Psychotherapy

Seventy-six percent of 65 psychotherapy cases seen in a child guidance clinic either did not change or improved following a mandated report of suspected child abuse. In a significant minority of cases, the therapy relationship deteriorated when the report was made about a client in treatment, and improved when the report was made about a third party not in treatment.

Clinical Perspectives aims to provide a venue for exploring topics of importance to child and adolescent psychiatry, fostering discussion about these issues, educating child and adolescent psychiatrists and the broader medical community, and bridging clinical practice and research. Where applicable, appropriate permissions for publication were obtained from the patient(s).

Previous research has supported the immediate activation of patient's strengths (resource activation) as an important mechanism of change in psychotherapy. We designed a brief (10 min) priming procedure in which therapists' attention was focused on the patients' individual strengths before each therapy session (resource priming). In a preliminary study, the priming procedure was carried out before each of the first five sessions (N 5 20). Preliminary results indicated that this brief preparatory intervention boosted resource activation as perceived by independent observers, fostered attachment and mastery experiences by the patient, and improved therapy outcome at Session 20. Improvement was assessed in comparison to a pairwise matched, nonrandomized control group of patients treated previously with the same treatment protocol at the same clinic.

There is now a well-established link between childhood maltreatment and psychosis. It is, however, unclear what the mechanisms are by which this occurs. Here, we propose a pathway linking the experience of childhood maltreatment with biological changes in the brain and suggest a psychological intervention to ameliorate its effects.

This article briefly reviews literature on responses towards same-sex (lesbian and gay) sexualities from psychoanalytic and ‘lesbian and gay affirmative’ psychotherapeutic perspectives. An analysis is presented of reports of countertransferential reactions to lesbian and gay clients, obtained from interviews with 14 psychotherapists who work in a lesbian and gay affirmative manner and 18 clients who had received affirmative psychotherapy. Data were subjected to grounded analysis. Participants consistently attended to the thoughts, feelings and values that therapists held in relation to lesbian and gay clients and how these affected the meanings and practices available to them. These were linked with the therapist’s sexual identity among other factors. Negative countertransferential reactions were regarded as potentially occurring among heterosexual and lesbian and gay therapists and were seen as arising from therapists’ conscious and unconscious fears about same-sex sexualities. These findings indicate a need to continue debating these issues more widely in the professional arena.

Obesity is generally a life-long problem with numerous weight-related complications. The relationship between body weight and risk of developing a significant disease, as well as total mortality and morbidity, has been examined in many epidemiological studies. Such studies provide insight into biological relationships. I addition to negative physical effects, obesity may also have deleterious psychological and social effects on the individual concerned. It is not obesity as a physical state that creates a psychological burden for many obese individuals, but rather the people or society who create this burden and suffering. Discrimination and prejudice may have adverse effects on the psychological well-being of a subgroup of obese persons. The psychological consequences of obesity are described in this chapter. Furthermore, the possible specific psychopathology of obese individuals in clinical settings, e.g., binge eating disorder and body dissatisfaction, are discussed. The second p...

In this article, we examine the manuals of empirically supported psychotherapies for borderline personality disorder (BPD) by comparing their common and specific treatment strategies. We compare these treatments using a previously constructed scale of treatment interventions. Individual psychotherapies for BPD have several common strategies: clear treatment framework, attention to affect, focus on treatment relationship, an active therapist, and exploratory and change-oriented interventions. Use of interpretations, supportive interventions, designating treatment targets, attention to patient functioning, multimodal treatment, and support for therapies varied across the psychotherapies. We discuss these findings in the context of clusters of BPD symptoms, reports regarding overlap in treatment interventions used by various psychotherapies, and the effectiveness of specific treatment strategies.

Excerpts of therapist-patient dialogue are presented to demonstrate three important elements of a successful session of psychodynamic therapy. These are the provision of insight through the use of transference, a focus on patient affect, and the therapist's attention to aspects of the therapeutic alliance. The article, in addition to explicating the clinical process in psychodynamic therapy, gives a theoretical explanation for the emphasis on each of these three elements and provides research support for their application.

