Internal cohesion psychotherapy: The nature,principles and application

Psychotherapy is widely used to treat different mental health disorders and emotional difficulties. The main objective of psychotherapy is to help clients become aware of and have control over their thoughts, moods, feelings and behaviours, as well as create healthy strategies to respond to challenging situations. Since the existing psychotherapy approaches and other methods of treatment are not always effective in treating mental health disorders, there is still space for new approaches to fill this gap. In this paper, we provide information about internal cohesion psychotherapy, which is a new integrative approach. This paper presents a new approach to eclectic psychotherapy, focussing on four detrimental aspects of human functioning through different time perspectives.     

An empirically-based rationale for a spiritually-integrated psychotherapy

In this paper, we offer an empirically-based rationale, for a particular kind of psychotherapy, spiritually-integrated psychotherapy. Drawing on several lines of research we note that: (1) spirituality can be a part of the solution to psychological problems; (2) spirituality can be a source of problems in and of itself; (3) people want spiritually sensitive help; and (4) spirituality cannot be separated from psychotherapy. We then discuss the defining characteristics of spiritually-integrated psychotherapy. It is based on a theory of spirituality, empirically-oriented, ecumenical, and capable of integration into virtually any form of psychotherapy. The paper concludes by considering potential problems associated with spiritually-integrated psychotherapy, including the risks of trivializing spirituality as simply a tool for mental health, reducing spirituality to presumably more basic motivations and drives, imposing spiritual values on clients, and overstating the importance of spirituality. Perhaps the greatest danger, however, is to neglect the spiritual dimension in psychotherapy. This paper sets the stage for the articles in this special issue of MHRC which describe the development and evaluation of several innovative approaches to spiritually-integrated psychotherapy.     

Online therapy for addictive behaviors.

Clinicians working in the field of addictive behaviors cannot afford to ignore the Internet. Psychological advice, help, and treatment for addicts are no exceptions, with both counseling and psychotherapy entering the computer age. This paper reviews the main issues in the area and approaches the discussion acknowledging that online therapy has to be incorporated within the overall framework of the need for clinical assistance. The paper also provides brief overviews of some websites as illustrative examples of what types of online therapy are available.     

Counseling and Guided Self‐Help Outcomes for Clients With Bulimia Nervosa: A Meta‐Analysis of Clinical Trials From 1980 to 2010

This meta‐analysis included 111 clinical trials exploring the effectiveness of counseling/psychotherapy and guided self‐help approaches in the treatment of bulimia nervosa. In general, single‐group studies supported higher efficacy of counseling/psychotherapy, whereas wait‐list, treatment‐as‐usual, and placebo studies indicated both approaches were equally effective at termination (posttest) and follow‐up in altering binging, purging, laxative use, and self‐reported bulimia or body dissatisfaction perceptions in nearly all comparisons.     

促进当事人的改变：基于治疗性最近发展区的视角

作为心理治疗的有效区域, 治疗性最近发展区是指当事人当前适应问题经验的能力和通过治疗师的协助能够达成的潜在能力之间的距离。早期的同化模型理论更注重对心理治疗改变过程的描述, 治疗性最近发展区理论则能够进一步解释治疗师在不同阶段的帮助策略。在研究上, 治疗性最近发展区理论建立在非传统的方法论基础上, 通过不断累积个案的质性研究, 帮助治疗师理解和解释不同咨询效果的互动过程, 并使理论得到持续发展; 在临床上, 治疗性最近发展区为理解心理治疗过程中倒退现象提供了新视角, 并能够有效指导在治疗过程中采取挑战性还是支持性策略。未来研究可从临床上探索经验丰富的治疗师的实践智慧, 也可选取较大跨度的治疗对话序列, 对不同流派的特点, 从不同参与者的视角出发进行研究, 进而深化对心理治疗过程机制的理解。     

Using dream interpretation to resolve group developmental impasses

This paper focuses on the use of dream interpretation in psychoanalytic group psychotherapy. One of the goals of the paper is to demonstrate that the kinds of dreams, manifestly about the group, offered at various points in the life history of the group, are influenced by, and, in turn, influence developmental phases in group. Dream interpretation also helps the therapist to identify emerging developmental themes in the group-as-a-whole as well as illuminate developmental impasses and resistances of the group. The second goal of this paper is to demonstrate how interpretations of these dreams can help lessen resistance and help the group to resolve the impasse. The paper first reviews some basic principles and approaches to dream interpretation in a group setting and then elucidates typical phases in group development. Two extended case examples are presented to illustrate how dream interpretation may be utilized to help the group move beyond the impasse.     

