Assessments in Psychotherapy with Suicidal Patients: The Precedence of Alliance Work

Journal of Contemporary Psychotherapy - In this article the aim was to explore how therapists handle suicide risk assessment in connection with patient’s experience of alliance in...     

Psychotherapy Supervision Since 1909: Some Friendly Observations About its First Century

Now a century old, psychotherapy supervision occupies a place of increasing prominence across all mental health disciplines and appears to generally be regarded as a (if not the) sine qua non for the teaching and learning of psychotherapy. Psychotherapy supervision has emerged as our “signature pedagogy.” In this paper, I take a look back at supervision’s last century and consider some (but by no means all) of the salient issues and themes that have defined its science and practice. The reviewed supervision issues and themes include the following: (1) the beginnings and evolution of supervision and supervision theory; (2) our evolving perspective about the supervision matrix; (3) methodological pluralism and diversity; (4) “good” and “bad” supervisor behaviors and the working alliance; (5) measurement; (6) effectiveness; (7) diversity; and (8) education. I use this “look back” to (1) give voice to where we have been and where we are now in psychotherapy supervision and (2) shine a light on some of what seems to lie ahead for supervision’s second century.     

Transference in Psychotherapy with Schizophrenic Patients

Three current approaches to the group therapy of the cognitively intact, depressed elderly are reviewed. Examination of the strengths and limitations of these three models—self psychology, developmental considerations such as reminiscing and life review, and cognitive—behavioral therapies—points in the direction of the usefulness of an integrated model. The main objectives of an integrated approach include: stabilization of the individual's sense of self, establishment of interpersonal competence, and enhanced mastery over the affects of depression and demoralization. Clinical illustrations are provided to demonstrate the practical considerations in this model of group therapy.     

Some Thoughts on the Integration of Narrative and Humanistic/Existential Approaches to Psychotherapy

Although humanistic and narrative approaches to psychotherapy make some different assumptions about the nature of the human condition and emphasize different aspects of human functioning in their therapeutic endeavors, I argue here that the underlying assumptions of these two approaches reflect a common view of humanness, thus making these two approaches candidates for attempts at integration. Four areas of commonality are discussed in detail: (a) life as a process of continual development, (b) the nature of experience and the process of meaning creation, (c) the nature of psychological dysfunction, and (d) the nature and importance of human relationships. The implications of these commonalities for the practice of therapy from an integrated perspective are explored in an extended case example.     

积极心理治疗思想概要

积极心理治疗虽然是以积极心理学作为自己的理论基础,但积极心理治疗的实践却早已有之。积极心理治疗作为心理治疗中的一个新生事物．它以反传统医学式心理治疗的面貌出现,运用故事作为治疗者与病人之间的媒介,充分发挥病人的直觉和想象,在与病人的观念不发生直接冲突的情况下提出改变病人观点的建议,这一较符合人性特点的心理疗法正越来越多地受到社会的广泛关注。     

The CAMS Approach to Working with Suicidal Patients

The Collaborative Assessment and Management of Suicidality (CAMS) is a novel clinical protocol designed to quickly identify and effectively engage suicidal outpatients in their own clinical care. The CAMS approach emphasizes a thorough and collaborative assessment of the patient's suicidality that then leads to problem-solving treatment planning that is coauthored by the clinician and the patient. This approach is specifically designed to launch a strong therapeutic alliance creating an effective treatment trajectory. The CAMS approach is designed to modify and change clinician behaviors in terms of how they initially identify, engage, conceptualize, assess, treatment plan, and manage suicidal outpatients. Critically, however, CAMS does not usurp clinical judgment or dictate treatment modality. Preliminary research has shown that CAMS leads to faster resolution of suicidality and may decrease nonmental health medical utilization. Given the challenges of clinical work with suicidality, increased concerns about malpractice liability, and the decreased use of inpatient hospitalization, CAMS provides a potentially important new approach to working with suicidal individuals on an outpatient basis.     

Telehealth Monitoring of Patients with Schizophrenia and Suicidal Ideation

A telehealth system was developed to monitor risk following hospitalization for suicidal ideation. We hypothesized that 3 months of telehealth monitoring will result in a greater reduction in suicidal ideation. Veterans with schizophrenia admitted with recent suicidal ideation and/or a suicidal attempt were recruited into a discharge program of VA Usual Care with daily Health Buddy© monitoring (HB) or Usual Care (UC) alone. Fifteen of 25 were randomized to HB and 10 received UC. Daily adherence in the use of the HB system during months 1–3 was, respectively, 86.9%, 86.3%, and 84.1%. There were significant improvements in Beck Scale for Suicide Ideation scores in HB participants. There were no changes in depressive symptoms. Telehealth monitoring for this population of patients appears to be feasible.     

重视终末期肾病患者的心理治疗

心理治疗在终末期肾病(ESRD)治疗中的作用非常重要,不但可缓解患者的心理压力,还可改善患者的生理障碍、减少并发症,因此重视对ESRD患者的心理治疗,可使患者保持良好的生理、心理状态,并能提高患者的生活质量,改善预后.     

重视终末期肾病患者的心理治疗

心理治疗在终末期肾病(ESRD)治疗中的作用非常重要,不但可缓解患者的心理压力,还可改善患者的生理障碍、减少并发症,因此重视对ESRD患者的心理治疗,可使患者保持良好的生理、心理状态,并能提高患者的生活质量,改善预后。     

Treating Depression in Older Medical Patients with Psychotherapy

This purpose of this paper is to discuss the effectiveness of psychotherapy for treating depression in older, primary care patients. This paper highlights the feasibility of implementing psychotherapy in primary care settings, patient preference for psychotherapy, and the utility of primary care versions of therapy in treating depression in older adults. The discussion is supported with examples from three ongoing research projects, specifically the San Francisco General Hospital Depression in Late Life Study, the Hartford Foundation/California Healthcare Foundation IMPACT study, and the NIMH PROSPECT study. The findings presented here support the value of offering psychotherapy as a treatment alternative in primary care medicine.     

Using Rebt and Supportive Psychotherapy with Post-Stroke Patients

This paper discusses the benefits of using Calabro's (1990) three-stage cognitive-behavioral model, to determine when to use supportive Psychotherapy or Rational-Emotive Behavior Therapy (REBT) with post-stroke patients. It also discusses the benefits of using a support group and how to decide when to use a group and/or individual psychotherapy.