Psychotherapy of depression: current status, future directions

This article reviews recent studies of psychotherapy for treatment of depression. There is evidence that cognitive behavioral and interpersonal therapies are useful treatments for depressed outpatients, roughly comparable to antidepressant pharmacotherapy. Pharmacotherapy and psychotherapy do not, however, necessarily treat the same patients and there is emerging evidence of a neurobiological "boundary" that may delimit therapy response. Psychotherapy plus pharmacotherapy combinations appear particularly useful for outpatients with more severe, recurrent depressions. Depression-focused psychotherapy may also provide an important alternative to an indefinite course of maintenance pharmacotherapy for patients at high risk for recurrence.     

Psychotherapy for the treatment of depression: a comprehensive review of controlled outcome research

Previous quantitative reviews of research on the efficacy of psychotherapy for depression have included only a subset of the available research or limited their focus to a single outcome measure. The present review offers a more comprehensive quantitative integration of this literature. Using studies that compared psychotherapy with either no treatment or another form of treatment, this article assesses (a) the overall effectiveness of psychotherapy for depressed clients, (b) its effectiveness relative to pharmacotherapy, and (c) the clinical significance of treatment outcomes. Findings from the review confirm that depressed clients benefit substantially from psychotherapy, and these gains appear comparable to those observed with pharmacotherapy. Initial analysis suggested some differences in the efficacy of various types of treatment; however, once the influence of investigator allegiance was removed, there remained no evidence for the relative superiority of any 1 approach. In view of these results, the focus of future research should be less on differentiating among psychotherapies for depression than on identifying the factors responsible for improvement.     

Allure of self-confirmation: a comment on Swann, Wenzlaff, Krull, and Pelham.

Swann, Wenzlaff, Krull, and Pelham (1992) described the results of 4 studies designed to examine the relation of depression and negative feedback seeking. Unfortunately, problems of the characterization of subjects and of constructs, as well as the interpretation of data trends, combine to limit the conclusions that can be drawn from these studies. We provide a brief review of these problems.     

Psychotherapy and the medical model: The hypocrisy of health insurance

Psychotherapists manifest a severe discrepancy between practice and preachment when they espouse rejection of a medical model of human problems and psychotherapyand accept health insurance for their work. When psychotherapists accept health insurance they classify their actions and their client's problems as medical or quasi-medical entities, confuse the literal and metaphoric definitions of illness and treatment, and support the medical model. Acceptance of health insurance may serve numerous functions including: symbolic legitimization of psychotherapists; monetary gain; and the obfuscation of moral/social issues. Accepting health insurance while criticizing the medical view is hypocritical and interferes with understanding human problems.     

家庭心理治疗：一种科学的治疗理念

家庭心理治疗作为一种新的、科学的治疗理念正引起心理治疗专家和学者的普遍兴趣和关注。它着眼于家庭和家庭内部关系,把一种新的治疗理念引入了心理治疗领域。在介绍家庭心理治疗基本问题和国内外发展概况的基础上,论述其在中国存在和发展的必然性及可能性,旨在为我国家庭心理治疗的发展和应用提供参考。     

Psychoanalytic thinking in primary care: The Tavistock Psychotherapy Consultation model

This paper describes the conceptual underpinnings, structure and operations of a novel service, the City and Hackney Primary Care Psychotherapy Consultation Service – a service set up partly with the aim of addressing the needs of patients who present with ‘medically unexplained symptoms’. As part of the Tavistock and Portman NHS Trust, this service moves its clinical base, staff members and daily work, as well as the foundations of psychoanalytic thinking that define the Trust's work, into the heart of a community, and provides psychoanalytically informed clinical practice and consultation to patients and general practitioners in the City and Hackney, one of London's (and the UK's) most deprived and ethnically diverse boroughs. The authors describe the psychoanalytical underpinnings of the model, the design and structure of the service, patient demographics and preliminary outcome data, as well as an example of consultation work with general practitioners. The authors propose that psychoanalytic applications have a place in primary care and that psychoanalytic thinking can help general practitioners and patients alike, even when the clinical interventions offered are not solely based on psychoanalytic technique or therapeutic approaches. The paper concludes with thoughts about the model, its origins and its future.     

家庭心理治疗:一种科学的治疗理念

家庭心理治疗作为一种新的、科学的治疗理念正引起心理治疗专家和学者的普遍兴趣和关注.它着眼于家庭和家庭内部关系,把一种新的治疗理念引入了心理治疗领域.在介绍家庭心理治疗基本问题和国内外发展概况的基础上,论述其在中国存在和发展的必然性及可能性,旨在为我国家庭心理治疗的发展和应用提供参考.     

Constructing Nonagency at the Beginning of Psychotherapy: The 10DT model

This study examined how nine clients discursively constructed non-agency in their first session of individual psychotherapy. With open reading and linguistic analysis of the transcribed first sessions, combined with theory-based considerations, we created a model of discursive means for ascribing agentic and non-agentic positions, the 10 Discursive Tools model (10DT). There was large variability in how the tools functioned to create the impression of problematic agency, and the clients could not be classified according to their tool use patterns. The study shows the potential of the 10DT model for the detailed examination of presentations of “not-being-able” produced by psychotherapy clients.     

Preventing postparchment depression: a model of career counseling for college seniors

College graduates and employers alike have expressed dissatisfaction with the lack of job competencies of new graduates. Both groups suggest that institutions of higher education must do a better job of preparing their students to meet workplace challenges. The author describes the problem and presents a model that is delivered via distance education at one university. One of the major goals of the program presented is to ease the transition of college graduates to the workforce. The practical suggestions are appropriate for practitioners who work with this population, and they can be adapted for individual or group counseling.     

The Value of Integration: Psychoanalytic Psychotherapy Meets Ego Psychology in a Psychotherapy Group for Children

ABSTRACT

Psychotherapy integration requires us to look beyond the confines of a particular theoretical or technical approach towards other perspectives. Integrative work with children, in particular, meets the socio-emotional needs of the child while simultaneously modeling behaviors and skills. This paper presents an explicitly integrative approach to child group psychotherapy: Relationships. Individuals. Skills. Engagement (RISE) Group. We begin with an in-depth discussion of the RISE group structure illustrated by clinical examples (the “what”) followed by a review of the theory and treatment modalities that inform the approach (the “why” and “how”). The RISE group is grounded in two theoretical perspectives (psychoanalytic principles and ego psychology) and draws upon clinical techniques from multiple treatment modalities (including cognitive behavior therapy, psychodynamic play therapy and dialectical behavior therapy). Combined, the merger of these perspectives results in a multilevel intervention that forges pathways to mastery and competence within the child. Finally, we discuss the value and limitations of integration as applied to group psychotherapy for children.     

Contemporary Psychotherapy: Moving Beyond a Therapeutic Dialogue

Psychotherapy was developed as a means of using words to heal emotional pain. Although a therapeutic dialogue can be helpful to many clients, some people need a more action-based intervention. Psychotherapy may be enhanced by adapting several therapeutic procedures that have been found effective in physical therapy. Where physical therapy can help clients learn to manage chronic physical pain, psychotherapy can help clients learn to manage chronic emotional pain. Both physical therapy and psychotherapy can help to facilitate awareness, flexibility, strength and endurance in order to maximize the clients functional ability.