骨髓造血干细胞移植治疗自身免疫性疾病的进展

本土化研究是当前世界人文社会科学发展的必然趋势,也是中国传统心理治疗思想发展的唯一出路。近百年来,随着西学热潮的兴起和现代西方心理治疗方法的涌入,我国心理学工作者和中医学工作者为了保护传统文化中的心理治疗思想,对其开展了广泛的研究,经历了萌芽阶段、曲折发展阶段、活跃阶段和繁荣阶段等四个时期。随着研究队伍的融合,未来的研究将不断凸显其自身特色,自身体系,并逐渐走向临床应用。     

阿德勒心理治疗方法与当代心理治疗整合精神的契合

阿德勒为心理治疗提供了一个经得起时间考验的综合理论。他对人类行为做了务实的概念化处理,并改变了程序使其可能整合当代心理治疗理论中众多有价值的见解。阿德勒心理治疗与当代实践之间存在很多相似之处,因为阿德勒治疗是一种现在与未来定向的、限时性的（即短程的）、整合性和折衷性的方法。     

Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis

During the last two decades a number of therapies, under the name of the third wave of cognitive behavior therapy (CBT), have been developed: acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), cognitive behavioral analysis system of psychotherapy (CBASP), functional analytic psychotherapy (FAP), and integrative behavioral couple therapy (IBCT). The purposes of this review article of third wave treatment RCTs were: (1) to describe and review them methodologically, (2) to meta-analytically assess their efficacy, and (3) to evaluate if they currently fulfil the criteria for empirically supported treatments. There are 13 RCTs both in ACT and DBT, 1 in CBASP, 2 in IBCT, and none in FAP. The conclusions that can be drawn are that the third wave treatment RCTs used a research methodology that was significantly less stringent than CBT studies; that the mean effect size was moderate for both ACT and DBT, and that none of the third wave therapies fulfilled the criteria for empirically supported treatments. The article ends with suggestions on how to improve future RCTs to increase the possibility of them becoming empirically supported treatments.     

Client self-image,therapist acting,and the establishment of the therapeutic alliance in a training context

This study examined how clients’ self-image and perception of therapist’s behavior are related to the therapeutic alliance, as well as how these variables change in the psychotherapy process in trainee-led psychotherapy. A total of 164 participants (M = 28.9 years) who attended two semesters of treatment at the Psychology Clinic of Umeå University completed the Working Alliance Inventory (WAI) to evaluate their perception of their alliance with the therapist. They also completed two questionnaires based on the Structural Analysis of Social Behavior (SASB) model to give insight into their self-image patterns and to analyze their perceptions of the therapist’s behavior. The results show that a positive self-image and positive perceptions of the therapist’s actions increased significantly over the course of the therapy, with a corresponding decrease in negative patterns. The alliance scores show that the therapeutic alliance gains significance over time and that it is influenced more by the perception of the therapist’s behavior than by the self-image. The self-image becomes relevant after the mid part of therapy, underlining the role of the therapist in co-creating the treatment relationship. The implications of these results are discussed, and so are directions for future research in other trainee-led settings and samples.     

Methods and mechanisms in the efficacy of psychodynamic psychotherapy

Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler (see record 2010-02208-012). Shedler summarized a large body of research that shows psychodynamic therapy to have a substantial effect size, comparable to that for many empirically supported treatments. This is an important finding, in part refuting the concerns raised by Bornstein (2001, 2002) regarding the future of psychodynamic approaches had there been no substantial changes in how practitioners and researchers approached the science to demonstrate efficacy. Further, Shedler showed that the efficacy of psychoanalytic psychotherapy is due to therapeutic methods commonly employed in cognitive behavior therapy (CBT), one of the most frequently cited empirically supported approaches for a wide range of psychological conditions. From a methodological perspective, there are some important limitations to the claim of psychodynamic psychotherapy's comparable efficacy to other empirically supported approaches.     

