Synthetiki Psychotherapy: An Integrative Psychotherapy for Individuals with Schizophrenic Symptoms

During the past 22 years, the author has developed an integrative psychotherapeutic model, called Synthetiki Psychotherapy (from the Greek word synthesis), for the treatment of individuals with schizophrenic symptoms. It has been influenced by certain philosophical and ethical principles, by ancient and modern Greek civilization and culture, and by the psychotherapy integration movement, and has been tested through research at the Laboratory of Clinical and Social Psychology of the University of Crete, Greece. The principles of Synthetiki Psychotherapy are presented and discussed.     

The Borderline Schizophrenic in Group Psychotherapy

SAGE is a group program developed for the community elderly. Groups led by professionals were compared to those led by the elderly, who were supervised SAGE graduates, and both of these groups of participants were compared to a wait-control group of elderly. A series of pre- and postmeasures on goal attainment scales and physical and mental health indices were used to evaluate the impact of the SAGE program. Professionally led groups had greater impact on improvement of mental health indices compared to the peer-led groups. These findings are discussed in the context of a framework used to analyze the differences between professionally conducted therapy, paraprofessionals, and peer-led self-help groups. Implications for the role of professionals in self-help are examined.     

The Use of Humor with Chronic Schizophrenic Patients

The use of a humorous therapeutic approach combined with drug therapy in the treatment of chronic schizophrenia patients institutionalized for protracted periods of time led to positive changes in their symptoms. The majority of the patients responded well to humorous interpretations. The patients felt that they had the option of adopting the doctor's humorous manner. This approach appealed to them and raised self-esteem; they likewise gained confidence in their own ability to form judgments. They cooperated better with the doctor in issues pertaining to treatment. The fact that humor made an impact on the patients' cognition demonstrated that patients with disturbed thought processes could be influenced in ways which improved coping. The patients' condition was evaluated according to the BPRS scale, before the treatment, on a monthly basis during the treatment, and three months upon the completion of the experiment. In the course of the experiment, pharmacological treatment remained unchanged. On the average, a perceptible reduction in the BPRS value (p < .05) was detected as a result of humor therapy. Amusing representations of affective external stimuli were incorporated into the patients' cognition and, along with a newly gained awareness of the possibility of relating to them with humor, were retained long after the termination of the project.     

Transference in Gerontologic Group Psychotherapy: Studies in Gerontologic Human Relations IV

For a number of reasons, we decided to bring three long-term, open-ended psychodynamic therapy groups to termination. We examine the process that began with the announcement of the change to a time-limited format, and concluded with the termination of the group. The transition had a powerful impact on the members and the group-as-a-whole. The therapists used supervision to deal with the intensity of the group process and the countertransference demands posed by the transition. Groups facing a similar change due to economic pressures may benefit from these observations.     

Treating Depression in Older Medical Patients with Psychotherapy

This purpose of this paper is to discuss the effectiveness of psychotherapy for treating depression in older, primary care patients. This paper highlights the feasibility of implementing psychotherapy in primary care settings, patient preference for psychotherapy, and the utility of primary care versions of therapy in treating depression in older adults. The discussion is supported with examples from three ongoing research projects, specifically the San Francisco General Hospital Depression in Late Life Study, the Hartford Foundation/California Healthcare Foundation IMPACT study, and the NIMH PROSPECT study. The findings presented here support the value of offering psychotherapy as a treatment alternative in primary care medicine.     

