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Abstract One of the main debates in the study of psychotherapy is whether specific techniques are best indicated for different problems or whether “common factors” better account for the efficacy of psychotherapy. Evidence for t...
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Abstract One of the main debates in the study of psychotherapy is whether specific techniques are best indicated for different problems or whether “common factors” better account for the efficacy of psychotherapy. Evidence for the superiority of specific techniques is mixed and limited to a handful of diagnoses. By contrast, evidence for the importance of common factors is riddled with methodological weaknesses and may be of limited clinical utility. The stagnation in this debate may reflect that the research methods heretofore employed have reached a plateau in their ability to advance knowledge regarding psychotherapy processes. The articles of the special issue move beyond simple bivariate relationship and attempt to model the real-world complexity involved in the process of psychotherapy. It is argued that these types of investigations, which model the interactions of patient characteristics as well as multiple specific and “common factors,” are the best way to advance the state of knowledge regarding psychotherapy processes.
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Personal analysis is a central requirement for the training of UK child and adolescent psychotherapists and is part-funded by the National Health Service in the UK. Empirical research on the significance of analysis for the profes...
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Personal analysis is a central requirement for the training of UK child and adolescent psychotherapists and is part-funded by the National Health Service in the UK. Empirical research on the significance of analysis for the professional development of child psychotherapists is virtually non-existent. Some empirical literature supports the importance of personal psychotherapy for the training of adult psychotherapists, but the differences between adult and child psychotherapy make the findings of this literature tenuous and difficult to apply directly to the child psychotherapy training. This study aims to explore this issue by studying qualified child psychotherapists' views on the role that personal analysis has played in their professional development, with a particular focus on the ways in which it affects the relationships they form with their patients. Semi-structured interviews were conducted with six UK-based child and adolescent psychotherapists, focusing on their views about the role of personal analysis in their professional development during training and post-qualification. These interviews were audio-recorded and analysed using thematic analysis. Thematic analysis of the interview material points to three main themes: the holistic experience of being a patient; the supportive aspect of analysis during training; and factors associated with the impact of the analysis being part of the training. In brief, it appears that personal analysis during training enabled the participants to learn things they would not have been able to learn in any other way; however, the close links between the training schools and the analysts were seen as a more controversial topic.
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Increasingly, many psychotherapists identify with an integrative approach to psychotherapy. In recent years, more attention has been directed toward the operationalization and evaluation of competence in professional psychology an...
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Increasingly, many psychotherapists identify with an integrative approach to psychotherapy. In recent years, more attention has been directed toward the operationalization and evaluation of competence in professional psychology and health care service delivery. Aspects of integrative psychotherapy competency may differ from competency in other psychotherapy orientations, although convergence is more often the case. Despite the potential differences, there exist very few formal training programs or guidelines to systematically guide clinicians in developing a competent integrative practice. This paper attempts to distill the essential elements of competent integrative psychotherapy practice and focuses on how these might be developed in training and supervision. We address most of these complex issues from a specific integrative perspective: principle-based assimilative integration.
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Within the frame of the 'Richtlinien'- psychotherapy the dichotome education and treatment situation for medical and psychological psychotherapists (cognitive behavioural therapy (CBT) or psychodynamic and psychoanalytic therapy (...
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Within the frame of the 'Richtlinien'- psychotherapy the dichotome education and treatment situation for medical and psychological psychotherapists (cognitive behavioural therapy (CBT) or psychodynamic and psychoanalytic therapy (PD/PT), respectively) does not correspond to the demands of a transnosologic and disorder oriented understanding of mental disorders which has been successfully practiced both in out- and inpatient psychotherapy. Instead of the frequently accidentally choice of a psychotherapist and his psychotherapeutic procedure there is a need for an adaptive indication taking into account the patients' characteristics, his or her mental disorder and the treatment goals. The basis for this adaptive indication could be the integration of CBT and PD/PA, respectively, from which both transnosologic specific competence and disorder specific interventions can be developed.
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Therapy manuals have their origins in research. After it came to light that the variance in the practical application of a defined therapeutic procedure was surprisingly high, there was growing concern to form the basis of better ...
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Therapy manuals have their origins in research. After it came to light that the variance in the practical application of a defined therapeutic procedure was surprisingly high, there was growing concern to form the basis of better comparability, at least for research purposes. In order to achieve this so-called manuals were constructed in which it was laid down what a practitioner does or what should be done when the therapy is to be applied which is meant to be applied. When it became clear that not all practitioners adhered even to that which was laid down in the manual, a further step became necessary: checking the treatment fidelity (adherence to the manual). In order to collate this, neutral observers assess from tape recordings (previously) or video tapes (presently) to what extent the therapy proceeds in accordance with the guidelines. Treatment fidelity can by definition be assessed most easily when the treatment rules are more precisely defined (manual precision). Therefore, treatment guidelines can have different grades of commitment and different degrees of precision with which they can be implemented within certain treatment situations. The concern of this article is to contribute to the transfer of results obtained in research to their practical implementation. For this purpose examples for the therapy of various anxiety disorders are presented. The so-called unified protocol for the transdiagnostic psychodynamic treatment of anxiety disorders (Leichsenring und Salzer, Psychotherapy 51:224-245, advance online public. 10.1037/a0033815, 2013) is presented for the first time in the German language. The remarkable feature of this manual is that the individual steps have been proven to be effective by empirical testing. All manuals presented in this article are based on the Principles of Psychoanalytic Psychotherapy established by Luborsky in 1984.
