The Great Psychotherapy Debate: Models, Methods, and Findings comprehensively reviews the research on psychotherapy to dispute the commonly held view that the benefits of psychotherapy are derived from the specific ingredients contained in a given treatment (medical model). The author reviews the literature related to the absolute efficacy of psychotherapy, the relative efficacy of various treatments, the specificity of ingredients contained in established therapies, effects due to common factors, such as the working alliance, adherence and allegiance (...) to the therapeutic protocol, and effects that are produced by different therapists. In each case, the evidence convincingly corroborates the contextual model and disconfirms the prevailing medical model. (shrink)

This exciting volume brings together leading figures across existential psychology in a clear-sighted guide to its current practice and therapeutic possibilities. Its accessible yet scholarly presentation dispels common myths about existential psychotherapy while demonstrating core methods and innovative techniques as compatible with the range of clinicians' theoretical orientations and practical approaches. Chapters review the evidence for its therapeutic value, and provide updates on education, training, and research efforts in the field, both in the US and abroad. Throughout, existential (...) class='Hi'>psychotherapy emerges as a vital, flexible, and empirically sound modality in keeping with the current-and future-promotion of psychological well-being. Highlights of the coverage include: Emotion, relationship, and meaning as core existential practice: evidence-based foundations. · Meaning-centered psychotherapy: a Socratic clinical practice. Experience processing as an aspect of existential psychotherapy: life enhancement methodology. Structural Existential Analysis (SEA): a phenomenological method for therapeutic work. Experiencing change: an existential perspective. Creating the World Congress for existential therapy. Clarifying and Furthering Existential Psychotherapy will spark discussion and debate among students, therapists, researchers, and practitioners in existential psychology, existential psychotherapy, and allied fields as well as the interested public. It makes a suitable text for graduate courses in existential therapy, psychological theories, and related subjects. (shrink)

Explicates the mutually fundamental commonalities between the methods and practices of Western psychotherapies, especially those whose bases are social, interpersonal, and communicational, and the disciplines of Buddhism, Vedanta, Yoga, and Taoism.

Summary The article substantiates the possibility and meaningfulness of a coherent theoretical system for psychotherapy, as it is strived for in Gestalt Theoretical Psychotherapy and presented in several articles in this issue of the journal "Gestalt Theory". The necessity of consistency in the theoretical assumptions and concepts of a psychotherapy method is not derived from scientific considerations alone, but already arises from the elementary role of consistency in human life. This also results in the requirements for the (...) consistency of theoretical foundations of psychotherapy. It is not fulfilled in a mere internal, logical consistency of its models, but only in the actual fitting together with the critical-phenomenal and naive-phenomenal worlds of the therapists and their clients in the reality test of life. (shrink)

The problem -- Fearless speech -- Talking versus writing -- The critical method -- Reasons and causes -- Elucidations -- Back to the rough ground -- The self and images -- A non-foundational therapy.

Psychotherapy style is conceptualized as the therapeutic method that a therapist employs while working with clients during treatment. It influences both the therapeutic process and results of therapeutic actions. The present study developed and validated the Psychotherapy Style Scale. By following a systematic psychometric development process, a three-factor structure of the PSS was identified. Exploratory factor analysis and confirmatory factor analysis provided evidence of multidimensional structure and validity of the PSS. Cronbach’s α suggested that the resulting scale was (...) highly reliable. Criterion validity was also satisfactory, demonstrated by correlations between the scale and criterion validity measures. The PSS has the potential to help better understand therapists’ behavioral characteristics and select the most appropriate therapists for clients who undergo psychotherapy. (shrink)

The "Essentials of Gestalt Theoretical Psychotherapy" offer for the first time in English an insight into the guiding ideas of this integrative psychotherapy method, which is consistently anchored in Gestalt psychology (and in this respect also differs substantially from most streams of Gestalt therapy, with which it should not be confused). The anthology includes ten contributions by authors from Austria, Italy, Germany and the USA. These deal with fundamental questions and concepts of any psychotherapy: The role and (...) meaning of consistency in practical life and in psychotherapy; the question of human epistemic possibilities and an epistemology appropriate for psychotherapy; the personality theory of Gestalt Theoretical Psychotherapy; the basic principles of therapeutic relationship and practice; the role of emotions in the example of phenomenal causality of feelings; the task of diagnostics in Gestalt Theoretical Psychotherapy; a clinical example related to anorexia; Gestalt psychological viewpoints for therapy progress; the role of relational determination in intrapsychic and interpersonal experience. (shrink)

