‘Mr K’ – A successful case of analytic oriented therapy documented empirically: the role of the therapeutic relationship and reflexive self-awareness

A successful case of analytic treatment over the course of 250 sessions is described from different perspectives, including considerations from the two-year follow-up. The therapeutic alliance and the patient’s experiencing were evaluated. Pre-treatment diagnosis was validated via diagnostic interview. Symptoms and interpersonal problems were assessed at intervals. Data were analysed using two different time-series analyses. Aspects of agency with regard to mentalizing capacity were assessed with the Metacognitive Assessment Scale. We obtained the following main results: (1) Symptoms and interpersonal problems improved continuously until the end of treatment. Symptom severity fell to below the clinical cut-off. This successful outcome remained stable at the two-year follow-up. (2) The therapeutic relationship improved during the therapeutic process. (3) The patient’s capability for reflexive self-awareness, operationalized as experiencing, decreased. (4) The metacognitive mastery of the patient increased. The following conclusions were made after combining the empirical data with the clinical observations: (1) Mr K improved clinically in terms of symptoms, self-regulation and interpersonal problems as a result of his gaining affect control. (2) The patient’s experiencing does not capture a positive outcome in all cases. (3) Aspects of agency (i.e. metacognitive mastery) deserve further attention in psychoanalytic treatments.     

Guidance counselling as a whole school responsibility in the Irish post primary sector

ABSTRACT

This paper will deliberate upon the relevance of guidance counselling as a ‘whole school’ responsibility in the context of recent policy and practice changes in the Irish post primary sector since the Government of Ireland Budget 2012. Pertinent issues including the complexities of delivering a whole school approach to guidance counselling during a period of resource rationalisation will be addressed through the findings from recent case study research [Hearne, L., Geary, T., & Martin, N. (2016). A single case study of a whole school approach to guidance counselling in an Irish post-primary school; Case report. Retrieved from University of Limerick website: http://www.ul.ie/soedu/node/1481]. A single explanatory case study methodology investigated the complex phenomenon and interventions of whole school guidance counselling in a mixed gender school in the context of increasing demands for evidence-based data and methodological sophistication in lifelong guidance [European Lifelong Guidance Policy Network. (2015a). The evidence base on lifelong guidance; A guide to key findings for effective policy and practice, extended summary. Jyväskylä: Kariteam; Hearne, L. (2009). Towards an understanding of the measurement of individual progression in adult guidance (Unpublished doctoral dissertation). Waterford Institute of Technology, Waterford; Stake, R. E. (2004). Standards-based & responsive evaluation. Thousand Oaks, CA: Sage; Yin, R. K. (2009). Case study research: Design and methods (4th ed.). Thousand Oaks, CA: Sage; Yin, R. K. (2014). Case study research (5th ed.). Thousand Oaks, CA: Sage].     

CONSISTENT VISUAL ANALYSES OF INTRASUBJECT DATA

Visual inspection of single‐case data is the primary method of interpretation of the effects of an independent variable on a dependent variable in applied behavior analysis. The purpose of the current study was to replicate and extend the results of DeProspero and Cohen (1979) by reexamining the consistency of visual analysis across raters. We recruited members of the board of editors and associate editors for the Journal of Applied Behavior Analysis to judge graphs on a 100‐point scale of experimental control and by providing a dichotomous response (i.e., “yes” or “no” for experimental control). Results showed high interrater agreement across the three types of graphs, suggesting that visual inspection can lead to consistent interpretation of single‐case data among well‐trained raters.     

一例运用催眠疗法治疗失眠症的案例报告

本次案例主要采用催眠疗法,并结合行为疗法和认知疗法对个案进行了心理问题的矫正,尤其是将系统脱敏和认知疗法融入到催眠疗法之中,在对求助者的心理进行整合式治疗后,其睡眠状况明显改善,精神状况得到提高,抑郁情绪消除,焦虑程度显著降低。再次进行问卷自测后分数明显下降,该咨询取得了较好的效果。     

The patient's private construction of meaning and canons of science: Freud's case studies noch einmal1

Starting from Freud's classical case studies, the author highlights the tension between the psychoanalytical starting point in the subject's own meaning construction and the claims of the professional expert to objectivity, privileged knowledge and interpretative precedence. Psychoanalytic investigation of subjective phenomena came into existence parallel with Freud's magnifi cent project to furnish ‘a psychology that shall be a natural science’. The privileged knowledge of the specialist was substituted by the explicit intention to listen to the individual's own stories and private explanatory constructions. In order to investigate the territory of the unconscious, Freud had to develop various strategies for uncovering and correcting errors, and for testing clinically anchored hypotheses. However, Freud regularly failed to follow his own intentions. The thesis the author presents here is that departures from the explicit ambition to follow the subject's own meaning construction, and departures from the scientifi c attitude, easy to trace in Freud's case studies, accompany each other. These departures have had far‐reaching consequences for the present status of the psychoanalytic knowledge.     

