This paper is an adaptation of Kohlenberg and Tsai's work, Functional Analytical Psychotherapy (1991), or FAP, to group psychotherapy. This author applied a behavioral rationale for interpersonal process groups by illustrating key points with a hypothetical client. Suggestions are also provided for starting groups, identifying goals, educating…
Tasca, Giorgio A; Balfour, Louise; Presniak, Michelle D; Bissada, Hany
We assessed whether an attachment-based treatment, Group Psychodynamic Interpersonal Psychotherapy (GPIP) had a greater impact compared to Group Cognitive Behavioral Therapy (GCBT) on Cold/Distant and Intrusive/Needy interpersonal problems. Ninety-five individuals with Binge Eating Disorder (BED) were randomized to GPIP or GCBT and assessed at pre-, post-, and six months post-treatment. Both therapies resulted in a significant decrease in all eight interpersonal problem subscales except the Nonassertive subscale. GPIP resulted in a greater reduction in the Cold/Distant subscale compared to GCBT, but no differences were found for changes in the Intrusive/Needy subscale. GPIP may be most relevant for those with BED who have Cold/Distant interpersonal problems and attachment avoidance.
Moran, Tracy E.; Larrieu, Julie A.; Zeanah, Paula; Evenson, Amber; Valliere, Jean
Postpartum depression (PPD) affects a significant portion of women and has serious negative short- and long-term consequences for the woman, infant, and family. This article highlights the feasibility and acceptability of group interpersonal psychotherapy (IPT-G), a manualized approach to PPD treatment, with a high risk and underserved sample of…
Krupnick, Janice L; Green, Bonnie L; Stockton, Patricia; Miranda, Jeanne; Krause, Elizabeth; Mete, Mihriye
The aim of this study was to assess the efficacy of group interpersonal psychotherapy (IPT) for low-income women with chronic posttraumatic stress disorder (PTSD) subsequent to interpersonal trauma. Non-treatment-seeking predominantly minority women were recruited in family planning and gynecology clinics. Individuals with interpersonal trauma histories (e.g., assault, abuse, and molestation) who met criteria for current PTSD (N=48) were randomly assigned to treatment or a wait list. Assessments were conducted at baseline, treatment termination, and 4-month follow-up; data analysis used a mixed-effects regression approach with an intent-to-treat sample. The results showed that IPT was significantly more effective than the wait list in reducing PTSD and depression symptom severity. IPT participants also had significantly lower scores than waitlist individuals on four interpersonal functioning subscales: Interpersonal Sensitivity, Need for Social Approval, Lack of Sociability, and Interpersonal Ambivalence.
Bender, A; Ewashen, C
When practicing as group leaders, mental health nurses often incorporate Irvin Yalom's (1995, 1998) concepts of social microcosm and here-and-now. This article examines these concepts from a feminist perspective and offers an approach to group psychotherapy that processes gender issues and fosters collective consciousness-raising. A feminist perspective in group therapy challenges us to view the social microcosm as a reenactment of sociopolitical contexts and the here-and-now as a medium for developing personal and social responsibility. Therapy is not only about individual and interpersonal change in group members, but is an opportunity for healthy social change. Therapy becomes political work, raising the social consciousness of each participant as well as the group as a whole.
Wilfrey, Denise E.; And Others
Evaluated effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating among 56 women with nonpurging bulimia. At posttreatment, both CBT and IPT conditions showed significant improvement in reducing binge eating, compared to waiting-list condition. Binge eating remained significantly…
Soldz, S; Budman, S; Davis, M; Demby, A
Development of a new scale to measure patient behavior in group psychotherapy, the Individual Group Member Interpersonal Process Scale (IGIPS), is described. This scale captures clinically important aspects of how patients act in group, including how they respond to the other group members. The IGIPS was applied to videotapes of the first four sessions of seven 15-session outpatient therapy groups (52 patients) in the Mental Health Department of a health maintenance organization. The scale was found to have five factors (Activity, Interpersonal Sensitivity, Comfort with Self, Self-Focus, and Psychological Mindedness). Patient behavior that was moderate on two IGIPS dimensions was connected with better outcome than was that of patients with more extreme behavior in either direction.
Verdeli, Helen; Clougherty, Kathleen; Onyango, Grace; Lewandowski, Eric; Speelman, Liesbeth; Betancourt, Teresa S; Neugebauer, Richard; Stein, Traci R; Bolton, Paul
This article reviews the use of Interpersonal Psychotherapy (IPT) with depressed youth living in Internally Displaced Persons (IDP) camps in North Uganda. This youth has been exposed to severe losses and disruptions in relationships with caregivers, family, and community members; limited access to formal education; exposure to malnutrition and infections; and pressure to prematurely assume adult family roles. The process of adaptation to the content and training of IPT for these youth is presented and illustrated with case examples.
Gallagher, Meagan E; Tasca, Giorgio A; Ritchie, Kerri; Balfour, Louise; Maxwell, Hilary; Bissada, Hany
Yalom and Leszcz (2005) indicated that interpersonal learning is a key therapeutic factor in group psychotherapy. In this study, we conceptualized interpersonal learning as the convergence over time between an individual's and the group's perception of the individual's cohesion to the group. First, we developed parallel measures of: (a) an individual's self-rated cohesion to the group (Cohesion Questionnaire-Individual Version [CQ-I]), and (b) the group's rating of the individual's cohesion to the group (CQ-G) based on the original Cohesion Questionnaire (CQ; Piper, Marache, Lacroix, Richardsen, & Jones, 1983). Second, we used these parallel scales to assess differences between an individual's self-rating and the mean of the group's ratings of the individual's cohesion to the group. Women with binge eating disorder (N = 102) received Group Psychodynamic Interpersonal Psychotherapy. Participants were assigned to homogeneously composed groups of either high or low attachment anxiety. Outcomes were measured pre- and post-treatment, and the CQ-I and CQ-G were administered every fourth group session. We found significant convergence over time between the CQ-I and mean CQ-G scale scores in both attachment anxiety conditions. Participants with higher attachment anxiety had lower individual self-ratings of cohesion and had greater discrepancies between the CQ-I and CG-G compared with those with lower attachment anxiety. There was a significant relationship between greater convergence in cohesion ratings and improved self-esteem at post-treatment. More accurate self-perceptions through feedback from group members may be a key factor in facilitating increased self-esteem in group therapy. Group therapists may facilitate such interpersonal learning, especially for those higher in attachment anxiety, by noting discrepancies and then encouraging convergence between an individual and the group in their perceptions of cohesion to the group.
Hewitt, Paul L; Mikail, Samuel F; Flett, Gordon L; Tasca, Giorgio A; Flynn, Carol A; Deng, Xiaolei; Kaldas, Janet; Chen, Chang
This study sought to determine whether clinically significant improvement could be obtained using a psychodynamic/interpersonal group treatment based on a comprehensive conceptualization of perfectionism. A sample of 71 community-recruited perfectionistic individuals participated in the University of British Columbia Perfectionism Treatment Study. Eighteen of these participants were initially nonrandomly assigned to a waitlist control condition. All participants completed measures of perfectionism traits, perfectionistic self-presentation, and automatic perfectionistic thoughts, as well as measures of distress including depression, anxiety, and interpersonal problems at pretreatment, posttreatment, and at a 4-month follow-up. Multilevel modeling demonstrated that perfectionism levels decreased with large effect sizes and that these decreases were associated with reductions in distress measures. Clinically significant decreases were found in all perfectionism components, and posttreatment scores on most variables were significantly lower in the treatment condition versus the waitlist control condition. The findings suggest that psychodynamic/interpersonal group treatment is effective in treating components of perfectionism.
Brakemeier, Eva-Lotta; Frase, Lukas
In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.
Young, Jami F; Benas, Jessica S; Schueler, Christie M; Gallop, Robert; Gillham, Jane E; Mufson, Laura
Given the rise in depression disorders in adolescence, it is important to develop and study depression prevention programs for this age group. The current study examined the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a group prevention program for adolescent depression, in comparison to group programs that are typically delivered in school settings. In this indicated prevention trial, 186 adolescents with elevated depression symptoms were randomized to receive IPT-AST delivered by research staff or group counseling (GC) delivered by school counselors. Hierarchical linear modeling examined differences in rates of change in depressive symptoms and overall functioning from baseline to the 6-month follow-up assessment. Cox regression compared rates of depression diagnoses. Adolescents in IPT-AST showed significantly greater improvements in self-reported depressive symptoms and evaluator-rated overall functioning than GC adolescents from baseline to the 6-month follow-up. However, there were no significant differences between the two conditions in onset of depression diagnoses. Although both intervention conditions demonstrated significant improvements in depressive symptoms and overall functioning, results indicate that IPT-AST has modest benefits over groups run by school counselors which were matched on frequency and duration of sessions. In particular, IPT-AST outperformed GC in reduction of depressive symptoms and improvements in overall functioning. These findings point to the clinical utility of this depression prevention program, at least in the short-term. Additional follow-up is needed to determine the long-term effects of IPT-AST, relative to GC, particularly in preventing depression onset.
Miller, Lisa; Gur, Merav; Shanok, Arielle; Weissman, Myrna
The objective of this study was to test the feasibility, acceptability and helpfulness of group Interpersonal Psychotherapy (IPT-PA) for depression in pregnant adolescents. Method: Two open clinical trials were conducted of IPT-PA delivered in group format in a New York City public school for pregnant girls. Study 1 tests IPT-PA for management of…
Leblanc, Jean; Streit, Ursula
Interpersonal Psychotherapy was developed in the years 1969-84, specifically at that time, for the treatment of depression (later called Major Depression). Today, its indications have been extended to numerous other clinical syndromes and situations. This article describes the empirical basis on which IPT was developed until it evolved to its current format. A description of the phases of treatment is presented and the four problem areas commonly encountered in IPT are more explicitly detailed. Several techniques utilized in the course of this treatment are enumerated and the strategy underlying their usage is explained. IPT is an evidence-based psychotherapy and a clarification is made about its specificity, compared to other commonly used forms of psychotherapy.
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.
Rounsaville, Bruce J.; And Others
Examined relation between general dimensions of psychotherapy process, rated with the Vanderbilt Psychotherapy Process Scale (VPPS), and a manual-guided psychotherapy, Short-Term Interpersonal Psychotherapy of Depression (IPT). VPPS-rated dimensions of patients and therapist behaviors were significantly correlated with IPT competence ratings.…
Giannone, Francesca; Giordano, Cecilia; Di Blasi, Maria
This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.
Miniati, Mario; Callari, Antonio; Calugi, Simona; Rucci, Paola; Savino, Mario; Mauri, Mauro; Dell'Osso, Liliana
Interpersonal psychotherapy (IPT) is a dynamically informed and present-focused psychotherapy originally conceived for patients with unipolar depression and subsequently modified for other disorders, including postpartum depression (PPD). The aim of this paper is to review the evidence on the efficacy of IPT for PPD. We conducted a systematic review of studies published between 1995 and April 2013 assessing the efficacy of IPT for PPD using PubMed and PsycINFO. We included the following: (i) articles that presented a combination of at least two of the established terms in the abstract, namely, interpersonal [all fields] and ("psychotherapy" [MeSH terms] or psychotherapy [all fields]) and (perinatal [all fields] or postpartum [all fields]) and ("depressive disorder" [MeSH terms] or ("depressive" [all fields] and "disorder" [all fields]) or depressive disorder [all fields] or "depression" [all fields] or depression [MeSH terms]); (ii) manuscripts in English; (iii) original articles; and (iv) prospective or retrospective observational studies (analytical or descriptive), experimental, or quasi-experimental. Exclusion criteria were as follows: (i) other study designs, such as case reports, case series, and reviews; (ii) non-original studies including editorials, book reviews, and letters to the editor; and (iii) studies not specifically designed and focused on IPT. We identified 11 clinical primary trials assessing the efficacy of IPT for PPD, including 3 trials with group interventions (G-IPT) and one that required the presence of the partner (PA-IPT). We also identified six studies interpersonal-psychotherapy-oriented preventive interventions for use in pregnancy. IPT studies showed overall clinical improvement in the most commonly used depression measures in postpartum depressed women (EPDS, HDRS, BDI) and often-full recovery in several cases of treated patients. Evidence from clinical trials indicates that, when administered in monotherapy (or in combination with
Rafaeli, Alexandra Klein; Markowitz, John C
Interpersonal Psychotherapy (IPT), a time-limited, evidence-based treatment, has shown efficacy in treating major depressive disorder and other psychiatric conditions. Interpersonal Psychotherapy focuses on the patient's current life events and social and interpersonal functioning for understanding and treating symptoms. This case report demonstrates the novel use of IPT as treatment for posttraumatic stress disorder (PTSD). Preliminary evidence suggests IPT may relieve PTSD symptoms without focusing on exposure to trauma reminders. Thus IPT may offer an alternative for patients who refuse (or do not respond to) exposure-based approaches. Interpersonal Psychotherapy focuses on two problem areas that specifically affect patients with PTSD: interpersonal difficulties and affect dysregulation. This case report describes a pilot participant from a study comparing 14 weekly sessions of IPT to treatment with two other psychotherapies. We describe the session-by-session IPT protocol, illustrating how to formulate the case, help the patient identify and address problematic affects and interpersonal functioning, and to monitor treatment response.
Hilbert, Anja; Saelens, Brian E.; Stein, Richard I.; Mockus, Danyte S.; Welch, R. Robinson; Matt, Georg E.; Wilfley, Denise E.
The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined…
Frank, Ellen; Ritchey, Fiona C; Levenson, Jessica C
We employed standard literature search techniques and surveyed participants on the International Society for Interpersonal Psychotherapy listserve (firstname.lastname@example.org) to catalogue the multiple and highly creative ways in which Klerman's and Weissman's original concept of interpersonal psychotherapy (IPT) has been modified to meet the needs of a vast range of patient populations. Focusing first on adaptations of the individual treatment model for subgroups of adult patients, we next describe further adaptations of four major off-shoots of IPT: interpersonal counseling (IPC), IPT for adolescents (IPT-A), group IPT (IPT-G) and most recently, brief IPT (IPT-B). We then discuss IPT "in-laws," those treatments that have married IPT with of other forms of psychotherapy for patients with bipolar disorder, panic symptomatology, and substance abuse. We conclude with that although there have been myriad successful adaptations of IPT, there remain some conditions for which IPT adaptations have not been found to be efficacious.
Lichtmacher, Jonathan; Eisendrath, Stuart J.; Haller, Ellen
Objective: Interpersonal psychotherapy (IPT) for depression is a brief, well researched treatment for acute major depression. This article describes the implementation of IPT as an evidence-based treatment for depression in a psychiatry residency program. Method: The authors tracked the implementation process over 5 years as interpersonal…
Young, Jami F.; Mufson, Laura; Davies, Mark
Background: Indicated interventions for adolescents with elevated depressive symptoms may help decrease rates of depression. The current study reports on the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a group indicated preventive intervention. Methods: Forty-one adolescents with elevated depression symptoms were…
Penna, Carla; Castanho, Pablo
Group analytic practice in Brazil began quite early. Highly influenced by the Argentinean Pichon-Rivière, it enjoyed a major development from the 1950s to the early 1980s. Beginning in the 1970s, different factors undermined its development and eventually led to its steep decline. From the mid 1980s on, the number of people looking for either group analytic psychotherapy or group analytic training decreased considerably. Group analytic psychotherapy societies struggled to survive and most of them had to close their doors in the 1990s and the following decade. Psychiatric reform and the new public health system have stimulated a new demand for groups in Brazil. Developments in the public and not-for-profit sectors, combined with theoretical and practical research in universities, present promising new perspectives for group analytic psychotherapy in Brazil nowadays.
Schramm, E; Berger, M
In general work involves health promoting functions but can also have hazardous impacts on well-being. Due to a massive change in working conditions it has become increasingly more recognized that depressive disorders are highly prevalent at the workplace and that work stress belongs to the most common triggers of depressive disorders, particularly in men. It is relevant to differentiate between subjectively experienced burnout and clinical depression. The best investigated psychosocial work stressors include increased job demands in connection with low control possibilities and lack of gratification, interpersonal conflicts, role stress and social isolation. For the treatment of work-related clinical depression, an additional focus of interpersonal psychotherapy (IPT) of depression, namely "work-related stress and burnout experience" was conceptualized based on a vulnerability-stress model and the fact that work usually takes place in an interpersonal context. This new problem area focuses on role stress and conflicts at work and the reduction of stressful working conditions. Interpersonal psychotherapy has so far been useful for the treatment of depression due to problems at work; however, further studies are needed to evaluate the efficacy of this newly designed problem area.
Clark, Carlton F. "Perk"
Transpersonal group psychotherapy is a carpet of theory, technique, and experiences woven from threads of contemporary psychology, mysticism, and a perennial philosophy many centuries old. Introduces the basic concepts of transpersonal group psychotherapy, proposes a model of transpersonal group psychotherapy, discusses the training of…
Mufson, Laura; Sills, Rebecca
This paper reviews the main principles of Interpersonal Psychotherapy and its adaptation for depressed adolescents (IPT-A). The work of IPT-A is put in the context of the significant problem of depression in adolescence and the other treatments and their efficacy in the treatment of adolescent depression. The paper also provides an overview of the approach and specific techniques to be used with adolescents. The efficacy and effectiveness data on IPT-A are presented briefly. IPT-A is an empirically supported psychotherapy for depressed, non-bipolar and non-psychotic adolescents. IPT-A is unique among evidence-based treatments in its demonstrated effectiveness when transported from a laboratory setting to a community setting (school-based health clinics) and delivered by community clinicians. Future studies are needed with other populations that include long-term follow-up of outcomes and are conducted by other investigator teams.
O'Shea, Gabrielle; Spence, Susan H; Donovan, Caroline L
The aim of this study was to investigate whether depressed adolescents differed from non-depressed adolescents in terms of constructs consistent with those that are proposed to underpin interpersonal psychotherapy. In particular, it was hypothesized that compared with non-depressed adolescents, depressed adolescents would demonstrate a greater number of negative life events associated with interpersonal loss and major life transitions, a more insecure attachment style and poorer communication skills, interpersonal relationships and social support. Thirty-one clinically diagnosed depressed adolescents were matched with 31 non-depressed adolescents on age, gender and socio-economic status. The 62 participants were aged between 12 and 19 years and comprised 18 male and 44 female adolescents. On a self-report questionnaire, depressed adolescents reported a greater number of negative interpersonal life events, a less secure attachment style and scored higher on all insecure attachment styles compared with the non-depressed adolescents. In addition, depressed adolescents demonstrated lower levels of social skill (on both adolescent and parent report), a poorer quality of relationship with parents (on both adolescent and parent report) and lower social competence (adolescent report only). Parents of depressed adolescents also reported more negative parental attitudes and behaviours towards their adolescent compared with parents of non-depressed adolescents. Thus, the results of this study are consistent with the constructs underlying interpersonal psychotherapy and suggest their usefulness in the assessment, conceptualization and treatment of adolescent depression. Clinical implications are discussed.
Ravitz, Paula; McBride, Carolina; Maunder, Robert
Interpersonal psychotherapy (IPT) is an effective treatment for depression across the lifespan and across cultures. However, even when delivered with fidelity, some patients drop out and others do not improve sufficiently. Attention to IPT treatment attrition, dropout, nonresponse, or failure can elucidate its limitations and the opportunities to improve its effectiveness. Studies of factors known to moderate and negatively predict IPT depression treatment response are reviewed along with recommended modifications to improve outcomes. Although the risk of treatment failure always exists, it is possible to enhance treatment effectiveness by attending to the therapeutic alliance, strategically addressing depression, and adapting IPT to patient characteristics. These include adding pharmacotherapy, extending the course of treatment, and targeting specific symptoms or interpersonal vulnerabilities. Case examples illustrate several of these points.
FRANK, ELLEN; RITCHEY, FIONA C.; LEVENSON, JESSICA C.
We employed standard literature search techniques and surveyed participants on the International Society for Interpersonal Psychotherapy listserve (email@example.com) to catalogue the multiple and highly creative ways in which Klerman’s and Weissman’s original concept of interpersonal psychotherapy (IPT) has been modified to meet the needs of a vast range of patient populations. Focusing first on adaptations of the individual treatment model for subgroups of adult patients, we next describe further adaptations of four major off-shoots of IPT: interpersonal counseling (IPC), IPT for adolescents (IPT-A), group IPT (IPT-G) and most recently, brief IPT (IPT-B). We then discuss IPT “in-laws,” those treatments that have married IPT with of other forms of psychotherapy for patients with bipolar disorder, panic symptomatology, and substance abuse. We conclude with that although there have been myriad successful adaptations of IPT, there remain some conditions for which IPT adaptations have not been found to be efficacious. PMID:26453344
This article provides a particular view on the use of Functional Analytical Psychotherapy (FAP) in a group therapy format. This view is based on the author's experiences as a supervisor of Functional Analytical Psychotherapy Groups, including groups for women with depression and groups for chronic pain patients. The contexts in which this approach…
Amongst the many modifications and applications of Interpersonal Psychotherapy (IPT), its utilisation in the treatment of psychological trauma is amongst the most complex. Psychological trauma is usually defined as Post Traumatic Stress Disorder (PTSD) in the Anglo-American literature. Despite the focus of the scientific literature on PTSD, psychological trauma engenders profound disturbances of mood, affect regulation, self-concept, interpersonal adjustment and a profound existential crisis in the lives of those afflicted. In the light of this, no one psychological therapy is positioned to 'treat'all aspects of psychological traumatic stress. Through its focus upon the individual and his or her experience of their interpersonal world, IPT provides scope for a psychological intervention which, whilst aiming at relief of distress, approaches issues not usually addressed in symptom focussed treatments. In this paper, I will attempt to outline the rationale for the use of IPT in psychological trauma and PTSD and then provide some evidence of its utility in the clinical setting.
Beeber, Linda S.; Schwartz, Todd A.; Holditch-Davis, Diane; Canuso, Regina; Lewis, Virginia; Matsuda, Yui
Formidable barriers prevent low-income mothers from accessing evidence-based treatment for depressive symptoms that compromise their ability to provide sensitive, responsive parenting for their infant or toddler. interpersonal psychotherapy (IPT), an evidence-based psychotherapy for depression, was tailored for in-home delivery to mothers…
Hall, Elisabeth Baerg; Mufson, Laura
This article describes the treatment of a depressed adolescent (15 years of age) boy using Interpersonal Psychotherapy for depressed adolescents (IPT-A). IPT-A is an empirically supported psychosocial intervention for adolescents suffering from a depressive episode. It is delivered as an individual psychotherapy with a minimum of parental…
Reviews the literature on the selection of members for and the composition of psychotherapy groups. Discusses viewpoints on inclusion-exclusion criteria as well as theories on group composition. (Author)
Bowen, Sarah; Haworth, Kevin; Grow, Joel; Tsai, Mavis; Kohlenberg, Robert
Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1991) aims to improve interpersonal relationships through skills intended to increase closeness and connection. The current trial assessed a brief mindfulness-based intervention informed by FAP, in which an interpersonal element was added to a traditional intrapersonal mindfulness…
Hoffart, Asle; Borge, Finn-Magnus; Sexton, Harold; Clark, David M.
The purpose of this study was to test cognitive and interpersonal models for improving social phobia. Eighty patients with social phobia were randomized to 10-week residential cognitive (RCT) or residential interpersonal psychotherapy (RIPT). They completed process measures every Thursday and a sub-outcome measure every Monday. The ratings were…
Pattison, E. Mansell
An ad hoc committee of the American Group Psychotherapy Association (AGPA) was charged to investigate the use of group methods in Community mental health centers (CMHC), to assess the conceptual basis for the use of various group methods, to relate the use of group methods to group psychotherapy, and to evaluate trends in this area of mental…
Amaranto, E A; Bender, S S
This paper describes a form of combined psychotherapy in which the individual sessions are used as an adjunct to group therapy. Each group member is seen regularly in individual sessions to focus primarily on the member's ongoing group work. The individual sessions are scheduled on a rotating basis. Typically, each group member is seen in an individual session once every four weeks. Additional individual sessions are available only when immediate attention is appropriate and necessary. The group is viewed as the primary therapeutic component. A cost-effective therapeutic approach that uses both individual and group methods, this modality lends itself well to a clinic and to a private practice setting.
Flores, Philip J
This article selectively highlights relevant areas of neuroscience research which have direct application for attachment theory and group psychotherapy. Emerging evidence from the neurosciences is revealing that the developing brain of the infant, sculpted by the earliest attachment relationships, continues to be malleable in adulthood and can be profoundly influenced by ongoing relationships throughout one's lifespan. Advances in the neurosciences are also supporting the idea that strong attachment bonds and external interpersonal interactions that arise within the context of these attachments are registered as a person's neurophysiology and neurobiology. Attachment theory in particular provides a common language and conceptual framework from which the contributions from the neurosciences can be made applicable to group psychotherapy.
Swartz, Holly A; Grote, Nancy K; Graham, Patricia
Brief Interpersonal Psychotherapy (IPT-B) is an eight-session adaption of Interpersonal Psychotherapy (IPT), an evidence-based psychotherapy for depression. The rationale for developing a briefer form of IPT rests on the paucity of empirical evidence linking increased therapy "dose" to enhanced therapeutic effects. The goal of IPT-B is to allow individuals who are unlikely to attend 16 sessions of psychotherapy-because of external or internal constraints-to receive the full benefits of IPT in fewer sessions. We provide an overview of IPT-B and describe the modifications made to standard IPT to adjust for the truncated time course. We then review the empirical evidence supporting this briefer model of IPT, including four open studies, one matched case-control study, and three randomized controlled trials. We conclude that IPT-B offers the dual advantages of rapid relief from suffering and decreased resource utilization.
Ravitz, Paula; Wondimagegn, Dawit; Pain, Clare; Araya, Mesfin; Alem, Atalay; Baheretibeb, Yonas; Hanlon, Charlotte; Fekadu, Abebaw; Park, Jamie; Fefergrad, Mark; Leszcz, Molyn
Psychotherapies, such as Interpersonal Psychotherapy (IPT), that have proven effective for treating mental disorders mostly lie dormant in consensus-treatment guidelines. Broadly disseminating these psychotherapies by training trainers and front-line health workers could close the gap between mental health needs and access to care. Research in continuing medical education and knowledge translation can inform the design of educational interventions to build capacity for providing psychotherapy to those who need it. This paper summarizes psychotherapy training recommendations that: adapt treatments to cultural and health organizational contexts; consider implementation barriers, including opportunity costs and mental health stigma; and engage local opinion leaders to use longitudinal, interactive, case-based teaching with reflection, skills-coaching, simulations, auditing and feedback. Community-based training projects in Northern Ontario, Canada and Ethiopia illustrate how best-education practices can be implemented to disseminate evidence-supported psychotherapies, such as IPT, to expand the therapeutic repertoire of health care workers and improve their patients' clinical outcomes.
Hall, Elisabeth Baerg; Mufson, Laura
This article describes the treatment of a depressed adolescent (15 years of age) boy using Interpersonal Psychotherapy for depressed adolescents (IPT-A). IPT-A is an empirically supported psychosocial intervention for adolescents suffering from a depressive episode. It is delivered as an individual psychotherapy with a minimum of parental involvement. The following case study illustrates the principal strategies and techniques of IPT-A.
Buchele, B J
Psychodynamic group psychotherapy is gaining renewed attention as an effective form of treatment, due in part to increasing economic constraints that make other forms of treatment less accessible. The author highlights some innovative applications of both extended and time-limited groups. She also describes specific issues that can be addressed effectively in homogeneous time-limited group therapy.
Anderson, Timothy; Knobloch-Fedders, Lynne M; Stiles, William B; Ordoñez, Tatiana; Heckman, Bernadette D
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.
Fincke, Janna I.; Möller, Heidi; Taubner, Svenja
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
Szwabo, Peggy; Thale, Thomas T.
Traditionally, the elderly have not been viewed as appropriate candidates for dynamic psychotherapy. To examine the effectiveness of a psycho-dynamically oriented group (focusing on the issues of aging, conflict resolution, and self-actualization) on 6 older adult participants, ages 63 to 87 years, systematic clinical observations of group…
Young, Jami F.; Mufson, Laura; Davies, Mark
Objective: To assess the impact of comorbid anxiety on treatment for adolescent depression in an effectiveness study of interpersonal psychotherapy for depressed adolescents (IPT-A). Method: A randomized clinical trial was conducted from April 1, 1999, through July 31, 2002. Sixty-three depressed adolescents, ages 12 to 18, received either IPT-A…
Heird, Emily Benton; Steinfeldt, Jesse A.
Research has shown that disruptive circumstances in an athlete's career (temporary injury, permanent injury, retirement) can pose significant difficulties, especially if the athlete has developed a salient athletic identity at the expense of a multidimensional self-concept. The authors present an interpersonal psychotherapy approach to case…
Sburlati, Elizabeth S.; Lyneham, Heidi J.; Mufson, Laura H.; Schniering, Carolyn A.
In order to treat adolescent depression, a number of empirically supported treatments (ESTs) have been developed from both the cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT-A) frameworks. Research has shown that in order for these treatments to be implemented in routine clinical practice (RCP), effective therapist…
Young, Jami F.; Makover, Heather B.; Cohen, Joseph R.; Mufson, Laura; Gallop, Robert J.; Benas, Jessica S.
Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a…
Nylen, Kimberly J.; O'Hara, Michael W.; Brock, Rebecca; Moel, Joy; Gorman, Laura; Stuart, Scott
Objective: We examined the course and predictors of postpartum depression in the 18 months following interpersonal psychotherapy (IPT). Method: We enrolled 120 community women with major depression in a 12-week randomized trial of individual IPT during the postpartum period (O'Hara, Stuart, Gorman, & Wenzel, 2000). At 6, 12, and 18 months…
Ilardi, Dawn L; Kaslow, Nadine J
The social brain model emphasizes improving our understanding of the relational factors that influence treatment adherence. Consistent with this framework, which has been applied to medical adherence, it was hypothesized that insecure attachment styles, interpersonal hassles, and low levels of social support would explain group psychotherapy attendance. Results from 51 abused and suicidal low-income, African American women who attended at least 1 session of an empowerment group psychotherapy indicated that lower attendance was related to (a) insecure attachment styles (fearful) and (b) interpersonal hassles (perceived social differences, lack of social acceptability, social victimization). Perceived social support did not predict group therapy attendance. The value of addressing attachment styles and interpersonal factors to enhance treatment participation is underscored.
Chevron, Eve S.; And Others
The training of psychotherapists has been an ongoing process in psychiatry and clinical psychology. Recently, however, a growing demand to operationalize competence criteria to enable independent evaluation of therapists' skills in specifically defined psychotherapies has occurred. To examine this phenomenon, evaluation procedures were developed…
Roback, Howard B.
Group forms of therapy have been growing at a rapid rate, in part because of their documented effectiveness and economic considerations such as managed care. It is therefore becoming increasingly important to assess the psychological risks of these interventions. The author provides an overview of the published literature and conference presentations on negative effects in adult outpatient groups. Although much of the literature on adverse outcomes in group therapy focuses on single risk factors (e.g., negative leader, group process, or patient characteristics), the author argues that an interactional model should be encouraged. Means of reducing casualties are also discussed, as well as methodological issues and research directions. PMID:10896735
Johnson, Jennifer E; Price, Ann Back; Kao, Jennifer Chienwen; Fernandes, Karen; Stout, Robert; Gobin, Robyn L; Zlotnick, Caron
This randomized controlled pilot trial examined the feasibility, acceptability, and preliminary efficacy of an adapted interpersonal psychotherapy (IPT) for major depressive disorder (MDD) following perinatal loss (miscarriage, stillbirth, or early neonatal death). Fifty women who experienced a perinatal loss within the past 18 months, whose current depressive episode onset occurred during or after the loss, were randomized to the group IPT adapted for perinatal loss (the Group IPT for Major Depression Following Perinatal Loss manual developed for this study is available at no cost by contacting either of the first two authors) or to the group Coping with Depression (CWD), a cognitive behavioral treatment which did not focus on perinatal loss nor social support. Assessments occurred at baseline, treatment weeks 4 and 8, post-treatment, and 3 and 6 months after the end of treatment. IPT was feasible and acceptable in this population. Although some participants were initially hesitant to discuss their losses in a group (as occurred in IPT but not CWD), end of treatment satisfaction scores were significantly (p = 0.001) higher in IPT than in CWD. Confidence intervals around between-groups effect sizes favored IPT for reductions in depressive symptoms during treatment as well as for improvement in mode-specific targets (social support, grief symptoms) and recovery from a post-traumatic stress disorder over follow-up. This group IPT treatment adapted for MDD after perinatal loss is feasible, acceptable, and possibly efficacious.
McGrew, Linda G.; Lewis, Stephen D.
Indicates the importance of interpersonal skills in the workplace and suggests that the business curricula offers many opportunities for incorporation of group activities. Offers steps for planning student group activities. (JOW)
Frew, J E
In Gestalt therapy, transference is viewed as a contact boundary disturbance which impairs the patient's ability to accurately perceive the present therapy situation. The boundary disturbances in Gestalt therapy most closely related to the analytic notion of transference are projection, introjection, and confluence. In Gestalt group psychotherapy, group members interfere with the process of need identification and satisfaction by distorting their contact with each other through projecting, introjecting, and being confluent. The Gestalt group therapist uses interventions directed to individuals and to the group to increase participants' awareness of these boundary disturbances and of the present contact opportunities available to them when these disturbances are resolved. In formulating interventions, the leader is mindful of the function of boundary disturbances to the group-as-a-whole as well as to individuals.
Berry, C E
This article discusses self psychology as a theory of personality development and conceptual framework for diagnosing psychopathology. It seeks to show how specific components of this theory, including selfobjects, bipolar self, mirroring, tension arc, and nuclear self, can be compared with the "curative factors" of group psychotherapy, as presented by Yalom (1975). These include altruism, group cohesiveness, universality, interpersonal learning, guidance, and family reenactment. Existing literature is used to explain both theories and develop their synthesis.
Hatcher, Robert L
Professional practice in psychology is anchored in interpersonal or relational skills. These skills are essential to successful interactions with clients and their families, students, and colleagues. Expertise in these skills is desired and expected for the practicing psychologist. An important but little-studied aspect of interpersonal skills is what Stiles and colleagues (Stiles, Honos-Webb, & Surko, 1998; Stiles, 2009, 2013) have called appropriate responsiveness. In treatment relationships, appropriate responsiveness is the therapist's ability to achieve optimal benefit for the client by adjusting responses to the current state of the client and the interaction. This article was designed to clarify this aspect of responsiveness, showing its links to empathy, illustrating how responsiveness has been detected in controlled clinical trials, discussing how educators and supervisors have worked to enhance students' responsiveness, and considering how appropriate responsiveness has been assessed. The article also discusses the development of skills underlying appropriate responsiveness and the role of stable differences in talent in training of professional psychologists. Notwithstanding other pessimistic reports on psychologists' expertise, demonstrable expertise may exist in the effective, responsive use of these skills in treatment settings. Appropriate responsiveness may be a variety of executive functioning, organizing and guiding the use of many specific competencies. As such it may be a metacompetency, with implications for the design of competency schemes. Key to all of these considerations is the distinction between therapeutic techniques and their responsive use, which involves astute judgment as to when and how to utilize these responses to best effect in the treatment situation.
Moel, Joy E; Buttner, Melissa M; O'Hara, Michael W; Stuart, Scott; Gorman, Laura
Women's sexual functioning in the postpartum period is understudied given its potential impact on women's mental health and their relationships with their partners. The sexual functioning of women with postpartum depression (PPD) in particular is not well characterized. The goals of this study were to examine factors associated with the sexual functioning of postpartum women and to compare the long-term sexual functioning of depressed postpartum women treated with interpersonal psychotherapy with a group of postpartum women who had never been depressed. Depressed (120) and never depressed (56) postpartum women were enrolled. Self-report questionnaires and clinician-rated measures were completed at initial entry to study, immediately post-treatment, and at 6, 12, and 18 months post-treatment. Analyses revealed significant differences in sexual interest between depressed and never depressed postpartum women (t (171) = 11.82, p <0.001). Although sexual interest improved significantly following treatment for depression (t (104) = -3.18, p < 0.01), those women who fully recovered continued to experience less interest (F (2, 140) = 32.24, p < 0.0001) and less sexual satisfaction through 2 years postpartum than never depressed women. These findings suggest that differences in sexual functioning exist between depressed and never depressed postpartum women, even after depressed women are treated and have recovered from their depression. Clinicians should inquire about changes in sexual functioning when treating women with PPD.
Howard, Jonathan K.
Research on therapeutic factors of group psychotherapy for adult alcoholics is reviewed. The research in this area has focused on determining whether or not group psychotherapy is an effective treatment modality for alcoholics. This review examines therapeutic factors in three phases of treatment: (1) preadmission, (2) primary intervention, and…
In the course of group analytic psychotherapy, where we discovered the power of the therapeutic effects, there occurred the need of group analytic psychotherapy researches. Psychotherapeutic work in general, and group psychotherapy in particular, are hard to measure and put into some objective frames. Researches, i. e. measuring of changes in psychotherapy is a complex task, and there are large disagreements. For a long time, the empirical-descriptive method was the only way of research in the field of group psychotherapy. Problems of researches in group psychotherapy in general, and particularly in group analytic psychotherapy can be reviewed as methodology problems at first, especially due to unrepeatability of the therapeutic process. The basic polemics about measuring of changes in psychotherapy is based on the question whether a change is to be measured by means of open measuring of behaviour or whether it should be evaluated more finely by monitoring inner psychological dimensions. Following the therapy results up, besides providing additional information on the patient's improvement, strengthens the psychotherapist's self-respect, as well as his respectability and credibility as a scientist. PMID:25478094
Ogren, Marie-Louise; Sundin, Eva C.
Psychotherapy supervision is considered crucial for psychotherapists in training. During the last decades, group supervision has been a frequently used format in many countries. Until recently, very few studies had evaluated the small-group format for training of beginner psychotherapists and psychotherapy supervisors. This article aims to…
Partnerships are often optimal processes for interpersonal growth. The ability to have and keep a partner in mind should, therefore, be thought about and learnt. Although reciprocity, some symmetry, and mutual give and take are important aspects of partnerships, this article emphasizes a partners ability to process difficulties for the other as an aid to growth. The containment and elaboration of distress in partnerships is discussed using three examples of such potential relationships. The emotional beginning of a partnership, whether starting from love, working relationship or from hate, is the focus of the article. Individual, dyadic, and group aspects as separation-individuation and containment processes are described as contributing to partnership-building. The ability of a therapy group to process splitting and projecting phenomena are discussed. Co-therapists seem to have to work through painful conflicts between themselves to develop the therapists' containment abilities inside a functional partnership. Supervision may help process these emotional hardships. Within families, mothers could contribute to a better processing of their sons violence shared through infant dreams, which represent an effort to cope with inner and outer aggression. Growth-promoting aspects of dream telling as potential partnerships in families and groups are discussed. Finally, partnership building between hating foes is exemplified by the efforts made by participants in Israeli and Palestinian peace dialogues. In groups, interpersonal development may be furthered by helping participants mutually contain and be contained, enabling partnership opportunities to grow after love and sympathy are over.
Bulimia Nervosa (BN) is a chronic disorder that results in a high degree of psychological impairment for many women. This article presents a description of Interpersonal Therapy for Group (IPT-G), an evidence-based approach for the treatment of BN. The author presents a rationale for the use of IPT-G, an outline of the group model, and provides…
Fain, Dana Shindel; Sharon, Amos; Moscovici, Lucian; Schreiber, Shaul
In this article we explore the content and dynamics of patients' verbalizations within a "living with medications" group. Patients' perceptions of their psychotropic medications are interpreted and classified within the framework of object relations theory. One's perception of the role of medication in one's life can serve as a gateway to one's inner world and the way that he or she perceives authority figures, peers, and oneself. We suggest that working through patients' relationships with their medications can help them to achieve better integration of internal object relations. Discussing patients' views about medications should therefore be seen as an important part of psychotherapy with many individuals. Such a discussion may enhance and improve efficacy of both psychotherapy and pharmacotherapy. It is of particular importance in group therapy, within milieu environments and with individuals reluctant to explicitly discuss interpersonal matters. Vignettes from the group sessions illustrate the way in which discussing medication advances group process.
Mufson, Laura H.; Dorta, Kristen Pollack; Olfson, Mark; Weissman, Myrna M.; Hoagwood, Kimberly
This paper describes the process of modifying and transporting an evidence-based treatment, Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), from a university setting to school-based health clinics. It addresses conceptual issues involved in the shift from efficacy to effectiveness research as well as operational issues specific to…
Grote, Nancy K.; Bledsoe, Sarah E.; Swartz, Holly A.; Frank, Ellen
Objective: To minimize barriers to care, ameliorate antenatal depression, and prevent postpartum depression, we conducted a pilot study to assess the feasibility of providing brief interpersonal psychotherapy (IPT-B) to depressed, pregnant patients on low incomes in an obstetrics and gynecological (OB/GYN) clinic. Method: Twelve pregnant,…
McBride, Carolina; Atkinson, Leslie; Quilty, Lena C.; Bagby, R. Michael
Anxiety and avoidance dimensions of adult attachment insecurity were tested as moderators of treatment outcome for interpersonal psychotherapy (IPT) and cognitive-behavioral therapy (CBT). Fifty-six participants with major depression were randomly assigned to these treatment conditions. Beck Depression Inventory-II, Six-Item Hamilton Rating Scale…
Delmonico, R L; Hanley-Peterson, P; Englander, J
Residual emotional and behavioral difficulties in individuals who have sustained a traumatic brain injury (TBI) have been well documented in the literature. The issues are complex, interdependent, and often include substance abuse, depression, anxiety, chronic suicidal or homicidal ideation, poor impulse control, and significant degrees of frustration and anger. Often, preexisting psychological conditions and poor coping strategies are exacerbated by the trauma. Emotional and behavioral difficulties can interfere with the neurorehabilitation process at all levels. In acute rehabilitation, these issues have traditionally been addressed on an individual basis. However, in postacute settings, an interpersonal group format can be effectively implemented. The majority of individuals with TBI have minimal funding for long-term cognitive and behavioral remediation; often the only avenue available is support groups. This article will describe group psychotherapy models used with individuals with acute or postacute TBI within a comprehensive rehabilitation center. Interdisciplinary treatment of frustration and substance abuse and a continuum of care will be emphasized. Education, social support, skills development, interpersonal process, and cognitive-behavioral approaches will also be discussed. The psychotherapy groups focus on treatment of substance abuse and frustration management through education, social support, and development of interpersonal skills. Practical considerations of running such groups are presented.
