The emerging therapeutic landscape of psychotherapy in the twenty-first century and the contribution of anthroposophic psychotherapy

In recent years the counselling and psychotherapy profession has experienced significant changes. On the one hand there has been the advent of managed care and evidence based practice which in the UK takes the form of the Improved Access to Psychological Therapy scheme. On the other hand there has, during the same period since the 1980s, been a rich and varied process of innovation in the profession. This has included the so-called relational inter subjective turn in the United States. Second, an increased sensitivity to the interface between therapy and social and political phenomena. Third, the revolution in neuroscientific thinking. Finally, the development of therapy as an interdisciplinary intervention in complementary and alternative medicine teams as in the case of the spiritually-orientated anthroposophic psychotherapy in Europe. In this article I will argue that these innovatory developments, which I refer to as the ‘new integration’, are much needed in order to counterbalance the increasing dominance of managed care and evidence based practice.     

Talking about talking: Interpersonal process recall as an intersubjective approach to research

Research methods are often marked by inequalities between researcher and researched, maintained through dominant discourses that structure expectations of research. This study considers how therapeutic skills such as reflexivity can help to develop alternative discourses, raise awareness and challenge inequalities in research. An approach to the qualitative analysis of research interviews using interpersonal process recall (IPR) is outlined. By focusing attention on the dialogue and enabling researcher and research participant to review and explore their interaction reflexively, IPR offers an opportunity to understand interviews as intersubjective events. It thus facilitates the collaborative identification of processes and narratives as key moments for further analysis and increases awareness of the potential blurring of genres between therapeutic and research conversations. The contribution of IPR to an intersubjective lens and greater equality in research interviewing is discussed. Potential implications for both research and therapy practices are suggested.     

Speech and Language Disorders in Kenyan Children: Adapting Tools for Regions with Few Assessment Resources

This study sought to adapt a battery of Western speech and language assessment tools to a rural Kenyan setting. The tool was developed for children whose first language was KiGiryama, a Bantu language. A total of 539 Kenyan children (males=271, females=268, ethnicity=100% Kigiryama) were recruited. Data were initially collected from 52 children (pilot assessments), and then from a larger group of 487 children (152 cerebral malaria, 156 severe malaria and seizures, 179 unexposed). The language assessments were based upon the Content, Form and Use (C/F/U) model. The assessment was based upon the adapted versions of the Peabody Picture Vocabulary Test, Test for the Reception of Grammar, Renfrew Action Picture Test, Pragmatics Profile of Everyday Communication Skills in Children, Test of Word Finding and language specific tests of lexical semantics, higher level language. Preliminary measures of construct validity suggested that the theoretical assumptions behind the construction of the assessments were appropriate and re-test and inter-rater reliability scores were acceptable. These findings illustrate the potential to adapt Western speech and language assessments in other languages and settings, particularly those in which there is a paucity of standardised tools.     

Banking on brains: Insights of brain donor relatives and friends from an experiential perspective

Brain donation is critical to understand the pathological causes of neurodegenerative diseases. Increasing levels of donation requires an understanding of those factors that both encourage and deter donation. At present, there are few studies of how people understand, feel and decide about brain donation for scientific research. This qualitative experiential study contributes to the growing literature on brain donation through its specific focus on how the donation process is experienced from the perspectives of family members and friends. Nineteen semi-structured interviews were analysed using a phenomenologically informed thematic analysis. Four themes were derived from the analysis, three of which are described in detail: Making the decision to donate; a personal perspective on the donation process; the significance of the brain; beliefs about brain donation. In particular, the thematic analysis highlights the variation of individual decision making and the emotions and reasons underpinning such decisions. Key conclusions include the importance of integrated practice amongst relevant healthcare professionals as well as the need for supportive and informed communication. Also, in light of the finding that the brain assumed no special significance for most participants, the value of the distinction between brain donation for research purposes and organ transplantation is questioned.     

Combining binocular and monocular curvature features.

A study is reported of the perception of visual surfaces in wire-frame stimuli generated by combinations of monocular surface contours and binocular disparity that provide differing information about 3-D relief. Observers vary considerably in the relative contribution made by the binocular and monocular cues to the perception of overall 3-D form. Without training, many observers may entirely fail to perceive surface curvature from the binocular disparity patterns, interpreting the form of the surface only according to the monocular information. For other observers, both cues contribute to the end percept, with the monocular interpretation dominating where the disparity information indicates planarity and with disparity dominating where disparity information suggests curvature and the monocular interpretation suggests planarity. Where stereo and monocular interpretations indicate inconsistent surface curvature features at a common location, more complex resolution strategies are suggested.     

The predictive moment: reverie,connection and predictive processing

ABSTRACT

According to the theory of predictive processing, understanding in the present involves non-consciously representing the immediate future, based on probabilistic inference shaped by learning from the past. This paper suggests links between this neuroscientific theory and the psychoanalytic concept of reverie – an empathic, containing attentional state – and considers implications for the ways therapists intuit implicit material in their clients. Using findings from a study about therapists’ experiences of this state, we propose that reverie can offer practitioners from diverse theoretical backgrounds a means to enter the predictive moment deeply, making use of its subtle contents to connect with clients.