Louise Benns‐Coppin 《Psychoanalytic Psychotherapy》2013,27(4):262-284

The purpose of this paper is to promote thought and discussion around how and why we treat patients in chosen ways. In the present climate practitioners are required to treat patients following NICE guidelines in which cognitive behavioural therapy (CBT) is the treatment of choice in the majority of diagnoses. This paper raises concerns that this may lead to an homogenization of treatment, loss of invaluable skills and understanding from other treatment approaches, and loss to the patient who may be best cared for by a combination of treatments and approaches, most notably patients presenting with complex pathology. This paper aims to present this as a general principle, and by way of example, will focus on coupling two specific treatment orientations, cognitive behavioural therapy with psychodynamic psychotherapy, with the specific diagnosis of obsessive compulsive disorder (OCD).

Methods: Clinical material is drawn from case studies from practice in secondary adult mental health care services within the NHS. All patients were referred to the psychological services for treatment for OCD and provided with 1:1 therapy with UKCP‐registered therapists. Details have been anonymized by describing fictitious cases re‐constructed from clinical material. A theoretical understanding is included which provides both an overview for integrating treatment for the specific example of OCD and is intended by extension to other diagnoses.

Results: Working with the commonalities of therapeutic approaches, and integrating specific skills of CBT and psychodynamic psychotherapy, appears to offer a viable mode of treatment for cases resistant to single‐orientation therapies.

Conclusions: Coupling the skills of different therapies can be effective in treating complex patients that are referred to the secondary mental health services. Conversely, restricting practice to single orientation therapies can lead to an impoverished care for patients and diminution of invaluable therapeutic skills which may become underused, undervalued and lost in the practice of mental health care within the NHS. Acknowledgement of the skills of others, valuing these and learning from each other can help to avoid the defensive reactions of practitioners, where each may defensively retreat to their corners of specialism. Respecting and sharing skills from different orientations, and acknowledging this in the NICE guidelines, is good for both mental health services and patient care and addresses the concerns raised by practitioners exemplified by Bateman (2000 Bateman, A. 2000. Integration in psychotherapy: An evolving reality in personality disorder.. British Journal of Psychotherapy, 17(2): 147–156.  [Google Scholar], p. 147) that ‘psychotherapy continues to be bedeviled by ideological schisms with practitioners apparently ignoring alternative conceptualizations and potentially superior interventions’.  相似文献   

    

Eva Gilboa‐Schechtman  Elisheva Ben‐Artzi  Pablo Jeczemien  Sofi Marom  Haggai Hermesh 《Cognition & emotion》2013,27(2):209-231

We assessed dysphoric and clinically distressed individuals' ability to ignore the emotional aspects of facial expressions using the Garner speeded‐classification task. Garner's paradigm tests the ability to selectively focus on a single relevant dimension while ignoring variations on other, irrelevant, ones. In the present task, the stimuli were faces of men and women expressing happy, angry, and neutral emotions. In Experiments 1 and 2, dysphoric and nondysphoric participants performed the Garner task, focusing on gender and ignoring emotion (Experiment 1) and focusing on emotion and ignoring gender (Experiment 2). Results suggest that dysphoric individuals exhibited more difficulty ignoring the emotional dimension of social stimuli even under specific instructions to do so than nondysphoric individuals. In Experiments 3 and 4, we replicated these results in clinically distressed and nondistressed individuals. The results of Experiment 3 further suggested that depression was more closely associated with the inability to selectively ignore emotion than was social anxiety. Experiment 4 confirmed that this failure of selective attention was specific to processing emotional, and not gender features. The implications of these findings for cognitive and interpersonal theories of depression are discussed.  相似文献   

    

Ian Mccready‐Flora 《Philosophy and phenomenological research》2014,89(2):394-435

I offer a novel interpretation of Aristotle's psychology and notion of rationality, which draws the line between animal and specifically human cognition. Aristotle distinguishes belief (doxa), a form of rational cognition, from imagining (phantasia), which is shared with non‐rational animals. We are, he says, “immediately affected” by beliefs, but respond to imagining “as if we were looking at a picture.” Aristotle's argument has been misunderstood; my interpretation explains and motivates it. Rationality includes a filter that interrupts the pathways between cognition and behavior. This prevents the subject from responding to certain representations. Stress and damage compromise the filter, making the subject respond indiscriminately, as non‐rational animals do. Beliefs are representations that have made it past the filter, which is why they can “affect [us] immediately.” Aristotle's claims express ceteris paribus generalizations, subject to exceptions. No list of provisos could turn them into non‐vacuous universal claims, but this does not rob them of their explanatory power. Aristotle's cognitive science resolves a tension we grapple with today: it accounts for the specialness of human action and thinking within a strictly naturalistic framework. The theory is striking in its insight and explanatory power, instructive in its methodological shortcomings.  相似文献   

