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.     

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.     

Psychotherapy Process Measure Research and the Evaluation of Psychotherapy Orientation: A Narrative Analysis

This article discusses the need for a systematic method that enables researchers to evaluate integrative therapy approaches using a range of therapy process measures. The Narrative System Process Coding (NPCS; Angus, Hardtke, & Levitt, 1996) is proposed as such a method, and is applied with the Experiencing Scale (Klein, Mathieu, Gendlin, & Keisler, 1970) and the Levels of Client Perceptual Processing (LCPP; Toukmanian, 1986) to three brief good outcome integrative therapy modalities to illustrate this need. The study found higher Experiencing Scale scores to be most strongly related to an experiential approach to therapy and to the NPCS internal narrative processes. Higher LCPP scores were most strongly related to the NPCS reflexive narrative process and to a perceptual-processing approach. The discussion initiates a discourse on the importance of explicating process measures' origins when comparing different therapy approaches in order to allow for the meaningful consolidation of process research findings.     

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.     

Child and Adolescent Psychotherapy Research: Developmental Issues

Describes developmental issues that pose current challenges to the design of treatment outcome investigation with children and adolescents. Normal childhood development and the development of childhood disorders are discussed using the transactional model of development. Challenges in diagnostic decision making, the selection of the most appropriate treatment regimen, and the measurement methods are highlighted. Recognition of the need to study child treatments through long-term follow-up periods underscores the need for resolution of these developmental issues.     

An Overview of Directions in Psychotherapy Integration Research

In general, empirical research in psychotherapy integration has lagged behind the growing theoretical and clinical interest in the field. Even though many of the theoretically integrative treatment models currently available are based on empirical findings and clinical observations, the models themselves remain, for the most part, untested. Rigorous examination of integrative psychological theories and therapeutic programs is a necessary and useful way to increase our understanding of the process of psychotherapy and establish the efficacy and effectiveness of integrative therapies. The present article explores five different research areas in the field of psychotherapy integration, discussing several published studies in each area. The utility of this research for practicing clinicians is also discussed. Additional investigations in these areas and others are encouraged, with the goals of greater understanding of psychotherapy, as well as the further development and acceptance of integrative approaches.     

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。

     

Definitional and Research Issues in the Common Factors Approach to Psychotherapy Integration: Misconceptions, Clarifications, and Proposals

This paper focuses on two common misconceptions of common factors in therapy. The first misconception entails the confusion between common factors and therapeutic factors, and thus the inappropriate and misleading use of the term therapeutic common factors in various situations. The second misconception is the mixing of commonalities of different kinds and levels in proposed lists and studies of common factors. These areas are discussed and clarified, and recommendations designed to facilitate conceptual and methodological improvements relative to each misconception are offered. The selection of best levels and kinds of common factors to be studied are further explored (i.e., the study of client change events and antecedent therapist behaviors across different therapies), and specific proposals for their research are outlined.     

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.     

Psychosis: New Existential, Systemic, and Cognitive-Behavioral Developments

Until recently, perhaps the major avenues of working with severely disturbed patients have been based upon either organic-chemical or intrapsychic determinants and treatment components. One recent development is an emphasis upon interpsychic and interpersonal factors and determinants in both the understanding and the treatment of extreme psychotic disturbances. Existential, systemic, and cognitive-behavioral conceptualizations and therapies maintain substantial independence of one another. Yet these three share at least two significant commonalities. One is that they each emphasise the interpsychic and interpersonal. A second is this first commonality has led to some exciting new developments in the understanding and treatment of psychosis.     

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。     

Re-Collection in Existential Psychotherapy with Couples and Families Dealing with Death

Re-collection is a treatment dynamic in existential family therapy in which the client family is helped to remember and honor meanings that family members have previously actualized and deposited in the past. This shrinks the family meaning vacuum and those symptoms and problems that grow and flourish in a family meaning vacuum. In this article, an existential orientation to re-collection with families who are dealing with the death of a loved one is presented, described, and illustrated with case material.     