Borderline Personality disorder is a severe personality dysfunction characterized by behavioural features such as impulsivity, identity disturbance, suicidal behaviour, emptiness, and intense and unstable relationships. Approximately 2% of the population are thought to meet the criteria for BPD. The authors of this volume - Anthony Bateman and Peter Fonagy - have developed a psychoanalytically oriented treatment to BPD known as mentalization treatment. With randomised controlled trials having shown this method to be effective, this book presents the first account of mentalization (...) treatment for BPD. The first section gives an overview of BPD, including discussion of nosology, epidemiology, natural history, and psychosocial aetiology. It additionally summarises the present state of our research knowledge about effective psychotherapeutic treatments and use of medication. The second section outlines the authors' theoretical approach and contrasts it with other well known methods, including DBT, CAT, and CBT. In the extensive final section, the authors outline their clinical approach starting with how treatment is organised. A detailed account of the transferable features of the model is provided along with the main strategies and techniques of treatment. Numerous clinical examples are given to illustrate the core techniques and detailed information provided about how to apply aspects of the mentalization based treatment approach in everyday practice. Aimed at mental health professionals, along with counsellors, psychotherapists, and psychoanalysts, the book will be a valuable tool, providing an effective means of treating those suffering from Borderline Personality Disorder. (shrink)

With its focus on evidence, psychology has grown into a mature, professional, and scientifically supported practice over the last decades. In general, psychotherapy and psychological counselling have shown to be more efficacious than waiting it out and a staggering 350 specific treatments have been scientifically supported as effective. Although, evidencebased treatments seem to work equally well, not all people benefit from evidence-based treatments, and it often remains unclear why. This raised the field-wide concern of what works for whom and (...) sparked a wealth of research on specific ingredients, common factors, process factors, and intra- and... (shrink)

The question of what works in psychotherapy has been a subject of debate in the recent years, occupying both clinicians and researchers. In this study, we aimed to assess the current perspectives held by clinicians regarding the processes which produce changes in psychotherapy, as well as the predictors of specific views. Licensed therapists, consisting mainly of psychodynamically and integratively oriented psychologists, were asked to write in their own words what they think works in psychotherapy. Thematic analysis was (...) employed to assess the main mechanisms of change as perceived by the therapists. Differences in the prevalence of specific themes were assessed using Friedman and Wilcoxon signed-rank tests. Univariate logistic regressions were employed to assess the factors that predict the probability of reporting a specific mechanism of change. The results indicated that the therapeutic bond was the most highly reported mechanism of change, followed by theory-driven mechanisms of change, therapist characteristics, therapist professionalism, and client motivation. Male therapists were more likely to indicate the professionalism as a mechanism of change compared to female therapists. Higher education was associated with lower reports of therapists’ characteristics as the mechanisms of change. These results suggest that therapists acknowledge the importance of the working alliance, and that the perception of the mechanism of change is associated with various factors which comprise therapist orientation. Limitations and directions for future research are discussed. (shrink)

