Demand characteristics and inferential processes in psychotherapeutic change.
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Adult↗
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[The healing process in psychotherapeutic treatment of children].
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Adaptation, Psychological↗
Teaching the psychotherapeutic method: some literary parallels.
There is a need for a theoretical account of the psychotherapeutic process or method, as distinct from psychotherapeutic or psychoanalytic theory itself. A four-stage model is presented which attempts to delineate the elements of the psychotherapeutic method: structure, space, discovery and description. This account puts discovery as the central theme in psychotherapy. The psychotherapeutic method as described is compared first with Medawar's account of the scientific method, and then with two literary versions of creativity. The conditions under which psychotherapeutic discovery occurs, scientific hypotheses arise and artistic activity takes place are structurally similar. The implications of this for teaching psychotherapy are discussed, especially in relation to the establishment and recognition of transferential experience.
Art↗
Information metabolism as a model of human experiences.
This paper presents Kepiński's concept of "information metabolism", which attempts to describe processing of the information as an analogy of energy metabolism. It is a biological model based upon the structural organization of the cell. The following terms: control center, boundaries, functional structures, centers of elimination and centers of energy are considered here. The model is complementary to computational models, which are helpful in research and theoretical studies, but not useful in interpersonal contacts. The model of information metabolism aims at explanation of relations between psychological and somatic processes and helps in understanding of psychotherapeutic processes.
Humans↗
Psychotherapeutic schema based on the paranoid process.
A psychotherapeutic schema is proposed based on the analysis of the paranoid process. The paranoid process involves a paranoid construction of the patient's view of reality and his environment, particularly the social environment. The paranoid construction sustains and makes sense out of the patient's projective system. These projective elements reflect and are derived from the introjects--the internalized objects around which the patient's inner world and his experience of himself are organized. The schema aims at focusing the therapy on these introjects as central to the psychopathology. The following steps of the schema are outlined and discussed: establishing the therapeutic alliance, defining the projective system, testing reality, clarification of the introjects, derivation of the introjects, motivation of the introjects, mourning of infantile attachments, emergence of transference dependence, transference resolution, and termination.
Attitude of Health Personnel↗
Fundamental dilemmas in contemporary psychotherapy: a transtheoretical concept.
The transtheoretical nature of fundamental dilemmas in contemporary psychotherapy is explored. The basic distinction between technical and ethical dilemmas in clinical practice is discussed, as well as the ramifications for the psychotherapist. Clinical dilemmas identified by survey research studies and interviews with master psychotherapists are reviewed. In addition to dilemmas relevant to circumscribed areas of psychotherapy, such as brief therapy, managed mental health care, sexual questions, feminist therapy, dilemmas fundamental to the psychotherapeutic process as a whole are examined. Finally, clinical examples are provided that include such issues as hospitalization of the suicidal patient, dealing with known contraindications, treating the intractable patient, and self-care of the psychotherapist.
Bioethical Issues↗
Patient, therapist, and supervisor in a psychiatric institution: inner freedom and inner structure.
The authors discuss issues concerning the psychotherapeutic process in a psychiatric institution. They develop the concept of the institution as an internalized object in addition to its being an objective object. As such, it has an effect on the inner freedom and the internal structure of the patient, the therapist, and the supervisor. It is claimed that it is crucial for the development of an identity as a psychotherapist that the supervisor be aware of the institution as an inner and real object. The authors raise questions about what kind of "space" is possible in a psychiatric institution and what influence that may have on the therapeutic process. The impact on the therapist's professional identity is discussed. They point to the process of becoming a therapist via supervision and examine some relevant dilemmas. The authors conclude by discussing the duality of inner freedom and internal structure, and their specific manifestations within an institution.
Health Facility Environment↗
The early impact of therapeutic alliance in brief psychodynamic psychotherapy.
