Integrative time-limited group therapy for bulimia nervosa.

This article presents an integrative group therapy model for the treatment of bulimia nervosa (BN) and describes the 12-session format, incorporating components of cognitive-behavioral therapy (CBT), psychoeducation, interpersonal therapy (IPT), and relational therapy (RT), in detail. Previous reports have found CBT, IPT, and RT to be effective approaches for BN when used separately. The integrative approach may have the advantage of achieving symptom reduction by two different mediating mechanisms, those that directly affect eating behaviors and those that address the interpersonal and relational context in which the disordered eating has developed. The group approach makes use of the peer group in providing new opportunities for self-exploration and self-correction. One advantage of an integrative model is patients' exposure to several different treatment modalities from which they can identify specific approaches that are most helpful to their recovery. This identification is valuable in directing future treatment, if needed. Pilot data for this approach are presented.     

Contributions of object relations theory and self psychology to relational psychology and group psychotherapy

Object relations theory and self psychology are psychoanalytic perspectives that are especially concerned with interpersonal relations and their mental representations. Object relations theory began as an intrapsychic "singleton" psychology with the work of Freud and Melanie Klein. It subsequently evolved into a multi-person psychology with the work of Bion on groups, as well as the clinical and theoretical contributions of Winnicott and Fairbairn. Kohutian self psychology, which emerged later, has been interested in the relations between the self and significant others as mirroring and idealizing "self-objects." Stolorow's "inter-subjective perspective" emerged from self psychology as a full-fledged multi-person point of view. This article considers the significance of contemporary object relations theory and self psychology as relational, multi-person perspectives in terms of their application to group psychotherapy, focusing upon the group-as-a-whole, projective identification, transitional space and object, and self/self-object relations as particularly useful constructs. A clinical vignette is provided.     

A modified cognitive-behavioral approach to group therapy with the elderly

Group approaches to treatment subsume a wide variety of techniques. The present article describes a modified cognitive behavioral approach as developed by the author for certain groups of elderly clients. This modified approach incorporates principles of cognitive behavioral therapy in combination with humanistic, and developmental perspectives, while leaving room for addressing psychodynamic issues if desired. It is suggested that such an approach is of value where structured group techniques are called for.     

A group treatment program for bulimia nervosa

Seventeen female patients diagnosed as exhibiting bulimia nervosa participated in a shortterm group treatment program. A combination of exposure with response prevention, life skills training, and psychodynamic group interaction was provided. Results in pretest vs. posttest scores on a battery of tests demonstrated improved control over eating behavior and lowered anxiety and depression.     

A comparison of two psychological treatments for bulimia nervosa

Two standardized psychological treatments for bulimia nervosa were studied. A cognitive behavioural approach was compared with a form of short-term focal psychotherapy. Twenty-four patients who met strict diagnostic criteria for bulimia nervosa were randomly allocated to the two treatments. All the interviews were tape-recorded so that checks on their content could be made. Assessments took place at the beginning and end of treatment, and at 4-, 8- and 12-month follow-up. None of the patients dropped out of treatment or follow-up, but 1 patient from each treatment group had to be withdrawn on clinical grounds. Patients in both groups made substantial improvements which were well maintained over the 12-month treatment-free follow-up period. The cognitive behavioural approach was superior to short-term focal psychotherapy in terms of its effect on the patients' overall clinical state, their general psychopathology and social adjustment, and their assessment of their outcome.     

Struggling with self: The personal projects of students seeking psychological counselling

Personal projects can be described as self-articulated goals and related sequences of actions. In order to investigate what kind of personal projects people with psychological problems have, and how they work on them, 28 counselling client students, 44 students of psychology, and 45 students of technology completed a Finnish version of Little's (1987) Personal Project Inventory. The results showed that the clients scored lower on project accomplishment than other groups. Their personal projects were frequently self-related, while those of the technology students were often task-related. The higher their sense of coherence, self-esteem, mental health and life satisfaction, the more subjects expected to accomplish their projects, the more frequently they described task-related projects, the less negative affect they reported, and the less frequently they described self-related projects. These results suggest that psychologically distressed individuals struggle with self-related projects and have problems in accomplishing their projects.     

