积极心理治疗模式与发展趋势

积极心理治疗是在跨文化的基础上以冲突为中心的治疗模式,治疗中关注个人实际的和潜在的能力,并借助东方寓言故事哲理,用跨文化的认知观点解释冲突。这种符合人性特点的心理治疗模式,为心理治疗开辟了新的途径,促进了心理治疗的发展。     

Judicial Wisdom: The Process of Constructing Wise Decisions

Surprisingly little research exists on the role of wisdom within legal decision making. To shed light on this topic, we interviewed 11 U.S. judges who were nominated by their peers for their legal wisdom. They were asked to describe their experience of wise legal decision making and the qualities and processes they felt characterize wise judges. Their interviews were subjected to a grounded theory analysis to develop an understanding of the psychological processes and interpersonal performances that constitute wise legal decision making. Among other findings, results identified attitudes in judges that were thought to lead to better decisions, such as an attitude of curiosity. They identified courtroom management styles that were characterized by magnanimity and compassion as instilling public faith in the system, in contrast to a distant or overly adversarial tone. They tended to agree that, when possible and within the confines of the law, rulings oriented toward rehabilitation were preferable to punitive ones. As well, wise judges described the ways they managed personal challenges arising from value conflicts or ambiguous evidence when making decisions. The article provides clarity on the meanings of the term wisdom within the judicial profession and its construction within the alternative discourses of retributive and procedural justice.     

积极心理治疗思想概要

积极心理治疗虽然是以积极心理学作为自己的理论基础,但积极心理治疗的实践却早已有之。积极心理治疗作为心理治疗中的一个新生事物．它以反传统医学式心理治疗的面貌出现,运用故事作为治疗者与病人之间的媒介,充分发挥病人的直觉和想象,在与病人的观念不发生直接冲突的情况下提出改变病人观点的建议,这一较符合人性特点的心理疗法正越来越多地受到社会的广泛关注。     

Proof of complex theories regarding conflicts, neuroses and their therapy, exemplified by Mjasiscew's theory of relations

Most psycho-dynamic theories emphasize the role of intra-personal conflicts in the aetiology and therapy of neurotic disorders, but very few can be empirically tested. The social psychological and psychodynamic "pathogenetic" theory of the "Leningrad School" of psychotherapy according to Mjasiscew (Lauterbach, 1984) maintains that conflicts between a person's relations with his social, material and cultural environment may be the cause of his neurosis. This theory is used to demonstrate that psychodynamic hypotheses about the role of intra-personal conflicts can be empirically tested with the help of "tests of conflict" (Lauterbach, 1987).     

Psychodynamic focal group treatment for psychosomatic inpatients--with an emphasis on work-related conflicts

Conflicts arising from the work setting have remained a neglected issue in psychotherapy. To address this, the present study investigated the effectiveness of a manualized focal group treatment for psychotherapeutic inpatients suffering from vocational strains and conflicts and identified predictors of outcome. Cohorts of patients were assigned either to a treatment (N=144) or control condition (N=135). The group therapy intervention was found to be highly accepted by participants who were also more optimistic about returning to work and more favorable in their evaluations of treatment than patients in the treatment-as-usual condition. Group climate was found to be a predictor of favorable outcome. The findings suggest that a group therapy intervention with a strong emphasis on motivations and attitudes about work may be particularly suitable to deal with vocational conflicts and strains.     

Cognitive complexity and the similarity-attraction paradigm

The study investigated the role of cognitive complexity as a moderator of the similarity-attraction relationship described by Byrne (1971). Subjects conducted face-to-face interviews with confederates who played roles as job applicants. Similarity-dissimilarity was manipulated by the confederate roles, as well as by the information given the subjects in accordance with the procedures described by Byrne (1971). The situation was viewed as one in which judgments were made about a complex, multidimensional stimulus. Information received about another person in an interview setting was viewed as consisting of different dimensions to be assessed by the perceiver. The hypothesis was tested and confirmed that cognitively complex judges were more likely than simple judges to perceive and evaluate similarity/dissimilarity in others. Thus, complex judges evaluated similar applicants more positively than dissimilar applicants, while no differences were found for simple judges. Cognitive complexity thus appears to moderate the “Law of Attraction” described by Byrne (1971).     

Bridging the Divide

Abstract

Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients.     

