconscious phenomena in peers - in other words, to better detect implicit knowledge related to individual self-experience. METHODOLOGY AND PRINCIPAL FINDINGS: First, we collected 14 videos from seven healthy adults who had experienced a sibling's cancer during childhood and seven matched controls. Subjects and controls were asked to give a 5-minute spontaneous free-associating speech following specific instructions created in order to activate a buffer zone between fantasy and reality. Then, 18 raters (three psychoanalysts, six medical students, three oncologists, three cognitive behavioral therapists and three individuals with the same experience of trauma were randomly shown the videos and asked to blindly classify them according to whether the speaker had a sibling with cancer using a Likert scale. Using a permutation test, we found a significant association between group and recognition score (ANOVA: p = .0006. Psychoanalysts were able to recognize, above chance levels, healthy adults who had experienced sibling cancer during childhood without explicit knowledge of this history (Power = 88%; p = .002. In contrast, medical students, oncologists, cognitive behavioral therapists and individuals who had the same history of a sibling's cancer were unable to do so. CONCLUSION: This experiment supports the view that implicit recognition of a subject's history depends on the rater's specific abilities. In the case of subjects who did have a sibling with cancer during childhood, psychoanalysts appear better able to recognize this particular history.

  2. [Psychotherapy of borderline personality disorder: similarities and differences in evidence-based disorder-specific treatment approaches].

    Science.gov (United States)

    Sollberger, D; Walter, M

    2010-12-01

    Borderline personality disorder (BPD) is known as a serious psychiatric disorder with high prevalence rates in clinical psychiatric populations. BPD is often very difficult to treat and is linked with conflicts among therapists and treatment teams. Over the last decades, in particular, neurobiological findings and psychotherapeutic research have led to a better understanding and treatment outcomes in BPD. The therapy of choice is psychotherapy. In the following review four efficient disorder-specific treatments for BPS are presented, two of which are cognitive-behaviourally oriented (dialectical behavioural therapy, DBT; scheme-focused therapy, SFT), and the other two are psychodynamically oriented (transference focused psychotherapy, TFP; mentalisation-based treatment, MBT). In this review, the similarities and differences of the methods are elaborated and discussed. After the current considerable progress in disorder-specific treatments for BPS, the development of differential indication criteria for the various treatments could lead to an additional improvement of BPD therapy in the future. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Counseling and Psychotherapy: Toward A New Perspective.

    Science.gov (United States)

    Ivey, Allen E.

    1981-01-01

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

  4. PSYCHOTHERAPY WITH THE PARENT EGO STATE

    Directory of Open Access Journals (Sweden)

    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.

  5. Cognitive Behavioral Psychotherapies: History and Development

    Directory of Open Access Journals (Sweden)

    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

  6. Transference focused psychotherapy: overview and update.

    Science.gov (United States)

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

    2008-06-01

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

  7. Psychotherapy: from exorcism to cognitive theories

    Directory of Open Access Journals (Sweden)

    Durval Mazzei Nogueira Filho

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

  8. 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...... psychotherapy; and, third, what is the outcome of the group psychotherapies? We searched in two databases: PsycINFO and PubMed. Inclusion and exclusion criteria and checklists from standardized assessment tools were applied to the research literature. Qualitative and quantitative papers were included. In total......, 8 articles were considered eligible for the review. Findings from the evaluation suggested that the concepts of spirituality and religiosity were poorly conceptualized and the way in which spiritual and religious factors were integrated into such group psychotherapies, which distinguished it from...

  9. NONVERBAL STORIES: THE BODY IN PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    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.

  10. Treatment failure in humanistic and experiential psychotherapy.

    Science.gov (United States)

    Watson, Jeanne C

    2011-11-01

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

  11. 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...

  12. Premature conclusions about psychotherapy for dysthymia

    OpenAIRE

    Cuijpers, P.

    2009-01-01

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

  13. Patterns of Client Emotion in Helpful Sessions of Cognitive-Behavioral and Psychodynamic-Interpersonal Therapy

    Science.gov (United States)

    Mackay, Hannah C.; Barkham, Michael; Stiles, William B.; Goldfried, Marvin R.

    2002-01-01

    Whereas cognitive-behavioral (CB) therapy sessions aim to be instructive and encouraging, psychodynamic-interpersonal (PI) sessions aim to be exploratory and may be emotionally painful. Raters rated degree of pleasure and arousal in each sentence of client speech in CB and PI sessions (N=18) that therapists had identified as particularly helpful.…

  14. Patients' crying experiences in psychotherapy: Relationship with the patient level of personality organization, clinician approach, and therapeutic alliance.

    Science.gov (United States)

    Zingaretti, Pietro; Genova, Federica; Gazzillo, Francesco; Lingiardi, Vittorio

    2017-06-01

    The present study sought to further understand patients' crying experiences in psychotherapy. We asked 64 clinicians to randomly request one patient in their practice to complete a survey concerning crying in psychotherapy as well as a measure of therapeutic alliance. All clinicians provided information regarding their practice and patient diagnostic information. Fifty-five (85.93%) patients cried at least once, and 18 (28.1%) had cried during their most recent session. Patients' frequency of crying episodes in therapy was negatively related with psychotic level of personality organization, while patients' tendency to feel more negative feelings after crying was positively related to lower levels of personality organization. Patients' feeling more in control after crying was positively related with an interpersonal therapeutic approach, while patients' perception of therapists as more supportive after crying was positively related to a psychodynamic approach. Patients' tendency to experience more negative feelings after crying was significantly related with both lower levels of personality organization and patients' perception of the therapeutic alliance as weak. In regard to their most recent crying event in treatment, therapeutic alliance was related to gaining a new understanding of experience not previously recognized by the patient. Further, patients' experiences of having never told anyone about their experience related to a crying episode, as well as their realization of new ideas and feeling of having communicated something that words could not express was positively related to the goal dimension of alliance. Patients' perception of crying as a moment of genuine vulnerability, greater feelings of self-confidence and self-disclosure as well as having had a therapist response that was compassionate and supportive, was positively related with the bond dimension of alliance. Clinical implications and future research directions regarding patient crying

  15. Psychodynamic therapy for depression in women with infants and young children.

    Science.gov (United States)

    Kurzweil, Sonya

    2012-01-01

    It has long been known that the rate of depression is high among women with infants and young children. In recent research a psychodynamic therapy group was found to be beneficial for a self-selected, postnatal subgroup of women who were of middle socio-economic status (SES), educated and who met DSM-IV criteria for clinical or subclinical depression. The current study sought to replicate these findings with individual psychodynamic therapy and to compare outcomes for three psychodynamic treatment conditions: individual, group, and combined individual and group. Patients began and left treatment from each of the three psychodynamic therapy conditions on a self-determined basis. Pre- and postintervention DSM-IV Global Assessment of Functioning (GAF) were obtained by reliable blind raters. A ten-variable, self-administered postintervention outcome questionnaire provided further data. Women (n = 58) in all three therapeutic conditions showed statistically significant improvement in their pre-to-post GAF and large treatment effects. On the questionnaire, they indicated that they were affected positively by all three conditions. Statistically significant differences among treatment conditions favored the individual treatment. Psychodynamic therapy appears well suited for the population of women in this study, especially when administered on an individual basis. The model employed here emphasized receiving and developing empathic emotional attunement, insight into one's relationships and early experiences, and a process for expressing feelings and resolving problems. Compared to group and combination therapies, the individual treatment may afford the greatest opportunity for receiving and developing these features and, thus, the best outcomes.

  16. Cognitive-behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial.

    Science.gov (United States)

    Goodyer, Ian M; Reynolds, Shirley; Barrett, Barbara; Byford, Sarah; Dubicka, Bernadka; Hill, Jonathan; Holland, Fiona; Kelvin, Raphael; Midgley, Nick; Roberts, Chris; Senior, Rob; Target, Mary; Widmer, Barry; Wilkinson, Paul; Fonagy, Peter

    2017-03-01

    Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment. Observer-blind, parallel-group, pragmatic superiority randomised controlled trial. A total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London. Adolescents aged 11-17 years with Diagnostic and Statistical Manual of Mental Disorders -Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses. In total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up. Mean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post

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

    Directory of Open Access Journals (Sweden)

    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.

  18. A QUALITATIVE METHODOLOGY FOR THEORY ELUCIDATION, EXPLICATION, AND DEVELOPMENT APPLIED WITHIN AN INTENSIVE GROUP PSYCHOTHERAPY PROGRAM

    Directory of Open Access Journals (Sweden)

    Jaime Williams

    2012-04-01

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

  19. [Psychotherapy of posttraumatic stress disorders].

    Science.gov (United States)

    Schnyder, U

    2000-01-01

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

  20. [Psychosomatic medicine and psychotherapy in Austria].

    Science.gov (United States)

    Pieringer, Walter; Schüssler, Gerhard

    2004-01-01

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

  1. [Summary: Scientific evaluation of EMDR psychotherapy].

    Science.gov (United States)

    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.

  2. Obstacles to early career psychiatrists practicing psychotherapy.

    Science.gov (United States)

    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.

  3. From medicine to psychotherapy: the placebo effect.

    Science.gov (United States)

    Justman, Stewart

    2011-01-01

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

  4. [Psychodynamic and forensic approach of constitutional mythomania: a case report].

