Group process studies within the scope of directed dynamic group psychotherapy

Footing on specific pr?misses of Intended Dynamic Group Psychotherapy three different types of development are described on the basis of factor analytical investigations towards the behaviour and experience of the group members and of the therapeut. At a period of 34 sessions of stationary psychotherapy data of 15 groups were comprehended and globally related to the effectivity. There are shown up the problems of therapeuticle behaviour, of indication and of effectivity.     

Musiktherapie bei Kindern mit Migräne

Migraine in childhood is a serious health problem with a tendency for chronification. According to the bio-psycho-social model migraine is considered as a disorder generated by multiple factors and requiring an interdisciplinary treatment concept consisting of both medical and psychotherapeutic interventions. Music therapy as a nonverbal, creative arts therapy is especially apt for the treatment of children. A specific treatment concept in music therapy for children with migraine, to be applied within a multidisciplinary framework, and its theoretical background are presented in this article. Music therapy is firmly established within the context of stationary infant psychiatric care. Also, it is presently used as a method of outpatient psychotherapy mainly for children and adolescents. Additionally, music therapy finds frequent use in medical care, special needs education and curative education for children. This article will be limited to the presentation of music therapy as artistic psychotherapy.     

The dodo bird revisited: A qualitative study of psychotherapy efficacy research

This article is a qualitative study of psychotherapy efficacy research spanning more than four decades. The findings are organized into five temporal categories characterizing the evolution of psychotherapy research. All five categories are integrated in the central phenomenon of two views of human behavior, a reactive or a proactive view. The categories are (1) psychotherapy is no more effective than no psychotherapy (1950s and 1960s), (2) the “core conditions” (empathic understanding, unconditional positive regard, and congruency) are necessary and sufficient conditions for therapeutic personality change (1960s and 1970s), (3) psychotherapy is for better or for worse (early 1960s), (4) the core conditions are necessary but not sufficient for therapeutic personality change (late 1970s and mid-1980s), and (5) specific techniques are uniquely effective in treating particular disorders (late 1980s and early 1990s). The findings concerned with Categories 4 and 5 are (a) that the conclusion that Rogers's attitudinal conditions are necessary but not sufficient has virtually no direct research support, and (b) that the research concerning specificity of treatment, dysfunction, therapist variables, and client variables is characterized by fragmentation, few replications, and lack of generalizability. Implications of the study indicate that specificity research, driven by the unfounded assertion that Rogers' attitudinal conditions are not sufficient, have yielded inconclusive and misleading findings. The pattern of research is one that culminates in the picture of a self-fulfilling model driven and directed by the “scientificating” deterministic view of human behavior, the movement toward narrow and specific application. Over four decades, the major thread in psychotherapy efficacy research is the presence of the therapist attitudes hypothesized by Rogers.     

Psychotherapy: Definitions, Mechanisms of Action, and Relationship to Etiological Models

In this paper, we define psychotherapy as a modality of treatment in which the therapist and patient(s) work together to ameliorate psychopathologic conditions and functional impairment through focus on the therapeutic relationship; the patient's attitudes, thoughts, affect, and behavior; and social context and development. The possible mechanisms of action and active ingredients of psychotherapy in children and adolescents are discussed, with an emphasis on the above-noted domains. The adult psychotherapy literature strongly supports the central roles of the therapeutic relationship and therapeutic empathy; this has been much less intensively explored in the child and adolescent psychotherapy literature. Similarly, there have been few studies examining the mediation of treatment effects by impact on specific domains. Ideally, treatment studies should gather data that can be informative about the impact of putative mediating and moderating psychosocial and biological variables on outcome and course. The results of such studies can aid further refinements in both theories of etiology and improvement in treatments for children and adolescents.     

Self and external management compared with psychotherapy in the control of obesity

Seventy-four obese TOPS (Take Off Pounds Sensibly) members were assigned to one of five conditions: delayed treatment control, insight psychotherapy, self-management training plus external reinforcement, self-management training only, or external reinforcement only. The latter four groups met once per week for ten weeks and were seen at three and six months and followup. It was hypothesized that self-management plus external reinforcement would be superior to other conditions at both post-treatment and followup, and that this condition alone would produce continuing weight losses. Analysis of covariance on body weight, with pretreatment weight as covariate, indicated that self-management plus external reinforcement, self-management only, and external reinforcement only, did not differ in mean body weight at post-treatment. These three groups differed significantly from control and psychotherapy conditions, which did not differ from one another. Self-management plus external reinforcement produced better performance of techniques. At three and six month followup, differences between the four treatment conditions were no longer significant. Results are discussed in terms of evaluation of psychotherapy and behavior modification and durability of results.     

Ideal antecedent criteria variables in psychotherapy: A proposed solution to the irregular effects phenomenon

The concept of antecedent criteria variables is introduced as a means of understanding the conditions necessary for the development of psychotherapy. Previous psychotherapy research is criticized for its failure to define the criteria variables essential for the evolution of the necessary and sufficient factors that would determine if psychotherapy is occurring. In order to test the hypothesis that antecedent criteria variables are important, a questionnaire was mailed to 1600 practicing psychotherapists. From the 545 questionnaires returned, the data indicates that psychotherapists consider the concept important, although the application of the criteria is somewhat irregular. Findings are discussed in terms of the implications for future clinical research.     