Psychoanalysis, in Freud’s day and our own, has met with and continues to meet with staunch opposition from critics. The most ruinous criticism comes from philosophers, with a special interest in science, who claim psychoanalysis does not measure up to the above-board canons of acceptable scientific practices and, thus, is not scientific. It is common today to direct such criticisms to all metempirical forms of psychotherapy—i.e., psychotherapies that in no way concern themselves with grounding their claims with empirical research. (...) The most common defense is to cold-shoulder the criticism and counter that psychoanalysis, whether or not Freud recognized it, is a hermeneutical, not an etiological, method of therapy. In that regard, its measure of success is not symptom-removal or redirection of drive-energy in socially condoned or acceptable ways, but broadened understanding through a commonly created myth, effected by therapist and patient, for the patient’s wellbeing. In this undertaking, I argue that the hermeneutical apologia of psychoanalysis is a dodge, not a defense—an impenetrable asylum in which therapists can find refuge by buffering themselves from the possibility of criticism of the scientificity of their discipline. Because hermeneuticism disavows the possibility of knowledge in any meaningful sense—and, with that, scientific knowledge gained through observation or experimentation—it levels the epistemological playing field. With knowledge impossible and science annulled, no “investigative” inquiry or discipline can claim a status superior to any other and, hence, psychotherapy is an investigative discipline as legitimate as any other. The literature on the hermeneutic defence of psychotherapy is vast—too vast for anything but a representative sample of it in this critique. I focus merely on some of the most recent literature. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychodramatic Psychotherapy for Schizophrenic IndividualsJohn Nolte, MD, PhD (bio)As a long-time student, practitioner, trainer, author and advocate of J. L. Moreno, MD,’s works and specifically the psychodramatic method, I am always appreciative of efforts, like Chapy’s, to commend and advocate for psychodrama. This is especially so because for a time, Moreno and psychodrama were heavily criticized, even maligned in the mental health professions. At the same time, considering (...) how poorly Moreno and his methods have been understood as well as the difficulty of accessing his original material, I feel an obligation to set the record straight when confronted with incomplete, inadequate, or sometimes incompetent expositions of Moreno’s psychodrama.Chapy’s article recommends psychodrama as a treatment method for schizophrenic people by calling upon existentialist and phenomenological concepts. Psychodrama, he proposes, opens up existence by allowing “schizophrenic patients to incorporate the experience of an ‘absolutely other.’”There are major flaws in Chapy’s presentation. His “clinical illustration,” the presentation of a psychodrama with a schizophrenic patient, while it may be considered psychodrama under the broadest definition of the term, hardly fulfills the requirements of a psychotherapeutic psychodrama. We must question the competence of the psychodramatist in Chapy’s example. Chapy’s description of the drama itself falls short of being an adequate account of a psychodrama, failing to convey the emotional intensity and realness which a well directed and reported psychodrama achieves. We do not learn, for example, if Damien’s perception of his father is introduced through role reversal with the father, a standard psychodramatic technique which is done in order to give the auxiliary ego taking that role an understanding how Damien experiences his father. We do not know if role reversals are made throughout the drama so that Damien can experience how he is perceived by father, can feel the force of his confrontation in the role of father, and is required to reply as his father to his confrontation. We are given little information about the psychodramatic techniques employed by the director other than the scene setting of the studio in which the psychodramatic [End Page 227] encounter takes place, and the soliloquy in which Damien expresses his worry and hopes for the outcome of the confrontation. It should be clear in the description of the drama whether the father’s statements in the drama were produced by Damien in role reversal, or by the auxiliary ego playing the role. There is a difference and it is significant. Although we are told that Damien “evokes a systematic relationship between him and his father” during the psychodrama, we do not see how this happens. Every psychodrama is an existential experience and its description should fully communicate its meaning and emotion.A more serious problem, however, is that this drama does not deal with Damien’s psychosis. Although Damien may be diagnosed as schizophrenic, his disorder is obviously in remission or controlled by psychotropic drugs. The drama reveals none of the hallucinations, delusions, or disorder characteristic of schizophrenic disorders. It could be psychodrama of any young man with a complaint about his father.The notion that people with schizophrenia can be successfully treated by psychodrama is not new. Moreno began developing psychodramatic psychotherapy at his Beacon Hill Sanitarium, established in 1936. He and psychodrama gained some fame because of his success in treating schizophrenic patients at a time when schizophrenic individuals were considered incapable of benefitting from psychotherapy. Moreno’s approach to the treatment of schizophrenic patients was much more robust than the psychodrama described by Chapy. During a psychotic attack, the individual’s perception of the world and self are distorted in ways that made action and interaction in the world of conventional reality impossible. Additionally, the psychotic episode makes the psychotic person incapable of being comprehended by anyone else, including the psychiatrist. Moreno’s solution was to make the chaotic, bewildering, sometimes violent and always terrifying inner world visible and tangible in the surplus reality of the psychodramatic stage. In moments of lucidity following the psychotic episode, he asked his schizophrenic patients to reenact their psychotic experiences. The result was that, “In this imaginary reality on the psychodramatic stage, the... (shrink)

Although the term psychotherapy evokes the idea of an incisive intervention, psychotherapy is fundamentally different from any procedure found in medicine or surgery aimed at curing a disrupted body. Psychotherapy does not aim to cure the body or even the brain; it aims to persuade a person in distress to think and behave differently. It is a method common in some form to all cultures. The late Jerome Frank, a psychiatrist and esteemed scientific investigator of psychotherapy, (...) used the study of therapies that succeeded and failed to define several characteristics common to all successful therapies (Frank and Frank 1991). In addition, he found that patients seek psychotherapy for reassurance, hope, and support .. (shrink)

The paper presents a method for interpreting religious texts for use in psychotherapy. In particular, the paper takes the example of the pivotal character Arjuna in Bhagavad-Gita as having low frustration tolerance and uses the collective philosophy of the Bhagavad-Gita and Bhagavata-Purana through six steps of Logic-Based Therapy to overcome it. Although the paper uses Hindu religious texts, the treatment of these texts will speak to anyone interested in the possibility of integrating religious texts into psychotherapy.

"The work of Jacques Lacan is associated more with literature and philosophy than mainstream American psychology, due in large part to the dense language he often employs in articulating his theory - often at the expense of clinical illustration. As a result, his contributions are frequently fascinating, but their utility in the therapeutic setting can be difficult to pinpoint. Lacanian Psychotherapy aims to fill in this clinical gap by presenting theoretical discussions in clear, accessible language and applying them to (...) several chapter-length case studies, thereby demonstrating their clinical relevance. The central concern of this book is the application of Lacan’s notion that the unconscious is structured like, and by, language. This implies a peculiar manner of listening ("to the letter") and intervention, which Miller applies to a number of common clinical concerns - including case formulation, dreams, transference, and diagnosis - in the context of psychotherapy"–Provided by publisher. (shrink)