    Science.gov (United States)

    Ben Thabet, J; Zouari, N; Charfeddine, F; Zouari, L; Maâlej, M

    2012-12-01

    Constitutional mythomania presents several diagnostic, aetiopathogenic and forensic problems for the doctor. We have discussed these aspects through the analysis of a case report. The case report relates to a 43 year-old man, who was subjected to a penal expertise following the emission of cheques without provision. During the examination, he pretended being both a doctor and a lawyer at the same time. He was in charge, among other things, of sale contracts dealing sometimes with high value transactions, obviously without following the required legal procedure. He was pursued subsequently for many other affairs of swindle. Data collected from his medical file indicated that he was the only boy of his family. Since his father had suffered from psychotic episodes, his grandfather had reared him; which he did it in a strictly religious way. He spent his childhood isolated. He was 15 years old when his grandfather died. He had then expressed religious and megalomaniac ideas that had motivated psychiatric management. Later on, he expressed imaginative ideas evoking unsystematized delusion (he pretended to have made a trip to America and to have seen a fish flying and turning into a woman). From a psychodynamic point of view, constitutional mythomania is considered as a borderline personality. It reflects an important narcissisic cleavage. The deceitfulness of the mythomaniac allows him to keep in touch with reality and to avoid mental disintegration. The recognition, by others, of these delusions allows the mythomaniac to have access to his proper level of existence. For a while, to the experts our patient appeared to be suffering from schizophrenia. Therefore, we can apply the Maleval theory to him, which identifies four periods as delusion structuring levels in psychosis : P0 (consequence of the phallic signification deficiency, it includes anxiety, annihilation, perplexity, interrogative attitude), P1 (stage of paranoid delusion), P2 (stage of paranoiac delusion

  5. Differential efficacy of cognitive behavioral therapy and psychodynamic therapy for major depression : A study of prescriptive factors

    NARCIS (Netherlands)

    Driessen, E.; Smits, N.; Dekker, J.J.M.; Peen, J.; Don, F.J.; Kool, S.; Westra, D.; Hendriksen, M.; Cuijpers, P.; Van, H.L.

    2016-01-01

    Minimal efficacy differences have been found between cognitive behavioral therapy (CBT) and psychodynamic therapies for depression, but little is known about patient characteristics that might moderate differential treatment effects. We aimed to generate hypotheses regarding such potential

  6. Psychotherapy as assisted homeostasis: activation of emotional processing mediated by the anterior cingulate cortex.

    Science.gov (United States)

    Corrigan, F M

    2004-01-01

    Although psychotherapy is successful in altering emotional distress, the biological mechanism by which it achieves this has not been the subject of intensive neurobiological investigation. Mindful processing of emotion has been proposed [Mindfulness-Based Cognitive Therapy for Depression, The Guilford Press, New York, 2002] to be a key factor in prevention of relapse in depressive illness and here that hypothesis is developed and extended to include other conditions in which emotion processing may be obstructed or dysregulated. Cognitive therapy, interpersonal psychotherapy, psycho-dynamic psychotherapy and dialectical behaviour therapy, each in a different way and with a distinct emphasis, encourage awareness of emotions and their associated cognitions and biographies, and their varying success may depend on the degree to which they achieve activation of internal healing processes. In eye movement desensitisation and reprocessing (EMDR), the selected target is formatted for endogenous processing which is facilitated and accelerated by eye movements or alternating bilateral auditory or tactile stimulation. The ability to sustain focussed attention on the affect and its visceral, cognitive and biographical components is postulated to activate a homeostatic process of distress resolution, seen most clearly in treatment of post-traumatic stress disorder (PTSD) with EMDR, in which resolution of distress can be intense and rapid while therapist input is non-directive, although supportive, empathic, and non-judgemental. Once the therapist has helped to frame the questions, the patient's brain will find the answers needed for the resolution of the distress and all the components of the traumatic event, whether visceral, cognitive, affective or interpersonal. The anterior cingulate cortex, especially the dorsal and rostral components, is suggested to be the key neurobiological substrate for the efficacious psychotherapeutic relief of distress, and relevant functional

  7. Effects of Psychotherapy Training and Intervention Use on Session Outcome

    Science.gov (United States)

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

    2010-01-01

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

  8. A review of studies on the psychotherapy of obsessive

    Directory of Open Access Journals (Sweden)

    Quan-chao XING

    2013-12-01

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

  9. Ancient Greek psychotherapy for contemporary nurses.

    Science.gov (United States)

    Kourkouta, Lambrini

    2002-08-01

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

  10. WELLFOCUS PPT: Modifying positive psychotherapy for psychosis.

    Science.gov (United States)

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

    2016-03-01

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

  11. Technology-enhanced human interaction in psychotherapy.

    Science.gov (United States)

    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).

  12. The influence of psychotherapy on marriage typology

    Directory of Open Access Journals (Sweden)

    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.

  13. Psychotherapy and the perfect storm of change.

    Science.gov (United States)

    Clemens, Norman A

    2009-09-01

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

  14. Psychotherapy and black women: a survey.

    Science.gov (United States)

    Gray, B A; Jones, B E

    1987-02-01

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

  15. [The future of psychotherapy in psychosomatic medicine].

    Science.gov (United States)

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

    2013-01-01

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

  16. What should we expect from psychotherapy?

    Science.gov (United States)

    Goldfried, Marvin R

    2013-11-01

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

  17. [Dropout behavior during inpatient psychotherapy ].

    Science.gov (United States)

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

    2014-01-01

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

  18. Psychotherapies in Acute and Transient Psychoses

    Directory of Open Access Journals (Sweden)

    Manuel González de Chávez

    2014-10-01

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

  19. Toward a common focus in psychotherapy research.

    Science.gov (United States)

    Elkins, David N

    2012-12-01

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

  20. Avoidance motivation in psychological problems and psychotherapy.

    Science.gov (United States)

    Holtforth, Martin Grosse

    2008-03-01

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

  1. Measuring treatment differentiation for implementation research: the Therapy Process Observational Coding System for Child Psychotherapy Revised Strategies scale.

    Science.gov (United States)

    McLeod, Bryce D; Smith, Meghan M; Southam-Gerow, Michael A; Weisz, John R; Kendall, Philip C

    2015-03-01

    Observational measures to assess implementation integrity (the extent to which components of an evidence-based treatment are delivered as intended) are needed. The authors evaluated the reliability of the scores and the validity of the score interpretations for the Therapy Process Observational Coding System for Child Psychotherapy-Revised Strategies scale (TPOCS-RS; McLeod, 2010) and assessed the potential of the TPOCS-RS to assess treatment differentiation, a component of implementation integrity. The TPOCS-RS includes 5 theory-based subscales (Cognitive, Behavioral, Psychodynamic, Client-Centered, and Family). Using the TPOCS-RS, coders independently rated 954 sessions conducted with 89 children (M age = 10.56, SD = 2.00; age 7-15 years; 65.20% White) diagnosed with a primary anxiety disorder who received different treatments (manual-based vs. nonmanualized) across settings (research vs. practice). Coders produced reliable ratings at the item level (M intraclass correlation coefficient = .76, SD = .18). Analyses support the construct validity of the Cognitive and Behavioral subscale scores and, to a lesser extent, the Psychodynamic, Family, and Client-Centered subscale scores. Correlations among the TPOCS-RS subscale scores and between the TPOCS-RS subscale scores and observational ratings of the alliance and client involvement were moderate suggesting independence of the subscale scores. Moreover, the TPOCS-RS showed promise for assessing implementation integrity as the TPOCS-RS subscale scores, as hypothesized, discriminated between manual-guided treatment delivered across research and practice settings and nonmanualized usual care. The findings support the potential of the TPOCS-RS Cognitive and Behavioral subscales to assess treatment differentiation in implementation research. Results for the remaining subscales are promising, although further research is needed. 2015 APA, all rights reserved

  2. Measuring Treatment Differentiation for Implementation Research: The Therapy Process Observational Coding System for Child Psychotherapy Revised Strategies Scale

    Science.gov (United States)

    McLeod, Bryce D.; Smith, Meghan M.; Southam-Gerow, Michael A.; Weisz, John R.; Kendall, Philip C.

    2014-01-01

    Observational measures to assess implementation integrity (the extent to which components of an evidence-based treatment are delivered as intended) are needed. We evaluated the reliability of the scores and the validity of the score interpretations for the Therapy Process Observational Coding System for Child Psychotherapy – Revised Strategies scale (TPOCS-RS; McLeod, 2010) and assessed the potential of the TPOCS-RS to assess treatment differentiation, a component of implementation integrity. The TPOCS-RS includes five theory-based subscales (Cognitive, Behavioral, Psychodynamic, Client-Centered, Family). Using the TPOCS-RS, coders independently rated 954 sessions conducted with 89 children (M age = 10.56, SD = 2.00; aged 7–15 years; 65.20% Caucasian) diagnosed with a primary anxiety disorder who received different treatments (manual-based vs. non-manualized) across settings (research vs. practice). Coders produced reliable ratings at the item level (M ICC = .76, SD = .18). Analyses support the construct validity of the Cognitive and Behavioral subscale scores and, to a lesser extent, the Psychodynamic, Family, and Client-Centered subscale scores. Correlations among the TPOCS-RS subscale scores and between the TPOCS-RS subscale scores and observational ratings of the alliance and client involvement were moderate suggesting independence of the subscale scores. Moreover, the TPOCS-RS showed promise for assessing implementation integrity as the TPOCS-RS subscale scores, as hypothesized, discriminated between manual-guided treatment delivered across research and practice settings and non-manualized usual care. The findings support the potential of the TPOCS-RS Cognitive and Behavioral subscales to assess treatment differentiation in implementation research. Results for the remaining subscales are promising, although further research is needed. PMID:25346995

  3. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru

    2013-01-01

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

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

    Science.gov (United States)

    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.

  5. Systems psychodynamics: the formative years of an interdisciplinary field at the Tavistock Institute.

    Science.gov (United States)

    Fraher, Amy L

    2004-02-01

    Systems psychodynamics is an interdisciplinary field amalgamating a triad of influences -the practice of psychoanalysis, the theories and methods of the field of group relations, and the task and boundary awareness of open systems perspectives. Although systems psychodynamics is not a new field of study, there has been a general lack of awareness of its roots, how its formative elements have become intertwined over the years, and the role of the Tavistock Institute in developments in the field. This article provides a synthesis of this history and focuses, in particular,on the intellectual foundations of the Tavistock method of working experientially with groups and the application of this method to the study of organizations.

