Integrative Therapie von narzisstisch gestörten Patienten

The psychotherapy of patients with a narcissistic personality disorder continues to be a psychotherapeutic challenge. There is still no psychotherapeutic program for the treatment of these patients which integrates different psychotherapeutic methods and strategies. Therefore the therapy of narcissistic patients remains difficult and only few psychotherapists voluntarily meet the challenge of treating such patients. In this article an integrative psychotherapeutic concept for the treatment of narcissistic patients using psychotherapeutic methods of different psychotherapeutic schools is presented. This integrative concept includes basic strategies such as working with the therapeutic alliance, schema work and activation of resources. On the other hand specific modules for different core symptoms of these patients are proposed. With this article the authors hope to contribute to a new conceptualization of the psychotherapy of narcissistic patients.     

Cross Cutting Issues in the Practice of Psychotherapy in Nigeria

The need to bridge the gap between western based psychotherapeutic intervention and African psychotherapeutic interventions is the main objective of this paper. In order to do this, cross cutting issues in psychotherapy in Nigeria were reviewed. This review covered socio cultural, economic conditions and other contemporary issues such as child maltreatment, HIV/AIDS, chronic illness, terrorism and the impact of western civilization on Nigerian culture and how it has produced a heterogeneous Nigerian society described as westernized, traditional and transitional types of Nigerians. Also salient peculiarities that must be taken into consideration in bridging the gap between western and African based psychotherapy were identified. Some of these salient peculiarities were adumbrated and they include frequent somatic complaints of psychological origin, beliefs in spirits including ancestral spirits, independent spirits and the supreme spirit God to whom duties are owed to keep the moral order. Given this situation the authors expressed uncertainty in the use of western diagnostic illness categories. Also an attempt was made to describe traditional methods of treatment such as the popular prayer houses and traditional healers. From lessons learnt based on these cross cutting issues the authors reported the development of Harmony Restoration Therapy and Meseron treatment frameworks as attempts at indigenizing western psychotherapeutic methods. From these they proposed the way forward as a cultural blend through using culture based psychotherapeutic framework. This they suggest can be applied in other societies.     

Nature as therapist: Integrating permaculture with mindfulness- and acceptance-based therapy in the Danish Healing Forest Garden Nacadia

Nature-based therapy can be considered an umbrella term for a diverse range of psychotherapeutic and allied practices which integrate experiences and activities in nature as therapeutic means. The objective of this article is to describe the theoretical framework for nature-based therapy in a university-founded healing forest garden near Copenhagen, Denmark. The garden will offer a 10-week treatment for people who are on sick leave with stress-related illness. This article focuses on clarifying the integration between the psychotherapeutic and gardening aspects of the nature-based therapy. The psychotherapeutic aspects are based on mindfulness and an acceptance therapy, while the gardening aspects are highly inspired by permacultural principles and methods.     

„Da wirst du ja auch bekloppt bei“

Given a growing demand of psychotherapeutic care the interest of students in a psychotherapeutic occupation is gaining relevance. At the same time psychoanalytic training institutions and societies have been confronted with a continuous decrease of candidates over the last decades. Psychology students, medical students and students of educational sciences (the latter only in the child and adolescent treatment sector) are admitted for a psychotherapeutic training approved by the health care insurances in Germany and have the possibility to choose between a behavioral or a psychodynamic oriented training. In the present multimethodological cross-sectional study those student groups (N?=?679) were questioned about their interest in a psychotherapeutic training in general and, if they proved to be interested, about their specific choice of training. Amongst psychology students the largest group of those interested in a psychotherapeutic training would opt for a behavioral education. Amongst medical students and students of pedagogy and social pedagogy a psychotherapeutic training is less frequently an option for their future career plans. Amongst the students of educational sciences, for those interested in training, psychodynamic methods are more often of interest. Possible reasons for the students' decisions in the context of the specific German legal situation are discussed.     

Übertragung und Gegenübertragung in Verhaltenstherapie und Psychoanalyse

Most psychotherapists and researchers agree that a good relationship essentially contributes to therapeutic change. The psychoanalytic concepts transference and countertransference which describe fundamental aspects of the psychotherapeutic relationship have now become integrated into behavior therapy. These concepts, however, are used differently in psychoanalysis as well as in behavior therapy. This makes the communication between psychotherapists coming from different orientations difficult. Therefore, a research approach which describes the important verbal and nonverbal elements of a helpful therapeutic interaction independently from therapeutic orientation could help to evaluate their effectiveness in different psychotherapeutic methods. In this way a culture of integration into psychotherapy could be encouraged.     