Equine-Facilitated Psychotherapy is widely used, and the uses to which it can be put are still being developed. However, existing knowledge about this field is insufficient, and most of the research suffers from methodological problems that compromise its rigor. This review will explore research into the linked fields of Animal-Assisted Therapy and Equine-Assisted Activities/Therapies related to physical health. Existing knowledge of mental, emotional, and social applications of EAA/T is presented. Evaluation studies in the subfield suggest that people benefit from (...) interventions with horses. However, these studies suffer from fundamental problems, such as small sample size and lack of control groups. Naturalistic inquiry about theoretical aspects highlights the fundamental role that human-horse relations play in EAA/T, but these studies exhibit deficiencies in theory development. A multimethod approach could promote knowledge development for EFP. Suggestions for future research concern methodological solutions to improve evaluation studies, use of grounded theory method to develop theory, as well as applying attachment theory to the human-horse context, which may offer insight about the underlying processes for change. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. He clearly demonstrates (...) that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. He clearly demonstrates (...) that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

This article explores the interfaces between two constructs in linguistics and psychotherapy—metaphor and the human body—as a means of illustrating meaningful exchange between linguistic and mental health research. Three distinctly well-motivated research strands with underexplored overlaps: the theoretical relationship between metaphor and the body, the use and management of metaphors in therapy, and the body as a therapeutic resource complementing verbal interaction, are first described. Taking a practitioner-informed approach called “correspondent analysis,” which combines the methods and insights of the (...) metaphor researcher and psychotherapist, a series of session extracts are then analyzed to illustrate the connections between the three strands and what they imply for both metaphor research and therapeutic practice. This culminates in the proposal of a triangle model for the metaphor–body–psychotherapy relationship, with wider implications for applied metaphor research also discussed. (shrink)

Dawes points out the fallacy in many commonly held beliefs in therapy and takes issue with many current treatment methods.

Breakdown and Breakthrough examines the essential role of regression in the patient's recovery from mental illness. In light of this Nathan Field reassesses the role of the therapist tracing psychotherapy back to its earliest spiritual roots and comparing modern analytic methods with ancient practices of healing and exorcism. The author uses vivid examples from his psychotherapeutic practice to show how, with the apparent breakdown of the therapeutic method itself, patients can break through to a new level of functioning. The (...) book goes on to consider how psychotherapy has been affected by fundamental developments in twentieth century science, such as the move from old, classical assumptions of linear causation to non-linear complexity from reductionism to a holistic systems approach and from mental mechanisms to acknowledging the mysteries of unconscious interaction. Taking up the radical vision originally proposed by Carl Jung and later fostered by eminent psychotherapists such as Winnicott and Bion, the author shows how psychotherapy can be reframed to admit the existence of a psychological fourth dimension. Nathan Field reappraises ideas of health and pathology, psychoanalysis and healing, sex and spirituality in light of a dramatic shift in the way we understand ourselves. How this shift alters the shape of psychotherapy in the twenty-first century is the challenge the practitioners, teachers and trainees must all address. (shrink)

Summary Gestalt Theoretical Psychotherapy, in the broader sense of the term, has developed in various forms on both sides of the Atlantic since the 1920s. Gestalt Theoretical Psychotherapy, in the narrower sense of the term, came into being in the second half of the 1970s in German-speaking countries. In Austria, it is a state-approved, independent scientific psychotherapy method since 1995, and an integrative psychotherapeutic approach based on the Gestalt theory of the Berlin School. With reference to this (...) comprehensive, consistent, scientific theory, this article presents the basic concepts of therapeutic practice in the field of Gestalt psychotherapy. Starting from the overarching whole to the parts, the paper first examines the concept of therapeutic relationship and therapeutic attitude, and then describes the basic principles of the practical design of the therapeutic process. (shrink)

This book addresses selected central questions in phenomenological psychology, a discipline that investigates the experience of self that emerges over the course of an individual’s life, while also outlining a new method, the formal indication, as a means of accessing personal experience while remaining faithful to its uniqueness. In phenomenological psychology, the psyche no longer refers to an isolated self that remains unchanged by life’s changing situations, but is rather a phenomenon which manifests itself and constantly takes form over the (...) course of a person’s unique existence. Thus, the formal indication allows us to study the way in which ipseity relates to the world in different situations, in a way that holds different meanings for different people. Based on this new approach, phenomenological psychotherapy marks a transition from a mode of grasping the truth about oneself through reflection, to a mode of accessing the disclosure of self through a work of self-transformation that requires the person to actually change her position on herself. By putting forward this method, the authors shed new light on the dynamic interplay between a person’s historicity and uniqueness on the one hand, and the related physiopathological mechanisms on the other, providing evidence from the fields of genetics, cardiology, the neurosciences and psychiatry. The book will appeal to a broad readership, from psychiatrists, psychologist and psychotherapists, to researchers in these fields. (shrink)