INTRODUCTION: Therapeutic alliance is a key component of the psychotherapeutic process. This study estimated the impact of the therapeutic alliance as measured by CALPAS-P in an individual brief psychodynamic psychotherapy program. METHODS: To study the impact of the therapeutic alliance patients in psychotherapy answered to the CALPAS-P at the first and third session and to the Self-report Questionnaire (SRQ-20), to the Beck Depression Inventory (BDI) and to the Hamilton Anxiety Scale at the beginning and at the end of psychotherapy. RESULTS: The study of the impact of the therapeutic alliance in brief psychodynamic psychotherapy showed that higher TUI scores in the first session were significantly associated to the improvement on the BDI. Patients with best scores in the working alliance, measured at the third PWC session had also significant symptomatic changes. DISCUSSION: The study of the impact of the therapeutic alliance in brief psychotherapy indicated that patients who perceived that their therapists had the best capability to understand and to be involved in their issues had best results in reducing depressive symptoms and patients with higher capability to form the working alliance reached the best psychotherapy outcomes.
Adult↗
[Psychophysiologic microperspective in the psychotherapy process--a sequential approach of investigation].
To Investigate the interpersonal psychophysiology in the psychotherapeutic process a sequential approach using single case analysis is presented. During 18 psychoanalytic-psychosomatic initial interviews simultaneous recordings of heart periods (IBI) and arrhythmia scores (from ecg) and the psychotherapeutic dialogue were made from 10 patients with cardiac neurosis and their interviewers. The general finding is that therapists were able to forecast those segments better, in which their own physiological activity was involved than the segments of their patients. Consideration is given to the consequences which should be drawn from these results for psychophysiological psychotherapy research.
Adult↗
[Familial reality construction. On dealing with intrafamilial realization processes in psychodiagnostic and psychotherapeutic contexts].
Psychodynamic processes are connected to relationship-psychological and family dynamic phenomena in varied ways. Especially the processes of forming judgments and coming to realizations in the family influence the individual psychodynamics greatly. In these processes characteristics, purposes, roles and pathologies are ascribed to the individual family member. In this article these processes will be clearly shown with casuistic material. After this the author will clarify the theoretical relationship between the various levels of description which are the result of examining intrapsychic and family dynamic questions.
Child↗
Contributions of psychoanalysis to the understanding and treatment of depression.
Psychoanalysis continues to make important contributions to basic clinical understanding of adaptive and maladaptive psychological development, and particularly to the understanding of depression and its treatment. This paper demonstrates that a basic theoretical conceptualization, central to many of Freud's fundamental contributions, has provided the basis for a wide range of contemporary psychoanalytic and nonpsychoanalytic formulations of personality development and organization; for understanding various forms of psychopathology in adults as deriving from disruptions of normal developmental processes, especially personality disorders and depression; and for conducting research on psychotherapeutic process and outcome in both brief and long-term intensive treatment.
Adult↗
Psychodynamic perspective on therapeutic boundaries: creative clinical possibilities.
Discussion of boundaries in therapeutic work most often focuses on boundary maintenance, risk management factors, and boundary violations. The psychodynamic meaning and clinical management of boundaries in therapeutic relationships remains a neglected area of discourse. Clinical vignettes will illustrate a psychodynamic, developmental-relational perspective using boundary dilemmas to deepen and advance the therapeutic process. This article contributes to the dialogue about the process of making meaning and constructing therapeutically useful and creative boundaries that further the psychotherapeutic process.
Adult↗
[Incest and sexual abuse. A study among patients at a hospital for neuroses, Montebello].
A cross-sectional investigation on a day chosen at random i autumn 1987 in the Hospital for Neuroses, Montebello, Elsinore, revealed that a total of 25% of the female patients treated on that date had previously been the victims of incest (8.7%) or sexual abuse (17.3%). Of these, the great majority, 19 out of 23 (82%) had been abused prior to the age of 18 years. One out of 15 male patients (7%) had been the victim of previous sexual abuse. Approximately one third of the sexually abused women had been abused by more than one person. The incident had been reported to the police on one occasion only. In addition, previous incest/sexual abuse was presumed where further 10% of the female patients were concerned, on the basis of the opinions formed by the therapists from the clinical pictures and the case histories. In approximately half of the cases, the secrecy concerning the abuse was broken in the course of the psychotherapeutic process and it is concluded that frankness knowledge and courage on the part of the therapist are essential in order to establish sufficiently differentiated psychotherapeutic treatment and that increased knowledge about the problem in society will presumably exert a prophylactic effect.
Adult↗
Therapeutic aspects of Puerto Rican cult practices.