Multicultural professional psychologists routinely assert that psychotherapeutic interventions require culturally competent delivery for ethnoracial minority clients to protect the distinctive cultural orientations of these clients. Dominant disciplinary conceptualizations of cultural competence are "kind of person" models that emphasize specialized awareness, knowledge, and skills on the part of the practitioner. Even within psychology, this approach to cultural competence is controversial owing to professional misgivings concerning its culturally essentialist assumptions. Unfortunately, alternative "process-oriented" models of cultural competence emphasize such generic aspects of therapeutic interaction that they remain in danger of losing sight of culture altogether. Thus, for cultural competence to persist as a meaningful construct, an alternative approach that avoids both essentialism and generalism must be recovered. One means to capture this alternative is...

As hundreds of so-called "psychotherapies" have been foisted onto the public, all claiming to treat "mental illness," newer understandings of how the human brain actually works and the processes which drive the formations of mentation that we refer to as "the mind," demand a reassessment of what exactly we are referring to by the term "mental illness" and what kinds of intervention would be feasible in both the prevention of and recovery from cognitive and behavioral disorder. A fundamental process in the formation of an individual's mentation is the associations of experience. These associations not only account for constructive behavior, but can also lead to deleterious or negative behavior, suggesting that some associations are negative and therefore the negative behavior can be remolded through contrasting positive associations; however, to understand what this really means and how it works, we must start at the beginning and define what exactly is this negative behavior that we refer to by the term "mental illness." One of the most important axioms of life so simply but profoundly phrased by Oscar Wilde, is that "the truth is rarely pure and NEVER simple" (emphasis mine). Nothing can ever be explained by simple sound bites – oversimplification is just another word for misrepresentation – so to understand, we must truly engage the subject, and to engage the subject, we must first and foremost clearly define what it is that we are seeking to understand. In this case, it demands that we understand what exactly is mental illness.

The theory of structural dissociation of the personality proposes that patients with complex trauma-related disorders are characterized by a division of their personality into different prototypical parts, each with its own psychobiological underpinnings. As one or more "apparently normal" parts (ANPs), patients have a propensity toward engaging in evolutionary prepared action systems for adaptation to daily living to guide their actions. Two or more "emotional" parts (EPs) are fixated in traumatic experience. As EPs, patients predominantly engage Kathy Steele is affiliated with Metropolitan Psychotherapy Associates and Metropolitan Counseling Services, Atlanta, GA.

Objective: To explain the illusory nature of the self and explore its implications for psychotherapy.

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

Psychological research has shown the detrimental effects that overt heterosexism have on lesbian, gay, bisexual, and queer (LGBQ) clients and on the psychotherapeutic relationship. However, the effects of subtle forms of discrimination, specifically sexual orientation microaggressions, have on LGBQ clients and the therapeutic relationship have not been addressed. This study used qualitative methodology to explore the phenomenon of sexual orientation microaggressions with 16 self-identified LGBQ psychotherapy clients. Results of this study support the existence of sexual orientation microaggressions within the therapeutic environment and provide a descriptive account of 7 sexual orientation microaggression themes, channels of microaggression communication, and the impact microaggressions have on therapy and clients.

Previous scholarly studies have discussed the use of Zen Buddhism
within the person-centred approach of Carl Rogers, demonstrating the feasible influence of Buddhism over Rogers’s theories. The present research delves into the convergence and divergence of person-centred therapy and the Mahāyāna (one of the current mainstreams of Buddhism) philosophy explicated within the Vimalakīrti Nirdeśa Sūtra (a significant Mahāyāna canon); in particular, the bodhisattva spirit and four immeasurables, including loving-kindness, compassion, empathetic joy, and equanimity. Findings indicate that Carl Rogers’s counselling principles and practices comply with the Buddhist teachings of phenomenal vision, actualising tendency, and innate eagerness to alleviate suffering. This discussion also analyses ideas that have
seldom been examined in person-centred principles, such as bodhisattva
altruism, mind purity in nature and impurity caused by bewilderment,
compassion fatigue, causes of suffering, and counselling techniques.
Mahāyāna wisdom potentially offers references to the Rogerian family of
theories, which also sheds light on the use of Buddhist-influenced non-medical interventions.

