Description and First Steps Toward the Empirical Validation of the Plan Formulation Method for Couples

The aim of this paper is to empirically assess the reliability of the plan formulation method for couples, a procedure for formulating the case, planning, and monitoring the couple therapies according to control-mastery theory. We hypothesized that when couples are looking for couple therapy, they have an unconscious couple’s plan for the therapy, which includes the couple’s goals; the pathogenic beliefs that the partners want to disprove; the traumas from which these beliefs originated and that the partners want to master; the vicious relational circles that make the couple suffer and that the couple wants to break; the virtuous relational circles that are expressions of the couple’s resources and that the couple wants to fuel; and the relational insights that may help the couple get better. Our study involved 15 couples treated by four experienced therapists. Four raters independently formulated each couple’s plan based on the first three sessions following a standard procedure, and we calculated the intraclass correlation for pooled judges’ ratings. For a subsample of three couples—who before and after treatment had completed the dyadic adjustment scale (DAS) and the outcome questionnaire-45.2 (OQ-45.2)—the compatibility of the therapists’ interventions with the couples’ and partners’ plans was assessed. The relationship between the ratings of compatibility, DAS and OQ-45.2, was assessed. The results showed excellent interjudge reliability for each couple’s plan formulation (average ICC?=?0.82), attesting to the validity of the procedure; and preliminary data on the therapeutic process suggested that therapists’ interventions compatible with couple’s plans could help partners achieve good outcomes.

     

Abbruchs-(Re-)Inszenierungen zwischen Scheitern und Chance

Zusammenfassung Die Autorin gibt zun?chst einen kurzen überblick über die bisherige Analyseabbruchsliteratur seit Freuds berühmter Dora-Analyse. Sie beschreibt die Ver?nderung des Blicks auf Behandlungsabbrüche im Kontext der theoretischen und behandlungstechnischen Entwicklungen und hebt hervor, dass die unvermeidlich erfolgenden Verstrickungen von Analytikern mit ihren Patienten bei realen Abbrüchen oder Abbruchsdrohungen heute eher als wichtiges Material und nicht mehr nur als „Kunstfehler“ verstanden und entsprechend weniger scham- sowie schuldhaft erlebt und durchgearbeitet werden k?nnen. Es folgt ein Fallbericht über die schwierige Analyse einer jungen Erwachsenen, die einerseits beharrlich an ihrem destruktiven Agieren auf der Basis ihres narzisstischen Universums und ihrer ?dipalen Verstrickungen festhielt. Andererseits war sie mit aufrichtigem Erkenntnisinteresse dazu bereit, die dramatischen “enactments” zwischen sich und ihrer Analytikerin (re)konstruktiv zu verstehen und sich auf ihren immer wieder bedrohlichen Entwicklungsprozess einzulassen. Anhand von mehreren (über den gesamten Behandlungsverlauf verteilten) Abbruchsinszenierungen beschreibt die Autorin, wie sich über das beharrliche und konkrete Durcharbeiten dieser Szenen mit der Zeit schrittweise ein tieferes Verst?ndnis für deren Sinn und eine Milderung der Wucht der negativen Affekte herstellen lie?en. Den besonderen Akzent bei ihrer Behandlungsführung setzt die Autorin auf die Arbeit an und in der unmittelbaren übertragungsbeziehung zwischen sich und ihrer jungen Patientin: Diese forderte ihre Analytikerin immer wieder heraus, einerseits „Farbe zu bekennen“ und dabei gleichzeitig ihre analytische Professionalit?t verl?sslich aufrechtzuerhalten. Dieser behandlungstechnisch komplizierte Balanceakt zwischen Scheitern und Chance wird n?her beschrieben.

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Breaking-off-enactments between failure and chance

Abstract First, an overview of the literature about the breaking off of analyses since Freud's famous Dora case is given. Subsequently, a since then changed view of breakoffs of treatments is presented, derived from new developments in theory and technique of treatment. The inevitable entanglements of analysts and patients in case of breakoffs or threats of breaking off are seen, therefore, nowadays rather as important analytic material instead of viewing it as “malpractice”. They are less loaded with guilt and shame and so easier to work through. A case study is then presented about the difficult analysis of a young adult woman, who on the one side was tenaciously clinging to her destructive acting-outs rooting in her narcissistic universe and her oedipal entanglements. But on the other side she had a genuine interest in getting (re)constructive awareness about the dramatic enactments between herself and her analyst and to engage in a developmental process which had for her again and again a menacing quality. The author describes several breakoff-enactments in the course of this analysis, occuring at different times along the whole treatment, and how their consistent and concrete working through gradually led to a deeper understanding of their meaning and to a moderating of the vehemence of negative affects. The author's emphasize in her treatment was put especially on the work in the transference relationship: the patient challenged the analyst repeatedly on the one side to “come clean” and at the same time to maintain reliably the professional analytic attitude. This complex balancing act between failure and chance is described in detail.

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überarbeitete und erweiterte Fassung eines Vortrags im Dezember 2006 anl?sslich der Ernennung zur DGPT-Lehranalytikerin, gehalten vor der „Arbeitsgemeinschaft für Integrative Psychoanalyse, Psychotherapie und Psychosomatik Hamburg“ (APH). Ich danke Josef Hauphoff, Peter Fürstenau und Helmut Junker für ihre konstruktiven fachlichen Anregungen.     

