Integrating Cognitive and Existential Treatment Strategies in Psychotherapy With Dependent Patients

A dependent personality orientation is associated with increased risk for a broad array of Axis I and Axis II disorders. Although traditional treatment interventions have modest ameliorative effects on problematic dependency, the multifaceted nature of dependency suggests that integrated treatment strategies may hold more promise than traditional treatment approaches. This article outlines one potentially useful integrated treatment strategy, combining elements of cognitive and existential therapy to alter dependency-related thought, behavior, and emotional responding. Procedures for implementing an integrated cognitive-existential treatment model are outlined, and challenges in use of the model are discussed.     

试析欧文·雅洛姆的存在精神动力学理论

该理论以终极关怀的觉察→焦虑→防御机制这一基本动力结构为核心,深入探讨了死亡、自由、存在孤独和无意义这四个终极关怀的心理病理学价值,以移除个体成长的障碍为目标,以注重此时此地作为核心策略,高度重视治疗关系在治疗中的作用,对存在心理治疗理论的发展做出了贡献,具有一定的借鉴价值。     

Group Psychotherapy and Existential Concerns: An Interview with Irvin Yalom

Group psychotherapy can be used to help clients deal with most forms of emotional distress or problems with interpersonal functioning. Also, group therapy can be useful when helping clients to confront existential concerns such as isolation or meaning in ones life. During a recent interview, Irvin Yalom discussed a variety of issues related to group processes and existential matters that are involved in effective psychotherapy.     

Psychoanalysis and Psychosis: Trends and Developments

This paper presents the basic principles of insight-oriented therapy for schizophrenia, emphasizing the effectiveness of this approach: each treatment effort is a unique adventure, fueled by hopefulness in both participants. Next, it reviews the history of such treatment efforts and current tensions in the field. It presents information on the International Society for the Psychological treatments of the Schizophrenias and other psychoses (I.S.P.S.) and its current mission, to promote quality care for patients suffering from schizophrenia, to promote and facilitate research into this work, and to provide organizational support and ongoing educational programs for clinicians involved in these efforts.     

完美主义及其认知-行为治疗研究

完美主义是一种深刻影响人格的心理特征,与心理病理学现象有极为密切的联系。完美主义已经引起了心理界的关注。从完美主义的定义出发,提出完美主义认知和行为特征,总结了完美主义的评估方法及完美主义与心理障碍的关系研究,最后对完美主义的认知-行为治疗的方法和步骤进行了阐述。     

Poetry in Existential Psychotherapy with Couples and Families

The use of poetry during the process of existential psychotherapy with couples and families is described and illustrated. In this approach, poems can be utilized to help the couple and/or family notice meaning potentials in the future, actualize and make use of such meaning potentials in the here and now, and re-collect and honor meanings previously actualized and deposited in the past.     

Depression, Existential Family Therapy, and Viktor Frankl's Dimensional Ontology

In existential family therapy, it is believed that Viktor Frankl's dimensional ontology is a useful way to understand the different levels of depression that are important in both family assessment and family treatment. This article reviews Frankl's dimensional ontology, its usefulness for existential family treatment, the must, can, and ought levels of family depression, and presents clinical material illustrating the described existential family treatment approach.     

Comparing Values and Methods in Psychodynamic and Cognitive-Behavioral Therapy: Commonalities and Differences

To determine the underlying values and methods in cognitive-behavioral and psychodynamic therapy and to address the implications of those values and methods for integrating the two therapies, the Process Value and Methods Survey was sent to members of The Association for Advancement of Behavior Therapy (cognitive-behavioral sample) and Division 39 of American Psychological Association (psychodynamic sample). Members were asked to endorse items based on their ideal understanding of their respective orientations. A Principal Components Analysis (PCA) of the combined samples yielded six components for values, of which four were significant according to orientation. A second PCA, for therapeutic methods, yielded six components, five of which were significant according to orientation. In both PCAs, components significant for an orientation were consistent with the corresponding constructs of that orientation. The relationship between method and value components as well as how value components may be related to clinical practice and psychotherapy integration is discussed.     

存在焦虑的研究述评

存在焦虑是焦虑本体论的一种定义,是哲学、文学和心理学领域的重要概念之一。在心理学领域,存在焦虑理论主要包括罗洛·梅的焦虑本体论,布根塔尔的存在焦虑理论及存在焦虑与心理健康关系理论等等。目前的研究方法主要是量表测量法,但尚不成熟。为数不多的实证研究主要集中在：存在焦虑与心理健康的关系,与同一性地位的关系,与焦虑、抑郁的关系等等。今后研究的重点应包括概念研究的丰富、研究对象的拓宽及研究方法的改进和完善等     

Cognitive-Behavioral Therapy: The Truth Behind the Allegations

In response to several pejorative statements about Cognitive Behavioral Therapy in a recent issue of Psychotherapy (Silverman, 1999), a point by point counter argument to these criticisms are presented. Among other contentions, Silverman (1999) disparaged empirically validated methods as being simplistic and scientifically impoverished. The validity of these statements are challenged and empirical evidence is presented to support each counter argument. The efficacy of Cognitive Behavioral Therapy for a broad range of disturbances and presenting problems is presented. The future of Cognitive Behavioral Therapy and other empirically validated protocols are discussed, as well as recommendations for their use.     