How good is psychotherapy as a tool of research into human nature? There is an orthodox defence of it as a research tool, which relies on showing that interpretations are true of the patient when they satisfy certain criteria. This defence is examined and rejected. The reply is considered that an interpretation which 'keeps things moving' is true, or an approximation to the truth. This reply is rejected by comparing and contrasting an interpretation in psychotherapy with one from (...) brainwashing sessions. Two suppositions about psychotherapy (which weaken its discovery powers) are deliberately adopted — the suppositions that the material produced is 'perspective' and 'method' dependent. An unorthodox defence of psychotherapy is then offered — by means of a watery sense of 'discover'. This enables us to outline a weak sense in which psychotherapy is a valid enterprise, but one which is still strong enough for research purposes. (shrink)

This essay is unique in putting intersubjectivity front and center. It is an attempt to provide a clinical method to re-establish the fragile dialogue of the soul with oneself and with others. Throughout, the book builds on the assumption that to be human means to be in dialogue. It uses dialogue as a unitary concept to address three essential issues for clinical practice: 'What is a human being?', 'What is mental pathology'?, and 'What is care?'. To be human - it (...) is argued - means to be in dialogue with oneself and with other persons. Thus, mental pathology is the interruption of this dialogue - of the person with the alterity that inhabits them, and with the alterity incarnated in other persons. Therefore, therapy is a dialogue with a method whose aim is to re-enact one's interrupted dialogue with alterity. Lost in Dialogue provides a method to approximate the Other, to understand its experiences, actions, and in general, understand the world in which it lives. (shrink)

Objective: The present work aims to conduct the first naturalistic empirical investigation of the process and outcome assessment of functional psychotherapy treatment. The FP model of psychotherapy is rooted in psychoanalysis and integrates the verbal communication approach founded on transference and countertransference dynamics with the analysis of bodily processes.Method: The study sample included ten patients recruited on a voluntary basis and treated by clinicians in their private practices. Each patient received FP with an average duration of 40 h. (...) Therapies had weekly sessions, were audio-recorded with the patient’s written consent, and lasted for an average of 10 months. Outcome and process tools included the Minnesota Multiphasic Personality Inventory-2 and the Luborsky’s the Core Conflictual Relationship Theme, used to assess therapeutic benefit, and the Metacognition Assessment Scale and the Italian Discourse Attributes Analysis Program system, used to evaluate therapeutic benefit and process. The MMPI-2 was used also in the follow-up assessment.Results: Results show that FP had a positive therapeutic outcome on the patients assessed in this study, and that the therapeutic benefits were maintained over time. Some specific features of the FP approach were found to contribute more than others to the observed therapeutic benefits.Conclusion: The current investigation constitutes a first step toward assessment of the therapeutic effectiveness of FP. Future developments should apply the methodology to a larger sample, possibly introducing different methodologies to enable detection of specific bodily oriented processes and techniques. (shrink)

Objective: The COVID-19 pandemic is negatively impacting the mental health of COVID-19 patients and family members. Given the restrictions limiting in person contact to reduce the spread of the virus, a digital approach is needed to tackle the psychological aftermath of the pandemic. We present the development of a brief remote psychotherapy program for COVID-19 patients and/or their relatives.Methods: We first reviewed the literature on psychotherapeutic interventions for COVID-19 related symptoms. Based on this evidence, we leveraged ongoing clinical experiences (...) with COVID-19 survivors and family members to design an intervention model that could be disseminated and integrated into the workflow of the mental health system.Results: This 8-session model –inspired by constructivist and hermeneutic-phenomenological therapies– serves COVID-19 patients during hospitalization, remission and recovery. This model can also be delivered to people dealing with the COVID-19 hospitalization/discharge of a family member, or the loss of a family member due to COVID-19.Conclusion: We described a remote psychotherapeutic approach to tackle the COVID-19 pandemic psychological aftermath. To date, the approach seems feasible and highly customizable to patients’ needs. Studies are underway to test its preliminary efficacy. Once proven efficacious, this treatment model could provide a blueprint for future tele-psychology wide-scale interventions. (shrink)