The Value of Integration: Psychoanalytic Psychotherapy Meets Ego Psychology in a Psychotherapy Group for Children

ABSTRACT

Psychotherapy integration requires us to look beyond the confines of a particular theoretical or technical approach towards other perspectives. Integrative work with children, in particular, meets the socio-emotional needs of the child while simultaneously modeling behaviors and skills. This paper presents an explicitly integrative approach to child group psychotherapy: Relationships. Individuals. Skills. Engagement (RISE) Group. We begin with an in-depth discussion of the RISE group structure illustrated by clinical examples (the “what”) followed by a review of the theory and treatment modalities that inform the approach (the “why” and “how”). The RISE group is grounded in two theoretical perspectives (psychoanalytic principles and ego psychology) and draws upon clinical techniques from multiple treatment modalities (including cognitive behavior therapy, psychodynamic play therapy and dialectical behavior therapy). Combined, the merger of these perspectives results in a multilevel intervention that forges pathways to mastery and competence within the child. Finally, we discuss the value and limitations of integration as applied to group psychotherapy for children.     

Supervision in the Psychotherapy of Schizophrenia: Awareness of and Mutual Reflection upon Fragmentation

Historical and newly emerging models of schizophrenia suggest it is a disorder characterized by the fragmentation of the experience of the self and the world, leading to the interruption of how a unique life is unfolding in the world. It has been proposed that psychotherapy might therefore promote recovery by facilitating the development of a greater ability to integrate information about the self and others. In this paper we explore how the supervision of a metacognitively-oriented psychotherapy can assist therapists to experience and conceptualize fragmentation within sessions, join patients in the gradual process of making sense of their psychiatric problems and life challenges, and ultimately envision and achieve recovery. Common challenges and responses within supervision are described and discussed.

     

Emotions,narrative and change

There is a wide agreement that emotions are central to the evaluation and understanding of change processes in psychotherapy. Unfortunately, most of the debate on the role of emotions has been influenced by the reductionist view of ‘psychophysiological symbolism’ (Averill 1996). We defend the position that, in order to understand their role in psychotherapy fully, we need to move in the direction of a more complex view of emotions. This paper presents a view of emotionsas social constructed phenomena operating via language and narrative. We present research suggesting that these narratives may be an essential process for understanding psychological disorders, how these disorders are developed and, finally, how they can be changed.     

Culture-sensitive functional analytic psychotherapy

Functional analytic psychotherapy (FAP) is defined as behavior-analytically conceptualized talk therapy. In contrast to the technique-oriented educational format of cognitive behavior therapy and the use of structural mediational models, FAP depends on the functional analysis of the moment-to-moment stream of interactions between client and therapist. This distinctive feature makes FAP particularly sensitive to the challenges posed by cultural differences between client and therapist. Core elements of FAP philosophy are invoked to argue that this vulnerability paradoxically implies an increased ability to capture and use relevant issues in the therapy process with culturally different clients. This argument focuses FAP's preference for concrete behavior over theoretical modeling, its emphasis on functional principles rather than topographically defined techniques, and its inclusion of the therapist's behavior in the assessment of clients' clinically relevant behavior. Suggestions are given concerning how academic and practical training and personal experience may be used to foster sound multicultural practice.     

Psychological science treatment

New discoveries in psychological science have changed our understanding of some basic psychological processes. The new science, however, has not of yet been properly incorporated into the practice of psychotherapy. This has created a confusing state of affairs, lacking clear distinctions between therapy interventions rooted in lore and personal insight and those based on systematic scientific inquiry. In this paper, I discuss the problems caused by the current situation and propose a new distinction by which the psychological (science) treatment of psychological disorders is differentiated from psychotherapy. The implications of the proposed distinction for clinical research and training are discussed.     

