Outcome of psychodynamic child psychotherapy in routine practice

The aim of the present naturalistic study was to explore the effectiveness of psychodynamic child psychotherapy in routine practice. The sample comprised 207 psychotherapies with children 4–12?years of age with a broad range of mental health problems. Data on two measures, children’s global assessment scale (CGAS) and strength and difficulties questionnaire (SDQ), were collected pre-post therapy. Within-group changes were analysed using repeated measures mixed-models ANOVA. Individual changes were examined by means of clinical significance. The analyses revealed improvement in general functioning, decrease in problem severity and problem impact on the child’s everyday life, as well as an increase in prosocial behaviour. For CGAS, an interaction effect was discovered suggesting a larger improvement for younger children (4–6?years) than for older children (10–12?years). After therapy, 38% (n 76) achieved clinically significant improvement. Time-limited psychotherapy proved favourable for children assigned to that particular treatment modality. The study generated similar results as previous well-controlled trials, revealing statistically significant results in a large sample and in spite the use of non-specific outcome measures. The study provides everyday evidence to the effectiveness of child psychodynamic treatment with parallel parental work for a broad range of child mental health problems.     

A challenge to ‘self’ centred ‘psycho’: Therapy as an introduction to an ‘inter-relational therapy’

This paper focuses on ‘psychotherapy’, particularly exploring the emphasis on the ‘psyche’. The term ‘psyche’ is described as potentially having different interpretations depending on the underlying ontological assumptions that influence its understanding and these, it is suggested, will have considerable implications for the therapy that identifies with the label ‘psychotherapy’. Two very different ontological perspectives are highlighted in this paper in order to illustrate the different conception of the term ‘psyche’; firstly, Freud’s interpretation of what is meant by ‘psyche’, which is then contrasted with a phenomenological perspective, with reference to the philosophy of Husserl and Heidegger. Both the Freudian and phenomenological approaches are then criticised for focusing on, what is described here as, an egocentric perspective and it is suggested that the term ‘psycho-therapy’ will inevitably lead to a preoccupation with putting the ‘self’ first as a basis for relating to the external world. An alternative term, ‘Inter-relational therapy’, is presented based on the ideas of Levinas and MacMurray, both of who are critical of a cultural preoccupation with focusing on the ‘self’ and suggest a need to acknowledge relationships with the external world, including the other people that populate it, prior to a ‘self’ reflective process.     

Client perspectives and uses of psychotherapy

The present paper argues for the importance of studying user perspectives on ongoing psychotherapy. Four approaches to such studies are discussed. It is stressed that studies of user perspectives may allow us to develop a broader and more robust understanding of clients as the primary agents of their own change processes, and that if the studies focus on clients' everyday lives during the course of psychotherapy, they allow us a better understanding of how clients include their psychotherapy, give it a particular significance, fight over it, and transform it as a part of their changing everyday practice in other places than the session. the rationale and design of such a study is presented. It is a study of a small number of family therapies with the present author as a co-therapist. Some preliminary findings from this study are presented.     

Gadamer: Psychotherapy as conversation

Outcome research into psychotherapy shows that therapeutic approaches may all be equally valid forms of therapy despite the mutually exclusive theories on which they are based. Reviews of what therapists do in practice suggest a largely atheoretical and eclectic approach in which non-specific factors such as empathy, clinical management and persuasion are prominent. This paper proposes that a hermeneutic approach based on the work of the German philosopher Hans-Georg Gadamer can be useful in providing a non-dogmatic basis for therapy which makes room for these non-specific qualities. It outlines a hermeneutic mode of therapy and shows how this can allow for the rhetorical, interpretative and poetic dimensions of therapy-in-action.     