精神科住院患者团体心理治疗准备性会谈与治疗后访谈初探

精神科住院患者团体心理治疗较门诊患者团体心理治疗存在临床情境的特殊性,本研究探索将准备性会谈与治疗后访谈纳入治疗计划,治疗前向患者普及住院治疗、心理治疗的知识,澄清团体心理治疗的形式、目标、内容,了解患者对团体心理治疗的疑问、期望,允许患者做出是否参加治疗的决定,并在治疗后的访谈中强化疗效因子。     

Behandlungskrisen ambulanter Psychotherapien aus der Sicht einer Krisenstation

The purpose of the following study is to identify characteristics of the clinical treatment of patients who came into a crisis during an out-patient psychotherapy and were admitted to a crisis intervention ward. Most of the patients particularly reacted to a disruption of the treatment process as a result of conflicts in their relationship with their therapists. By means of a psychodynamic short diagnostics these conflicts were elucidated although they were often hidden and had to be traced back to their origins in the therapeutic relationship. Moreover, the authors describe their therapeutic focus on the conflict-solution-oriented short-term psychotherapy of the disruption of the therapeutic bond between patient and therapist which leads to a fixation of the setting. The in-patient crisis intervention aims at preparing the patients to continue the out-patient psychotherapy.     

Aspects of a dilemma of middle age: whether or not to place aged, failing parents in a nursing home

A middle-aged person's involvement in making a decision about whether or not to institutionalize an aged parent whose physical and/or mental capacities have failed inevitably arouses intense feelings, memories, fantasies, and conflicts. Fantasies that equate putting the parent in a nursing home with abandonment and murder, as well as the narcissistic threat posed by seeing one's own future in a parent's deterioration, are common. The conflicts aroused may upset long-standing psychological balances. This paper explores ego, superego, id, and reality issues that are aroused as they were seen in the psychoanalysis and psychotherapy of several patients involved in making this decision. The importance of looking for the unique aspects of the conflicts set off in each individual facing this dilemma is stressed, as is the potential for countertransference responses.     

Exploring How Parents Make Sense of Change in Parent-Child Psychotherapy

Understanding how change occurs in psychotherapy is imperative in informing clinical practice. Increasing attention has been given to the role that qualitative research could play in enhancing our understanding of therapeutic change. Although quantitative research suggests that parent-child psychotherapy is effective in facilitating change, no research to date has focused on how parents make sense of their change experience. In this study, interpretative phenomenological analysis was used to analyze semi-structured interviews of eight parents who had completed parent-child psychotherapy about their understanding of change. Five master themes emerged that encapsulated participants’ understanding of change. These included constructing a survivor narrative, the experience of being understood enabling further understanding, adjusting expectations and practicing acceptance, and feeling empowered to relinquish control. The final theme summarized how despite psychotherapy being conceptualized as a “precious” resource, there was a sense that its limitations could negatively impact participant’s well-being.     

Patients' experiences of forensic psychotherapy

In forensic psychotherapy there may be competing goals and agendas, influenced respectively by concerns about mental health and well-being, risk reduction and psychodynamically-significant change. There has, to date, been no published study of the goals and concerns of forensic patients undergoing therapy. Semi-structured interviews with ten patients considered by their therapists as having gained from forensic psychotherapy were analysed thematically. Results indicate the importance to patients of trust and acceptance in the therapeutic relationship, and changes in the domains of perception of self and interpersonal functioning as well as changes in problematic behaviours. These findings have implications for the choice of measures in systematic outcome research.     

Integrating Religion and Psychology in Therapy: Issues and Recommendations

This article explores the history of the relationship between religion and psychology, integration difficulties within psychotherapy, and recommendations for problem resolution. Two religious frameworks psychologists can use to reduce conflicts and enhance psychotherapy with regard to religious concerns are provided2.     

Ambulante Psychotherapie in Deutschland aus Sicht der Patienten

This study analyzed the provision of outpatient psychotherapy services in Germany in typical practice settings. In a representative survey (from June 2008 to September 2009) 1,212 subjects who received outpatient psychotherapy during the past 6 years were questioned about their experiences with outpatient psychotherapy via telephone interviews. Socio-economic data, reasons for seeking treatment, access paths, financial resources and psychosocial support data were collected. Therapeutic settings and modalities and concomitant medication treatment are described. The findings illustrate the problem of multiple psychiatric morbidity in the clinical practice and confirm the urgent need for patient access to professional psychotherapeutic services. Improving access to these services requires close cooperation between care providers.     