Benefits and Challenges of Conducting Psychotherapy by Telephone

Telephone-delivered psychotherapy has increased utility as a method of service delivery in the current world, where a number of barriers, including economic hardships and limited access to care, may prevent people from receiving the treatment they need. This method of service provision is practical and has the potential to reach large numbers of underserved people in a cost-effective manner. The aim of this paper is to review the state-of-the-art of telephone-delivered psychotherapy and to identify improvements and possible solutions to challenges. Results of randomized controlled trials indicate high client acceptance and positive outcomes with this method of delivering psychotherapy. Nonetheless, psychotherapists wishing to deliver psychotherapy by telephone face a number of challenges, including a lack of control over the environment, potential compromises of privacy and confidentiality, developing therapeutic alliance without face-to-face contact, ethical and legal issues in providing psychotherapy by telephone, handling crisis situations at a distance, and psychotherapist adjustment to conducting psychotherapy in an alternative manner. There remains a need for further research, including direct comparisons of face-to-face psychotherapy with telephone-delivered psychotherapy and feasibility of telephone delivery of psychotherapies other than cognitive behavioral therapy.     

The Mark of Oppression by Abraham Kardiner and Lionel Ovesey

This article examined how intensive group cognitive-behavioral therapy (GCBT) and group psychodynamic psychotherapy (GPDT) modified depressive symptoms and processing of social information (hostility attributions in a variety of ambiguous situations). The sample (N = 37) comprised individuals who were attending psychotherapy due to psychological distress (GCBT or GPDT). The study examined how group psychotherapy influences depression symptoms and social cognition. There was a decrease in depressive symptoms after three months of intensive CBGT, but PDGT did not significantly improve symptoms of depression. Moreover, in both psychotherapies, the authors noted a significant decrease in hostile attributions, mainly in situations involving people with whom one does not have a close relationship.     

Diagnostische Methoden in der Gesprächspsychotherapie

As in other scientifically recognized psychotherapy procedures diagnostic methods are highly valued in modern client-centered psychotherapy. On the one hand diagnostics provide the necessary documentation of the effects of therapy (as legally prescribed), on the other hand they enable the indications for psychotherapy and monitoring of the therapy process. Besides theory-overlapping instruments (especially for comparing the effects with those of other therapies) there is a respectable repertoire of client-centered theory-oriented diagnostic methods, primarily for the diagnostics of essential process variables. For the three domains of diagnosis, pretesting, process diagnosis and post-testing, the methods used by client-centered therapists are introduced and theory-oriented methods are delineated with recommendations for acquisition. Moreover, the use of other procedures is also suggested.     

Dealing with labyrinths. General practice and research in psychoanalysis--an evaluation

If psychotherapy research is to yield results relevant for therapeutic practice, it must broaden its receptiveness for the peculiarities of this field and for the methods employed by therapists. The therapist works on-line, while the researcher enjoys the advantage of working off-line. Research in psychotherapy has addressed the world of images and affects, the interactive process, the dependence on models, and the specific manner of information processing characteristic of therapy. The author compares the different ways in which the therapeutic and the empirical settings handle suspicion and error.     

Interpersonal Behavior Therapy (IBT), Functional Assessment,and the Value of Principle-Driven Behavioral Case Conceptualizations

The Psychological Record - We introduce interpersonal behavior therapy (IBT) in the context of a brief history of evolving paradigms of psychotherapy research and the rise of the third-wave...     

Improving cognitive therapy for depression with functional analytic psychotherapy: Theory and case study

A behavioral reconceptualization of cognitive therapy is presented to illustrate that clinical behavior analysis (CBA) has much to offer traditional cognitive behavior therapy. Particular attention is given to the distinction between cognitive structures and products and the theoretical dilemma facing cognitive therapists when they attempt to devise interventions aimed at changing nonbehavioral entities. The distinction between rule-governed and contingency-shaped behavior and the implications of functional analytic psychotherapy (Kohlenberg & Tsai, 1991) are used to resolve the dilemma and to suggest methods for enhancing cognitive therapy. In a case study, a CBA-enhanced version of cognitive therapy was introduced after 7 weeks of standard cognitive treatment for a 35-year-old depressed male. The client-therapist relationship provided opportunities during the therapy session for learning new behavior called for in the behaviorally reconceptualized cognitive therapy. The enhanced treatment improved clinical efficacy and increased the client's focus on his deficits in interpersonal repertoires. Because the present case study involved only one of several enhancements suggested by CBA, the possibility of increased efficacy from a more comprehensive application is discussed.     