Aim: Understanding the effects of psychotherapy is a crucial concern for both research and clinical practice, especially when outcome tends to be negative. Yet, while outcome is predominantly evaluated by means of quantitative pre-post outcome questionnaires, it remains unclear what this actually means for patients in their daily lives. To explore this meaning, it is imperative to combine treatment evaluation with quantitative and qualitative outcome measures. This study investigates the phenomenon of non-improvement in psychotherapy, by complementing quantitative pre-post (...) outcome scores that indicate no reliable change in depression symptoms with a qualitative inquiry of patients’ perspectives. Methods: The study took place in the context of a Randomized Controlled Trial evaluating time-limited psychodynamic and cognitive behavioural therapy for major depression. A mixed methods study was conducted including patients’ pre-post outcome scores on the BDI-II-NL and post treatment Client Change Interviews. Nineteen patients whose data showed no reliable change in depression symptoms were selected. A grounded theory analysis was conducted on the transcripts of patients’ interviews. Findings: From the patients’ perspective, non-improvement can be understood as being stuck between knowing versus doing, resulting in a stalemate. Positive changes (mental stability, personal strength and insight) were stimulated by therapy offering moments of self-reflection and guidance, the benevolent therapist approach and the context as important motivations. Remaining issues (ambition to change but inability to do so) were attributed to the therapy hitting its limits, patients’ resistance and impossibility and the context as a source of distress. “No change” in outcome scores therefore seems to involve a “partial change” when considering the patients’ perspectives. Conclusion: The study shows the value of integrating qualitative first-person analyses into standard quantitative outcome evaluation and particularly for understanding the phenomenon of non-improvement. It argues for more multi-method and multi-perspective research to gain a better understanding of (negative) outcome and treatment effects. Implications for both research and practice are discussed. (shrink)

Using Conversation Analytic methods, the present study attempts to analyze the various functions of face-based therapist empathy, and how they are sequentially realized in different psychotherapeutic settings. Four types of face-based therapeutic functions are discussed; more specifically, it is illustrated how therapist empathy may serve to maintain, enhance, threaten or even save the client’s face. The findings gained could contribute to a better understanding of the face-based therapeutic functions of empathy; also, the study may inspire researchers to further investigate other (...) functions of therapist empathy in psychotherapy. (shrink)

This article examines how therapists and patients start building and managing relationships and pursue institutional goals at the same time. Based on a corpus of 6 audio-recorded therapies (client-centered therapy and psychodynamic therapy), I investigate first encounters between therapists and patients as the starting points of any therapeutical process and the place where a relationship between the interactants is established for the first time. Following a microlinguistic qualitative approach and applying methods from conversation analysis and discourse analysis, I show how (...) therapists, on the one hand, try to align with patients to build a positive working alliance and, on the other hand, work to fulfill specific interactive tasks of therapeutic discourse which demand disaligning with the patients’ communicative activity and their interactive expectations. Specific interactive “jobs” that need to be fulfilled in psychotherapy are identified, namely the performance of institutional roles by the interactants, the establishment of an interaction structure and the pursuit of helpful change in the patient. I show at which places in the interaction therapists (dis-)align with the patients’ projected communicative activity and how aligning and disaligning are related to the interactive process and the establishment and performance of these interactive jobs. The analysis shows that, at the beginning of therapy, alignment and disalignment are both important processes for the following reasons: Aligning with the patient contributes to a positive relationship, which has been shown to be vital for successful psychotherapy, while disaligning introduces the patient to the specific discursive mechanisms that characterize therapeutic discourse and constitute the basis for its effectiveness. Overall, the paper argues that reducing therapy to a dichotomy between relationship and “technique” seems overly simplistic, as both aspects need to be handled and managed at the same time. (shrink)

Recent models of psychopathology and psychotherapy highlight the importance of interpersonal factors. The current review offers a biological perspective on these interpersonal processes by examining inter-brain synchrony—the coupling of brain activity between people interacting with one another. High inter-brain synchrony is associated with better relationships in therapy and in daily life, while deficits in the ability to achieve inter-brain synchrony are associated with a variety of psychological and developmental disorders. The review suggests that therapy improves patients’ ability to achieve (...) such synchrony through inter-brain plasticity—a process by which recurring exposure to high inter-brain synchrony leads to lasting change in a person’s overall ability to synchronize. Therapeutic sessions provide repeated situations with high inter-brain synchrony. This can lead to a long-term increase in the ability to synchronize, first with the therapist, then generalized to other interpersonal relationships, ultimately leading to symptom reduction. The proposed inter-brain plasticity model offers a novel biological framework for understanding relational change in psychotherapy and its links to various forms of psychopathology and provides testable hypotheses for future research. Understanding this mechanism may help improve existing psychotherapy methods and develop new ones. (shrink)

From the tape-recording of naturally occurring Chinese psychotherapy sessions, this article explores how repeated occurrences of resistance are managed in the course of interactional sequences and the participants’ actions within these sequences. By employing the methods of conversation analysis, we discuss the main discursive strategies employed by the clients to express their resistance and investigate how the therapist manages this. We find that clients show their resistance to the therapist’s questions in four ways: keeping silence, providing minimal response, making (...) non-answer responses, and being over-talkative. Persistent asking is the main technique we identify in the data for the therapist to manage the resistance; in the meantime, asking questions in a stepwise way, making requests after facing resistance to questions, active retreating and reformulating of the client’s words are employed as subsidiary techniques. The successful management of resistance leads to a smooth sequential development of the psychotherapy, while inappropriate strategies might result in a halt or even breakdown of the therapeutic work. In psychotherapy, resistance is a result of the shared interaction between client and therapist. It is such a complex issue that, in order to understand and manage it, we also take into consideration the broader social and cultural context in which it occurs. (shrink)

In this book, Raabe argues that philosophy can effectively inform and improve conventional methods of treating mental illness. He presents clinical evidence showing that mild and so-called clinical mental illnesses can be both prevented and alleviated with philosophical talk therapy. Raabe offers concrete case examples that support his findings.

