虚拟现实技术在心理治疗中的应用

虚拟现实系统具有良好的沉浸性、互动性和构想性而被广泛应用于军事、工业、建筑、教育等诸多领域。近年来,国外一些研究者将虚拟现实技术用于恐惧症、社交焦虑症、创伤后应激性障碍和厌食症等心理疾病的治疗,并取得了良好效果。本文简要介绍了国外在方面开展的主要工作,并对未来的研究趋势进行了展望。     

Transference-Focused Psychotherapy for Borderline Adolescents: A Neurobiologically Informed Psychodynamic Psychotherapy

In this article we first contextualize and then outline a model of TFP adapted for working with adolescents with Borderline Personality Disorders. We discuss how to take the normal developmental challenges of adolescence, such as separation-individuation in consideration, and how to support this in the context of the therapeutic work, while at the same time stimulating curiosity through clarification and confronting the adolescent with self-defeating and destructive patterns and dangerous behavior. Furthermore, we give examples of working with split–off parts of self and other representations through clarification to increase self-awareness and confrontations with contradictions within the adolescents communication and nonverbal behavior, with the aim of facilitating the integration of identity.     

Synthetiki Psychotherapy: An Integrative Psychotherapy for Individuals with Schizophrenic Symptoms

During the past 22 years, the author has developed an integrative psychotherapeutic model, called Synthetiki Psychotherapy (from the Greek word synthesis), for the treatment of individuals with schizophrenic symptoms. It has been influenced by certain philosophical and ethical principles, by ancient and modern Greek civilization and culture, and by the psychotherapy integration movement, and has been tested through research at the Laboratory of Clinical and Social Psychology of the University of Crete, Greece. The principles of Synthetiki Psychotherapy are presented and discussed.     

The hospice: Humane care for the dying

The hospice movement arose as a reaction to the dehumanizing atmosphere of acute-care hospitals, where excessive utilization of life support equipment deprived dying patients of a meaningful vision of their destiny. Respecting the spiritual quest of the terminally ill for wholeness and dignity, the hospice concept prescribes the rendering of compassionate and pastoral care by a benevolent community of family, health care staff, friends, and clergy. Approximately 800 hospice programs are currently evolving in the United States. St. Mary's (formerly “Hillhaven”) Hospice in Tucson, Arizona, offers the most comprehensive program of services, including home care, inpatient care, and artistic media through which the dying express their creativity. Numerous demonstration projects funded by several government agencies, principally the Health Care Financing Administration (HCFA), are expected to result in the legislative actions eliminating barriers to reimbursement of the cost of hospice services by Medicare, Medicaid, and other third-party payers. Existential analysis reveals the value of religion and spiritual support in enabling the dying to banish anxiety and muster the hope requisite for fully appreciating the authentic meaning of their destiny.     

The hospice: Humane care for the dying

The hospice movement arose as a reaction to the dehumanizing atmosphere of acute-care hospitals, where excessive utilization of life support equipment deprived dying patients of a meaningful vision of their destiny. Respecting the spiritual quest of the terminally ill for wholeness and dignity, the hospice concept prescribes the rendering of compassionate and pastoral care by a benevolent community of family, health care staff, friends, and clergy. Approximately 800 hospice programs are currently evolving in the United States. St. Mary's (formerly Hillhaven) Hospice in Tucson, Arizona, offers the most comprehensive program of services, including home care, inpatient care, and artistic media through which the dying express their creativity. Numerous demonstration projects funded by several government agencies, principally the Health Care Financing Administration (HCFA), are expected to result in legislative actions eliminating barriers to reimbursement of the cost of hospice services by Medicare, Medicaid, and other third-party payers. Existential analysis reveals the value of religion and spiritual support in enabling the dying to banish anxiety and muster the hope requisite for fully appreciating the authentic meaning of their destiny.     

Proposal for Centers for the Study of Biblical Psychotherapy

This paper describes the need for a Biblically based psychotherapy to replace a psychotherapy dominated by Greek mythology. Centers for Biblical Psychotherapy are proposed and sample curriculae are discussed.     