  6. A comparative analysis of the therapeutic focus in cognitive-behavioral and psychodynamic-interpersonal sessions.

    Science.gov (United States)

    Goldfried, M R; Castonguay, L G; Hayes, A M; Drozd, J F; Shapiro, D A

    1997-10-01

    This study compared therapeutic foci in a sampling of 30 cognitive-behavioral and 27 psychodynamic-interpersonal manual-driven treatments for depression. High- and low-impact sessions were coded for each client, with the Coding System of Therapeutic Focus. Results indicated that psychodynamic-interpersonal sessions focused more on such variables as emotion, patterns, incongruities, the impact that others made on clients, clients' expected reaction of others, the tendency to avoid therapeutic progress, therapists themselves, clients' parents, and links between people and time periods in clients' lives. Cognitive-behavioral sessions placed greater emphasis on external circumstances and clients' ability to make decisions, gave more support and information and encouraged between-session experiences, and focused more on the future. Relatively few differences emerged as a function of session impact. Results are discussed in terms of the different and similar theoretical conceptions of the change process.

  7. Christophe Dejours’ psychodynamic theory of work and its implications for leadership

    OpenAIRE

    Dashtipour, Parisa; Vidaillet, Bénédicte

    2016-01-01

    International audience; Psychoanalytic approaches to leadership centre on emotions and the role of the leader as the manager of emotion (Gabriel, 2011). These perspectives have often focused on the dysfunctions of leadership, the way in which leaders contribute to ‘dark’ and unhealthy organizational lives. In contrast to such approaches, in this paper we draw from Christophe Dejours’ psychodynamic theory of work, in order to explore what role leaders could play to facilitate health in organiz...

  8. Change of the model of homosexuality in psychodynamic approach (review of foreign literature references)

    OpenAIRE

    Strokova S.S.

    2013-01-01

    At present homosexuality is not regarded as a mental disorder in contrast to a long period in the past when it was treated as a disease. The majority of psychodynamic approach representatives adhered to the estimation of nontraditional sexual orientation as a psychopathic state. Homosexuality was often viewed as a symptom of a major psychic impairment like confused self-identity, but with time the authors came to a conclusion that homosexuality is an alternative, yet possible type of psychos...

  9. Facts and values in psychotherapy-A critique of the empirical reduction of psychotherapy within evidence-based practice.

    Science.gov (United States)

    Berg, Henrik; Slaattelid, Rasmus

    2017-10-01

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

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

    African Journals Online (AJOL)

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

  11. Multicultural Approaches in Psychotherapy: A Rejoinder

    Science.gov (United States)

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

    2011-01-01

    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…

  12. Bentuhua: culturing psychotherapy in postsocialist China.

    Science.gov (United States)

    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.

  13. Serious Games for Psychotherapy: A Systematic Review.

    Science.gov (United States)

    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.

  14. Antidepressants versus interpersonal psychotherapy in treating ...

    African Journals Online (AJOL)

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

  15. Existential psychotherapy of students as learning strategy

    DEFF Research Database (Denmark)

    Dræby, Anders

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

  16. Supervision of Psychotherapy: Models, Issues, and Recommendations

    Science.gov (United States)

    Westefeld, John S.

    2009-01-01

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

  17. Interventions and Strategies in Counseling and Psychotherapy.

    Science.gov (United States)

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

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

  18. [Pharmaco- and psychotherapy in psychiatric ambulatory care].

    Science.gov (United States)

    Burner, M

    1983-01-01

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

  19. Reflections on Psychotherapy and Aerobic Exercise.

    Science.gov (United States)

    Silverman, Wade

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

  20. Premature conclusions about psychotherapy for dysthymia

    NARCIS (Netherlands)

    Cuijpers, P.

    2009-01-01

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

  1. Toward a Neurobiology of Child Psychotherapy

    Science.gov (United States)

    Kay, Jerald

    2009-01-01

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

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

    Science.gov (United States)

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

    2009-11-01

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

  3. Ethical dimensions of psychotherapy: a personal perspective.

    Science.gov (United States)

    Chodoff, P

    1996-01-01

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

  4. Frontolimbic Neural Circuit Changes in Emotional Processing and Inhibitory Control Associated With Clinical Improvement Following Transference-Focused Psychotherapy in Borderline Personality Disorder

    Science.gov (United States)

    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

    2015-01-01

    Aim 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 aims to investigate neural activation associated with, and predictive of, clinical improvement in emotional and behavioral regulation in BPD following TFP. Methods BPD subjects (N=10) were scanned pre- and post-TFP treatment using a within-subjects design. A disorder-specific emotional-linguistic go/no-go fMRI paradigm was used to probe the interaction between negative emotional processing and inhibitory control. Results 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. Conclusions These preliminary findings demonstrate potential TFP-associated alterations in frontolimbic circuitry and begin to identify neural mechanisms associated with a psychodynamically-oriented psychotherapy. PMID:26289141

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

    Directory of Open Access Journals (Sweden)

    Pieter Koortzen

    2012-01-01

    Full Text Available Orientation: The researchers conducted a literature review to analyse the assumptions of systems psychodynamics, the Tavistock model of group relations, object relations theory and the most relevant constructs in the systems psychodynamic perspective. They then described the assumptions and most relevant constructs in the positive psychology perspective in order to analyse theoretically the psychological effect of large-scale sports events on a community or country. The objective of the empirical study was to investigate some of the unconscious emotions, fears, anxieties and conflicts (dynamics that prevailed in South Africa before the 2010 Fédération Internationale de Football Association (FIFA World Cup and some of the positive emotional experiences associated with it.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.

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

    Science.gov (United States)

    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.

  7. 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.

  8. First Do No Harm: An Analysis of the Risk Aspects and Side Effects of Clinical Holistic Medicine Compared With Standard Psychiatric Biomedical Treatment

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available Clinical holistic medicine (CHM is short-term psychodynamic psychotherapy (STPP complemented with bodywork and philosophical exercises, to be more efficient in treating patients with severe mental and physical illness. STPP has already been found superior to psychiatric treatment as usual (TAU and thus able to compete with psychiatric standard treatment as the treatment of choice for all non-organic mental illnesses; we have found the addition of bodywork and philosophy of life to STPP to accelerate the process of existential healing and recovery (salutogenesis. In this paper we compare the side effects, suicidal risk, problems from implanted memory and implanted philosophy of CHM with psychopharmacological treatment. Method: Qualitative and quantitative comparative review. Results: In all aspects of risks, harmfulness, and side effects, we have been considering, CHM was superior to the standard psychiatric treatment. The old principle of “first do no harm“ is well respected by CHM, but not always by standard psychiatry. CHM seems to be able to heal the patient, while psychopharmacological drugs can turn the patient into a chronic, mentally ill patient for life. Based on the available data CHM seems another alternative to patients with mental illness. There seem to be no documentation at all for CHM being dangerous, harmful, having side effects of putting patients at risk for suicide. As CHM uses spontaneous regression there is no danger for the patient developing psychosis as, according to some experts, has been seen with earlier intensive psychodynamic methods. CHM is an efficient, safe and affordable cure for a broad range of mental illnesses.

  9. The Efficacy of Cognitive-Behavioral Therapy and Psychodynamic Therapy in the Outpatient Treatment of Major Depression : A Randomized Clinical Trial

    NARCIS (Netherlands)

    Driessen, Ellen; Van, Henricus L.; Don, Frank J.; Peen, Jaap; Kool, Simone; Westra, Dieuwertje; Hendriksen, Marielle; Schoevers, Robert A.; Cuijpers, Pim; Twisk, Jos W. R.; Dekker, Jack J. M.

    Objective: The efficacy of psychodynamic therapies for depression remains open to debate because of a paucity of high-quality studies. The authors compared the efficacy of psychodynamic therapy with that of cognitive-behavioral therapy (CBT), hypothesizing nonsignificant differences and the

  10. The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial

    NARCIS (Netherlands)

    Driessen, E.; Van Henricus, L.; Don, F.J.; Peen, J.; Kool, S.; Westra, D.; Hendriksen, M.; Schoevers, R.; Cuijpers, P.; Twisk, J.W.R.; Dekker, J.J.M.

    2013-01-01

    Objective: The efficacy of psychodynamic therapies for depression remains open to debate because of a paucity of high-quality studies. The authors compared the efficacy of psychodynamic therapy with that of cognitive-behavioral therapy (CBT), hypothesizing nonsignificant differences and the

  11. The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial.

    NARCIS (Netherlands)

    Driessen, E.; Van, H.L.; Don, F.J.; Peen, J.; Kool, S.; Westra, D.; Hendriksen, M.; Schoevers, R.A.; Cuijpers, P.; Twisk, J.W.R.; Dekker, J.J.H.

    2013-01-01

    OBJECTIVE The efficacy of psychodynamic therapies for depression remains open to debate because of a paucity of high-quality studies. The authors compared the efficacy of psychodynamic therapy with that of cognitive-behavioral therapy (CBT), hypothesizing nonsignificant differences and the

  12. 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...

  13. Self and its anxieties in existential psychotherapy

    Directory of Open Access Journals (Sweden)

    Marica Mircea Adrian

    2017-05-01

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

  14. [Psychotherapy with Immigrants and Traumatized Refugees].

    Science.gov (United States)

    Erim, Yesim; Morawa, Eva

    2016-09-01

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

  15. Difficulties in integrating spirituality into psychotherapy

    Science.gov (United States)

    Schultz-Ross, RA; Gutheil, TG

    1997-01-01

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

  16. Psychotherapy with people with developmental disabilities

    Directory of Open Access Journals (Sweden)

    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.