The place of rationality in Stoicism and REBT -- Ellis and Epictetus: dialogue vs. method in psychotherapy -- The intellectual origins of Rational Psychotherapy: twentieth-century writers -- REBT and rationality: philosophical approaches -- Rationality and the shoulds -- When did a psychologist last discuss "chagrin"?: American psychology's continuing moral project -- The social psychology of "pseudoscience": a brief history -- Historical aspects of mindfulness and self-acceptance in psychotherapy -- Marginalisation is not unbearable, is it even undesirable?

In this book, Raabe argues that philosophy can effectively inform and improve conventional methods of treating mental illness. He presents clinical evidence showing that mild and so-called clinical mental illnesses can be both prevented and alleviated with philosophical talk therapy. Raabe offers concrete case examples that support his findings.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 93-96 [Access article in PDF] Phenomenological Methods in Psychiatry:A Necessary First Step M. Gupta and L. Rex Kay Keywords: behavior, empathy, human science, methodology, natural science, phenomenology. WE ARE GRATEFUL to the journal for prviding the opportunity for exchange and discussion of some of the themes raised in our paper, "The impact of phenomenology on North American psychiatric assessment" and we are pleased (...) to be able to reply to the two excellent commentaries by McMillan and Morley. Both McMillan and Morley question the prospect of employing phenomenology and its methods in psychiatric assessment, and in psychiatric practice more generally. McMillan questions the utility of such a step, and Morley is pessimistic about its feasibility. We shall address each author's concerns in turn.Initially, let us restate the aims of our paper to contextualize our arguments and those made in the commentaries. First, we sought an understanding of what is meant by North American psychiatrists, working within the DSM framework, when they refer to the phenomenological approach to psychiatric assessment. To elucidate this meaning, we compared the contemporary North American usage to a small number of definitions of phenomenology, particularly those definitions that were, and are now, applied to clinical psychiatric work. Contrary to McMillan's suggestion, we did not intend to state definitively what should or should not count as phenomenological, but rather to compare North American psychiatric assessment to what typically has counted as phenomenological. Second, we sought to examine phenomenology's influence on North American psychiatric practice, particularly psychotherapy.Morley argues that such influences usually exemplify the inappropriate appending of phenomenology to psychiatric practice rather than true integration of different paradigms. Although we do not disagree with this general contention, we will argue that the deployment of phenomenological methods in psychiatric assessment is a necessary first step toward the kind of integration he proposes.McMillan makes two related but unintegrated points. First, he argues that objective, behavioral data are phenomenological, according to his broad definition of the term. Second, he proposes that, if the behavioral and the phenomenological are different, we are better off staying with the behavioral when it comes to psychiatric nosology. Let us consider these two points in succession.McMillan seeks to broaden Jasper's definition of phenomenology to include objective observations [End Page 93] as phenomenological. To this end, he distinguishes methods from aims. He summarizes Jasper's definition of phenomenology as "an empirical method for investigating 'individual psychic experience (p 55)" and claims that this is a statement of aim or objectives. He then urges us to "consider the merits of different phenomenological methodologies in terms of their success in achieving this objective" whether or not they utilize "all the methods" of phenomenology. This is much like saying that if we treat waving one's hand as a method for greeting someone, we are then free to treat the objective of the wave as one of greeting someone, and then say that anything that serves as a greeting is, by definition, a "wave." Whatever else McMillan's objective observations are, he has not convinced us that they are phenomenological, anymore than we are likely to convince you that a kiss on the lips is really just a wave.Nonetheless, it is worthwhile seeing what McMillan does with this argument. He tells us that we can "read the first-person experience from behavior in a fairly accurate and informative way." He uses the example of a father gazing at his young child and notes that it is not unreasonable to infer that he is experiencing loving and nurturing feelings. It is, indeed, not unreasonable to draw such an inference. But it is far more reasonable to infer that the father is experiencing a cacophony of feelings, including, but not limited to, love, concern, anxiety, pride, envy, hope, and sadness (Stern 1995, 18-58). If we are able to distinguish which of these feelings is dominant at any given moment—which we are—and if we are also able to track subtle shifts in such feelings... (shrink)