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Although integration has been formally influencing the field of psychotherapy since the 1930s, its impact gained significant momentum during the 1980s. Practical, theoretical, and scientific reasons help to explain the growing inf...
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Although integration has been formally influencing the field of psychotherapy since the 1930s, its impact gained significant momentum during the 1980s. Practical, theoretical, and scientific reasons help to explain the growing influence of integration in psychotherapy. The field of psychotherapy is characterized by many challenges which integration may change into meaningful opportunities. Nonetheless, many obstacles remain when seeking to advance integration. To appreciate the strength of integration in psychotherapy we describe an integrative, comprehensive approach to service delivery, research, and training. We then discuss the role of integration in the future of psychotherapy.
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The aim of this study was to assess the efficacy of group interpersonal psychotherapy (IPT) for low-income women with chronic posttraumatic stress disorder (PTSD) subsequent to interpersonal trauma. Non-treatment-seeking predomina...
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The aim of this study was to assess the efficacy of group interpersonal psychotherapy (IPT) for low-income women with chronic posttraumatic stress disorder (PTSD) subsequent to interpersonal trauma. Non-treatment-seeking predominantly minority women were recruited in family planning and gynecology clinics. Individuals with interpersonal trauma histories (e.g., assault, abuse, and molestation) who met criteria for current PTSD (N =48) were randomly assigned to treatment or a wait list. Assessments were conducted at baseline, treatment termination, and 4-month follow-up; data analysis used a mixed-effects regression approach with an intent-to-treat sample. The results showed that IPT was significantly more effective than the wait list in reducing PTSD and depression symptom severity. IPT participants also had significantly lower scores than waitlist individuals on four interpersonal functioning subscales: Interpersonal Sensitivity, Need for Social Approval, Lack of Sociability, and Interpersonal Ambivalence.
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Supervisors and teachers who are interested in advancing integrative psychotherapy in the 21st century have the dual task of surveying the range of treatment approaches that have been developed and distilling these approaches down...
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Supervisors and teachers who are interested in advancing integrative psychotherapy in the 21st century have the dual task of surveying the range of treatment approaches that have been developed and distilling these approaches down to a manageable number of influences that have been found to have the greatest impact on clinical practice over time. It has been proposed that there are four bona fide schools of psychotherapy that would be most useful for comprehensive training and supervision that would contribute to either (a) case conceptualization or (b) the process of clinical interviewing: psychodynamic psychotherapy; cognitive-behavioral psychotherapy; family systems therapy; and, humanistic/client-centered therapy. The goal for such broadly based clinical instruction would be for students, trainees, and interns to have an ability to provide a multi-level case conceptualization for any of the psychotherapy cases for which they are providing treatment. Thorough instruction in clinical reasoning and decision-making in this type of multi-level case formulation can provide some of the most valuable tools for novice and experienced clinicians alike.
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Supervisors and teachers who are interested in advancing integrative psychotherapy in the 21st century have the dual task of surveying the range of treatment approaches that have been developed and distilling these approaches down...
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Supervisors and teachers who are interested in advancing integrative psychotherapy in the 21st century have the dual task of surveying the range of treatment approaches that have been developed and distilling these approaches down to a manageable number of influences that have been found to have the greatest impact on clinical practice over time. It has been proposed that there are four bona fide schools of psychotherapy that would be most useful for comprehensive training and supervision that would contribute to either (a) case conceptualization or (b) the process of clinical interviewing: psychodynamic psychotherapy; cognitive-behavioral psychotherapy; family systems therapy; and, humanistic/client-centered therapy. The goal for such broadly based clinical instruction would be for students, trainees, and interns to have an ability to provide a multi-level case conceptualization for any of the psychotherapy cases for which they are providing treatment. Thorough instruction in clinical reasoning and decision-making in this type of multi-level case formulation can provide some of the most valuable tools for novice and experienced clinicians alike.
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Anxiety disorders are characterized by high levels of anxiety and avoidance of anxiety-inducing situations and of negative emotions such as anger. Emotion-focused therapy (EFT) and psychodynamic psychotherapy (PP) have underscored...
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Anxiety disorders are characterized by high levels of anxiety and avoidance of anxiety-inducing situations and of negative emotions such as anger. Emotion-focused therapy (EFT) and psychodynamic psychotherapy (PP) have underscored the therapeutic significance of processing and transforming repressed or disowned conflicted or painful emotions. Although PP provides sophisticated means of processing intrapsychic and interpersonal conflict, EFT has empirically tested a set of techniques to access, deepen, symbolize, and transform emotions consistent with current conceptualizations of emotions and memory. Based on our clinical experience, we propose that an integrative emotion-focused and psychodynamic approach opens new avenues for treating anxiety disorders effectively, and we present a transdiagnostic manual for emotion-focused psychodynamic psychotherapy. The therapeutic approach takes into account both the activation, processing, and modification of emotion and the underlying intrapsychic and interpersonal conflicts. The short-term treatment is based on the three phases of initiating treatment, therapeutic work with anxiety, and termination. Emotional poignancy (or liveliness) is an important marker for emotional processing throughout treatment. Instead of exposure to avoided situations, we endorse enacting the internal process of generating anxiety in the session providing a sense of agency and access to warded-off emotions. Interpretation serves to tie together emotional experience and insight into the patterns and the nature of underlying intrapersonal and interpersonal conflict. Treatment modules are illustrated by brief vignettes from pilot treatments.
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