PubMed Health⌕ Search

Biomedical subjects

Anthony Ryle

Publications and source records attributed to Anthony Ryle.

6 recordsLinked to original sources
PubMed2007

Multiplicity of selves and others: cognitive analytic therapy.

In cognitive analytic therapy (CAT), multiplicity is understood in terms of a range of self-other patterns (reciprocal role relationships) originating in childhood. These alternate in determining experience and action according to the situation (contextual multiplicity). They may be restricted by adverse childhood experiences (diminished multiplicity), and severe deprivation or abuse may result in a structural dissociation of self-processes ( pathological multiplicity). Therapeutic interventions, to be effective, must be based on an understanding of the structure of the individual patient's self-processes. In CAT practice, descriptions of dysfunctional relationship patterns and of transitions between them are worked out by therapist and patient at the start of therapy and are used by both throughout its course. This approach is illustrated by an account of the treatment of a depressed and anxious 70-year-old man who alternated between two main patterns.

Cognitive Behavioral Therapy↗
PubMed2006

Resolving threats to the therapeutic alliance in cognitive analytic therapy of borderline personality disorder: a task analysis.

BACKGROUND: Alliance ruptures and premature drop out from psychotherapy are very common with patients who have a diagnosis of borderline personality disorder, limiting the clinical effectiveness of treatment. AIM: To test and refine a model of how therapists successfully resolve threats to the therapeutic alliance involving enactment of problematic relationship patterns in the cognitive analytic therapy of borderline personality disorder. METHOD: Task analysis (Greenberg, 1984a) of 107 enactments from 66 sessions in four good outcome cases, compared with 35 enactments from 16 sessions in two poor outcome cases. This systematically compares a rational model of process with empirically coded transcripts of therapy sessions where independent raters have identified an alliance threat event. RESULTS: The process stages of the rational model were observed, and 20 refinements were made, including a new process stage, heuristic principles and 'when-then' steps. Therapists were found to cycle between stages. Therapists in good outcome cases recognized the majority of these enactments and focused attention to them in contrast to poor outcome cases where therapists usually failed to notice or draw attention to the alliance threat and did not adhere to the model. CONCLUSION: Competent resolution of alliance-threatening events is crucially dependent on therapists' ability to recognize them, and secondarily on their adherence to the principles in the refined model. The model is consistent with prior research and can be used in supervision and quality improvement strategies.

Adolescent↗
PubMed2004

The contribution of cognitive analytic therapy to the treatment of borderline personality disorder.

This article describes ways the theory and practice of cognitive analytic therapy (CAT) can contribute to the treatment and management of patients with borderline personality disorder (BPD). CAT, as its name suggests, was derived initially from an integration of conventionally opposed models. From the beginning, it was delivered within a limited timeframe, usually of 16 weekly sessions, extended to 24 in the case of more disturbed patients. Over time, on the basis of clinical experience, conceptual debate, and research, it has evolved into a general theory and has demonstrated itself to be of value over a wide range of conditions and contexts. The evolution of the basic theory and practice of CAT over the past 25 years is summarized, followed by a description of the theoretical developments concerned specifically with BPD. The techniques used in the individual psychotherapy of borderline patients are described in detail and illustrated with case material. The application of methods and understandings derived from individual therapy to staff supervision and the treatment and management of patients in day hospitals, therapeutic communities, and community mental health centers is then considered. A final section describes research contributions to the development and evaluation of CAT with borderline patients.

Adaptation, Psychological↗
PubMed2003

Something more than the 'something more than interpretation' is needed: a comment on the paper by the Process of Change Study Group.

A critique is offered of the paper on non-interpretive mechanisms in psychoanalytic therapy by the Process of Change Study Group (Stern et al., 1998a). The attention paid to procedural learning and to the need to attend to implicit relational knowledge is welcomed but a number of the group's assumptions are questioned. In particular, it is argued that the differences between mother-infant and therapist-patient relationships are inadequately considered, that the polarisation of non-symbolic and verbal memory is unhelpful and that the separation of the therapy relationship into three strands is problematic. The assumption that pursuing the goal of intersubjective understanding is in itself therapeutic is questioned. It is suggested that the recognition of the importance of implicit relational knowledge calls for a wider reappraisal of important aspects of theory and practice and that direct means of making such knowledge explicit should be considered.

Humans↗