  17. Psychotherapy and sociology: flirtation, marriage or divorce?

    Science.gov (United States)

    Cox, M; Cox, C

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

  18. [Indikationsfragen zur psychotherapie bei psychosomatischen patientinnen.].

    Science.gov (United States)

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

    2003-12-01

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

  19. The outcome problem in psychotherapy: a reply.

    Science.gov (United States)

    Eysenck, H J

    2013-03-01

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

  20. USING BACH FLOWER IN HOLISTIC PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Vagner Ferreira do Nascimento

    2017-05-01

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

  1. Minding the body: psychotherapy and cancer survival.

    Science.gov (United States)

    Spiegel, David

    2014-09-01

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

  2. Recognition of psychotherapy effectiveness: the APA resolution.

    Science.gov (United States)

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

    2013-03-01

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

  3. Outcome in psychotherapy evaluated by independent judges.

    Science.gov (United States)

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

    1977-10-01

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

  4. On the Movement Toward Psychotherapy Integration

    Science.gov (United States)

    GOLDFRIED, MARVIN R.; WISER, SUSAN L.; RAUE, PATRICK J.

    1992-01-01

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

  5. The Autism Psychodynamic Evaluation of Changes (APEC) scale: a reliability and validity study on a newly developed standardized psychodynamic assessment for youth with Pervasive Developmental Disorders.

    Science.gov (United States)

    Haag, Geneviève; Botbol, Michel; Graignic, Rozenn; Perez-Diaz, Fernando; Bronsard, Guillaume; Kermarrec, Solenn; Clement, Marie-Christine; Cukierman, Annick; Druon, Catherine; Duprat, Andrée; Jardin, Françoise; du Chatellier, Anik Maufras; Tricaud, Jacqueline; Urwand, Simone; Guilé, Jean-Marc; Cohen, David; Tordjman, Sylvie

    2010-12-01

    The present study was designed to examine the reliability and validity of the Autism Psychodynamic Evaluation of Changes (APEC) scale, developed to assess the evolution in individuals with autism under treatment. The APEC scale focuses on the key role of impairment in body image construction, which requires cross-modal sensory integration through emotional communication with motor representations. Thus, the body image construction is associated simultaneously with spatial and temporal organization and allows the emergence of self- and others-representations. The use of the APEC scale, with its seven domains (expression of emotion in relationships, eye contact, body image, graphic productions, exploration of space and objects, time perception, and verbal language), underlines the importance in autistic disorder of anxieties related to body and spatial representations, and of impairment in the body ego construction which is closely linked to the emergence of individuation/separation processes. This study was conducted on 73 children and adolescents with autistic disorder. They were recruited in day care facilities where two caregivers independently gave their ratings based on their clinical observation on a daily basis during the same month. Analyses included assessing construct validity through correspondence analyses and inter-rater reliability using kappa coefficients. The APEC scale offers a reliable and validated psychodynamic assessment of interest for professionals (such as child psychiatrists, caregivers, therapists or teachers) and researchers working with children, adolescents and adults with autistic disorder, especially in the follow-up of their evolution. The APEC scale provides an approach at the interface of psychoanalysis and neuroscience, and is also of interest for clinical and developmental psychology. Using the APEC scale in a range of different practical and research settings will foster links between psychoanalytic perspectives and educational

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

    Science.gov (United States)

    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.

  7. Applied philosophy and psychotherapy: Heraclitus as case study

    Directory of Open Access Journals (Sweden)

    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.

  8. Benefits and Challenges of Conducting Psychotherapy by Telephone.

    Science.gov (United States)

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

    2011-12-01

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

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

    DEFF Research Database (Denmark)

    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 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....... 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....

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

    Science.gov (United States)

    Taylor, David; Carlyle, Jo-anne; McPherson, Susan; Rost, Felicitas; Thomas, Rachel; Fonagy, Peter

    2012-06-11

    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. Patients with treatment resistant/treatment refractory depression. 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. Moderate or severe learning disability, psychotic illness, bipolar disorder, substance dependency or receipt of test intervention in the previous two years. Pragmatic, randomised controlled trial with qualitative and clinical components. 18 months of weekly psychoanalytic psychotherapy, manualised and fidelity-assessed using the Psychotherapy Process Q-Sort. Treatment as usual, managed by the referring practitioner. GP referrals from primary care. HRSD (with ≤14 as remission). 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). 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. TRD needs complex, long-term intervention and extended research follow-up for the proper evaluation of treatment outcome. This pushes at the limits of the design of randomised therapeutic trials. We discuss some of the consequent problems and suggest how they may be mitigated. Current

  11. [Psychotherapy for pregnant women with psychiatric disorders].

    Science.gov (United States)

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

    2015-01-01

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

  12. The Arts, Crafts, and Sciences of Psychotherapy.

    Science.gov (United States)

    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.

  13. Commentary: toward a psychodynamic understanding of filicide--beyond psychosis and into the heart of darkness.

    Science.gov (United States)

    Papapietro, Daniel J; Barbo, Elizabeth

    2005-01-01

    Much of the literature on filicide explores acute psychosis, sociopathy, or malignant narcissism (psychiatrically ill versus not psychiatrically ill) as primary explanations of why parents kill children. In this issue, Hatters Friedman et al. review the literature on acute psychiatric symptoms in an effort to identify key risk factors for filicide that might have predictive value. In this commentary, we assert the argument that filicide is a complex phenomenon that is the result of more than just psychosis or environmental stressors and that, because not all parents who become psychiatrically ill kill, there may be specific risk factors related to individual underlying psychodynamic conflicts.

  14. Psychodynamic day treatment programme for patients with schizophrenia spectrum disorders: Dynamics and predictors of therapeutic change.

    Science.gov (United States)

    Pec, Ondrej; Bob, Petr; Pec, Jan; Hrubcova, Adela

    2017-09-13

    The purpose of this study was to test whether a psychodynamically based group psychotherapeutic programme might improve symptoms, social functions, or quality of life in patients with schizophrenia spectrum disorders and to investigate factors that might predict clinical improvement or dropouts from the programme. A quantitative prospective cohort study. We have investigated 81 patients with schizophrenia spectrum disorders who participated in a 9-month psychodynamically based psychotherapeutic day programme. The patients were assessed at the beginning and end of the programme, and then at 1-year follow-up. The assessment included psychotic manifestations (HoNOS), quality of life (WHOQOL-BREF), demographic data, and daily doses of medication. 21 patients dropped out from the programme, and 46 patients succeeded in undergoing follow-up assessment. The psychotic manifestations (self-rating version of HoNOS) and quality of life measured with WHOQOL-BREF (domains of social relationships and environment) were significantly improved at the end of the programme and at follow-up. However, the manifestations on the version for external evaluators of HoNOS were improved only at follow-up. Years of psychiatric treatment, number of hospitalizations or suicide attempts, and experience of relationships with a partner were negatively related to clinical improvement, whereas symptom severity, current working, or study activities were related positively. The results show that a group psychodynamic programme may improve the clinical status and quality of life of patients with schizophrenia spectrum disorders. This type of programme is more beneficial for patients with higher pre-treatment symptom severity and the presence of working or study activities. A psychodynamically based group programme improves the clinical status and quality of life in patients with schizophrenia spectrum disorders. Data indicate that changes on the subjective level are detectable by the end of the

  15. Sadism linked to loneliness: psychodynamic dimensions of the sadistic serial killer Jeffrey Dahmer.

    Science.gov (United States)

    Martens, Willem H J

    2011-08-01

    In this article the psychodynamic link between loneliness and sadism is examined on basis of a case report of the sadistic and cannibalistic serial killer Jeffery Dahmer. Envy, shame/rage mechanism, a disturbed oral-sadistic development, castration fear and severe feelings of inferiority, the conviction of being unlovable and unacceptable, need to diminish tension, powerful and sadistic fantasies as a consequence of inadequate and frustrated parenting, and reality distortion appear to be involved in sadistic etiology. © 2011 N.P.A.P.

  16. 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

  17. 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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. The Experiential as a Unifying Construct in Psychotherapy.

    Science.gov (United States)

    Bohart, Arthur C.

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

  1. Conceptual Frame for Selecting Individual Psychotherapy in the Schools

    Science.gov (United States)

    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…

  2. Solicited diary studies of psychotherapy in qualitative research

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward

    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...

  3. Shapes of Early Change in Psychotherapy under Routine Outpatient Conditions

    Science.gov (United States)

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

    2007-01-01

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

  4. 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 ...

  5. Emotional experience and alliance contribute to therapeutic change in psychodynamic therapy.

    Science.gov (United States)

    Fisher, Hadar; Atzil-Slonim, Dana; Bar-Kalifa, Eran; Rafaeli, Eshkol; Peri, Tuvia

    2016-03-01

    Accumulating evidence suggests that the therapeutic alliance and clients' contact with emotions during therapy sessions can be effective in reducing their suffering outside of sessions. However, the complex associations among these determinants are not yet clear. Using data collected in therapy on a session-by-session basis, this study explored (a) the temporal associations between emotional experience and the therapeutic alliance; (b) the temporal associations between emotional experience and clients' level of functioning; and (c) the direct and indirect associations among emotional experience, the therapeutic alliance, and functioning. Clients (N = 101) undergoing psychodynamic therapy completed a functioning and distress measure prior to each session, and reported on their emotional experience and perceived alliance strength following each session. Longitudinal multilevel models indicated that higher therapeutic alliance scores at the end of 1 session predicted a greater emotional experience in the next session but that emotional experience did not predict subsequent levels of alliance. The results provided evidence of reciprocal prediction in which a previous emotional experience predicted a subsequent change in functioning and vice versa. Finally, the alliance predicted emotional experience, which, in turn, predicted functioning; hence, alliance strength indirectly predicted clients' level of functioning. Findings indicate that emotional experience and the therapeutic alliance are important determinants of the therapeutic process, which contribute to predict clients' improvement in functioning within psychodynamic treatment. (c) 2016 APA, all rights reserved).

