Complexity science: A framework for psychotherapy integration

The paradigm of complexity science provides a new way to address the problem of psychotherapy integration and allows us to bypass the various shortcomings of the linear-interventionist perspective. Nine criteria are outlined, which should be satisfied by any integrative approach to psychotherapy: (a) the use of complexity science to provide a meta-theoretical and generic understanding of change processes (from neuronal to social system levels); (b) a comprehensive and formalised modelling of change processes and personality development; (c) an integrative method of case formulation; (d) the ability to understand a variety of techniques in terms of basic change principles; (e) criteria to guide microdecisions; (f) the application of data-driven feedback and real-time monitoring of change dynamics; (g) standardised assessment of outcomes in naturalistic settings; (h) guidelines for training; and (i) strategies that are well-suited to science–practice integration. Using these criteria as a framework for evaluation, one may grasp the potential of complexity science to drive innovation in the pursuit of psychotherapy integration.     

A pluralistic framework for counselling and psychotherapy: Implications for research

Historically, training, research and practice in counselling and psychotherapy have been dominated by unitary theoretical models. Although integrative and eclectic positions have been developed as alternatives, these have not been successful in generating research and have resulted in a further proliferation of competing models. In this paper we introduce a ‘pluralistic’ framework for counselling and psychotherapy and discuss the implications of this framework for research. The basic principle of this pluralistic framework is that psychological difficulties may have multiple causes and that there is unlikely to be one, ‘right’ therapeutic method that will be appropriate in all situations—different people are helped by different processes at different times. This pluralistic framework operates as a meta‐theory within which it is possible to utilise concepts, strategies and specific interventions from a range of therapeutic orientations. The framework is structured around three domains—goals, task and methods—by which therapeutic processes can be conceptualised, critically examined and empirically investigated. These domains, and the relationships between them, are outlined and the collaborative relationship at the heart of the pluralistic framework is discussed. The pluralistic framework provides a means for empirical research directly to inform practice and potential lines of empirical inquiry are outlined, along with findings from a recent study of counselling in schools.     

An integrative framework for psychopathology and psychotherapy

This article presents an integrative framework for psychopathology and psychotherapy. The framework differs in kind from previous ones in that it is entirely pre-empirical (specifically, conceptual and logical) in character and does not represent an attempt to create a new empirical theory (cf. Newton's pre-empirical creation of a new conceptual system, which creation proved a necessary precondition for his subsequent empirical contentions). The present integration is accomplished in three parts. In the first of these, a definition of pathology as behavioral disability or functional impairment is presented and defended. In the second, this definition is used as a centerpiece to achieve a logical unification of many prominent explanations of psychopathology that are at present widely considered to be theoretically divergent and incompatible. In part three, established forms of intervention from our most influential schools of psychotherapy are shown to be both conceptually coherent and compatible in practice within the present overarching framework.     

A qualitative meta-synthesis on the experience of psychotherapy for deaf and hard-of-hearing people

A review was conducted to examine the experiences that affect the therapeutic relationship when a person who is deaf or hard-of-hearing meets with a therapist. Electronic databases were searched using keywords and 10 qualitative articles were retrieved that met the inclusion criteria. A qualitative meta-synthesis was conducted on the articles, including appraisal, comparison, and synthesis of findings. The results of the synthesis highlighted seven areas where the therapeutic relationship is challenged, including issues which occur before and during psychotherapy. The findings of the review are discussed in the context of the articles’ limitations. The implications of the results are discussed in terms of clinical practice, future research, and current models in psychology which are based on hearing participants.     

Facilitating the client's experience of relational depth in counselling and psychotherapy: A thematic review

Aim

There is increasing interest in relational depth and its relevance and benefits for clients receiving therapy in a number of different therapeutic orientations. This research set out to draw together the available evidence from a wide range of therapies about clients' experiences of relational depth. The aim was to identify approaches that create the conditions where relational depth is more likely to be facilitated. The research focused on clients' views, given the increasing emphasis on their experiences in therapy.

Methodology

A systematic search of papers published in English between January 1996 and September 2022 was conducted using EBSCO Host, Google Scholar and citation chaining. Twenty-seven papers met the inclusion criteria, and a thematic analysis was conducted on these papers.

Findings

Six themes were identified: (1) establishing dialogue with the client's inner world, (2) working with attachment in therapy, (3) responding sensitively to the client's beliefs and values, (4) deepening the client's understanding of the therapist, (5) addressing ruptures in therapy and (6) the client's role in meeting at relational depth.

Conclusion

Facilitating the client's experience of relational depth can support and enhance many aspects of therapeutic practice and in itself may contribute to healing. Therapists who offer warmth and genuine engagement are more able to build confidence and trust, as long as these conditions are received by their clients. It is the clients who ultimately decide whether or not to share their deepest feelings.     

