Torticollis spasmodicus and addiction

From a random sample of 49 patients suffering from torticollis spasmodicus and dependence on alcohol or medicaments, 6 have been selected and are discussed with i view to findings possible mutual influences between the disorders. In particular, premorbid accentuation of personality presented itself as a potential risk factor leading to both tortocollis and alcoholism. In various cases, the patient makes use of alcohol for self-treatment of extrapyramidal-motor symptoms. But such phenomenological developments are preceded by varied constellations of conditions, that have to be taken into account in the treatment.     

The contribution of feedback to outcome in long-term group psychotherapy

Two long-term analytic inpatient psychotherapy groups, comprised of severely disturbed neurotic and personality disordered patients, were intensively investigated using process ratings and therapist and patient reports to examine the contribution of interpersonal feedback to treatment outcome. We found that feedback was important throughout the course of therapy, and that patients who derived the most benefit from the groups were those who experienced a greater level of group cohesiveness and were most active in terms of self-disclosure, receipt of feedback, and making significant behavioral modifications within treatment. These successful patients received both positive and negative feedback, primarily from other group members, and worked effectively toward the goals that brought them to treatment.     

Supervisees' perspectives on the contribution of supervision to psychotherapy outcomes

Objective

The aim of this study was to examine supervisees' perspectives about the contribution of two predefined aspects of supervision, supervisory bond (SB) and didactic input of supervisor (DI), to their ascribed outcome of therapy.

Method

Supervisees anonymously assessed the SB, supervisors' DI and their contribution to therapy outcome. Assessment was quantitative and qualitative. The supervisory aspects were assessed using a questionnaire constructed for this study. Perceived contribution was evaluated by two scaled questions, and themes generated by an open question. Supervisees (n = 111) evaluated 16 supervisors and supervision’s contribution to psychotherapy outcomes of 111 clients.

Findings

Hierarchical regression showed that supervisees' age, supervisors' status and frequency of supervision accounted for 24% of the variance ascribed to outcome. SB and DI accounted for 51% of the variance. These values, which are higher than reported in the literature, may be attributed to the assessment of predefined aspects of supervision by the same assessor. Thematic analysis of the didactic input produced more themes than for the supervisory bond.

Conclusion

Sociodemographic variables and supervisory relationship variables determine supervisees' evaluations of supervision’s contribution to outcome.

Implications for practice

Training and supervision may benefit from information obtained from quantitative and qualitative measures regarding these and other predefined variables related to supervision. The in-depth look at views and experiences shared by supervisees may advance training, practice and research.     

The emerging therapeutic landscape of psychotherapy in the twenty-first century and the contribution of anthroposophic psychotherapy

In recent years the counselling and psychotherapy profession has experienced significant changes. On the one hand there has been the advent of managed care and evidence based practice which in the UK takes the form of the Improved Access to Psychological Therapy scheme. On the other hand there has, during the same period since the 1980s, been a rich and varied process of innovation in the profession. This has included the so-called relational inter subjective turn in the United States. Second, an increased sensitivity to the interface between therapy and social and political phenomena. Third, the revolution in neuroscientific thinking. Finally, the development of therapy as an interdisciplinary intervention in complementary and alternative medicine teams as in the case of the spiritually-orientated anthroposophic psychotherapy in Europe. In this article I will argue that these innovatory developments, which I refer to as the ‘new integration’, are much needed in order to counterbalance the increasing dominance of managed care and evidence based practice.     

The contribution of ego psychology to understanding the process of termination in psychoanalysis and psychotherapy

Ego psychology is presented as an integrated psychoanalytic developmental theory, including a theory of object relations. The process of termination is employed as one of the many possible illustrations of the usefulness of this theory. Termination is regarded as a process that pervades the treatment from the outset, rather than as the final phase of treatment only, because the treatment process, whether psychoanalysis or psychotherapy, includes continuous promotion of ever-increasing autonomy. Ideally, by the time termination proper takes place, maximum autonomy has been attained. To the definition of autonomy as intersystemic, involving relative independence of the ego from the drives (and from the super-ego), an object-relations dimension is added which extends that definition to include an intrasystemic consideration--namely, relative independence of the self-representation from the object representations. Especially in the treatment of the borderline conditions is the intrasystemic factor cogent because borderline states are characterized by varying degrees of incompletely differentiated self- and object representations. The objective, in the psychoanalysis of neurosis, where self- and object constancy already exist to a large degree, is ego autonomy in the intersystemic sense. In the psychotherapy of the borderline conditions, the objective is greater differentiation of the self-representation from the object representations.     

The contribution of Kleinian psychotherapy to the treatment of a disturbed five-year-old girl and her family

The theories of Melanie Klein are incorporated into many family therapy 'models' in regular use, although a detailed understanding of these theories is not an essential part of the repertoire of family therapists. In the present case, however, Klein's theories provided essential insight into the personality development of a five-year-old girl with severely disordered behaviour, as well as a foundation for the treatment offered to her and to her family.     

Introduction to object relations group psychotherapy.

The author shows how object relations group therapy focuses on primitive defense mechanisms that shape the group-entity image or "basic assumptions group." Such primitive defense mechanisms as splitting, projective identification, omnipotent denial, projection, and introjection are the mental resources to protect the endangered self and the threatened objects from the fantasized imminent destruction. Object relations group psychotherapy addresses those defenses and the underlying psychotic anxieties, offering members opportunities to search for other ways to respond to their primitive fears. The author introduces two extensive clinical vignettes to illustrate how object relations group methods are different from other group-centered psychoanalytic techniques. He concludes by commenting on future theoretical refinements and on the problems in the professional practice of this modality.     

A multiple group psychotherapy approach to adolescents with psychiatric and substance abuse comorbidity.

Multiple group psychotherapy was employed as the primary treatment modality in a day-treatment program as an innovative multifaceted approach to treating adolescents comorbid for psychiatric and substance abuse diagnoses. The concurrent educational program included a high school on site. The groups included Substance Abuse Group, which promoted the 12-step model; Health Group; Psychotherapy Group; Leisure Time Group; Self-Awareness Group; and Multiple Family Group. The effect of the multiple groups was to provide a variety of experiences focusing on varied aspects of normal and dysfunctional adolescent development. Together the combination of groups served to strengthen the participants' cohesiveness, communicating skills, and hopefulness.     

Culture tales. A narrative approach to thinking, cross-cultural psychology, and psychotherapy

Narrative (or storytelling) approaches to understanding human action have recently become more popular in several areas of psychology. Treating human thinking as instances of story elaboration offers numerous implications for many domains of psychological theory, research, and practice. For example, several instances of cultural diversity take on a different hue when viewed from a narrative perspective. Finally, several authors (e.g., Bruner, 1986; Howard, 1989; Mair, 1989; McAdams, 1985; Polkinghorne, 1988; Sarbin, 1986) see the development of identity as an issue of life-story construction; psychopathology as instances of life stories gone awry; and psychotherapy as exercises in story repair.     

Group-analytic psychotherapy.

Group analysis is a flexible and effective method of providing group psychotherapy, thereby promoting maturation and symptom relief. Its metapsychology remains incompletely worked out but provides potentially exciting interfaces with biological and physical sciences, through Foulkes's (1973) seminal concept of the group matrix.