  6. Psychotherapy with multiple-sclerosis patients.

    Science.gov (United States)

    Langenmayr, A; Schöttes, N

    2000-04-01

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

  7. Predicting Psychotherapy Dropouts: A Multilevel Approach.

    Science.gov (United States)

    Kegel, Alexander F; Flückiger, Christoph

    2015-01-01

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

  8. Efficacy of interpersonal psychotherapy for postpartum depression.

    Science.gov (United States)

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

    2000-11-01

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

  9. Comparison of Cognitive-Behavioural Therapy and Psychodynamic Therapy in the Treatment of Anxiety among University Students: An Effectiveness Study

    Science.gov (United States)

    Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico

    2014-01-01

    The aim of the present study was to compare the effectiveness of cognitive-behavioural (CBT) and psychodynamic (PDT) therapies in the treatment of anxiety among university students. To this aim, the Symptom Questionnaire (SQ) was completed by 30 students assigned to CBT and by 24 students assigned to PDT, both at the beginning and at the end of…

  10. [The importance of transference in Junguian psychotherapy].

    Science.gov (United States)

    Scotillo, Irene Alejandra

    2012-01-01

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

  11. A Kantian critique of cognitive psychotherapy.

    Science.gov (United States)

    Yesavage, J A

    1980-01-01

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

  12. Review of Psychotherapy as a human science.

    Science.gov (United States)

    Langan, Robert

    2008-12-01

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

  13. Psychotherapy, psychoanalysis and urban poverty in Argentina.

    Science.gov (United States)

    Epele, Maria Esther

    2016-12-01

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

  14. [New Developments in Video Games for Psychotherapy].

    Science.gov (United States)

    Brezinka, Veronika

    2016-01-01

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

  15. Indian family systems, collectivistic society and psychotherapy.

    Science.gov (United States)

    Chadda, Rakesh K; Deb, Koushik Sinha

    2013-01-01

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

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

    Science.gov (United States)

    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.

  17. The movement toward integrating the psychotherapies: an overview.

    Science.gov (United States)

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

    1989-02-01

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

  18. Critique of Sohlberg and Birgegard's (2003) report of persistent complex effects of subliminal psychodynamic activation messages.

    Science.gov (United States)

    Fudin, Robert

    2006-10-01

    Silverman in 1983 held that the unconscious encoding of MOMMY AND I ARE ONE triggers a fantasy of symbiotic union with the good mother of early childhood. In contrast, later Sohlberg and Birgegard contended that MOMMY AND I triggers associations to similarity issues with mother, associations that may be influenced by the words following MOMMY AND I. Although their messages produce, lmost invariably, no reportable sensation, Sohlberg and Birgegard claimed strong evidence for the influence of such messages on perception, motivation, and memory, 10 ays poststimulation and suggestive evidence 4 mo. later. Their findings are not compelling evidence for these claims; and there is no evidence that any result was associated with the unconscious encoding of the psychodynamic meaning of a multiword message.

  19. 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

    compared with the other two groups. Early improving patients were less likely to have participated in short-term groups, and only one third participated in additional treatment compared with more than 69% of the other patients. Severe and socially affected psychiatric patients, and patients with anxiety...... and socio-demographic characteristics. Late improvers, as compared with early improvers, were characterized by anxiety symptoms and lack of network support after controlling for GSI at admission. Similarly, deteriorating patients had longer duration of illness and less favourable social characteristics...... 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....

  20. 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...... of social education, I demonstrate how the often conflicting demands and expectations are being played out in the interrelational tension between the researcher (myself) and the interviewee or narrator. In a confrontation with "inner" expectations and concerns regarding a future profession and one's ability...... to cope, and the "outer" socially and culturally embedded discourses as they are played out in the objectives of self-development and education, the narrative about a forthcoming internship is filled with tension and contradiction. In this article I will demonstrate how such tensions and contradictions...

  1. Therapist interventions and client emotional experiencing in expert psychodynamic-interpersonal and cognitive-behavioral therapies.

    Science.gov (United States)

    Wiser, S; Goldfried, M R

    1998-08-01

    Eighteen sessions of cognitive-behavioral (CB) and 13 sessions of psychodynamic-interpersonal therapy obtained from experienced clinicians in a naturalistic setting were investigated to determine the various therapeutic interventions associated with high and low emotional experiencing (EXP). Clients receiving reflections and acknowledgments, affiliative and noncontrolling interventions, or interventions highlighting nonspecific client content were associated with maintained high EXP. Lengthier interventions and interventions rated as affiliative but moderately controlling were associated with shifts to low EXP. For clients of CB therapists, questions, interventions rated affiliative but controlling, and highlighting minimal emotional content were also associated with shifts to low EXP. Male therapists were associated with clients who maintained high EXP and female therapists were associated with clients who shifted to low EXP.

  2. The psychodynamics and developmental psychology of the borderline patient: a review of the literature.

    Science.gov (United States)

    Shapiro, E R

    1978-11-01

    The author reviews the psychodynamics and developmental psychology of the borderline patient as described in the literature on intensive therapy, early mother-child interaction, and family interaction. Focusing on the borderline patient's characteristic difficulties in intimate relationships, he describes the patient's use of splitting and projective identification as seen in the characteristic transference-countertransference interaction in intensive therapy. These primitive defensive mechanisms, which are also utilized by family members, appear to contribute to a failure of empathic responses both during the child's early development and in the family interactions during his adolescence. The author concludes that conceptual attempts to relate adult and child phenomena, although highly speculative, create new and useful perspectives for the treatment of the borderline patient.

  3. Psychodynamics of stress and perceived life stress level at cardio surgical (CAD) patients in/at the Special Hospital for Surgical Diseases “FILIP II”

    OpenAIRE

    Naumoska, Ljubica; Ristovska, Frosina; Dojcinovski, Ilija

    2010-01-01

    The aim of this study is to explore the psychodynamic of stress at CDH patients and the perceived level of life stress events as a risk factor in the development of the stress-related illness (coronary heart disease).

  4. 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...

  5. A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder.

    Science.gov (United States)

    Gregory, Robert J; Remen, Anna L

    2008-03-01

    The authors introduce a manual-based treatment, labeled dynamic deconstructive psychotherapy, developed for those patients with borderline personality disorder who are most difficult to engage in therapy, such as those having co-occurring substance use disorders. This treatment model is based on the hypothesis that borderline pathology and related behaviors reflect impairment in specific neurocognitive functions, including association, attribution, and alterity that form the basis for a coherent and differentiated self. Dynamic deconstructive psychotherapy aims to activate and remediate neurocognitive self-capacities by facilitating elaboration of affect-laden interpersonal experiences and integration of attributions, as well as providing novel experiences in the patient-therapist relationship that promote self-other differentiation. Treatment involves weekly individual sessions for a predetermined period of time and follows sequential stages. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  6. Hypnosis-based psychodynamic treatment in ALS: a longitudinal study on patients and their caregivers.

    Directory of Open Access Journals (Sweden)

    Johann Roland Kleinbub

    2015-06-01

    Full Text Available Background: Evidence of psychological treatment efficacy is strongly needed in ALS, particularly regarding long-term effects.Methods: Fifteen patients participated in a hypnosis treatment and self-hypnosis training protocol after an in-depth psychological and neurological evaluation. Patients’ primary caregivers and 15 one-by-one matched control patients were considered in the study.Measurements of anxiety, depression and quality of life were collected at the baseline, post-treatment, and after 3 and 6 months from the intervention. Bayesian linear mixed-models were used to evaluate the impact of treatment and defense style on patients’ anxiety, depression, quality of life, and functional impairment (ALSFRS-r, as well as on caregivers’ anxiety and depression.Results: The statistical analyses revealed an improvement in psychological variables’ scores immediately after the treatment. Amelioration in patients’ and caregivers’ anxiety as well as caregivers’ depression, were found to persist at 3 and 6 months follow-ups. The observed massive use of primitive defense mechanisms was found to have a reliable and constant buffer effect on psychopathological symptoms in both patients and caregivers. Notably, treated patients decline in ALSFRS-r score was observed to be slower than that of control group’s patients.Discussion: Our brief psychodynamic hypnosis-based treatment showed efficacy both at psychological and physical levels in patients with ALS, and was indirectly associated to long-lasting benefits in caregivers. The implications of peculiar psychodynamic factors and mind-body techniques are discussed. Future directions should be oriented toward a convergence of our results and further psychological interventions, in order to delineate clinical best practices for ALS.

  7. Evaluation of a transdiagnostic psychodynamic online intervention to support return to work: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Rüdiger Zwerenz

    Full Text Available Given their flexibility, online interventions may be useful as an outpatient treatment option to support vocational reintegration after inpatient rehabilitation. To that purpose we devised a transdiagnostic psychodynamic online intervention to facilitate return to work, focusing on interpersonal conflicts at the workplace often responsible for work-related stress.In a randomized controlled trial, we included employed patients from cardiologic, psychosomatic and orthopedic rehabilitation with work-related stress or need for support at intake to inpatient rehabilitation after they had given written consent to take part in the study. Following discharge, maladaptive interpersonal interactions at the workplace were identified via weekly blogs and processed by written therapeutic comments over 12 weeks in the intervention group (IG. The control group (CG received an augmented treatment as usual condition. The main outcome, subjective prognosis of gainful employment (SPE, and secondary outcomes (psychological complaints were assessed by means of online questionnaires before, at the end of aftercare (3 months and at follow-up (12 months. We used ITT analyses controlling for baseline scores and medical group.N = 319 patients were enrolled into IG and N = 345 into CG. 77% of the IG logged in to the webpage (CG 74% and 65% of the IG wrote blogs. Compared to the CG, the IG reported a significantly more positive SPE at follow-up. Measures of depression, anxiety and psychosocial stressors decreased from baseline to follow-up, whereas the corresponding scores increased in the CG. Correspondingly, somatization and psychological quality of life improved in the IG.Psychodynamic online aftercare was effective to enhance subjective prognosis of future employment and improved psychological complaints across a variety of chronic physical and psychological conditions, albeit with small effect sizes.