Existential psychotherapy places pivotal significance upon the inter-relational aspects of human experience. By so doing, the therapeutic relationship itself becomes the principal means through which the client’s presenting symptoms and disorders are disclosed as direct expressions and outcomes of the client’s overall “way of being” rather than as isolated and disruptive impediments. At the same time, existential therapy emphasises the actual relationship that emerges between psychotherapist and client and argues that it is via the contrast and comparison of this (...) lived experience with that of their ‘wider world’ experience that clients can find the means to reconsider and reconstruct their “ways of being”. This paper seeks to demonstrate that, as well as their shared aims and methods of enquiry, it is the mutual emphasis upon inter-relatedness as a foundational value for human enquiry that reveals substantive and intriguing points of connection between existential psychotherapy and phenomenological enquiry. The paper furthermore argues that existential psychotherapy might best be viewed as a clearly formulated expression of phenomenological enquiry. (shrink)

Psychotherapy is entrusted with the ingrate mission to fight an enigmatic and demanding scourge of humanity—mental illnesses—with all its emotional suffering and personal distress, let alone their behavioral, physiological, interpersonal and societal consequences–and if this would not be enough a challenge, psychotherapists are left alone to their own devices, which is nothing more than words and wisdom. Thus, the feat to achieve clinically relevant sustainable changes and reductions in face of these demands and possibilities can hardly be overrated.It might (...) be reasoned that this is made possible by the constant evolvement and refinement of psychological models and methods, which underlie, stimulate and steer... (shrink)

Within emotion-focused therapy, the client’s ability to express and reflect on core emotional experiences is seen as fundamental to constructing the self and to entering into a change process. For this study, we 1) examine storytelling contexts in which clients do not disclose the emotional impact of their narrative, and 2) identify the interactional practices through which EFT therapists subsequently call attention to what the client may have felt. In doing so, we examine client stories drawn from video-taped individual (...) class='Hi'>psychotherapy sessions involving clinically depressed clients. Client stories and therapists’ responses to these stories were analysed using conversation analytic methods. Three different therapist response types were identified: eliciting, naming and illustrating the emotional impact of the client’s prior narrative. These responses also were found to differ in terms of how effectively they could display empathy and secure affiliation with clients. The implications of this work for therapeutic practice are discussed. (shrink)

Psychotherapy with the use of psychedelic substances, including psilocybin, lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxymethamphetamine (MDMA), has demonstrated promise in treatment of post-traumatic stress disorder (PTSD), anxiety, addiction, and treatment-resistant depression. Psychedelic-assisted psychotherapy (PP) represents a unique psychopharmacological model that leverages the profound effects of the psychedelic experience. That experience is characterized by strong dependency on two key factors: participant mindset and the therapeutic environment. As such, therapeutic models that utilize psychedelics reflect the need for careful design (...) that promotes an open, flexible, trusting mindset and a supportive setting. To meet this need, the PP model is increasingly supplemented by auxiliary methods, including meditation, relaxation, visualization or spiritual practices. We suggest virtual reality (VR) as a full-spectrum tool able to capitalize on and catalyze the innately therapeutic aspects of the psychedelic experience, such as detachment from familiar reality, alteration of self-experience, augmentation of sensory perception and induction of mystical-type experiences. This is facilitated by VR’s evidenced capacity to: aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy. While these unique VR features appear promising, VR’s potential role in PP remains speculative due to lack of empirical evidence on the combined use of VR and PP. Given the increased commercial interest in this synergy there is an urgent need to evaluate this approach. We suggest specific VR models and their role within PP protocols to inspire future direction in scientific research, and provide a list of potential disadvantages, side effects and limitations that need to be carefully considered. These include sensory overstimulation, cyber-sickness, triggering memories of past traumatic events as well as distracting from the inner experience or strongly influencing its contents. A balanced, evidence-based approach may provide continuity across all phases of treatment, support transition into and out of an ASC, deepen acute ASC experiences including mystical states and enrich the psychotherapeutic process of integration. We conclude that the potential application of VR in modulating psychedelic-assisted psychotherapy demands further exploration and an evidence-based approach to both design and implementation. (shrink)

Cet article s’intéresse aux méthodes psychothérapeutiques utilisées dans la déparentification : la reconnaissance de l’empreinte de la parentification à l’âge adulte, l’évaluation et son élaboration lors des psychothérapies individuelles ou familiales. La déparentification consiste à mettre au travail la position paradoxale du sujet parentifié, celle de prendre totalement en charge l’autre, une position salvatrice au départ qui se révèle trop lourde dans un deuxième temps, car en contradiction avec les propres intérêts du sujet. Un des objectifs de la déparentification est (...) d’élaborer la position de sollicitude extrême, celle du « sauveur » qu’on aperçoit dans les relations lorsque l’adulte perçoit un infantile traumatique chez l’autre comme il l’avait perçu chez son parent en souffrance. La déparentification met en évidence une parentalité précoce construite sur du vide ou à partir du négatif de la parentalité, nous faisant penser à une parentalité défensive d’emprunt, réparatrice, compulsive et agissante. (shrink)