This paper seeks to explore the phenomenon of possession trance in the ritual context from still another tack, complementary to the studies cited above, by analyzing it as an active and perhaps necessary component in the development of significant personal relationships basic to the organization and goals of some religous cults.-1 This view has been suggested by data gathered in study of social process in Puerto Rican Spiritist cults-2 which examined the relationship between patterns of cult social organization and the cult execution of a culturally patterned psychotherapeutic process for committed adherents whose emotional problems are diagnosed by cult headers as manifestations of developing "faculties" for communication with the spirit world-3 (see Koss; Rogler and Hollingshead, 1965, pp. 244-254; Seda Bonilla, 1964).
Affective Symptoms↗
Learning and insight in psychotherapy.
The main objectives of this paper are: (a) an overview of therapeutic parallels and differences between psychoanalytic and behavioral psychotherapy; (b) an analysis of learning process with reference to insight taking place during psychotherapy. For attaining these objectives, the author reviews the literature and explores the cognitive and educational values inherent in the psychotherapeutic process.
Behavior Therapy↗
[Success of psychosomatic rehabilitation as a function of treatment length].
Clinical practice, effect studies, the time structure of psychotherapeutic processes and treatment outcome data show that the legally provided treatment time of no more than 3 weeks for inpatient medical rehabilitation is usually not sufficient to achieve satisfactory and long-term stable psychotherapeutic improvement. In an evaluation study in a psychosomatic rehabilitation clinic the change in symptoms of 266 inpatients was recorded using the German version of the CES-D scale (ADS-L) and the Symptom Check List SCL90R. Values obtained after 21 days of treatment were compared with data obtained on discharge after an average of 45 days. Multiple patient characteristics, therapy parameters and process aspects were studied empirically in order to select patient groups which show sufficient effects after a 3 weeks treatment. Irrespective of patient characteristics, therapeutic experience, clinically significant and long-term stable effects were only achieved after treatment periods exceeding 3 weeks.
Adult↗
[Research in psychotherapy].
Psychotherapy is an empirical discipline and is therefore open to exact investigations which is one of the prerequisites of its further development. The beginnings of exact research are associated with the names of H. J. Eysenck and C. R. Rogers. The contemporary research based frequently on the generic model of psychotherapy whose authors are D. E. Orlinsky and K. J. Howard is concerned in particular with the effectiveness of psychotherapy; it compares the action of different procedures, deals with differentiated indications and "mechanisms" inducing changes. The most frequent research strategies are an experimental approach, comparative (correlating) research and intensive research strategy. The most important source of information on research are meta-analyses which make it possible to summarize and compare an unlimited amount of mutually independent investigations. The hitherto most extensive meta-analytic processing of research projects was implemented in the Institute of Psychology of Bern University headed by K. Graw. It was revealed among others that psychotherapy exerts a very differentiated action and that in neurotic patients and patients with personality disorders cognitive behavioural psychotherapy, Rogers psychotherapy and psychoanalytic psychotherapy, cca 100 sessions, proves definitely effective. Close to the criterium of objectively effective psychotherapy is also shape psychotherapy and systematically oriented family therapy. In the Czech Republic research is conducted on a small scale but the work is demanding as regards methods and is of a high standard. Exact research of the psychotherapeutic process and therapeutic results contributes to the gradual shaping of a psychotherapeutic model which is internally differentiated and which integrates verified findings of various psychotherapeutic schools and trends.
Humans↗
[Evaluation of the therapeutic process in inpatient psychotherapy with the Repertory Grid technique].
With a sample of 155 patients undergoing psychoanalytic inpatient psychotherapy, the clinical relevance of nomethetic measures derived from Repertory Grids (Role Construct Repertory Test; Kelly 1955) shall be demonstrated. Results lead to the conclusion that valuable findings concerning the psychotherapeutic process can be obtained from the grid without necessarily recurring to the framework of Personal Construct Psychology. In general, cognitive differentiation seems to diminish as therapy goes on. Successful patients start to deal with their parental imagines earlier in the therapeutic process than less successful ones. Moreover, they adapt the construction of their Self to the one of their Ideal Self, just as they construe the treating therapist increasingly similar to their Ideal Self. This points to the eminence of the therapeutic relationship for successful therapy outcome. Finally, the paper presents some possibilities to demonstrate transference processes within the scope of inpatient psychotherapy by means of grid measures. All in all, we consider the repertory grid technique as a promising tool for the evaluation of therapeutic processes, but it requires considerable expenditure to fit into clinical routine.
Adolescent↗