Three modes of psychotherapy and their requisite core skills

The field of psychotherapy suffers from the lack of an integrative meta‐perspective on the large variety of existing psychotherapies and on the therapeutic skills involved. In the present paper, it is suggested that the development of a more comprehensive view of this field may be facilitated if we differentiate between three modes of psychotherapy, which require different therapeutic core skills: (a) an educational mode, which requires teaching skills; (b) a reparative mode, which requires analytic‐conceptualising skills to identify some kind of disordered functioning, in combination with specific relational‐technical skills to repair this dysfunction; and (c) a developmental mode, which involves engaging in a therapeutic relationship with patients to facilitate their personal growth, and which requires non‐directivity skills. In addition, some therapeutic skills (e.g., awareness and communication skills) may be more or less important in all modes of treatment. Concrete manifestations of the three different modes of psychotherapy are discussed in terms of five different theoretical perspectives on psychotherapy: the common factors, the humanistic‐experiential mindfulness cognitive‐behavioural (CBT) and psychodynamic perspective. The common factors model is criticised as being insufficient in several respects. Finally, it is argued that if personal therapeutic skills are essential to the effects of psychotherapy, then empirical research on psychotherapy needs to be re‐oriented towards a person‐oriented study of therapist skills in action, in the context of a study of the interaction between therapist and patient.     

Blair on Rodin: Rejoinder

The article is a brief response to Jacob Blair’s critique of David Rodin’s argument in War and Self-Defense that there are circumstances in which war conceivably could be justified not as self-defence, but as law enforcement or punishment. It argues that while Rodin’s position potentially is less dilemmatic than Blair suggests, Blair nevertheless usefully highlights tensions within it. Blair’s own argument in favour of ar as law-enforcement is suggestive, but in no way conclusive.

Putting Short-Term Memory Into Context: Reply to Usher, Davelaar, Haarmann, and Goshen-Gottstein (2008)

The temporal context model posits that search through episodic memory is driven by associations between the multiattribute representations of items and context. Context, in turn, is a recency weighted sum of previous experiences or memories. Because recently processed items are most similar to the current representation of context, M. Usher, E. J. Davelaar, H. J. Haarmann, and Y. Goshen-Gottstein (2008) have suggested that the temporal context model (TCM-A) embodies a distinction between short-term and long-term memory and that this distinction is central to TCM-A's success in accounting for the pattern of recency and contiguity observed across short and long timescales. The authors dispute Usher et al's claim that context in TCM-A has much in common with classic interpretations of short-term memory. The idea that multiple representations interact in the process of memory encoding and retrieval (across timescales), as proposed in TCM-A, is very different from the classic dual-process view that distinct rules govern retrieval of recent and remote memories.     

A context-based theory of recency and contiguity in free recall

The authors present a new model of free recall on the basis of M. W. Howard and M. J. Kahana's temporal context model and M. Usher and J. L. McClelland's leaky-accumulator decision model. In this model, contextual drift gives rise to both short-term and long-term recency effects, and contextual retrieval gives rise to short-term and long-term contiguity effects. Recall decisions are controlled by a race between competitive leaky accumulators. The model captures the dynamics of immediate, delayed, and continual distractor free recall, demonstrating that dissociations between short- and long-term recency can naturally arise from a model in which an internal contextual state is used as the sole cue for retrieval across time scales.     

The conceptualisation of the psychical in psychoanalysis

This article aims to clarify the psychoanalytic conceptualisation of the psychical, which includes a discussion of the relationship between consciousness and the unconscious. The unconscious is conceived of as being on the border between the so-called 'ego's conscious intending' and a rudimentary body-ego experiencing. Phenomenological ideas on the essence of consciousness are used in order to help delineate the crucial differences between consciousness and the unconscious. Only consciousness is characterised by an awareness of itself, that is; self-consciousness. Furthermore, consciousness is characterised by an intentional, synthesising capacity, whereas the functioning of the unconscious, in its most radical form, is the opposite ofthe intentionality of consciousness. It is argued that the unconscious pre-supposes certain pre-sexual processes, in the form of a body-ego's formation of continuity, coherence and wholeness. The body-ego belongs to the sphere of consciousness/self-consciousness, even if self-consciousness is only given implicitly in the body-ego and not as a fully fledged ego cogito . Attention is drawn to neglected issues in psychoanalytic theorising, namely self-consciousness and the constitution of existence. The importance of this neglected area for the psychoanalytic process is illustrated with clinical examples.     

Long-term outcome of Internet-delivered cognitive-behavioural therapy for social phobia: A 30-month follow-up

Internet-delivered guided cognitive behaviour therapy for social anxiety disorder has been found to generate promising short-term results, up to one year posttreatment. No study has however documented longer follow-up periods. In this 30-month follow-up we contacted 57 participants from the original study of which 77.2% (44/57) responded to the Internet-administered outcome measures and 66.7% (38/57) completed a telephone interview. Results showed large pretreatment to follow-up within-group effect sizes for the primary outcome measures (Cohen's d 1.10-1.71), and a majority (68.4%; 26/38) reported improvements in the interview. The findings suggest that the long-term effects seen in previous live treatment CBT trials can occur in Internet-delivered treatment as well.     

Continuous self-recording of epigastric pain with two rating scales: Compliance,authenticity, reliability,and sensitivity

The present study compared two self-recording scales: VAS (Visual Analogue Scale) and DIBS (Duration, Intensity, Behavior Scale) with respect to compliance, authenticity, sensitivity, and reliability using a population of 32 patients with chronic epigastric pain. Compliance, authenticity, and sensitivity data revealed no significant differences between the two scales. With respect to reliability, high temporal stability coefficients were found for pain intensity over a 2-day period, for pain duration, and for a pain index calculated from DIBS. DIBS pain intensity data showed a greater temporal stability than VAS. Since DIBS yields more clinically useful information without suffering deficits in compliance, authenticity, or reliability, it appears to be a preferable instrument for monitoring chronic pain.     

THE EFFECTS OF REARRANGING WARD ROUTINES ON COMMUNICATION AND EATING BEHAVIORS OF PSYCHOGERIATRIC PATIENTS

Several aspects of ward routine were changed to study the effects of environmental manipulation on the behavior of 21 psychogeriatric patients. Furniture was rearranged to be more conducive to conversation (i.e., grouped around tables instead of along corridor walls), and mealtime routines were changed to allow patients more time to eat, more freedom in choosing the composition of the meal, and more pleasant surroundings. Patients were divided into experimental and control groups, and data were collected on the frequency of verbal and tactile communication and degree of skill in eating behavior. Following baseline, environmental changes were introduced across behaviors. Results show that the frequency of communication increased for the experimental group, as compared to both baseline and the control group. Eating behavior also improved significantly for the experimental group. The study shows that minor changes in the physical environment can promote therapeutic change in the behavior of patients diagnosed as senile dementia.