Can research influence clinical practice?1

After briefly reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefits to clinical practice of analysts being involved in research activities, the author examines whether the findings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specific condition of the patient and the relationship that the individual establishes with the analyst. He argues that research findings can influence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specificity of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment.     

Working with severely traumatized,chronically depressed analysands

Surprisingly often in the psychoanalyses of chronically depressed patients, depression represents an unconscious attempt to psychically cope with unbearable psychic pain following severe traumatisation: dissociative states, a chronified psychic state of shock, a disappearance of emotions, an emptying of the self and the object relationships, as well as a disappearance of the psyche in the body are among the possible consequences. The treatment of these difficult groups of analysands can also frequently bring analysts to the limits of the endurable. Often related to this is the repeated danger of denying the trauma, and a re‐traumatisation of the analysand in the analytic situation. The lecture discusses the fact that in comparison with other therapeutic approaches, psychoanalysis has a highly differentiated conceptualisation of the psychic determinants and the treatment of chronic depression at his disposal. However, in order to retain its creativity and innovation as a scientific discipline and to be thus perceived in the non‐psychoanalytic world, it must constantly further develop its conceptualization by way of systematic and extra‐clinical research – as is witnessed in the insufficient conceptual account of severe traumatisation during the genesis of chronic depression. In this connection, several exemplary examples from extra‐clinical studies in the sphere of psychotherapeutic research, neurobiology, epigenetics and embodied cognitive science will be accounted for. As will be treated in the final part of this paper, of no less importance are the conceptualizations in clinical research on psychoanalysis, which are based on meticulous, careful analyses of trauma reactivation in the transference, and understanding and working through them in the analytic relationship.     

Choosing Assessment Instruments for Depression Outcome Research With School‐Age Youth

Using effect size results from Erford et al.'s (2011) meta‐analysis for treatment of depression in school‐age youth, the authors analyzed 6 commonly used instruments for practical and technical strengths and weaknesses. Effect size estimates from these 6 instruments were compared to indicate likely results when used in future depression outcome research.     

Essential theory, processes, and procedures for successful group psychotherapy: Group cohesion as exemplar

With few exceptions or at the very least cautions (cf. Burlingame, MacKenzie & Strauss, 2003) group psychotherapy has proven to be an effective and efficient treatment for a number of psychological disorders (Burlingame, Kapetanovic, & Ross, 2005). This article will briefly describe a theory that underlies successful group therapies. In addition, certain group processes—those elements that occur during the group itself that appear to be necessary conditions for improved patient outcomes—will also be addressed, although unfortunately, the sufficient conditions tying moment-to-moment process to actual outcome (improved patient functioning by the end of therapy, and at 6-month follow-up, for instance) are not quite as easily delineated. A closer study of the group therapeutic factor cohesion will be utilized as an example of these practice and research dilemmas. Finally, suggestions for future directions, which might more clearly uncover important connections between process and outcome, are addressed.     

Helping and change without traditional therapy: Commonalities and opportunities

The therapeutic elements of four types of helping interactions (friends/family, religion, cinematherapy/bibliotherapy, and self-help groups), and their commonalities with traditional psychotherapy are explored. Empirical findings in these areas are discussed, along with suggestions for process and outcome research. Recommendations for the integration of self-help and paraprofessional counseling with professional therapy are presented.     

The ‘inseparable bond between cure and research’: clinical case study as a method of psychoanalytic inquiry

Abstract

Since Freud's own time, there has been great deal of debate about the most appropriate research methodology for investigating psychoanalytic psychotherapy [Fonagy, Journal of Child Psychotherapy, 29 (2): 129 – 136, 2003 Fonagy, P. 2003. ‘The research agenda: the vital need for empirical research in child psychotherapy’. Journal of Child Psychotherapy, 29(2): 129–136. [Taylor &; Francis Online] , [Google Scholar]; Rustin, Journal of Child Psychotherapy, 29 (2): 137–145, 2003 Rustin, M. 2003. ‘Research in the consulting room’. Journal of Child Psychotherapy, 29(2): 137–145. [Taylor &; Francis Online] , [Google Scholar]]. The single case study, which has a long tradition both within child psychotherapy and the wider research field, has been widely criticised as an approach to research, even while its contribution to clinical practice, the development of new ideas and teaching have been acknowledged. After reviewing the history of case study as a research method, this paper argues that there are a broad range of approaches to the study of the single case, each of which may be appropriate depending on the particular research question. Each of these approaches, however, must respond to the three perceived weaknesses of the clinical case study as a research method: the ‘data problem’, the ‘data analysis problem’ and the ‘generalisability problem’. This paper outlines the nature of these criticisms and, using many examples of actual research projects, suggests various ways in which the criticisms can be addressed, in order for the single case study to re-gain its place at the heart of psychoanalytic research.     

文化人类学视域下的《内经》研究

文化人类学具有跨文化研究的学科优势,其理论与方法逐渐在中医研究中得到关注,文化人类学在中医经典著作的《黄帝内经》的研究中理应发挥作用。理顺了法、英、美等西方有影响力的人类学家的理论与方法,并将其运用到《内经》研究中,分析了《内经》冠以“黄帝”书名的缘由、“祝由”治病、对重视“脏腑”功能的理解以及对所蕴含的传统文化思想的解读等相关内容,不仅拓宽了《内经》的研究领域,而且对于社会文化传播、《内经》国际化的学术交流以及教学都是有益的。