Ghuman, H S; Sarles, R M
The authors describe three types of group psychotherapy settings on an adolescent service. The group setting which included all patients on the unit and employed multiple therapists and several nursing staff provided better communication, cohesiveness, and greater opportunity for staff training. Small groups provided comparatively more time for patient participation, less distraction, and better disclosure. Mixing patients from different units resulted in objective and keener observations by patients, but hall meetings became increasingly necessary to work out interpersonal issues among patients from the same unit. These observations by staff were confirmed by a patient questionnaire.
Young, Jami F; Kranzler, Amy; Gallop, Robert; Mufson, Laura
This paper reports on school and social functioning outcomes in a randomized depression prevention study that compared Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) with usual school counseling (SC). Outcome analyses were performed utilizing hierarchical linear models and mixed model analysis of variance. IPT-AST adolescents had significantly greater improvements than SC adolescents in total social functioning and friend functioning during the intervention. IPT-AST adolescents also demonstrated improvements in school, dating, and family functioning and emotional engagement in school, although these improvements were not significantly greater than seen in SC adolescents. Finally, in the 18 months following the intervention, IPT-AST adolescents were less likely than SC adolescents to be asked to leave school for academic or behavioral reasons. These findings extend the potential range of impact of depression prevention programs such as IPT-AST and provide preliminary evidence of the benefits of these programs on school and social functioning.
Ollila, Pekka; Knekt, Paul; Heinonen, Erkki; Lindfors, Olavi
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.
Powell, Janet E.
This article outlines considerations in planning inpatient groups for psychiatric patients and presents a model for group psychotherapy with a heterogeneous admission ward population. The model includes session plans based on objectives graded according to patients' levels of functioning. Also discussed are group rules and the therapist's role.…
Hamm, Jay A; Leonhardt, Bethany L
The recovery movement has not only challenged traditional pessimism regarding schizophrenia but also presented opportunities for the possibilities for psychotherapy for people with the disorder. Though in the past psychotherapy models were often pitted against one another, recently there have been emergent reports of a range of integrative models sharing an emphasis on recovery and a number of conceptual elements. These shared elements include attention to the importance of interpersonal processes, personal narrative, and metacognition, with interest in their role in not only the disorder but also the processes by which people pursue recovery. This article explores one application of this framework in the psychotherapy of a woman with prolonged experience of schizophrenia and significant functional impairments.
Cicchetti, Dante; Toth, Sheree L; Handley, Elizabeth D
Genetic moderation of interpersonal psychotherapy (IPT) efficacy for economically disadvantaged women with major depressive disorder was examined. Specifically, we investigated whether genotypic variation in corticotropin releasing hormone receptor 1 (CRHR1) and the linked polymorphic region of the serotonin transporter gene (5-HTTLPR) moderated effects of IPT on depressive symptoms over time. We also tested genotype moderation of IPT mechanisms on social adjustment and perceived stress. Non-treatment-seeking urban women at or below the poverty level with infants were recruited from the community (N = 126; M age = 25.33 years, SD = 4.99; 54.0% African American, 22.2% Caucasian, and 23.8% Hispanic/biracial) and randomized to individual IPT or Enhanced Community Standard groups. The results revealed that changes in depressive symptoms over time depended on both intervention group and genotypes (5-HTTLPR and CRHR1). Moreover, multiple-group path analysis indicated that IPT improved depressive symptoms, increased social adjustment, and decreased perceived stress at posttreatment among women with the 0 copies of the CRHR1 TAT haplotype only. Finally, improved social adjustment at postintervention significantly mediated the effect of IPT on reduced depressive symptoms at 8 months postintervention for women with 0 copies of the TAT haplotype only. Post hoc analyses of 5-HTTLPR were indicative of differential susceptibility, albeit among African American women only.
Tomasulo, Daniel J.
Mental health disorders are considerably more prevalent among people with intellectual disabilities than in the general population, yet research on psychotherapy for people with dual diagnosis is scarce. However, there is mounting evidence to show that adults with a dual diagnosis can find help through group therapy and have more productive and…
Young, Jami F; Makover, Heather B; Cohen, Joseph R; Mufson, Laura; Gallop, Robert J; Benas, Jessica S
Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a depression prevention program. Ninety-eight adolescents were randomized to receive IPT-AST or school counseling (SC). Outcome and predictor analyses were performed utilizing hierarchical linear models. IPT-AST adolescents had significantly greater reductions in anxiety and depressive symptoms than SC adolescents during the intervention. Baseline anxiety symptoms predicted change in depressive symptoms for adolescents in both intervention conditions, with adolescents low in baseline anxiety demonstrating more rapid change in depressive symptoms than adolescents high in baseline anxiety. These findings indicate that IPT-AST is effective at decreasing both depressive and anxiety symptoms. For adolescents with comorbid symptoms of anxiety, there may be slower rates of change in depressive symptoms following prevention programs.
Martinez-Taboada, Cristina; Amutio, Alberto; Elgorriaga, Edurne; Arnoso, Ainara
(1) What is the history and the theoretical orientation of group therapy in Spain? (2) How is training organized? (3) What role does group psychotherapy play in the health system in Spain? (4) What is the relationship between group psychotherapy research and clinical practice in Spain? (5) What topics can be identified as unique to therapy groups in Spain? (6) How are group-related issues important within the social background of Spain? and (7) What does group work hold for the future? Although not even a century has passed since the birth of this discipline, there have already been many events associated with the management of power and knowledge, the development of a sense of community, and the evolution of the political and social life of our country. Group therapy training is still evolving and is properly supported and accredited by prestigious institutions. In the 2013 Symposium of the Spanish Society of Group Psychotherapy and Group Techniques (SEPTG), the need for joint group theories and techniques within the profession's activities was clearly highlighted. Further, the enthusiasm of group psychotherapists to open themselves to specific social perspectives (health, education, community prevention, organizations) is a way of encouraging society to untangle conscious and unconscious knots that are created in social interaction.
Mott, Juliette M; Barrera, Terri L; Hernandez, Caitlin; Graham, David P; Teng, Ellen J
This study examined rates of referral for medication, individual psychotherapy, and group psychotherapy within a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty mental health clinic. Participants were 388 Iraq and Afghanistan veterans who were referred for PTSD treatment following a mental health evaluation required for all new VA enrollees. The majority of the sample was referred for medication (79 %), with comparatively fewer referrals for individual (39 %) or group psychotherapy (24 %). Forty percent of participants were referred for combined medication and psychotherapy. Patient demographic and clinical characteristics were examined to determine whether these variables predicted referral type. Female veterans and those with lower clinician ratings of overall functioning were more likely to be referred for individual therapy. Group psychotherapy referrals were more common in veterans who were older, unemployed, identified as an ethnic minority, and had a comorbid anxiety disorder. There were no significant predictors of medication referral.
Bozzatello, Paola; Bellino, Silvio
Few investigations evaluated the long-term effects of psychotherapies in borderline personality disorder (BPD). In a previous study, we compared efficacy of combination of fluoxetine and interpersonal psychotherapy adapted to BPD (IPT-BPD) versus single fluoxetine administered for 32 weeks. This study is aimed to investigate whether the results obtained with the addition of IPT-BPD persist during a follow-up period. Forty-four patients who completed the 32 weeks trial underwent 24 months of follow-up receiving fluoxetine 20-40 mg/day. Clinical Global Impression Severity (CGI-S), Hamilton Rating Scales for Depression and Anxiety (HDRS, HARS), Social and Occupational Functioning Assessment Scale (SOFAS), Satisfaction Profile (SAT-P), and Borderline Personality Disorder Severity Index (BPDSI) were repeated at 6, 12, and 24 months. Statistical analysis was performed with the general linear model. Results showed that most of the differences between combined therapy and single pharmacotherapy at the end of the 32 weeks trial were maintained after 24 months follow-up. The addition of IPT-BPD to medication produced greater effects on BPD symptoms (impulsivity and interpersonal relationships) and quality of life (perception of psychological and social functioning) that endured after termination of psychotherapy. On the contrary, different effects on anxiety symptoms and affective instability were lost after 6 months.
Background Without effective treatment, PTSD and depression can cause persistent disability in disaster-affected populations. Methods Our objective was to test the efficacy of Interpersonal Psychotherapy (IPT) delivered by trained local personnel compared with treatment as usual (TAU) for Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) among adults affected by the Sichuan 2008 earthquake. A small randomized controlled trial of IPT + TAU versus TAU alone was delivered by local mental health personnel in Shifang, China. Between July 2011 and January 2012, 49 adults ≥ 18 years with PTSD, MDD or both were enrolled and randomized to 12 weekly sessions of IPT + TAU (27) or TAU (22) alone x 12 weeks. IPT was then offered to the TAU group. Unblinded follow up assessments were conducted at three and six months. IPT was a 12 session, weekly one hour treatment delivered by local personnel who were trained and supervised in IPT. TAU was continuation of prescribed psychotropic medication (if applicable) and crisis counseling, as needed. Main Outcome(s) and Measures (s): Clinician Administered PTSD Scale (CAPS) PTSD diagnosis; Structured Clinical Interview for DSM-IV (SCID) for MDD diagnosis. Secondary measures included PTSD/depression symptoms, interpersonal conflict/anger, social support, self-efficacy and functioning. Results Using an intent-to-treat analysis, 22 IPT + TAU and 19 TAU participants were compared at three months post-baseline. A significantly greater reduction of PTSD and MDD diagnoses was found in the IPT group (51.9%, 30.1%, respectively) versus the TAU group (3.4%, 3.4%, respectively). Despite the small sample, the estimates for time-by-condition analyses of target outcomes (2.37 for PTSD (p = .018) and 1.91 for MDD (p = .056)) indicate the improvement was better in the IPT + TAU condition versus the TAU group. Treatment gains were maintained at 6 months for the IPT group. A similar treatment response
In this interview, Dr. Irvin Yalom, director of the Adult Psychiatry Clinic at Stanford University School of Medicine, discusses his beginnings as a group psychotherapist, current issues in group work, and the future of group work. (Author/TE)
Sperling, M B; Kibel, H D; Loutsch, E M
Building upon Wolf's (1949) notion of the use of an alternate session in group psychotherapy, this paper suggests that an alternate therapist substituting for an absent regular therapist in milieu group psychotherapy can facilitate similar therapeutic benefits. The mechanism of this process of overcoming transference resistance is seen as twofold: (1) sessions with a substitute therapist allow patients to confront the infantilization often present in a milieu setting and experiment with more autonomous ego functioning. (2) Sessions with a substitute therapist create conditions which are apart from the ongoing process of the therapy group, thereby allowing for a therapeutic splitting process to develop wherein transference feelings about the regular therapist can be expressed to his or her "alter ego." Several case vignettes are presented in order to illustrate the clinical utility of a substitute therapist.
Scheibe, G; Albus, M; Walther, A U; Schmauss, M
The one-year supportive group-psychotherapy (3 groups with 8-9 patients) was carried out once-weekly by two therapists in 26 patients who met the DSM-III-R criteria for panic disorder and agoraphobia. Patients filled in various ratings at the beginning and at the end of the therapy and a visual analog scale before as well as after each session. Twelve months after the end of the group-therapy the Longitudinal Interval Follow-up Evaluation (LIFE) was carried out. During the group-psychotherapy panic sensations, anxiety, nervousness and fears as well as psychosocial disability decreased. Duration of illness affected the reduction of panic sensations, anxiety, nervousness and fears during the first 6 months of the group-psychotherapy. Phobic fears and avoidance behavior mostly improved in patients with a duration of illness of more than 5 years and an additional depressive disorder. At the one-year follow-up 80% of panic patients without depressive disorder were symptom-free and reported better partner-relationships, more satisfaction, and a better social adjustment compared with panic patients with concomitant depressive disorders.
Azima, Fern J.
This paper defines a useful strategy for therapists working with adolescents which includes: (1) a general model of the group leader's responsibilities and (2) a cataloguing of some of the specific impediments for both adolescent peers and the therapist that prevent effective communication. The goal of the group therapy is to identify the specific…
Ettin, Mark F; Cohen, Bertram D
Macropolitical evolution, starting with authoritarian monarchism, has moved through anarchistic transitions either to the totalitarianism of fascism and communism or to liberal and social democracy. We posit analogous micropolitical development in process-oriented therapy groups: "dependence" and "counterdependence" corresponding to monarchism and anarchism; and "independence" and "interdependence" to liberal and social democracy, respectively. Transition from counterdependence to independence and interdependence may be: (1) facilitated through group members' cooperative experience of rebellion, or (2) blocked by collective identification, the internalization of dystopian or utopian fantasies that coalesce as "group-self" perceptions. We explore how group therapists work clinically with and through these several "political cultures" in the service of group and self transformation.
Tschuschke, V; Catina, A; Beckh, T; Salvini, D
Several change mechanisms, their interrelationship, and their relation to outcome as well as to long-term follow-ups have been investigated in an inpatient group therapy. Eight of initially ten patients finished a long-term group in an inpatient setting for severe neurotics and personality disorders. Successful patients were able to change significant behavior characteristics, to develop a higher cohesiveness towards the group and especially to use aspects of family reenactment in order to change internalized significant object representations. The results indicate that important changes occur early during the treatment. The contributing change mechanisms and their interdependency are described and discussed in detail.
Cognolato, S; Silvestri, A; Fiorellini Bernardis, A L; Santonastaso, P
The aim of this study is to explore the effectiveness of a short-term psychodynamic oriented group therapy with a selected sample of obese patients. We selected, from the patients referred to the Eating Disorders Consultation Service, 7 obese patients. Selection criteria were as follows: 1) aged between 20 and 40; 2) absence of severe organic disorders, as determining factors for the onset of obesity; 3) absence of severe psychiatric symptomatology. In addiction the selected subjects had to be sufficiently motivated to take up a psychological treatment. Subject underwent a clinical semi-structured interview and two questionnaires (SCL90 and TFEQ) were administered. Patients were re-evaluated at the end of the treatment and a two-years follow-up has been carried out. The group was conducted by a psychiatric and a psychologist, supervised by a group therapist. The group therapy lasted 6 months with 75' minutes weekly sessions. When the therapy was over all subjects showed an improved clinical picture: two of them had a remarkable weight reduction and one subject reached his ideal weight. The weight loss and maintenance at follow-up compared favorably with the results reported for other psychological treatments for obesity. The group setting, for its homogeneity, allowed great cohesiveness and let the members achieve, an increased emotional awareness of their self-image. This experience seem to confirm the effectiveness of a short-term group therapy in an institutional setting.
Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark
Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.
Medini, G; Rosenberg, E H
Gossip, a phenomenon as old as history itself, is reflected upon in terms of its need-fulfilling functions for persons and social groups. It is seen as one of the sources of knowledge about life that has potentials for wisdom, and its interpersonal and intrapsychic functions are shown to have similarities to many salient functions of psychotherapy.
Jacobson, Colleen M; Mufson, Laura
Non-suicidal self-injury (NSSI), the intentional destruction of one's own body tissue without the conscious intent to die, is a significant health concern among adolescents, however, there are few psychosocial interventions designed to treat NSSI. The current paper describes an adaptation of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) to be used with adolescents who have symptoms of depression and are engaging in NSSI. Specifically, we describe the rationale for the adaptations made to IPT-A for self-injury (IPT-ASI), and a case vignette to illustrate the implementation of IPT-ASI. Non-suicidal self-injury is often triggered by interpersonal stressors, and IPT-ASI directly aims to help clients to improve their interpersonal relationships by increasing emotional awareness and understanding, and teaching communication and problem solving skills via supportive and didactic techniques. The case vignette demonstrates the successes and challenges of using IPT-ASI for an adolescent with moderate depression and NSSI behaviors who began treatment with much difficulty expressing her emotions.
Verdeli, Helen; Therosme, Tatiana; Eustache, Eddy; Hilaire, Olissaint St; Joseph, Benissois; Sönmez, Cemile Ceren; Raviola, Giuseppe
After the 2010 Haiti earthquake, Zanmi Lasante, a local health care organization, implemented a collaborative stepped-care model to address depression in community and primary care settings in rural Haiti. Specialized community health workers, the ajans santé, collaborate with local psychologists and primary care doctors to offer home-based evaluation, support, and follow-up. The services include brief interpersonal psychotherapy (IPT) and/or medication to persons who met locally defined criteria for depression. A cross-national (Haiti-United States) expert mental health team has been overseeing the program. The present IPT supervision case of a severely depressed, physically abused, and pregnant young woman illustrates the U.S.-based supervisor's internal struggle to reconcile awareness of and respect for local norms while maintaining a human rights-based framework. It also highlights the critical role of community health workers in addressing the mental health treatment gap in regions plagued by extreme poverty and adversity.
Rieger, Elizabeth; Van Buren, Dorothy J; Bishop, Monica; Tanofsky-Kraff, Marian; Welch, Robinson; Wilfley, Denise E
Several studies support the efficacy of interpersonal psychotherapy (IPT) in the treatment of eating disorders. Treatment outcomes are likely to be augmented through a greater understanding, and hence treatment targeting, of the mechanisms whereby IPT induces therapeutic gains. To this end, the present paper seeks to develop a theoretical model of IPT in the context of eating disorders (IPT-ED). After providing a brief description of IPT, the IPT-ED model is presented and research supporting its theorized mechanisms is summarized. This model proposes that negative social evaluation plays a pivotal role as both a cause (via its detrimental impact on self evaluation and associated affect) and consequence of eating disorder symptoms. In the final section, key eating disorder constructs (namely, the developmental period of adolescence, clinical perfectionism, cognitive dysfunction, and affect regulation) are re-interpreted from the standpoint of negative social evaluation thereby further explicating IPT's efficacy as an intervention for individuals with an eating disorder.
McBride, Carolina; Atkinson, Leslie; Quilty, Lena C; Bagby, R Michael
Anxiety and avoidance dimensions of adult attachment insecurity were tested as moderators of treatment outcome for interpersonal psychotherapy (IPT) and cognitive- behavioral therapy (CBT). Fifty-six participants with major depression were randomly assigned to these treatment conditions. Beck Depression Inventory--II, Six-Item Hamilton Rating Scale for Depression scores, and remission status served as outcome measures. Patients higher on attachment avoidance showed significantly greater reduction in depression severity and greater likelihood of symptom remission with CBT as compared with IPT, even after controlling for obsessive-compulsive and avoidant personality disorder symptoms. Results were replicated across treatment completers and intent-to-treat samples. These results suggest that it is important to consider the interaction between attachment insecurity and treatment type when comparing efficacy of treatments.
Hogan, Christopher; Harris, Rafael S.; Cassidy, Jennie M.
The impact of including process observers (all master's-level trainees) and their notes on the outcome of interpersonal group therapy at a university counseling center was investigated. For a total of four groups, one method per group of delivering the notes to the participants was designated and assessed for perceived differences. A self-report…
Constantino, Michael J; Coyne, Alice E; Luukko, Emily K; Newkirk, Katie; Bernecker, Samantha L; Ravitz, Paula; McBride, Carolina
The therapeutic alliance has historically emerged as a pantheoretical correlate of favorable psychotherapy outcomes. However, uncertainty remains about the direction of the alliance-outcome link, and whether it is affected by other contextual variables. The present study explored (a) if early alliance quality predicted subsequent symptom change while controlling for the effect of prior symptom change in interpersonal psychotherapy (IPT) for depression, and (b) whether baseline patient characteristics moderated the alliance-outcome relation (to help specify conditions under which alliance predicts change). Data derived from an open trial of 16 sessions of individual IPT delivered naturalistically to adult outpatients (N = 119) meeting criteria for major depression. Patients rated their sociodemographic, clinical, and interpersonal characteristics at baseline, their alliance with their therapist at Session 3, and their depressive symptoms at baseline, after every session, and at posttreatment. Data were analyzed using hierarchical linear modeling. Results indicated that alliance quality did not predict subsequent depression change, controlling for prior depression change. However, a significant education by alliance interaction emerged in predicting quadratic depression change (γ = .0007, p = .03); patients with higher levels of education who reported good early alliances with their therapists had the most positively accelerated change trajectory (i.e., faster depression reduction), whereas patients with higher levels of education who reported poorer early alliances had the most negatively accelerated change trajectory (i.e., slower depression reduction). The findings may help clarify a specific condition under which alliance quality influences subsequent improvement in an evidence-based treatment for depression. (PsycINFO Database Record
Thorngren, Jill M.; Kleist, David M.
Multiple Family Group Therapy has been identified as a viable treatment model for a variety of client populations. A combination of family systems theories and therapeutic group factors provide the opportunity to explore multiple levels of intrapersonal and interpersonal relationships between families. This article depicts a Multiple Family Group…
Scharff, Jill Savege; Scharff, David E
This paper describes The Group Affective Model, a method for teaching psychoanalytic concepts and their clinical application, using multi-channel teaching, process and review in group settings, and learning from experience in an open systems learning community for psychoanalysts and psychotherapists. This innovation arose in response to criticism of existing methods in psychoanalytic education that have subordinated the primary educational task to that of the training analysis. Noticing this split between education and training analysis, between cognition and affect, and between concepts of individual and group unconscious processes, we developed the Group Affective Model for teaching and learning psychoanalysis and psychotherapy in an open psychological space in which students and faculty experience individual and group processes of digestion, assimilation, and review, which demonstrate the concepts in action and make them available for internalization selectively. We discuss our philosophy and our educational stance. We describe our institution and our participants. We give examples of teaching situations that we have studied to provide some insight about assimilation and internalization of the concepts and clinical approaches being taught. We discuss the transferability of the Group Affective Model to other teaching settings and psychoanalytic training institutions and propose it as the fourth pillar of psychoanalytic training, next to analytic treatment, clinical supervision, and didactic seminars.
MACKENZIE, K. ROY; TSCHUSCHKE, VOLKER
Process and outcome measures were compared in two long-term groups. The measure "Relatedness" reflected an individual’s attachment to and comfort with the group, and "Group Work" indicated perception of the group as having a positive working climate. High Relatedness scores predicted better outcome at 18-month follow-up. Group Work scores were not related to outcome. Relatedness and Group Work scores were not correlated. Results replicate in a group psychotherapy population the importance, reported in individual therapy literature, of an early and sustained positive therapeutic alliance (Relatedness). However, a measure that is closely related to the concept of "working alliance" (Group Work) did not predict outcome. PMID:22700138
Schermer, V L
Object relations theory and self psychology are psychoanalytic perspectives that are especially concerned with interpersonal relations and their mental representations. Object relations theory began as an intrapsychic "singleton" psychology with the work of Freud and Melanie Klein. It subsequently evolved into a multi-person psychology with the work of Bion on groups, as well as the clinical and theoretical contributions of Winnicott and Fairbairn. Kohutian self psychology, which emerged later, has been interested in the relations between the self and significant others as mirroring and idealizing "self-objects." Stolorow's "inter-subjective perspective" emerged from self psychology as a full-fledged multi-person point of view. This article considers the significance of contemporary object relations theory and self psychology as relational, multi-person perspectives in terms of their application to group psychotherapy, focusing upon the group-as-a-whole, projective identification, transitional space and object, and self/self-object relations as particularly useful constructs. A clinical vignette is provided.
Opiyo, Elizabeth; Ongeri, Linnet; Rota, Grace; Verdeli, Helen; Neylan, Thomas; Meffert, Susan
We examine the efficacy of nonspecialists delivering interpersonal psychotherapy (IPT) to HIV-positive (HIV+) women. We describe a case in which local personnel without prior mental health training delivered IPT for the treatment of depression and posttraumatic stress disorder in an HIV+ woman who reported experiencing gender-based violence and was enrolled in HIV care at the Family AIDS, Care, Education and Services program in Kisumu, Kenya.
Huibers, Marcus J. H.; Cohen, Zachary D.; Lemmens, Lotte H. J. M.; Arntz, Arnoud; Peeters, Frenk P. M. L.; Cuijpers, Pim; DeRubeis, Robert J.
Introduction Although psychotherapies for depression produce equivalent outcomes, individual patients respond differently to different therapies. Predictors of outcome have been identified in the context of randomized trials, but this information has not been used to predict which treatment works best for the depressed individual. In this paper, we aim to replicate a recently developed treatment selection method, using data from an RCT comparing the effects of cognitive therapy (CT) and interpersonal psychotherapy (IPT). Methods 134 depressed patients completed the pre- and post-treatment BDI-II assessment. First, we identified baseline predictors and moderators. Second, individual treatment recommendations were generated by combining the identified predictors and moderators in an algorithm that produces the Personalized Advantage Index (PAI), a measure of the predicted advantage in one therapy compared to the other, using standard regression analyses and the leave-one-out cross-validation approach. Results We found five predictors (gender, employment status, anxiety, personality disorder and quality of life) and six moderators (somatic complaints, cognitive problems, paranoid symptoms, interpersonal self-sacrificing, attributional style and number of life events) of treatment outcome. The mean average PAI value was 8.9 BDI points, and 63% of the sample was predicted to have a clinically meaningful advantage in one of the therapies. Those who were randomized to their predicted optimal treatment (either CT or IPT) had an observed mean end-BDI of 11.8, while those who received their predicted non-optimal treatment had an end-BDI of 17.8 (effect size for the difference = 0.51). Discussion Depressed patients who were randomized to their predicted optimal treatment fared much better than those randomized to their predicted non-optimal treatment. The PAI provides a great opportunity for formal decision-making to improve individual patient outcomes in depression. Although
Huprich, Steven; Rosen, Alexandra; Kiss, Andrea
The present study investigated the relationship between normative and pathological dependency and anaclitic and introjective depressive experiences among 71 patients participating in outpatient psychotherapy at a university-based psychology clinic. We examined the interrelationships among the Relationship Profile Test subscales, the Depressive Experiences Questionnaire subscales and the Outcome Questionnaire-45.2. Results indicated that destructive overdependence was positively correlated with anaclitic and introjective depression and negatively correlated with overall perceptions of mental health. Dysfunctional detachment was positively correlated with introjective depression and negatively correlated with generalized perceptions of one's own mental health. Healthy dependency was negatively correlated with introjective depression and positively correlated with mental health. These results not only support the construct validity of the Relationship Profile Test but also shed light on a link between depression, dependence and self-criticism.
Fassone, G; Valcella, F; Pallini, S; Scarcella, F; Tombolini, L; Ivaldi, A; Prunetti, E; Manaresi, F; Liotti, G
Assessing Interpersonal Motivations in Transcripts (AIMIT) is a coding system aiming to systematically detect the activity of interpersonal motivational systems (IMS) in the therapeutic dialogue. An inter- and intra-rater reliability study has been conducted. Sixteen video-recorded psychotherapy sessions were selected and transcribed according to the AIMIT criteria. Sessions relate to 16 patients with an Axis II diagnosis, with a mean Global Assessment of Functioning of 51. For the intra-rater reliability evaluation, five sessions have been selected and assigned to five independent coders who where asked to make a first evaluation, and then a second independent one 14 days later. For the inter-rater reliability study, the sessions coded by the therapist-coder were jointly revised with another coder and finally classified as gold standard. The 16 standard sessions were sent to other evaluators for the independent coding. The agreement (κ) was estimated according to the following parameters for each coding unit: evaluation units supported by the 'codable' activation of one or more IMS; motivational interaction with reference to the ongoing relation between patient and therapist; an interaction between the patient and another person reported/narrated by the patient; detection of specific IMS: attachment (At), caregiving (CG), rank (Ra), sexuality (Se), peer cooperation (PC); and transitions from one IMS to another were also scored. The intra-rater agreement was evaluated through the parameters 'cod', 'At', 'CG', 'Ra', 'Se' and 'PC' described above. A total of 2443 coding units were analysed. For the nine parameters on which the agreement was calculated, eight ['coded (Cod)', 'ongoing relation (Rel)', 'narrated relation (Nar)', 'At', 'CG', 'Ra', 'Se' and 'PC'] have κ values comprised between 0.62 (CG) and 0.81 (Cod) and were therefore satisfactory. The scoring of 'transitions' showed agreement values slightly below desired cut-off (0.56). Intra-rater reliability was
Rosen, D; Stukenberg, K W; Saeks, S
The authors review the theoretical basis of group psychotherapy performed at The Menninger Clinic and demonstrate how the theory has been put into practice on two different types of inpatient units. The fundamental elements of the theory and practice used can be traced to object relations theory as originally proposed by Melanie Klein. Her work with individuals was directly applied to working with groups by Ezriel and Bion, who focused on interpreting group tension. More modern approaches have reintegrated working with individual concerns while also attending to the group-as-a-whole. Historically, these principles have been applied to long-term group treatment. The authors apply the concepts from the group-as-a-whole literature to short- and medium-length inpatient groups with open membership. They offer clinical examples of the application of these principles in short-term inpatient settings in groups with open membership.
Gunther, Marianne; Crandles, Sheila; Williams, Gillian; Swain, Margaret
Describes Project HOPE (New York), a psycho-social support program for noninfected children of HIV-positive parents, including the challenges of starting and implementing the program's psychotherapy group for grieving adolescents and clinical examples of group process and effective interventions in group leadership. Explicates the four stages in…
Little, Linda F.
Gestalt therapy respects parents' perceptions of their children and does not attempt to train parents to become therapists for their children. To examine the impact of Gestalt group psychotherapy on parents' perceptions of children identified as problematic, an experimental group of 10 parents participated in 10 2-hour Gestalt sessions. A group of…
Oshiro, Claudia Kami Bastos; Kanter, Jonathan; Meyer, Sonia Beatriz
Functional Analytic Psychotherapy (FAP) is emerging as an effective psychotherapy for psychiatric clinical cases. However, there is little research demonstrating the process of change of FAP. The present study evaluated the introduction and withdrawal of FAP interventions on therapy-interfering verbal behaviors of two participants who were in…
Heck, Nicholas C
Although there are descriptions of transgender-affirmative group psychotherapy services in the literature, there is limited research on the topic. Mental health professionals who plan to offer such services should draw on evidence-based treatments, where appropriate, and have a working knowledge of current standards of care, practice guidelines, and counseling competencies. This article reviews and synthesizes the existing research and scholarship on this topic, placing an emphasis on group-specific competencies and intervention components that can be integrated into psychotherapy groups for transgender and gender nonconforming clients.
Devi, Akasha; Fenn, Edwin
This paper describes a systematic thematic analysis of one particular latency-aged children's group and includes a discussion about potentially helpful outcomes measures. The impetus for our small, practice-based qualitative research project came from the two papers by Reid (1999) and Canham (2002) about children's psychotherapy groups,…
Coche, Erich; Polikoff, Barbara
Explores whether self-disclosure in group psychotherapy produces better group outcome. Although the expected positive relationship between the two variables was found, results also indicate a need for caution in postulating a link between self-disclosure and improvement. (BP)
Honagodu, Abhijit Ramanna; Krishna, Murali; Sundarachar, Rajesh; Lepping, Peter
Studies investigating effectiveness of group psychotherapy intervention in depression in persons with HIV have showed varying results with differing effect sizes. A systematic review of randomized controlled trials of group psychotherapy in depression in persons with HIV has been conducted to present the best available evidence in relation to its effect on depressive symptomatology. Electronic databases were searched to identify randomized controlled trials. Selected studies were quality assessed and data extracted by two reviewers. If feasible, it was planned to conduct a meta-analysis to obtain a pooled effect size of group psychotherapeutic interventions on depressive symptoms. Odds ratio for drop out from group was calculated. The studies were assessed for their quality using the Quality Rating Scale and other parameters for quality assessment set out by COCHRANE. The quality of reporting of the trials was compared against the Consolidated Standards of Reporting Trials (CONSORT) checklist for non-pharmacological studies (CONSORT-NPT). Four studies met the full inclusion criteria for systematic review. The trials included in the review examined group interventions based on the Cognitive behavioral therapy model against other therapeutic interventions or waiting list controls. In all four studies, group psychotherapy was an effective intervention for reducing depressive symptoms in persons with HIV in comparison to waiting list controls. The reported benefits from the group psychotherapy in comparison to active controls were less impressive. There were no statistically significant differences in drop outs at post treatments across group psychotherapy, wait list control, and other active interventions. The methodological quality of the studies varied. The quality of reporting of the studies was sub-optimal. The results of this systematic review support that group psychological interventions for depression in persons with HIV have a significant effect on depressive
Priebe, S.; Savill, M.; Wykes, T.; Bentall, R. P.; Reininghaus, U.; Lauber, C.; Bremner, S.; Eldridge, S.; Röhricht, F.
Background Negative symptoms of schizophrenia have a severe impact on functional outcomes and treatment options are limited. Arts therapies are currently recommended but more evidence is required. Aims To assess body psychotherapy as a treatment for negative symptoms compared with an active control (trial registration: ISRCTN84216587). Method Schizophrenia out-patients were randomised into a 20-session body psychotherapy or Pilates group. The primary outcome was negative symptoms at end of treatment. Secondary outcomes included psychopathology, functional, social and treatment satisfaction outcomes at treatment end and 6-months later. Results In total, 275 participants were randomised. The adjusted difference in negative symptoms was 0.03 (95% CI −1.11 to 1.17), indicating no benefit from body psychotherapy. Small improvements in expressive deficits and movement disorder symptoms were detected in favour of body psychotherapy. No other outcomes were significantly different. Conclusions Body psychotherapy does not have a clinically relevant beneficial effect in the treatment of patients with negative symptoms of schizophrenia. PMID:27151073
Tschacher, Wolfgang; Zorn, Peter; Ramseyer, Fabian
Background This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain. Methodology and Findings 69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome. Conclusions/Significance The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders. PMID:22745811
Barolin, Gerhard S
Group-therapy and autogenic training in combination show mutual potentiation. Our results have proved the hypothesis to be true and we have also been able to explain it by an analysis of the neurophysiological and psychological findings concerning both methods. Our "model" has proved to be very economical in time and can be easily applied. It needs basic psychotherapeutical education but no special additive schooling. It is particularly well employed in rehabilitation patients, elderly patients and geronto-rehabilitation patients. As numbers of such patients are steadily increasing, it could soon become highly important, and in the technically dominated medicine of today, the particularly communicative component that we postulate in integrated psychotherapy could also grow in importance. By combining the two methods, it is not method that is at the centre of our endeavours but the patient.
Gayle, Robin G
Meaningful group structures are co-created within the long-term outpatient psychotherapy group through a hermeneutical interaction between structure and immediate experience of structure by individuals embedded in personal and collective contexts. Co-created meanings expand original group- and self-understandings and further evolve structures that are stable yet do not exist independently of the narratives and affects of the members who interact with them. Group structures do not reduce, expand, or dissolve but change in connection to the experiences and meaning attributions within the group. This intersubjective process mediates the emphasis within group theory on leader responsibility for culture building that risks overpromoting certain psychotherapeutic cultural intentions over others. Three examples of intersubjective hermeneutical interaction within long-term psychotherapy groups lend insight into global, cultural, and societal groups.
Drakulić, Aleksandra Mindoljević
Resistance refers to all types of behaviour that oppose the exploration processes in the therapeutic process and inhibit work. Very common types of resistances, such as forgetting the time of session, being late, non-payment of sessions and such are found in every type of psychotherapy, including psychodrama psychotherapy. The attempt to break resistance in order to evoke changes could be dangerous as it represents the necessary defence mechanism and it is also a vital element of the person's functioning in therapy. In psychodrama, which is a type of action method of group psychotherapy, resistance can manifest through continuous verbalization of problems, in not wanting to act out the problem, the protagonist's typical non-verbal message or the most obvious manifestation: the absence of the protagonist. This paper will be on the typical resistance which the therapist has noticed during the first session of psychodrama psychotherapy, with a small group of adult clients. As the group was young and with undeveloped cohesiveness, resistance represented a certain balancing power for maintaining mental homeostasis of the group.
Harris, Ben; Lightner, Jean
Most histories of psychology and psychiatry attribute the first group psychotherapy to Joseph Pratt's 1905 class for tuberculosis patients. Pratt's actual treatment procedures are examined. They are shown to have consisted primarily of operant and social-learning techniques, aimed at increasing patient compliance with a demanding therapeutic…
Wade, Christine E.; Cameron, Bruce A.; Morgan, Kari; Williams, Karen C.
Trust between group members has been suggested as an important part of small group work in online classrooms. Developing interpersonal relationships with group members may promote a sense of trust among them; however, research shows mixed results. The current study explored how students' perceptions of the importance of interpersonal relationships…
Chida, Yoichi; Schrempft, Stephanie; Steptoe, Andrew
This randomized controlled trial aimed to examine the effect of the Happy Science doctrine-based group psychotherapy on depressive symptoms in 118 Japanese mental disorder outpatients. The treatment group (n = 58) took part in five 90-min sessions at one-week intervals, while the control group (n = 60) received standard care including medication. Depressive symptoms were assessed before the intervention, 5 weeks after the intervention, and at 3-month follow-up. Compared to the control group, the treatment group showed a significant reduction in depressive symptoms both at post-intervention and at 3-month follow-up. In conclusion, this group psychotherapy might be of benefit in treating depressive symptoms.
In relation to self-psychology narcissism-construct is important in analytic-oriented psychotherapy theoretical and practical and is more superior to emotional-relationship based conception by practical and living operalization opposite Roger's conception. We found based on variables-oriented multidimensional psychodiagnostical tests for neurotics in group-psychotherapy that questionnaires are suitable to diagnose narcissism in psychodynamical psychotherapy. Throughout on the one hand single scales of narcissism-states correlate with social desirability on the other hand are related to hypochondria, to psychastenic, depressive and schizoid tendencies. Through those patients having difficults to work reflexive and are attaining higher scores in narcissism-questionnaire opposite patients are optimal working, higher narcissism-scores are not condition for therapy success or unsuccess. In clusters of unsuccessful patients are reacting with defensive behaviour in group-psychotherapy in relation to higher narcissism-scores. Successful patients are more emotional-stable and additional more social-oriented and optimistic. These findings in study are therapy-valide with research-results in Psychoanalyse.
Nicastro, Emanuele; Continisio, Grazia Isabella; Storace, Cinzia; Bruzzese, Eugenia; Mango, Carmela; Liguoro, Ilaria; Guarino, Alfredo; Officioso, Annunziata
Disclosure of the HIV status to infected children is often delayed due to psychosocial problems in their families. We aimed at improving the quality of life in families of HIV-infected children, thus promoting disclosure of the HIV status to children by parents. Parents of 17 HIV-infected children (4.2-18 years) followed at our Center for pediatric HIV, unaware of their HIV status, were randomly assigned to the intervention group (8 monthly sessions of family group psychotherapy, FGP) or to the control group not receiving psychotherapy. Changes in the Psychological General Well-Being Index (PGWB-I) and in the Short-Form State-Trait Anxiety Inventory (Sf-STAI), as well as the HIV status disclosure to children by parents, were measured. Ten parents were assigned to the FGP group, while 7 parents to the controls. Psychological well-being increased in 70% of the FGP parents and none of the control group (p=0.017), while anxiety decreased in the FGP group but not in controls (60% vs. 0%, p=0.03). HIV disclosure took place for 6/10 children of the intervention group and for 1/7 of controls. Family group psychotherapy had a positive impact on the environment of HIV-infected children, promoting psychological well-being and the disclosure of the HIV status to children.
Discusses research designs in which psychotherapy treatments are compared to placebo conditions, and suggests that chemotherapy and psychotherapy research efforts are complementary rather than analogous. Recommends the elimination of placebo groups in psychotherapy research. Discusses the negative connotation of psychotherapy as a placebo. (JAC)
Poteat, V Paul; Mereish, Ethan H; Birkett, Michelle
Social development theories highlight the centrality of peer groups during adolescence and their role in socializing attitudes and behaviors. In this longitudinal study, we tested the effects of group-level prejudice on ensuing positive and negative interpersonal interactions among peers over a 7-month period. We used social network analysis to identify peer groups based on sociometric nominations, followed by multilevel modeling of the effects of sexual prejudice at the group level on interpersonal interactions among individuals in these groups. As hypothesized, the interpersonal interactions in peer groups with stronger group-level sexual prejudice were distinct from and poorer than those in groups with weaker group-level sexual prejudice. Moreover, longitudinal models indicated that adolescents in groups with stronger initial sexual prejudice reported worse interpersonal interactions with their peers seven months later. These findings provide a contextual understanding of prejudice and its negative effects on how adolescents come to relate with one another over time.
Drakulić, Aleksandra Mindoljević
Modern history of short-term group psychotherapy dates back to the late 1950-ies. From then to present day, this psychotherapeutic method has been used in various forms, from dynamic-oriented to cognitive behavioural psychotherapies. Although it has always been considered rather controversial, due its cost-effectiveness, it has been capturing more and more popularity. This paper presents the specificities of first session short-term psychotherapy psychodrama group through session work with two examined groups: a group of 20 adult women who suffer from mild or moderate forms of unipolar depression and a group of 20 students of the School of Medicine in Zagreb without any psychiatric symptomatology. The results indicate the high importance of having structure in first psychodrama session, of relating it with the previously thoroughly conducted, initial, clinical, interviews, and of the clarity and focus in terms of determining the goals of therapy, especially in a clinical context. This study also confirmed assumptions regarding the need for different approaches of warming-up in psychodrama, both in the clinical and in non-clinical samples. A psychodrama psychotherapist should have good time managing skills and capability to convert the time available into an opportunity for directly boosting the group energy and work on therapeutic alliance.
The main purposes of the article are to present the history of integration in psychotherapy, the reasons of the development integrative approaches, and the approaches to integration in psychotherapy. Three approaches to integration in psychotherapy exist: theoretical integration, theoretical eclecticism, and common factors in different psychotherapeutic trends. In integrative psychotherapy, the basic epistemology, theory, and clinical practice are based on the phenomenology, field theory, holism, dialogue, and co-creation of dialogue in the therapeutic relationship. The main criticism is that integrative psychotherapy suffers from confusion and many unresolved controversies. It is difficult to theoretically and methodologically define the clinically applied model that is based on such a different epistemological and theoretical presumptions. Integrative psychotherapy is a synthesis of humanistic psychotherapy, object relations theory, and psychoanalytical self psychology. It focuses on the dynamics and potentials of human relationships, with a goal of changing the relations and understanding internal and external resistances. The process of integrative psychotherapy is primarily focused on the developmental-relational model and co-creation of psychotherapeutic relationship as a single interactive event, which is not unilateral, but rather a joint endeavor by both the therapist and the patient/client. The need for a relationship is an important human need and represents a process of attunement that occurs as a response to the need for a relationship, a unique interpersonal contact between two people. If this need is not met, it manifests with the different feelings and various defenses. To meet this need, we need to have another person with whom we can establish a sensitive, attuned relationship. Thus, the therapist becomes this person who tries to supplement what the person did not receive. Neuroscience can be a source of integration through different therapies. We
Restek-Petrović, Branka; Orešković-Krezler, Nataša; Grah, Majda; Mayer, Nina; Bogović, Anamarija; Mihanović, Mate
Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.