Amazon Purchasing Link:

https://www.amazon.com/theory-practice-psychotherapy-specific-disorders/dp/0398025398

DOI Link:
https://doi.org/10.1192/bjp.123.3.363-a

Book Description:

This book is unique in several basic ways.  It presents a theoretical discussion of the essence of the psychotherapeutic process, which goes beyond just the remediation of pathological symptoms, and also acquaints the reader with the essence of the growth process, which enables one to continue one's personal growth beyond the removal of pathological symptoms to personal maturity, fulfillment, and self-realization.

This book is also unique in that its format approaches the understanding of the therapeutic process through the understanding of the treatment of patients with specific psychopathologies discussed by consistently successful professional psychotherapists.

This book is unique as well in that in addition to the various major neurotic and psychotic disorders, it also covers areas rarely, if ever, found discussed in other psychotherapy books, such as psychodynamics and psychotherapy of suicidal patients, psychotherapy of patients with psychosomatic disorders, psychotherapy of patients with acting-out disorders, psychotherapy of patients with sexual disorders, psychotherapy with the aged, and an entire chapter devoted to establishig some basic criteria for an effective psychotherapy process.

Essentially, this book is designed to serve as a source book or reference book for professional psychotherapists, and students studying to be psychotherapists in such fields as psychology, psychiatry and social work, and it could also be useful as a textbook for advanced courses in psychotherapy, as well as a supplemental text for basic introductory courses in psychotherapy.  Each of the contributors has deliberately taken the pains to try to communicate in a way that will be intelligible to the student, as well as offer material that will be new, informative, and challenging to the more sophisticated clinician. This book goes beyond being what may be called a how-to-do-it type primer. It is not meant to be a structured "cookbook" or set of formulas blueprinting the course of psychotherapy.

Each contributor to this book is a renowned authority  in the area of the treatment of the specific disorder  about which he is writing, and he shares with the reader his understanding of the basic nature of the disorder, along with the therapeutic  considerations and insights that he has found to be most valuable in dealing effectively and successfully with persons with this particular kind of pathology. Case illustrations are appropriately supplied in order to help clarify  for the reader how this contributing therapist deals with the particular kinds of patients under discussion.  However, the suggestions made by each contributor should in no way be interpreted as the only way such problems can be approached and resolved. Rather, it only represents the way that one outstanding clinician tends to deal with the special problems involved in the treatment of persons with the particular disorder under discussion, and it is meant to serve only as a helpful guide for the reader.

As the reader may have already gathered,  the emphasis in this book is primarily focused on the professional and practical aspects rather than on the academic aspects of psychotherapy.  It is meant to fill a void and be consistent with a growing trend today in which professional clinicians and students studying to be psychotherapists want material to study that will provide them with the necessary skills most relevant to exactly what they will be doing in their professional career, rather than the strongly academic emphasis to which they have been exposed at most educational institutions.

This book recognizes that effective psychotherapy is not something that can be learned by being exposed only to theories, techniques, or research findings. Psychotherapy is not just a doing, or a predetermined set of techniques, as such, and, therefore, there is no formula, or systematic defined procedure, that has to be mastered. Rather, it involves an empathically sensitive, genuinely caring, engaged, being-with or intimate experiential communion, and the understanding of patients that naturally arises from that, from which then flows the therapist's appropriate responses. One has to truly, and deeply, here before one can act appropriately and meaningfully. Thus, the best way for one to really come to learn anything significant about effective psychotherapy is to have those clinicians who are truly masters of the art and science of psychotherapy share with others their sensitive and profound understanding of the nature of psychotherapy with patients with particular pathological symptoms.

Art and Pornography presents a series of essays
which investigate the artistic status and aesthetic
dimension of pornographic pictures, films, and
literature, and explores the distinction, if there is
any, between pornography and erotic art. Is there
any overlap between art and pornography, or are
the two mutually exclusive? If they are, why is
that? If they are not, how might we characterize
pornographic art or artistic pornography, and how
might pornographic art be distinguished, if at all,
from erotic art? Can there be aesthetic experience of
pornography? What are some of the psychological,
social, and political consequences of the creation and
appreciation of erotic art or artistic pornography?
Leading scholars from around the world address these
questions, and more, and bring together different
aesthetic perspectives and approaches to this widely
consumed, increasingly visible, yet aesthetically
underexplored cultural domain. The book, the first
of its kind in philosophical aesthetics, will contribute
to a more accurate and subtle understanding of the
many representations that incorporate explicit sexual
imagery and themes, in both high art and demotic
culture, in Western and non-Western contexts. It is
sure to stir debate, and healthy controversy.