Renunciation of the self in psychotherapy

Self-renunciation or self-denial, although often misunderstood, is a foundational concept in several major religions and is frequently associated with spiritual maturity. In spite of this, the action of self-renunciation has been viewed with suspicion by the psychological community and criticized as repressive. This article argues that the concept of self-denial found in the Sufi tradition of rebirth and the salvation paradox found in the synoptic Gospels can bring a valuable perspective to psychotherapy. First, a brief summary of the history of psychotherapy and its contributions to the understanding of the self are provided. Next, a cursory overview of the Sufi tradition of rebirth is given. Third, the salvation paradox found in the synoptic Gospels is reviewed. It is argued that these two traditions offer valuable insight into ideas surrounding the self. Finally, the clinical implications of self-denial are discussed, and conclusions are drawn related to how psychotherapy can benefit self-renunciation.     

A phenomenological examination of dating attitudes in ultra-orthodox Jewish emerging adult women

The current study investigated the dating attitudes of Ultra-Orthodox Jewish women using a qualitative analysis. Interviews were conducted with eight Ultra-Orthodox Jewish young women. Themes reflected pressures associated with the dating process and the importance of dating for marriage. Additionally, respondents expressed satisfaction with the dating system due to its single-minded focus on finding a marriage partner and due to perceptions of alternative more Western systems.     

Between Hippocrates and God: Ugandan mental health professional's views on suicide

A negative attitude towards suicide is generally assumed to be predominant in low-income countries. In order to understand the negative attitude in general it is necessary to look at how religion and morality influence the attitudes. Our aim in this qualitative interview study was to investigate what attitudes professional mental health workers in Uganda bear towards suicide and suicidal persons. The professionals argue for their attitude by employing religious, communal and medical ethics arguments, which draw both in a negative and positive direction. The professionals are in general unambiguously negative towards suicide and positive towards suicidal people who are mentally ill. In cases other than mental illness non-accepting attitudes surface. This is discussed against previous research showing that effective treatment of suicidal people is to be based on a trusting and accepting relationship.     

Understanding Islamic Perspective of Mental Health and Psychotherapy

This paper is an attempt to provide foundational information about Islamic perspective of mental health and psychotherapy. It further highlights the historical contribution of Muslim philosophers and physicians to the field of psychotherapy. In the aftermath of the 9/11 and 7/7 tragedies, there has been a growing need to understand the Islamic perspective of mental health and gain insight into the followers of this faith otherwise perceived as ‘mysterious and Far Eastern’. A case example illustrates how counselors/therapists can effectively incorporate religious-cultural aspects of Islam in their work with Muslim clients so that they could work more effectively with their Muslim clients in the post 9/11 climate. Health care professionals must be sensitive to and fully aware of the unique religious traditions, cultural norms and gender sensitive values of their Islamic psychiatric patients so that they could introduce modern therapeutic interventions with less resistance from their clients.     

Addressing disparities: The impact of a lesbian,gay, bisexual,and transgender graduate counselling course

Background: Lesbian, gay, bisexual and transgender (LGBT) individuals experience serious mental health disparities and treatment inequities. Counsellor education has been identified as both a contributing factor to these problems as well as an ameliorating mechanism to address these inequalities. Aim: The purpose of the current study was to evaluate the impact of an LGBT‐affirmative counselling course. Method: A total of 23 students enrolled in a graduate LGBT counselling course were administered the Sexual Orientation Counselor Competency Scale (SOCCS, Bidell, 2005) and the Lesbian, Gay, and Bisexual Affirmative Counseling Self‐Efficacy Inventory (LGB‐CSI, Dillon & Worthington, 2003) pre‐ and post‐course. In addition, a comparison group of 23 matched counselling students was obtained from an existing data source in order to make further assessments of the course's effectiveness. Those in the comparison group were not enrolled in the LGBT course, but were administered the SOCCS at analogous time intervals. Results: After completing the LGBT course, enrolled students demonstrated significant improvements regarding their sexual orientation counsellor competency and self‐efficacy. In addition, these students showed significant gains in SOCCS scores versus those in the comparison group. Implications: Results from this study show the positive effect a full‐credit LGBT psychotherapy course can have on graduate counselling students' sexual orientation counsellor competency and self‐efficacy. The findings also indicate that such a course can significantly impact counselling skills, a facet of LGBT cultural competency found to be the most attenuated. Findings are discussed in conjunction with LGBT‐affirmative counsellor training and clinical practice.