心理治疗的过程研究

心理治疗的过程研究是辨识心理治疗的活性成分和改变机制,是心理治疗效果研究的重要领域。心理治疗过程研究的最新进展体现在研究内容的扩展,研究方法的改进及研究结果的新发现等方面。对未来研究的几点建议：活性成分的层次性观点,改变机制的双线研究及与治疗过程模型的结合,借鉴邻近学科的研究成果,改善RCTs时间设计,关注质化研究,临床工作者与研究者的合作,以及开展本土化研究。     

A Participant-Observer's Perspective on Psychotherapy Integration

Jacobson has raised a number of issues about the usefulness of psychotherapy integration. Some of his concerns stem from his doubt that people are capable of change, and some that appear to be the result of a misinterpretation of what constitutes psychotherapy integration. This article attempts to clarify some of these misunderstandings, which seem to be the result of equating psychotherapy integration with the integration of theories. Comments are also made about the research underpinings related to work in this area.     

The Therapeutic Relationship as Viewed by Existential Psychotherapy: Re-Embracing the World

Existential psychotherapy places pivotal significance upon the interrelational aspects of human experience. By so doing, the therapeutic relationship itself becomes the principal means through which the client's presenting symptoms and disorders are disclosed as direct expressions and outcomes of the client's overall way of being rather than as isolated and disruptive impediments. This paper examines the therapeutic relationship as viewed from four primary interrelational dimensions. Further, it focuses upon psychotherapy's tendency to exclude the world from the therapeutic relationship and provides two novel and challenging alternatives whose principal aim is to bring the world back into the therapeutic relationship.     

Some Practical Implications of Integrating Narrative and Humanistic/Existential Approaches to Psychotherapy

Although the humanistic/existential and the narrative approaches to psychotherapy are clearly distinct perspectives with some marked differences at the level of metatheory, they also show very important similarities in their conceptualization of the human condition and the processes involved in living adaptively (Richert, 1999). These similarities make these two approaches reasonable candidates for integration. The present paper examines five specific points of integration at the level of strategy and techniques (Neimeyer, 1993b): Interplay of experiential meanings and narrative structure in developing client meaning, use of existential themes in client narratives, deconstruction as a means of dealing with existential guilt, contextualization of wishes as a means of mobilizing will, and reflexivity as a way of developing the I–Thou relationship. A brief theoretical rationale is offered for each of these points of integration, and each is illustrated with clinical examples.     

An Outsider's Perspective on Psychotherapy Integration

This article offers those who are identified with progress in psychotherapy integration an outsider's perspective on progress in the field. The author argues for a contextual study of psychotherapy and psychotherapy integration, noting that the social psychology of psychotherapy may be an overlooked dimension in the study of psychotherapy integration. He suggests that perceptions of progress in psychotherapy integration may be exaggerated due to the lack of such a perspective.     

Special Issues in Psychotherapy with Minority Deaf Women

Abstract

Minority Deaf women have been traditionally underserved by mental health professionals, and specifically, therapists are unaware of issues unique to this population. It would be highly unlikely for a minority Deaf woman to have a therapist who matches her in racial background, hearing status, and communication mode. Therefore, the therapy process will be completely cross-cultural. Therapists who provide psychotherapy services to minority Deaf women need to be aware that their clients are members of a community where deafness is a culture and not a disability. Minority Deaf women are also likely to report feeling forced to choose between competing identities in order to get important needs met. In the following article, case examples are provided which illustrate some of the major issues that are likely to arise in therapy with minority Deaf women. These issues include: access to important information; communication, support and level of involvement with biological families; competing cultural demands; health concerns; and coping with chronic mental illness.     

兰恩存在精神病学的心理治疗观

兰恩是20世纪英国著名的存在主义精神病学家,在反对传统精神病学诊疗观的基础上,提出了独特的存在精神病学的心理治疗观。在精神疾病的诊断上,兰恩主张从存在主义——现象学的视角来理解精神疾病,要从一个人的环境或背景中来理解他的行为。在精神疾病的心理治疗上,兰恩强调通过改变患者的生存环境来促进其自我恢复。