Kandidaten in psychotherapeutischer Ausbildung

In the context of the discussion about a reform of psychotherapeutic training in Germany the question arises, which factors influence the decision of psychologists and physicians for a particular training. 343 candidates in psychodynamic, behavioural or psychoanalytic training were asked about their motives for the training, their professional objectives in general and their satisfaction with their choice of training. The candidates' decision for a particular training was associated with personal attitudes and professional goals, with the given information about psychotherapeutic treatment within their studies and with their field of study. For the most part, the respondents are not satisfied with the quality and quantity of information on psychotherapeutic treatment within their studies. Candidates in analytic training are altogether more satisfied with their choice of training and do not plan to start an additional psychotherapeutic training as often as candidates in behavioral training. The consequences of these results in particular for the medical and psychological curricula (a more balanced representation of psychotherapeutic methods) are discussed.     

Catamnestic studies of patients with writer's cramp following inpatient psychotherapy

The paper gives the results of a follow-up study of 58 patients after psychotherapeutic treatment as in-patients for writer's cramp. Where as immediately after discharge 74.1% of the patients felt an improvement in their condition, at the time of the follow-up study only 17.2% were demonstrably improved, with 37.9% subjectively feeling an improvement over their state before treatment as in-patients. These results suggest that the customary psychotherapeutic methods employed have less effect on the evidently multifactorial extrapyramidal-motor basic complaint but rather have the effect of improving the patient's ability to cope with this in daily life.     

Zukunft der Psychotherapie in der Psychiatrie

The conceptual development of the German mental health system can only be understood against the background of the specific historical development process; therefore, the emigration of psychodynamic psychotherapists during the Third Reich as well as the complicated reintegration of psychotherapy into psychiatry during the postwar period are of particular relevance. The current discussion concerning the relationship of psychiatry and psychotherapy is characterized by the development of new techniques and methods and the concept of modular psychiatry, whereas the traditional complex psychotherapeutic procedures are becoming less important. In the future, the development of clinical and scientific research should focus on psychotherapy in old age as well as adolescence psychotherapy, the combination of psychopharmacological and psychotherapeutic treatment and issues concerning chronic courses as well as resistance to therapy.     

Exchange,Balance, and Formal Organization in Psychotherapeutic Interactions*

ABSTRACT: Psychotherapeutic interactions in crisis situations are analyzed in terms of the “sociodynamic” concepts of exchange, balance, and formal organization. It is argued that psychodynamic interpretations of crisis intervention therapy tend to be incomplete and nonsystematic and, thus, fail to produce adequate predictions, explanations, and control of psychotherapeutic outcomes. Small-group principles and methods are applied to selected crisis cases to illustrate gains in prediction and control over psychiatric approaches.     

Systemically-Based Psychotherapeutic Techniques in Genetic Counseling

The uses of systemically-based psychotherapeutic methods in genetic counseling are discussed in the context of the origin of genetic counseling, the definition of genetic counseling, and the adjustments that one must make in order to implement these methods. Selected systemic methods which can be readily incorporated into genetic counseling are presented: use of genograms to explore family attitudes and beliefs about genetic risk, communications skills, and applications of family of origin work in genetic counseling. The need for research regarding the methodology and process of genetic counseling is presented with discussion of the need for theories of practice for genetic counseling.     

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.     

Role of countertransference in complex psychotherapy]

The psychotherapist has a key position in any psychotherapeutic situation, participating in the psychotherapeutic process with all his personality and responding both consciously and unconsciously to the patient and the entire psychotherapeutic system. Countertransference consists of those actions and emotional manifestations on the part of the psychotherapist, which originate from his unconscious strata as a reaction to the overall situation. The existence of countertransference and its possible interference with, and perhaps adverse effect on, the psychotherapeutic process require close scientific and social controls. Also, it will be necessary to make "self-experience" psychotherapy (educational analysis) a required subject. Countertransference also has important perception- and empathy-promoting functions.     