Treating Parents and Children Together

SUMMARY

In this paper I look at two traditions of psychotherapy with children: family therapy {here considered in its common paradigm of systems theory and not in its diversity of approaches) and individual psychodynamically oriented child therapy. The author examines how, in these two modalities of treatment, the real world of the parent-child relationship, which remains mostly a world of women and children, tends to be left out in practice. Many family therapists “exclude” children from their sessions and concentrate on the marital relationship while child therapists “exclude” parents from the core of the therapeutic process. The issues for therapists and the consequences for adults and children in families in this com-partmentalization of services are examined within a feminist framework. The development which is advocated is for therapists to expose themselves fully to the world of the parent-child relationship as a fust step in reexamining their stereotypical views of motherhood and fatherhood which trap women in conflicted and potentially exploitative situations and do not consider that children actively construct their own relationships.     

Psychiatry,Cultural Competency,and the Care of Ultra-Orthodox Jews: Achieving Secular and Theocentric Convergence Through Introspection

Several socio-cultural factors complicate mental health care in the ultra-Orthodox Jewish population. These include societal stigma, fear of the influence of secular ideas, the need for rabbinic approval of the method and provider, and the notion that excessive concern with the self is counter-productive to religious growth. Little is known about how the religious beliefs of this population might be employed in therapeutic contexts. One potential point of convergence is the Jewish philosophical tradition of introspection as a means toward personal, interpersonal, and spiritual growth. We reviewed Jewish religious-philosophical writings on introspection from antiquity (the Babylonian Talmud) to the Middle Ages (Duties of the Heart), the eighteenth century (Path of the Just), the early Hasidic movement (the Tanya), and modernity (Alei Shur, Halakhic Man). Analysis of these texts indicates that: (1) introspection can be a religiously acceptable reaction to existential distress; (2) introspection might promote alignment of religious beliefs with emotions, intellect and behavior; (3) some religious philosophers were concerned about the demotivating effects of excessive introspection and self-critique on religious devotion and emotional well-being; (4) certain religious forms of introspection are remarkably analogous to modern methods of psychiatry and psychology, particularly psychodynamic psychotherapy and cognitive-behavioral therapy. We conclude that homology between religious philosophy of emotion and secular methods of psychiatry and psychotherapy may inform the choice and method of mental health care, foster the therapist-patient relationship, and thereby enable therapeutic convergence.     

Lines of advance in psychoanalytic psychotherapy

Freud's 1919 paper is taken as a starting-point to review how far we have advanced towards fulfilment of his prophetic remarks about the need to develop psychoanalytic psychotherapy for the masses. A glance is taken back to some of the circumstances and characters involved in Budapest where the paper was given at the 1918 congress, where there was much talk about the need to do something about the war neuroses. Similar pressures led to the founding of the Tavistock Clinic and Cassel Hospital in the UK, long before the start of the NHS. The pressures of both world wars advanced the applications of psychoanalysis; the next wave of pressures may come from NHS changes and entry into Europe. The history of psychoanalytic psychotherapy in the UK is also considered via looking briefly at the history and development of psychoanalytic publications, of the Tavistock Clinic, of psychoanalytic training, of child psychotherapy and the emergence of adult (non-medical) psychotherapy. There have always been tensions between exponents of the pure gold of analysis and the needs of its wider applications. More flexible arrangements and boundaries are necessary if we are to spread psychoanalysis beyond London and to fulfil Freud's own hopes about the large-scale application of psychoanalytic therapy.