Leisure-time physical activity and psychological well-being in university students

An analysis of psychological well-being (self-esteem and subjective vitality) of 639 Spanish university students was performed, while accounting for the amount of leisure-time physical activity. The Spanish versions of the Rosenberg Self-Esteem Scale and Subjective Vitality Scale were employed. Participants were divided into four groups (Low, Moderate, High, and Very high) depending on estimation of energy expenditure in leisure-time physical activity. Men and women having higher physical activity rated higher mean subjective vitality; however, differences in self-esteem were observed only in men, specifically between Very high and the other physical activity groups.     

The application of self psychology principles to long-term group therapy with schizophrenic inpatients

Concepts derived from a self psychology model are applied to an intensive long-term group therapy with hospitalized chronic schizophrenic patients. The clinical data suggest that initially patients' needs for safety and security predominate group process. Once an atmosphere of safety has been developed, patients begin to display needs for recognition and confirmation of themselves as unique, worthwhile individuals and for solace and consolation in regard to their traumatic life histories. A case study of the development of two group members reveals that these patients progressed from unshared, isolated, sometimes delusional visions of reality to the sharing of playful fantasies within the group and finally to an acknowledgement of painful life experiences. In their relationship with each other the patients moved from mutual isolation to a primitive relationship based on unconditional support, admiration and togetherness to a friendship in which they became increasingly able to confront each other with empathic failures and tolerate one another's separateness without withdrawal or decompensation.     

Potentiating group psychotherapy for bulimia with ancillary rational-emotive-hypnotherapy

A rational-emotive-hypnotherapy (REH) treatment was administered to five bulimic females who were concurrently participating in electic group psychotherapy. A within-group time series analysis design was employed to examine subjects' binge and purge symptoms. The combined treatments produced a declining frequency in symptoms for four subjects across three phases of the study. REH was responsible for 4 out of 8 possible treatment effects and appeared to potentiate the group psychotherapy. A theoretical explanation is offered for the REH effects along with recommendations for future REH with bulimics. This study was presented as a paper to the annual meeting of the American Psychological Association, 1982, Washington, DC. Appreciation is extended to Don W. Ball, Ph.D. for editorial and technical assistance in the preparation of this article.     

Dependency and perfectionism: Short-term dynamic group psychotherapy for university students

Abstract

This paper is based on the authors' experiences of conducting short-term psychodynamic group therapy with university students. The therapy groups focus on common problems among the members, i.e. perfectionism, procrastination, and fear of graduation. Working on their dependency and on their inadequate separation from parental figures typically helps the students cope more creatively with their academic problems. The paper explores technical questions and possible advantages in working within a short time frame using a group analytic approach.     

A psychological approach to ethics

This article has the purpose of calling attention to C.G. Jung's archetypal concept of the Self as an approach to ethics. The distinction between simple morality and transcendent ethics is established. Comparison is made between the archetype of the Self and Kant's categorical imperative. Freud's superego, however, is assimilated to a natural outlook on morality, such as the notion of altruism in sociobiology. The superego is only the psychic effect of the current moral code—which could be explained either culturally or as a Lamarckian acquired characteristic of the unconscious. Jung's transcendent ethics is expressed in an ethical mandala.     

A socio-emotional relational framework for infidelity: the relational justice approach

Current clinical models for addressing infidelity tend not to make social context issues a central focus; yet, societal gender and power structures, such as female responsibility for relationships and limited male vulnerability, affect the etiology of affairs and create power imbalances in intimate relationships. How therapists respond to these societal influences may either limit or enhance the mutual healing of both persons in the relationship. Thus attention to these societal processes is an ethical issue. This paper presents one perspective, the Relational Justice Approach, for working with infidelity. It places gender, power, and culture at the center of intervention in couple therapy, and includes three stages: (1) creating an equitable foundation for healing, (2) placing the infidelity in a societal context, and (3) practicing mutuality. Each stage is illustrated with case examples and contrasted with current practice regarding infidelity.