Luthar, S S; Suchman, N E
The Relational Psychotherapy Mothers' Group (RPMG), a developmentally informed, supportive psychotherapy designed to serve heroin-addicted mothers with children up to 16 years of age, aims at addressing psychosocial vulnerabilities, and facilitating optimal parenting, among at-risk mothers. We present preliminary evidence on the efficacy of RPMG as an "add on" treatment in comparison with standard methadone counseling alone. At the end of the 24-week treatment period, mothers receiving RPMG plus standard methadone counseling demonstrated lower levels of risk for child maltreatment, greater involvement with their children, and more positive psychosocial adjustment than women who received methadone counseling alone. Children of RPMG participants also reflected fewer problems in multiple areas. At 6 months posttreatment, RPMG recipients continued to be at a relative advantage, although the magnitude of group differences was often attenuated. Notably, urinalyses indicated that RPMG mothers showed greater improvements in levels of opioid use over time than comparison mothers.
Simon, Gregory E; Ding, Victoria; Hubbard, Rebecca; Fishman, Paul; Ludman, Evette; Morales, Leo; Operskalski, Belinda; Savarino, James
Administrative data were used to examine early dropout among 16,451 health plan members calling to request psychotherapy for depression. Compared to members referred to group-model therapists, those referred to network-model therapists were more likely to drop out before the initial visit (OR 2.33, 95% CI 2.17 – 2.50) but less likely to drop out after the first visit (OR 0.45, 95% CI 0.43 – 0.48). These differences were unaffected by adjustment for neighborhood income and educational attainment, antidepressant use, or generosity of insurance coverage. Efforts to increase the effectiveness of psychotherapy may required different strategies in group- and network-model practice. PMID:21710256
Gross, J M
Knowledge of the basic economic factors underlying managed mental health care directly impacts the clinical practitioners' ability to make constructive changes in the system. To aid understanding this article introduces the managed care marketplace model, the interactive relationship between medical necessity and patient co-payment, and demand management economics. The author encourages practitioners to develop strategies to overcome specific economic obstacles that prevent the promotion of group psychotherapy.
Skinner, Kay Lesley; Hyde, Sarah J.; McPherson, Kerstin B. A.; Simpson, Maree D.
Health professional students must be equipped with the skills necessary to interact with patients. Effective interpersonal skills are difficult to both learn and teach, requiring development, practise and evaluation in both educational and clinical settings. In professions such as physiotherapy, traditional approaches to teaching these skills have…
Barkowski, Sarah; Schwartze, Dominique; Strauss, Bernhard; Burlingame, Gary M; Barth, Jürgen; Rosendahl, Jenny
Group psychotherapy for social anxiety disorder (SAD) is an established treatment supported by findings from primary studies and earlier meta-analyses. However, a comprehensive summary of the recent evidence is still pending. This meta-analysis investigates the efficacy of group psychotherapy for adult patients with SAD. A literature search identified 36 randomized-controlled trials examining 2171 patients. Available studies used mainly cognitive-behavioral group therapies (CBGT); therefore, quantitative analyses were done for CBGT. Medium to large positive effects emerged for wait list-controlled trials for specific symptomatology: g=0.84, 95% CI [0.72; 0.97] and general psychopathology: g=0.62, 95% CI [0.36; 0.89]. Group psychotherapy was also superior to common factor control conditions in alleviating symptoms of SAD, but not in improving general psychopathology. No differences appeared for direct comparisons of group psychotherapy and individual psychotherapy or pharmacotherapy. Hence, group psychotherapy for SAD is an efficacious treatment, equivalent to other treatment formats.
Raufman, Ravit; Nesher, Ronit; Weinberg, Haim
In Israel, the sense of belonging carries special meaning for historical and contemporary reasons. Since its establishment, Israel, with a background of centuries of persecution of the Jews, has been subjected to a consistent threat of war and terror that makes it a traumatized society. On the one hand, this intensifies social cohesiveness, especially in times of war. Yet many of the threats pose existential, political, and ideological dilemmas. The trauma of the Holocaust coupled with the continuous existence of wars enhanced the development of special kinds of groups. No wonder group therapy in Israel flourishes, perhaps more than in any other Western country (Nuttman-Shwartz & Weinberg, 2002).
Strauss, B; Dauert, E; Gladewitz, J; Kaak, A; Kieselbach, S; Lammert, K; Struck, D
Within a research project dealing with the process and outcome of inpatient group psychotherapy, the core conflictual relationship theme method (CCRT) was used to determine if the central basic interpersonal problems of patients differ in comparison of individual pre- and postreatment sessions, if the CCRT determined at the beginning of treatment is related to outcome, and if there is a similarity between the CCRT from individual and group sessions. Comparisons of the CRRT(-components) from the beginning and the end of treatment (related to 19 patients) indicated marked changes on the levels of wishes and responses from others as well as "formal" changes of the narratives (temporal relations as well as the objects mentioned). The second part of the study (n = 26) revealed differences between subgroups determined on the basis of differential outcome measures with respect to the structure of their conflicts. The similarity of the CCRT from group and individual sessions which was studied for nine patients appeared to be moderate. The study revealed that the CCRT might need some minor revisions but appears to be an important method to thoroughly describe the effects of psychotherapies.
Ettin, M F
Group psychotherapy evidenced a growth spurt in the decade of the 1930s and prior to World War II. Following upon the pioneering efforts of the psychoeducators (Pratt, Marsh, Lazell) and the writings of the early analysts (Freud, Adler, Dreikurs, Burrow), the next wave of practitioners and theorizers popularized and expounded the use of the group treatment modality in hospitals, clinics, and private practice. A review of the seminal ideas and efforts of Jacob Moreno, Louis Wender, Paul Schilder, Lauretta Bender, Alexander Wolf, and Samuel Slavson continues the historical overview begun earlier in this journal (Ettin, 1988). In a continuing effort to call up the wisdom of the past in the service of the work of the present, the emphasis in this paper will be on practical application. Representative quotes will be embedded in the text to capture the tenor of the times, and special attention will be given to (1) theoretical underpinnings such as the proposed advantages, curative variables, and therapy goals of a group treatment; (2) the basic logistics of practice, including optimum group size, composition, membership and exclusion criteria, and length, frequency, and structure of the meetings; and (3) technical considerations, such as the role of the therapist and the techniques, procedures, and processes of the ongoing group endeavor, as well as the interface between individual and group sessions. In conclusion, it will be argued that group psychotherapy matured just in time to respond to the pressing need for efficient mental treatment mandated by the coming of the Second World War.
Abstract A model of inpatient group psychotherapy that focuses on two frequently observed patient subgroups reflecting contrasting attitudes toward authority is presented. The counterdependent subgroup overly values autonomy, opposes unit restrictions, and rejects treatment. The dependent subgroup tends to accept the unit's treatment and structure but is overly passive. In this model these attitudes are addressed in order to help patients adapt to the unit and to facilitate discharge. The author describes a three-stage group designed to help patients achieve these goals.
Joyce, Anthony S; Piper, William E; Ogrodniczuk, John S
The current study explored the relative ability of aggregate therapeutic alliance and cohesion variables to predict short-term group therapy outcome. Data were collected from a comparative trial of two forms of time-limited group psychotherapy for complicated grief (Piper, McCallum, Joyce, Rosie, & Ogrodniczuk, 2001). The therapeutic alliance and elements of the cohesion construct were measured from the perspectives of each patient and the group therapist at intervals during the groups; scores were aggregated across assessments. Hierarchical multiple regression analyses, adjusting for the effects of treatment approach (interpretive vs. supportive) and specific group membership, demonstrated that the patient-rated alliance was a consistent predictor of outcome. Two cohesion measures, reflecting other participants' (therapist, other members) views of the patient's "fit" with the group, also accounted for variation in outcome. Implications of the findings for research and clinical practice, and the limitations of the measurement approach taken in this study, are considered.
Benson, Jarlath F; Moore, Robert; Kapur, Raman; Rice, Cecil A
Conducting group psychotherapy in a situation of intractable conflict such as Northern Ireland activates turbulent emotional dilemmas within psychotherapists and group members alike. Professional practice and therapeutic zeal must struggle daily to survive the stark encounter with the reality of a regressive and primitive psychology and on occasion may succumb to atavistic tendencies, dragging relationships down to primitive levels and leaving connections broken. In this article, three group therapists describe their countertransference struggles when leading such groups. They meet in a psychosocial setting in which the risk to one's psyche parallels the risk to one's life and limb. The countertransference experienced here is dark, indeed identified by one author as not unlike Dante's Inferno. They describe how understanding their personal countertransference enables them to survive emotionally even though it may not always lead to the survival of their groups. The effect of those struggles also troubled the act of writing itself, making cooperation difficult on occasion, a mirror of the external social matrix.
Benson, Jarlath F; Moore, Robert; Kapur, Raman; Rice, Cecil A
Conducting group psychotherapy in a situation of intractable conflict such as Northern Ireland activates turbulent emotional dilemmas within psychotherapists and group members alike. Professional practice and therapeutic zeal must struggle daily to survive the stark encounter with the reality of a regressive and primitive psychology and on occasion may succumb to atavistic tendencies, dragging relationships down to primitive levels and leaving connections broken. In this article, three group therapists describe their countertransference struggles when leading such groups. They meet in a psychosocial setting in which the risk to one's psyche parallels the risk to one's life and limb. The countertransference experienced here is dark, indeed identified by one author as not unlike Dante's Inferno. They describe how understanding their personal countertransference enables them to survive emotionally even though it may not always lead to the survival of their groups. The effect of those struggles also troubled the act of writing itself making cooperation difficult on occasion, a mirror of the external social matrix.
Furlan, P. M.; Benedetti, G.
Fifty individual psychotherapies of schizophrenic patients, supervised by a control group for fourteen years, are examined. 80 percent of the patients have shown important clinical progress and, in many cases, have been healed, especially those who continued therapy for more than two years and who had a deep and reciprocal emotional involvement with the therapist during and after treatment; there was a reduction by 70 percent of hospitalizations during this treatment and only one of these had a relapse. Other data confirm the efficacy of psychotherapy; however, to give a new instrument of scientific confirmation to this type of individual and subjective work, we tried to observe how the psychopathological and therapeutic mechanism of "symbiosis" induces personal dynamics in the therapist which are reflected in the control group. The psychopathological symbiotic disturbance of the patient, the therapeutic symbiotic relationship, and the way in which the group reacts to these permit the creation of a useful triangle, both for the therapist to understand his position toward the patient and to confirm or correct the subjective aspects of such a deep and emotional relationship. PMID:4049915
Marks, Michael W.; Vestre, Norris D.
College students (N=27) were assigned to a time-extended or a marathon group or a control condition to evaluate the effects of encounter experiences on self-perception and interpersonal behavior. Both experimental groups showed significantly greater changes in self-perceptions from pretest to posttest than the control group. (Author)
To fully understand the complexities of eroticism in groups, it may be necessary to review a conceptual differentiation of desire and its allies: agony and ecstasy. This article suggests that psychoanalytic group psychotherapy is made for neither agony nor ecstasy. Sexual excitement maybe; eroticism and desire, yes; agony and ecstasy, no. While agony or ecstasy imply a threat to the survival of the group, eroticism and desire reaffirm its existence. In this manner the group may be converted into a theater where desire may be celebrated, while the threat of being dissolved in the depths or exaltation of agony and ecstasy is elaborated and worked through: "Desire is desire only if it succeeds in postponing something".
Breitbart, William; Rosenfeld, Barry; Gibson, Christopher; Pessin, Hayley; Poppito, Shannon; Nelson, Christian; Tomarken, Alexis; Timm, Anne Kosinski; Berg, Amy; Jacobson, Colleen; Sorger, Brooke; Abbey, Jennifer; Olden, Megan
Objectives An increasingly important concern for clinicians who care for patients at the end of life is their spiritual well-being and sense of meaning and purpose in life. In response to the need for short-term interventions to address spiritual well-being, we developed Meaning Centered Group Psychotherapy (MCGP) to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose in their lives, even as they approach the end of life. Methods Patients with advanced (stage III or IV) solid tumor cancers (N = 90) were randomly assigned to either MCGP or a supportive group psychotherapy (SGP). Patients were assessed before and after completing the 8-week intervention, and again 2 months after completion. Outcome assessment included measures of spiritual well-being, meaning, hopelessness, desire for death, optimism/pessimism, anxiety, depression and overall quality of life. Results MCGP resulted in significantly greater improvements in spiritual well-being and a sense of meaning. Treatment gains were even more substantial (based on effect size estimates) at the second follow-up assessment. Improvements in anxiety and desire for death were also significant (and increased over time). There was no significant improvement on any of these variables for patients participating in SGP. Conclusions MCGP appears to be a potentially beneficial intervention for patients’ emotional and spiritual suffering at the end of life. Further research, with larger samples, is clearly needed to better understand the potential benefits of this novel intervention. PMID:19274623
Poteat, V. Paul; Mereish, Ethan H.; Birkett, Michelle
Social development theories highlight the centrality of peer groups during adolescence and their role in socializing attitudes and behaviors. In this longitudinal study, we tested the effects of group-level prejudice on ensuing positive and negative interpersonal interactions among peers over a 7-month period. We used social network analysis to…
Ebrahimi, Hossein; Kazemi, Abdul Hassan; Fallahi Khoshknab, Masoud; Modabber, Raheleh
Introduction: Suicide is a great economical, social and public health problem. It is prevalent worldwide and has a lot of negative effects on individuals, families and society. Depression is often prelude to Suicide. An important part of the treatment of the mentally ill patients is spiritual-religious psychotherapy which should be done after physical treatment. The aim of this study was to determine the effect of spiritual and religious group psychotherapy on suicidal ideation in depressed patients. Methods: 51 depressed patients with suicidal ideation from Razi hospital (Tabriz, Iran) participated in this clinical trial. To collect Data questionnaire was used which included demographic and Beck Suicide Scale Ideation. Experimental group participated in 10 sessions of group psychotherapy. Each section lasted 1 hour. Two weeks after the last section post test was done. Statistical software SPSS ver 13 was used for data analysis. Results: Results of independent t-test revealed no difference between two groups in terms of suicidal ideation before intervention but after study there is a statistical difference. Also the results of ANCOVA test showed a significant relationship between spiritual group therapy and decrease in suicidal ideation, so that this intervention can make 57% of variance in suicidal ideation of experimental group. Conclusion: Regarding positive effect of spiritual and religious group psychotherapy on decreasing suicidal ideation of depressed patients, we suggest this intervention to be held in Psychiatric Wards and also more study on depression and other psychiatric patients with greater sample size would be helpful. PMID:25276756
McVea, Charmaine S; Gow, Kathryn; Lowe, Roger
This study investigated the process of resolving painful emotional experience during psychodrama group therapy, by examining significant therapeutic events within seven psychodrama enactments. A comprehensive process analysis of four resolved and three not-resolved cases identified five meta-processes which were linked to in-session resolution. One was a readiness to engage in the therapeutic process, which was influenced by client characteristics and the client's experience of the group; and four were therapeutic events: (1) re-experiencing with insight; (2) activating resourcefulness; (3) social atom repair with emotional release; and (4) integration. A corrective interpersonal experience (social atom repair) healed the sense of fragmentation and interpersonal disconnection associated with unresolved emotional pain, and emotional release was therapeutically helpful when located within the enactment of this new role relationship. Protagonists who experienced resolution reported important improvements in interpersonal functioning and sense of self which they attributed to this experience.
Miller, Ted R.; Stout, Robert L.; Zlotnick, Caron; Cerbo, Louis A.; Andrade, Joel T.; Wiltsey-Stirman, Shannon
Purpose This article describes the protocol for a Hybrid Type I cost-effectiveness and implementation study of interpersonal psychotherapy (IPT) for men and women prisoners with major depressive disorder (MDD). The goal is to promote uptake of evidence-based treatments in criminal justice settings by conducting a randomized effectiveness study that collects implementation data, including a full cost-effectiveness analysis. Background More than 2.3 million people are incarcerated in the United States on any given day. MDD is the most common severe mental illness among incarcerated individuals. Despite the prevalence and consequences of MDD among incarcerated populations, this study will be the first fully-powered randomized trial of any treatment for MDD in an incarcerated population. Design Given the politically charged nature of the justice system, advantageous health outcomes are often not enough to get an intervention implemented in prisons. To increase the policy impact of this trial, we sought advice from prison providers and administrators about outcomes that would be persuasive to policy-makers and defensible to the public. In this trial, effectiveness questions will be answered using a randomized clinical trial design comparing IPT plus prison treatment as usual (TAU) to TAU alone, with outcomes including depressive symptoms (primary), suicidality, and in prison functioning (enrollment and completion of correctional programs; disciplinary and incident reports; aggression/victimization; social support). Implementation outcomes will include cost-effectiveness; feasibility and acceptability of IPT to clients, providers, and administrators; prison provider intervention fidelity, attitudes, and competencies; and barriers and facilitators of implementation assessed through surveys, interviews, and process notes. PMID:26845030
Stone, W N
When working with narcissistically vulnerable and angry patients in group psychotherapy one must take into account the entire treatment context. Interaction takes place among the identified patient, the other members, the therapist, and the image of the group as a whole. In members' counter-reactions to the difficult person, group-destructive forces frequently are stimulated. The offending individual may flee, or the group may reach an impasse in which little growth occurs. In this communication, I have focused on alter-ego relationships and transferences as a way of understanding aspects of group formation and destruction. Angry patients may have intense wishes to be like others and to feel part of the human condition. They suffer from feeling alone. Disruption of an alter-ego relationship may result in rage. A self-psychological perspective in concert with knowledge of group dynamics enables the clinician to formulate ways of intervening in problematic group interactions. The therapist's capacity to attend to the vulnerabilities of the self of all persons involved in the group is often severely tested, particularly under circumstances of emotional contagion. Elucidation of twinship and alter-ego transferences may help stabilize difficult patients and enable them to restart their psychological growth.
Psychoanalysis has paid limited attention to disability, and at times the approach has lacked political awareness. Over recent decades the international disability rights movement has argued that disabled people constitute an oppressed, systemically disadvantaged minority. Lately, a critical psychoanalytic view has connected disablist discrimination to universal unconscious conflicts evoked by impairment. Corresponding evocations emerge in the therapeutic frame, producing countertransference responses to the impaired body. Drawing on psychoanalytically oriented group psychotherapy with severely physically impaired adults, countertransference phenomena were studied in developing discussion on disability-related clinical work. The complex, uncertain role of psychoanalytic practice in combating oppression was also examined. Key issues include challenges to the traditional frame, the crossing of psychic boundaries, anxieties relating to not knowing, and the role of unconscious factors in marginalizing disabled experience.
Belt, Ritva; Punamaki, Raija-Leena
In this article we present a novel method of outpatient care: brief, dynamic mother-infant group psychotherapy with mothers who have substance use problems. In this therapy, substance abuse treatment is part of mental health and parenting interventions. The focus is on preventing disturbance in the mother-infant relationship in this high-risk…
Peterson, Sarah E.; Schreiber, James B.
We report the results of two replication studies using attribution theory to analyze personal and interpersonal motivation for collaborative projects. Undergraduate students responded to questionnaires containing hypothetical vignettes depicting success or failure outcomes due to ability or effort for dyads working on a group project. Dependent…
Begovac, Branka; Begovac, Ivan
This article presents, in the form of a clinical illustration, a therapeutic group of bereaved mothers with special reference to their dreams about their deceased children. The article presents descriptions of the emotions of these mothers and countertransference feelings, a topic that, to our knowledge, has not been frequently studied. The group was small, analytically oriented, slow-open, comprised of women bereaved by the death of a child, and conducted by a female therapist. Over more than three years, the group included 20 members in total. This article describes a number of dreams recorded during a period when the group included seven members. Dreams helped the group members access their emotional pain, helplessness, yearning for a relationship with the deceased, guilt, and feelings of survival guilt. The transference-countertransference relationships were characterized by holding. Countertransference feelings of helplessness predominated. The therapist and the group as a whole contained various emotions, allowing the group members to return to the normal mourning processes from the parallel encouragement of group development and interpersonal relationships.
Bergonzi, P; Ferro, F M; Mazza, S; Zolo, P
Epileptic patients show a large range of psychopathologic manifestations, both from a qualitative point of view (even with an exact reference to the nature and the site of lesion) and from a quantitative point of view (from the so-called characterial attitude to the psychotic developments). Perhaps all these alterations of psychiatric interest have a common denominator because, after all, they arise from the sum of two essential moments: the experience of the critical event on the one hand, and the interactive network between the patient and those who are present to his critical manifestations on the other. In particular this complex relational psychopathology needs several therapeutic interventions which are to be complementary and concordant so that they may give satisfactory results of psychosocial reinsertion. We think that the model of intervention to be preferred for its effectiveness is that drawn from group-psychotherapy tecniques: the model in which "psychoanalysis meets sociology (Foulkes) seems to be particularly specific to this problem because it concerns the microsocial and investigates (and, by means of the conduction, it resolves) distorted ways of communication and conflictual dynamic interactions. We followed some epileptics in the group-community of the neurological department of a general hospital (of course with other mental, not epileptic, patients). These preliminary studies lead us to point out the theoretical reasons and the practical justifications of such possible management of the psychological manifestations of epileptic patients.
Seyedi Asl, Seyed Teymur; Sadeghi, Kheirollah; Bakhtiari, Mitra; Ahmadi, Seyed Mojtaba; Nazari Anamagh, Alireza; Khayatan, Tayebeh
Background Positive psychotherapy is one of the new approaches in psychology which is innovated for treating psychological disorders and enhancing positive emotions. The aim of this study is to investigate the effectiveness of the group positive psychotherapy on elevation of life satisfaction and quality of life in infertile women. Materials and Methods In a randomized trial study, Beck Depression Inventory II (BDI-II) and clinical interview were used in a pre-test post-test control group design. After analyzing the result of the questionnaire, 36 infertile women who showed signs of mild to moderate depression were randomly placed into two following groups: control (n=18) and intervention (n=18). Before the treatment, the members of both groups answered BDI-II, Satisfaction With Life Scale (SWLS) and 12 item Short Form Health Survey (SF-12). The intervention group received six sessions of group positive psychotherapy, but the treatment of the control group began six weeks after the intervention group. Results The results showed that the life satisfaction scores of the intervention group were significantly elevated from 22.66 in pre-test to 26.13 in post-test (P<0.001), while this improvement was not significant in the control group (P=0.405). The difference between life satisfaction scores of the intervention and the control groups was also significant (F=8.92, P=0.006). However, no significant change in the quality of life level of the intervention and control groups was observed (P=0.136). Conclusion Thus it can be deduced from the findings that this treatment method could be introduced as solution to increase the life satisfaction in infertile women, but not as a treatment for elevating their quality of life (Registration Number: IRCT2013042810063N3). PMID:27123207
Picardi, Angelo; Gaetano, Paola
In the last decades, psychotherapy has gained increasing acceptance as a major treatment option for mood disorders. Empirically supported treatments for major depression include cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), behavioural therapy and, to a lesser extent, short-term psychodynamic psychotherapy. Meta-analytic evidence suggests that psychotherapy has a significant and clinically relevant, though not large, effect on chronic forms of depression. Psychotherapy with chronic patients should take into account several important differences between patients with chronic and acute depression (identification with their depressive illness, more severe social skill deficits, persistent sense of hopelessness, need of more time to adapt to better circumstances). Regarding adolescent depression, the effectiveness of IPT and CBT is empirically supported. Adolescents require appropriate modifications of treatment (developmental approach to psychotherapy, involvement of parents in therapy). The combination of psychotherapy and medication has recently attracted substantial interest; the available evidence suggests that combined treatment has small but significant advantages over each treatment modality alone, and may have a protective effect against depression relapse or recurrence. Psychobiological models overcoming a rigid brain-mind dichotomy may help the clinician give patients a clear rationale for the combination of psychological and pharmacological treatment. In recent years, evidence has accumulated regarding the effectiveness of psychological therapies (CBT, family-focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to medication in bipolar disorder. These therapies share several common elements and there is considerable overlap in their actual targets. Psychological interventions were found to be useful not only in the treatment of bipolar depressive episodes, but in all phases of the disorder. PMID
Dion, Kenneth L
The issues of interpersonal and group processes in long-term spacecrews from the perspectives of social and organizational psychology are considered here. A contrast between the Amundsen vs. Scott expeditions to the South Pole 90 yrs. ago highlights the importance of personnel selection and attention to interpersonal and group dynamics in expeditions to extreme and dangerous environments, such as long-term spaceflights today. Under the rubric of personnel selection, some further psychological "select-in" and "select-out" criteria are suggested, among them implicit measures of human motivation, intergroup attitudes ("implicit" and "explicit" measures of prejudice, social dominance orientation, and right-wing authoritarianism), attachment styles, and dispositional hardiness. The situational interview and the idea of "selection for teams," drawn from current advances in organizational psychology, are recommended for selecting members for future spacecrews. Under the rubrics of interpersonal and group processes, the social relations model is introduced as a technique for modeling and understanding interdependence among spacecrew members and partialling out variance in behavioral and perceptual data into actor/perceiver, partner/target, and relationship components. Group cohesion as a multidimensional construct is introduced, along with a consideration of the groupthink phenomenon and its controversial link to cohesion. Group composition issues are raised with examples concerning cultural heterogeneity and gender composition. Cultural value dimensions, especially power distance and individual-collectivism, should be taken into account at both societal and psychological levels in long-term space missions. Finally, intergroup processes and language issues in crews are addressed. The recategorization induction from the common ingroup identity model is recommended as a possible intervention for overcoming and inhibiting intergroup biases within spacecrews and between space
Lee, Eun Jin
The aim of the current study was to describe participants' experiences and examine the effects of group therapy on self-esteem and state anger among the adolescent children of immigrants in the US. A quasi-experimental design and qualitative and quantitative methods were used. Group therapy was conducted for 8weeks. Thirty-three adolescents took part in the study. Quantitative results revealed that group therapy improved self-esteem (t=2.222. p<.05) but not state anger. However, qualitative results suggested that group therapy helped improve interpersonal relationships and communication skills, the forgiveness of others, and the management of anger. Furthermore, group therapy utilizing positive psychology strategies improved self-esteem, interpersonal relationships, and communication skills.
Wang, Zuoming; Walther, Joseph B.; Hancock, Jeffrey T.
This study investigates the influence of interpersonal communication and intergroup identification on members' evaluations of computer-mediated groups. Participants (N= 256) in 64 four-person groups interacted through synchronous computer chat. Subgroup assignments to minimal groups instilled significantly greater in-group versus out-group…
Background Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors (MCGP-CS) was designed to help patients to sustain or enhance a sense of meaning and purpose in their lives. The aim of the proposed study is to evaluate the effectiveness and cost-effectiveness of MCGP-CS. Methods/Design Survivors diagnosed with cancer in the last 5 years and treated with curative intent, are recruited via several hospitals in the Netherlands. After screening, 168 survivors are randomly assigned to one of the three study arms: 1. Meaning-Centered Group Psychotherapy (MCGP-CS) 2. Supportive group psychotherapy (SGP) 3. Care as usual (CAU). Baseline assessment takes place before randomisation, with follow up assessments post-intervention and at 3, 6 and 12 months follow-up. Primary outcome is meaning making (PMP, PTGI, SPWB). Secondary outcome measures address quality of life (EORTC-30), anxiety and depression (HADS), hopelessness (BHS), optimism (LOT-R), adjustment to cancer (MAC), and costs (TIC-P, EQ-5D, PRODISQ). Discussion Meaning-focused coping is key to adjustment to life after cancer, however, there is a lack of evidence based psychological interventions in this area. Many cancer survivors experience feelings of loneliness and alienation, and have a need for peer support, therefore a group method in particular, can be beneficial for sustaining or enhancing a sense of meaning. If this MCGP-CS is effective for cancer survivors, it can be implemented in the practice of psycho-oncology care. Trial registration Netherlands Trial Register, NTR3571 PMID:24467861
Locke, Kenneth D
Six studies (N = 1,682) used the Circumplex Scales of Intergroup Goals (CSIG)--an inventory based on the interpersonal circle-to assess individuals' agentic and communal goals for interactions between groups (nations in Studies 1-4, organizations in Study 5, political parties in Study 6). Noteworthy findings included the following: People with stronger unagentic-and-uncommunal goals perceived other groups as dangers, were wary of intergroup negotiations, and sanctioned authoritarianism and inequality. People with stronger agentic-and-uncommunal goals proudly identified with their country and compatriots, disapproved of nations unlike their own, and preferred the conservative candidate in a national election. People with stronger communal-and-unagentic goals identified with people beyond their ingroup, and wanted their group to resolve intergroup conflicts by behaving cooperatively rather than competitively or aggressively. By providing an encompassing framework capable of organizing and integrating these types of diverse findings, the circumplex model can facilitate cumulative scientific progress.
van Schoor, E P
A deep strain of individualism permeates American culture, rooted in the political-economic ideology of capitalism. The ideal of a self-governing individual is promoted, independent from social, historical, and cultural forces, whose thoughts and emotions are located within the construct of a masterful self, ready to be filled and expanded. This article traces the influence of self-liberatory ideology in American group psychotherapy through the religious revivalist and Mental Hygiene movements. The "progressivism" of pioneering group theorists is examined in terms of revisionist psychology and self-liberatory practice. Psychodrama and T-groups are demonstrated to be precursors to the encounter group movement in which the belief in self-liberation reached its zenith. Early group analytic approaches are seen to eschew transpersonal and group dynamic processes.
Breitbart, William; Rosenfeld, Barry; Pessin, Hayley; Applebaum, Allison; Kulikowski, Julia; Lichtenthal, Wendy G.
Purpose To test the efficacy of meaning-centered group psychotherapy (MCGP) to reduce psychological distress and improve spiritual well-being in patients with advanced or terminal cancer. Patients and Methods Patients with advanced cancer (N = 253) were randomly assigned to manualized eight-session interventions of either MCGP or supportive group psychotherapy (SGP). Patients were assessed before and after completing the treatment and 2 months after treatment. The primary outcome measures were spiritual well-being and overall quality of life, with secondary outcome measures assessing depression, hopelessness, desire for hastened death, anxiety, and physical symptom distress. Results Hierarchical linear models that included a priori covariates and only participants who attended ≥ three sessions indicated a significant group × time interaction for most outcome variables. Specifically, patients receiving MCGP showed significantly greater improvement in spiritual well-being and quality of life and significantly greater reductions in depression, hopelessness, desire for hastened death, and physical symptom distress compared with those receiving SGP. No group differences were observed for changes in anxiety. Analyses that included all patients, regardless of whether they attended any treatment sessions (ie, intent-to-treat analyses), and no covariates still showed significant treatment effects (ie, greater benefit for patients receiving MCGP v SGP) for quality of life, depression, and hopelessness but not for other outcome variables. Conclusion This large randomized controlled study provides strong support for the efficacy of MCGP as a treatment for psychological and existential or spiritual distress in patients with advanced cancer. PMID:25646186
Tasca, Giorgio A
This is a commentary on 3 case studies of relationship-focused therapies for eating disorders. The 3 approaches vary along a number of dimensions, but nevertheless share important similarities especially related to the role played by variables such as interpersonal problems and affect dysregulation. I briefly review research on interpersonal- and attachment-based models of eating disorders that provide the evidence-base for theories of therapy that are relationship-focused. The Interpersonal Psychotherapy case presented by Tanofsky-Kraff, Shomaker, Young, and Wilfley (2016) illustrates how a group context can facilitate change in key role disputes and role transitions in an adolescent at risk of developing an eating disorder later in her life. The Integrative-Dynamic Therapy case presented by Richards, Shingleton, Goldman, Siegel, and Thompson-Brenner (2016) is a novel sequential combination of cognitive-behavioral therapy followed by dynamic psychotherapy for a young adult with bulimia nervosa that likely reflects what most clinicians do in everyday practice. The Psychoanalytic Psychotherapy case presented by Lunn, Poulsen, and Daniel (2016) of a patient with severe personality pathology demonstrates how treatments for eating disorders sometimes must address complex attachment dysfunction, self-organization, and therapist countertransference in order to provide a useful therapeutic experience. Relationship-focused theories and therapies for eating disorders have come a long way over the past decades, thus providing therapists with a wider range of approaches that can be truly personalized to their clients. (PsycINFO Database Record
Haug, Severin; Sedway, Jan; Kordy, Hans
Little is known about processes characterizing therapeutic Internet-chat groups, which offer a novel way of providing group therapy over distances. In this study group processes and group evaluations were examined in a treatment setting where face-to-face inpatient groups are followed by chat aftercare groups. For a sample of 121 patients who participated in both treatment modalities, group processes and group evaluations were modeled using hierarchical linear modeling. The group evaluations followed a consistent upward course from the beginning of therapy until the end of chat aftercare. For the process measures Activity and Emotional Reactivity, the initial scores at the beginning of the chat groups were lower than at the end of the inpatient treatment, but higher than at admission. During chat aftercare, Activity and Emotional Reactivity scores increased less than during the inpatient phase, but on average Activity and Emotional Reactivity were higher during Internet-chat aftercare. The predictive value of the acquaintance of the therapist from inpatient treatment and the course of group evaluations during inpatient treatment on the course of group evaluations during chat aftercare were examined.
The last decade has seen progress in psychotherapy research, despite the methodological complexity in this field. However, empirical research has influenced training and clinical practice to only a limited extent. This article is a brief evaluation of trends and some findings in modern psychotherapy research that may influence professional psychotherapy training and practice. PMID:10523428
Makanga, Prestige Tatenda; Schuurman, Nadine; Randall, Ellen
Interpersonal violence is a major contributor to the burden of disease globally, and in South Africa, it is the leading cause of injury. There is an emerging consensus that the development of actionable policy and effective prevention strategies for interpersonal violence requires an understanding of the contextual matters that elevate risk for interpersonal violence. The objective of this study was to explore community perceptions of risks for interpersonal violence in five townships in Cape Town, South Africa, with high rates of violence. Focus group discussions were conducted with community members to identify key factors in that contributed to being either a perpetrator or victim of interpersonal violence. The ecological framework was used to classify the risk factors as occurring at individual, relationship, community or society levels. Some of the risk factors identified included alcohol abuse, poverty, informality of settlements and cultural norms. Differences in how each of these risk factors are expressed and experienced in the five communities are also elucidated. This approach enabled the collection of contextual community-based data that can complement conventional surveillance data in the development of relevant community-level strategies for interpersonal violence prevention.
Applebaum, Allison J.; Lichtenthal, Wendy G.; Pessin, Hayley A.; Radomski, Julia N.; Gökbayrak, N. Simay; Katz, Aviva M.; Rosenfeld, Barry; Breitbart, William
Objective The generalizability of palliative care intervention research is often limited by high rates of study attrition. This study examined factors associated with attrition from a randomized controlled trial comparing meaning-centered group psychotherapy (MCGP), an intervention designed to help advanced cancer patients sustain or enhance their sense of meaning to the supportive group psychotherapy (SGP), a standardized support group. Methods Patients with advanced solid tumor cancers (n = 153) were randomized to eight sessions of either the MCGP or SGP. They completed assessments of psychosocial, spiritual, and physical well-being pretreatment, midtreatment, and 2 months post-treatment. Attrition was assessed in terms of the percent of participants who failed to complete these assessments, and demographic, psychiatric, medical, and study-related correlates of attrition were examined for the participants in each of these categories. Results The rates of attrition at these time points were 28.1%, 17.7%, and 11.1%, respectively; 43.1% of the participants (66 of 153) completed the entire study. The most common reason for dropout was patients feeling too ill. Attrition rates did not vary significantly between study arms. The participants who dropped out pretreatment reported less financial concerns than post-treatment dropouts, and the participants who dropped out of the study midtreatment had poorer physical health than treatment completers. There were no other significant associations between attrition and any demographic, medical, psychiatric, or study-related variables. Conclusions These findings highlight the challenge of maintaining advanced cancer patients in longitudinal research and suggest the need to consider alternative approaches (e.g., telemedicine) for patients who might benefit from group interventions but are too ill to travel. PMID:21751295
Existential and spiritual issues are at the frontier of new clinical and research focus in palliative and supportive care of cancer patients. As concepts of adequate supportive care expand beyond a focus on pain and physical symptom control, existential and spiritual issues such as meaning, hope and spirituality in general have received increased attention from supportive care clinicians and clinical researchers. This paper reviews the topics of spirituality and end-of-life care, defines spirituality, and suggests measures of spirituality that deal with two of its main components: faith/religious beliefs and meaning/spiritual well-being. These two constructs of spirituality are reviewed in terms of their role in supportive care. Finally, a review of existing psychotherapeutic interventions for spiritual suffering are reviewed and a novel meaning-centered group psychotherapy for advanced cancer patients is described.
Starting with a 1890 essay by Freud, the author goes in search of an interpersonal psychology native to Freud's psychoanalytic method and to in psychoanalysis and the interpersonal method in psychiatry. This derives from the basic interpersonal nature of the human situation in the lives of individuals and social groups. Psychiatry, the healing of the soul, and psychotherapy, therapy of the soul, are examined from the perspective of the communication model, based on the essential interpersonal function of language and the spoken word: persons addressing speeches to themselves and to others in relations, between family members, others in society, and the professionals who serve them. The communicational model is also applied in examining psychiatric disorders and psychiatric diagnoses, as well as psychodynamic formulas, which leads to a reformulation of the psychoanalytic therapy as a process. A plea is entered to define psychoanalysis as an interpersonal discipline, in analogy to Sullivan's interpersonal psychiatry.
Berger, Sarah Shafer; Elliott, Camden; Ranzenhofer, Lisa M; Shomaker, Lauren B; Hannallah, Louise; Field, Sara E; Young, Jami F; Sbrocco, Tracy; Wilfley, Denise E; Yanovski, Jack A; Tanofsky-Kraff, Marian
This study investigated the links among interpersonal problem areas, depression, and alexithymia in adolescent girls at high risk for excessive weight gain and binge eating disorder. Participants were 56 girls (Mage = 14.30, SD = 1.56; 53% non-Hispanic White) with a body mass index (BMI, kg/m(2)) between the 75th and 97th percentiles (MBMI z = 1.57, SD = 0.32). By design, all participants reported loss of control eating patterns in the past month. Adolescents were individually interviewed prior to participating in a group interpersonal psychotherapy obesity and eating disorder prevention program, termed IPT for the prevention of excessive weight gain (IPT-WG). Participants' interpersonal problem areas were coded by trained raters. Participants also completed questionnaires assessing depression and alexithymia. Primary interpersonal problem areas were categorized as interpersonal deficits [as defined in the eating disorders (ED) literature] (n = 29), role disputes (n = 22), or role transitions (n = 5). Girls with interpersonal deficits-ED had greater depressive symptoms and alexithymia than girls with role disputes (p's ≤ 0.01). However, girls with role transitions did not differ from girls with interpersonal deficits-ED or role disputes. Interpersonal problem area had an indirect association with depression via alexithymia; interpersonal deficits-ED were related to greater alexithymia, which in turn, was related to greater depressive symptoms (p = 0.01). Among girls at risk for excess weight gain and eating disorders, those with interpersonal deficits-ED appear to have greater distress as compared to girls with role disputes or role transitions. Future research is required to elucidate the impact of interpersonal problem areas on psychotherapy outcomes.
Shear, M K; Weiner, K
Although medications and panic-focused cognitive behavior therapy are considered standard treatments for panic disorder, other types of psychotherapy may also be helpful. Many patients with panic disorder have some residual underlying vulnerability, as suggested by the continued occurrence of symptoms. These patients may benefit from a more broad-based psychotherapy, as might those in whom comorbid symptoms occur. Some patients are unable or choose not to participate in a structured prescriptive treatment requiring homework. Our psychotherapeutic approach to treating panic disorder, called emotion-focused treatment, targets identifying and managing negative emotions, especially as they relate to common psychological themes of fear of separation, fear of constriction, and the need for interpersonal control.
Bychkova, Tetyana; Hillman, Saul; Midgley, Nick; Schneider, Celeste
An innovative methodology is presented for describing the therapeutic processes involved in five types of adolescent treatments: psychoanalysis, psychodynamic psychotherapy, cognitive-behavioural therapy, mentalisation-based treatment and interpersonal psychotherapy. Using the "Adolescent Psychotherapy Q-Set" (APQ), 18 experienced clinicians…
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,…
Background: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and “V” shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a “V” shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and “V” shape of SCC change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis. PMID:26579001
Strong emotions, either positive or negative, as well as vulnerability to stress are often major factors in triggering, maintaining and emphasizing the symptoms of bronchial asthma. On a group of 99 patients suffering from moderately and severely persistent allergic bronchial asthma for more than 2 years, I applied a situational test of emotional intelligence, the NEO PI-R personality test provided by D&D Consultants and I also elaborated a psychosocial test form of asthma by which I evaluated the frequency of physical symptoms, the intensity of negative emotional symptoms arisen during or subsequent to the crisis and the level of the patients' quality of life. I have presumed first that if the level of the emotional intelligence grew, this fact would have a significant positive influence on controlling the negative emotional symptoms arisen during or subsequent to the crisis and on patients' quality of life. This was invalidated, the correlations between the mentioned variables being insignificant. Secondly, I have presumed the existence of positive significant correlations between the emotional intelligence coefficient and the personality dimensions: extraversion, openness, conscientiousness and a negative significant correlation between the emotional intelligence coefficient and the dimension neuroticism. This presumption was totally confirmed. Finally, we proposed a group psychotherapy plan in 7 steps for asthmatic patients that has as main objectives to improve symptoms and therefore the patients' quality of life.
Spitzer, C; Rullkötter, N; Dally, A
In German-speaking countries inpatient psychotherapy plays a major role in the mental healthcare system. Due to its characteristic features, i. e. multiprofessionalism, multimodality and method integration, the inpatient approach represents a unique and independent type of psychotherapy. In order to be helpful, the manifold verbal and non-verbal methods need to be embedded into an overall treatment plan. Additionally, the therapeutic milieu of the hospital represents an important effective factor and its organization requires a more active construction. The indications for inpatient psychotherapy are not only based on the mental disorder but also on illness, setting and healthcare system-related criteria. In integrative concepts, the multiprofessional team is a key component with many functions. The effectiveness of psychotherapeutic hospital treatment has been proven by meta-analysis studies; however, 20-30% of patients do not benefit from inpatient psychotherapy and almost 13% drop-out prematurely.
Currie, Michael; Startup, Mike
This study evaluates efficacy and effectiveness of "Doing Anger Differently" (DAD), a group treatment for reactively aggressive 12-15 year old males. DAD uses percussion exercises to aid treatment. Study 1 compared a ten-week treatment with a waitlist control at pre, post and 6 month (treatment group only) follow-up. Study 2 replicated Study 1,…
An operational group is defined; how operational groups theory was applied at an ISSSTE clinic is described. It is underlined how operational groups promote change around the corerstone of a "task". The vicissitudes of an operational group with four psychiatrists who worked in community psychiatry at the ISSSTE, are described.