Die Verantwortung der Psychoanalyse für die Psychotherapie

Whether psychoanalysis can take over the responsibility for psychotherapy when it is not operating as a part of psychoanalysis but on its own is a question which has currently become significant again. The present paper gives an affirmative answer, but under certain limiting conditions only. Psychoanalysis can take responsibility for psychotherapy. It can base this on the fact that the definition of “depth psychological psychotherapy” binds psychotherapy—as it is usually called—to psychoanalysis. How this is possible in practice is determined during the training. The training at the Michael-Balint-Institute in Hamburg is presented which partly occurs jointly and partly separately, in this way representing the reality of the two separate fields linked to each other and yet independent. The common ground is constituted by the basic principles of psychoanalysis. As an example of this common ground, the seminar on the technique of diagnosis and treatment, which is part of the early curriculum, is discussed in detail. Later on in the training, the two curricula separate more and more, each taking over its own responsibility. Not only questions of the contents but also formal aspects have to be considered. There are good reasons for establishing an independent Institute for Psychotherapy which runs the necessary arrangements together with the Institute for Psychoanalysis, from which it derives, and also remains close to the latter. Finally, it is pointed out that all of this is only possible when respecting each other’s work. Independent psychotherapy is not less valuable than psychoanalysis, but simply something else.     

Culturally adapted psychotherapy and the legitimacy of myth: a direct-comparison meta-analysis

Psychotherapy is a culturally encapsulated healing practice that is created from and dedicated to specific cultural contexts (Frank & Frank, 1993; Wampold, 2007; Wrenn, 1962). Consequently, conventional psychotherapy is a practice most suitable for dominant cultural groups within North America and Western Europe but may be culturally incongruent with the values and worldviews of ethnic and racial minority groups (e.g., D. W. Sue, Arredondo, & McDavis, 1992). Culturally adapted psychotherapy has been reported in a previous meta-analysis as more effective for ethnic and racial minorities than a set of heterogeneous control conditions (Griner & Smith, 2006), but the relative efficacy of culturally adapted psychotherapy versus unadapted, bona fide psychotherapy remains unestablished. Furthermore, one particular form of adaptation involving the explanation of illness-known in an anthropological context as the illness myth of universal healing practices (Frank & Frank, 1993)-may be responsible for the differences in outcomes between adapted and unadapted treatments for ethnic and racial minority clients. The present multilevel-model, direct-comparison meta-analysis of published and unpublished studies confirms that culturally adapted psychotherapy is more effective than unadapted, bona fide psychotherapy by d = 0.32 for primary measures of psychological functioning. Adaptation of the illness myth was the sole moderator of superior outcomes via culturally adapted psychotherapy (d = 0.21). Implications of myth adaptation in culturally adapted psychotherapy for future research, training, and practice are discussed.     

Psychotherapy research: an interplay between inner and outer and a succession of meanings

Psychotherapy research is a rapidly developing area of study that aims to explore the integration of inner and outer conditions of an individual’s experience, the interplay between subjective and objective, as well as between individual and collective. Questions regarding a more integrative view and qualitative research in psychotherapy are discussed in the paper. The author introduces some ideas from the studies on psychotherapy effectiveness that were done at Vilnius University by a group of researchers who work in the ‘Centre for research on the psychodynamics of personality’. Clinical psychologists who hold a doctorate degree or who are in doctoral studies in the Department of Psychology at Vilnius University are members of this research group. The subjective understanding about healing episodes and the development of depth premises were the main tasks of these studies. Among other methods, the researchers used the drawing a picture of a healing moment and telling a psychotherapy story recalled by the client to collect data. Two examples of drawing a picture of a healing moment and one example of telling a therapy story are analyzed in the paper. The themes of subjective experience of renewal in psychotherapy as well as the multiplicity of experience and results in psychotherapy are discussed in the paper with case illustrations. This study showed that drawing a picture opens one more dimension of reflection and that it can be an appropriate tool for developing individual narratives as well. Authoring and re‐authoring one’s life narrative is accepted as part of a productive therapy as well as discovering one’s inner authorship. The ability to follow a succession of meanings, as well as a connection to nature and culture could be one of the ways of actualizing an integrative view in psychotherapy research.     

Hope as empowerment model: A client-based perspective on the process of hope development

Abstract

Research on the relationship of client hope to successful therapy outcome underlines the need to discover the processes and conditions when hope flourishes. Snyder’s Hope Theory has been applied to psychotherapy but client subjective experiences are needed to illuminate nuances in the process. The present study examined the trajectory of hope development in psychotherapy using interviews with 18 counseling clients, analyzed using grounded theory methodology. Findings were synthesized into a dynamic model titled hope as empowerment model (HEM) that shares features of Snyder’s Hope Theory. HEM introduces patterns of particular salience to psychotherapy. The compatibility of client preferences with therapist input raised faith in the process of counseling and, in turn, hope in a positive outcome. A number of conditions, including the flexibility of client role preferences and the directiveness of hope-inspiring therapeutic strategies, influenced the nature and strength of client hope. Implications for therapy and positive psychology are considered.     

