Die Wirkung von traumatischem Stress auf biopsychische Selbstorganisationsprozesse

Social frameworks have influenced the understanding of trauma-reactive psychic disorders during the course of the past two centuries.The 20th century has further shaped this understanding by the various concepts established by the different therapeutic schools.The incorporation of scientific results, as well as the theory of complex dynamic systems particularly that of synergetics supply now abundant impulses stimulating the discussion of posttraumatic stress disorders on a psychodynamic, neurophysiological, and systemspecific basis, thereby leaving those schools behind.Comparing synergetic models with the current state of neuroscientific research of post traumatic stress disease (PTSD) gives surprising insights of the dynamics of this disorder,and the resulting therapeutic principles.Specific therapeutic approaches, with the two phases of stabilisation and of trauma processing can be derived from such functional principles of neuronal networks.     

The causality principle of psychotherapy and supportive methods in group psychotherapy--reflections on the principles of method combinations

A causality principle of psychotherapy is offered, starting from a technologically orientated concept of psychotherapy as a process. Working from target, commencement, principles, and means, psychotherapeutic methods may be characterised. From these, rules governing the therapist's mode of conduct are arrived at. The causality principle provides a theoretic and practical basis for the integration of ancillary methods into various therapeutic concepts, and for therapeutic teamwork.     

Family Reconstruction

Family reconstruction, as described by Virginia Satir, is important for its transformative possibilities. This therapeutic tool can integrate a person into the historical and psychological matrix of his or her family of origin. This article describes how a reconstruction can be accomplished in three hours by using certain steps and principles. A case study is provided illustrating these steps and principles, including the personal reflections of the participant group.     

Therapeutic jurisprudence and the resolution of value conflicts: what we can realistically expect, in practice, from theory

This article assesses the criticisms of therapeutic jurisprudence that it cannot resolve value conflicts, especially between autonomy rights and therapeutic values, or, less radically, that it has not provided a general method for resolving conflicts. Grounded in general jurisprudential principles about conflict resolution, including novel developments respecting the meaning of weighing and balancing, the article rejects the criticisms as unfounded. The article also develops and critiques arguments maintaining that therapeutic jurisprudence cannot resolve certain value conflicts because the values are incommensurable. The argument is illustrated by examples concerning the right to refuse treatment, and jurisprudential analyses of that right.     

From the Roots of Psychosocial Practice-Therapeutic Use of Self in the Classroom: Practical Applications for Occupational Therapy Faculty

The roots of occupational therapy stem from psychosocial practice and embrace concepts of humanism, client-centered practice and therapeutic use of self. These concepts are integral to both clinical and academic settings. As the profession has moved toward graduate level education, increased numbers of non-traditional students are entering the field. Models of teaching that incorporate principles of active learning and therapeutic use of self within the classroom provide a consumer-learner-based model of education that is uniquely suited to students of diverse backgrounds, lifestyles, and educational needs. This article presents a brief overview of andragogical principles and the development of the student-faculty relationship. Mosey's concepts of conscious use of self are introduced as a means by which positive faculty-student relationships can be formed in order to enhance student learning and educational outcomes.     

The clinician-investigator: unavoidable but manageable tension

The "difference position" holds that clinical research and therapeutic medical practice are sufficiently distinct activities to require different ethical rules and principles. The "similarity position" holds instead that clinical investigators ought to be bound by the same fundamental principles that govern therapeutic medicine--specifically, a duty to provide the optimal therapeutic benefit to each patient or subject. Some defenders of the similarity position defend it because of the overlap between the role of attending physician and the role of investigator in a research trial. This overlap is maximal when the same physician occupies both roles with respect to a particular patient-subject. We address the ethical tensions inherent in that role conflict and argue that the tensions are real but manageable. The difference position provides a sound ethical framework within which to manage those tensions, while the similarity position is unsatisfactory because it seeks to deny the existence of the tensions.     

Thinking Differently Principles of Process in Living Systems and the Specificity of Being Known

As a way of integrating emerging knowledge of biological systems, developmental process, and therapeutic process, we identify principles in the process of exchange between organism and its context of life support that are present at all levels of complexity in living systems, from the cellular to the organization of consciousness. These principles range from specificity, rhythmicity, recurrence, and pattern to coherence, wholeness, and a relative unity in the organization of component parts. By proposing that these principles are also governing the exchange between mother and infant as they negotiate a sequence of essential tasks of adaptation, or “fitting-together” between them over the first years of life, the author suggests that the biological level becomes integrated with the developmental. A sequence of adaptive tasks extends from specificity of recognition in the newborn state, to recognition of inner awareness, purpose, and intention—shaping conscious organization. The bridge to the therapeutic level is constructed as therapist and patient build increasingly inclusive and coherent moments of recognition between themselves at the level of conscious organization, which act as corrective experiences, bringing the patient's own senses of “true self” and of “agency-to-initiate” to new levels of validity and competence.     