The Phenomenological Approach to Art Therapy

The present paper discusses the phenomenological approach to art-therapy and suggests an operational terminology for its main theoretical concepts. First we present the general assumptions that underline art therapy. Definitions, leading approaches, and the therapeutic effect of artwork are considered. Next we indicate the need for relevant and particular theories of art therapy. Phenomenological theory is examined as a case in point because of its popularity among art therapists. Despite its philosophical appeal, however, we find phenomenological theory lacking the operational terminology that is essential to form a coherent and distinct school of therapy. In the present paper, we extract from phenomenological theory operational principles, which can be followed and applied by art therapists. In this analysis, we take into consideration Betensky's pioneer attempt to create the bridge between phenomenological theory as applied in verbal psychotherapy and art therapy. We end by discussing the urgent need to operationalize other verbal psychotherapeutic theories so they are relevant for art-therapy practice and may help create greater similarities among art therapists of the same school of psychotherapy.     

The Mutual Development of Intersubjectivity and Metacognitive Capacity in the Psychotherapy for Persons with Schizophrenia

While cognitive behavioral approaches have been shown to help some individuals with schizophrenia, these approaches may be limited when working with patients with impairments in the metacognitive abilities required to form complex and integrated representations of themselves and others. In response, this paper explores the possibility that a key to working with patients with relatively impaired self-reflectivity lies in explicitly focusing on a patient’s intersubjective experience within psychotherapy. We offer theoretical and empirical support for the assertion that the tolerance and capacity for intersubjectivity is a basis for the development of self-reflectivity in general. We also explore how the fostering of intersubjective processes in psychotherapy might enable some patients to form more complex ideas about themselves and so better ward off delusions in the face of the challenges of daily life. To illustrate these principles we present the case of a patient with tenaciously held delusions and limited capacity for self-reflection. We discuss when and how the therapist’s awareness and verbalization of intersubjective processes within session allowed her and the patient to develop more complex and consensually valid ideas about him as a being in the world, which then assisted the patient to achieve improvements in a number of domains in his life.     

Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern‐based qualitative analytic approaches

Thematic analysis methods, including the reflexive approach we have developed, are widely used in counselling and psychotherapy research, as are other approaches that seek to develop ‘patterns’ (themes, categories) across cases. Without a thorough grounding in the conceptual foundations of a wide variety of across‐case analytic approaches, and qualitative research more broadly—something rarely offered in counselling training—it can be difficult to understand how these differ, where they overlap, and which might be appropriate for a particular research project. Our aim in this paper is to support researchers in counselling and psychotherapy to select an appropriate across‐case approach for their research, and to justify their choice, by discussing conceptual and procedural differences and similarities between reflexive thematic analysis (TA) and four other across‐case approaches. Three of these are also widely used in counselling and psychotherapy research—qualitative content analysis, interpretative phenomenological analysis and grounded theory. The fourth—discourse analysis—is less widely used but importantly exemplifies the critical qualitative research tradition. We contextualise our comparative approach by highlighting the diversity within TA. TA is best thought of as a spectrum of methods—from types that prioritise coding accuracy and reliability to reflexive approaches like ours that emphasise the inescapable subjectivity of data interpretation. Although reflexive TA provides the point of comparison for our discussion of other across‐case approaches, our aim is not to promote reflexive TA as ‘best’. Rather, we encourage the knowing selection and use of analytic methods and methodologies in counselling and psychotherapy research.     

文化心理学视域下的心理治疗

近年来,心理治疗的文化取向日益为心理学界所关注。在概要分析文化心理学理论取向和传统心理治疗特点的基础上,重点对文化心理学取向下的心理病因观、医患关系、心理治疗方法、心理治疗效果评价观做了相应分析,并对未来文化取向下的心理治疗理论进行了展望,希望对我国心理治疗理论和实践有所帮助。     

Beyond grounded theory: The use of a heuristic approach to qualitative research

The grounded theory approach has become established as the qualitative methodology of choice for many counselling and psychotherapy researchers. It is now becoming apparent to many researchers that there are significant difficulties associated with defining what the grounded theory method actually is, and how is should be implemented. In addition, its popularity has tended to keep other qualitative approaches under‐explored and under‐utilised. This paper explores some of the methodological issues raised by the grounded theory approach, before presenting and then contrasting heuristic inquiry as a very different but equally useful form of qualitative methodology. Finally, the notion of researcher as bricoleur will be considered in the light of the need to develop pluralistic approaches to qualitative research in counselling and psychotherapy.     

Transference focused psychotherapy: overview and update

This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non-analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.     

Narrative and discursive approaches to the analysis of subjectivity in psychotherapy

This paper reviews research that utilises language-based analyses (narrative analysis, discourse analysis and conversation analysis) to examine aspects of subjectivity in the context of psychotherapy. The studies reviewed fall broadly into two main groups. On the one hand, studies which share a view of subjectivity as the sum of internal 'voices' in dialogue adopt a narrative approach, examine subjectivity in terms of organisation, coherence and self-reflection, and consider psychotherapy a process of restoring an organised polyphony. On the other hand, studies which conceptualise subjectivity in terms of 'subject positions' adopt a discursive approach, emphasise the availability of subject positions and flexibility in adopting them and examine psychotherapy as a process of facilitating the flexible adoption by the client of a variety of subject positions. Theoretical, epistemological and methodological issues regarding each of the two approaches are discussed, along with representative studies. We finally examine the implications of these two approaches for understanding psychotherapeutic practice and for theorising and researching subjectivity.     