Discussion

Stresses precipitating the request for psychotherapeutic help, including the psychological conflicts involved in such stress, were assessed by judges listening to taped psychotherapy interviews with 43 outpatients. This paper reports upon the methods devised to record these judgments. Good agreement by two independent judges on the measures employed suggested that psychotherapy interviews selectively focused on limited goals can be valid sources of information about current stressors, conflicts, and modes of behavior, and increase understanding about the resolution of crises.     

Lernziel: Kontextbezogene psychotherapeutische Kompetenz

Several authors (e.g. Thomä 2004) of critical reviews about psychoanalytical training stated repeatedly, that the learning objective of psychoanalytical training is not to be defined. In the case of psychoanalytical training, being at the same time a pedagogical undertaking, the search for a learning objective is seen as indispensable. Wampold (2001) presented a metaanalysis of psychotherapeutic outcome studies. He examined and evaluated the results of psychotherapeutic research on the basis of hypotheses derived from the “medical model” and the “contextual model”. He concludes that psychotherapeutic treatments based on theoretical models and implementations derived from the “contextual model” are those which are effective. Starting from Wampold’s empirically evaluated theses a definition of contextual psychotherapeutic competence is developed. This definition is proposed to serve as the central learning objective of psychoanalytic education. With regard to this learning objective aspects of a contextual pedagogical conception of the psychoanalytical education are discussed. Which pedagogical theory and concepts of learning and teaching, are to be subsumed under the “contextual model” and are, therefore, suited for psychoanalytical training? What is the difference between psychotherapeutical and pedagogical relationship in psychoanalytic training? What is a contextual pedagogical competence of the analytic teacher? Are learning opportunities in psychoanalytic training apt to challenge psychoanalysts-in-training to develop spontaneously contextual psychotherapeutic competence? With regard to these questions the practice of psychoanalytic training, i.e. self-experience, supervision, imparting of theory and family observation are discussed.     

Intimacy and confidentiality in psychotherapeutic relationships

This article explores the relations among and between intimacy, psychotherapeutic relationships and moral advice. The article concludes that a psychotherapeutic relationship is not usefully explained in terms of intimacy. Instead, a psychiatric relationship is a form of moral advice, and it is this dimension of a psychotherapeutic relationship as a form of moral advice that poses a natural limit to the confidentiality necessary for engaging in psychotherapy.     

Psychiatry of the physician J.C. Reil--a critical view

Reil (1759-1813) was one of the doctors who developed psychiatry in Germany. He represented a materialist psychiatry with dialectical aspects. His concept, which was orientated mainly on therapy, is based on the assumption that mental disturbances can be healed. He proposed the establishment of psychiatric hospitals in order to eliminate the hospitalization of the sick in the same building as healthy and to permit the application of specific forms of treatment. The methods he used to heal mental disorders were partly repressive, but they also contained elements of psychotherapeutic treatment.     

Wissenschaftliche Prüfung und wissenschaftliche Anerkennung psychotherapeutischer Verfahren

The authors focus on the following questions: firstly, what anthropological preconceptions lie behind the nomological scientific viewpoints adopted by the scientific advisory board “psychotherapy”, secondly, to what extend a general efficacy of psychotherapy can be verified using the criteria it proposes. The authors demonstrate that in the proposed testing procedure humans are conceptualized as beings without consciousness and subjectivity. Furthermore, nomologically designed investigations cannot verify a general efficacy of new forms of psychotherapy, nor could they verify the general efficacy of those psychotherapeutic methods already approved by the insurance companies.     

Therapeutic tasks: what kind of help is sought in psychotherapeutic sessions?

One of the main conditions for a good psychotherapeutic alliance is the agreement on therapeutic tasks and goals. This article explores the kind of help that clients expect from therapeutic sessions. By means of a written questionnaire, the clients of a private psychotherapy center, prior to the sessions, expressed their priorities regarding the work to be carried out in them. The assessment of 873 questionnaires showed that clients prefer to participate in therapeutic work that helps them plan actions, understand what is happening, and assess possibilities for change. Also important are therapeutic tasks that help clients evaluate their own actions, both past and planned. The importance that clients attach to different kinds of help varies above all according to how near they feel to resolving their problems. Nine different kinds of psychotherapeutic tasks are identified, which cover the possible requests a client can make of his/her therapist. This article discusses the clinical application of this model as a basis for planning and classifying psychotherapeutic interventions.