Seligman, Martin E P; Rashid, Tayyab; Parks, Acacia C
Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported them to be "life-changing." Delivered on the Web, positive psychology exercises relieved depressive symptoms for at least 6 months compared with placebo interventions, the effects of which lasted less than a week. In severe depression, the effects of these Web exercises were particularly striking. This address reports two preliminary studies: In the first, PPT delivered to groups significantly decreased levels of mild-to-moderate depression through 1-year follow-up. In the second, PPT delivered to individuals produced higher remission rates than did treatment as usual and treatment as usual plus medication among outpatients with major depressive disorder. Together, these studies suggest that treatments for depression may usefully be supplemented by exercises that explicitly increase positive emotion, engagement, and meaning. ((c) 2006 APA, all rights reserved).
Lange, Julia; Schöttke, Henning
Using latent class analysis the Personality Disorder Screening (PDS) classifies patients into 4 groups: personality disordered (PD) patients (PDS+), healthy patients (PDS -) and 2 hybrid classes with exaggerated personality styles (histrionic/dependent and avoidant/obsessive-compulsive). The present study investigated if the PDS groups differ concerning sociodemographic and clinical variables, psychological distress and treatment outcome. We analyzed the PDS response patterns of 555 outpatients. PDS+ group membership is associated with typical PD characteristics, chronic depression and a high level of general psychological distress. Patients of both hybrid classes are found to show average psychological distress. The treatment was effective for all patients. Membership in the histrionic/dependent hybrid class is associated with early drop out from outpatient therapy.
Smith, Ashley M; Jensen-Doss, Amanda
Improving mental health services for youth in usual care (UC) is one of the most critical issues in mental health services research. Identification of change groups in UC (e.g., recovery, improvement, no response, deterioration) can help researchers gain a richer understanding of UC and facilitate efforts to tailor UC to individuals who may not be responding well to treatment. This study used the reliable change index (RCI; Jacobson & Truax, 1991) to examine change groups within youth UC on two parent report outcome measures-symptom severity and functioning-using a large, naturalistic sample of youth (N = 672) treated in UC served at four clinics operating under a large county-wide public mental health authority. Results indicated that the majority of youth exhibited no reliable change. Furthermore, findings revealed low concordance between how youth were classified on both outcome measures. Multinomial logistic regression was used to predict group membership from an expanded set of youth demographic and clinical variables. Findings indicated that baseline problem severity and lower baseline functioning generally predicted higher likelihood of being classified into a more positive change group. Older age predicted increased likelihood of being in a more positive change group, while diagnosis of an internalizing disorder or serious mental illness (SMI) both predicted greater likelihood of falling into a more negative change group. Overall, these results suggest the importance of a more nuanced understanding of change in UC, as well as work aimed at identifying targets for improvement for youth who are not responding well. (PsycINFO Database Record
Budman, S H; Demby, A; Soldz, S; Merry, J
This study reports on the time-limited (18-month long) group therapy of 49 outpatients, most of whom were diagnosed with DSM-III-R, Axis II personality disorders (American Psychiatric Association, 1987). Although many patients did not complete the full course of treatment, those who did experienced many areas of change. Completers reported substantial changes in self-esteem, symptomatology, and diagnosability on Axis II. This type of group treatment appears to be a promising mode of intervention for those with personality disorders.
Gushue, George V.; Brazaitis, Sarah J.
A new class of medications, protease inhibitors, has dramatically improved the health of many people with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). This development has had a major impact on the lives of those affected by HIV/AIDS. This article considers how a group is affected by the larger systems of…
Begovac, Branka; Begovac, Ivan
This article presents, in the form of a clinical illustration, a therapeutic group of bereaved mothers with special reference to their dreams about their deceased children. The article presents descriptions of the emotions of these mothers and countertransference feelings, a topic that, to our knowledge, has not been frequently studied. The group…
Fagan, Joen; And Others
This group of articles discusses various aspects of Gestalt Therapy including its major contributions, role in psychotherapy, and contributions of Gestalt psychology in general. There is some discussion of the philosophical background of Gestalt therapy along with Gestalt theory of emotion. A case study and an annotated bibliography are included…
Lagana, Luciana; Fobair, Patricia; Spiegel, David
The need for the psychosexual rehabilitation of breast cancer survivors and their intimate partners is underscored by the high prevalence of multiple psychosexual difficulties encountered by this patient population. Concerns about health, sexuality, and emotional distress are common among women with breast cancer and are often related to the side effects of cancer treatment. Additionally, both intimate relationship problems and partners’ distress are likely to influence patients’ psychosexual health. A clearer understanding of these complex clinical issues is needed in order to implement effective psychosexual rehabilitation interventions. In this article, we extended the use of the manualized and empirically validated Supportive-Expressive Group Therapy (SEGT) model to target the specific psychosexual needs of couples with breast (as well as other types of) cancer. In view of the pertinent literature in this area and based on our clinical experience utilizing this group therapy model with different patient populations, we have discussed how clinicians involved in the psychosexual care of oncology patients could apply such a model within a couples group therapy format. PMID:27239398
Greenstein, M; Breitbart, W
Cancer illness affects people in many ways, physical, financial, and existential. In this paper, we describe a proposed group intervention for individuals with advanced disease who want help finding a sense of meaning at this critical juncture in their lives. This intervention has a brief, semi-structured format, and is informed by the work of Viktor Frankl, empirical findings in the area of meaning and trauma, and the empirical findings of other group interventions for cancer patients. Individual sessions focus on different aspects of meaning, including responsibility to others, creativity, transcendence, and ascertaining one's values and priorities. Having goals on which to focus and feeling like part of a larger whole are critically important to the ability to find meaning and cope with terminal illness. Such goals may be generated by a number of sources, including connectedness with others, or a sense of the temporal continuity of one's own life despite the disruption posed by severe illness. Didactic discussions and experiential exercises help to facilitate exploration of these various elements in group members' lives. The finite structure of the intervention may also highlight these issues, as people who are faced with similar issues work together in a limited time frame in order to accomplish the goals they set out for themselves.
Darrow, Sabrina M.; Dalto, Georgia; Follette, William C.
Functional Analytic Psychotherapy (FAP) is an interpersonal behavior therapy that relies on a therapist's ability to contingently respond to in-session client behavior. Valued behavior change in clients results from the therapist shaping more effective client interpersonal behaviors by providing effective social reinforcement when these behaviors…
Philipsen, Alexandra; Richter, Harald; Peters, Julia; Alm, Barbara; Sobanski, Esther; Colla, Michael; Münzebrock, Mirka; Scheel, Corinna; Jacob, Christian; Perlov, Evgeniy; Tebartz van Elst, Ludger; Hesslinger, Bernd
Attention deficit hyperactivity disorder (ADHD) is a serious mental disorder that often persists in adulthood. In a pilot study, a structured skills training group program for adult ADHD led to significant symptomatic improvements. The present study evaluated the program's effectiveness, feasibility, and patient acceptability in a multicenter setting. Seventy-two adult ADHD patients were assigned to 13 two-hour weekly sessions at 4 different therapy sites. The therapy was well tolerated and led to significant improvements of ADHD, depressive symptoms, and personal health status (p < 0.001). The factors treatment site and medication did not contribute to the overall improvement. Patients regarded the program topics "behavioral analyses," "mindfulness," and "emotion regulation" as the most helpful. In this multicenter study, the therapy program showed therapist-independent effects and seemed to be disorder-specific. This warrants the effort of organizing further controlled studies.
Petrowski, Katja; Hessel, Aike; Körner, Annett; Weidner, Kerstin; Brähler, Elmar; Hinz, Andreas
Attitudes towards psychotherapy are important predictors for the acceptance and usage of psychotherapy. A survey examined attitudes towards psychotherapy in a sample representative of the German population including 2089 persons between 14 to 92 years of age. Two thirds of the sample indicated a positive attitude towards psychotherapy. Men as well as individuals with lower education reported a more negative attitude towards psychotherapy than women and persons with higher educational level. Education had a medium effect size (d=0.44). Individuals with somatoform symptoms did not indicate a more negative attitude towards psychotherapy than the general population. Even though the majority of the population has a more positive attitude towards psychotherapy, this positive attitude does not apply for all groups of the -population.
Seligman, Martin E. P.; Rashid, Tayyab; Parks, Acacia C.
Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported…
Lazar, Susan G
Psychotherapy is an effective and often highly cost-effective medical intervention for many serious psychiatric conditions. Psychotherapy can also lead to savings in other medical and societal costs. It is at times the firstline and most important treatment and at other times augments the efficacy of psychotropic medication. Many patients are in need of more prolonged and intensive psychotherapy, including those with personality disorders and those with chronic complex psychiatric conditions often with severe anxiety and depression. Many patients with serious and complex psychiatric illness have experienced severe early life trauma in an atmosphere in which family members or caretakers themselves have serious psychiatric disorders. Children and adolescents with learning disabilities and those with severe psychiatric disorders can also require more than brief treatment. Other diagnostic groups for whom psychotherapy is effective and cost-effective include patients with schizophrenia, anxiety disorders (including posttraumatic stress disorder), depression, and substance abuse. In addition, psychotherapy for the medically ill with concomitant psychiatric illness often lowers medical costs, improves recovery from medical illness, and at times even prolongs life compared to similar patients not given psychotherapy. While "cost-effective" treatments can yield savings in healthcare costs, disability claims, and other societal costs, "cost-effective" by no means translates to "cheap" but instead describes treatments that are clinically effective and provided at a cost that is considered reasonable given the benefit they provide, even if the treatments increase direct expenses. In the current insurance climate in which Mental Health Parity is the law, insurers nonetheless often use their own non-research and non-clinically based medical necessity guidelines to subvert it and limit access to appropriate psychotherapeutic treatments. Many patients, especially those who need
Gore-Felton, Cheryl; Spiegel, David
Reviews research indicating that group psychotherapy is an effective adjunctive therapy to medical treatment for women with breast cancer. States that Supportive-Expressive group therapy has been effective in assisting patients in reducing anxiety related to death and dying, strengthening interpersonal relationships, and improving the quality of…
Zhou, Xinyu; Hetrick, Sarah E; Cuijpers, Pim; Qin, Bin; Barth, Jürgen; Whittington, Craig J; Cohen, David; Del Giovane, Cinzia; Liu, Yiyun; Michael, Kurt D; Zhang, Yuqing; Weisz, John R; Xie, Peng
Previous meta-analyses of psychotherapies for child and adolescent depression were limited because of the small number of trials with direct comparisons between two treatments. A network meta-analysis, a novel approach that integrates direct and indirect evidence from randomized controlled studies, was undertaken to investigate the comparative efficacy and acceptability of psychotherapies for depression in children and adolescents. Systematic searches resulted in 52 studies (total N=3805) of nine psychotherapies and four control conditions. We assessed the efficacy at post-treatment and at follow-up, as well as the acceptability (all-cause discontinuation) of psychotherapies and control conditions. At post-treatment, only interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) were significantly more effective than most control conditions (standardized mean differences, SMDs ranged from −0.47 to −0.96). Also, IPT and CBT were more beneficial than play therapy. Only psychodynamic therapy and play therapy were not significantly superior to waitlist. At follow-up, IPT and CBT were significantly more effective than most control conditions (SMDs ranged from −0.26 to −1.05), although only IPT retained this superiority at both short-term and long-term follow-up. In addition, IPT and CBT were more beneficial than problem-solving therapy. Waitlist was significantly inferior to other control conditions. With regard to acceptability, IPT and problem-solving therapy had significantly fewer all-cause discontinuations than cognitive therapy and CBT (ORs ranged from 0.06 to 0.33). These data suggest that IPT and CBT should be considered as the best available psychotherapies for depression in children and adolescents. However, several alternative psychotherapies are understudied in this age group. Waitlist may inflate the effect of psychotherapies, so that psychological placebo or treatment-as-usual may be preferable as a control condition in psychotherapy
Background Continuous feedback on patient improvement and the therapeutic alliance may reduce the number of dropouts and increase patient outcome. There are, however, only three published randomized trials on the effect of feedback on the treatment of eating disorders, showing inconclusive results, and there are no randomized trials on the effect of feedback in group therapy. Accordingly the current randomized clinical trial, initiated in September 2012 at the outpatient clinic for eating disorders at Stolpegaard Psychotherapy Centre, aims to investigate the impact of continuous feedback on attendance and outcome in group psychotherapy. Methods/design The hypothesis is that continuous feedback to both patient and therapist on treatment progress and alliance will increase attendance and treatment outcome. The trial is set up using a randomized design with a minimum of 128 patients allocated to either an experimental or control group at a ratio of 1:1. The experimental group will receive standard treatment (systemic and narrative group psychotherapy) with feedback intervention, whereas the control group will receive standard treatment only. The participants are diagnosed with bulimia nervosa, binge eating disorder, or an eating disorder not otherwise specified, according to the DSM-IV. In the experimental group feedback to the participants, based on the Outcome Rating Scale (ORS) and the Group Session Rating Scale (GSRS), is actively added to standard treatment. The ORS assesses areas of life functioning known to change as a result of therapeutic intervention. The GSRS assesses key dimensions of effective therapeutic relationships. In the control group, the patients fill out the Outcome Rating Scale only, and feedback is not provided. The primary outcome is the rate of attendance to treatment sessions. The secondary outcome is the severity of eating disorder symptoms. Exploratory outcomes are the level of psychological and social functioning, and suicide or self
Kearns, Patricia M.
This thesis is an analysis of data concerning drug usage among three groups of young soldiers and isolates significant factors relating to characteristic interpersonal and intrafamilial relationships prevalent in these groups. Those soldiers dependent on drugs all came from families that they considered disharmonious. The following variables…
The New Beginnings program was developed at the Anna Freud Centre and originally piloted in Her Majesty Prisons in the United Kingdom. This study aimed to explore the use of this manualized parent-infant psychotherapy group model in an African setting with high-risk mother-infant dyads, and describes the implementation and investigation of this 12-week group psychotherapy intervention in two Johannesburg shelters for homeless women. The measures used to investigate treatment efficacy were the Parent Development Interview (A. Slade, J.L. Aber, I. Bresgi, B. Berger, & M. Kaplan,), the Emotional Availability Scales (Z. Biringen, J.L. Robinson, & R.N. Emde,), the Kessler-10 (R.C. Kessler et al.,), and the Griffiths Scales of Mental Development (D. Luiz et al., . At pretesting, infants exhibited delays in a number of developmental areas, and mothers showed high levels of depression and generally low capacities for reflective function. While significant shifts in the mothers' capacities for reflective function were not found in the treatment condition, significant shifts were found in the infants' speech abilities and in the mothers' abilities to structure their interactions with their infants. This suggests that the program enabled mothers to become more sensitized to their infants' needs in interaction and that communication between mother and infant increased. The number of sessions attended by the dyads correlated with improvements made by the mothers and their infants.
Willing, Kathlene R.
The study examined the family backgrounds, attentional patterns, and interpersonal styles of 20 Canadian learning disabled (LD students (10-22 years old). Using the Test for Attentional and Interpersonal Styles and a questionnaire, 94 family members, including the 20 Ss, were interviewed. Although no strong familial patterns of import were…
Velasco de Ongay, M E
The problems of an ISSSTE clinic were approached within the general systems theory and it was observed that within the group there existed forces to maintain the status-quo and forces towards change; to produce the latter the group was handled during 20 hours with a slightly directive technique. The goals were to improve interpersonal relationships, to increase communication, to make known to individuals their attitudes within a group and make them sensitive to problems they shared with others. The results were good, the status-quo was broken and change started occurring.
Page, Richard C.; Bridges, Ned
Assessed how illegal drug users (N=12) related to one another during a 16-hour unstructured group marathon. Interaction analysis supported the effectiveness of the marathon group. Members and facilitators were able to relate to each other by confronting significant behaviors and receiving feedback about ways to cope with personal problems. (JAC)
Glaize, David L.; Myrick, Robert D.
Compared the effectiveness of a computer assisted guidance program (DISCOVER), a small group guidance intervention (Vocational Exploration Group), and a combined approach on career maturity and decidedness in 120 high school students. All three interventions were significantly helpful to students. (JAC)
Project REAL (Relationship skills, Education on violence prevention, Academics, Leadership and decision-making skills) was a practicum designed to increase the academic achievement of middle school students exposed to domestic violence. Eleven students and their parents participated in a 12-week interpersonal-cognitive counseling group and its…
Interpersonal, Nonverbal, and Small Group Communication: Abstracts of Doctoral Dissertations Published in "Dissertation Abstracts International," July through December 1981 (Vol. 42 Nos. 1 through 6).
ERIC Clearinghouse on Reading and Communication Skills, Urbana, IL.
This collection of abstracts is part of a continuing series providing information on recent doctoral dissertations. The 32 titles deal with a variety of topics, including the following: (1) the analysis of conversational sequencing in group systems; (2) the effects of hearing aids on interpersonal perceptions; (3) styles of communication between…
Constantino, Michael J; Schwaiger, Elizabeth M; Smith, Julianna Z; DeGeorge, Joan; McBride, Carolina; Ravitz, Paula; Zuroff, David C
The therapeutic alliance consistently predicts positive psychotherapy outcomes. Thus, it is important to uncover factors that relate to alliance development. The goal of this study was to examine the association between patient interpersonal characteristics and alliance quality in interpersonal therapy for depression. Data derive from a subsample (n = 74) of a larger naturalistic database of outpatients treated at a mood disorders clinic of a university-affiliated psychiatric hospital. Following Session 3 of treatment, therapists completed the Impact Message Inventory (Kiesler & Schmidt, 1993) to assess patients' interpersonal impacts on them. Also following Session 3, patients completed the Working Alliance Inventory (Horvath & Greenberg, 1989) to assess alliance quality. As predicted, patients' affiliative interpersonal impacts, as perceived by their therapists, were positively associated with alliance quality, controlling for baseline depression severity. Although unrelated to the initial hypotheses, patients concurrently taking psychotropic medications reported better alliances than patients receiving psychotherapy only.
Deckersbach, Thilo; Peters, Amy T.; Sylvia, Louisa; Urdahl, Anna; Magalhães, Pedro V.S.; Otto, Michael W.; Frank, Ellen; Miklowitz, David J.; Berk, Michael; Kinrys, Gustavo; Nierenberg, Andrew
Objective At least 50% of individuals with bipolar disorder have a lifetime anxiety disorder. Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration, greater illness severity, and poorer treatment response. The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome. Method In the Systematic Treatment Enhancement Program randomized controlled trial of psychotherapy for bipolar depression, participants received up to 30 sessions of intensive psychotherapy (family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) or collaborative care, a three-session comparison treatment, plus pharmacotherapy. Using the number needed to treat, we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year. Results A total of 269 patients (113 women) with a comorbid lifetime anxiety disorder (N=177) or without a comorbid lifetime anxiety disorder (N=92) were included in the analysis. Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care (66% compared with 49% recovered over 1 year; number needed to treat=5.88, small to medium effect). For patients without a lifetime anxiety disorder, there was no difference between rates of recovery in psychotherapy compared with collaborative care (64% compared with 62% recovered; number needed to treat=50, small effect). Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care (84% compared with 53% recovered; number needed to treat=3.22, medium to large effect), whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments (54% compared with 46% recovered; number needed to treat=12.5, small effect). Conclusions Depressed patients
Slaten, Christopher D.; Elison, Zachary M.
Youth mental health is an area of profound disparity between the demand and supply of services, particularly in schools that serve students at risk of school dropout. This article describes the conceptual foundations and implementation of "MAGNIFY", a program that provides free group counseling to small alternative schools with students…
Bhatia, Subhash C.; Madabushi, Jayakrishna; Kolli, Venkata; Bhatia, Shashi K.; Madaan, Vishal
The Bhagavad Gita is based on a discourse between Lord Krishna and Arjuna at the inception of the Kurukshetra war and elucidates many psychotherapeutic principles. In this article, we discuss some of the parallels between the Gita and contemporary psychotherapies. We initially discuss similarities between psychodynamic theories of drives and psychic structures, and the concept of three gunas. Arjuna under duress exhibits elements of distorted thinking. Lord Krishna helps remedy this through a process akin to Cognitive Behavioral Therapy (CBT). We ascertain the analogies between the principles of Gita and CBT, grief emancipation, role transition, self-esteem, and motivation enhancement, as well as interpersonal and supportive psychotherapies. We advocate the pragmatic application of age old wisdom of the Gita to enhance the efficacy of psychotherapeutic interventions for patients from Indian subcontinent and to add value to the art of western psychotherapies. PMID:23858274
Nozawa, Takayuki; Sasaki, Yukako; Sakaki, Kohei; Yokoyama, Ryoichi; Kawashima, Ryuta
Research of interpersonal neural synchronization (INS) using functional near-infrared spectroscopy (fNIRS) hyperscanning is an expanding nascent field. This field still requires the accumulation of findings and establishment of analytic standards. In this study, we therefore intend to extend fNIRS-based INS research in three directions: (1) verifying the enhancement of frontopolar INS by natural and unstructured verbal communication involving more than two individuals; (2) examining timescale dependence of the INS modulation; and (3) evaluating the effects of artifact reduction methods in capturing INS. We conducted an fNIRS hyperscanning study while 12 groups of four subjects were engaged in cooperative verbal communication. Corresponding to the three objectives, our analyses of the data (1) confirmed communication-enhanced frontopolar INS, as expected from the region's roles in social communication; (2) revealed the timescale dependency in the INS modulation, suggesting the merit of evaluating INS in fine timescale bins; and (3) determined that removal of the skin blood flow component engenders substantial improvement in sensitivity to communication-enhanced INS and segregation from artifactual synchronization, and that caution for artifact reduction preprocessing is needed to avoid excessive removal of the neural fluctuation component. Accordingly, this study provides a prospective technical basis for future hyperscanning studies during daily communicative activities.
Wetterneck, Chad T.; Hart, John M.
Problems with intimacy and interpersonal issues are exhibited across most psychiatric disorders. However, most of the targets in Cognitive Behavioral Therapy are primarily intrapersonal in nature, with few directly involved in interpersonal functioning and effective intimacy. Functional Analytic Psychotherapy (FAP) provides a behavioral basis for…
Lorentzen, Steinar; Fjeldstad, Anette; Ruud, Torleif; Marble, Alice; Klungsøyr, Ole; Ulberg, Randi; Høglend, Per A
We compared differences in self-concept change across three years after short-(STG) and long-term (LTG) psychodynamic group psychotherapy, in a mixed sample of outpatients. Self-concept was assessed at baseline and three years later, using the Structural Analysis of Social Behavior Questionnaire. Vector scores Affiliation and Autonomy were primary, and the eight cluster scores-self-free, self-affirm, self-love, self-protect, self-control, self-blame, self-attack, and self-neglect-were secondary outcome measures. Within group univariate analyses showed change in LTG across three years on the vector scores Affiliation and Autonomy, while STG only changed on Autonomy. Comparisons between STG and LTG demonstrated a significantly larger improvement in Affiliation in LTG than in STG. This difference was explained by a higher improvement in the cluster scores of self-blame, self-attack, and self-neglect in LTG, dimensions that weight negatively on the Affiliation score. Patients with more serious self-neglect and harsh, punitive self-attack/self-blame may profit more in long-term than in short-term groups.
Taft, Casey T.; Murphy, Christopher M.; Musser, Peter H.; Remington, Nancy A.
Recent studies have demonstrated that the working alliance predicts treatment outcome for partner violent men. This study examined the influence of personality and interpersonal characteristics, motivational readiness to change, and demographic factors on working alliance formation among a sample of men (N = 107) participating in a…
Mahendran, Rathi; Tan, Joyce Yi Siang; Griva, Konstadina; Lim, Haikel Asyraf; Ng, Hui Ying; Chua, Joanne; Lim, Siew Eng; Kua, Ee Heok
Introduction Despite the rising trend of cancer prevalence and increase in family caregiving, little attention has been paid to the efficacy of psychosocial interventions among Asian caregiver samples, particularly support groups, given the benefits that have been shown in studies on Western populations. This trial aims to evaluate the effectiveness of a pilot 4-week group psychotherapy for Singaporean family caregivers of patients receiving outpatient care. Methods and analysis Facilitated by a clinical psychologist, this intervention is primarily based on the brief integrative psychological therapy with a supportive-expressive intent. Participants will be recruited while they are accompanying their care recipients for outpatient consultations. Since this is a pilot study, a sample size of 120 participants is targeted on the basis of sample sizes of previous studies. The study adopts a quasi-experimental design, as participants are assigned the intervention or control arms based on their availability to attend the intervention. A mixed methods approach is used to evaluate the outcomes of the intervention. A self-administered battery of tests is completed at four time points: baseline, postintervention and follow-up at 1-month and 2-month postinterventions; semi-structured interviews are conducted at baseline and post-intervention. Primary outcomes are quality of life and anxious and depressive symptoms; secondary outcomes are stress and basic psychological needs. Analysis using analysis of covariance would be conducted to determine the effectiveness of the intervention. Ethics and dissemination This study protocol has ethics approval from the National Healthcare Group Domain Specific Review Board (NHG DSRB Ref: 2013/00662). Written informed consent is obtained from every participant. Results will be disseminated through journals and conferences, and will be particularly relevant for clinicians intending to implement similar support groups to address the
de Figueiredo, John M; Gostoli, Sara
In most societies, members of a culture have attempted to help each other in times of trouble with various types of healing methods. Demoralization - an individual experience related to a group phenomenon - responds to certain elements shared by all psychotherapies. This article has three objectives: (1) to review the theoretical background leading to our current views on culture and demoralization in psychotherapy, (2) to discuss the methodological challenges faced in the cross-cultural study of demoralization and psychotherapy, and (3) to describe the clinical applications and research prospects of this area of inquiry. Demoralization follows a shattering of the individual's assumptive world and it is different from homeostatic responses to a stressful situation or from depressive disorders. Only a few comparative studies of this construct across cultures have been undertaken. The presentation of distress may vary widely from culture to culture and even within the same culture. To avoid 'category fallacy', it is important to understand the idioms of distress peculiar to a cultural group. A cultural psychiatrist or psychotherapist would have to identify patient's values and sentiments, reconstruct his/her personal and collective ambient worlds, and only then study demoralization. The limitations of our current diagnostic systems have resulted in methodological challenges. Cultural clinicians should consider using a combination of both 'clinimetric' and 'perspectivistic' approaches in order to arrive at a diagnosis and identify the appropriate intervention. The presenting problem has to be understood in the context of the patient's individual, social and cultural background, and patients unfamiliar with Western-type psychotherapies have to be prepared to guide their own expectations before the former are used. Future research should identify the gaps in knowledge on the effectiveness of cultural psychotherapy at reversing or preventing demoralization.
The social and intellectual climate of the late 1940s and early 1950s in America helped nourish humanistic, person-centered views of human behavior. During that time, psychologists such as Gordon Allport, Abraham Maslow, David McClelland, Harry Murray, and Carl Rogers emphasized the positive growth potential in human character. The psychiatrist Harry Stack Sullivan proposed that personality can best be understood within the context of interpersonal transactions, and he provided a practical, street-smart understanding of psychiatric symptoms that was quite an advance over the traditional medical and psychoanalytic viewpoints. These ideas, along with the concept of dimensionalizing traits rather than categorizing them, inspired my colleagues and I to conduct our cooperative work on the interpersonal circumplex, which culminated in the publication of my monograph. Interpersonal Diagnosis of Personality (Leary, 1957).
Brief psychotherapy has demonstrated its effectiveness in treating emotional disorders and helping with problems that typically present to primary care physicians. Because practitioners receive little instruction about this treatment option and often have erroneous preconceived ideas about it, psychotherapy remains underprescribed. Effective brief therapy enables the patient to problem-solve, facilitates the relationship with the provider, and ultimately clarifies the patient's situation. Referral of appropriate patients for psychotherapy will enhance the effectiveness of the doctor in primary care. PMID:15014662
Smith, Lloyd F.
Psychotherapy is a word to describe an age-old process. It would be better not to speak of psychotherapy, but of psychotherapies. Specialists are not the only ones who act as psychotherapists, since every human being fills this role at one time or another. Besides this, no two persons follow an identical approach. Finally, all therapists change technique constantly. The kinds of psychotherapy must therefore approach infinity. Some physicians appear to assume that only one type of psychotherapy may claim a scientific basis. Although Freud first put psychotherapy on a scientific path, there is no reason to say that Freud must be the last in this field. Over the past few years a new trend has started in psychotherapy which deserves close study. This new trend challenges some old beliefs and gives a new tool to help patients of some types. It is called non-directive or client-centered psychotherapy. This therapy does not try to solve the patient's problems for him, but rather establishes the conditions under which a patient can work out his own salvation. Each year non-directive psychotherapy grows in importance. Much can be learned from the method. PMID:14778014
Papp, Barbara; Péley, Bernadette
Evaluation of the efficacy in psychotherapy dates back to the beginnings of psychotherapy itself. However, it is not an easy task to undertake efficacy evaluation because it is expensive and several methodological difficulties may be also present. The authors discuss some questions related efficacy evaluation in psychotherapy, including criteria for selecting the cases and the actual target of evaluation. In addition, the authors analyze the narrative psychological content analysis method which includes the analysis of psychological features and their changes of texts written by the patient about him- or herself. They conclude that this method can open novel perspectives in psychotherapy.
Mellin, Elizabeth Anne
In an attempt of fill the gap in theoretical and empirical information available for treatment of adolescent depression, interpersonal therapy for adolescents (IPT-A) was developed. Interpersonal psychotherapy (IPT) is a brief, time-limited therapy originally developed for use with adults diagnosed with major depression. Several outcome studies…
Layne, Christopher M.; Saltzman, William R.; Poppleton, Landon; Burlingame, Gary M.; Pasalic, Alma; Durakovic, Elvira; Music, Mirjana; Campara, Nihada; Dapo, Nermin; Arslanagic, Berina; Steinberg, Alan M.; Pynoos, Robert S.
The study assesses the comparative efficacy of a classroom-based psycho-education and skills intervention and a school-based trauma- and grief-focused group treatment of a three-tiered mental health program for adolescents exposed to severe war-trauma, traumatic bereavement, and postwar adversity. The two-tier approach, combined with…
Lovejoy, Travis I.; Heckman, Timothy G.; Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene
By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30% of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥ 50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults. PMID:24668254
Lovejoy, Travis I; Heckman, Timothy G; Sikkema, Kathleen J; Hansen, Nathan B; Kochman, Arlene
By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30 % of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults.
Peres, Julio F P
There is increasing recognition of the need to take into account the cultural environment and belief systems of psychotherapy patients because these values reflect basic assumptions about man's nature and the cognitive references used to cope with psychological difficulties. Currently accepted psychotherapeutic approaches take no account of the belief in life after death held by most of the world's population. The World Values Survey (http://www.worldvaluessurvey.org) showed that there are large numbers of reincarnationists around the world, and whatever the reasons for believing in reincarnation, psychotherapeutic approaches should not ignore this significant group of people. Respect for patient opinions and subjective realities is a therapeutic need and an ethical duty, even though therapists may not share the same beliefs. Guidelines are suggested for professionals to develop collaborative models that help patients mobilize their intrinsic intelligence to find solutions to their complaints.
Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio
Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study describes preliminary data from a group format manual-based intervention, the Interpersonal Problem-Solving for Workplace Adaptation Programme, aimed at improving the cognitive and metacognitive process of social problem-solving skills focusing on typical social situations in the workplace based on mediation as the main strategy. A total of 50 adults with Asperger syndrome received the programme and were compared with a control group of typical development. The feasibility and effectiveness of the treatment were explored. Participants were assessed at pre-treatment and post-treatment on a task of social problem-solving skills and two secondary measures of socialisation and work profile using self- and caregiver-report. Using a variety of methods, the results showed that scores were significantly higher at post-treatment in the social problem-solving task and socialisation skills based on reports by parents. Differences in comparison to the control group had decreased after treatment. The treatment was acceptable to families and subject adherence was high. The Interpersonal Problem-Solving for Workplace Adaptation Programme appears to be a feasible training programme.
Pitman, Seth R; Hilsenroth, Mark J
We attempted to replicate earlier findings of interpersonal subtypes in patients with anxiety disorder (Psychotherapy. 2011;48:304-310) and examine whether these subtypes are characterized by different types of pathology and respond differently to treatment. Interpersonal problems were measured by the Inventory of Interpersonal Problems (Inventory of Interpersonal Problems Manual. San Antonio, TX: Psychological Cooperation; 2000) in a sample of 31 patients with anxiety disorder. Results demonstrated the existence of 4 interpersonal subtypes. The subtypes did not differ in severity of anxiety and global levels of symptoms at pretreatment or in Reliable Change Index of anxiety symptoms over the course of treatment. However, they were significantly different in terms of overall interpersonal problems (p = 0.004). Regarding treatment variables, half of the patients in the nonassertive cluster discontinued treatment prematurely. The number of psychotherapy sessions attended was significantly different across the 4 clusters (p = 0.04), with socially avoidant patients attending significantly greater number of sessions.
Rode, Sibylle; Wagner, Petra; Bräunig, Peter
On the basis of a vulnerability-stress-model psycho-educative, cognitive-behavioural, family-oriented and interpersonal approaches of psychotherapy for bipolar disorders are described. This is followed by a review of randomised controlled trials investigating the treatment efficacy of psychotherapeutic interventions. These studies show positive results particularly for psychoeducation, cognitive-behavioural therapy and family-oriented therapy. Finally, it is discussed in which respects evidence for the successful implementation of psychotherapy is still missing and why it is so important to move towards manualized psychotherapeutic programs.
Henry, Hani M
Islamic prayers can produce spiritual energy that may yield many psychological benefits, such as amelioration of stress and improvement in subjective well-being, interpersonal sensitivity, and mastery. Islamic prayers can also be integrated into mainstream therapeutic interventions with religious Muslim clients, and this integration can mobilize, transform, and invigorate the process of psychotherapy. This paper provides methods that can be used for the explicit integration of Islamic prayers into traditional psychotherapy. Further, the paper offers strategies for avoiding potential pitfalls that may hamper this process. Finally, a case study illustrating this therapeutic integration and its psychological benefits will be presented.
Spiegel, Jeremy; Severino, Sally K.; Morrison, Nancy K.
The authors propose to clarify concepts of emotional attunement and failures of attunement in early development derived from theoretical and clinical work (Kohut) and infant psychiatry (Stern). Early attunement failures are experienced as shameful by the infant/child, and without repair they form a nidus for later destructive adult interpersonal relationships, “social blindness,” and depression. The authors present a case illustrating these ideas. The role of empathic attunement experienced in the unique setting/structure of psychotherapy emerges as the single critical variable for a successful outcome. PMID:10608906
Scotillo, Irene Alejandra
Transference is an absolutely natural and spontaneous process which cannot be developed in an artificial and voluntary manner by the therapist. Transference is carried out in a subjective interpersonal relation consisting of a patient and an analyst. Jung will say he feels happy when transference takes place calmly or runs virtually unnoticed and the therapist can then focus on other therapeutic factors that play an important role. One could argue that Jungian psychotherapy consists of two people who get together to try to understand what is happening in the subconscious of one of them. The Jungian therapist is an active therapist who encourages and helps the patient to develop its individuation.
Mellin, Elizabeth A.; Beamish, Patricia M.
This article provides mental health counselors with information about the prevalence and course of adolescent depression, other empirically tested treatments for adolescent depression, an explanation of Interpersonal psychotherapy for adolescents (IPT-A) treatment protocol, and results of outcome studies on the effectiveness of IPT-A. Suggestions…
Lefley, Harriet P.; Bestman, Evalina W.
Caribbean mental health professionals are concerned with the types of psychotherapy that are relevant to the needs of their clients, and with the uses of psychotherapy in a political context. They appear to be divided into two schools: one seeking to promote in clients a change from a traditional world view to a modern one, and the other seeking…
BUCKLEY, PETER F.; LYS, CHRISTINE
Psychotherapy for patients with schizophrenia, although almost universally practiced in some form with clinical management of schizophrenia, has not been the present focus of such rigorous scientific inquiry as has been afforded to other current treatment modalities. This review highlights areas of potential progress and opportunities for clearer definition of psychotherapies for schizophrenia. PMID:22700288
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…
Petersen, I; Bhana, A; Baillie, K
Within the context of a large treatment gap for depression and a scarcity of specialist resources, there is a need for task shifting to scale up mental health services to address this gap in South Africa. This study assessed the feasibility of an adapted manualized version of grouped based Interpersonal Therapy (IPT) for use by supervised community health workers through a pilot study on 60 primary health care clinic users screened as having moderate to severe depression. Retention was good and participants in the group-based IPT intervention showed significant reduction in depressive symptoms on completion of the 12-week intervention as well as 24 weeks post baseline compared to the control group. Qualitative process evaluation suggests that improved social support, individual coping skills and improved personal agency assisted in the reduction of depressive symptoms.
Zilcha-Mano, Sigal; McCarthy, Kevin S.; Dinger, Ulrike; Chambless, Dianne L.; Milrod, Barbara L.; Kunik, Lauren; Barber, Jacques P.
Objective Panic disorder (PD) is associated with significant personal, social, and economic costs. However, little is known about specific interpersonal dysfunctions that characterize the PD population. The current study systematically examined these interpersonal dysfunctions. Method The present analyses included 194 patients with PD out of a sample of 201 who were randomized to cognitive-behavioral therapy, panic-focused psychodynamic psychotherapy, or applied relaxation training. Interpersonal dysfunction was measured using the Inventory of Interpersonal Problems–Circumplex (Horowitz, Alden, Wiggins, & Pincus, 2000). Results Individuals with PD reported greater levels of interpersonal distress than that of a normative cohort (especially when PD was accompanied by agoraphobia), but lower than that of a cohort of patients with major depression. There was no single interpersonal profile that characterized PD patients. Symptom-based clusters (with versus without agoraphobia) could not be discriminated on core or central interpersonal problems. Rather, as revealed by cluster analysis based on the pathoplasticity framework, there were two empirically derived interpersonal clusters among PD patients which were not accounted for by symptom severity and were opposite in nature: domineering-intrusive and nonassertive. The empirically derived interpersonal clusters appear to be of clinical utility in predicting alliance development throughout treatment: While the domineering-intrusive cluster did not show any changes in the alliance throughout treatment, the non-assertive cluster showed a process of significant strengthening of the alliance. Conclusions Empirically derived interpersonal clusters in PD provide clinically useful and non-redundant information about individuals with PD. PMID:26030762
Koole, Sander L.; Tschacher, Wolfgang
During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship– or alliance– and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in the coupling of patient and therapist’s brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another’s internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients’ emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains. PMID:27378968
Cox, Daniel W; Owen, Jess J; Ogrodniczuk, John S
One of the most potent protective factors against psychiatric symptoms after military trauma is perceived social support. Although group psychotherapy has been linked with increasing social support, no research has evaluated which therapeutic mechanisms are associated with this increase beyond symptom reduction. We investigated which interpersonal therapeutic factors were related to changes in social support, beyond posttraumatic stress disorder (PTSD) symptom reduction. Participants were 117 veterans in a multimodal outpatient group psychotherapy treatment designed to reduce PTSD symptoms and interpersonal difficulties. Generally, therapeutic factors were related to improvements in social support from baseline to posttreatment beyond the effects of PTSD symptom reduction. Specifically, social learning was associated with changes in appraisal support, secure emotional expression was associated with changes in tangible support, and neither was associated with changes in belonging support. Depending on the goals of treatment, understanding these variations are important so clinicians and researchers can appropriately design and target their interventions to facilitate desired changes.
Phase I interpersonal performance assessment system: selection of the target group , identification of performance dimensions, and performance scale...development. > Target Group Selection The U.S. Army Special Forces (SF) was chosen as the target group because interpersonal skills are critical for the...1 IDENTIFYING THE TARGET GROUP ................................................................................... 2 IDENTIFYING CRITICAL
Carcione, Antonino; Nicolò, Giuseppe; Pedone, Roberto; Popolo, Raffaele; Conti, Laura; Fiore, Donatella; Procacci, Michele; Semerari, Antonio; Dimaggio, Giancarlo
Individuals with personality disorders (PDs) have difficulties in modulating mental states and in coping with interpersonal problems according to a mentalistic formulation of the problem. In this article we analyzed the first 16 psychotherapy sessions of 14 PD patients in order to explore whether their abilities to master distress and interpersonal problems were actually impaired and how they changed during the early therapy phase. We used the Mastery Section of the Metacognition Assessment Scale, which assesses the use of mentalistic knowledge to solve problems and promote adaptation. We explored the hypotheses that a) PD patients had problems in using their mentalistic knowledge to master distress and solve social problems; b) the impairments were partially stable and only a minimal improvement could be observed during the analyzed period; c) patients' mastery preferences differed from one another; d) at the beginning of treatment the more effective strategies were those involving minimal knowledge about mental states. Results seemed to support the hypotheses; the patients examined had significant difficulties in mastery abilities, and these difficulties persisted after 16 sessions. Moreover, the attitudes towards problem-solving were not homogenous across the patients. Lastly, we discuss implications for assessment and treatment of metacognitive disorders in psychotherapy.
Meier, Emily A.; Irwin, Scott A.
Caring for patients with cancer involves addressing their myriad physical, psychological, social, and spiritual needs. Although many cancer treatments focus on physical or psychological needs, few treatments specifically target the basic need for meaning and spiritual well-being in this population. This article describes the creation and evolution of a new psychotherapy devoted to these needs, a therapy termed “meaning-centered psychotherapy.” In this article, a detailed description of meaning-centered psychotherapy is provided. An explanation of the current research findings related to this treatment are also offered, with information about the various group and individual treatments as well as the new expansions for use with cancer survivors or nursing staff. Overall, meaning-centered psychotherapy shows promise for enhancing meaning and spiritual well-being among patients with cancer and offers exciting possibilities for future research in other areas. PMID:25182513
There is a tension between those who hold that psychotherapy is a scientific discipline and therefore "value-free," and those who believe that values are inherent in the nature of psychotherapy. Psychoanalysis has moved from a science-based ideology, through the ethical concerns of Melanie Klein, to a recognition of the "aesthetic" dimension--the creation of suitable forms that can contain psychological distress. From this latter perspective, the antagonism between religion and psychotherapy, initiated by Freud, becomes less acute. Action-based ethical systems, which ignore the inner world, are critically scrutinized. The evidence suggesting there is a relationship between good outcome in psychotherapy and shared values between therapist and client is reviewed. It is posited that through examination of the "ethical countertransference," therapists should become aware of their own value systems and how they influence practice.
Farber, Barry A.; Geller, Jesse D.
Psychotherapy is viewed by college students as highly useful in dealing with living problems, yet--when given the availability of other treatment methods (peer interaction, yoga, meditation)-- it is frequently not the first choice of the student. (MJB)
Dukes, Denzel; And Others
Frederic Leer's article "Running as an Adjunct to Psychotherapy" (January 1980 issue of this journal) is criticized by three authors. They focus on the psychological and social effects of running and its usefulness as a treatment for depressed adults. (LAB)
Beginning with Paul Federn--a contemporary of Sigmund Freud--every generation of psychotherapists for the past hundred years has included a small number of determined clinicians who have worked psychotherapeutically with psychotic patients, and written about their work. This special issue of the American Journal of Psychotherapy contains seven papers by clinicians in this generation who are using psychotherapy in the treatment of psychosis.