  8. Hypnosis-based psychodynamic treatment in ALS: a longitudinal study on patients and their caregivers

    Science.gov (United States)

    Kleinbub, Johann R.; Palmieri, Arianna; Broggio, Alice; Pagnini, Francesco; Benelli, Enrico; Sambin, Marco; Sorarù, Gianni

    2015-01-01

    Background: Evidence of psychological treatment efficacy is strongly needed in ALS, particularly regarding long-term effects. Methods: Fifteen patients participated in a hypnosis treatment and self-hypnosis training protocol after an in-depth psychological and neurological evaluation. Patients' primary caregivers and 15 one-by-one matched control patients were considered in the study. Measurements of anxiety, depression and quality of life (QoL) were collected at the baseline, post-treatment, and after 3 and 6 months from the intervention. Bayesian linear mixed-models were used to evaluate the impact of treatment and defense style on patients' anxiety, depression, QoL, and functional impairment (ALSFRS-r), as well as on caregivers' anxiety and depression. Results: The statistical analyses revealed an improvement in psychological variables' scores immediately after the treatment. Amelioration in patients' and caregivers' anxiety as well as caregivers' depression, were found to persist at 3 and 6 months follow-ups. The observed massive use of primitive defense mechanisms was found to have a reliable and constant buffer effect on psychopathological symptoms in both patients and caregivers. Notably, treated patients decline in ALSFRS-r score was observed to be slower than that of control group's patients. Discussion: Our brief psychodynamic hypnosis-based treatment showed efficacy both at psychological and physical levels in patients with ALS, and was indirectly associated to long-lasting benefits in caregivers. The implications of peculiar psychodynamic factors and mind-body techniques are discussed. Future directions should be oriented toward a convergence of our results and further psychological interventions, in order to delineate clinical best practices for ALS. PMID:26136710

  9. Evaluation of a transdiagnostic psychodynamic online intervention to support return to work: A randomized controlled trial.

    Science.gov (United States)

    Zwerenz, Rüdiger; Becker, Jan; Gerzymisch, Katharina; Siepmann, Martin; Holme, Martin; Kiwus, Ulrich; Spörl-Dönch, Sieglinde; Beutel, Manfred E

    2017-01-01

    Given their flexibility, online interventions may be useful as an outpatient treatment option to support vocational reintegration after inpatient rehabilitation. To that purpose we devised a transdiagnostic psychodynamic online intervention to facilitate return to work, focusing on interpersonal conflicts at the workplace often responsible for work-related stress. In a randomized controlled trial, we included employed patients from cardiologic, psychosomatic and orthopedic rehabilitation with work-related stress or need for support at intake to inpatient rehabilitation after they had given written consent to take part in the study. Following discharge, maladaptive interpersonal interactions at the workplace were identified via weekly blogs and processed by written therapeutic comments over 12 weeks in the intervention group (IG). The control group (CG) received an augmented treatment as usual condition. The main outcome, subjective prognosis of gainful employment (SPE), and secondary outcomes (psychological complaints) were assessed by means of online questionnaires before, at the end of aftercare (3 months) and at follow-up (12 months). We used ITT analyses controlling for baseline scores and medical group. N = 319 patients were enrolled into IG and N = 345 into CG. 77% of the IG logged in to the webpage (CG 74%) and 65% of the IG wrote blogs. Compared to the CG, the IG reported a significantly more positive SPE at follow-up. Measures of depression, anxiety and psychosocial stressors decreased from baseline to follow-up, whereas the corresponding scores increased in the CG. Correspondingly, somatization and psychological quality of life improved in the IG. Psychodynamic online aftercare was effective to enhance subjective prognosis of future employment and improved psychological complaints across a variety of chronic physical and psychological conditions, albeit with small effect sizes.

  10. Exploring the development of an organisational culture of control and dependency from a systems psychodynamic perspective

    Directory of Open Access Journals (Sweden)

    René van Eeden

    2010-03-01

    Full Text Available Orientation: Globalisation and accelerating rates of change characterise the work environment.Research purpose: The aim of this research was to study the impact of the change process at a plant of a South African production company.Motivations for the study: Problems were experienced in terms of production and a need for transformation at different levels was expressed. Co-dependence in the environment necessitated exploration of intra-organisational dynamics.Research design, approach and method: The study focused on the management team at a specifc plant, but by applying the systems psychodynamic perspective it was possible to also explore the mutual effect of relationships with other systems in the organisation, the company as a whole and the environment. Respondents included the directors of manufacturing and of human resources, the general manager, an 11-member management team and staff representatives. Semi-structured one-to-one interviews, group interviews and a group consultation session were held.Main findings: Hypotheses were formulated regarding the change experienced in the company, the overemphasis of control in the various systems, efforts to move from dependency to interdependence, personal authority as a requirement for interdependent functioning and problems with interrelatedness.Practical/managerial implications: The study illustrates the application of the systems psychodynamic approach in exploring the interaction between and mutual infuence of various organisational systems, especially in times of change.Contribution/value add: At a broader level, the study contributes to the understanding of the application of the theory as well as suggesting the use of a methodology. Recommendations for an intervention of this nature were also made.

  11. The right brain is dominant in psychotherapy.

    Science.gov (United States)

    Schore, Allan N

    2014-09-01

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

  12. Analytic and Systemic Specialized Incest Group Psychotherapy

    DEFF Research Database (Denmark)

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

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

  13. Thirty years of teaching psychotherapy skills.

    Science.gov (United States)

    Lewis, J M

    1991-10-01

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

  14. The use of autobiography in psychotherapy.

    Science.gov (United States)

    Sommer, Robert

    2003-02-01

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

  15. Analysis of transference in Gestalt group psychotherapy.

    Science.gov (United States)

    Frew, J E

    1990-04-01

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

  16. Reluctance to change and end psychotherapy

    Directory of Open Access Journals (Sweden)

    John E. Berg

    2018-01-01

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

  17. Feedback in Group Psychotherapy for Eating disorders

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  18. The Use of Dreams in Psychotherapy

    Science.gov (United States)

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

    2000-01-01

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

  19. Reprint of "The Effects of Psychotherapy: An Evaluation."

    Science.gov (United States)

    Eysenck, H. J.

    1992-01-01

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

  20. Enhancing the Personalization of Psychotherapy With Dynamic Assessment and Modeling.

    Science.gov (United States)

    Fisher, Aaron J; Boswell, James F

    2016-08-01

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

  1. College Psychotherapy at a Hong Kong Counseling Center

    Science.gov (United States)

    Leung, Eugenie Y.

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  3. 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).

  4. Hazards of long-term psychotherapy during psychiatric residency.

    Science.gov (United States)

    Dubovsky, S L; Scully, J H

    1990-05-01

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

  5. 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.

  6. Toward a neurobiology of psychotherapy: basic science and clinical applications.

    Science.gov (United States)

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

    2005-01-01

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

  7. HELPFUL ASPECTS OF THE THERAPEUTIC RELATIONSHIP IN INTEGRATIVE PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    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.

  8. Segmented assimilation and attitudes toward psychotherapy: a moderated mediation analysis.

    Science.gov (United States)

    Rogers-Sirin, Lauren

    2013-07-01

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

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

    Science.gov (United States)

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

    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.

  10. Cost-effectiveness of psychotherapy for cluster B personality disorders.

    Science.gov (United States)

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

    2010-05-01

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

  11. The relationship of body image with symptoms of depression and anxiety in patients with anorexia nervosa during outpatient psychotherapy: Results of the ANTOP study.

    Science.gov (United States)

    Junne, Florian; Zipfel, Stephan; Wild, Beate; Martus, Peter; Giel, Katrin; Resmark, Gaby; Friederich, Hans-Christoph; Teufel, Martin; de Zwaan, Martina; Dinkel, Andreas; Herpertz, Stephan; Burgmer, Markus; Tagay, Sefik; Rothermund, Eva; Zeeck, Almut; Ziser, Katrin; Herzog, Wolfgang; Löwe, Bernd

    2016-06-01

    Body image disturbance represents a central characteristic of anorexia nervosa (AN). Depression and anxiety are the most common mental comorbidities in patients with AN. This study aims to investigate the relationship of body image with symptoms of depression and anxiety during outpatient psychotherapy in AN. Analyses were conducted using the data set of the Anorexia Nervosa Treatment Outpatient Study (ANTOP) randomized controlled trial. The ANTOP study included N = 242 females with AN between 18 and 56 years of age. The trial was designed to compare enhanced cognitive behavioral therapy (CBT-E) and focal psychodynamic therapy (FPT) with optimized treatment as usual (TAU-O) for patients with AN. The analyses on body image dimensions were conducted using measures of correlations and multiple linear regression analyses to assess the relationship and longitudinal prediction of symptoms of depression and anxiety by body image dimensions. Results showed that body image perceptions were significantly associated with symptoms of depression and anxiety in patients with AN at all treatment stages. In addition, body image dimensions at early treatment stages predict depression and anxiety in follow-up measurements. The correlation of symptoms of depression and anxiety by body image perceptions increased along treatment course. The persistence of body image disturbance, while body mass index increases under treatment (persistency effect), may constitute a relevant factor contributing to the course of the most common affective comorbidities of depression and anxiety in patients with AN. Body image disturbances in patients with AN should therefore be explicitly targeted within the specialized psychotherapy of affected patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  14. [The Psychoanalytic-interactional Method (PIM): A Psychodynamic Treatment for Adolescents with Severe Disorders of Personality Functioning].