This milestone text provides a comprehensive and state-of-the art overview of perfectionism theory, research, and treatment from the past 25 years, with contributions from the leading researchers in the field. The book examines new theories and perspectives including the social disconnection model of perfectionism and the 2 × 2 model of perfectionism. It also reviews empirical findings, with a special focus on stress, vulnerability, and resilience, and examines perfectionism in specific populations. Finally, it considers how perfectionism relates to physical health and psychophysiological processes and introduces new approaches to effective prevention and treatment. By increasing our understanding of perfectionism as a complex personality disposition and providing a framework for future explorations, this landmark publication aims to promote further research in this field. It will be invaluable reading for academics, students, and professionals in personality psychology, clinical and counselling psychology, applied psychology and related disciplines.

The METAPSYCHOLOGY part is about everything that is psychically relevant, that is, everything concerning people. People mainly use language to express these matters. Therefore, to differentiate areas of the psychical relevant, I differentiate them similar to how our language is differentiated. (→ Analogy between language and the psychical relevant).
In the part PSYCHOLOGY, I also use this classification for the psyche. Among other things, this leads to a more comprehensive definition of the psyche.
In the part METAPSYCHIATRY, I describe how a confusion of basic meanings can produce inverted, strange realities, thus mental illnesses, too.
I mainly show this process in the part PSYCHIATRY using the example of schizophrenia.
Moreover, I examine the psychotherapeutic quality both of the most important worldviews and religions in the part METAPSYCHOTHERAPY and the most known psychotherapeutic schools of thought in the part PSYCHOTHERAPY.
Finally, I present an ideology-free psychotherapy in the chapter called 'Primary Psychotherapy'.

Introduction: This paper presents a range of concepts from transactional analysis, an approach which shares many of the values of experiential psychotherapy. A short glossary is included at the end of the paper-terms are explained and referenced as they are described, and they are illustrated with practical examples. Objectives: The article is provided to share useful TA concepts with those engaged in experiential psychotherapy, in a way that can be applied to consideration of therapeutic style, client diagnosis, contracting with clients, dealing with self, diversity, planning and making interventions, and dealing with ruptures to the relationship. Methods: Hermeneutic, phenomenological reflections based on the professional experiences and theoretical learning of the author. Results: Consideration of the application of a number of transactional analysis concepts within elements of case studies. Conclusions: The paper demonstrates potential applications of various transactional analysis concepts in ways that align with the values of experiential psychotherapy; the author aims to stimulate further interest and possible application. Comprehensive referencing is included for those who wish to explore further.

Congruence or genuineness is a relational quality that has been highly prized throughout the history of psychotherapy, but of diminished research interest in recent years. In this article, we define and provide examples of this attribute of the therapy relationship and present an original meta-analytic review of the empirical literature showing its relation to improvement. Analysis of 16 studies (k), representing 863 patients (N), resulted in a weighted aggregate ES (r) of .24 ( p ϭ .003; 95% CI ϭ .12 to .36). Moderators of the association between congruence and treatment outcome are examined, and limitations of the extant research are discussed as well. In closing, we advance several therapist practices that are likely to foster congruence and thus improve psychotherapy outcomes.

timelessness. We experience this oneness within the world and the world within oneness; we experience non-duality within duality and duality within non-duality. We are beings in the world. We can experience purity within polarities, love within hate, and hate within love. This is the true purity of appearance and eventually the purity of apparitionalness.

Gender, sexuality, and relationships are all given a high level of importance in 21st century western culture. We’re generally asked to identify ourselves on the basis of our gender, sexual ‘orientation’, and relationship status on forms and on social media, and there are moral panics over those who step outside the perceived norm in any of these areas. Consider recent news stories, TV documentaries, and social media ‘storms’ around trans people or sex addiction for example. Gender, sexuality, and relationships are likely to be of great significance in our clients’ lives, and it is important to have a good working knowledge of the diversity of forms they can take. Before going into this however, we need to have a clear sense of the understanding of gender, sexuality, and relationships that dominates in our current cultural context. This understanding will shape how we – and our clients – make sense of ourselves and others, and how we experience the world.

