Interaktionelle Methode und übertragungsfokussierte Psychotherapie

The psychoanalytic interactional therapy proposed by Heigl-Evers and the transference-focused psychotherapy (TFP) suggested by Kernberg are two established methods for the treatment of patients with personality disorders in general, and especially of Borderline patiens. These approaches are often compared with each other due to several important similarities we may consider as specific for those disorders. They include among others the active involvement of the therapist, the use of clarifications and confrontations, a greater attention to the setting of the treatment, and the working in the “here and now.” According to current literature, a more exact analysis of the two procedures and of their development as well as of their implicit metatheories reveal that in spite of the recent rapprochement of interactional therapy to psychoanalysis there are still important theoretical and technical differences between these two treatment methods. This observation is demonstrated here by some typical examples of the particular interventions though without discussing a possible differential effectivity of the two methods. Basically, the two treatments are not fully comparable, because the interactional therapy was developed for groups and TFP was designed for the individual setting. In the final analysis, the “answer” principle of the interpersonal, partly on the neo-psychoanalysis and ego-psychology oriented interactional therapy and the “interpretation” principle of the on object-psychology oriented TFP cannot be considered equivalent. Beside that interactional therapy may bear more risks for becoming pedagogical as TFP does.     

意义疗法的理论、方法与技术:基于存在积极心理学的视角

意义疗法是以存在积极心理学为理论基础,以构建个体生命意义为目的,实现生活正负两极性的动态平衡,从而解决其心理困扰获得心理治愈与成长的一种整合性心理咨询与治疗方法。起源于Frankl意义学说的意义疗法是通往人类美好生活的路径,它源于对苦难生活所隐含意义的本质认识。在理论上,意义疗法以意义定向看世界为中心,以意义管理理论和双系统模型为支架; 在方法上,为保障意义获得,应遵循8个基本问题和12条原则,充分发挥意义源的作用,实现意义获得的双路径统一; 在技术上,灵活采用趋向性(PURE)策略、回避性(ABCDE)策略、以及双视角双通道策略或其它策略的整合。意义疗法因包含了精神成分而超越了心理动力学和个体心理学等传统心理治疗方式。未来研究还需明确意义疗法整合了哪些流派的具体方法和技术,细化意义疗法主要的技术与策略的操作步骤,考察成熟幸福感量表在中国文化下的适用性,以及充分整合质性与量化研究方法检验意义疗法在中国的适用性     

A Critical Methodological Review of Discourse and Conversation Analysis Studies of Family Therapy

Discourse (DA) and conversation (CA) analysis, two qualitative research methods, have been recently suggested as potentially promising for the study of family therapy due to common epistemological adherences and their potential for an in situ study of therapeutic dialog. However, to date, there is no systematic methodological review of the few existing DA and CA studies of family therapy. This study aims at addressing this lack by critically reviewing published DA and CA studies of family therapy on methodological grounds. Twenty‐eight articles in total are reviewed in relation to certain methodological axes identified in the relevant literature. These include choice of method, framing of research question(s), data/sampling, type of analysis, epistemological perspective, content/type of knowledge claims, and attendance to criteria for good quality practice. It is argued that the reviewed studies show “glimpses” of the methods’ potential for family therapy research despite the identification of certain “shortcomings” regarding their methodological rigor. These include unclearly framed research questions and the predominance of case study designs. They also include inconsistencies between choice of method, stated or unstated epistemological orientations and knowledge claims, and limited attendance to criteria for good quality practice. In conclusion, it is argued that DA and CA can add to the existing quantitative and qualitative methods for family therapy research. They can both offer unique ways for a detailed study of the actual therapeutic dialog, provided that future attempts strive for a methodologically rigorous practice and against their uncritical deployment.     

Memory retrieval in treating adult survivors of sexual abuse

Abstract

Therapists working with adult survivors of sexual abuse must be sensitive to the powerful ambivalence such clients have toward addressing their victimization. They fear experiencing the significant emotional turmoil which occurs in therapy and the powerful loyalty conflicts they encounter in their families-of-origin. Establishing rapport and allowing clients to set the pace for disclosing and addressing their abuse are critical components of the therapy process. The authors describe effective Ericksonian approaches for establishing these critical treatment elements. Ericksonian techniques for utilizing the client's internal resources and retrieving repressed memories are also discussed, followed by case examples illustrating specific hypnotic methods.     