Sociodynamic aspects of psychotherapy

Definitions of psychotherapy are determined by sociocultural and epistemological factors, which, in turn, influences the objectives and practical consequences of the use of psychotherapy (for example, selection, indication, and method used). The current state of knowledge and social needs tend to modify views of the role and functions of psychotherapy in medical and extramedical fields and areas, which sociodynamic aspects of psychotherapeutic processes and their applications being considered and utilized differently. It is within the framework of different social orders that potentially equivocal functions and ways of making use of psychotherapy can be either promoted or inhibited. Consequently, it is desirable to try to clarify corresponding prerequisites and conditions, which has been attempted by the author in his present paper.     

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.     

An empirically-based rationale for a spiritually-integrated psychotherapy

In this paper, we offer an empirically-based rationale, for a particular kind of psychotherapy, spiritually-integrated psychotherapy. Drawing on several lines of research we note that: (1) spirituality can be a part of the solution to psychological problems; (2) spirituality can be a source of problems in and of itself; (3) people want spiritually sensitive help; and (4) spirituality cannot be separated from psychotherapy. We then discuss the defining characteristics of spiritually-integrated psychotherapy. It is based on a theory of spirituality, empirically-oriented, ecumenical, and capable of integration into virtually any form of psychotherapy. The paper concludes by considering potential problems associated with spiritually-integrated psychotherapy, including the risks of trivializing spirituality as simply a tool for mental health, reducing spirituality to presumably more basic motivations and drives, imposing spiritual values on clients, and overstating the importance of spirituality. Perhaps the greatest danger, however, is to neglect the spiritual dimension in psychotherapy. This paper sets the stage for the articles in this special issue of MHRC which describe the development and evaluation of several innovative approaches to spiritually-integrated psychotherapy.     

Persuasion criteria in research and practice: Gathering more meaningful psychotherapy data

Psychotherapy research should ultimately benefit the psychotherapy client. Unfortunately, traditional psychotherapy research continues to have little influence on practicing clinicians and, therefore, does not benefit psychotherapy clients. As behavior analysts begin to show interest in this area of research, they may be in a position to improve its quality. We argue that traditional psychotherapy researchers have become prematurely wedded to a methodology that does not address the concerns of clinical audiences. Furthermore, we make a case for defining and evaluating psychotherapy data in terms of its capacity to influence both researchers and clinicians. We also suggest several alternative methods for gathering psychotherapy data based on the case formulation approach. We argue that this approach may be one of the most promising methods for gathering useful psychotherapy data.     

Silence in group psychotherapy: a powerful communication

Silence in a psychotherapy group, including leader, member, subgroup, and whole-group silence, is a common phenomenon with many possible forms, uses, and meanings. Five common sources of silence in group psychotherapy are described: situational factors, individual dynamics, member-to-member interactions, group dynamics, and leader-related dynamics. Silence can reflect defenses or indicate conditions favorable to intensified group work. Silence, sometimes mistaken for psychological inactivity, should be viewed as significant communication.     

On the psycho-social conditions of psychotherapy in post-Soviet Georgia

The article describes the social, economic and political conditions that influence the practice of psychotherapy in post-Soviet Georgia. The author looks at the specific Soviet and post-Soviet mentalities and defines certain characteristics of these mentalities, the master-slave relationship between the people and the State, the materialistic world view, the nostalgia for the past and idealization of Soviet times, the identity crisis produced by the socio-economic traumas. The paper then provides clinical illustrations of these phenomena and shows how they can interfere with the process of psychotherapy.     

Psychoanalytic Psychotherapy with People in Abusive Relationships

Summary

Psychoanalytic perspectives on violence between partners is describedand forms a foundation for an approach to group and individual psychotherapy of men and women in relationships in which there is physical violence between partners. The empirical results of a study of the outcome of psychoanalytically oriented psychotherapy are described. Nineteen men and 16 women completed research measures before beginning psychotherapy and after completing 16 sessions of group psychotherapy. Twelve people who completed group psychotherapy continued in individual psychotherapy and completed measures again after 16 sessions of individual psychotherapy, and nine people completed measures again after the 16 sessions of group and 32 sessions of individual psychotherapy. Statistical analyses addressed outcomes in terms of verbal and physical aggression and dysphoric affects and anger. Both research and clinical outcomes are discussed.     

文化心理学视域下的心理治疗

近年来,心理治疗的文化取向日益为心理学界所关注。在概要分析文化心理学理论取向和传统心理治疗特点的基础上,重点对文化心理学取向下的心理病因观、医患关系、心理治疗方法、心理治疗效果评价观做了相应分析,并对未来文化取向下的心理治疗理论进行了展望,希望对我国心理治疗理论和实践有所帮助。