Assessing offenders: dying for reprieve

As is true for those who face death, the trauma of arrest and conviction for a crime and subsequent imprisonment takes the individual through a series of psychological stages, In the offender, these defenses are to some extent prescribed by the culture. The nature of and the person's adaptation to this process has not been previously recognized and argues for an assessment approach that emphasizes developmental rather than static formulations. Examination and treatment implications are discussed.     

Psychotherapy in the school

Counseling and psychotherapy are two terms for the same function; there is no essential difference in the nature of the relationship, the process, the methods and techniques, the purposes or goals, or the results. Vocational counseling is not a different kind or level of counseling, requiring less background or preparation. If anything, preparation for vocational counseling requires more time than does preparation for therapeutic or personal counseling—the former includes the latter. Therefore, if counseling has a place in our schools, it cannot be limited to vocational counseling.

It appears that there is a need or place for counseling and counselors in our schools, and that recognition and acceptance of this need is growing. The school has the opportunity, and the responsibility, for providing counseling, broadly conceived, to its students.

The staff member who has been designated as a school counselor appears to be the logical person to provide counseling services. While it is true that in the past the school counselor has not in fact been a counselor, nor adequately prepared to function as a counselor, counseling is presently accepted as the major function of the school counselor, and his preparation is becoming essentially preparation for performing the counseling function. While there are some who resist this trend, it appears to be well established.     

The Relation of Psychotherapy Integration to the Established Systems of Psychotherapy

That individuals (and groups) have vested interests is part of the nature of the human condition and is captured in the cognitive theoretical concept “personal domain” (Beck, 1976, p. 56). Of relevance to psychotherapy integration (and consistent with this concept), there are some apparent philosophical differences between advocates of psychotherapy integration and those of the major systems of psychotherapy. In the same manner that the various schools of integrative and eclectic psychotherapy compete with one another (Lazarus & Messer, 1991, p. 144), so too do they contend with the established systems. In this article, we present several issues about which the systems of psychotherapy and the integration movement may differ, and we respond to criticisms of cognitive therapy that have been the focus of previous articles in this journal. Finally, we give examples of how those who research and apply the contemporary systems of psychotherapy can, within those systems, explore possibilities for psychotherapy integration. We conclude that there is probably much that the integration movement and the established systems of psychotherapy can offer each other.     

Aggression Observation Scale for Group Psychotherapy

An observational scale to record aggressive behaviors, defenses, and interventions that occur during a psychotherapy group has been developed. Content and process items were included. The content items focus on the spoken material and are on a continuum of increasing group members' awareness of and responsibility for their anger. The process items are directed to underlying psychodynamic issues on a continuum from avoiding anger, to indirect and then expression of anger. Leader interventions (responses) are also included. The development of the scale, the Aggression Observation Scale for Group Psychotherapy (AOSGP), is described including pilot testing and reliability and validity findings.     

Selection of Patients for Group Psychotherapy

The concept of projective identification is reviewed, and its application to family and group systems is noted. Projective identification is then applied as a construct central to couples' groups, particularly useful in sorting out dynamics within couples, between couples, and toward the group-as-a-whole and its leader(s). Clinical examples are provided from a couples group co-led by the author, with indications of how this perspective on disavowal, interaction, and containment can be utilized therapeutically to provide a stimulus for intrapsychic and interpersonal change. The couples group offers a unique forum for working with projective identification, where this process presents a challenge to the therapist regarding the multiple levels from which to select appropriately and to “contain” skillfully.     

On the dynamics of dying

This study is concerned with dynamic processes that underly the rapid, degenerative changes associated with the “dying” stage of the multicellular organism's life cycle. The interaction between negative and positive feedback cycles is discussed: negative feedback cycles underly the superstability characteristic of health and illness. When negative feedback cycles fade in the dying phase of life, positive feedback cycles, previously held in check by the negative feedback cycles to which they had been coupled, rise explosively, driving physiologic variables from their normal values towards extremes. This results in the rapid downturn that we associate with dying—an accelerating disintegration terminating in death. A medical case history is analyzed.