Using a cross‐contextual qualitative diary design to explore client experiences of psychotherapy

Qualitative research in counselling and psychotherapy has largely been based on interviews carried out with clients and therapists. However, other approaches to qualitative data collection are possible. The present paper uses a diary design to explore the connection between what goes on in therapy sessions, and client activities and experiences in other contexts. Clients and counsellors kept diaries about significant aspects of therapy sessions, while clients also kept diaries about new and different experiences in other contexts in their lives. Ethical and practical issues involved in the use of diaries are discussed, and the methods that were employed to analyse diary‐based data are described. The types of findings that the study generated are presented, along with discussion of their implications for research into client experiences of therapy.     

‘I didn't violent punch him’: parental accounts of punishing children with mental health problems

This paper examines the ways in which parents attending family therapy report how they discipline their children. The children are reported to have mental health problems and by the nature of their disorders present challenging behaviours. Within the family therapy setting, parents account for their methods of punishment which includes threatening, punching, hitting and smacking with belts. They report desires to inflict physical damage upon the child, contrast their punishment strategies against the extremeness of the child and co‐construct the essential and necessary nature of the discipline. Investigating parental perspectives has wider implications for child discipline and child protection and the growing social impact of discipline techniques for policy‐makers.     

The Results of Family Therapy: A Critical Review of the Literature

A search was conducted in the family therapy literature for studied which reported on the outcome of family therapy. It was difficult to find any consensus on a definition of family therapy. Therefore an arbitrary definition, involving the predominant use of joint and family interviews, was stipulated. A total of eighteen studies met minimal standards for inclusion and were summarized and discussed in this paper. Only two of these studies could be considered adequate in their research design; the remainder of the studies were (with one borderline exception) considered inadequate. The clinical evaluations of family therapy were summarized and possible methods and goals for future research into the outcome of family therapy are discussed.     

The child's participation in family therapy: A review and a model

A major gap in family therapy, the treatment of children and adults together, is addressed. The literature on the children's participation is reviewed and a model which systematizes their involvement is presented. The full participation of the child necessitates the use of play. To create a context of play without alienating the rest of the family, action-promoting methods are used. These methods are implemented through family activities and role playing, which are followed by discussion. The advantages, the indications, and the contraindications to the use of action in family therapy are presented.     

Life space mapping: Preliminary results from the development of a new method for investigating counselling outcomes

Counselling outcomes are often measured in terms of standardised questionnaires. Though efficient for large numbers of participants, this method cannot capture the unique and subtle ‘shifts’ that clients often report when qualitative methods are utilised. Further, such questionnaires usually focus on the individual, missing the wider social implications of therapy. This paper presents the preliminary findings from a study that utilises the client's own perceptions of changes in their “Life Space” to establish the significance of their change process. These results are compared and contrasted with a standard outcome questionnaire and the participant's experiences of using the two methods are explored.     

Parent as Saboteur in the Therapeutic Treatment of Children

Children present some unique challenges to the therapist regarding treatment. Unlike adult patients, they are obviously still dependent upon the parent for transportation, the payment of fees, and the success or failure of treatment. Thus the parents make the ultimate decision to continue or terminate treatment. But sometimes a parent's characterological problems are activated by their child's treatment. These diagnostic problems can be classified as envy, jealousy, competition, and narcissism. When any or all of these unresolved parental issues are touched by the treatment of their child, some parents become determined to sabotage therapy, despite the necessity of the treatment for their child. The author's intent is to identify the parental characterological issues for sabotaging therapy through both a theoretical analysis and a discussion of the particular methods parents employ to achieve this end. Identification of the various strategies for handling hostile parents and elaboration of various methods that the therapist may employ are discussed when parental sabotaging of treatment becomes a problem. Recommendations for particular interventions are suggested to illuminate the challenges the therapist faces with those parents whose intent is to sabotage treatment.     

A Review of Family Therapy in Residential Settings

This article provides an overview of the history of family involvement in residential treatment as well as a synthesis of the research showing family-centered interventions and outcomes for youth in residential settings. There are many methods for engaging families in residential treatment that are discussed in the literature; however, there is a significant gap as the field has not yet identified specific family therapy approaches that demonstrate efficacy in working with youth and their families in this particular setting. A review of the literature over the past 10 years will highlight the emerging family therapy models being utilized in this setting, which include multiple-family group intervention, family-directed structural therapy, and narrative family therapy. The article will also include a discussion of three major, well-established theoretical approaches that have been found to be effective in working with youth with conduct issues and show promise in treating youth and families in the complex setting of residential treatment: brief strategic family therapy, multi systemic therapy, and functional family therapy.     

Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: Part I--Description of treatment

This paper describes a novel method of behaviour therapy applied to cancer-prone and coronary heart disease-prone patients in a prophylactic manner, to reduce the probability of their dying of cancer or coronary heart disease. The treatment can also be applied to patients already suffering from cancer in order to prolong their lives. The methods used are described in considerable detail, together with the rationale leading to their adoption. In Part II of this paper are the results of several studies showing that the methods are surprisingly successful in preventing death in cancer-prone and coronary heart disease-prone probands, and prolonging life in patients already suffering from terminal disease.     

Reviving Nostalgia for an Era of Practice: An Illustration of the Therapeutic Use of Projective Methods/Media in Occupational Therapy

Projective methods have long had their roots in psychosocial occupational therapy and they remain valuable to the profession. In this article, the author hopes to reawaken interest for an era of practice that was strongly influenced by psychoanalytic theories. She critiques the conceptual models that inform their use in mental health and argues the importance of having a sound theoretical stance in light of the profession’s unique value in this area. She articulates the methods’ clinical utility and relevance to occupational therapy practice and recovery-oriented care. Using a clinical illustration, she demonstrates the potency of the unfolding process between therapist, client and activity.     

阿尔茨海默病的非药物干预与照料

目前阿尔茨海默病尚无根治性的治疗方法,药物治疗基本上是针对临床症状的对症治疗,只能在一定时期内起到改善或延缓疾病发展的作用。非药物治疗包括心理、社会、环境等综合干预,通过多重感官刺激、身体和智能锻炼、芳香治疗、感觉刺激、个性化音乐等方法,配合药物治疗以期尽可能长地保持阿尔茨海默病患者的功能水平,延迟日常生活能力的下降,减轻照料者负担,从而改善阿尔茨海默病患者及其家属的生活质量。对照料者的培训是非药物治疗的重要环节,照料的质量直接影响患者及家属的情绪和生活质量。     

EVALUATING AUTISTIC CLIENTS

Effective occupational therapy intervention depends on adequate occupational therapy evaluation. First, this article describes the syndrome of autism and surveys formal methods currently available for evaluating autistic clients. Prominent advantages and disadvantages of the surveyed methods are summarized. Secondly, it describes informal methods for use in the occupational therapy evaluation of autistic children. Finally, a format for a unified evaluation summary organized around the concept of the whole person is presented.     

Screening for Physical Violence in Couple Therapy: Methodological,Practical, and Ethical Considerations

Over two-thirds of clients in family therapy clinics engage in some form of physical violence against their partners within the year prior to the initiation of therapy. However, family therapists are aware of only a small proportion of these cases. The purpose of this article is to enhance the ability of family therapists to detect marital violence. We examine client and therapist reasons for why physical violence is not detected. We then review various methods to screen for the presence of physical violence, especially the Conflict Tactics Scales. Finally, indicators of life-threatening violence are presented to help family therapists detect cases that require immediate intervention to protect the partner whose life may be in danger.     

Family of origin as a therapeutic resource for adults in marital and family therapy: you can and should go home again.

This paper presents a general method of involving adults who are in marital and family therapy in sessions with their family of origin, offering a clinical application of the author's depth theoretical orientation. The method is based on the thesis that current marital and family difficulties are elaborations of relationship problems of the spouses in their original families. If adults are able to go back to deal directly with past and present issues with their families or origin, an opportunity exists for reconstructive changes to come about in their present family. This present work is compared with Bowen's methods. Procedures are outlined for preparing for these sessions and for overcoming resistances. Typical courses these sessions tend to take are described, and some preliminary results are presented. Several case histories are presented, and theoretical and clinical implications of this method are discussed.     

Burning or Building Bridges

SUMMARY

Among the population of physically abused women who present individually in therapy, there is a portion who struggle with their indecisiveness about whether or not they should work toward resolving or terminating their heterosexual relationship. This paper will examine clinical methods that are employed through individually based systemic therapy to assist women who find themselves in such confusing and perilous situations. Due to the complexity of the problem” emphasis is placed on addressing salient issues efficiently and non-judgmentally. Central to treatment is client engagement and the challenging of constraining client beliefs.     

Psychological and pharmacological treatments of bulimia nervosa: a research update

Bulimia nervosa (BN) is an eating disorder, primarily afflicting young women, which can be successfully treated. The two most intensively researched treatments for BN have been antidepressant medication and cognitive-behavior therapy (CBT). Controlled studies of the separate and combined effects of these methods are critically reviewed, and the theoretical and clinical implications of their findings discussed.