Inherent Self,Invented Self,Empty Self: Constructivism,Buddhism, and Psychotherapy

Constructivist and Buddhist approaches to counseling and psychotherapy share increasing popularity as well as similar epistemological assumptions and understanding of human dysfunction and its amelioration. These approaches can be seen as consistent with postmodern psychology, which is distinguished from a realist or foundationalist view. This article provides an overview of these 2 models and describes some of their implications for psychopathology and psychotherapy, including examples of specific therapeutic approaches drawn from each perspective that might mutually inform practitioners who wish to apply this perspective to a higher view of the human situation.     

A Mother,A Baby,and Two Treatment Approaches: Discussing A Switch Case from CBT and Mentalization Perspectives

ABSTRACT

As the literature on perinatal depression and anxiety grows, there is an increased need for dialogue among theoretical approaches for mother-infant mental health. This article describes a community mental health program incorporating a range of treatment models for pregnant and postpartum women experiencing issues during the transition to parenthood. Perinatal distress can affect parenting practices, from breastfeeding to health care access, creating the need for targeted, practical, and concrete interventions. Interventions that aim to foster secure attachment relationships and mentalization capacities can also help increase maternal sensitivity and attunement and joy in caregiving, and reduce withdrawn/hostile behaviors that may be associated with perinatal distress. The article describes psychotherapy with a mother and her newborn that began from a cognitive-behavioral approach and transitioned to a psychodynamic mentalization-focused treatment. Working principles and examples of two additional components of treatment, a group psychotherapy and research measures, are discussed. The case helps demonstrate how attachment theory can inform treatment and build a bridge between alternative approaches.     

Halachic Judaism's Influence on the Practice of Psychotherapy

This paper enumerates and discusses some halachic principles and values which are exerting increasing influence on the practice of psychotherapy. This trend is linked to the resurgence of spiritual values and content in mainstream psychology and therapy, and to the changing concepts of the philosophy of science. The cultural roots of psychotherapy, specifically the contrast between the Greek and Jewish approaches to freedom are also briefly analyzed. The Jewish stand is viewed as imposing a set of values which has as its core enormous respect for the person and his/her ability to choose. Another factor regarded as pivotal is that Jewish teachings foster esteem for objectivity as opposed to the rampant subjectivity seen in some contemporary psychotherapeutic methods. An additional factor discussed is the relation of character traits to therapy. Finally, some facets of the unconscious are analyzed as to their relation to psychotherapy and Judaism.     

Client perspectives and uses of psychotherapy

The present paper argues for the importance of studying user perspectives on ongoing psychotherapy. Four approaches to such studies are discussed. It is stressed that studies of user perspectives may allow us to develop a broader and more robust understanding of clients as the primary agents of their own change processes, and that if the studies focus on clients' everyday lives during the course of psychotherapy, they allow us a better understanding of how clients include their psychotherapy, give it a particular significance, fight over it, and transform it as a part of their changing everyday practice in other places than the session. the rationale and design of such a study is presented. It is a study of a small number of family therapies with the present author as a co-therapist. Some preliminary findings from this study are presented.     

Politics in psychotherapy: Therapists' responses to political material

This paper reviews the psychotherapeutic literature that addresses the ways in which political material is engaged with by psychotherapists. The paper explores this in both the traditional and contemporary psychotherapeutic approaches. The paper concludes with a recognition of some of the challenges psychotherapy faces in developing politically sensitive approaches which draw upon the lessons learned across therapeutic theory.     

Sailing between Scylla and Charybdis1: Incorporating qualitative approaches into child psychotherapy research

Starting from the acknowledged gap between research and practice in child psychotherapy, this paper offers an historical perspective on the relation between these two activities, and suggests that qualitative approaches to research may offer new ways of bringing them together. After introducing the fundamental concepts of qualitative analysis, three areas where qualitative forms of research may be useful to child psychotherapists are explored: relevant but non-psychotherapy research; accounts of therapy research; and therapy process research. Examples of all of these types of research are presented, and some of the challenges to incorporating qualitative approaches into child psychotherapy research are discussed.     

Psychotherapy Appointment No-Shows: Clinicians’ Approaches

Missed psychotherapy appointments and eleventh hour cancellations contribute to financial burdens, reduced scheduling efficiency, and lowered effectiveness of the therapeutic services delivered. This paper attempts to explore more specific clinical process factors related to patient no-shows. Psychotherapists and their patients in the outpatient psychiatry department of a public safety-net hospital were surveyed to examine how frequently patients missed scheduled psychotherapy appointments and for what reasons. Clinicians with the lowest rates of patient no-shows (n = 12) were asked to discuss their approaches to psychotherapy attendance and provided clinical examples. Clinicians’ responses were thematically grouped into five aspects of negotiating missed appointments and no-shows. Clinicians identified the importance of improving patient motivation, developing a positive therapeutic alliance, setting an established treatment frame, communicating about no-shows throughout the course of treatment, and maintaining their own scheduling accountability as important factors in their approaches to managing patient non-attendance.