How Might Personal Construct Psychology Benefit from Narrative Approaches?

Constructivist and narrative psychotherapies share an understanding of the self as fragmented, relational, distributed, and discursive. Collaboration of these two modalities might offer a synergistic perspective for working with people. Hermeneutically driven therapy concerns personal development, which is seen as a unique effort of the individual to narrate different stories about him- or herself and others. The therapeutic process is viewed as a raising of awareness about marginalized discourses and empowering alternative voices. Furthermore, the making of an alternative story implies a new understanding of oneself, new interpretation of the past, and anticipation of the future. A case study is presented in which these principles are implemented in therapeutic practice.     

Boundaries in the practice of humanistic counselling

The multifaceted concept of boundary is used to describe the ground rules, quality and type of therapeutic relationship in a humanistic form of counselling that develops some of the principles of Carl Rogers and blends them with principles from psychodynamic practice. The concept of boundaries is first discussed in relation to its usages and practical consequences. An analysis of some core principles and assumptions about boundaries that guide the communicative psychotherapy approach of Robert Langs leads into a comparison with person-centred counselling. The aim is to develop a middle path for humanistic practice along more formal lines, involving a more fluid understanding of relationships and precise use of counselling principles. This also involves finding aspects of agreement between the psychodynamic and humanistic styles of working, by omitting some concepts and practices and identifying areas of common ground. Several comments on practice are made by comparing the two perspectives. The concept of boundary enables counsellors of all schools to think about points of similarity and difference. Finally, the notion of boundary itself is critiqued, and intersubjectivity is proposed as a potentially more meaningful term.     

Is Therapeutic Alliance Influenced by a Feminist Approach to Therapy?

Although the feminist critique of marriage and family therapy has been a significant part of the literature for many years, its impact has been blunted by two criticisms. The first suggests that the feminist critique lacks empirical support. The second suggests that the feminist critique promotes an alliance with women clients at the expense of men. The first criticism has been addressed in recent years. The present study examined the relationship between feminist principles and therapeutic alliance. Results suggest that feminist principles actually enhance therapeutic relationship for men clients but has no effect on therapeutic relationship for women clients.of the Marriage and Family Therapy Program     

Session-Intersession Sequences in the Treatment of Chronic Anorexic-Bulimic Patients: Following the Model of "Family Games"

In this article, the author presents some technical aspects of a psychotherapeutic approach for treating chronic anorectic patients. Two basic principles underlie the approach. First, the main purpose of the treatment is to improve the patient's relational skills in order to enable her to cope with her family's "game". Second, the therapeutic relationship is considered hierarchically subordinate to her relationships outside the therapeutic context. Mastering the model of families with anorectics is essential if the therapist is to be consistent with these principles. Specialized training in verbal and nonverbal communication is considered a useful tool.     

Acceptance in behavior therapy: Understanding the process of change

Acceptance is integral to several cutting-edge behavior therapies. However, several questions about acceptance remain to be clearly answered. First, what does acceptance look like, and can it be observed and measured? Second, what are the behavioral principles involved in the promotion of acceptance? Third, when is acceptance indicated or contraindicated as a therapeutic goal? The current paper attempts to clarify answers to these questions. The goal is to provide a conceptualization of the what, how, and when of acceptance that is accessible to behavior analysts, both to promote our understanding of acceptance as a behavioral phenomenon and to facilitate its empirical study and therapeutic utility.     