Existential Marital Psychotherapy and the Experience of Managed Care

ABSTRACT

In this article the experience of managed care is over-viewed from the perspective of existential marital therapy. It is concluded that managed care disrupts the experiential nature of participation between couple and therapist, dilutes the authentic nature of the treatment relationship, decreases the importance of subjectivity, disturbs the discovery of meaning and purpose in marital life and deters existential communication.     

存在主义心理治疗的两个哲学教条

作为基本信念的两个哲学教条,即“存在先于本质”和“人是绝对自由”,导致存在主义心理治疗遭受各种诟病。前者造成人的存在与本质分裂,过分夸大个体选择意义和忽略人的现实性等问题;后者造成自由与必然关系的割裂,忽略自由的条件性和抽掉人的社会历史性等问题。基于对两个哲学教条的反思,存在主义心理治疗要求“抽象人”与“具体人”,“个体性”与“社会性”,“此在性”与“历史性”的辩证统一,从根本上实现对人的科学理解,进而提升实效性。

     

When a Small Group Turned Large: An Existential Encounter on 11/9 as an Enactment of 9/11

This paper was drafted in late November and mid-December 2001, two to three months after 9/11/01, in the weeks following the Opening Plenary of the Eastern Group Psychotherapy Society's Annual Conference held on 11/9/01. It was written from the position of observer-discussant-participant and impromptu large group facilitator, with the aim of reviewing and drawing meaning from what transpired during the Conference's opening plenary, which focused on existential issues in group psychotherapy. The plenary was chaired by Dr. Bernard Frankel and was comprised of a short talk, demonstration group, discussants' responses, and audience reaction. The emphasis in this review is on the process, content, and synchronous impingement of a real-life event on a remarkable demonstration group. Being in the group demonstration on 11/9 so closely paralleled being in the world of 9/11 that a small group turned into a large group.     

A Comparison of Computer-Assisted Psychotherapy and Cognitive-Behavioral Therapy in Groups

This study is the first independent, randomized controlled study in a clinical setting of a computer-assisted therapy program (Therapeutic Learning Program; TLP) developed to permit individualized therapy in a group setting. This software differs from other computer-assisted approaches in that targets for change are chosen by the patient rather than determined by the software. TLP was compared to a standard cognitive-behavioral treatment in 109 patients with 6-month follow-up. Although both treatments were associated with a significant reduction in symptoms of anxiety and depression at posttreatment and follow-up, no differences were found between treatments with respect to patient-rated satisfaction and effectiveness, clinician ratings of improvement, and scores on measures of anxiety and depression. At treatment midpoint patients tended to give more neutral ratings of satisfaction and treatment effectiveness of the TLP treatment, perhaps suspending judgment about this more novel treatment until its completion. It is concluded that at least one form of computer-assisted psychotherapy is as effective and acceptable to patients in a clinical setting as standard short-term cognitive-behavioral therapy conducted by experienced clinicians.     

Some thoughts on the existential lens in group psychotherapy

Existential psychotherapy provides a useful perspective, or lens through which to view the practice of group psychotherapy. The field encompasses a variety of theoretical and practical points of view, many not usually thought of as existential. Some relate to the therapist, some to the enterprise of psychotherapy, and some to conceptions of psychic or external reality. This paper identifies several of these vertices, emphasizing especially (1) the importance of relationship in psychotherapy, (2) the problem of meaning (3) addressing existential concerns, especially the centrality of death as a problem in living, and (4) the task of the therapist. Attention is paid to the historical development of these ideas. The work of Martin Buber, Otto Rank, Wilfred Bion, and Viktor Frankl is especially emphasized, although proto-existential concepts from other waters are also noted. The heart of the paper deals with the application of these vertices to group psychotherapy. Extensive attention will be given to the differing viewpoints of Hugh Mullan and Irvin Yalom. Practical applications in group psychotherapy, including clinical vignettes, are offered.This paper was originally delivered, in somewhat different form, at the National Group Psychotherapy Institute of the Washington School of Psychiatry on April 23, 1995. It was dedicated to Hugh Mullan, who had been one of my teachers at the school two decades earlier.     

An Existential Perspective of Body Beliefs and Health Assessment

Successful health assessments are ongoing and rely on a clinician/client interaction, which is influenced by both the client’s and the clinician’s beliefs about their bodies. These beliefs about the human body arise out of religious and cultural contexts. Theories often explain cultural context by comparison of differences and similarities between the client and the clinician and/or between the client and the dominant culture. This approach can carry a bias inherent in the comparison to dominant beliefs held by those with the most power and economic advantage. The author suggests an existential approach in which client and clinician bodies interact each as adept, autonomous individuals with a conglomerate of beliefs about body and health.The author is an Interdisciplinary PhD candidate in Music Therapy and Health Psychology at the University of Missouri-Kansas City Conservatory of Music. Her research goals include the interrelationship of music, spirituality, and cardiovascular health. She is a Board Certified music therapist and has served in that capacity since 1980 in mental health facilities, hospice, and private practice.