Resistance in mandated psychotherapy: Its function and management

A significant proportion of the cases that come for therapy, perhaps as high as 25 percent, do so at the initiative of some outside person or agency. A brief literature survey describing the particular motivational set established by such extrinsic motivation is examined, and its potential as the gathering point-the summation of the internal along with the external resistance-is discussed. Clinical vignettes are presented to illustrate how important it is for the therapist to step away from the patient's designation (of him or her) as the enemy and available scapegoat in the saga of the unacceptable mandate. Only by the therapist's acknowledging the legitimacy of the patient's negativism towards the mandate, and dissociating both therapist and therapy from this external resistance can the internal resistance to change be successfully addressed. To not make this distinction is to risk the patient's characteristic rebelliousness and authority conflicts, perseverating on the mandate and subverting the quiet cry for help that is audible in every troubled individual, if we allow ourselves to hear it.     

It's never too late to change: A group psychotherapy experience for older women

Group psychotherapy in a mixed gender group is seen as useful for treatment of the unique existential and emotional problems of the older woman. This article describes the first year of a psychotherapy group for older adults, four women and three men in their early fifties to late sixties. Some issues discussed unique to this age group were loss, isolation, changing body image, and changed political views. There were differences in reactions between the men and women. The major value of group psychotherapy for older women is seen as providing a safe arena for exploring current issues, integrating a sense of self, enhancing self-worth, and overcoming isolation and despair.     

A method for studying the analysis of aspects of the patient's experience of the relationship in psychoanalysis and psychotherapy

We have described a coding scheme for obtaining an objective account of the analysis of resisted aspects of the patient's experience of the relationship with the therapist in single, audio-recorded sessions of psychoanalysis and psychotherapy. The focus is on what is often regarded as an important first step in the analysis of transference: the identification and exploration of the preconscious points of attachment of transference ideas in the here-and-now. Related to the scheme is the view that there is generally a plausible basis in the here-and-now for the patient's ideas about the therapist. The implications of that view for the concept of transference are discussed. Future directions for research are noted, including improving the reliability of the scheme and testing various hypotheses regarding how the particular step in technique assessed by the method affects other aspects of the process and outcome.     

Resistance and countertransference in child and adolescent psychotherapy

Countertransference brings to light the influence of both anxiety and family processes on the child's or adolescent's maturation and character development. The significance of developmental, dynamic, and family-interpersonal factors have all been stressed as part of the latent communication inherent in resistance. Family influences on resistance and countertransference have to be the subject of analytic scrutiny. The engagement of children and adolescents in the therapeutic process seriously threatens parents' defensive operations both as couples and as individuals. Countertransference responses afford the opportunity not only to clarify the meaning of resistances but also to pinpoint anxieties that have been reexperienced by the child or adolescent with the analyst at points of threat and disorganization. The twofold therapeutic task with children and adolescents consists of delineating and counteracting the family's negative impact on the child's development and self, in addition to addressing the children's contribution to their own pathological traits and immaturities. Countertransference anxiety confirms the dynamic and family implications of the analyst's participation with the patient. Countertransference resistance suggests the analyst's lack of openness in investigating how the treatment has evoked the child's anxiety, the parent's anxiety, and the analyst's anxiety. Resistance-transference-countertransference exchanges reveal the child's or adolescent's efforts to move towards health while emerging from the internalized family.     

Psychoanalytic psychotherapy and its supervision via videoconference: experience,questions and dilemmas*

The American Journal of Psychoanalysis - The patient lives in Berlin, the therapist in Lisbon and the supervisor in Budapest. Not long ago, continuous psychotherapy and supervision would have been...     

The psychotherapy adaptation and modification framework: application to Asian Americans

Although effective treatments for many mental disorders have been developed, little research has been conducted to determine whether these interventions are effective in treating those from diverse backgrounds. Recent reports have suggested that ethnic minorities are less likely to receive quality health services and that they evidence worse treatment outcomes when compared with other groups. To improve care for those from diverse backgrounds, Western-developed psychotherapies may need to be culturally modified or adapted to become more effective in treating ethnic minorities. This article addresses the need for adapting psychotherapy and provides a conceptual framework for making such modifications. The psychotherapy adaptation and modification framework model is applied to recent Asian American immigrants as an illustrative example. However, it may also serve as a point of departure to adapt therapies for other ethnocultural groups.     

Buddhism,Christianity, and psychotherapy: A three-way conversation in the mid-twentieth century

Abstract

This article explores the scope of ‘religion-psy dialogue’ in the mid-twentieth century, via a case study from Japan: Kosawa Heisaku, a Buddhist psychoanalyst based in Tokyo. By putting this case study in brief comparative perspective, with the conversation that took place in 1965 between Paul Tillich and Carl Rogers, the article discusses both the promise and the pitfalls of the modern and contemporary world of ‘religion-psy dialogue’, alongside the means by which specialists in a variety of fields might investigate and hold it to account.