On Principles of Educational Change and Principled Action in Psychotherapy Supervision

Change strategies/principles, a well-recognized and accepted component of therapeutic practice, have yet to be comparably considered in psychotherapy supervision. Can there be educational change strategies/principles for psychotherapy supervision? I take up that question subsequently. I contend that supervision is forever a principle-driven activity, that supervisors practice in a principle-driven manner, and that a common core of guiding supervision strategies/principles can be identified. Reasoning by analogy from the seminal works of Goldfried (Am Psychol 35:991–999, 1980; How people change: inside and outside therapy, Springer, New York, 1991; Clin Psychol Rev 33, 862–869, 2013) and Castonguay and Beutler (Principles of therapeutic change that work, Oxford University Press, New York, 2006a; J Clin Psychol 62:631–638, 2006b; Principles of therapeutic change that work, Oxford University Press, New York, 2006c), I propose one such common core: 20 educational strategies/principles that cut across any and all forms of supervision. What follows is foremost a stimulus paper, a starting point, designed to provoke further dialogue about this crucial but unconsidered aspect of supervision practice.     

Penetrating the boundaries of latent conflict

The psychotherapeutic process has customarily been divided into an opening phase, a working-through phase, and a termination phase. Beyond recognition of these stages, few theorists have offered criteria for tracking the transition from one phase to the next. A related problem affecting each of these stages has been whether dynamically-oriented psychotherapy can predict latent conflict before it becomes manifest. Developmental principles derived from the early life relationship between caregiver and infant may provide therapists with a viable approach for handling these issues. By applying these principles analogously to the therapeutic situation, therapists may be able to better predict the transitions between stages, as well as to identify latent conflict before it is manifested. Moreover, these principles may also provide criteria for determining when treatment should be terminated.     

The democratic therapeutic and training communities of the Open Psychotherapy Centre: A multifactorial communal approach

This paper describes the structure, function and effectiveness of a multifactorial communal approach which is applied in the therapy department and the four training institutes of the Open Psychotherapy Centre in Athens. The therapeutic philosophy of this approach is based on the principles of group analysis, therapeutic community and emprosopon psychotherapy which are applied in combination with each other.     

Context and Culture: The Initial Clinical Interview with the Latina/o Client

Changing social demographics require that psychotherapists and mental health delivery systems become accountable for developing attitudes and skills for working multiculturally. This article immerses the reader in contextual and cultural principles for establishing an initial therapeutic relationship with Latinas/os. These contextual and cultural principles also can be implemented across any theoretical orientation or clinical interview structure psychotherapists employ. This article also reports on data from a subset of participants (n = 27) that self-identified as bilingual, bicultural, and highly culturally competent from a larger mixed-methods study of 89 Latina/o therapists. The results support the utility of personalismo, respeto, charlar (small talk), language and education, and self-disclosure in building respectful relationships with, and in conducting the initial interview with Latina/o clients. These findings are highly consistent with the common factors literature and lend further support to the proposition that the therapeutic relationship serves as the base for therapeutic interventions across all cultures.     

The open dialogue approach to acute psychosis: its poetics and micropolitics

In Finland, a network-based, language approach to psychiatric care has emerged, called "Open Dialogue." It draws on Bakhtin's dialogical principles ( Bakhtin, 1984 ) and is rooted in a Batesonian tradition. Two levels of analysis, the poetics and the micropolitics, are presented. The poetics include three principles: "tolerance of uncertainly,""dialogism," and "polyphony in social networks." A treatment meeting shows how these poetics operate to generate a therapeutic a therapeutic dialogue. The micropolitics are the larger institutional practices that support this way of working and are part of Finnish Need-Adapted Treatment, Recent research suggests that Open Dialogue has improved outcomes for young people in a variety of acute, severe psychiatric crises, such as psychosis, as compared to treatment as-usual settings. In a nonrandomized, 2-year follow up of first-episode schizophrenia, hospitalization decreased to approximately 19 days; neuroleptic medication was needed in 35% of cases; 82% had no, or only mild psychotic symptoms remaining; and only 23% were on disability allowance.     

Passt oder passt nicht?

Differential indication in psychotherapy should be a process of decision making, that takes multiple factors into account, and not just the assignment of a particular disorder to the adequate therapeutic method. Unspecific characteristics of the patient, instead of disorder-specific features, as well as personality characteristics of the therapist having therapeutic relevance are important factors either. In this way decisions for an indication then turn into the crucial question of matching between patient and therapist. The receptivity of the patient is a central component. As a result of successful maching, the therapeutic relationship will improve which has a positive influence on the outcome of psychotherapy. According to the generic model of psychotherapy 4 levels of the decision-making process are defined. They serve as orientation for a differential indication taking into account both persons and methods. The realization of this indication model in in-patient treatment has some preconditions. Obligatory is the availability of a variety of therapists differing in therapeutic methods and personal characteristics. The mostly applied principles of matching decisions are listed in tabular form and illustrated by a case report.