When confidentiality mandates a secret be kept: a case report.

The success of group psychotherapy is impeded when group members maintain secrets and fail to self-disclose to other group members. However, revealing secrets sometimes conflicts with the legal and ethical constraints of confidentiality, thus placing a greater burden on the group. The case reported here illustrates how complex the dynamics of group therapy become when one group member maintains a secret. In this case, one member maintained a secret about another to preserve that individual's right to privacy and confidentiality. This case also details the group member's deliberations and confusion about the effect his secret had on the group's success, as well as the burden he experienced by choosing to preserve confidentiality at the expense of successful therapy for himself.     

Encounters with Boundary Challenges: A Preliminary Model of Experienced Psychotherapists’ Working Strategies

Five experienced clinical psychologists were interviewed about their strategies for maintaining boundaries in psychotherapy. The interviews were subjected to qualitative analysis using grounded theory techniques to develop a preliminary model of boundary maintenance. The central principle exhibited by the interviewees was maintaining a therapeutic relationship to facilitate client self care. Overall, the central principle was comprised of three main working strategies: (1) maintaining client boundaries to ensure a clear focus on client needs; (2) maintaining psychotherapist boundaries to protect effective practice; and (3) maintaining psychotherapy boundaries to facilitate client reflection, awareness, and assumption of responsibility. Each strategy included two or three distinct meaning categories, explicated in the paper. Implications for clinical work and future research are discussed.     

The Role of Applicant Nonverbal Communication in the Employment Interview

This research examined the effects that the nonverbal behavior of job applicants had on subsequent hiring evaluations. Interviewees (n = 32) were instructed to use one of four styles of nonverbal behavior during the recording of short job interviews with a standard content. The videotaped interviews were watched by behavior raters (n = 22), who assessed nonverbal-cue usage, and by judges (n = 50), who evaluated the applicants as prospective employees. The applicants were also rated by judges (n = 30) for physical attractiveness. Results supported the hypothesis that nonverbal behavior in the job interview operates as subtle reinforcement. Implications for job-counseling programs are discussed.     

A closer look at the ability to predict psychotherapeutic outcome

On the basis of previous findings on the varying ability clinically to predict the outcomes of psychotherapy, this study is focussed on the judgmental processes of good and not-so-good judges. To chart the mechanisms of predictive accuracy, the relations between the ratings of each judge and the criteria have been modelled in terms of structural equations. Further, the predictions of one good and one not-so-good judge have been analysed by multiple regression, with aspects of patient information as independent variables. The analyses suggest that, compared to the not-so-good judge, the good judge utilises more information and has more adequate ideas about its validity but not about its internal correlational structure. While not neglecting secondary process thinking, the good judge still leaves room for intuitive, non formalised judgment and also utilises available information in a more discriminating, or radical, manner. The not-so-good judge appears as an overly conscious and cautious person, neglecting much valid information, not discriminating among the variables, and using negatively valid information positively.     

A successful trial utilizing the Leuzinger-Bohleber methodology for evaluation of psychoanalytic treatment: Preliminary report

Utilizing audio-recorded psychoanalytic interviews of both patients and their analysts, group discussions of these interviews, and the application of questionnaires commonly used in psychotherapy research, the authors investigate the potential use of the Leuzinger-Bohleber methodology as an objective evaluative instrument to assess the quality of psychoanalytic treatment. Preliminary study results were obtained through interviews conducted with seven analysts and their respective patients, three of whom were treated with psychoanalysis (three or more sessions per week, for a duration of no less than one year) and four with psychotherapy (one or two sessions per week, for a duration of no less than one year). Patients were found to be eager to participate, and no adverse experiences were reported by analysts, patients or the research team. In addition to the interviews, further data were obtained through review of mailed-in questionnaires completed by 21 patients. The authors present both preliminary observations regarding the methodology as a whole, as well as the detailed results of one specifi c case subject treated with psychotherapy. Review of study fi ndings supports the utilization of this methodology as an evaluative instrument which may ultimately advance current knowledge of the process and outcome of psychoanalytic treatment.