Intertransference: Transference Relationships between Members of the Psychotherapy Team

Abstract

There has been limited published research on the effectiveness of manualized psychoeducational approaches for the mental health and behavioral problems of child sexual abuse (CSA) survivors. The present study aims to add to the evidence base for the effectiveness and acceptability of such interventions. A total of 37 enrolled into a brief psychoeducation program (i.e., 10 sessions) aiming to help stabilize mental health and behavioral outcomes (e.g., self-harm), while on the waiting list for mental health services. Participants completed a set of self-rated measures at baseline, pre-intervention, post-intervention and 3-month follow-up. Although there was no change over time with regard to general distress, traumatic symptomatology, depression, anxiety, self-esteem, and life satisfaction, completers were less likely to report self-harm and presented with decreased rates of smoking, alcohol and substance misuse, and involvement in illegal and antisocial behaviors at post-treatment and follow-up. Qualitative data also suggested that overall the program is well tolerated by participants, despite the high attrition rate (43%). Although further research is required to establish the efficacy of this intervention, preliminary results indicate that the new intervention may be useful for stabilizing behavioral problems at post-treatment and follow-up. Strategies to improve attrition rates in future research and clinical practice are discussed.     

Case Studies of Two Schizophrenic Patients

A recent meta-analysis found that the Rorschach Prognostic Rating Scale (RPRS) had a strong ability to predict subsequent outcome (r = .44, N = 783; Meyer &; Handler, 1997, this issue). However, that review did not directly address questions of incremental validity. This article focuses on the ability of the RPRS to predict outcome after taking into account other sources of data. Across studies that examined both the RPRS and the MMPI Ego Strength scale, the RPRS had a strong ability to predict outcome (r = .40, N = 187), whereas the MMPI scale did not (r = .02, N = 280). Nine studies examined the RPRS along with an intelligence test and allowed direct numerical estimates of incremental validity to be calculated. Across studies, the RPRS demonstrated strong incremental validity after controlling for intelligence (incremental r = .36, N = 358). It is clear that the Rorschach can make unique contributions to understanding clinically relevant processes in ways that self-reports or measured intelligence cannot. Contemporary Rorschach scales should continue to be evaluated for their distinctive and incremental contribution to clinical practice.     

重视终末期肾病患者的心理治疗

心理治疗在终末期肾病(ESRD)治疗中的作用非常重要,不但可缓解患者的心理压力,还可改善患者的生理障碍、减少并发症,因此重视对ESRD患者的心理治疗,可使患者保持良好的生理、心理状态,并能提高患者的生活质量,改善预后。     

重视终末期肾病患者的心理治疗

心理治疗在终末期肾病(ESRD)治疗中的作用非常重要,不但可缓解患者的心理压力,还可改善患者的生理障碍、减少并发症,因此重视对ESRD患者的心理治疗,可使患者保持良好的生理、心理状态,并能提高患者的生活质量,改善预后.     

Using Rebt and Supportive Psychotherapy with Post-Stroke Patients

This paper discusses the benefits of using Calabro's (1990) three-stage cognitive-behavioral model, to determine when to use supportive Psychotherapy or Rational-Emotive Behavior Therapy (REBT) with post-stroke patients. It also discusses the benefits of using a support group and how to decide when to use a group and/or individual psychotherapy.     

Strategic Issues in the Psychotherapy of Patients with Narcissistic Pathology

Narcissistic personality disorder is a relatively uncommon diagnosis in clinical settings; however, these patients are frequently in need of and referred for long-term psychotherapy. Such patients may not seek therapy willingly but do so at a time when they experience sufficient vulnerability to accept therapy. Given these and other characteristics, the narcissistic patient can be challenging for therapists. This paper suggests some strategic approaches that may be employed with patients with narcissistic pathology. Partly, these approaches incorporate more contemporary understandings of narcissistic pathology such as appreciating that these patients can present both the grandiose and vulnerable elements of narcissistic pathology and that a gender focus using theories of masculinity may enlighten our approach to these patients. Specifically the strategies reviewed are: starting therapy by assessing for the patient’s vulnerable characteristics and offering some gratification for their need for acknowledgement; monitoring and managing the risk of suicide and comorbid disorder in patients with narcissistic pathology and in the working through phase of therapy, recognizing the need for patients to developed increased self-cohesion and the importance of supervision/consultation in the working through process of therapy.