浅谈产科镇痛与人文关怀

实施无痛分娩是对每位产妇最贴切的人文关怀,每位产妇都有享受这种关怀的权利,而在我国分娩镇痛仍未普遍采用.通过实际案例及产科镇痛发展史,论证了当今实施产科镇痛的必要性及技术条件的成熟性,剖析了当今实施此技术的人为及社会障碍,并提出了解决这一问题的方法和途径.     

公共卫生与全民的健康意识

SARS事件使公共卫生和全民的健康意识问题成为全社会的焦点问题,现在人们更加关注的是后SARS时代我国公共卫生建设和全民健康意识喜忧参半的现状,也许更有意义的是探讨公共卫生与全民健康意识的关系,明确健康意识的内涵,认清民众的健康误区,重视全民的健康教育.     

Social support,negative social exchange,and response to case formulation-based cognitive behavior therapy

We investigated associations between pretreatment social support, negative social exchange, and slope of weekly symptom change for depression, anxiety, and stress over the course of ideographic, case formulation-based, cognitive behavior therapy. Participants were 74 adults treated in a private practice setting. We used self-report measures to assess social support and negative social exchange at intake and to assess symptoms on a weekly basis. At pretreatment, a higher level of social support was associated with lower levels of depression, and a higher level of negative social exchanges was associated with higher levels of depression and stress. Pretreatment social support was not significantly associated with slope of symptom change. However, a higher level of pretreatment negative social exchanges was associated with steeper slope of change in symptoms of depression and stress during treatment. These findings suggest that the association between pretreatment negative social exchanges and subsequent symptoms may be stronger than that of social support and subsequent symptoms. Additionally, we discuss the possibility that having data on negative social exchanges at the start of treatment may benefit the outcome of ideographic, case formulation-based, cognitive behavior therapy.     

Psychodynamic Psychotherapy Process Research: A quick ride through what you should know about process (research)

This paper gives an overview of psychoanalytic process research, which brings to light the complexity of psychotherapy sessions. This complexity is so rich that many instruments intended to make the process measurable failed in the past because they initially used a strategy of complexity reduction. This method however did not help to further our understanding of the complexity involved. Three former presidents of the Society for Psychotherapy Research (Stiles, Hill, Elliot 2015) decided to solve the following equivalence paradox: many therapies work successfully though they all follow different theories, produce a heterogeneity of processes and often enough a misfit between what theories maintain to be a good process and their realization in the treatment room. As theories are often compared to maps, a driver would wonder which route to take. But therapists‐as‐drivers go undaunted ‐ and nevertheless achieve their goals together with their patients. Norcross and Wampold (2018) found that good therapists invent new therapies with every new patient. They hypothesize that it is because of conversation. This is in accord with the 3 former presidents’ proposal to return to detailed single case analyses including the micro‐analytic power of conversation analysis of which a few insights are outlined in this article.     

Evidence from masked‐priming that initial identification of brand names is via abstract letter identities

Although visual‐word recognition is often assumed to proceed on the basis of case‐invariant letter representations, previous research has shown a role for letter‐case in recognizing brand names. One recent study reported early effects of letter‐case in a brand‐decision task using masked primes (Perea et al., 2015, British Journal of Psychology, 106, 162). The present study attempts to replicate this finding using brand names typically presented in all lowercase (e.g., adidas), all uppercase (e.g., IKEA), or titlecase (e.g., Ford). Across three masked‐priming experiments, we found no advantage for case‐matched identity primes over case‐mismatched identity primes. This finding suggests that brand‐specific letter‐case information does not play a role in the early processing of brand names. However, we observed evidence that case may be used as a cue for making brand decisions, which may explain the effect reported by Perea et al. (2015, British Journal of Psychology, 106, 162).