Background: The use of positive psychological interventions may be considered as a complementary strategy in mental health promotion and treatment. The present article constitutes a meta-analytical study of the effectiveness of positive psychology interventions for the general public and for individuals with specific psychosocial problems.

Every palliative care patient should have the expectation that acute and chronic pain management will be an integral part of their overall care. However, in all too many instances, the pain of cancer is often grossly under-treated. This issue is of concern because more than 80% of patients with cancer pain can ®nd adequate relief through the use of simple pharmacological methods. It is even more troubling to note that women and minority groups have their cancer pain under-treated more frequently. Physicians with the basic skills of assessment and treatment will be able to control the symptoms in the majority of cancer pain patients. However, there are still some patients who may require other modalities to control their moderate to severe pain. A thorough understanding of all pain management options will help the gynaecological oncologist to maintain an acceptable quality of life for their patients throughout the therapeutic and palliative phases of care.

We examined the effect of Systemic Couple Therapy on a patient diagnosed with dysthymic disorder and her partner. Marge and Peter, a middle-aged married couple, showed significant and meaningful changes in their pattern of interaction over the course of the therapy and, by the end of it, Marge no longer met the diagnostic criteria for dysthymic disorder. Her scores on the SCID-I and BDI-II were in the clinical range before treatment and in the non-clinical one at the end of therapy. Although scores on Dyadic Adjustment Scale showed different patterns, both members reported significant improvement. The analysis of change in the alliance-related behaviors throughout the process concurred with change in couple"s pattern of interaction.

Much has been written about the juncture where Jungian psychology and shamanism converge . Indeed, Jung, who developed the concept of archetype, might agree that both are instances of the same primordial image or instinctual pattern known the world over.

The discipline of psychology and its sub-disciplines of social, cognitive, and industrial psychology undertake to identify taxonomies that help to identify, understand, and explain human behavior. In consideration of the traumatic effects of narcissistic parenting, this paper will discuss a single case analysis of patient A. In light of this patient's upbringing, I will discuss two main personality theorists, Freud and Jung, to describe patient A's self-reported personal identity, as he understands himself. I will describe the milestones that helped to formulate his beliefs, values and behaviors, familial and interpersonal relationships. The goal I will accomplish is to formulate a developmental assessment to support my theoretical perspectives of patient A.

Anormal Psikoloji kitabı, ruhsal bozukluklar alanında çalışan tüm profesyoneller, psikiyatristler, klinik psikologlar, psikologlar, psikolojik danışmanlar, hekimler, sosyal hizmet uzmanları, psikiyatri hemşireleri ve bu alanlarda öğrenci yetiştiren akademisyenler ile eğitim alan öğrenciler için temel bir başvuru kitabıdır.
2013 yılının Mayısı ayında yayımlanan DSM-5 ölçütlerine göre ruhsal bozukluklarla ilgili sunulan bilgilerin güncellemesinin de yapıldığı bu kitap, tüm dünyada pek çok üniversitenin psikiyatri ve psikoloji bölümlerinde ders kitabı olarak okutulmaktadır.
Kitabın her bölümünde, ilk olarak ruhsal bozukluklarla ilgili vakalar sunulmakta, daha sonra bozuklukların klinik tanıları yapılmakta ve DSM-IV-TR’den farklı olan DSM-5’te yapılan değişikliklere yer verilmektedir. Ayrıca, DSM-5’teki tanı ölçütleri, bozuklukların etiyolojisi ve epidemiyolojisi, bozukluklar üzerinde kalıtımın ve çevrenin etkileri, biyolojik ve sosyal ve kültürel etkiler, en güncel araştırmalardan elde edilen verilerle harmanlanarak sunulmaktadır. Ruhsal bozuklukların tedavisinde etkili olacak terapi yaklaşımları ve ilaçla yapılan tedaviler hakkında da bilgiler veren kitap, sahip olduğu zengin içeriği ile eşsiz bir kaynaktır.
Anormal Psikoloji kitabının; profesyoneller ve öğrenciler için önemli bir rehber olacağına, yardıma ihtiyaç duyan insanların sorunlarının çözümüne, ruhsal bozuklukların tanı ve tedavisinde önemli katkılar sağlayacağına inanıyoruz.