Altshul, Victor A
Yakeley and Adshead present a broad view of the increasing influence of psychodynamically informed thought and practice on the British criminal justice system, adumbrating a model they call forensic psychotherapy. They explore such topics as mitigating factors, influences on recidivism, and psychotherapy with incarcerated inmates. While I am sympathetic with their overall aims, I outline some theoretical and practical difficulties in attempting to wed two very different systems of thought and the limitations that these difficulties impose.
Cuijpers, Pim; Koole, Sander L.; van Dijke, Annemiek; Roca, Miquel; Li, Juan; Reynolds, Charles F.
Background There is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder. Aims To examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression. Method We conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group. Results The target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23-0.47; NNT = 5, 95% CI 4-8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment. Conclusions Psychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed. PMID:25274315
Heerdink, Marc W; van Kleef, Gerben A; Homan, Astrid C; Fischer, Agneta H
How do emotional expressions of group members shape conformity versus deviance in groups? We hypothesized that angry and happy responses to a group member's deviating opinion are interpreted as signals of imminent rejection versus acceptance. In 5 studies, the majority's expressions of anger led the deviant individual to feel rejected, whereas expressions of happiness made the deviant feel accepted. Because conformity can be seen as strategic behavior aimed at gaining (re)acceptance, the effects of emotional expressions on conformity should be moderated by social-contextual factors that determine the motivation to be accepted by the group and by the extent to which conformity is a means to this end. Accordingly, in Study 2, the availability of alternative groups determined whether a deviant conformed to the current group or abandoned the group after an angry reaction. In Study 3, anger and happiness were only associated with conformity pressure in situations that were perceived as cooperative (rather than competitive). Employing an interactive group task in Study 4, we showed that individuals who received an angry reaction contributed less in a cooperative group task than did those who received a neutral or happy reaction. Finally, in Study 5, peripheral group members conformed more after an angry reaction than after a happy reaction, but prototypical group members did not. Moreover, conformity was still manifest 3 weeks after the experiment, and this effect was mediated by feelings of rejection. We discuss implications of these findings for theorizing about social functions of emotions and the role of emotions in groups.
Shame, guilt, and posttraumatic stress disorder in adult survivors of childhood sexual abuse at risk for human immunodeficiency virus: outcomes of a randomized clinical trial of group psychotherapy treatment.
Ginzburg, Karni; Butler, Lisa D; Giese-Davis, Janine; Cavanaugh, Courtenay E; Neri, Eric; Koopman, Cheryl; Classen, Catherine C; Spiegel, David
This study evaluated the effectiveness of group psychotherapy in reducing levels of shame and guilt in adult survivors of childhood sexual abuse at risk for HIV, and whether such reductions would mediate the effects of treatment on posttraumatic stress disorder (PTSD) symptoms. One hundred sixty-six women were randomized into 3 conditions: a trauma-focused group, a present-focused group, and a waitlist group. Women received 6 months of treatment and were assessed at pretreatment (T1), immediately posttreatment (T2), and 6 months posttreatment (T3). Both treatment conditions resulted in reduced shame and guilt. The treatment effect on PTSD symptoms was mediated by changes in shame, but it was not associated with changes in guilt. These findings suggest that, when treating childhood sexual abuse survivors' PTSD, it is important to address the negative self-appraisals, such as shame, that commonly accompany such symptoms.
... Facts for Families Guide 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 ...
Riches, Simon; Schrank, Beate; Rashid, Tayyab; Slade, Mike
Positive psychotherapy (PPT) is an established psychological intervention initially validated with people experiencing symptoms of depression. PPT is a positive psychology intervention, an academic discipline that has developed somewhat separately from psychotherapy and focuses on amplifying well-being rather than ameliorating deficit. The processes targeted in PPT (e.g., strengths, forgiveness, gratitude, savoring) are not emphasized in traditional psychotherapy approaches to psychosis. The goal in modifying PPT is to develop a new clinical approach to helping people experiencing psychosis. An evidence-based theoretical framework was therefore used to modify 14-session standard PPT into a manualized intervention, called WELLFOCUS PPT, which aims to improve well-being for people with psychosis. Informed by a systematic review and qualitative research, modification was undertaken in 4 stages: qualitative study, expert consultation, manualization, and stake-holder review. The resulting WELLFOCUS PPT is a theory-based 11-session manualized group therapy.
Fournier, Jay C.; Price, Rebecca B.
Technological advances in neuroimaging have enabled researchers to examine, in vivo, the relationship between psychotherapeutic interventions and markers of brain activity. This review focuses on two kinds of neuroimaging studies in psychotherapy: those that examine the patterns of brain activity associated with response to treatments and those that examine the changes that occur in brain activity during treatment. A general, hypothetical neural model of psychotherapy is presented, and support for the model is evaluated across anxiety disorders and major depression. Neuroimaging studies are broadly consistent in observing associations between response to psychotherapy and baseline activity in several key regions within the prefrontal cortex, basal ganglia, and limbic areas. These regions are involved in the generation and regulation of emotion, fear responding, and response to reward. Pre-post examinations of change following psychotherapy also typically observe that psychological treatments for anxiety and depression can affect neural activity in these regions. Despite general consensus that activity in these regions is associated with psychotherapy, substantial discrepancy persists regarding the precise direction of the observed relationships. Methodological challenges of the existing literature are considered, and future directions are discussed. PMID:25346646
van der Want, Anna C.; den Brok, Perry; Beijaard, Douwe; Brekelmans, Mieke; Claessens, Luce C. A.; Pennings, Helena J. M.
This article investigates the link between teachers' appraisal of specific interpersonal situations in classrooms and their more general interpersonal identity standard, which together form their interpersonal role identity. Using semi-structured and video-stimulated interviews, data on teachers' appraisals and interpersonal identity standards…
Thompson, Vetta L. Sanders; Akbar, Maysa D.; Bazile, Anita
The attitudes and beliefs about utilization of mental health services of 201 African Americans, 18 years and older, are explored. One hundred and thirty-four females and 66 males participated in mixed sex focus groups conducted in an urban, Midwestern city. Discussion probes addressed participant perceptions of psychotherapists and psychotherapy,…
This article presents an introduction to cross-cultural psychotherapy, with reference to historical theories of art, symbols and myth, and to the therapist working with the client--both individual and groups. Cross-cultural dimensions of art therapy are delineated with a support for further research and cooperation between cultures, with attention…
This article addresses the relevance of spirituality to psychology and psychotherapy. It argues that spiritual experience is phenomenologically legitimate and worthy of study, especially by students of mental health. It utilizes Fox's (1985) definition of spirituality as "unitive experience" to show that spiritual experience is often present, overtly or covertly, within the ritual of psychotherapy. The paper argues that the therapist's adoption of an empathic posture is essentially a spiritual position. This position consists of a sense of peace, eternity, forgiveness, faith, love, truth, and God. These aspects are part of an integrated spiritual gestalt which is, though generally unacknowledged, fundamental to the communal healing process of psychotherapy. The paper concludes by asserting that greater involvement with the unitive (as opposed to the disunitive) represents a positive paradigmatic shift for psychology and humanity.
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…
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)
Clark, Frances Vaughan
Emerging paradigms in transpersonal psychotherapy are discussed in relation to values and attitudes of the therapist and the place of transpersonal experience in the growth process, which goes beyond self-actualization to self-transcendence. Transpersonal therapy is not identified with specific techniques, but three distinct stages of therapy are…
Responds to previous article (Stiles and Shapiro, this issue) that suggests abandoning model of drug research in exploring psychotherapy effectiveness. Contends that Stiles and Shapiro's analysis can be challenged on methodological grounds involving failure to use multivariate analytic approaches, incomplete exploitation of advantages of growth…
Del Giacco, Maureen
The purpose of my paper is to identify the difference between psychotherapy and art therapy. Then to introduce a technique within the field of art therapy that is relevant to neuro-plasticity Del Giacco Neuro Art Therapy. The paper identifies the importance of the amygdala and the hippocampus within the role of art therapy. Supporting…
Friedman, T L
It is difficult to apply Piaget's theory to psychotherapy because the place of affect in it is ambiguous. When the alternatives are considered, it seems most consistent with Piaget's ideas to regard both cognitive and affective phenomena as problem-solving organizations. Piaget's remarkable discoveries in the cognitive sphere are a consequence of the easy access in that sphere to the kind of problems that need solving, and the phasic development of solutions. But the nature of the problems to be solved or the values to be guarded by a patient in psychotherapy are not knowable independently of the patient's actual behavior. In one respect all that is left from Piaget's approach for psychotherapy generally is the truism that therapy fosters differentiation and integration. However, even if we cannot frame a peculiarly Piagetian paradigm of psychotherapy, Piaget is valuable in posing a subsidiary question, namely, what in therapy fosters problem-solving activity. A reading of Piaget suggests that a patient learns by acting on his therapist and tacitly interpreting the results of his actions, that difficulties in therapy are the material from which therapy proceeds, and that in order to grasp the situation of the patient, the therapist himself may need to act on him and not just think about him. An implied lesson for training would be that supervision should instill a professional identity that is reinforced rather than challenged by therapy difficulties, and does not rely solely on theoretical categorizing.
The increasing number and sophistication of available psychotherapies suggests that a critical appraisal of the methodological issues of psychotherapy studies is highly needed. Several key questions regarding the efficacy of a given intervention, the understanding of whether positive effects observed following the delivery of a psychotherapeutic intervention are specifically attributable to the intervention itself or to other “non specific” factors, such as benefit expectations, therapist attention and support, and the possibility of improving psychotherapy research need an answer. This, in turn, could provide clinicians with more rigorous information about psychotherapy outcomes and could properly address several shortcomings that are frequently observed in current psychotherapy studies. Accordingly, in this editorial I will highlight some of the most important critical issues that a well designed psychotherapy study should take into account, including the need for appropriate control groups, appropriate randomization and blinding procedures, and the importance of performing appropriately powered studies that include a sufficiently long follow-up period. Finally, I will build on my expertise in the field of mindfulness based interventions, in particular mindfulness based stress reduction and mindfulness based cognitive therapy, to show how such issues have been and can be successfully implemented in the design of future psychotherapy studies. PMID:25237607
Beuchot, Alberto; Bullen, Mark
This longitudinal study evaluated the amount and type of interaction and interpersonal content in messages posted by online graduate students in small group asynchronous forums. It also assessed the relationship between interpersonality and interactivity. To achieve this, a new coding scheme was developed to categorize the content of online…
Haggerty, Greg; Siefert, Caleb; Stoycheva, Valentina; Sinclair, Samuel Justin; Baity, Matthew; Zodan, Jennifer; Mehra, Ashwin; Chand, Vijay; Blais, Mark A
Growing economic pressure on inpatient services for adolescents has resulted in fewer clinicians to provide individual psychotherapy. As a result, inpatient treatment trends have favored group psychotherapy modalities and psychopharmacological interventions. Currently, no clinician-rated measures exist to assist clinicians in determining who would be able to better utilize individual psychotherapy on inpatient units. The current study sought to demonstrate the utility of the Readiness for Inpatient Psychotherapy Scale with an adolescent inpatient sample. This study also used the RIPS as it is intended to be used in everyday practice. Results from the authors' analyses reveal that the RIPS demonstrates good psychometrics and interrater reliability, as well as construct validity.
Gunlicks-Stoessel, Meredith; Mufson, Laura; Jekal, Angela; Turner, J. Blake
Objective: Aspects of depressed adolescents' perceived interpersonal functioning were examined as moderators of response to treatment among adolescents treated with interpersonal psychotherapy for depressed adolescents (IPT-A; Mufson, Dorta, Moreau, & Weissman, 2004) or treatment as usual (TAU) in school-based health clinics. Method:…
Held, Barbara S.; And Others
An interpersonal theory of dangerousness asserts that dangerousness is a function of perceptions and attributions within an interpersonal context, rather than a stable personality trait. Using the guards and 78 inmates of a penal complex, the interpersonal theory of dangerousness was tested from a racial perspective. (Author)
MacDonald, Peter J.; Brown, Alan
A large number of patients with psychosocial or psychiatric disorders present to family physicians, and the family physician needs a model of psychotherapy with which to cope with their problems. A model of brief psychotherapy is presented which is time limited, goal directed and easy to learn. It consists of four facets drawn from established areas of psychotherapy: characteristics of the therapist; characteristics of the patient; Eriksonian developmental stages; and the process of therapy as described by Carkhuff. These facets fit together in a way which is useful to the family physician in managing those patient problems for which brief psychotherapy is indicated. PMID:21267176
MAHONEY, MICHAEL J.; GRANVOLD, DONALD K.
Constructivism is a metatheoretical perspective that embraces diverse traditions in medicine, philosophy, psychology, and spiritual wisdom. Constructive psychotherapy emphasizes complex cycles in the natural ordering and reorganizing processes that characterize all development in living systems. Individuals are encouraged to view themselves as active participants in their lives. Within rich contexts of human relationship and symbol systems, people make new meanings as they develop. Techniques from many different traditions can help people find and refine their sense of balance as they develop. PMID:16633512
Mahoney, Michael J; Granvold, Donald K
Constructivism is a metatheoretical perspective that embraces diverse traditions in medicine, philosophy, psychology, and spiritual wisdom. Constructive psychotherapy emphasizes complex cycles in the natural ordering and reorganizing processes that characterize all development in living systems. Individuals are encouraged to view themselves as active participants in their lives. Within rich contexts of human relationship and symbol systems, people make new meanings as they develop. Techniques from many different traditions can help people find and refine their sense of balance as they develop.
Gold, Jerry; Stricker, George
This article addresses the issue of failures in psychodynamic psychotherapy. Drawing on the clinical and research literatures, and utilizing our clinical experiences, we first describe and define criteria for success and failure in treatment. We then review five factors that can lead to failure: client factors, therapist factors, technical factors, relationship factors, and environmental factors. We illustrate our presentation with a case example, and conclude by discussing ways in which the likelihood of failures in psychodynamic treatment can be lowered.
Keats, C. J.; McGlashan, T. H.
The literature on strategies of investigative psychotherapy of schizophrenia is selectively reviewed, and a case history is presented. The format is modelled on the authors' research technique of contrasting theory with practice. While long-term observation of single cases does not address cause and effect, descriptions of cases with a variety of known outcomes can help to build a typology of treatment processes. PMID:4049907
Hendricks, C. Bret; Bradley, Loretta J.
Interpersonal psychotherapy (IPT-A) is a brief, time-limited therapy developed for use with adolescents diagnosed with major depression. IPT-A has been shown to be effective with adolescents in family counseling milieus. Music therapy techniques also have been successfully used to treat adolescent depression. This article provides mental health…
Interpersonal, Nonverbal, and Small Group Communication: Abstracts of Doctoral Dissertations Published in "Dissertation Abstracts International," July through December 1983 (Vol. 44 Nos. 1 through 6).
ERIC Clearinghouse on Reading and Communication Skills, Urbana, IL.
This collection of abstracts is part of a continuing series providing information on recent doctoral dissertations. The 15 titles deal with the following topics: (1) the development of a module to attain the leadership competency of encouraging improved interpersonal communication through feedback; (2) communicating in an American Taoist…
SAPORTA, JOSÉ A.; GANS, JEROME S.
The authors examine the process of taking an initial history of childhood abuse and trauma in psychodynamic psychotherapy. In exploring the advantages, complexities, and potential complications of this practice, they hope to heighten the sensitivities of clinicians taking trauma histories. Emphasis on the need to be active in eliciting important historical material is balanced with discussion of concepts that can help therapists avoid interpersonal dynamics that reenact and perpetuate the traumas the therapy seeks to treat. Ensuring optimal psychotherapeutic treatment for patients who have experienced childhood trauma requires attention to the following concepts: a safe holding environment, destabilization, compliance, the repetition compulsion, and projective identification. PMID:22700250
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. Gender personality
Wampold, Bruce E.
Although it is well established that psychotherapy is remarkably effective, the change process in psychotherapy is not well understood. Psychotherapy is compared with medicine and cultural healing practices to argue that critical aspects of psychotherapy involve human processes that are used in religious, spiritual, and cultural healing practices.…
Wampold, Bruce E
There are many forms of psychotherapies, each distinctive in its own way. From the origins of psychotherapy, it has been suggested that psychotherapy is effective through factors that are common to all therapies. In this article, I suggest that the commonalities that are at the core of psychotherapy are related to evolved human characteristics, which include (a) making sense of the world, (b) influencing through social means, and (c) connectedness, expectation, and mastery. In this way, all psychotherapies are humanistic.
Clarici, Andrea; Pellizzoni, Sandra; Guaschino, Secondo; Alberico, Salvatore; Bembich, Stefano; Giuliani, Rosella; Short, Antonia; Guarino, Giuseppina; Panksepp, Jaak
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 behavior, 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-weeks period, 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 () and a semi-quantitative assessment by the therapist of the mother’s depressive symptoms and of 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. Therefore, the neuropeptide would appear to play some role in the modulation of cerebral functions involved in the self-centered (narcissistic) dimension of the suffering that can occur with postnatal depression. Based on these results, there was support for our hypothesis that what is generally defined as postnatal depression may include disturbances of narcissistic affective balance, and oxytocin supplementation can
Karasu, T Byram
Psychotherapy is an instrument for remediation of psychological deficits and conflict resolution, as well as an instrument for growth and self-cultivation. In fact, psychotherapy is the finest form of life education. All of this is done without psychotherapists' playing a teacher, a minister, a priest, a rabbi, an imam, or a Buddhist monk, but by being familiar with what they know and more. That "more" is about understanding "the attributes" of gods and religions as they serve the all-too-human needs of believing and belonging. It is about the distillation of common psychological, sociological, moral, and philosophical attributes of religions, and the recognition that the attributes themselves are faith and God. Attributes that serve the affiliative needs define faith, for example, belonging is faith; attributes that serve the divine needs define God, for example, compassion is God. Those who have recovered from their primitive innocence need to formulate their ideas of God and religion, regardless of their affiliation with a religious community. One may need to resonate emotionally with the God of his or her religion, but intellectually need to transcend all its dogma and cultivate a personal concept of divinity free from any theological structure. Such an enlightened person achieves enduring equanimity by striving to own the attributes of Gods--to be godly. This is equally true for psychotherapists as it is for their patients.
Zamm, Anna; Wellman, Chelsea; Palmer, Caroline
Interpersonal synchrony, the temporal coordination of actions between individuals, is fundamental to social behaviors from conversational speech to dance and music-making. Animal models indicate constraints on synchrony that arise from endogenous rhythms: Intrinsic periodic behaviors or processes that continue in the absence of change in external stimulus conditions. We report evidence for a direct causal link between endogenous rhythms and interpersonal synchrony in a music performance task, which places high demands on temporal coordination. We first establish that endogenous rhythms, measured by spontaneous rates of individual performance, are stable within individuals across stimulus materials, limb movements, and time points. We then test a causal link between endogenous rhythms and interpersonal synchrony by pairing each musician with a partner who is either matched or mismatched in spontaneous rate and by measuring their joint behavior up to 1 year later. Partners performed melodies together, using either the same or different hands. Partners who were matched for spontaneous rate showed greater interpersonal synchrony in joint performance than mismatched partners, regardless of hand used. Endogenous rhythms offer potential to predict optimal group membership in joint behaviors that require temporal coordination.
Weissman, Myrna M; Hankerson, Sidney H; Scorza, Pamela; Olfson, Mark; Verdeli, Helena; Shea, Steven; Lantigua, Rafael; Wainberg, Milton
Interpersonal Counseling (IPC) comes directly from interpersonal psychotherapy (IPT), an evidenced-based psychotherapy developed by Klerman and Weissman. It [IPC?] is a briefer, more structured version for use primarily in non-mental health settings, such as primary care clinics when treating patients with symptoms of depression. National health-care reform, which will bring previously uninsured persons into care and provide mechanisms to support mental health training of primary care providers, will increase interest in briefer psychotherapy. This paper describes the rationale, development, evidence for efficacy, and basic structure of IPC and also presents an illustrated clinical vignette. The evidence suggests that IPC is efficacious in reducing symptoms of depression; that it can be used by mental health personnel of different levels of training, and that the number of sessions is flexible depending on the context and resources. More clinical trials are needed, especially ones comparing IPC to other types of care used in the delivery of mental health services in primary care.
White, Scott Allyn
This paper reviews the empirical research on short-term psychodynamic psychotherapy (STDP). It begins with a brief history of STDP, identifying current developers and researchers of STDP and listing commonalities among various short-term dynamic psychotherapies. In this review, research is grouped broadly into two categories: controlled…
Benish, Steven G.; Quintana, Stephen; Wampold, Bruce E.
Psychotherapy is a culturally encapsulated healing practice that is created from and dedicated to specific cultural contexts (Frank & Frank, 1993; Wampold, 2007; Wrenn, 1962). Consequently, conventional psychotherapy is a practice most suitable for dominant cultural groups within North America and Western Europe but may be culturally incongruent…
Cruz Arceo, B
The author describes his experience in institutional psychotherapy, at the Clínica Hospital of Villahermosa, Tabasco. He mentions factors in the patient, in the psychiatrist, in the institution and in the culture, as fostering the success or the failure of institutional psychotherapy. He shows the effectiveness of this type of treatment in this enviroment and describes ways of improving this kind of work.
Rosselló, Jeannette; Bernal, Guillermo; Rivera-Medina, Carmen
This study compared individual (I) to group (G) formats of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for the treatment of depression in adolescents. One hundred and 12 Puerto Rican adolescents were randomized to four conditions (CBT-I, CBT-G, IPT-I, IPT-G). Participants were assessed at pretreatment and posttreatment with structured interviews to establish diagnosis and with self-report measures to assess treatment outcome. The results suggest that CBT and IPT are robust treatments in both group and individual formats. However, CBT produced significantly greater decreases in depressive symptoms and improved self-concept than IPT. The implications of these findings are discussed.
Ryum, Truls; Vogel, Patrick A; Walderhaug, Eirik P; Stiles, Tore C
The present study examined the relationship between self-image and outcome in psychotherapy. Patients (n = 170) received treatment-as-usual at a university clinic, and met diagnostic criteria for mostly anxiety and depression related disorders. Self-image was measured with the Structural Analysis of Social Behavior (SASB-I) introject pre and post-treatment. Using multiple regression analyses, higher levels of Self-ignore and Self-blame pre-treatment predicted a poorer treatment outcome in terms of symptoms (SCL-90-R) and interpersonal problems (IIP-64), respectively. Increase in Self-love and decrease in Self-blame (pre to post) predicted reduced symptoms at post-treatment, whereas decrease in Self-attack and Self-control, as well as increase in Self-affirm, predicted reduced interpersonal problems. The results suggest that self-image improvement may be important in order to achieve a good outcome in psychotherapy.
Darrow, Sabrina M.; Dalto, Georgia; Follette, William C.
Functional Analytic Psychotherapy (FAP) is an interpersonal behavior therapy that relies on a therapist’s ability to contingently respond to in-session client behavior. Valued behavior change in clients results from the therapist shaping more effective client interpersonal behaviors by providing effective social reinforcement when these behaviors occur in or between sessions. One crucial discrimination for therapists to make is the distinction between the topography or physical form of their behavior versus how well or poorly it actually functions to shape client behavior. We notice that there are times when some therapists may focus too sharply on how similar their behavior is to that of a supervisor or prototypical therapist rather than focusing on how effectively their behavior functions as reinforcement. A review of some traditional psychotherapy adherence and competence literature suggests that therapists and supervisors may overly attend to the topography of behavior in assessing treatment fidelity. This paper will suggest strategies to minimize an over-reliance on topography, including shifting the focus from technique to principle. PMID:24533011
Schneider, Kirk J; Längle, Alfried
This special section highlights the renewal of humanism in psychotherapy. For the purposes of this special section, humanism is defined as a philosophical perspective whose subject matter is the whole human being. In psychotherapy, humanism places special emphasis on the personal, interpersonal, and contextual dimensions of therapy and on clients' reflections on their relationship with self, others, and the larger psychosocial world. The contributors to this special section-Bruce Wampold, David Elkins, Steven Hayes, Robert Stolorow, Jurgen Kriz, Lillian Comas-Diaz, and the authors of this introduction-are each leaders in their respective therapeutic specialties: research and training, cognitive-behavioral therapy, psychoanalytic therapy, European therapy, and multicultural therapy. In the manner of a "roundtable," each contributor was asked to provide a short article on the renewal of humanism in his or her respective specialty followed by brief comments on the initial round of articles. The conclusion of these reflections is that the renewal of humanism is a viable and growing phenomenon among the leading specialty areas of psychotherapy. The corollary conclusion is that although many theoretical and practical questions remain, humanism is (1) a foundational element of therapeutic effectiveness; (2) a pivotal (and needed) dimension of therapeutic training; and (3) a critical contributor to societal well-being.
Moseley, Sullivan; Briggs, Wanda P.; Magnus, Virginia
The authors review the literature on the prevalence of sex offenders; multiple treatment modalities; and implications of the use of hypnotic psychotherapy, coupled with cognitive behavioral treatment programs, for treating sex offenders. (Contains 2 tables.)
Wright, Jesse H.; Wright, Andrew S.
The rationale for using computers in psychotherapy includes the possibility that therapeutic software could improve the efficiency of treatment and provide access for greater numbers of patients. Computers have not been able to reliably duplicate the type of dialogue typically used in clinician-administered therapy. However, computers have significant strengths that can be used to advantage in designing treatment programs. Software developed for computer-assisted therapy generally has been well accepted by patients. Outcome studies have usually demonstrated treatment effectiveness for this form of therapy. Future development of computer tools may be influenced by changes in health care financing and rapid growth of new technologies. An integrated care delivery model incorporating the unique attributes of both clinicians and computers should be adopted for computer-assisted therapy. PMID:9292446
Zeig, Jeffrey K
Psychotherapy can be conceived as a symbolic drama in which patients can experientially realize their capacity to change. Methods derived from hypnosis can empower therapy without the use of formal trance. A case conducted by Milton Erickson is presented and deconstructed in order to illuminate Erickson's therapeutic patterns. A model is offered for adding drama to therapy, and the model is placed into a larger model of choice points in psychotherapy.
de Andrade, Ana Claudia Fontes; Frank, Ellen; Neto, Francisco Lotufo; Houck, Patricia R
Objective This article describes the adaptation of a rating scale of interpersonal psychotherapy problem areas to include a fifth problem area appropriate to bipolar disorder and an interrater agreement study in identifying interpersonal problem areas and selecting a primary treatment focus if patients were to engage in treatment. Method Five research interpersonal psychotherapists assessed nine audiotapes of a single interview with five bipolar and four unipolar patients in which the interpersonal inventory and identification of problem areas were undertaken. Results Raters agreed on presence and absence of problem areas in seven tapes. Kappas for identification of problem areas were 1.00 (grief), 0.77 (role dispute), 0.61 (role transition), 0.57 (interpersonal deficits) and 1.00 (loss of healthy self). Kappa for agreement on a primary clinical focus if patients were to engage in interpersonal psychotherapy treatment was 0.64. Conclusions The adaptation of the original scale to include an area pertinent to bipolar disorder proved to be applicable and relevant for use with this population. The results show substantial interrater agreement in identifying problem areas and potential treatment focus. PMID:19142412
Horowitz, Jason L.; Garber, Judy; Ciesla, Jeffrey A.; Young, Jami F.; Mufson, Laura
This study evaluated the efficacy of 2 programs for preventing depressive symptoms in adolescents. Participants were 380 high school students randomly assigned to a cognitive-behavioral program (CB), an interpersonal psychotherapy-adolescent skills training program (IPT-AST), or a no-intervention control. The interventions involved eight 90-min…
Feinstein, Robert E.; Yager, Joel
Background/Objective: Guided by ACGME's requirements, psychiatric residency training in psychotherapy currently focuses on teaching school-specific forms of psychotherapy (i.e., cognitive-behavioral, supportive, and psychodynamic psychotherapy). On the basis of a literature review of common factors affecting psychotherapy outcomes and…
Liebherz, Sarah; Rabung, Sven
Background In Germany, inpatient psychotherapy plays a unique role in the treatment of patients with common mental disorders of higher severity. In addition to psychiatric inpatient services, psychotherapeutic hospital treatment and psychosomatic rehabilitation are offered as independent inpatient treatment options. This meta-analysis aims to provide systematic evidence for psychotherapeutic hospital treatment in Germany regarding its effects on symptomatic and interpersonal impairment. Methodology Relevant papers were identified by electronic database search and hand search. Randomized controlled trials as well as naturalistic prospective studies (including post-therapy and follow-up assessments) evaluating psychotherapeutic hospital treatment of mentally ill adults in Germany were included. Outcomes were required to be quantified by either the Symptom-Checklist (SCL-90-R or short versions) or the Inventory of Interpersonal Problems (IIP-64 or short versions). Effect sizes (Hedges’ g) were combined using random effect models. Principal Findings Sixty-seven papers representing 59 studies fulfilled inclusion criteria. Meta-analysis yielded a medium within-group effect size for symptom change at discharge (g = 0.72; 95% CI 0.68–0.76), with a small reduction to follow-up (g = 0.61; 95% CI 0.55–0.68). Regarding interpersonal problems, a small effect size was found at discharge (g = 0.35; 95% CI 0.29–0.41), which increased to follow-up (g = 0.48; 95% CI 0.36–0.60). While higher impairment at intake was associated with a larger effect size in both measures, longer treatment duration was related to lower effect sizes in SCL GSI and to larger effect sizes in IIP Total. Conclusions Psychotherapeutic hospital treatment may be considered an effective treatment. In accordance with Howard’s phase model of psychotherapy outcome, the present study demonstrated that symptom distress changes more quickly and strongly than interpersonal problems
Modern consciousness is a cultural and historical achievement in the West and a developmental task for each person now. Modern consciousness consists in the emancipation from the power of community, animistic nature and the unconscious. It is connected with neurosis and psychotherapy because it has to do with inner conflicts. But today there is an increasing number of cases which are characterized by dissociation and acting out, without the feeling of conflicts. Consciousness seems to be changing toward a new conception which might be called 'postmodern consciousness'. The essence of postmodern consciousness is shown by interpreting two dreams internally. The first dream from a case of depersonalization indicates that it is not necessary to be entangled with the object. There is a different kind of coniunctio in the mode of seeing. The second dream from a case of dissociative disorder shows a world which has neither traces of pre-modern cosmology-high and low, here and the beyond-nor modern interiority. There is only surface and self-reflection without content. The discussion of dreams suggests that postmodern consciousness is not to be understood as premature and pathological. It is therapeutically important to refine and deepen postmodern consciousness.
Deakin, Elisabeth; Gastaud, Marina; Nunes, Maria Lucia Tiellet
This study aims to discuss the most recent data about child psychotherapy dropout, especially child psychoanalytical psychotherapy. The authors also try to offer some possible alternatives to prevent such a phenomenon. The definition of "child psychotherapy dropout" is extensively discussed. The goal has been to attempt to create a standardised…
Schwartzman, Deborah; Stamoulos, Constantina; D'Iuso, Debora; Thompson, Katherine; Dobson, Keith S; Kramer, Ueli; Drapeau, Martin
Individuals with depression process information in an overly negative or biased way (e.g., Henriques & Leitenberg, 2002) and demonstrate significant interpersonal dysfunction (e.g., Zlotnick, Kohn, Keitner, & Della Grotta, 2000). This study examined the relationship between cognitive errors (CEs) and interpersonal interactions in early psychotherapy sessions of 25 female patients with major depression. Transcripts were rated for CEs using the Cognitive Error Rating Scale (Drapeau, Perry, & Dunkley, 2008). Interpersonal patterns were assessed using the Structural Analysis of Social Behavior (Benjamin, 1974). Significant associations were found between CEs and markers of interpersonal functioning in selected contexts. The implications of these findings in bridging the gap between research and practice, enhancing treatment outcome, and improving therapist training are discussed.
Since multiculturalism is not fully theorised it has created much confusion in counselling and psychotherapy. It has been criticised for ignoring questions of power relations, and for emphasising the cultural differences of ethnic minority groups rather than focus on their similar predicaments of racism, sexism, misogyny, homophobia and economic…
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.
Andreoli, A; Burnand, Y; Cochennec, M-F; Ohlendorf, P; Frambati, L; Gaudry-Maire, D; Di Clemente, Th; Hourton, G; Lorillard, S; Canuto, A; Frances, A
To determine whether ambulatory psychotherapy targeted to abandonment experiences and fears can reduce suicidality and improve outcome in borderline patients referred to the emergency room with major depressive disorder and self-destructive behavior severe enough to require medical/surgical treatment and a brief psychiatric hospitalization. A total of 170 subjects were randomized at hospital discharge into three treatment groups: treatment as usual (TAU), abandonment psychotherapy delivered by certified psychotherapists, and abandonment psychotherapy delivered by nurses. Assessments were performed before randomization and at 3-month follow-up. Continued suicidality and other outcome measures were significantly worse in the treatment-as-usual as compared to both abandonment psychotherapy groups, but there were no differences between the two psychotherapy groups. These results suggest the efficacy of manualized psychotherapy that specifically targets the abandonment fears and experiences that are so common as precipitants to suicidal and self-destructive acts in borderline patients. It does not appear that formal psychotherapy training is associated with better outcomes.
Krupnick, Janice L.; And Others
Examined the relationship between therapeutic alliance and treatment outcome for depressed outpatients who received interpersonal psychotherapy, imipramine with clinical management, or placebo with clinical management. Clinical raters scored videotapes of early, middle, and late therapy sessions for 225 cases (619 sessions). Results indicate the…
Pedersen, Eric R.; Callaghan, Glenn M.; Prins, Annabel; Nguyen, Hong; Tsai, Mavis
Evidence-based treatments for Posttraumatic Stress Disorder (PTSD) may be enhanced by Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1991; Tsai et al., 2009). As PTSD can include a variety of problems with interpersonal relationships (e.g., trust of others), manualized treatments may not afford clinicians enough time and flexibility to…
Narayan, Angela J.; Bucio, Griselda Oliver; Rivera, Luisa M.; Lieberman, Alicia F.
Childhood experiences of interpersonal trauma often leave a legacy of painful emotions and memories that can be especially destructive when adults transition to parenthood. In this article, the authors present a promising treatment approach, Perinatal Child-Parental Psychotherapy (P-CPP), adapted from evidence-based Child-Parent Psychotherapy…
Brown, Nina W.; Sullivan, James
Hipple's Interpersonal Relationship Rating Scale (1972) was administered to graduate students in a counselor education program. The results were factor analyzed and six scales were extracted. The IRRS was then administered to two classes of students in group counseling. Both groups had significant discrepancy scores. (Author)
Fernández-Álvarez, Héctor; Consoli, Andrés J; Gómez, Beatriz
Although integration has been formally influencing the field of psychotherapy since the 1930s, its impact gained significant momentum during the 1980s. Practical, theoretical, and scientific reasons help to explain the growing influence of integration in psychotherapy. The field of psychotherapy is characterized by many challenges which integration may change into meaningful opportunities. Nonetheless, many obstacles remain when seeking to advance integration. To appreciate the strength of integration in psychotherapy we describe an integrative, comprehensive approach to service delivery, research, and training. We then discuss the role of integration in the future of psychotherapy. (PsycINFO Database Record
Whitehouse, Richard M.; Tudway, Jeremy A.; Look, Roger; Kroese, Biza Stenfert
Background: Historically, adults with intellectual disabilities have had little access to individual psychotherapy. Over the last 20 years an increasing body of literature has described psychotherapy with this client group and reported methods for adapting traditional psychotherapeutic techniques. Method: The current review identified the…
Research into the use of videoconferencing for clinical purposes, in particular psychotherapy, is gradually expanding. A number of case studies and case series have suggested that videoconferencing can be clinically effective and acceptable to patients. Nevertheless, there is a lack of methodologically rigorous studies with adequate sample sizes…
Peterkin, Allan D.; Dworkind, Michael
Most family physicians state that they “do psychotherapy” and yet are often unclear as to whether they are using a supportive or an insight-oriented approach. This paper discusses short-term psychotherapy with an emphasis on the theoretical differences between these two approaches, as well as suggestions for learning them. PMID:21229014
Pejic, Nicholas G
The author summarizes his experience with palm and Tarot card readers in New Orleans. The history, practice, and psychodynamics of palmistry and Tarot are explored. It's postulated that these practices are forms of archaic psychotherapy, which employ supportive treatment and placebo. These tactics are used to elicit hope for its clients.
Ogrodniczuk, John S; Piper, William E; Joyce, Anthony S; Steinberg, Paul I; Duggal, Satna
Narcissistic personality disorder is the subject of extensive discussion in the literature. Yet, the validity of this diagnostic category remains questionable. This is owed, in large part, to the relative absence of empirical work that has examined narcissism in clinical samples. Descriptions and findings from studies involving non-clinical samples suggest that narcissism is associated with considerable interpersonal impairment. The objective of the present study was to examine this possibility in a sample of psychiatric outpatients. Consecutively admitted patients (N=240) to a day treatment program completed measures of narcissism, interpersonal problems, and general psychiatric distress. Patients were categorized into high, moderate, and low narcissism groups. The groups were compared on overall interpersonal impairment, as well as on particular domains of interpersonal behavior. Treatment duration and discharge status were also compared among the three groups. Analysis of covariance and chi-square analyses were used. At baseline, higher levels of narcissism were significantly associated with greater interpersonal impairment. The interpersonal style of the more narcissistic patients was particularly characterized by domineering, vindictive, and intrusive behavior. At post-treatment, only the association between narcissism and intrusive behavior remained significant. Change in interpersonal difficulties following treatment did not differ significantly among the groups. However, failure to complete treatment was associated with narcissism. The results underscore the interpersonal impairment associated with narcissism and support the notion of narcissistic personality disorder as a valid diagnostic category.
Keltner, John W.
A review of the history and development of experiential learning in its educational and therapeutic contexts emphasizes the value of self-awareness as a prerequisite to interpersonal and group development. It also serves to underscore the potential of the Self Awareness and Interpersonal Communication (SAIC) program in an American society with…
Behere, Prakash B; Das, Anweshak; Yadav, Richa; Behere, Aniruddh P
The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.
Behere, Prakash B.; Das, Anweshak; Yadav, Richa; Behere, Aniruddh P.
The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of “traditional mental health promoting practices” was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a “mind control” as referred by Caraka, is achieved through “spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health. PMID:23858273
Dietz, Laura J.; Marshal, Michael P.; Burton, Chad M.; Bridge, Jeffrey A.; Birmaher, Boris; Kolko, David; Duffy, Jamira N.; Brent, David A.
Objective Changes in adolescent interpersonal behavior before and after an acute course of psychotherapy were investigated as outcomes and mediators of remission status in a previously described treatment study of depressed adolescents. Maternal depressive symptoms were examined as moderators of the association between psychotherapy condition and changes in adolescents’ interpersonal behavior. Method Adolescents (n = 63, mean age = 15.6 years, 77.8% female, 84.1% Caucasian) engaged in videotaped interactions with their mothers before randomization to cognitive behavior therapy (CBT), systemic behavior family therapy (SBFT), or nondirective supportive therapy (NST), and after 12–16 weeks of treatment. Adolescent involvement, problem solving and dyadic conflict were examined. Results Improvements in adolescent problem solving were significantly associated with CBT and SBFT. Maternal depressive symptoms moderated the effect of CBT, but not SBFT, on adolescents’ problem solving; adolescents experienced increases in problem solving only when their mothers had low or moderate levels of depressive symptoms. Improvements in adolescents’ problem solving were associated with higher rates of remission across treatment conditions, but there were no significant indirect effects of SBFT on remission status through problem solving. Exploratory analyses revealed a significant indirect effect of CBT on remission status through changes in adolescent problem solving, but only when maternal depressive symptoms at study entry were low. Conclusions Findings provide preliminary support for problem solving as an active treatment component of structured psychotherapies for depressed adolescents and suggest one Pathway by which maternal depression may disrupt treatment efficacy for depressed adolescents treated with CBT. PMID:24491077
Maxwell, Hilary; Tasca, Giorgio A; Ritchie, Kerri; Balfour, Louise; Bissada, Hany
An interpersonal model of Binge Eating Disorder (BED) posits that difficulties with social functioning precipitate negative affect, which in turn causes binge eating as a means of coping. Thus, long-term decreases in attachment insecurity may be important for women with BED. No research has assessed if long-term change in attachment insecurity is associated with sustained change in other outcomes. In the current study, we hypothesized that changes in attachment anxiety and avoidance will decrease at posttreatment and will be maintained up to 12 months after Group Psychodynamic Interpersonal Psychotherapy (GPIP). We further hypothesized that long-term stability of these changes in attachment insecurity will be related to other long-term outcomes. Women with BED (N = 102) attended 16 sessions of GPIP. Measures were completed pretreatment, posttreatment, at 6 and 12 months follow-up. Attachment anxiety, attachment avoidance, and the other outcome variables decreased significantly at 12 months posttreatment. Reductions in attachment anxiety and avoidance were significantly related to decreases in interpersonal problems up to 12 months posttreatment, and reduction in attachment anxiety was significantly related to decreases in depressive symptoms 12 months posttreatment. Further, the significant relationship between reduced attachment avoidance and decreased interpersonal problems strengthened over the long term. This is the first study to show an association between change in attachment insecurity and change in other outcomes in the long term, and to show an adaptive spiral in which greater reduction in attachment avoidance is increasingly associated with ongoing improvement of interpersonal problems.
Tuckman, Bruce W.
The Tuckman Teacher Feedback Form identifies five interpersonal teaching factors and styles: organized (managerial), dynamic (charismatic), flexible (laissez-faire), warm/accepting (personable), and creative (imaginative). The feedback generated can help student teachers adjust teaching style prior to service. (SK)
Saunders, William S.