    Science.gov (United States)

    Cropp, Carola

    2017-07-01

    The Psychoanalytic-interactional Method (PIM): A Psychodynamic Treatment for Adolescents with Severe Disorders of Personality Functioning The psychoanalytic-interactional method (PIM) was developed as a psychodynamic treatment for adult patients with severe disorders of personality functioning (Streeck u. Leichsenring, 2015). However, it is also well suited for the treatment of adolescent patients because its techniques fit with specific conditions of adolescence. A modified version of the PIM for adolescents (Streeck-Fischer, Cropp, Streeck, Salzer, 2016) has proven to be efficacious. The paper describes the basic principles of the PIM and names aspects that have to be taken into account in the treatment of adolescents with severe disorders of personality functioning. Finally, previous empirical results regarding the PIM treatment in adolescence are presented.

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

    OpenAIRE

    Sibel Halfon; Alev Cavdar; Franco Orsucci; Guenter Karl Schiepek; Silvia Andreassi; Alessandro Giuliani; Giulio de Felice

    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 express...

  16. Psychotherapy Knowledge Translation and Interpersonal Psychotherapy: Using Best-Education Practices to Transform Mental Health Care in Canada and Ethiopia.

    Science.gov (United States)

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

    2014-01-01

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

  17. Cognitive-Behavioral and Psychodynamic Therapy in Female Adolescents With Bulimia Nervosa: A Randomized Controlled Trial.

    Science.gov (United States)

    Stefini, Annette; Salzer, Simone; Reich, Günter; Horn, Hildegard; Winkelmann, Klaus; Bents, Hinrich; Rutz, Ursula; Frost, Ulrike; von Boetticher, Antje; Ruhl, Uwe; Specht, Nicole; Kronmüller, Klaus-Thomas

    2017-04-01

    The authors compared cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) for the treatment of bulimia nervosa (BN) in female adolescents. In this randomized controlled trial, 81 female adolescents with BN or partial BN according to the DSM-IV received a mean of 36.6 sessions of manualized disorder-oriented PDT or CBT. Trained psychologists blinded to treatment condition administered the outcome measures at baseline, during treatment, at the end of treatment, and 12 months after treatment. The primary outcome was the rate of remission, defined as a lack of DSM-IV diagnosis for BN or partial BN at the end of therapy. Several secondary outcome measures were evaluated. The remission rates for CBT and PDT were 33.3% and 31.0%, respectively, with no significant differences between them (odds ratio [OR] = 0.90, 95% CI = 0.35-2.28, p = .82). The within-group effect sizes were h = 1.22 for CBT and h = 1.18 for PDT. Significant improvements in all secondary outcome measures were found for both CBT (d = 0.51-0.82) and PDT (d = 0.24-1.10). The improvements remained stable at the 12-month follow-up in both groups. There were small between-group effect sizes for binge eating (d = 0.23) and purging (d = 0.26) in favor of CBT and for eating concern (d = -0.35) in favor of PDT. CBT and PDT were effective in promoting recovery from BN in female adolescents. The rates of remission for both therapies were similar to those in other studies evaluating CBT. This trial identified differences with small effects in binge eating, purging, and eating concern. Clinical trial registration information-Treating Bulimia Nervosa in Female Adolescents With Either Cognitive-Behavioral Therapy (CBT) or Psychodynamic Therapy (PDT). http://isrctn.com/; ISRCTN14806095. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  19. Clinical Thanatology and Psychotherapy: Some Reflections on Caring for the Dying Person.

    Science.gov (United States)

    Feigenberg, Loma; Shneidman, Edwin S.

    1979-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  1. Glucocorticoids enhance extinction-based psychotherapy.

    Science.gov (United States)

    de Quervain, Dominique J-F; Bentz, Dorothée; Michael, Tanja; Bolt, Olivia C; Wiederhold, Brenda K; Margraf, Jürgen; Wilhelm, Frank H

    2011-04-19

    Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, double-blind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions. Subjects returned for a posttreatment assessment 3-5 d after the last treatment session and for a follow-up assessment after 1 mo. Adding cortisol to exposure therapy resulted in a significantly greater reduction in fear of heights as measured with the acrophobia questionnaire (AQ) both at posttreatment and at follow-up, compared with placebo. Furthermore, subjects receiving cortisol showed a significantly greater reduction in acute anxiety during virtual exposure to a phobic situation at posttreatment and a significantly smaller exposure-induced increase in skin conductance level at follow-up. The present findings indicate that the administration of cortisol can enhance extinction-based psychotherapy.

  2. Use of extratransference interpretation in psychoanalytic psychotherapy

    Directory of Open Access Journals (Sweden)

    Jojić Boris R.

    2005-01-01

    Full Text Available Background. In psychoanalytic psychotherapy, the transference analysis takes the central position of the work. The work in the extratransference sphere and experience in a professional practice with extratransference interventions have not been reported much in the literature. Extratransference sphere includes less transferring relation to a psychotherapist, transference to other objects, or may refer to the external reality rather than the psychic reality or fantasy. Case report. We pointed out extratransference interventions. We demonstrated an application of a genetic interpretation and reconstruction, too, which could restore and establish the connections between the past and the present, in order to understand the influences of the current reality and the past, and helping us, further, to resolve the infantile conflicts. Conclusion. Interpretation of extratransference situations takes an important part of an analytical work and it is an essential category of the interpretation. Analytic understanding should include transference and extratransference spheres, fantasy and reality, past and present. Working with neurotic patterns and character resistance needs an optimal choice of intervention in the given moment of the analytic process. Extratransference interventions are an essential category of intervention, irreplaceable for its effectiveness in the analytic process.

  3. Was ist eine erfolgreiche Psychotherapie? Was ist erfolgreich in der Psychotherapie?

    Science.gov (United States)

    Fäh

    1998-01-01

    What Is Successful Treatment? What Is Success in Therapy? - Observations on Psychotherapy ResearchThe author raises the following questions: What are the criteria for the evaluation of successful psychotherapeutic treatment? Which are the suitable research methods for the assessment of psychotherapeutic success? He proposes a research paradigm based on multiple criteria and multiple methods. Psychotherapeutic treatment success must be assessed on different levels: aetiology of disease, disease as nosologic category (e. g. depression), symptomatology, consequences (psychic, physical, social, economical) of disease. He further develops a research logic that is multimethodical: Results from different research methods must be aggregated on the basis of convergent findings. The three 'key research methods' in psychotherapy research are: single-case studies, controlled trials, naturalistic catamnestic research. Statements about any psychotherapeutic method or intervention strategy are only valid when results from these different study types converge. It may be a very severe bias when findings from only one study type (e. g. controlled trials) are generalised as a final verdict on certain psychotherapeutic methods.

  4. A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy.

    Science.gov (United States)

    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.

  5. Applications of Mindfulness in Psychotherapy – Contemporary Dilemmas

    Directory of Open Access Journals (Sweden)

    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.

  6. Transference and counter-transference in systems psychodynamic group process consultation: The consultant’s experience

    Directory of Open Access Journals (Sweden)

    F. Cilliers

    2004-10-01

    Full Text Available This study explored consultants’ experiences of transference and counter-transference when conducting group relations training from the systems psychodynamic stance. A phenomenological research design was used with semistructured interviews conducted on a purposive sample of 13 organisational development consultants in a financial institution. The data was analysed by means of content analysis. The results showed that consultants have varied receptiveness in terms of receiving projections and managing transference. These differences involve triggers, characteristics and systemic valence. The consultants experienced counter- transference on five different cognitive and emotional levels. Distinguishing between personal and group emotions, receiving projections and managing transference, all contribute to the complexity of organisational consulting. Opsomming Hierdie studie het ondersoek ingestel na konsultante se ervarings van oordrag en teen-oordrag tydens groepverhoudingsopleiding vanuit die sistemiese psigodinamiese posisie. ’n Fenomenologiese navorsingsontwerp is gebruik met semi-gestruktureerde onderhoude gevoer met ’n doelgerigte steekproef van 13 organisasie ontwikkelingskonsultante in ’n finansiële instelling. Die data is ontleed deur middel van inhoudsontleding. Die resultate het aangetoon dat konsultante uiteenlopende ontvanklikheid het wat betref die ontvangs van projeksies en die hantering van oordrag. Hierdie verskille behels snellers, kenmerke en sistemiese valensie. Die konsultante het teen-oordrag ervaar op vyf verskillende kognitiewe and emosionele vlakke. Om onderskeid te tref tussen persoonlike en groep-emosies, die ontvang van projeksies en die hantering van oordrag, dra alles by tot die kompleksiteit van konsultering.

  7. Leader and team behaviour during organisational change: A systems psychodynamic stance

    Directory of Open Access Journals (Sweden)

    Frans Cilliers

    2006-01-01

    Full Text Available The aim of this research was to explore the dynamic nature of leader and team behaviour during organizational change, using five different organisational constellations or neurotic personality styles, namely the paranoid, schizoid, depressive, compulsive and histrionic styles. Qualitative research was conducted, comprising of two focus groups with eight psychologists consulting regularly to organisational change. The data was content analysed and interpreted from the systems psychodynamic stance. Each style’s leader and team behavioural manifestations are discussed. The findings and recommendations can be used by consulting psychologists towards understanding and implementing organisational change dynamics. Opsomming Die doel van hierdie navorsing was om die dinamiese aard van leier- en spangedrag tydens organisasieverandering te eksploreer, deur gebruik te maak van vyf verskillende organisasie konstelasies of neurotiese persoonlikheids style, naamlik die paranoide, skisoide, depressiewe, kompulsiewe en histrioniese style. Kwalitatiewe navorsing is uitgevoer, bestaande uit twee fokusgroepe met agt sielkundiges wat gereeld konsulteer in die veld van organisasieverandering. Die data is aan inhoudsanalise onderwerp en geinterpreteer vanuit die sisteem-psigodinamiese benadering. Elke styl se leier en span gedrag word bespreek. Die bevindinge en aanbevelings kan gebruik word deur sielkundiges in konsultasies ten einde organisasieveranderingsdinamika te verstaan en te implementeer.