Target-related coupling in bimanual reaching movements

While bimanual interference effects can be observed when symbolic cues indicate the parameter values of simultaneous reaching movements, these effects disappear under conditions in which the target locations of two movements are cued directly. The present study investigates the generalizability of these target-location cuing benefits to conditions in which symbolic cues are used to indicate target locations (i.e., the end points of bimanual movements). Participants were asked to move to two of four possible target locations, being located either at the same and different distances (Experiment 1), or in the same and different directions (Experiment 2). Circles and crosses served as symbolic target-location cues and were arranged in a symmetric or non-symmetric fashion over the four target locations. Each trial was preceded by a variable precuing interval. Results revealed faster initiation times for equivalent as compared to non-equivalent target locations (same vs. different cues). Moreover, the time course of prepartion suggests that this effect is in fact due to target-equivalence and not to cue-similarity. Bimanual interference relative to movement parameter values was not observed. These findings suggest that cuing target locations can dominate potential intermanual interference effects during the concurrent programming of different movement parameter values.     

Comparison of treatment seeking compulsive buyers in Germany and the United States

OBJECTIVE: The aim of this pilot study was to compare a German (Bavaria) and an American (North Dakota) sample of women suffering from compulsive buying. METHOD: Thirty-eight German and 39 American female compulsive buyers were screened with the Compulsive Buying Scale (CBS), and the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV) prior to entering a group treatment study. Psychiatric co-morbidity was assessed with the Structured Clinical Interview for DSM-IV Axis I disorders (SCID). RESULTS: There were no statistically significant differences between the German sample and the American sample with regard to age (mean 43.7 and 45 years, respectively), and with regard to the scores on the CBS and the Y-BOCS-SV. A high lifetime co-morbidity rate with Axis I disorders, especially mood disorders, anxiety disorders, substance use disorders, OCD, and binge eating disorder was detected in both samples. Almost all participants met criteria for at least one lifetime Axis I disorder. However, German compulsive buyers showed significantly higher current prevalence rates of any affective disorder, and higher current and lifetime prevalence rates of any anxiety disorder and somatoform disorder. In addition, German compulsive buyers were significantly more likely to have more than one Axis I disorder. CONCLUSION: The groups did not differ with regard to age and with regard to the severity of compulsive buying and showed a high co-morbidity with Axis I disorders. However, the German compulsive buying sample presented with significantly more psychiatric co-morbidity compared to the American sample. Further research is needed to provide a better understanding of this disorder in general and cross-culturally.     

Psychotherapeutenausbildung aus Sicht der Absolventen

Background

A survey was performed to assess the current situation in education and to identify critical issues 10 years after the inception of the psychotherapy act in Germany.

Methods

In August 2008 all non-medical psychotherapists who had graduated since 2002 according the psychotherapy act were invited to take part in the survey and a total of 863 persons participated. The answers from 666 could be evaluated corresponding to a participation rate of 20%.

Results

A total of 57.6% of the graduates had completed a full-time training and approximately 50% of the graduates had completed the training within the allotted time. In the majority of cases evaluation occurred only for the theoretical courses. During the practical work (PT I) 36.8% of the graduates did not receive any salary or remuneration, 82% had their own field of activity and of these 38% treated patients without the presence of qualified tutor.

Conclusions

The training often lasts longer than intended, the financial situation in the PT I is exceptionally critical and in clear contrast to the field of activity in this section of training. Further detailed results will be presented and discussed.     

Building information systems as universalized locals

We report on our experiences in a participatory design project to develop ICTs in a hospital ward working with deliberate self-harm patients. This project involves the creation and constant re-creation of socio-technical ensembles that satisfy the various, changing and often contradictory and conflicting needs in this context. Such systems are shaped in locally meaningful ways but nevertheless reach beyond their immediate context to gain wider importance and to be integrated with the larger environment. currently working on a participatory design project developing IT systems for psychiatrists working in a toxicology ward of a large general hospital. His research focuses on the local co-production of technologies which he currently explores in a production management context. His research interests lie in the field of human factors and interactive systems design, particularly approaches to IT systems design and development, the relationships between work and technology, and inter-disciplinary approaches to the design of dependable computing systems. carrying out a number of ethnomethodologically informed studies in a variety of applications. He holds a Ph.D. in ethnomethodology from the University of Manchester and is currently involved in research on computer-aided prompting systems for radiological work. He has interests in ethnomethodology, CSCW, SSK and the philosophy of social sciences. where he convenes an interdisciplinary research programme on ‘the social shaping of technology’.     

Children's and Adults' Understanding of the Feeling Experience of Courage

Children's and adults' feeling experience of courage was investigated using an interview technique for younger children and an open-ended questionnaire method for adolescents and adults. There were 80 subjects in four age groups, 6, 9, 14 years, and adults, with 20 subjects and equal numbers of males and females per age group. Six-year-olds described courage in terms of an internal state corresponding to behaviour, whereas with increasing age courage was described as a multifaceted internal state experience, centring on fear and overcoming fear. Increasingly with age, subjects believed that control over the complex experience of courage could be gained by psychological strategies, such as concentrating on one's abilities and allowing all one's feelings and thoughts. Child age groups viewed courageous activity in terms of physical risk-taking but older subjects focused on psychological risk-taking. Results are interpreted in terms of an increasingly mentalistic understanding of courage.