Higher education does not address the central challenges of daily interpersonal life--being a parent, spouse, friend, and offspring; dealing with change, loss, sickness, death. But education can instill "tacit knowing"--knowing in the bones, prior to conceptualization or verbalization. This knowing can be imparted by great literature. (MLW)
Town, Joel M.; Abbass, Allan
Background. Intensive Short-Term Dynamic Psychotherapy (ISTDP), as developed by Habib Davanloo, is an intensive emotion-focused psychodynamic therapy with an explicit focus on handling resistance in treatment. A core assumption in ISTDP is that psychotherapeutic effects are dependent on in-session emotional processing in the form of rise in complex transference feelings that occurs when treatment resistance is challenged. Recent research indicates that an unlocking of the unconscious, a powerful emotional breakthrough achieved at a high rise in complex transference feelings, can potentially enhance ISTDP’s effectiveness. While ISTDP has a growing evidence base, most of the research conducted has used small samples and has tested therapy delivered by expert therapists. The aims of this study were to evaluate the overall effectiveness of ISTDP when delivered in a tertiary psychotherapy service, and to investigate if having an unlocking of the unconscious during therapy predicted enhanced treatment effectiveness. Methods. A total of 412 patients were included in the analyses. The average length of treatment was 10.2 sessions (SD 13.3). Multilevel growth curve modeling was used to evaluate treatment effectiveness and the association between unlocking the unconscious and outcome. A number of control predictors including type of treatment resistance were selected and included in the analyses. Outcome measures were the Brief Symptom Inventory (BSI) and the Inventory of Interpersonal Problems (IIP). About half of the patients in the study were treated by therapists in training and the other half by more experienced therapists. Results. Growth curve analyses using the full intention-to-treat sample revealed significant within-group effects of ISTDP on both the BSI and the IIP. Effect sizes were large (>0.80). Unlocking the unconscious during therapy was associated with significantly larger treatment outcome. The relationship was further moderated by type of treatment
Beels, C Christian
Some psychotherapies may work because they resemble rites of passage. To explore this idea, this article describes an "individual" case of depression in which drug, cognitive, and narrative approaches fell short of effectiveness, and change occurred in a series of experiences that resemble a rite of passage. This resemblance is illuminated by examining two apparently quite different healing processes--Alcoholics Anonymous and multifamily group therapy in schizophrenia--to explore the elements they have in common with the case described: the acceptance of what Victor Turner called a liminal experience, and the importance of witnesses to the ritual support for that acceptance. The discussion contributes to a loosening of the distinctions between the processes of individual, family, group, and other social therapies and leads to questions about the expert knowledge the therapist provides.
Earle, Timothy C.
The study of human learning has neglected interpersonal learning, mainly because of its complexity. However, with the recent development of a new methodology and research paradigm, empirical studies have been initiated. This is a report on one such study, involving 40 male University of Oregon students divided into two groups of 10 pairs of…
Miller, Mark D
Interpersonal psychotherapy (IPT) has been shown to be an efficacious evidence-based treatment for major depression in combination with antidepressant medication, as a maintenance treatment in combination with medication, and as monotherapy (with placebo). After reviewing the salient features of IPT that make it a good fit for treating older patients, I summarize the extant literature. New adaptations of IPT for depressed older adults with cognitive impairment are delineated. An argument is articulated for why IPT may be the ideal psychotherapy for older patients.
Brook, Judith S; Lee, Jung Yeon; Finch, Stephen J; Brown, Elaine N; Brook, David W
Research on stability and change in delinquent behavior over time has important implications for both the individual and the criminal justice system. The present research looks at this issue by examining the associations between the trajectories of delinquent behavior in adolescence and adult functioning. Data for the present study are from a four-wave longitudinal study of African American and Hispanic participants. Participants provided information at mean ages 14, 19, 24, and 29. We used growth mixture modeling to extract trajectory groups of delinquent behavior in adolescence and young adulthood. Regression analyses were conducted to examine whether memberships in the trajectory groups of delinquent behavior from mean age 14 to mean age 24 were associated with violence, substance abuse and dependence, partner discord, peer substance use, and residence in a high-crime neighborhood at mean age 29 when compared with the reference trajectory group of participants with low or no delinquent behavior. Four trajectory groups of delinquent behavior were identified: the no/low, the decreasing, the moderate, and the high persistent trajectory groups. Memberships in the trajectory groups were significantly correlated with variations in adult functioning. Memberships in some trajectory groups of delinquent behavior are significant predictors of later violent behavior, substance abuse and dependence, partner discord, peer substance use, and residence in a high-crime neighborhood. The findings reinforce the importance of investing in interventions to address different patterns of delinquent behavior. Findings are discussed in relation to previous investigations with non-Hispanic White samples.
Lundell, F. W.; Mann, Alan M.
Many traditional concepts are being challenged in contemporary psychiatric practice, including the classical “one-to-one” relationship of individual psychotherapy. Where the patient's presenting difficulties include significant inability to function or feel happy in the marital role, the technique of conjoint psychotherapy (having both partners treated simultaneously by the same doctor) may be indicated. Conjoint therapy is envisaged as a continuum, embracing a considerable range of situations where it is sound practice to see husband and wife together. The treatment plan has three stages: complaint, clarification, and compromise, each of which presents specific features and pitfalls. Emphasis is placed on dealing with individual psychopathology of each partner, both per se and in relation to the marital situation. Results to date suggest that conjoint treatment represents a promising therapeutic modality. Even in cases where individual psychopathology cannot fully be resolved, certain plateaus of satisfaction may be attained as communication improves. PMID:5904927
de Vries, Ulrike; Schüßler, Gerhard; Petermann, Franz
Recent advances achieved in the field of clinical neuro(bio-)psychology have been varied and impressive. Together with the related social and psychosocial aspects, they contribute to and enrich the development of new options in diagnosis and psychotherapy. Important research results are discussed here based on the examples of depression, Alzheimer's disease and self-injury, which profit greatly from neuropsychological research, especially through early detection of symptoms and prevention.
Interpersonal, Nonverbal, and Small Group Communication: Abstracts of Doctoral Dissertations Published in "Dissertation Abstracts International," January through June 1981 (Vol. 41 Nos. 7 through 12).
ERIC Clearinghouse on Reading and Communication Skills, Urbana, IL.
This collection of abstracts is part of a continuing series providing information on recent doctoral dissertations. The 14 titles deal with the following topics: (1) the relationships between power, gender, and mode of conflict management in superior/subordinate relationships; (2) the interaction processes of groups with varying levels of…
Interpersonal, Nonverbal, and Small Group Communication: Abstracts of Doctoral Dissertations Published in "Dissertation Abstracts International," July through December 1985 (Vol. 46 Nos. 1 through 6).
ERIC Clearinghouse on Reading and Communication Skills, Urbana, IL.
This collection of abstracts is part of a continuing series providing information on recent doctoral dissertations. The 18 titles deal with a variety of topics, including the following: (1) ways of conceptualizing and evaluating group discussion; (2) participant observations of communication themes in families facing death; (3) perceptions of…
scale and standard instrumentation , typically quantifying. • How are IPS evaluated? * o Where evaluation was defined as the comparison of data to a...interact in ways that are effective (to enhance the attainment of instrumental goals through interacting with others). It is generally assumed that...programs are multidimensional, multi-method pedagogical instruments . Training of interpersonal skill relies on strategic combinations of instruction
Lavarenne, Anaïs; Segal, Emily; Sigman, Maxine
This case study describes a single group psychotherapy session of six individuals suffering from schizophrenia or schizoaffective illness, which was characterized by numerous manifestations of fragile Ego boundaries. Based on these illustrations of fragile Ego boundaries, we explore some of the group's core therapeutic actions against psychosis. We discuss how the group (1) provides access to a structuring auxiliary Ego, (2) acts as a containing object by establishing firm boundaries and by mentalizing patients' psychotic productions, and (3) may become a solid object representation introjected by individuals wrestling with porous Ego boundaries and a poor sense of self. We conclude that, in addition to the known role of group therapy in increasing mature defenses, developing insight and providing social support, the group promotes healthier Ego boundaries, and eventually improves self-differentiation, and also tolerance to interpersonal proximity. This case study clarifies group therapy dynamics with individuals suffering from psychosis.
Sobel, H J
This study investigated preferences for behavioural, analytic and gestalt psychotherapy among a sample of 40 SES class III and IV adult females and 67 college freshmen who had never been actual therapy patients. A scaled survey assessed general preference, preference given an imagined long-standing depressive disorder, preference given an imagined specific phobia, and preference for the therapist-patient relationship. Three audio tapes were designed, each describing one of the modalities. High inter-rater reliability and agreement were determined by three independent judges. Results showed that young females had a general preference for gestalt therapy. Young and old females, but not young males, significantly preferred behavioural therapy for a specific phobia. Under forced-choice conditions the group as a whole significantly preferred gestalt therapy. No differences were found for the relationship or preference given a depressive disorder. Preference was hypothesized as a cognitive structure with potential use in therapist-client matching.
Haggerty, Greg; Blanchard, Mark; Baity, Matthew R.; Defife, Jared A; Stein, Michelle B.; Siefert, Caleb J.; Sinclair, Samuel J.; Zodan, Jennifer
The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a clinical rating system assessing eight domains of self and interpersonal relational experience which can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943]; early memories narratives) or oral data (e.g., psychotherapy narratives, Relationship Anecdotal Paradigms). In the current study, seventy-two psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS-G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating disordered behavior and history of nonsuicidal self-injury. SCORS-G composite ratings achieved an acceptable level of inter-rater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy; history of nonsuicidal self-injury). SCORS-G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS-G with adolescents. PMID:25010080
Dermody, Sarah S; Quilty, Lena C; Bagby, R Michael
Personality, as characterized by the Five-Factor Model, predicts response to psychotherapy for depression. To explain how personality impacts treatment response, the present study investigated patient and therapist interpersonal processes in treatment sessions as an explanatory pathway. A clinical trial was conducted in which 103 outpatients (mean age: 41.17 years, 65% female) with primary major depressive disorder completed 16-20 weeks of cognitive-behavioral or interpersonal therapy. Before treatment, patients completed the Revised NEO Personality Inventory to assess personality domains (neuroticism, extraversion, openness-to-experience, agreeableness, and conscientiousness). After 3 and 13 weeks, patient interpersonal behavior was rated by the therapist and vice versa to determine levels of patient and therapist communal and agentic behaviors. Depression levels were measured before and after treatment. Structural equation modeling supported that patients' interpersonal behavior during therapy mediated the associations between pretreatment personality and depression treatment outcome. Specifically, extraversion, conscientiousness, and neuroticism (inverse) predicted higher levels of patient communion throughout treatment, which was in turn associated with improved treatment outcomes. Furthermore, patient agreeableness was inversely associated with agency throughout treatment, which was linked to poorer treatment response. Therapist interpersonal behavior was not a significant mediator. Results suggest that patient interpersonal behavior during treatment may be one way that patient personality impacts clinical outcomes in depression. Results underscore the clinical utility of Five-Factor Model domains in treatment process and outcome. (PsycINFO Database Record
Carson, David K.; Becker, Kent W.
Creativity is paramount to the therapeutic process. This article explored the role of creativity in counseling and psychotherapy through a critical analysis of several key articles in a special issue of The Journal of Clinical Activities, Assignments, & Handouts in Psychotherapy Practice (L. L. Hecker, 2002). Implications for counselors/therapists…
Story, Norman L.
This brief article describes a session with a client utilizing a device known as the Electromyometer (EMG) and biofeedback processes. The author explains how his procedure encompasses aspects of Dynamic Psychotherapy, which is a therapeutic approach utilizing galvanic skin resistance in psychotherapy, and EMG which has been primarily used on…
Maitland, Daniel W. M.; Gaynor, Scott T.
Functional Analytic Psychotherapy (FAP) is a form of therapy grounded in behavioral principles that utilizes therapist reactions to shape target behavior. Despite a growing literature base, there is a paucity of research to establish the efficacy of FAP. As a general approach to psychotherapy, and how the therapeutic relationship produces change,…
This Practice Parameter describes the principles of psychodynamic psychotherapy with children and is based on clinical consensus and available research evidence. It presents guidelines for the practice of child psychodynamic psychotherapy, including indications and contraindications, the setting, verbal and interactive (play) techniques, work with…
Kales, J C; Cadieux, R J; Soldatos, C R; Kales, A
This is the first report of the effectiveness of psychotherapy in treating adult night-terror patients. Night terrors were eliminated or drastically reduced in two patients who completed psychotherapy. A third patient discontinued therapy and showed no improvement. Thus, the primary role of psychopathology in the production of night terrors in adulthood was illustrated.
Kopta, Stephen Mark; And Others
Used psychotherapy dosage model in which effect was probability of recovery to compare treatment response rates for psychological symptoms. Administered symptom checklists to 854 psychotherapy outpatients at intake and during treatment. Chronic distress symptoms demonstrated fastest average response rate, whereas characterological symptoms…
Frank, Ellen; Novick, Danielle; Kupfer, David J.
This review focuses on information concerning antidepressants and psychotherapy in the treatement of both acute and chronic forms of unipolar depression in the English language literature. In it, we address the use of combination therapy, both from the outset of treatment and in a variety of sequences, ie, we examine the potential advantages of adding a targeted psychotherapy to an incompletely effective pharmacotherapy and the potential advantages of adding pharmacotherapy to an incompletely effective psychotherapy The number of research reports available to address these questions is small relative to their importance for clinical practice. There is a clear need for more information about the relative efficacy of pharmacotherapy-psychotherapy combinations or sequences versus either pharmacotherapy or psychotherapy provided as monotherapies. PMID:16156384
Fenton, W S
Some form of individual psychotherapy, in combination with the prescription of antipsychotic medications, is likely the most common treatment for patients with schizophrenia. In the absence of empirical data supporting the efficacy of a particular approach, psychotherapy has often been guided by ideology and deference to authority. In recent years, a reformulation of schizophrenia as a disorder requiring individualized, comprehensive treatment has allowed the development and empirical testing of new targeted and illness-phase-specific individual psychotherapies. This report reviews randomized clinical trials that have evaluated individual psychotherapy of schizophrenia in the context of changing contemporaneous beliefs about the disorder's etiology and treatment. A general approach to individual treatment, termed "flexible psychotherapy," derived from historical approaches but consistent with available clinical and research perspectives, is outlined.
As a specialist Obstetrics and Gynaecology I then became a specialist also in psychotherapy, including: psychodynamic therapy, group therapy, hypnotherapy, and body-therapy. In the last nineteen years I have been working to integrate the medical and psychotherapeutic approach, including attention to psychosocial factors. After some years, I found our German rate of premature birth to be 7%. This amazed me because prematurity very rarely occurred in my patients, which was down to about 1%. In France they did some surveys and studies. By informing the mothers how to live, and reducing smoking and drugs, they reduced their prematurity rate to about half, but still much above my rate of 1%. I have described my method in articles. This is vital work, because serious prematurity is responsible for most damage and death amongst the children. A mother's complaint may be an early suggestion of danger. We then check it with the regular obstetric assessments. Even before birth symptoms can indicate a problem, such as premature labour, much as postnatal problems while breast feeding are indicated by symptoms. And before birth, as well as after birth stress and emotional problems can be the cause for serious somatic illness. It is really an effect of one relationship on the other. The way a woman relates to her child depends on her feeling of security among all who support her. All her relationships are important: how she grew up with her parents; her work: her other children. Further problems that experience of psychotherapy can help to reduce are: exceeding the estimated date of delivery: pre-eclampsia: HELLP-syndrome (Hemolysis, Elevated Liver enzymes and Low Platelets). The lectures we offer on the subject are also relevant to psychotherapeutic understanding and in guiding to treatment.
Solbakken, Ole André; Hansen, Roger Sandvik; Havik, Odd E; Monsen, Jon Trygve
The present study investigated the relationship between baseline levels of affect integration and the magnitude of change during and after open-ended psychotherapy. Affect integration reflects the capacity for accessing and utilizing the adaptive properties of affects for personal adjustment, along with the more general capability of tolerating and regulating affective activation. It is thus a capacity with relevance for the postulated mechanisms of change in various treatment modalities. Overall, the results indicated that patients with more severe problems in affect integration had larger improvements in symptoms, interpersonal and personality problems in open-ended treatment than those with less severe problems. This was also the case when examining the predictive effects of the integration of specific affects on changes in interpersonal relatedness. It was indicated that increasing problems with the integration of discrete affects were associated with distinct patterns of change in different interpersonal problem domains.
Wolf, Markus; Maurer, Wolf-Jürgen; Dogs, Peter; Kordy, Hans
We introduce an aftercare program for psychotherapy inpatients, which is based on regular communication via E-mail. The organizational and operational structure of the program are described within the context of computer mediated communication. First results on utilization and acceptance are reported. In comparison to patients who did not participate in either aftercare program of the clinic, the E-mail participants are younger and higher educated. Inpatient treatment of the participants was three days shorter in duration than that of non participants. Both groups were similar with regard to symptom distress at discharge from hospital. A low dropout rate of 8%, the high activity and satisfaction emphasize the positive acceptance of the program. Therapists' E-mail activity turned out to be important for the participants. Neither age, internet experience or symptom related variables nor the own E-mail activity were associated with participants' evaluation of the new service. Based on these first positive experiences the perspectives of using E-mail in psychotherapy will be discussed.
In this article, I review major advances in the development of the interpersonal circle and its measurement, as delineated by Timothy Leafy (1957) and his colleagues. In my early work (Lorr & McNair, 1963, 1965), an interpersonal Behavior Inventory consisting of manifest behavioral statements was constructed. The 14 categories were found to fit a circular order in several samples. Studies using LaForge and Suczek's (1955) Interpersonal Check List, and Wiggins's (1979) Interpersonal Adjective Scales further established the value of Leary's conceptions and extended them. Several major theorists, researchers, and clinicians including Benjamin, Carson, Horowitz, Kiesler, and Wiggins have been inspired by Leary and, in many cases, have extended his ideas in ways not originally envisioned. Recent research (e.g., Hofstee, de Raad, & Goldberg, 1992; Millon, 1987) demonstrated the pertinence of the interpersonal conception of personality to the 5-factor model and personality disorders.
Keating, Leah; Tasca, Giorgio A; Gick, Mary; Ritchie, Kerri; Balfour, Louise; Bissada, Hany
Attachment to groups is analogous to attachment to individuals, and may play an important role in group functioning and in group psychotherapy outcomes. This study examined whether attachment to the therapy group can change during treatment, and whether such change predicts improvements in treatment outcomes, including individual attachment, up to 1 year posttreatment. Eighty-seven women with binge eating disorder (BED) attended Group Psychodynamic Interpersonal Psychotherapy (GPIP). Participants were assigned to one of two conditions in which groups were homogeneously composed of women with either higher or lower individual attachment anxiety. Outcomes were assessed pre, post, 6 months, and 1 year posttreatment. Attachment to the group was assessed at weeks 4, 8, 12, and 16 of GPIP. Group attachment insecurity decreased significantly during treatment. Reductions in group attachment avoidance predicted decreases in individual attachment insecurity at 1 year posttreatment. Study condition did not moderate these associations. These results indicate that women with BED who receive GPIP are able to generalize improvements in group attachment security to their individual attachment relationships outside of therapy up to 1 year post group treatment.
Gray Armstrong, Victoria; Howatson, Rosie
Art psychotherapy involves the use of the image-making process within a therapeutic relationship to help clients explore and communicate feelings and experiences. This article explores whether art psychotherapy groups can be an effective intervention for parent-infant dyads who may be involved with social work and health teams due to concerns about their relationship, possibly due to postnatal depression or attachment difficulties. We describe a model of parent-infant art psychotherapy groups and examine some of the key themes in this intervention alongside vignettes of case work and quantitative and qualitative evidence from the evaluations of two such groups. We believe that the Create Together group demonstrates how knowledge from research into infant mental health and attachments, together with an understanding of the creative process, can be applied in practice to offer a successful early intervention.
Tasca, Giorgio A; Ritchie, Kerri; Demidenko, Natasha; Balfour, Louise; Krysanski, Valerie; Weekes, Kirsti; Barber, Ann; Keating, Leah; Bissada, Hany
We hypothesized that compared to therapy groups homogeneously composed of women with binge eating disorder (BED) and low attachment anxiety, groups with high attachment anxiety would have better outcomes and a greater alliance-outcome relationship. We assigned 102 women with BED to therapy groups homogeneously composed of low attachment anxiety (n =52) or high attachment anxiety participants (n=50) who received Group Psychodynamic Interpersonal Psychotherapy (GPIP). GPIP resulted in improved outcomes with large effects. Attachment anxiety condition did not moderate outcomes. However, attachment anxiety condition did moderate the alliance-outcome relationship: i.e., group alliance growth was associated with improved binge eating only in the high attachment anxiety condition. Clinicians should be attentive to and encourage the growth of group therapy alliance especially for anxiously attached individuals.
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.
Kleptsova, Elena Yuryevna; Balabanov, Anton Anatolyevich
The article reflects some theoretical aspects of humanization of interpersonal relationships in the sphere of education. The notion "humanization of interpersonal relationships" is being analyzed. The authors offer a characterization of some parameters of relationships: orientation, modality, valence, intensity, awareness,…
Peplau, H E
Interpersonal competencies of nurses are key to assisting patients in the work necessary for regaining health and well-being. Peplau's theory of interpersonal relations is detailed, and examples are given of the three phases which occur in developing nurse-patient relationships, along with associated challenges.
Six different types of interpersonal exchanges, or educational telecomputing activities that incorporate the use of interpersonal skills are presented: (1) "keypals"; (2) global classrooms; (3) electronic "appearances"; (4) electronic monitoring; (5) question-and-answer services; and (6) impersonations. From this presentation,…
This paper identifies the origins of the concept of feedback and its entry into the interpersonal communication literature as a social science variable. It touches on why feedback might be important in interpersonal relations, what it consists of, some of the relevant research, and some possible dangers or misuses. It speaks to how the process of…
Body centered Psychotherapy IKP is treated in this article under the aspect of a holistic approach. First the theory and the system of science are summarised and shown as to which amount they are changing concerning knowledge of details and wholeness. It is pointed out that the actual paradigma "to the depth" has to be completed by that of "wideness". The way of holistic-multirelational thinking, stating a diagnosis and doing therapy is demonstrated along a case study going on at the background of a therapeutic encounter-relationship which is emotionally warm (Gestalt-approach).
Kocsis, James H.; Gelenberg, Alan J.; Rothbaum, Barbara O.; Klein, Daniel N.; Trivedi, Madhukar H.; Manber, Rachel; Keller, Martin B.; Leon, Andrew C.; Wisniewski, Steven R.; Arnow, Bruce A.; Markowitz, John C.; Thase, Michael E.
Context Previous studies have found that few chronically depressed patients remit with antidepressant medications alone. Objective To determine the role of adjunctive psychotherapy in the treatment of chronically depressed patients with less than complete response to an initial medication trial. Design This trial compared 12 weeks of (1) continued pharmacotherapy and augmentation with cognitive behavioral analysis system of psychotherapy (CBASP), (2) continued pharmacotherapy and augmentation with brief supportive psychotherapy (BSP), and (3) continued optimized pharmacotherapy (MEDS) alone. We hypothesized that adding CBASP would produce higher rates of response and remission than adding BSP or continuing MEDS alone. Setting Eight academic sites. Participants Chronically depressed patients with a current DSM-IV–defined major depressive episode and persistent depressive symptoms for more than 2 years. Interventions Phase 1 consisted of open-label, algorithm-guided treatment for 12 weeks based on a history of antidepressant response. Patients not achieving remission received next-step pharmacotherapy options with or without adjunctive psychotherapy (phase 2). Individuals undergoing psychotherapy were randomized to receive either CBASP or BSP stratified by phase 1 response, ie, as nonresponders (NRs) or partial responders (PRs). Main Outcome Measures Proportions of remitters, PRs, and NRs and change on Hamilton Scale for Depression (HAM-D) scores. Results In all, 808 participants entered phase 1, of which 491 were classified as NRs or PRs and entered phase 2 (200 received CBASP and MEDS, 195 received BSP and MEDS, and 96 received MEDS only). Mean HAM-D scores dropped from 25.9 to 17.7 in NRs and from 15.2 to 9.9 in PRs. No statistically significant differences emerged among the 3 treatment groups in the proportions of phase 2 remission (15.0%), partial response (22.5%), and non-response (62.5%) or in changes on HAM-D scores. Conclusions Although 37.5% of the
Abstract. The capacity to establish interpersonal synchrony is fundamental to human beings because it constitutes the basis for social connection and understanding. Interpersonal synchrony refers to instances when the movements or sensations of two or more people overlap in time and form. Recently, the causal influence of interpersonal synchrony on prosociality has been established through experiments. The current meta-analysis is the first to synthesize these isolated and sometimes contradictory experiments. We meta-analyzed 60 published and unpublished experiments that compared an interpersonal synchrony condition with at least one control condition. The results reveal a medium effect of interpersonal synchrony on prosociality with regard to both attitudes and behaviors. Furthermore, experimenter effects and intentionality moderate these effects. We discuss the strengths and limitations of our analysis, as well as its practical implications, and we suggest avenues for future research. PMID:28105388
Rajalin, Mia; Hirvikoski, Tatja; Salander Renberg, Ellinor; Åsberg, Marie; Jokinen, Jussi
Difficulties in interpersonal relationships are associated with a wide range of psychiatric diagnoses and have been reported as a trigger for suicidal behavior, too. The aim of this study was to examine the relationship between interpersonal problems and family history of suicide in suicide attempters and to describe relevant patterns of interpersonal problems in this patient group. The study involves 181 patients having their clinical follow-up after a suicide attempt. Family history of suicide was assessed by using the Karolinska Self Harm History Interview or retrieved in patient records. The Inventory of Interpersonal Problems was used to assess personal style in an interpersonal context. Suicide attempters with a family history of suicide had significantly more often an intrusive personal style. The results remained significant after adjustment for personality disorder. The specific interpersonal patterns associated with family history of suicide may interfere with the ability to create stable, long-lasting relationships. In regards to treatment, these personal qualities could cause difficulties in the alliance with health care personnel and make it harder for suicide attempters to accept or benefit from treatment. Attention to suicide attempters' interpersonal problems is of importance to lower their distress.
Goldberg, David A.
A multiaxial model that structures educational goals for psychodynamic psychotherapy has been developed. It specifies core aspects of psychodynamic psychotherapy, clusters them in categories that further define and link related areas, and presents a sequence that enables educators and students to focus on training goals in a consistent progression. This model has been used by the Director of Education as a basis for developing the curriculum, by students as a way of focusing learning and giving perspective to current work, and by supervisors to link individual teaching to the goals of the training program. This method has enhanced consistency, clarity, and efficiency in the psychotherapy program. PMID:9407472
Tasca, Giorgio A; Sylvestre, John; Balfour, Louise; Chyurlia, Livia; Evans, Jane; Fortin-Langelier, Benjamin; Francis, Kylie; Gandhi, Jasmine; Huehn, Linda; Hunsley, John; Joyce, Anthony S; Kinley, Jackie; Koszycki, Diana; Leszcz, Molyn; Lybanon-Daigle, Vanessa; Mercer, Deanna; Ogrodniczuk, John S; Presniak, Michelle; Ravitz, Paula; Ritchie, Kerri; Talbot, Jeanne; Wilson, Brian
Practice research networks may be one way of advancing knowledge translation and exchange (KTE) in psychotherapy. In this study, we document this process by first asking clinicians what they want from psychotherapy research. Eighty-two psychotherapists in 10 focus groups identified and discussed psychotherapy research topics relevant to their practices. An analysis of these discussions led to the development of 41 survey items. In an online survey, 1,019 participants, mostly practicing clinicians, rated the importance to their clinical work of these 41 psychotherapy research topics. Ratings were reduced using a principal components analysis in which 9 psychotherapy research themes emerged, accounting for 60.66% of the variance. Two postsurvey focus groups of clinicians (N = 22) aided in interpreting the findings. The ranking of research themes from most to least important were-Therapeutic Relationship/Mechanisms of Change, Therapist Factors, Training and Professional Development, Client Factors, Barriers and Stigma, Technology and Adjunctive Interventions, Progress Monitoring, Matching Clients to Therapist or Therapy, and Treatment Manuals. Few differences were noted in rankings based on participant age or primary therapeutic orientation. Postsurvey focus group participants were not surprised by the top-rated items, as they were considered most proximal and relevant to therapists and their work with clients during therapy sessions. Lower ranked items may be perceived as externally imposed agendas on the therapist and therapy. We discuss practice research networks as a means of creating new collaborations consistent with KTE goals. Findings of this study can help to direct practitioner-researcher collaborations.
Linden, David E J
The development of psychotherapy has been based on psychological theories and clinical effects. However, an investigation of the neurobiological mechanisms of psychological interventions is also needed in order to improve indication and prognosis, inform the choice of parallel pharmacotherapy, provide outcome measures and potentially even aid the development of new treatment protocols. This neurobiological investigation can be informed by animal models, for example of learning and conditioning, but will essentially need the non-invasive techniques of functional neuroimaging in order to assess psychotherapy effects on patients' brains, which will be reviewed here. Most research so far has been conducted in obsessive compulsive disorder (OCD), anxiety disorders and depression. Effects in OCD were particularly exciting in that both cognitive behavioural therapy and medication with a selective serotonin inhibitor led to a reduction in blood flow in the caudate nucleus. In phobia, brief courses of behavioural therapy produced marked reductions of paralimbic responses to offensive stimuli in line with the clinical improvement. Findings in depression are less consistent, with both increases and decreases in prefrontal metabolism being reported. However, they are important in pointing to different mechanisms for the clinical effects of pharmacotherapy (more "bottom up") and psychotherapy (more "top down"). For the future it would be desirable if the findings of psychotherapy changes to brain activation patterns were confirmed in larger groups with homogenous imaging protocols. Functional imaging has already made great contributions to the understanding of the neural correlates of psychopathology. For example, evidence converges to suggest that the subgenual cingulate is crucial for mood regulation. One current clinical application of these findings is deep brain stimulation in areas highlighted by such imaging studies. I will discuss their initial application in depression
Wilson, Laura C; Scarpa, Angela
This study examined the influence of interpersonal functioning as a mediator in the relationship between child sexual abuse and depression symptoms, after accounting for the influence of child physical abuse. The research questions build on the existing knowledge base by examining mechanisms of adult adjustment among child sexual abuse survivors. In the current study, 2,892 young adult women (18-29 years old; M = 19.06) reported on child sexual and physical abuse, 5 domains of interpersonal functioning, and depression symptoms. The results supported aggression, sensitivity, ambivalence, and lack of sociability as mediators in the relationship between child sexual abuse and depression symptoms. These results suggest that interpersonal difficulties related to hostility, emotional reactivity, inability to collaborate, and isolation may be of particular interest when understanding depression in child sexual abuse survivors. The findings support interpersonal problems as a key mechanism of depression symptoms following child sexual abuse and is even demonstrated when examining long-term outcomes and controlling for child physical abuse. The hypotheses and findings are discussed in the context of interpersonal psychotherapy for depression.
Bellino, Silvio; Brunetti, Chiara; Bozzatello, Paola
Borderline personality disorder (BPD) represents a significant therapeutic challenge. Critical factors in psychotherapeutic treatment of patients with BPD are noticeable and strictly related to the psychopathological dimensions of this disorder: affective and relational instability, behavioral impulsivity and precarious definition of identity. These features are emphasized by therapeutic intervention and become evident during the course of the treatment. Psychotherapeutic setting induces BPD patient to actualize the dysfunctional relational patterns that have been acquired during childhood. Specific critical factors concern the characteristics of the patient (risk of suicide, aggressive behaviors, chronic course of the disorder, disorganized attachment style), of the therapist (therapeutic skills, training, countertransference, risk of burnout) and of the setting of psychotherapy (patients selection, therapeutic alliance, need to set limits, duration and end of therapy). In Otto Kernberg's and Marsha Linehan's models of psychotherapy specific for DBP the authors identify substantially overlapping objectives and modalities of intervention. In particular, therapists should take care of patient safety, maintain boundaries of therapeutic setting and promote the development of psychotherapeutic process. The aim of this article is to analyze the main critical factors affecting psychotherapeutic process in patients with BPD. Objectives and priorities that therapist should consider to address these issues will be discussed. We will also try to make clear why interpersonal psychotherapy adapted to DBP can represent one of the therapeutic models that may be useful to manage and resolve these difficulties.
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. PMID:25379256
Krupitsky, Evgeny M; Burakov, Andrei M; Dunaevsky, Igor V; Romanova, Tatyana N; Slavina, Tatyana Y; Grinenko, Alexander Y
A prior study found that one ketamine-assisted psychotherapy session was significantly more effective than active placebo in promoting abstinence (Krupitsky et al. 2002). In this study of the efficacy of single versus repeated sessions of ketamine-assisted psychotherapy in promoting abstinence in people with heroin dependence, 59 detoxified inpatients with heroin dependence received a ketamine-assisted psychotherapy (KPT) session prior to their discharge from an addiction treatment hospital, and were then randomized into two treatment groups. Participants in the first group received two addiction counseling sessions followed by two KPT sessions, with sessions scheduled on a monthly interval (multiple KPT group). Participants in the second group received two addiction counseling sessions on a monthly interval, but no additional ketamine therapy sessions (single KPT group). At one-year follow-up, survival analysis demonstrated a significantly higher rate of abstinence in the multiple KPT group. Thirteen out of 26 subjects (50%) in the multiple KPT group remained abstinent, compared to 6 out of 27 subjects (22.2%) in the single KPT group (p < 0.05). No differences between groups were found in depression, anxiety, craving for heroin, or their understanding of the meaning of their lives. It was concluded that three sessions of ketamine-assisted psychotherapy are more effective than a single session for the treatment of heroin addiction.
Rev 2-89) Author: James R. Van Scotter, Major, USAF Title: Evidence for the Usefulness of Task Performance, Job Dedication, and Interpersonal ...task performance, job dedication, interpersonal facilitation, and overall performance had acceptable reliability. Another group of supervisors provided...independent ratings of the task performance, job dedication, interpersonal facilitation, and overall performance of 760 Air Force mechanics in a second
Vink, Roy; Wijnants, Maarten L; Cillessen, Antonius H N; Bosman, Anna M T
Cooperative learning has been shown to result in better task performance, compared to individual and competitive learning, and can lead to positive social effects. However, potential working mechanisms at a micro level remain unexplored. One potential working mechanism might be the level of interpersonal synchrony between cooperating individuals. It has been shown that increased levels of interpersonal synchrony are related to better cognitive performance (e.g., increased memory). Social factors also appear to be affected by the level of interpersonal synchrony, with more interpersonal synchrony leading to increased likeability. In the present study, interpersonal synchrony of postural sway and its relation to task performance and social factors (i.e., popularity, social acceptance, and likeability) was examined. To test this, 183 dyads performed a tangram task while each child stood on a Nintendo Wii Balance Board that recorded their postural sway. The results showed that lower levels of interpersonal synchrony were related to better task performance and those dyads who were on average more popular synchronized more. These results contradict previous findings. It is suggested that for task performance, a more loosely coupled system is better than a synchronized system. In terms of social competence, dyad popularity was associated with more interpersonal synchrony.
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.
Increasingly the philosophical discipline of hermeneutics is being applied to a systematic study of the human sciences. Yet a hermeneutic approach to psychotherapy has barely been considered. In this paper, the possible significance of a hermeneutic approach to the field of child psychotherapy is explored. Despite the fundamental differences between the two disciplines, both are faced with the task of understanding and interpreting the meaning of human expressions through words and images. Both encounter texts that call for deciphering. The author focuses first on the central concepts of experience, understanding and interpretation which lie at the heart of both disciplines. Subsequently, a hermeneutic approach to the expressions of experience in the form of child play and narratives is explored and some implications for child psychotherapy are drawn. Finally, a possible hermeneutic approach towards child psychotherapy is discussed. PMID:1958654
Reddy, M S
Spoken and written commentary on Bhagavad Gita, the distilled spiritual essence of Vedas and Upanishads, is aplenty. Mahatma Gandhi was quoted as saying that whenever he had a problem Bhagavad Gita offered an answer and the solution. For a student of psychology Bhagavad Gita offers a valuable case study for lessons in psychotherapy - resolution of conflict and successful resumption of action from a state of acute anxiety and guilt laden depression that precipitated inaction. This presentation makes a humble attempt to discuss the therapy process involved in Bhagavad Gita in which Lord Krishna helped the grief-stricken Arjuna through dialogue and discussion. The focus would be on the conflict and diagnosis of patient, the background setting of the situation, personality of patient, technique of therapy, underlying psychological concepts/ principles/theories, the Guru - Sishya concept, etc.
Reddy, M. S.
Spoken and written commentary on Bhagavad Gita, the distilled spiritual essence of Vedas and Upanishads, is aplenty. Mahatma Gandhi was quoted as saying that whenever he had a problem Bhagavad Gita offered an answer and the solution. For a student of psychology Bhagavad Gita offers a valuable case study for lessons in psychotherapy – resolution of conflict and successful resumption of action from a state of acute anxiety and guilt laden depression that precipitated inaction. This presentation makes a humble attempt to discuss the therapy process involved in Bhagavad Gita in which Lord Krishna helped the grief-stricken Arjuna through dialogue and discussion. The focus would be on the conflict and diagnosis of patient, the background setting of the situation, personality of patient, technique of therapy, underlying psychological concepts/ principles/theories, the Guru - Sishya concept, etc. PMID:22661821
Harrison, A. A.; Connors, M. M.
The crucial importance of a thorough understanding of the psychological and interpersonal dimensions of Mars flights is indicated. This is necessary both to reduce the chances that psychological problems or interpersonal frictions will threaten the success of Mars missions and to enhance the quality of life of the people involved. Adaptation to interplanetary flight will depend on an interplay of the psychological stresses imposed by the missions and the psychological strengths and vulnerabilities of the crewmembers involved. Stresses may be reduced through environmental engineering, manipulating crew composition, and the structuring of situations and tasks. Vulnerabilities may be reduced through improving personnel selection procedures, training personnel in psychological and group dynamics, and providing mechanisms for emotional support. It is essential to supplement anecdotal evidence regarding the human side of space travel with the results of carefully conducted scientific research.
Silverman, Wade H
This article explores the trends of psychotherapy over the past 20 years and how some have faded while others have fully integrated into the field. It also presents 4 contemporary trends, including the new diversity, the expanding role of technology, the new economy and health care, and the emerging markets of performance enhancement and quality of life improvement. Perspectives on the biggest and most surprising changes, as well as important shifts in psychotherapy, are also discussed.
Harman, Marsha J.
Presents recent investigations and reports related to group psychotherapy in cancer patients' treatment. Describes primary characteristics and results of studies examining evidence of therapeutic factors, psychosocial support groups, women's adjustment to mastectomies, training in stress management and coping skills, pain and mood disturbance, and…
Dowell, Kathy A.; Ogles, Benjamin M.
Forty-eight child psychotherapy outcome studies offering direct comparisons of an individual child treatment group to a combined parent-child/family therapy treatment group were included in this meta-analytic review. Results indicate that combined treatments produced a moderate effect beyond the outcomes achieved by individual child treatments,…
... Psychiatric Association American Psychological Association National Association of Social Workers National Register of Health Service Psychologists Society of Clinical Child & Adolescent Psychology Society of Clinical Psychology National advocacy organizations have ...
Emphasis on identifying evidence-based therapies (EBTs) has increased markedly. Lists of EBTs are the rationale for recommendations for how psychotherapy provider training programs should be evaluated, professional competence assessed, and licensure and reimbursement policies structured. There are however methodological concerns that limit the external validity of EBTs. Among the most salient is the circularity inherent in randomized control trials (RCTs) of psychotherapy that constrains the manner in which the psychological problems are defined, psychotherapy can be practiced, and change evaluated. RCT studies favor therapies that focus of specific symptoms and can be described in a manual, administered reliably across patients, completed in relatively few sessions, and involve short-term evaluations of outcome. The epistemological assumptions of a natural science approach to psychotherapy research limit how studies are conducted and assessed in ways that that advantage symptom-focused approaches and disadvantage those approaches that seek to bring broad recovery-based changes. Research methods that are not limited to RCTs and include methodology to minimize the effects of "therapist allegiance" are necessary for valid evaluations of therapeutic approaches that seek to facilitate changes that are broader than symptom reduction. Recent proposals to adopt policies that dictate training, credentialing, and reimbursement based on lists of EBTs unduly limit how psychotherapy can be conceptualized and practiced, and are not in the best interests of the profession or of individuals seeking psychotherapy services.
Weitkamp, Katharina; Claaßen, Sanna; Wiegand-Grefe, Silke; Romer, Georg
There is evidence for the effectiveness of psychodynamic therapies in terms of symptom reduction. Up to now, there is little evidence to what extend therapy translates to the improvement of core analytical concepts, like psychic structure, interpersonal relatedness, and intrapsychic conflicts. The current study focuses on these concepts over the course of therapy as well as in connection with outcome. The concepts are assessed with the Operationalized Psychodynamic Diagnostics in Childhood and Adolescence (OPD-CA). Additionally, the OPD-CA axis prerequisites of treatment is tested as a predictor of outcome. 16 therapists rated 146 participating patients at the beginning and the end of therapy within the framework of a study on the effectiveness of psychoanalytical psychotherapy. Therapists rated the OPD-CA as well as the level of psychosocial impairment. Psychic structure, interpersonal relatedness, and intrapsychic conflicts improved significantly over the course of therapy. Positive outcome was predicted by communicative abilities, positive self-relatedness and an undistinctive intrapsychic conflict at the beginning of therapy as well as the improvement of these during therapy. Among the prerequisites of treatment only the subjective level of mental impairment and the intrapsychic resources were predictive of outcome. Psychoanalytic psychotherapy for children and adolescents improved central psychodynamic concepts like psychic structure, interpersonal relatedness, and intrapsychic conflicts.
Haller, Moira; Myers, Ursula S; McKnight, Aaron; Angkaw, Abigail C; Norman, Sonya B
Both pharmacotherapy and psychotherapy are effective treatments for posttraumatic stress disorder (PTSD). Better understanding factors that are associated with engaging in these different treatment options may improve treatment utilization and outcomes. This issue is especially important among veterans returning from Iraq and Afghanistan, given high rates of those seeking PTSD treatment. This study examined potential predictors of the type of treatment (psychotherapy, pharmacotherapy, or both) 232 returning veterans (92% male, mean age = 33.38) engaged in within 1 year of seeking treatment at a VA PTSD clinic. Results indicated that 32.3% of returning veterans engaged in pharmacotherapy only, 23.7% engaged in psychotherapy only, and 44.0% engaged in both. Veterans who engaged in pharmacotherapy only or in both pharmacotherapy and psychotherapy had higher pretreatment PTSD and depression symptoms than did those who engaged in psychotherapy only. History of pharmacotherapy treatment was associated with engagement in pharmacotherapy only or both pharmacotherapy and psychotherapy, as compared with psychotherapy only. Treatment engagement type was not significantly associated with differences in age, gender, race/ethnicity, service branch, alcohol use/misuse, history of psychotherapy, distance from the VA, or PTSD service connection. Implications for enhancing PTSD treatment engagement are discussed. (PsycINFO Database Record
Thomas, Katherine M; Hopwood, Christopher J; Donnellan, M Brent; Wright, Aidan G C; Sanislow, Charles A; McDevitt-Murphy, Meghan E; Ansell, Emily B; Grilo, Carlos M; McGlashan, Thomas H; Shea, M Tracie; Markowitz, John C; Skodol, Andrew E; Zanarini, Mary C; Morey, Leslie C
Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD.