    

Christopher Morgan‐Knapp 《Journal of applied philosophy》2014,31(2):113-126

Envy of others' material possessions is a potent motivator of consumerism. This makes it a prudentially and morally hazardous emotional response. After outlining these hazards, I present an analysis of the emotion of envy. Envy, I argue, presents things in the following way: the envier lacks some good that her rival possesses; this difference between them is bad for the envier; this difference reflects poorly on the envier's worth; and this difference is undeserved. I then discuss the conditions under which these presentations can be satisfied by differences in material possessions. My conclusion is that no difference in material possessions can simultaneously be all the ways envy presents it as being. Consequently, economic envy is systematically irrational: it is never a warranted response to the distribution of material wealth. Recognising this bolsters the prudential and moral case for reducing the degree to which we feel it and for resisting the inclinations it gives rise to when we do.  相似文献   

    

Christie J. Rizzo PhD  Christianne Esposito‐Smythers PhD  Lance Swenson PhD  Heather M. Hower LICSW  Jennifer Wolff PhD  Anthony Spirito PhD 《Suicide & life-threatening behavior》2014,44(3):338-351

The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self‐injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty‐five adolescents (ages 13–17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School‐Age Children clinical interview to assess NSSI and child abuse; adolescents completed self‐report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI.  相似文献   

    

Elizabeth A. Bates  Nicola Graham‐Kevan  John Archer 《Aggressive behavior》2014,40(1):42-55

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Kathy Ybañez‐Llorente  Quinn K. Smelser 《Counseling and values》2014,59(1):35-48

Addressing spirituality with clients from diverse spiritual backgrounds is a facet of culturally competent and ethical practice, yet various obstacles contribute to spirituality being overlooked. This article features a counseling technique used with clients who are experiencing difficulty with issues of a spiritual nature. Based on constructivist principles, the tree ring technique provides a context and process for examining clients’ spiritual conflicts, whereby the client is the expert and the counselor adopts a not‐knowing stance.  相似文献   

    

Hadassah Littman‐Ovadia  Sigal Zilcha‐Mano  Ellen Langer 《Journal of Employment Counseling》2014,51(4):170-179

In the past few decades, many studies have been conducted on the positive effects of mindfulness, a state of openness to novelty in which an individual actively constructs categories and distinctions. The authors tested the applicability of Langer's ( 1989a ) mindfulness theory to Holland's ( 1997 ) vocational personalities. Data from 156 Israeli full‐time employees were collected. The results link different types of vocational personalities to a mindful mind‐set.  相似文献   

    

Maria Carmen Aguilar‐Luzón  Antonia Calvo‐Salguero  Jose Maria Salinas 《Scandinavian journal of psychology》2014,55(6):619-629

Recent decades have seen a proliferation of studies aiming to explain how pro‐environmental behavior is shaped by attitudes, values and beliefs. In this study, we have included an aspect in our analysis that has been rarely touched upon until now, that is, the intelligent use of emotions as a possible component of pro‐environmental behavior. We applied the Trait Meta Mood Scale‐24 (TMMS‐24) and the New Environmental Paradigm scale to a sample of 184 male and female undergraduate students. We also carried out correlation and hierarchical regression analyses of blocks. The results show the interaction effects of the system of environmental beliefs and the dimensions of emotional intelligence on glass recycling attitudes, intentions and behavior. The results are discussed from the perspective of research on how the management of emotions guides thought and behavior.  相似文献   

    

Vanessa LoBue  Koraly Pérez‐Edgar 《Developmental science》2014,17(2):239-247

In the current brief report, we examined threat perception in a group of young children who may be at‐risk for anxiety due to extreme temperamental shyness. Results demonstrate specific differences in the processing of social threats: 4‐ to 7‐year‐olds in the high‐shy group demonstrated a greater bias for social threats (angry faces) than did a comparison group of low‐shy children. This pattern did not hold for non‐social threats like snakes: Both groups showed an equal bias for the detection of snakes over frogs. The results suggest that children who are tempermentally shy have a heightened sensitivity to social signs of threat early in development. These findings have implications for understanding mechanisms of early threat sensitivity that may predict later socioemotional maladjustment.  相似文献