The intensive emotional sharing which transpires during the psychotherapeutic process ranges from basic, complementary understanding and empathy to complex, pathological phenomena such as symbiotic: merger, projective identification, and psychotic transferences (Little, 1981; Shapiro, 1974). Increasing attention is being paid to the ways in which psychoanalytic psychotherapy recapitulates critical aspects of early development in both therapist and patient, deepening our understanding of psychodynamic and object relational qualities of the empathic, interactional process. Perhaps the most important expressions of these interactionaldevelopmental processes are transference and cou ntertransference. Transference and countertransference require additional consideration when treating novel categories of patients which challenge the clinical experience and self-knowledge of the psychotherapist. The religious patient belongs to this category, if only because the determinants of normal and pathological religious experience, and their meaning in therapy, are less well understood. Equally less well explored are those aspects of the therapist's personality that are most vulnerable to potentially distortive interaction with the "religious" aspects of the patient's personality.

The context-free diagnoses outlined by the Diagnostic and Statistical Manual of Mental Disorders might not provide enough information to represent the heterogeneity observed in depressed patients. Interpersonal factors have been linked to depression in a mutually influencing pathoplastic relationship where certain problems, like submissiveness, are related to symptom chronicity. This study evaluated interpersonal pathoplasticity in a range of depressive presentations. We examined archival data collected from 407 participants who met criteria for major depressive disorder (MDD), dysthymic disorder (DD), or subthreshold depression (sD). Latent profile analysis (LPA) identified 5 interpersonal subtypes (vindictive, intrusive, socially avoidant, exploitable, and cold). Apart from gender, the subtypes did not differ significantly on demographic characteristics, psychiatric comorbidity, or self-report depression severity. Socially avoidant participants were more likely to meet criteria fo...

Mothers who are involved with mental health services (for themselves or their children) rarely receive adequate support for their role as parents. Mental illness in a parent or child often exacerbates the challenges of managing psychological distress that is germane to the parenting roll. Mentalization-based approaches to psychotherapy for parents have the potential to address challenges of emotional regulation in parents by supporting their capacity to recognize and modulate negative affect during stressful parenting situations. In this study, we piloted Mothering from the Inside Out (MIO) with 17 mothers receiving services at a community-based mental health clinic. MIO is a 12-week, mentalization-based parenting intervention that demonstrated efficacy in two previous randomized controlled trials with substance using mothers. In this study, we were interested in determining whether community-based clinicians could deliver MIO with sustained fidelity. We were also interested in exam...

Many meta-analyses of comparative outcome studies found a substantial association of researcher allegiance (RA) and relative treatment effects. Therefore, RA is regarded as a biasing factor in comparative outcome research (RA bias hypothesis). However, the RA bias hypothesis has been criticized as causality might be reversed. That is, RA might be a reflection of true efficacy differences between treatments (true efficacy hypothesis). Consequently, the RA-outcome association would not be indicative of bias but an epiphenomenon of true efficacy differences. This meta-analysis tested the validity of the true efficacy hypothesis. This was done by controlling the RA-outcome association for true efficacy differences by restricting analysis to direct comparisons of treatments with equivalent efficacy. We included direct comparisons of different versions of trauma-focused therapy (TFT) in the treatment of posttraumatic stress disorder (PTSD). RA was measured from the research reports. Relative effect sizes for symptoms of PTSD were calculated. Random effects meta-regression was conducted. Twenty-nine comparisons of TFTs from 20 studies were identified. Initial heterogeneity among relative effect sizes was low. RA was a significant predictor of outcome and explained 12% of the variance in outcomes. The true efficacy hypothesis predicted the RA-outcome association to be zero; however, a substantial association was found. Thus, this study does not support the true efficacy hypothesis. Given findings from psychotherapy research and other fields that support a biasing influence of researcher preferences, RA should be regarded as a causal factor and conceptualized as a threat to the validity of conclusions from comparative outcome studies.