Thomas, Katherine M.; Hopwood, Christopher J.; Donnellan, M. Brent; Sanislow, Charles A.; Ansell, Emily B.; Grilo, Carlos M.; McGlashan, Thomas H.; Markowitz, John C.; Zanarini, Mary C.; Wright, Aidan G. C.; McDevitt-Murphy, Meghan E.; Shea, M. Tracie; Skodol, Andrew E.; Morey, Leslie C.
Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD. PMID:24015858
Describes a summer internship as a faculty technical writer with a business corporation, revising installation manuals based upon information from computer programers--an experience that highlighted technical writers' need for interpersonal skills. (HTH)
Markowitz, John C.; Petkova, Eva; Biyanova, Tatyana; Ding, Ke; Suh, EJ; Neria, Yuval
Background Axis I comorbidity complicates diagnosing Axis II personality disorders (PDs). PDs might influence Axis I outcome. No research has examined psychotherapy effects on PDs of treating Axis I comorbidity. Secondary analysis of a randomized controlled trial examined PD diagnostic stability after brief psychotherapy of chronic posttraumatic stress disorder (PTSD). Methods Patients with chronic PTSD were randomly assigned to 14 weeks of Prolonged Exposure, Interpersonal Psychotherapy, or Relaxation Therapy. Assessments included SCID-P and SCID-II at baseline, week 14, and for treatment responders (≥30% Clinician-Administered PTSD Scale improvement, defined a priori) at week 26 follow-up. We hypothesized patients whose PTSD improved would retain fewer baseline PD diagnoses posttreatment, particularly with personality traits PTSD mimics: e.g., paranoid and avoidant. Results Forty-seven (47%) of 99 SCID-II patients evaluated at baseline received a SCID-II diagnosis: paranoid (28%), obsessive-compulsive (27%), and avoidant (23%) PDs were most prevalent. Among 78 patients who repeated SCID-II evaluations posttreatment, 45% (N=35) had baseline PD diagnoses, which 43% (N=15/35) lost at week 14. Three (7%) patients without baseline PDs acquired diagnoses at week 14; ten others shifted diagnoses. Treatment modality and PTSD response were unrelated to PD improvement. Of treatment responders re-evaluated at follow-up (N=44), 56% with any baseline Axis II diagnosis had none at week 26. Discussion This first evaluation of Axis I psychotherapy effects on personality disorder stability found that acutely treating a chronic state decreased apparent trait – across most PDs observed. These exploratory findings suggest personality diagnoses may have limited prognostic meaning in treating chronic PTSD. PMID:26439430
Levy, Kenneth N; Ehrenthal, Johannes C; Yeomans, Frank E; Caligor, Eve
The growing number of individuals seeking treatment for mental disorders calls for intelligent and responsible decisions in health care politics. However, the current relative decrease in reimbursement of effective psychotherapy approaches occurring in the context of an increase in prescription of psychotropic medication lacks a scientific base. Using psychodynamic psychotherapy as an example, we review the literature on meta-analyses and recent outcome studies of effective treatment approaches. Psychodynamic psychotherapy is an effective treatment for a wide variety of mental disorders. Adding to the known effectiveness of other shorter treatments, the results indicate lasting change in many cases, especially for complex and difficult to treat patients, ultimately reducing health-care utilization. Research-informed health care decisions that take into account the solid evidence for the effectiveness of psychotherapy, including psychodynamic psychotherapy, have the potential to promote choice, increase mental health, and reduce society's burden of disease in the long run.
Dinger, Ulrike; Ehrenthal, Johannes C; Nikendei, Christoph; Schauenburg, Henning
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.
Introduction Although a plethora of studies have delineated the relationship between childhood trauma and onset, symptom severity, and course of depression and anxiety disorders, there has been little evidence that childhood trauma may lead to interpersonal problems among adult patients with depression and anxiety disorders. Given the lack of prior research in this area, we aimed to investigate characteristics of interpersonal problems in adult patients who had suffered various types of abuse and neglect in childhood. Methods A total of 325 outpatients diagnosed with depression and anxiety disorders completed questionnaires on socio-demographic variables, different forms of childhood trauma, and current interpersonal problems. The Childhood Trauma Questionnaire (CTQ) was used to measure five different forms of childhood trauma (emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and the short form of the Korean-Inventory of Interpersonal Problems Circumplex Scale (KIIP-SC) was used to assess current interpersonal problems. We dichotomized patients into two groups (abused and non-abused groups) based on CTQ score and investigated the relationship of five different types of childhood trauma and interpersonal problems in adult patients with depression and anxiety disorders using multiple regression analysis. Result Different types of childhood abuse and neglect appeared to have a significant influence on distinct symptom dimensions such as depression, state-trait anxiety, and anxiety sensitivity. In the final regression model, emotional abuse, emotional neglect, and sexual abuse during childhood were significantly associated with general interpersonal distress and several specific areas of interpersonal problems in adulthood. No association was found between childhood physical neglect and current general interpersonal distress. Conclusion Childhood emotional trauma has more influence on interpersonal problems in adult patients with
Tasca, Giorgio; Lelievre, Julien Yockell; Qiu, Qing; Ritchie, Kerri; Little, John; Trinneer, Anne; Barber, Ann; Chyurlia, Livia; Bissada, Hany; Gruslin, Andreé
Intro Binge eating disorder (BED) affects 3.5% of the population and is characterized by binge eating for at least 2 days a week for 6 months. Treatment options include cognitive behavioral therapy, interpersonal psychotherapy, and pharmacotherapy which are associated with varied success. Little is known about the biology of BED. Since there is evidence that the insulin like growth factor system is implicated in regulation of body weight, insulin sensitivity and feeding behavior, we speculated it may be involved in BED. Methods A cross-sectional comparison was made between three groups of women: overweight with BED, overweight without BED and normal weight without BED. Women were assigned to Group Psychodynamic Interpersonal Psychotherapy. Blood was collected before therapy, at completion and at 6months follow up for evaluation of IGF-II using Western blot. Results 97 overweight women with BED contributed to the cross-sectional comparison. The two control groups comprised 53 overweight women without BED, and 50 age matched normal weight women without BED. Obese women had significantly lower Big IGF-II than normal weight women, p = .028; Overweight women with BED had higher Mature IGF-II than normal weight women, p<.05. Big IGF-II showed a significant decreasing slope from pre- to post- to six months post-group psychological treatment, unrelated to changes in BMI (p = .008). Conclusion Levels of IGF-II isoforms differed significantly between overweight and normal weight women. Overweight women with BED display abnormal levels of circulating IGF-II isoforms. BED is characterized by elevated mature IGF-II, an isoform shown to carry significant bioactivity. This finding is not related to BMI or to changes in body weight. The results also provide preliminary evidence that BIG IGF-II is sensitive to change due to group psychological treatment. We suggest that abnormalities in IGF-II processing may be involved in the neurobiology of BED. PMID:24386136
Collado, Anahí; Lim, Aaron C; MacPherson, Laura
For decades, the literature has reported persistent treatment disparities among depressed Latinos. Fortunately, treatment development and evaluation in this underserved population has expanded in recent years. This review summarizes outcomes across 36 unique depression treatment studies that reported treatment outcomes for Latinos. Results indicated that there was significant variability in the quality of RCT and type/number of cultural adaptations. The review suggested that there might a relation between cultural adaptations with treatment outcomes; future studies are warranted to confirm this association. Cognitive Behavioral Therapy was the most evaluated treatment (CBT; n=18, 50% of all evaluations), followed by Problem Solving Therapy (PST; n=4), Interpersonal Therapy (IPT; n=4), and Behavioral Activation (BA; n=3). CBT seems to fare better when compared to usual care, but not when compared to a contact-time matched control condition or active treatment. There is growing support for PST and IPT as efficacious depression interventions among Latinos. IPT shows particularly positive results for perinatal depression. BA warrants additional examination in RCT. Although scarce, telephone and in-home counseling have shown efficacy in reducing depression and increasing retention. Promotora-assisted trials require formal assessment. Limitations and future directions of the depression psychotherapy research among Latinos are discussed.
Collado, Anahí; Lim, Aaron C.; MacPherson, Laura
For decades, the literature has reported persistent treatment disparities among depressed Latinos. Fortunately, treatment development and evaluation in this underserved population has expanded in recent years. This review summarizes outcomes across 36 unique depression treatment studies that reported treatment outcomes for Latinos. Results indicated that there was significant variability in the quality of RCT and type/number of cultural adaptations. The review suggested that there might a relation between cultural adaptations with treatment outcomes; future studies are warranted to confirm this association. Cognitive Behavioral Therapy was the most evaluated treatment (CBT; n = 18, 50% of all evaluations), followed by Problem Solving Therapy (PST; n = 4), Interpersonal Therapy (IPT; n = 4), and Behavioral Activation (BA; n = 3). CBT seems to fare better when compared to usual care, but not when compared to a contact-time matched control condition or active treatment. There is growing support for PST and IPT as efficacious depression interventions among Latinos. IPT shows particularly positive results for perinatal depression. BA warrants additional examination in RCT. Although scarce, telephone and in-home counseling have shown efficacy in reducing depression and increasing retention. Promotora-assisted trials require formal assessment. Limitations and future directions of the depression psychotherapy research among Latinos are discussed. PMID:27113679
The founding Editor of Psychotherapy offers some recollections of how the journal Psychotherapy came into being, and also provides a larger professional context for this event in the American Psychological Association at that time.
Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata
The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa.
Steinmetz, M; Himmerich, H; Steinberg, H
"Communicative psychotherapy" was developed in the 1960s by the East German psychotherapist and psychiatrist Christa Kohler (1928-2004) for the treatment of "neuroses". Similar to established present-day psychotherapeutic methods, such as cognitive behaviour therapy, it combined diverse therapeutic approaches into an integrated treatment programme. This included individual and group therapy, exercise, work and occupational therapy. In contrast to modern psychotherapeutic practice, communicative psychotherapy was based on a firm system of values, namely socialist ideals. According to this system, psychological breakdown was viewed and treated ideologically. In addition, any lack of conformity with the East German system was likewise regarded as a psychopathological deviation, which should be subjected to psychological treatment. The latter concept requires a critical analysis from a current-day perspective. For the first time, this paper concentrates on Kohler's work on neuroses and the theory and practice of her communicative psychotherapy, albeit without neglecting Kohler's other scientific works, her biographical information and her Stasi documents.
Simon, Gregory E; Imel, Zac E; Ludman, Evette J; Steinfeld, Bradley J
Objective Compare patient-reported outcomes for health plan members who did or did not return after an initial psychotherapy visit. Methods Routinely administered member surveys (n=2666) were used to assess satisfaction with care, patient-rated therapeutic alliance, and patient-rated clinical improvement following an initial psychotherapy visit. Results 34% of those making an initial therapy visit did not return within 45 days. The distribution of satisfaction, therapeutic alliance, and self-rated improvement scores differed significantly between those who did and did not return (p<.001 for all comparisons). Patients not returning were both more likely to report favorable outcomes (high satisfaction, strong therapeutic alliance, maximum improvement) and more likely to report unfavorable outcomes (low satisfaction, weak alliance, no improvement). Conclusion Failure to return after an initial psychotherapy visit can represent either successful and satisfying treatment or unsuccessful and unsatisfying treatment. Systematic outreach and outcome assessment will be necessary to distinguish these two groups of patients. PMID:22752034
Itzhar-Nabarro, Zohar; Silberschatz, George; Curtis, John T
To investigate the value of the Adjective Check List (ACL) as a psychotherapy outcome measure, the ACL and Symptom Checklist-90-Revised (SCL-90-R) were administered at four times (before therapy, immediately after therapy, and at 6-month and 1-year follow-ups) to 38 patients in brief dynamic psychotherapy. High correlations between selected ACL scales and SCL-90-R Global Severity Index scores (GSI) were found. GSI change from before to after therapy correlated with change on the ACL scales. Changes from before to after therapy were detected for ACL scales at both the mean group and the individual levels. Because the ACL provides valuable information on personality dimensions as well as concurrent levels of distress, it is a particularly promising psychotherapy outcome measure.
Riggs, Sally E; Garrett, Michael; Arnold, Kyle; Colon, Erik; Feldman, Elise N; Huangthaisong, Pongsak; Hyacinthe, Beatrice; Indelicato, Heather-Ayn; Lee, Eunkyung
This report consists of the personal reflections of seven frontline clinicians who participated in a formal training program for the psychotherapy of psychosis implemented in a large public clinic setting. The training was part of a quality improvement initiative, consisting of 12 hours of didactic presentation followed by 30 hours of weekly peer-group supervision. The clinicians comment on ways of working with patients prior to the training, and how their views and techniques changed as a result of the training. The reflections of frontline staff provide proof of the concept that psychotherapy for psychosis techniques can be added to existing clinical skills, and that it is possible to implement a program in psychotherapy for psychosis in a busy public clinic.
Clemens, Norman A; Plakun, Eric M; Lazar, Susan G; Mellman, Lisa
Though psychiatric residents are expected to be competent psychotherapists on graduation, further growth in skill and versatility requires continued experience in their ongoing career. Maturity as a psychotherapist is essential because a psychiatrist is the only mental health provider who, as a physician, can assume full responsibility for biopsychosocial patient care and roles as supervisor, consultant, and team leader. Graduating residents face an environment in which surveys show a steady and alarming decline in practice of psychotherapy by psychiatrists, along with a decline in job satisfaction. High educational debts, practice structures, intrusive management, and reimbursement policies that devalue psychotherapy discourage early career psychiatrists from a practice style that enables providing it. For the early-career psychiatrist there is thus the serious risk of being unable to develop a critical mass of experience or a secure identity as a psychiatric psychotherapist. Implementation of parity laws and the Affordable Care Act (ACA) will affect the situation in unpredictable ways that call for vigilance and active response. Additional service and administrative demands may result from the ACA, creating ethical dilemmas about meeting urgent patient needs versus biopsychosocial standards of care. The authors recommend 1) vigorous advocacy for better payment levels for psychotherapy and freedom from disruptive management; 2) aggressive action against violations of the parity act, 3) active preparation of psychiatric residents for dealing with career choices and the environment for providing psychotherapy in their practice, and 4) post-graduate training in psychotherapy through supervision/consultation, continuing education courses, computer instruction, and distance learning.
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.
Gunn, Heather E.; Troxel, Wendy M.; Hall, Martica; Buysse, Daniel J.
Objective The interpersonal environment is strongly linked to sleep. However, little is known about interpersonal distress and its association with sleep. We examined the associations among interpersonal distress, objective and subjective sleep in people with and without insomnia. Methods Participants in this cross-sectional observational study included men and women with insomnia (n = 28) and good sleeper controls (n = 38). Interpersonal distress was measured with the Inventory of Interpersonal Problems. Sleep parameters included insomnia severity, self-reported presleep arousal, and sleep quality; and polysomnographically-assessed sleep latency (SL), total sleep time (TST), wake after sleep onset (WASO), percent delta (stage 3+4 NREM), percent REM, and EEG beta power. Hierarchical Linear Regression was used to assess the relationship between distress from interpersonal problems and sleep and the extent to which relationships differed among insomnia patients and controls. Results More interpersonal distress was associated with more self-reported arousal and higher percentage of REM. More interpersonal distress was associated with greater insomnia severity and more cognitive presleep arousal for individuals with insomnia, but not for controls. Contrary to expectations, interpersonal distress was associated with shorter sleep latency in the insomnia group. Results were attenuated, but still significant, after adjusting for depression symptoms. Conclusion Distress from interpersonal problems is associated with greater self-reported arousal and higher percent REM. Individuals with insomnia who report more distress from interpersonal problems have greater insomnia severity and cognitive presleep arousal, perhaps due to rumination. These findings extend our knowledge of the association between interpersonal stressors and sleep. Assessment and consideration of interpersonal distress could provide a novel target for insomnia treatment. PMID:24529045
Marks, I M; Hallam, R S; Philpott, R; Connolly, J C
Five registered mental nurses (R.M.N.s) were trained over two years to become behavioural psychotherapists for adult neurotic disorders. They achieved results comparable to those obtained with similar patients and methods by psychologists and psychiatrists. Similar results were maintained when over a third year the therapists were seconded to work in four hospitals and a general practice. Patients were satisfied at being treated by nurses. After initial teething difficulties nurse therapists became valuable members of treatment teams during both training and secondment, becoming accepted by most nurses, psychologists, and psychiatrists with whom they came into contact. The training of further nurse therapists would facilitate treatment of many disabled neurotics who would otherwise go without effective treatment. Training nurse therapists takes less time and money than training psychologists and psychiatrists because less of their education is redundant to the skills involved. The pool of R.M.N.s suitable for training is much larger than that of psychiatrists and psychologists. The nurse therapists can be integrated relatively easily into treatment teams. The present nursing structure imposes restrictions on the advancement of clinical nurse specialists and a clinical tree is badly needed parallel with present administrative and teaching hierarchies. An 18-month course in adult behavioural psychotherapy has been recognized by the Joint Board of Clinical Nursing Studies for England and Wales so that nurse therapists seem destined to be a lasting feature of future treatment teams. PMID:1139262
Ceballos, Angela Milena Gomez; Andrade, Ana Claudia; Markowitz, Talia; Verdeli, Helen
Interpersonal counseling (IPC), a briefer and simplified adaptation of interpersonal psychotherapy (IPT), was used with internally displaced women (IDW) in Bogotá, Colombia, an implementation study of a mental health care pathway funded by Grand Challenges Canada. Preliminary evidence suggests that IPC led to positive outcomes for IDW and may be a feasible first line treatment for displaced women with elevated symptoms of common mental disorders. The case study demonstrates the use of IPC as an intervention to treat depression, anxiety, and posttraumatic stress symptoms in one participant across 11 sessions, from the case formulation through the termination phase.
Bush, Rita Masden; And Others
Most research in psychotherapy has focused on adult clients, while child psychotherapy has been comparatively neglected. To identify predictors of outcome in psychotherapy for children, the relationship between several client, therapist, and economic variables was examined. Subjects were 268 children and their families who had completed treatment…
Ottens, Allen J.; Klein, James F.
The authors show how theoretical and empirical findings from the common factors and psychotherapy integration literatures possess potential for infusing soul into psychotherapy. They describe the term soul, outline how the definition translates into soul-nurturing psychotherapy, examine the common factors and integration literatures, and discuss…
Kaplan, Betty Ann; Venza, James
The Parent-Child Psychotherapy Program (PPP) is a multifamily group therapy intervention for parents and young children at high risk for intergenerational patterns of neglect, abuse, and disorganized attachment. A "developmental and experiential model" that incorporates principles of attachment theory, the PPP addresses parent and child needs…
Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico
This work aimed to evaluate the short-term effectiveness of psychotherapy delivered at the counselling service of the University of Bologna (Italy), by means of a single group longitudinal study including a 6-months follow-up. To this end, sixty-six students completed the 6-months follow-up and filled in the Symptom Questionnaire (SQ) three times,…
Masillo, A; Valmaggia, L R; Saba, R; Brandizzi, M; Lindau, J F; Solfanelli, A; Curto, M; Narilli, F; Telesforo, L; Kotzalidis, G D; Di Pietro, D; D'Alema, M; Girardi, P; Fiori Nastro, P
A personality trait that often elicits poor and uneasy interpersonal relationships is interpersonal sensitivity. The aim of the present study was to explore the relationship between interpersonal sensitivity and psychosocial functioning in individuals at ultra-high risk for psychosis as compared to help-seeking individuals who screened negative for an ultra-high risk of psychosis. A total sample of 147 adolescents and young adult who were help seeking for emerging mental health problems participated in the study. The sample was divided into two groups: 39 individuals who met criteria for an ultra-high-risk mental state (UHR), and 108 (NS). The whole sample completed the Interpersonal Sensitivity Measure (IPSM) and the Global Functioning: Social and Role Scale (GF:SS; GF:RS). Mediation analysis was used to explore whether attenuated negative symptoms mediated the relationship between interpersonal sensitivity and social functioning. Individuals with UHR state showed higher IPSM scores and lower GF:SS and GF:RS scores than NS participants. A statistically negative significant correlation between two IPSM subscales (Interpersonal Awareness and Timidity) and GF:SS was found in both groups. Our results also suggest that the relationship between the aforementioned aspects of interpersonal sensitivity and social functioning was not mediated by negative prodromal symptoms. This study suggests that some aspects of interpersonal sensitivity were associated with low level of social functioning. Assessing and treating interpersonal sensitivity may be a promising therapeutic target to improve social functioning in young help-seeking individuals.
Clemens, Norman A
The author surveys the many forces of change that will have an impact on the practice of psychotherapy in coming years. These include parity, health care reform, federal and state deficits, electronic health records, evidence-based medicine, pay-for-performance, reimbursement issues, and attacks on fee-for-service medicine. Vulnerable aspects of psychotherapy are privacy and confidentiality, individualization and choice of therapy, access to therapy, therapist's choice about participation, denial of coverage based on diagnosis, and sufficient payments to sustain practice. Psychiatric workforce issues may compound the effects. The author identifies some issues calling for vigilance, advocacy, and defense of the key values of psychotherapy and the environment for providing it. (Journal of Psychiatric Practice 2009;15:408-414).
Owen, Jesse; Leach, Mark M; Wampold, Bruce; Rodolfa, Emil
In this rejoinder, the authors address several issues raised by R. L. Worthington and F. R. Dillon (2011) and C. R. Ridley and M. Shaw-Ridley (2011) regarding (a) the measurement of multicultural competencies (MCCs), (b) sampling considerations in multicultural research, and (c) the conceptual frame of multicultural psychotherapy research. The authors challenge the wisdom of exploring MCCs in psychotherapy research and provide a different framework to understand therapists' multicultural effectiveness with clients based on their cultural race/ethnicity. Additionally, the concept of therapists' multicultural orientation or approach is introduced to illuminate the process of aligning with clients about salient cultural issues in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Imel, Zac E; Caperton, Derek D; Tanana, Michael; Atkins, David C
Psychotherapy is on the verge of a technology-inspired revolution. The concurrent maturation of communication, signal processing, and machine learning technologies begs an earnest look at how these technologies may be used to improve the quality of psychotherapy. Here, we discuss 3 research domains where technology is likely to have a significant impact: (1) mechanism and process, (2) training and feedback, and (3) technology-mediated treatment modalities. For each domain, we describe current and forthcoming examples of how new technologies may change established applications. Moreover, for each domain we present research questions that touch on theoretical, systemic, and implementation issues. Ultimately, psychotherapy is a decidedly human endeavor, and thus the application of modern technology to therapy must capitalize on-and enhance-our human capacities as counselors, students, and supervisors. (PsycINFO Database Record
Liggan, Deborah Y.; Kay, Jerald
Ever since the idea was accepted that memory is associated with alterations in synaptic strength, studies on the cellular and molecular mechanisms responsible for the plastic changes in neurons have attracted wide interest in the scientific community. This article explores the process of memory consolidation leading to persistent modifications in synaptic plasticity as a mechanism by which psychotherapy facilitates changes in the permanent storage of information acquired throughout the individual's life. The psychobiological interrelationships of affect, attachment, and memory offer a perspective regarding the etiology and treatment of clinical disturbances of affect. Analogies between brain physiology and modes of psychotherapy provide the foundation for a review of psychiatric disorders involving the inability to control fear, obsessions, compulsions, and delusions, all of which respond to psychotherapeutic interventions.(The Journal of Psychotherapy Practice and Research 1999; 8:103–114) PMID:10079458
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.
Clemens, Norman A
Full parity of health insurance benefits for treatment of mental illness, including substance use disorders, is a major achievement. However, the newly-published regulations implementing the legislation strongly endorse aggressive managed care as a way of containing costs for the new equality of coverage. Reductions in "very long episodes of out-patient care," hospitalization, and provider fees, along with increased utilization, are singled out as achievements of managed care. Medical appropriateness as defined by expert medical panels is to be the basis of authorizing care, though clinicians are familiar with a history of insurance companies' application of "medical necessity" to their own advantage. The regulations do not single out psychotherapy for attention, but long-term psychotherapy geared to the needs of each patient appears to be at risk. The author recommends that the mental health professions strongly advocate for the growing evidence base for psychotherapy including long-term therapy for complex mental disorders; respect for the structure and process of psychotherapy individualized to patients' needs; awareness of the costs of aggressive managed care in terms of money, time, administrative burden, and interference with the therapy; and recognition of the extensive training and experience required to provide psychotherapy as well as the stresses and demands of the work. Parity in out-of-network benefits could lead to aggressive management of care given by non-network practitioners. Since a large percentage of psychiatrists and other mental health professionals stay out of networks, implementation of parity for out-of-network providers will have to be done in a way that respects the conditions under which they would be willing and able to provide services, especially psychotherapy, to insured patients. The shortage of psychiatrists makes this an important access issue for the insured population in need of care.
Roussos, Andrés J; Braun, Malena; Duarte, Adela Leibovich de
The ethical practices of psychotherapy researchers in Latin America were surveyed online. Of the 114 psychotherapy researchers to whom the survey was sent, 76 responded (67% response rate). Seventy-seven percent of the respondents had not received formal training in research ethics, yet 84% indicated that formal training is useful for the prevention of scientific misbehavior. Researchers admitted to various ethically questionable practices, the most common of which were related to authorship. None reported having fabricated or falsified data. The need for adequate training and evaluation of research projects is addressed.
Naccarato, A M E P; Reis, L O; Ferreira, U; Denardi, F
The aim of this study was to evaluate the impact of group psychotherapy and the use of a phosphodiesterase-5 inhibitor (PDE-5i) in the early rehabilitation stage of patients with prostate cancer undergoing radical prostatectomy (RP). Fifty-six patients undergoing RP for prostate cancer were randomised into four groups, and 53 completed the protocol: Group 1 - control (n = 11), Group 2 - group psychotherapy (n = 16), Group 3 - lodenafil 80 mg/one tablet per week (n = 12) and Group 4 - group psychotherapy + lodenafil 80 mg/one tablet per week (n = 14). The groups were individually evaluated for erectile function (IIEF-5) and quality of life - QoL (SF-36) weekly, with two meetings held a week apart before the RP and 12 weekly meetings after surgery. The ages ranged from 39 to 76 years, average 61.84. There were no significant medication side effects. Only Group 4 showed improvement in intimacy with a partner and satisfaction with their sex life (P = 0.045 and P = 0.013 respectively), and with no significant worsening of the IIEF-5 (P = 0.250) reported. All groups showed worsening in the final result of the role limitations caused by physical problems (P = 0.009) and role limitations caused by emotional problems (P = 0.002) of the SF-36, but Group 4 had a significantly higher score for the role limitations caused by physical problems (P = 0.009) than the other groups. In conclusion, precocious integral treatment involving group psychotherapy and PDE-5i before and after RP led to less deterioration of erectile function and other domains related to physical aspects (SF-36), with improvement in intimacy with their partner and satisfaction in their sex life, being superior to single treatments.
Lewis, Marilyn W.; Cavanagh, Paul K.; Ahn, Grace; Yoshioka, Marianne R.
Prior history of trauma may sensitize individuals to subsequent trauma, including terrorist attacks. Using a convenience sample of secondary, cross-sectional data, pregnant women were grouped based on lifetime interpersonal violence history. Cumulative risk theory was used to evaluate the association of lifetime interpersonal violence history and…
Kubey, Robert W.; Peluso, Thea
Describes a diffusion study that examined how a group of college students learned about the explosion of the Space Shuttle Challenger, and how they employed interpersonal exchanges and the media to cope with the news. The relationship between mass and interpersonal communication is discussed, and future studies are suggested. (19 references) (LRW)
Poulin, John E.
Compared the interpersonal involvement and morale of elderly persons residing in the community (N=154) and senior citizen housing (N=78). The senior housing residents had slightly larger and more supportive interpersonal networks but less contact with their closest friends. No differences were found in the two housing groups' life satisfaction.…
Proctor, Russell F., II; Adler, Ronald B.
Outlines a rationale, resources, and suggestions for teaching interpersonal communication with feature films. Includes a table of 72 widely available feature films and the interpersonal communication topics illustrated in each one. (SR)
Sharma, Vibhash D.; Jones, Randi; Factor, Stewart A.
Objective As the literature for the treatment of functional (psychogenic) movement disorders (FMD) is sparse, we assessed clinical outcomes in patients with FMD who underwent treatment with psychodynamic psychotherapy (PDP). Methods A retrospective analysis of the data of patients with FMD who were referred for PDP from 2008−2014 at Emory University Medical Center was performed. Results Thirty patients were included, mean age at presentation was 50 years (SD 13.9) and majority were female (27/30). Most common movement disorder was involuntary shaking/jerky movements (50%) and tremor (43%). Mean duration of symptoms was 3.2 years and mean number of PDP visits was 4.9. PDP lead to good outcomes in 10, modest in 8, and poor in 9. Three patients lost to follow up. Mean duration of symptoms between two groups (good vs. poor) was not statistically significant (p = 0.11), mean number of PDP visits showed a trend towards significance (p = 0.053). In all cases of good outcomes precipitants of the movement disorder were identified and a majority (60%) was receptive of the diagnosis and had good insight. Conclusion PDP lead to improvement in 60% of the patients which is encouraging as the treatment is challenging. This study supports heterogeneous causes of FMD including varied roles of past/recent events and demonstrates importance of psychological approaches such as PDP. Treatment with PDP should be considered in some patients with FMD but predicting who will respond remains a challenge. Further long term prospective studies with large sample size and placebo control are needed. PMID:28122424
Cultural knowledge is critical, but in the absence of interpersonal skills and rapport it is of little practical value. From this perspective , the...often in delicate positions that could be politically explosive. Interpersonal performance can be a critical component of success in these...tracking interpersonal performance would be useful to counter this dearth. The goal of this project was to develop a DVD-based interpersonal skill
Lenze, Shannon N.; Cyranowski, Jill M.; Thompson, Wesley K.; Anderson, Barbara; Frank, Ellen
Although much research has focused on the role of severe life events as risk factors for depression onset, less is known about the relationship between nonsevere life events and depression recurrence. The current study examined the cumulative effects of nonsevere and positive life events on depression recurrence in an outpatient sample of…
Gelo, Omar Carlo Gioacchino; Salvatore, Sergio
Notwithstanding the many methodological advances made in the field of psychotherapy research, at present a metatheoretical, school-independent framework to explain psychotherapy change processes taking into account their dynamic and complex nature is still lacking. Over the last years, several authors have suggested that a dynamic systems (DS) approach might provide such a framework. In the present paper, we review the main characteristics of a DS approach to psychotherapy. After an overview of the general principles of the DS approach, we describe the extent to which psychotherapy can be considered as a self-organizing open complex system, whose developmental change processes are described in terms of a dialectic dynamics between stability and change over time. Empirical evidence in support of this conceptualization is provided and discussed. Finally, we propose a research design strategy for the empirical investigation of psychotherapy from a DS approach, together with a research case example. We conclude that a DS approach may provide a metatheoretical, school-independent framework allowing us to constructively rethink and enhance the way we conceptualize and empirically investigate psychotherapy. (PsycINFO Database Record
In 1982, the first and only discussion of psychotherapy cults appeared in the literature. Temerlin and Temerlin (1982) studied five "bizarre" groups which were formed when five practitioners of psychotherapy simultaneously served as friends, lovers, relatives, employers, colleagues, and teachers, all to patients who were themselves mental health professionals. In choosing the term "psychotherapy cult," the authors have noted similarities of the groups they reviewed to some religious cults, citing the three definitions of the "cult" in Webster's 1966 Third New International Dictionary: (1) a system for the cure of disease based on the dogma, tenets or principles set forth by its promulgator to the exclusion of scientific experience or demonstration, (2) great or excessive dedication to some person, idea or organization, (3) a religion or mystic regarded as mysterious or unorthodox. The psychotherapy cults studied by Temerlin and Temerlin varied from 15 to 75 mental health professionals held together by their idealization of a shared therapist and the activities which they conducted jointly: workshops, seminars, courses, businesses, professional ventures, and social life. As patients became more involved in the social and personal life of their therapists, they gradually withdrew from all friends and family, becoming increasingly dependent on the therapist and their new "siblings." Upon joining the group, many patients felt a sense of being loved and belongingness. The authors described the "cognitive pathology" of idiosyncratic group jargon which served to maintain an illusion of knowledge, sophistication, and personal growth, while removing all ambivalence and uncertainty. The authors concluded that psychotherapy cult membership is an iatrogenically determined negative effect of psychotherapy. Of the former cult members they interviewed, most had perceived themselves as deteriorating or at an impasse, or had experienced disillusionment with their therapists
Educators are continuously faced with a wide range of communication challenges. Only by self-examining one's own approaches to interpersonal communication and being willing to improve can one put better communication to work in meeting those challenges--whether they are part of one's personal or professional life. Four principles are addressed…
Street, Richard L., Jr.; Murphy, Thomas L.
Indicates that (1) males with low interpersonal orientation (IO) were least vocally active and expressive and least consistent in their speech performances, and (2) high IO males and low IO females tended to demonstrate greater speech convergence than either low IO males or high IO females. (JD)
Weber, Mark J.
The goal of our lesson in this module is for you to become acquainted with the importance of es- tablishing and maintaining a shared vision of positive professional interpersonal relationship practices among all stakeholders on your campus. This module introduces the use of administrative tools designed to help you document and measure progress…
Alden, Lynn E.; Bieling, Peter M.
Numerous studies have suggested that depression and social anxiety are associated with perfectionism. The present study examines how self-oriented perfectionism and socially-prescribed perfectionism influence cognitive reactions to an interpersonal interaction. Undergraduate women (n=90) completed the Multidimensional Perfectionism Scale, the Beck…
Van Orden, Kimberly A.; Witte, Tracy K.; Cukrowicz, Kelly C.; Braithwaite, Scott R.; Selby, Edward A.; Joiner, Thomas E., Jr.
Suicidal behavior is a major problem worldwide and, at the same time, has received relatively little empirical attention. This relative lack of empirical attention may be due in part to a relative absence of theory development regarding suicidal behavior. The current article presents the interpersonal theory of suicidal behavior. We propose that…
Bayes, Marjorie A.
The results of this study suggest, first, that interpersonal warmth does seem to be a personality dimension which can be reliably judged and, second, that it was possible to define and demonstrate the relevance of a number of behavioral cues for warmth. (Author)
RTO-MP-HFM-202 7 - 1 Interpersonal Influence in Cross-Cultural Interactions D.A. van Hemert TNO Defence, Security and Safety Human...and the target audiences could have a negative impact upon influencing activities. To achieve effective interpersonal interactions in cross-cultural...military operations, insight is needed into determinants of successful interpersonal interactions. This paper discusses a generic theoretical
The purpose of this study is to examine the relationships between self-compassion and interpersonal cognitive distortions. Participants were 338 university students. In this study, the Self-compassion Scale and the Interpersonal Cognitive Distortions Scale were used. The relationships between self-compassion and interpersonal cognitive distortions…
Gans, Jerome S
Although what transpires in group therapy is not gossip per se-except perhaps when absent or former members are discussed-listening to group interaction through an understanding of the dynamics of gossip can contribute to a greater appreciation of group dynamics and group leadership as well as enlarge therapeutic space. After examining the interpersonal dynamics of gossip, this paper discusses six ways in which an understanding of these dynamics can inform group leadership and shed light on group psychotherapy. Central features of gossip that appear in group interactions are explored: These include projection, displacement, self-esteem regulation, clarification of motivation, unself-consciousness, social comparison and bonding, avoidance of psychic pain, and making the ego-syntonic dystonic. The lively use of imagination in the mature phase of group therapy is conceived of as the time when the darker side of human nature-imagined gossip harnessed for therapeutic purposes-can be welcomed in and processed in a kind, playful, and compassionate manner.
Knekt, Paul; Saari, Taru; Lindfors, Olavi
Intelligence has been suggested as a suitability factor for short-term therapy whereas its possible effect on short-term versus long-term therapy still is unknown. The aim of this study was to compare the prediction of intelligence on the level of psychiatric symptoms and psychosocial functioning in psychotherapies of different lengths. A total of 251 outpatients from the Helsinki Psychotherapy Study, aged 20–46 years, and suffering from mood or anxiety disorders were allocated to two long-term and two short-term therapies. Intelligence was assessed at baseline with the Wechsler Adult Intelligence Scale (WAIS-R). Psychiatric symptoms and psychosocial functioning were assessed 5–10 times during a 5-year follow-up using two primary symptom measures (HDRS and HARS) and one primary measure of psychosocial functioning (GAF). Short-term therapy was more effective than long-term therapy during the first year of follow-up. During the second to fourth follow-up year no differences between short- and long-term therapies or the intelligence groups were found. At the fifth follow-up year, however, long-term psychotherapy showed a statistically significantly larger change in all three primary measures compared to short-term therapy among those with higher intelligence. No differences between therapy groups were noted in those with lower intelligence. People with higher intelligence may benefit more from long-term than from short-term psychotherapy. These findings should be confirmed.
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…
Leva, Richard A.
The views of Carl Rogers and Milton H. Erickson are combined in this book on psychotherapy. The first section focuses on belief systems, views of man, new views of the unconscious, and a philosophy for change. Erickson and his relationship to myth, the nature of man and the goal of counseling, trance, and a radical view of the unconscious are…
Dembo, Justine Sarah; Clemens, Norman A
The instillation of hope is a common factor in most psychotherapies. A considerable literature exists on the ethics of providing false or positively biased hope in non-psychiatric medical settings, and ethicists have generally concluded that this practice is unethical. However, the literature on the ethics of encouraging hope in psychotherapy, especially in the case of treatment-resistant mental illness, is sparse. The author explores two clinical cases with the intention of examining the nature of hope, false hope, positive illusions, and denial, as they relate to our definitions of mental health and psychotherapy. The cases highlight the ethics of balancing an acknowledgment of likely treatment futility with a desire to hope. Clinical psychological studies on depressive realism and optimistic bias indicate that some degree of positive bias, referred to by some authors as "the optimal margin of illusion," is in fact necessary to promote what we define as "good mental health;" conversely, stark realism is correlated with mild to moderate depression. An examination of the existential literature, including Ernest Becker's work, The Denial of Death, indicates that without the defense mechanism of denial, human beings tend to experience paralytic despair as a result of being fallible, mortal creatures in a frightening world. The combination of these diverse bodies of literature, along with the surprising outcomes of our case examples, leads to an unexpected conclusion: it may occasionally be ethical to encourage some degree of optimistic bias, and perhaps even positive illusion, when treating patients in psychotherapy.
Jones, David P. H.
One approach to individual psychotherapy includes a five-part conceptualization of the traumatic experience: trauma, threat to ontogeny, neglect and emotional unavailability by the caregiver, child's feeling of exploitation, and the child's adaptation. Some common problems which occur are guilt, loss and anger, as well as alterations in the…
American Journal of Play, 2014
Terry Marks-Tarlow is a clinical and consulting psychologist and psychotherapist and a member of the teaching faculty at the Reiss Davis Child Study Center in Los Angeles. She is the author of "Awakening Clinical Intuition: An Experiential Workbook for Psychotherapists"; "Psyche's Veil: Psychotherapy, Fractals, and…
Functional analytic psychotherapy (FAP) is defined as behavior-analytically conceptualized talk therapy. In contrast to the technique-oriented educational format of cognitive behavior therapy and the use of structural mediational models, FAP depends on the functional analysis of the moment-to-moment stream of interactions between client and…
Barlow, David H.
In this article, the author responds to a set of comments on his original article, "Psychological Treatments." The author responds to each comment. Hal Arkowitz (2005) misread the proposed distinction between "psychological treatments" and "psychotherapy" by presuming that the author was implying that the former is evidence based and the latter is…
Schachter, Robert S.
Kinetic Psychotherapy consists of young children's games which facilitate interaction and mobilize feelings. When used as a mode of family therapy, this process enables the therapist to catalize and observe change in the family's patterns of communication, interaction, and level of functioning while involving members in a relatively nonthreatening…
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…
Roseborough, David John; McLeod, Jeffrey T.; Wright, Florence I.
Purpose: Attrition is a common problem in psychotherapy and can be defined as clients ending treatment before achieving an optimal response. Method: This longitudinal, archival study utilized data for 3,728 clients, using the Outcome Questionnaire 45.2. A Cox regression proportional hazards (hazard ratios) model was used in order to better…
Entin, Alan D.
Photographs and family albums are helpful in marriage and family psychotherapy to aid in the understanding of family processes, relationship patterns, goals, expectations, values, traditions, and ideals. Based on the assumption that a photograph is a form of communication, photography can be used to: (1) examine typical family picture-taking…
Swift, Joshua K.; Callahan, Jennifer L.
Delay discounting (DD) procedures are emerging as an important new method for psychotherapy researchers. In this paper a framework for conceptualizing existing, seemingly discrepant, research findings on termination is introduced and new directions for research are described. To illustrate the value of a DD framework, the common psychotherapy…
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…
Owen, Jesse; Leach, Mark M.; Wampold, Bruce; Rodolfa, Emil
In this rejoinder, the authors address several issues raised by R. L. Worthington and F. R. Dillon (2011) and C. R. Ridley and M. Shaw-Ridley (2011) regarding (a) the measurement of multicultural competencies (MCCs), (b) sampling considerations in multicultural research, and (c) the conceptual frame of multicultural psychotherapy research. The…
Wilk, Carole A.
This paper provides a personal account of the process of psychotherapy for Acquired Immune Deficiency Syndrome (AIDS) patients, as seen from both the client's and the psychotherapist's perspective, with a focus on countertransference issues found in the early phases of treatment. Based on case material, the discussion explores themes presented by…
Garcia, Rafael Ferro
Functional Analytic Psychotherapy (FAP), based on the principles of radical behaviorism, emphasizes the impact of eventualities that occur during therapeutic sessions, the therapist-client interaction context, functional equivalence between environments, natural reinforcement and shaping by the therapist. This paper reviews recent studies of FAP…
Lukowitsky, Mark R; Pincus, Aaron L
Impairments in self and interpersonal functioning are core features of personality pathology. Clinical theory and research indicate that compromised self-awareness and distorted interpersonal perceptions are particularly prominent in individuals exhibiting pathological narcissism and Narcissistic Personality Disorder. Therefore we conducted a study to gain a better understanding of interpersonal perception of pathological narcissism. A large sample (N=437) of moderately acquainted individuals assigned to 1 of 93 small mixed-sex groups completed self- and informant ratings on the Pathological Narcissism Inventory (PNI) in a round-robin design. The social relations model (SRM) was used to partition the variance in dyadic ratings to investigate several hypotheses about interpersonal perception of pathological narcissism. SRM analyses demonstrated evidence of assimilation (the tendency to perceive and rate others similarly) and consensus (the extent to which multiple observers form similar impressions of another person) in interpersonal perception of pathological narcissism. Results also indicated modest self-other agreement and assumed similarity (the tendency for people to perceive others as similar to themselves) for PNI higher order factors and subscale ratings. Finally, results suggested that individuals high in pathological narcissism had some awareness of how peers would rate them (metaperception) but believed that others would rate them similarly to how they rated themselves.