  8. Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

    Science.gov (United States)

    Cornelis, Shana; Desmet, Mattias; Van Nieuwenhove, Kimberly L. H. D.; Meganck, Reitske; Willemsen, Jochem; Inslegers, Ruth; Feyaerts, Jasper

    2017-01-01

    The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed. PMID:28649214

  9. Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study.

    Science.gov (United States)

    Cornelis, Shana; Desmet, Mattias; Van Nieuwenhove, Kimberly L H D; Meganck, Reitske; Willemsen, Jochem; Inslegers, Ruth; Feyaerts, Jasper

    2017-01-01

    The classical symptom specificity hypothesis (Blatt, 1974) particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2) documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009). Similar to the first empirical case study (Chapter 1), Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed.

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

    Directory of Open Access Journals (Sweden)

    Camilla Schmidt

    2012-11-01

    Full Text Available 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 processed as subjective experiences and reflected in the interrelational space created in narrative interviews with trainee social educators. By using a combination of interactionist theory and psychosocial theory in the analysis of an interview with a student of social education, I demonstrate how the often conflicting demands and expectations are being played out in the interrelational tension between the researcher (myself and the interviewee or narrator. In a confrontation with “inner” expectations and concerns regarding a future profession and one’s ability to cope, and the “outer” socially and culturally embedded discourses as they are played out in the objectives of self-development and education, the narrative about a forthcoming internship is filled with tension and contradiction. In this article I will demonstrate how such tensions and contradictions are valuable sources of information in understanding the process of becoming a social educator.

  11. THE CHALLENGE OF WORKING WITH TEENAGERS IN CONFLICT WITH THE LAW: PSYCHODYNAMIC WORK INTERVENTION

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    Jéssica Emanoeli Moreira da Costa

    2017-07-01

    Full Text Available Socio-educational Reintegration Workers play a role in the custody, safety and monitoring of teenagers, complying with socio-educational measures for having infringed the law according to Brazil’s Child and Teenager Statute. This study in terms of public policies has to do with education and sanction. Further, it discusses collective defense strategies from social reintegration workers, who deal on a daily basis with teenagers in conflict with the law. The methodology applied is based upon Work Psychodynamics.  The study concludes that given their strong unity, social reintegration workers protect themselves from work-related pathologies given that they preserve themselves from isolation by inserting themselves in a space of intersubjective relations that support their work and keep them from fear and anxiety. Collective strength comes through cooperation built around the almost prison-like discipline shown towards teenagers deprived of their freedom. This discipline disguises a collective defense strategy that denies the fact that teenagers in conflict with the law are in a vulnerable psychosocial situation. This collective defense strategy serves under current work conditions to protect social reintegration workers from the fear of building a close relationship with teenagers given the certainty that this relationship will leave the first group at risk and unprotected.

  12. Clinicians' emotional responses and Psychodynamic Diagnostic Manual adult personality disorders: A clinically relevant empirical investigation.

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    Gazzillo, Francesco; Lingiardi, Vittorio; Del Corno, Franco; Genova, Federica; Bornstein, Robert F; Gordon, Robert M; McWilliams, Nancy

    2015-06-01

    The aim of this study is to explore the relationship between level of personality organization and type of personality disorder as assessed with the categories in the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006) and the emotional responses of treating clinicians. We asked 148 Italian clinicians to assess 1 of their adult patients in treatment for personality disorders with the Psychodiagnostic Chart (PDC; Gordon & Bornstein, 2012) and the Personality Diagnostic Prototype (PDP; Gazzillo, Lingiardi, & Del Corno, 2012) and to complete the Therapist Response Questionnaire (TRQ; Betan, Heim, Zittel-Conklin, & Westen, 2005). The patients' level of overall personality pathology was positively associated with helpless and overwhelmed responses in clinicians and negatively associated with positive emotional responses. A parental and disengaged response was associated with the depressive, anxious, and dependent personality disorders; an exclusively parental response with the phobic personality disorder; and a parental and criticized response with narcissistic disorder. Dissociative disorder evoked a helpless and parental response in the treating clinicians whereas somatizing disorder elicited a disengaged reaction. An overwhelmed and disengaged response was associated with sadistic and masochistic personality disorders, with the latter also associated with a parental and hostile/criticized reaction; an exclusively overwhelmed response with psychopathic patients; and a helpless response with paranoid patients. Finally, patients with histrionic personality disorder evoked an overwhelmed and sexualized response in their clinicians whereas there was no specific emotional reaction associated with the schizoid and the obsessive-compulsive disorders. Clinical implications of these findings were discussed. (c) 2015 APA, all rights reserved).

  13. Employment equity practices in three South African information technology organisations: A systems psychodynamic perspective

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    Frans Cilliers

    2005-10-01

    Full Text Available This research explored the systems psychodynamic behaviour manifesting in the context of employment equity practices within three South African information technology organisations. In-depth interviews with the human resources practitioners involved, elicited seven themes around fantasies of power/opportunities, splits and defences, projective identification, paranoia, idealisation/competence, envy/guilt and coping styles. It was hypothesised that the experience around employment equity in these organisations got stuck in the paranoid-schizoid position, that the system was unconsciously colluding to keep the status quo, and that idealisation was projected on the white subgroup while denigration was projected on previously disadvantages employees and candidates. Recommendations for more optimal coping with these behaviours were formulated. Opsomming Hierdie navorsing het die sistemies psigodinamiese gedrag ondersoek wat gemanifesteer het in die konteks van gelyke indiensneming in drie Suid-Afrikaanse inligtingstegnologie organisasies. Indiepte onderhoude met die betrokke menslike hulpbron praktisyns het sewe temas na vore gebring wat insluit fantasieë oor mag/geleenthede, spleet en verdedigings, projektiewe identifikasie, paranoia, idealisering/kompetensie, afguns/skuld en coping style. Die hipotese is geformuleer dat die ervaring rondom gelyke indiensneming in hierdie organisasies vasgehak het in die paranoïde-skisoïde posisie, dat die stelsel onbewustelik saamsweer om die status quo te handhaaf, en dat idealisering geprojekteer word op die wit subgroep terwyl swartsmeerdery geprojekteer word op die voorheen benadeelde werknemers en kandidate. Aanbevelings oor meer optimale coping met hierdie gedrag is geformuleer.

  14. Interactions between Obsessional Symptoms and Interpersonal Ambivalences in Psychodynamic Therapy: An Empirical Case Study

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    Shana Cornelis

    2017-06-01

    Full Text Available The classical symptom specificity hypothesis (Blatt, 1974 particularly associates obsessional symptoms to interpersonal behavior directed at autonomy and separation from others. Cross-sectional group research, however, has yielded inconsistent findings on this predicted association, and a previous empirical case study (Cornelis et al., in press; see Chapter 2 documented obsessional pathology to be rooted in profound ambivalences between autonomous and dependent interpersonal dynamics. Therefore, in the present empirical case study, concrete operationalizations of the classical symptom specificity hypothesis are contrasted to alternative hypotheses based on the observed complexities in Chapter 2. Dynamic associations between obsessional symptoms and interpersonal functioning is further explored, aiming at further contribution to theory building (i.e., through suggestions for potential hypothesis-refinement; Stiles, 2009. Similar to the first empirical case study (Chapter 1, Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of supportive-expressive psychodynamic therapy. In line with findings from Chapter 1, findings reveal close associations between obsessions and interpersonal dynamics, and therapist interventions focusing on interpersonal conflicts are documented as related to interpersonal and symptomatic alterations. Observations predominantly accord to the ambivalence-hypothesis rather than to the classical symptom specificity hypothesis. Yet, meaningful differences are observed in concrete manifestations of interpersonal ambivalences within significant relationships. Findings are again discussed in light of conceptual and methodological considerations; and limitations and future research indications are addressed.

  15. 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

  16. 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

  17. 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…

  18. 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.

  19. ONLINE PSYCHOTHERAPY: GROWING DEMAND AND SUGGESTIONS FOR ITS REGULATION

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    Carmelita Gomes Rodrigues

    2017-01-01

    Full Text Available Online psychotherapy is a form of psychotherapy conducted by means of synchronous Internet sessions that are still not allowed in Brazil, except in a few instances defined by the Resolution 011/2012 of the Federal Council of Psychology. Such restriction is based on the understanding that the research available is insufficient to authorize a widespread use of this type of service. Studies on therapeutic alliance in psychological care provided exclusively over the internet show that the establishment of the therapeutic relationship in synchronous online calls occurs much like it does in face-to-face therapeutic processes, considering both, its benefits and challenges. This article aims to broaden the understanding of the online psychotherapy and to question its prohibition, signaling the dangers it entails, vis-a-vis the increasing demand for the service and its widespread use in disregard with the current restrictions. This article also makes suggestions for the regulation of the service in Brazil.

  20. Toward a renewal of personology in psychotherapy research.

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    Stolorow, Robert D

    2012-12-01

    The articles by Elkins (D. N. Elkins, 2012, Toward a common focus in psychotherapy research, Psychotherapy, 49, pp. 450-454) and Hayes (S. C. Hayes, 2012, Humanistic psychology and contextual behavioral perspectives, Psychotherapy, 49, pp. 455-460) serve as a springboard for a call for a renewal of personological methods in studies of the psychotherapeutic relationship-methods that can investigate the emotional worlds of patient and psychotherapist as well as the relational systems constituted by the interplay between them. I believe only such idiographic research can illuminate the nexus of humanistic elements in which the psychotherapeutic process takes form. The beginnings of the author's own phenomenological-contextualist psychoanalytic perspective hark back to a series of personological studies of the subjective origins of psychoanalytic theories. (c) 2012 APA, all rights reserved.