Background Suicidal and violent behaviours are interlinked and share common biological underpinnings. In the present study we analysed the association between violent behaviour as a child, childhood trauma, adult psychiatric illness, and substance abuse in relation to interpersonal violence as an adult in suicide attempters with mood disorders. Methods A total of 161 suicide attempters were diagnosed with Structured Clinical Interviews and assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6-14 years of age) and during adult life (15 years or older). Ninety five healthy volunteers were used as a comparison group. A logistic regression analysis was conducted with the two KIVS subscales, expressed violent behaviour as a child and exposure to violence in childhood together with substance abuse, personality disorder diagnoses and age as possible predictors of adult interpersonal violence in suicide attempters. Results Violent behaviour as a child, age and substance abuse were significant predictors of adult interpersonal violence. ROC analysis for the prediction model for adult violence with the KIVS subscale expressed violence as a child gave an AUC of 0.79. Using two predictors: violent behaviour as a child and substance abuse diagnosis gave an AUC of 0.84. The optimal cut-off for the KIVS subscale expressed violence as a child was higher for male suicide attempters. Conclusions Violent behaviour in childhood and substance abuse are important risk factors for adult interpersonal violent behaviour in suicide attempters. PMID:25001499
Waters, Hugh Richard; Hyder, Adnan Ali; Rajkotia, Yogesh; Basu, Suprotik; Butchart, Alexander
This article reviews evidence of the economic impact of interpersonal violence internationally. In the United States, estimates of the costs of interpersonal violence reach 3.3% of GDP. The public sector-and thus society in general-bears the majority of these costs. Interpersonal violence is defined to include violence between family members and intimate partners, and violence between acquaintances and strangers that is not intended to further the aims of any formally defined group or cause. Although these types of violence disproportionately affect poorer countries, there is a scarcity of studies of their economic impact in these countries. International comparisons are complicated by the calculation of economic losses based on foregone wages and income, thus undervaluing economic losses in poorer countries.
Wallen, John L.
This appendix contains descriptions of three exercises designed to develop basic communications skills for improving interpersonal relations. Each exercise--designed to be engaged in by teachers in dyads, triads, quadruples, or similar groups without the presence of a skilled leader--includes a statement of the problem, description of the skill…
Eckloff, Maurine C.; Petelle, John
The purpose of this study was to investigate the effects of cognitive abstractness levels, interpersonal perception abilities, and task type (factual or social problem solving) on group performance as measured by time consumed and adequacy of solutions. Eighteen college classes from Kearney State College participated in testing of perceptual…
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
Locke, Geoffrey W.; Shilkret, Robert; Everett, Joyce E.; Petry, Nancy M.
Background Interpersonal guilt is associated with psychopathology, but its relationship to pathological gambling has not been studied. Objectives This study examined the relationship between interpersonal guilt and pathological gambling. Methods In total, 1,979 college students completed a questionnaire containing the South Oaks Gambling Screen, Interpersonal Guilt Questionnaire, and questions about substance use. Students identified as pathological gamblers (n = 145) were matched to non-problem gamblers with respect to demographics and substance use. Results Pathological gamblers had significantly higher interpersonal guilt than their non-problem gambling peers. Conclusions and Scientific Significance Pathological gambling college students have excessive interpersonal guilt, and these findings may lead to novel treatment approaches. PMID:22746179
Gibbons, Mary Beth Connolly; Thompson, Sarah M.; Mack, Rachel A.; Lee, Jacqueline K.; Crits-Christoph, Paul
Objective We explored whether patients with varied levels of baseline deficits in compensatory skills and self-understanding had different outcomes across cognitive and dynamic therapies. Method The assessment battery was administered at intake and termination (N=97; 66% female, 81% Caucasian). We conducted regression analyses predicting symptom change from baseline levels of self-understanding and compensatory skills. We also evaluated the interaction between baseline skill levels and treatment condition in the prediction of psychotherapy outcome. Results There was a significant interaction between treatment group and baseline compensatory skills in the prediction of HAMD symptom change, F(1,76) = 4.59, p = .035. Baseline deficits in compensatory skills were significantly related to symptom change for patients who received cognitive treatment, ηρ = .40, p = .037, while baseline levels of self-understanding were not significantly predictive of treatment outcome in either condition. Baseline skill variables did not predict symptom change as measured by the HAMA. Conclusions The findings support a capitalization model of cognitive therapy, whereby patients with relative strengths in compensatory skills at baseline have better treatment outcomes. PMID:25779087
In this review, the author theoretically and empirically examined motives and interpersonal functions of aggression. A factor-analysis of Averill's questionnaire items on anger revealed that motives involved in aggressive responses were clustered into two groups: the hostile and the instrumental. It was also clarified that an individual is likely to engage in aggression particularly when some hostile motives are evoked. Concerning the interpersonal functions, the author proposed that aggression might serve four principal goals. (1) Aggression can be generated as an avoidance response to an aversive stimulus, such as frustration, annoyance, or pain, and so on. It depends on the severity of the stimulus. It was however emphasized that aggression is also mediated by social cognition, such as an attribution of intent to a harm-doer. (2) Aggression can be used as a means of coercing the other person into doing something. An individual is likely to use such a power strategy if he/she is lacking in self-confidence or a perspective for influencing the target person by more peaceful strategies. (3) Aggression can be interpreted as a punishment when it is directed toward a transgressor. In this case, aggression is motivated by restoration of a social justice, and thus its intensity is determined by the perceived moral responsibility of the transgressor. Further, it was indicated that aggression is intensified if it is justified as a sanctional conduct against the immoral. (4) Aggression can be also evoked when an individual's social identity is threatened. It was suggested that impression management motives are involved in aggression by an unexpected finding that the presence of audience or the identifiability rather facilitated retaliative aggression. The aggression-inhibition effect of apology was also explained in terms of impression management. In conclusion, it was presented that aggression is a behavioral strategy as an attempt to resolve interpersonal conflicts
Jordan, Kevin D; Foster, Penni Smith
Attention to interpersonal behaviors, communication, and relational factors is taking on increasing importance in medical education. Medical student empathy is one aspect of the physician-patient relationship that is often involved in beneficial interactions leading to improved clinical outcomes and patient satisfaction. As an interpersonal quality, empathy is a social behavior well-suited to be examined from an interpersonal perspective. The present study used the interpersonal theory of clinical, personality, and social psychology to examine the construct of empathy and theorize about likely interpersonal correlates. One hundred and sixty-three students from an academic health center in the southeastern United States participated in this study. The medical student version of the Jefferson Scale of Empathy was used to assess empathy and its factors: Perspective taking, compassionate care, and walking in the patient's shoes. Interpersonal assessments included the International Personality Item Pool-Interpersonal Circumplex, the Interpersonal Support Evaluation List, and the UCLA Loneliness Scale. Distinct interpersonal styles and correlates emerged among empathy and its factors. While all factors of empathy were related to interpersonal warmth, perspective taking and compassionate care were also associated with submissiveness. Of note, only walking in the patient's shoes was correlated with both social support and less loneliness. These findings are discussed in light of interpersonal theory with particular attention paid to the implications for medical education and professional development.
Follette, William C; Bonow, Jordan T
Whether explicitly acknowledged or not, behavior-analytic principles are at the heart of most, if not all, empirically supported therapies. However, the change process in psychotherapy is only now being rigorously studied. Functional analytic psychotherapy (FAP; Kohlenberg & Tsai, 1991; Tsai et al., 2009) explicitly identifies behavioral-change principles used to bring about therapeutic improvements in adult outpatients whose clinical problems stem from ineffective interpersonal repertoires. These principles include contingent responding to behavioral excesses and deficits by a therapist who has established him- or herself as a salient source of social reinforcement. Empirical support for FAP is emerging, but a variety of pragmatic and theoretical questions warrant investigation. Among the issues described in this paper are the training and dissemination of procedures for how to conduct a functional analysis, how to train therapists to identify functional stimulus classes, how to best address decreasing problem behavior without creating an aversive environment, how to enhance generalization, and how to account for the principle of equifinality when trying to specify therapeutic procedures. These and other issues stem largely from trying to disseminate a behavioral principle-based intervention rather than a topographically specified intervention. These issues present challenges and research opportunities for applied clinical behavior analysts if they wish to extend their science to address clinical issues important to the treatment of adult outpatients with normal intellectual functioning. PMID:22478517
Braun, Sarah R.; Gregor, Bettina; Tran, Ulrich S.
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. PMID:23840824
Group supervision was initiated in order to meet the training needs of psychiatric postgraduates. The experience of the group was surveyed at the end of one year. It was found that the use of groups as an adjunct to individual supervision was an eminently practical and acceptable method of facilitating training, accessing peer group support and auditing clinical care. PMID:21407927
Reynolds, Shirley; Wilson, Charlotte; Austin, Joanne; Hooper, Lee
This paper provides a comprehensive quantitative review of high quality randomized controlled trials of psychological therapies for anxiety disorders in children and young people. Using a systematic search for randomized controlled trials which included a control condition and reported data suitable for meta-analysis, 55 studies were included. Eligible studies were rated for methodological quality and outcome data were extracted and analyzed using standard methods. Trial quality was variable, many studies were underpowered and adverse effects were rarely assessed; however, quality ratings were higher for more recently published studies. Most trials evaluated cognitive behavior therapy or behavior therapy and most recruited both children and adolescents. Psychological therapy for anxiety in children and young people was moderately effective overall, but effect sizes were small to medium when psychological therapy was compared to an active control condition. The effect size for non-CBT interventions was not significant. Parental involvement in therapy was not associated with differential effectiveness. Treatment targeted at specific anxiety disorders, individual psychotherapy, and psychotherapy with older children and adolescents had effect sizes which were larger than effect sizes for treatments targeting a range of anxiety disorders, group psychotherapy, and psychotherapy with younger children. Few studies included an effective follow-up. Future studies should follow CONSORT reporting standards, be adequately powered, and assess follow-up. Research trials are unlikely to address all important clinical questions around treatment delivery. Thus, careful assessment and formulation will remain an essential part of successful psychological treatment for anxiety in children and young people.
Ribeiro, Maria Inês Lemos Coelho; Pedrão, Luiz Jorge
Studies on the theme concerning interpersonal relationship in technical nursing are scarce or non-existent However, since this professional category has an expressive number of representatives who deliver various types of direct care to patients, it needs theoretical and pratical contents. This study aimed at investigating how the content related to this theme is addressed among the teachers of a technical school, its importance to students and its aplicability by professionals in this level. To that end, questionnaires were used. The results showed interpersonal relationship as fundamental; however; its routine applicability is not clear. This leads to the conclusion that there are difficulties to identify the real content given, thus difficulty is also supposed to exist in to put it into practice.
While recent studies suggest that psychotherapy has little impact on recidivism, these studies are far from conclusive and they tell us little about the ultimate value of psychotherapy in the correctional setting. Aside from the issue of recidivism, psychotherapy in prison has many practical and humanistic advantages. The incarcerated offender may seek psychotherapy because of motivations that are totally unrelated to the issue of release. It is useful to consider psychotherapy of incarcerated offenders in terms of the relevance of helping factors that are critical to all types of psychotherapy. Some of these factors have less therapeutic influence in the prison setting than in the free world. Certain factors such as tension reduction and the learning of new behaviors probably have a greater therapeutic affect in the prison setting.
Perry, Anat; Levy-Gigi, Einat; Richter-Levin, Gal; Shamay-Tsoory, Simone G
An inherent feature of social interactions is the use of social space or interpersonal distance-the space between one individual and another. Because social deficits are core symptoms of Autistic Spectrum Disorder (ASD), we hypothesized that individuals on this spectrum will exhibit abnormal interpersonal distance preferences. The literature on interpersonal distance in ASD is not conclusive. While some studies show preferences for closer distances among this group, others show preferences for farther distances than controls. A common symptom of ASD that may explain the variance in responses to interpersonal distance in this population is social anxiety (SA), which has been shown to correlate with interpersonal distance preferences. In the current study, we investigated interpersonal distance preferences in a group of individuals with ASD using both behavioral and ERP measures. We found greater variance in interpersonal distance preferences in the ASD group than in the control group. Furthermore, we showed that this variance can be explained by differences in SA level and can be predicted by the N1 amplitude, an early ERP component related to attention and discrimination processes. These results hint at the early sensory and attentional processes that may be affecting higher social behaviors, both in subclinical and in clinical populations.
Dawood, Sindes; Thomas, Katherine M.; Wright, Aidan G.C.; Hopwood, Christopher J.
This study extended previous theory and research on interpersonal heterogeneity in depression by identifying groups of depressed young adults who differ in their type and degree of interpersonal problems, and by examining patterns of pathological personality traits and alcohol abuse among these groups. We examined the interpersonal problems, personality traits, and alcohol-related problems of 172 college students with at least moderate levels of self-reported depression on the Patient Health Questionnaire (Spitzer, Kroenke, & Williams, 1999). Scores from the Inventory of Interpersonal Problems – Short Circumplex (Soldz, Budman, Demby, & Merry, 1995) were subjected to latent profile analysis, which classified individuals into five distinct groups defined by the types of interpersonal problems they experience (dominant, warm, submissive, cold, and undifferentiated). As hypothesized, groups did not differ in depression severity, but did show predicted patterns of differences on normative and maladaptive personality traits, as well as alcohol-related problems. The presence of clinically meaningful interpersonal heterogeneity in depression may have important implications for designing more individualized treatments and prevention efforts for depression that target diverse associated interpersonal problems. PMID:23560433
Laberke, Patrick J; Martinez, Rosa Maria; Mauf, Sabrina; Bartsch, Christine
Interpersonal violence represents a widespread phenomenon with a high prevalence. Consequences of these acts of violence are serious and extensive to the victims and from a socio-economic point of view. Physical examination of the victims is a key aspect in the medic-legal expertise. This article describes the basic principles and the standard procedures in conjunction with the examination of violent crime victims.
Swanson, J. G.
To determine how family physicians perceive the support they get for psychotherapy and counseling, we surveyed a random sample of Ontario College of Family Physicians members. Of 100 physicians who had family medicine residency training with psychotherapy experience, 43% indicated that such training was inadequate for their current needs. Because family physicians often provide psychotherapy and counseling, their training should reflect the needs found in practice. PMID:8080505
Callender, J S
Psychotherapy is an activity which takes many forms and which has many aims. The present paper argues that it can be viewed as a form of moral suasion. Kant's concepts of free will and ethics are described and these are then applied to the processes and outcome of psychotherapy. It is argued that his ideas, by linking rationality, free will and ethics into a single philosophical system, offer a valuable theoretical framework for thinking about aims and ethical issues in psychotherapy. PMID:9752632
Plakun, Eric M
Psychotherapy and psychosocial treatment have been shown to be effective forms of treatment of a range of individual and complex comorbid disorders. The future role of psychotherapy and psychosocial treatment depends on several factors, including full implementation of mental health parity, correction of underlying false assumptions that shape treatment, payment priorities and research, identification and teaching of common factors or elements shared by effective psychosocial therapies, and adequate teaching of psychotherapy and psychosocial treatment.
Callender, J S
Psychotherapy is an activity which takes many forms and which has many aims. The present paper argues that it can be viewed as a form of moral suasion. Kant's concepts of free will and ethics are described and these are then applied to the processes and outcome of psychotherapy. It is argued that his ideas, by linking rationality, free will and ethics into a single philosophical system, offer a valuable theoretical framework for thinking about aims and ethical issues in psychotherapy.
Lipsitz, Joshua D.; Markowitz, John C.
Although interpersonal therapy (IPT) has demonstrated efficacy for mood and other disorders, little is known about how IPT works. We present interpersonal change mechanisms that we hypothesize account for symptom change in IPT. IPT’s interpersonal model integrates both relational theory, building on work by Sullivan, Bowlby, and others, and insights based on research findings regarding stress, social support, and illness to highlight contextual factors thought to precipitate and maintain psychiatric disorders. IPT frames therapy around a central interpersonal problem in the patient’s life, a current crisis or relational predicament that is disrupting social support and increasing interpersonal stress. By mobilizing and working collaboratively with the patient to resolve (better manage or negotiate) this problem, IPT seeks to activate several interpersonal change mechanisms. These include: 1) enhancing social support, 2) decreasing interpersonal stress, 3) facilitating emotional processing, and 4) improving interpersonal skills. We hope that articulating these mechanisms will help therapists to formulate cases and better maintain focus within an IPT framework. We propose interpersonal mechanisms that might explain how IPT’s interpersonal focus leads to symptom change. Future work needs to specify and test candidate mediators in clinical trials of IPT. We anticipate that pursuing this more systematic strategy will lead to important refinements and improvements in IPT and enhance its application in a range of clinical populations. PMID:24100081
Eysenck, H J
This reprinted article originally appeared in Psychotherapy: Theory, Research, & Practice, 1964(MONTH), 1(3), 97-100. (The following abstract of the original article appeared in record 1966-01631-001). Comments on the original article by H. H. Strupp (see record 1965-15636-001). In his recent article in this journal, Strupp (1963) has this to say in relation to the outcome problem in psychotherapy: "A brief review of Eysenck's (1952) widely quoted survey, which capitalized upon and added considerably to the existing confusion may be instructive." In reply I would like to suggest that Strupp's review is, in the lawyer's phrase, irrelevant, incompetent and immaterial. Fortunately, the points I wish to make are so simple that they will not take up much space.
Pincus, Aaron L; Cain, Nicole M; Wright, Aidan G C
This article briefly summarizes the empirical and clinical literature underlying a contemporary clinical model of pathological narcissism. Unlike the DSM Narcissistic Personality Disorder (NPD), this clinical model identifies and differentiates between two phenotypic themes of dysfunction-narcissistic grandiosity and narcissistic vulnerability-that can be expressed both overtly and covertly in patients' ways of thinking, feeling, behaving, and participating in treatment. Clinical recognition that narcissistic patients can and often do present for psychotherapy in vulnerable states of depression, anxiety, shame, and even suicidality increases the likelihood of accurate diagnosis and effective treatment planning. This article provides case examples derived from psychotherapies with narcissistic patients to demonstrate how narcissistic grandiosity and narcissistic vulnerability concurrently present in patients who seek treatment.
Short-term dynamic therapies, characterized by abbreviated lengths (10–40 sessions) and, in many cases, preset termination dates, have become more widespread in the past three decades. Short-term therapies are based on rapid psychodynamic diagnosis, a therapeutic focus, a rapidly formed therapeutic alliance, awareness of termination and separation processes, and the directive stance of the therapist. The emotional storm of adolescence, stemming from both developmental and psychopathological sources, leaves many adolescents in need of psychotherapy. Many adolescents in need of therapy resist long-term attachment and involvement in an ambiguous relationship, which they experience as a threat to their emerging sense of independence and separateness. Short-term dynamic therapy can be the treatment of choice for many adolescents because it minimizes these threats and is more responsive to their developmental needs. The article presents treatment and follow-up of a 17-year-old youth, using James Mann's time-limited psychotherapy method. PMID:10793128
Bleichmar, H B
The paper discusses the importance of developing specific psychotherapeutic approaches for the different psychopathological syndromes. It is stated that whether Psychotherapy deserves to be considered a science and not as a mere art will depend upon the formulation of goals and strategies in more definitive way, setting aside the general formulas we have up to now. Narcisistic Depression is taken as an example of the possibility of a planned psychotherapy. The psychopathology of depression is reviewed, and it is stated that the syndrome occurs when the following four conditions are present simultaneously: a) Discordance between the Self-representation and the Ideal Ego. b) A pattern of thinking in which the logic of all or nothing is at work. c) Certain traits are taken as if they were the whole Self-representation. d) A mood of hopelessness and helplessness. Several strategies for dealing with these four conditions are presented.
Brenes, Gretchen A.; Ingram, Cobi W.; Danhauer, Suzanne C.
Telephone-delivered psychotherapy has increased utility as a method of service delivery in the current world, where a number of barriers, including economic hardships and limited access to care, may prevent people from receiving the treatment they need. This method of service provision is practical and has the potential to reach large numbers of underserved people in a cost-effective manner. The aim of this paper is to review the state-of-the-art of telephone-delivered psychotherapy and to identify improvements and possible solutions to challenges. Results of randomized controlled trials indicate high client acceptance and positive outcomes with this method of delivering psychotherapy. Nonetheless, psychotherapists wishing to deliver psychotherapy by telephone face a number of challenges, including a lack of control over the environment, potential compromises of privacy and confidentiality, developing therapeutic alliance without face-to-face contact, ethical and legal issues in providing psychotherapy by telephone, handling crisis situations at a distance, and psychotherapist adjustment to conducting psychotherapy in an alternative manner. There remains a need for further research, including direct comparisons of face-to-face psychotherapy with telephone-delivered psychotherapy and feasibility of telephone delivery of psychotherapies other than cognitive behavioral therapy. PMID:22247588
Dimaggio, Giancarlo; D'Urzo, Maddalena; Pasinetti, Manuela; Salvatore, Giampaolo; Lysaker, Paul H; Catania, Dario; Popolo, Raffaele
Many patients with substance abuse problems present with co-occurrent cluster C personality disorders. Focusing on both disorders disrupts the maintenance mechanisms and the vicious cycle between the 2 conditions; however, treatment teams often neglect this issue. In this work, we describe the features of metacognitive interpersonal therapy as applied to a man with avoidant and depressive personality disorders and heroin, cocaine, and alcohol abuse. Psychotherapy proceeded through the following steps: (a) conducting drug therapy to deal with symptoms of abstinence from heroin; (b) forming a therapeutic bond to overcome the patient's severe emotional withdrawal; (c) fostering basic metacognitive capacities such as awareness of emotions and their triggers; (d) sharing formulations of maladaptive interpersonal schemas and descriptions of the associated states of mind; (e) conveying an understanding of the link between interpersonal events (recent ones and traumatic memories) and substance abuse; (f) facilitating the acquisition of critical distance from maladaptive schemas; and (g) promoting the use of adaptive coping skills instead of resorting to substance abuse. Implications for generalizing these procedures to the treatment of other patients with co-occurrent personality disorders and substance abuse are described.
More than 100 comparative outcome trials, directly comparing 2 or more psychotherapies for adult depression, have been published. We first examined whether these comparative trials had sufficient statistical power to detect clinically relevant differences between therapies of d=0.24. In order to detect such an effect size, power calculations showed that a trial would need to include 548 patients. We selected 3 recent meta-analyses of psychotherapies for adult depression (cognitive behaviour therapy (CBT), interpersonal psychotherapy and non-directive counselling) and examined the number of patients included in the trials directly comparing other psychotherapies. The largest trial comparing CBT with another therapy included 178 patients, and had enough power to detect a differential effect size of only d=0.42. None of the trials in the 3 meta-analyses had enough power to detect effect sizes smaller than d=0.34, but some came close to the threshold for detecting a clinically relevant effect size of d=0.24. Meta-analyses may be able to solve the problem of the low power of individual trials. However, many of these studies have considerable risk of bias, and if we only focused on trials with low risk of bias, there would no longer be enough studies to detect clinically relevant effects. We conclude that individual trials are heavily underpowered and do not even come close to having sufficient power for detecting clinically relevant effect sizes. Despite this large number of trials, it is still not clear whether there are clinically relevant differences between these therapies.
Ramseyer, Fabian; Tschacher, Wolfgang
Objective: The coordination of patient’s and therapist’s bodily movement – nonverbal synchrony – has been empirically shown to be associated with psychotherapy outcome. This finding was based on dynamic movement patterns of the whole body. The present paper is a new analysis of an existing dataset (Ramseyer and Tschacher, 2011), which extends previous findings by differentiating movements pertaining to head and upper-body regions. Method: In a sample of 70 patients (37 female, 33 male) treated at an outpatient psychotherapy clinic, we quantified nonverbal synchrony with an automated objective video-analysis algorithm (motion energy analysis). Head- and body-synchrony was quantified during the initial 15 min of video-recorded therapy sessions. Micro-outcome was assessed with self-report post-session questionnaires provided by patients and their therapists. Macro-outcome was measured with questionnaires that quantified attainment of treatment goals and changes in experiencing and behavior at the end of therapy. Results: The differentiation of head- and body-synchrony showed that these two facets of motor coordination were differentially associated with outcome. Head-synchrony predicted global outcome of therapy, while body-synchrony did not, and body-synchrony predicted session outcome, while head-synchrony did not. Conclusion: The results pose an important amendment to previous findings, which showed that nonverbal synchrony embodied both outcome and interpersonal variables of psychotherapy dyads. The separation of head- and body-synchrony suggested that distinct mechanisms may operate in these two regions: Head-synchrony embodied phenomena with a long temporal extension (overall therapy success), while body-synchrony embodied phenomena of a more immediate nature (session-level success). More explorations with fine-grained analyses of synchronized phenomena in nonverbal behavior may shed additional light on the embodiment of psychotherapy process. PMID
Safran, Jeremy D
In this brief discussion I highlight some dimensions of Angus and Kagan's (2013); Olivera, Braun, Gomez Penedo, and Roussos (2013); and Jock, Bolger, Olivera, and Roussos (2013) articles that are of particular interest to me. Reading their articles has served as a catalyst for me to reflect at a more general level on the state of the art of qualitative methods in psychotherapy research, and to articulate some informal reflections about qualitative research.
Equine-assisted psychotherapy (EAP) is an approach in which horses are an integral part of the therapeutic process. This article provides an overview of EAP, including a brief historical perspective, key definitions, and review of pertinent literature. Benefits of the approach are presented, from the standpoint of field observations, client self-reports, and formal research articles. Rather than offer a comprehensive literature review, this article is intended to help non-EAP practitioners become more familiar with the approach.
Campbell, Linda F; Norcross, John C; Vasquez, Melba J T; Kaslow, Nadine J
In August 2012, the American Psychological Association (APA) Council of Representatives voted overwhelmingly to adopt as APA policy a Resolution on the Recognition of Psychotherapy Effectiveness. This invited article traces the origins and intentions of that resolution and its protracted journey through the APA governance labyrinth. We summarize the planned dissemination and projected results of the resolution and identify several lessons learned through the entire process.
Tavormina, Romina; Tavormina, Maurilio Giuseppe Maria; Nemoianni, Eugenio
Psychosocial rehabilitation and in particular group dances allow the recovery of lost or compromised ability of patients with mental illness, and they facilitate their reintegration into the social context. The dance group has enabled users of the Day Centre of the Unit of Mental Health Torre del Greco ASL NA 3 south to achieve the objectives of rehabilitation such as: taking care of themselves, of their bodies and their interests, improving self-esteem , the management of pathological emotions, socialization and integration, overcoming the psychotic closing and relational isolation. In particular, patients with schizophrenia, psychotic and mood disorders had a concrete benefit from such rehabilitation activities, facilitating interpersonal relationships, therapy compliance and significantly improved mood, quality of life, providing them with the rhythm and the security in their relationship with each other. The dance group and for some individuals, also psychotherapy and drug therapy, have facilitated social inclusion, improved the quality of life and cured their diseases. The work is carrying out in a group with patients, practitioners, family members, volunteers, social community workers, following the operating departmental protocols. Using the chorus group "Sing that you go" as an operational tool for psychosocial rehabilitation and therapeutic element we promote the psychological well-being and the enhancement of mood.
de Greck, Moritz; Bölter, Annette F; Lehmann, Lisa; Ulrich, Cornelia; Stockum, Eva; Enzi, Björn; Hoffmann, Thilo; Tempelmann, Claus; Beutel, Manfred; Frommer, Jörg; Northoff, Georg
Somatoform disorder patients show a variety of emotional disturbances including impaired emotion recognition and increased empathic distress. In a previous paper, our group showed that several brain regions involved in emotional processing, such as the parahippocampal gyrus and other regions, were less activated in pre-treatment somatoform disorder patients (compared to healthy controls) during an empathy task. Since the parahippocampal gyrus is involved in emotional memory, its decreased activation might reflect the repression of emotional memories (which-according to psychoanalytical concepts-plays an important role in somatoform disorder). Psychodynamic psychotherapy aims at increasing the understanding of emotional conflicts as well as uncovering repressed emotions. We were interested, whether brain activity in the parahippocampal gyrus normalized after (inpatient) multimodal psychodynamic psychotherapy. Using fMRI, subjects were scanned while they shared the emotional states of presented facial stimuli expressing anger, disgust, joy, and a neutral expression; distorted stimuli with unrecognizable content served as control condition. 15 somatoform disorder patients were scanned twice, pre and post multimodal psychodynamic psychotherapy; in addition, 15 age-matched healthy control subjects were investigated. Effects of psychotherapy on hemodynamic responses were analyzed implementing two approaches: (1) an a priori region of interest approach and (2) a voxelwise whole brain analysis. Both analyses revealed increased hemodynamic responses in the left and right parahippocampal gyrus (and other regions) after multimodal psychotherapy in the contrast "empathy with anger"-"control." Our results are in line with psychoanalytical concepts about somatoform disorder. They suggest the parahippocampal gyrus is crucially involved in the neurobiological mechanisms which underly the emotional deficits of somatoform disorder patients.
de Greck, Moritz; Bölter, Annette F.; Lehmann, Lisa; Ulrich, Cornelia; Stockum, Eva; Enzi, Björn; Hoffmann, Thilo; Tempelmann, Claus; Beutel, Manfred; Frommer, Jörg; Northoff, Georg
Somatoform disorder patients show a variety of emotional disturbances including impaired emotion recognition and increased empathic distress. In a previous paper, our group showed that several brain regions involved in emotional processing, such as the parahippocampal gyrus and other regions, were less activated in pre-treatment somatoform disorder patients (compared to healthy controls) during an empathy task. Since the parahippocampal gyrus is involved in emotional memory, its decreased activation might reflect the repression of emotional memories (which—according to psychoanalytical concepts—plays an important role in somatoform disorder). Psychodynamic psychotherapy aims at increasing the understanding of emotional conflicts as well as uncovering repressed emotions. We were interested, whether brain activity in the parahippocampal gyrus normalized after (inpatient) multimodal psychodynamic psychotherapy. Using fMRI, subjects were scanned while they shared the emotional states of presented facial stimuli expressing anger, disgust, joy, and a neutral expression; distorted stimuli with unrecognizable content served as control condition. 15 somatoform disorder patients were scanned twice, pre and post multimodal psychodynamic psychotherapy; in addition, 15 age-matched healthy control subjects were investigated. Effects of psychotherapy on hemodynamic responses were analyzed implementing two approaches: (1) an a priori region of interest approach and (2) a voxelwise whole brain analysis. Both analyses revealed increased hemodynamic responses in the left and right parahippocampal gyrus (and other regions) after multimodal psychotherapy in the contrast “empathy with anger”—“control.” Our results are in line with psychoanalytical concepts about somatoform disorder. They suggest the parahippocampal gyrus is crucially involved in the neurobiological mechanisms which underly the emotional deficits of somatoform disorder patients. PMID:23966922
Centonze, Diego; Siracusano, Alberto; Calabresi, Paolo; Bernardi, Giorgio
Experimental research examining the neural bases of nondeclarative memory has offered intriguing insight into how functional and dysfunctional implicit learning affects the brain. Long-term modifications of synaptic transmission, in particular, are currently considered the most plausible mechanism underlying memory trace encoding and compulsions, addiction, anxiety, and phobias. Therefore, an effective psychotherapy must be directed to erase maladaptive implicit memories and aberrant synaptic plasticity. This article describes the neurobiological bases of pathogenic memory disruption to provide some insight into how psychotherapy works. At least two mechanisms of unwanted memory erasing appear to be implicated in the effects of psychotherapy: inhibition of memory consolidation/reconsolidation and extinction. Behavioral evidence demonstrated that these two ways to forget are profoundly distinct in nature, and it is increasingly clear that their cellular, synaptic, and molecular underpinnings are different. Accordingly, the blockade of consolidation/reconsolidation erases memories by reversing the plasticity associated with memory maintenance, whereas extinction is a totally new form of plasticity that, similar to the plasticity underlying the old memory, requires protein synthesis-dependent synaptic remodeling.
Müldner-Nieckowski, Łukasz; Cyranka, Katarzyna; Smiatek-Mazgaj, Bogna; Mielimąka, Michał; Sobański, Jerzy; Rutkowski, Krzysztof
Pregnancy is a major life change for many women. The related biological changes, especially complications in its course and in the course of delivery, carry a risk of developing a variety of psychological problems and mental disorders. However, their treatment is challenging due to the teratogenic effects of most psychoactive drugs and specific requirements for entering different psychotherapeutic programs. Mental disorders during pregnancy are undoubtedly an important issue for both gynecology and psychiatry. There is still a discussion considering the question whether psychotherapy during pregnancy is safe, although no scientifically valid data contradicting the safety of psychotherapy during pregnancy has been published so far. Together with psychotherapy - as a treatment of choice - clinicians approve some other relatively safe treatment methods for psychiatric disorders in pregnant women. Light therapy, limited pharmacotherapy, ECT are included. The goal of this paper is to review current opinions of clinicians and researches concerning possibilities, indications and outcome of psychological treatments as a way to help pregnant women who suffer from different psychiatric conditions, and also because this subject is not yet present in Polish psychiatric journals.
Benjamin, Lorna Smith
Contemporary training and practice of psychotherapy and the research that supports it is the subject of this review. I discuss it in the light of what I value most from my own professional training, which was, in my opinion, highly privileged by comparison with what is offered today. A minimal hoped-for outcome is that younger readers will find valuable tidbits here and there that will be useful in their own versions of psychotherapy. A maximal hope is that a few individuals who choose to maintain clinical skills as well as emphasize psychotherapy research might be encouraged to follow their instincts toward excellence. They would allow their curiosity to bloom and their work to be creative and more adherent to the rules of natural science than time allows in these days of dashboards that count funding associated with numbers of publications, grants, teaching, and service hours. Admittedly, that path less well traveled would be risky, because what truly is new takes time to develop and implement and the outcomes when research truly can disconfirm hypotheses (as distinct from fail to confirm them) are, well, uncertain.
Kiviruusu, Olli; Berg, Noora; Huurre, Taina; Aro, Hillevi; Marttunen, Mauri; Haukkala, Ari
This study investigated the association between interpersonal conflicts and the trajectory of self-esteem from adolescence to mid-adulthood. The directionality of effects between self-esteem and interpersonal conflicts was also studied. Participants of a Finnish cohort study in 1983 at age 16 (N = 2194) were followed up at ages 22 (N = 1656), 32 (N = 1471) and 42 (N = 1334) using postal questionnaires. Measures covered self-esteem and interpersonal conflicts including, conflicts with parents, friends, colleagues, superiors, partners, break-ups with girl/boyfriends, and divorces. Participants were grouped using latent profile analysis to those having "consistently low", "decreasing", or "increasing" number of interpersonal conflicts from adolescence to adulthood. Analyses were done using latent growth curve models and autoregressive cross-lagged models. Among both females and males the self-esteem growth trajectory was most favorable in the group with a consistently low number of interpersonal conflicts. Compared to the low group, the group with a decreasing number of interpersonal conflicts had a self-esteem trajectory that started and remained at a lower level throughout the study period. The group with an increasing number of interpersonal conflicts had a significantly slower self-esteem growth rate compared to the other groups, and also the lowest self-esteem level at the end of the study period. Cross-lagged autoregressive models indicated small, but significant lagged effects from low self-esteem to later interpersonal conflicts, although only among males. There were no effects to the opposite direction among either gender. Our results show that those reporting more and an increasing number of interpersonal conflicts have a lower and more slowly developing self-esteem trajectory from adolescence to mid-adulthood. While the result was expected, it does not seem to imply an effect from interpersonal conflicts to low self-esteem. Rather, if anything, our results
Manssour, Ana Beatriz Benites
Man and work histories are interlaced to tell us how the interaction among different human groups have helped in the development of intellectual capacities of our species. Creativity is mostly seen as a gift or an individual quality, for whose bloom and exercise there are internal and external factors, understood as stimulants of the creative process. Research for a master's thesis had, as its principal aim, the analysis of the subjective impact of telework on the workers personal satisfaction. Our second category authenticates the importance of interpersonal communication among fellow workers as incentive to personal creativity. The study was developed with columnists of a great newspaper with a big circulation in the south of Brazil, because telework is a tool of the press media, and creativity is a requirement for journalistic employment.
Geuens, Nina; Leemans, Annemie; Bogaerts, Annick; Van Bogaert, Peter; Franck, Erik
Organisational and work-related challenges faced by midwives make them vulnerable to burnout, but individual factors, such as interpersonal behaviour, can also contribute. A study in eight hospitals in the Dutch-speaking part of Belgium investigated the prevalence of burnout among Flemish midwives, assessed their interpersonal behaviour, and explored the relationship between interpersonal behaviour, burnout, job satisfaction and intention to leave. This article describes the study and reports the findings.
Weinstein, Lissa; Perez-Rodriguez, M Mercedes; Siever, Larry
While attachment has been a fruitful and critical concept in understanding enduring individual templates for interpersonal relationships, it does not have a well-understood relationship to personality disorders, where impairment of interpersonal functioning is paramount. Despite the recognition that attachment disturbances do not simply reflect nonoptimal caretaking environments, the relationship of underlying temperamental factors to these environmental insults has not been fully explored. In this paper we provide an alternate model for the role of neurobiological temperamental factors, including brain circuitry and neuropeptide modulation, in mediating social cognition and the internalization and maintenance of attachment patterns. The implications of these altered attachment patterns on personality disorders and their neurobiological and environmental roots for psychoanalytically based treatment models designed to ameliorate difficulties in interpersonal functioning through the medium of increased access to mature forms of mentalization is discussed.
Kealy, David; Ogrodniczuk, John S
Pathological narcissism is associated with significant interpersonal problems, which are unlikely to be acknowledged by narcissistic patients as clinical issues. Although a substantial clinical and theoretical literature deals with narcissism, a succinct overview of core narcissistic interpersonal problems is lacking, particularly in terms of their presentation in clinical settings. This article provides a descriptive overview of the major types of interpersonal problems associated with pathological narcissism: dominance, vindictiveness, and intrusiveness. We outline how these problems can manifest in patients' relations with others and in treatment situations. Clinical vignettes are provided to highlight the presentation of narcissistic interpersonal dysfunction in various types of clinical encounters, and to facilitate discussion of treatment implications.
Lipsitz, Joshua D; Markowitz, John C
Although interpersonal therapy (IPT) has demonstrated efficacy for mood and other disorders, little is known about how IPT works. We present interpersonal change mechanisms that we hypothesize account for symptom change in IPT. Integrating relational theory and insights based on research findings regarding stress, social support, and illness, IPT highlights contextual factors thought to precipitate and maintain psychiatric disorders. It frames therapy around a central interpersonal problem in the patient's life, a current crisis or relational predicament that is disrupting social support and increasing interpersonal stress. By mobilizing and working collaboratively with the patient to resolve this problem, IPT seeks to activate several interpersonal change mechanisms. These include: 1) enhancing social support, 2) decreasing interpersonal stress, 3) facilitating emotional processing, and 4) improving interpersonal skills. We hope that articulating these mechanisms will help therapists to formulate cases and better maintain focus within an IPT framework. Here we propose interpersonal mechanisms that might explain how IPT's interpersonal focus leads to symptom change. Future work needs to specify and test candidate mediators in clinical trials. We anticipate that pursuing this more systematic strategy will lead to important refinements and improvements in IPT and enhance its application in a range of clinical populations.
Widom, Cathy Spatz
Interpersonal behavior in psychopaths was explored using the Prisoner's Dilemma game. Various personality characteristics frequently cited as distinguishing psychopaths from others were operationalized and studied. (Editor)
Huffman, David D.; Fernando, Delini M.
Group work literature acknowledges that the group co-leader relationship influences the development of group members and the group as a whole. However, little direction has been offered for supervisors of group co-leaders to facilitate the development of the co-leader relationship. Reis and Shaver's (1988) interpersonal process model of intimacy…
Hatcher, Robert L.; Rogers, Daniel T.
An Inventory of Interpersonal Strengths (IIS) was developed and validated in a series of large college student samples. Based on interpersonal theory and associated methods, the IIS was designed to assess positive characteristics representing the full range of interpersonal domains, including those generally thought to have negative qualities…
Crits-Christoph, Paul; Gibbons, Mary Beth Connolly; Temes, Christina M.; Elkin, Irene; Gallop, Robert
Objective: The purpose of the current investigation was to examine the interpersonal accuracy of interventions in cognitive therapy and interpersonal therapy as a predictor of the outcome of treatment for patients with major depressive disorder. Method: The interpersonal accuracy of interventions was rated using transcripts of treatment sessions…
McCullough, James P; Lord, Benjamin D; Martin, Aaron M; Conley, Kathryn A; Schramm, Elisabeth; Klein, Daniel N
An interpersonal-emotional history procedure, the Significant Other History, is administered to the early-onset chronically depressed patient during the second therapy session in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Patients are asked to name up to six significant others and answer two questions: (1) What was it like growing up with or being around this person? (2) What is the emotional "stamp" you take from this relationship that informs who you are today? An interpersonal-emotional theme reflecting the early learning history of the patient is derived from these "stamps" or causal theory conclusions. One transference hypothesis (TH) is derived from the Significant Other History (SOH) and is formulated in one sentence, such as "If I do this, then the therapist will likely do that" (e.g., "If I make a mistake around Dr. E, then Dr. E will label me 'stupid' or 'incompetent"). The transference hypothesis highlights the interpersonal content that most likely informs the patient's expectancy of the therapist's reactions toward him or her. Throughout the therapy process, the therapist will proactively employ the transference hypothesis in a technique known as the Interpersonal Discrimination Exercise to help patients cognitively and emotionally discriminate the practitioner from hurtful significant others. The goal here is to increase the patient's felt safety within the therapeutic dyad and eventually to generalize the felt safety to the patient's other relationships.
Tanzer, Michal; Shahar, Golan; Avidan, Galia
The aim of the proposed theoretical model is to illuminate personal and interpersonal resilience by drawing from the field of emotional face perception. We suggest that perception/recognition of emotional facial expressions serves as a central link between subjective, self-related processes and the social context. Emotional face perception constitutes a salient social cue underlying interpersonal communication and behavior. Because problems in communication and interpersonal behavior underlie most, if not all, forms of psychopathology, it follows that perception/recognition of emotional facial expressions impacts psychopathology. The ability to accurately interpret one's facial expression is crucial in subsequently deciding on an appropriate course of action. However, perception in general, and of emotional facial expressions in particular, is highly influenced by individuals' personality and the self-concept. Herein we briefly outline well-established theories of personal and interpersonal resilience and link them to the neuro-cognitive basis of face perception. We then describe the findings of our ongoing program of research linking two well-established resilience factors, general self-efficacy (GSE) and perceived social support (PSS), with face perception. We conclude by pointing out avenues for future research focusing on possible genetic markers and patterns of brain connectivity associated with the proposed model. Implications of our integrative model to psychotherapy are discussed.