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321.
Therapy holds the potential to harm as well as help. This paper highlights approaches that may help prevent or decrease the incidence of negative effects in psychotherapy. These approaches include supervision, peer consultation, ongoing assessment of the therapeutic process, therapist-client matching, and referrals and transfers. We hope that this paper will serve as a stimulus for clinicians, psychotherapy researchers, and educators to put forth collabo-rative effort into identifying variables directly associated with adverse treat- ment outcomes and determining appropriate prevention and intervention strategies.  相似文献   
322.
    
Aims: First, this paper presents the rationale for a novel approach to training counsellors in which measures for psychotherapy process research are taught to students before moving on to teaching basic empathic reflections and interventions. The rationale for this is that client process measures can be re‐purposed to help orient and sensitise trainees to key in‐session moments. Second, we present a training outcome study that assesses the effectiveness of this approach. Method: Using an experiential‐integrative therapy approach, a 13‐week training program was used to teach psychotherapy skills and process research measures to22 clinical graduate students taken from two cohorts. As part of the course, trainees conducted several single sessions with volunteer clients on four separate occasions. Training outcomes were measured using both trainee and client reports. Results: Compared to baseline, therapists reported significant and steady gains (all p's<.05) in session management, reducing their anxious self‐awareness, and in improved sense of self‐efficacy, with the latter having the largest effect (partial Eta Sq.=.381). Discussion: While the findings provide some support for a new training strategy, a dismantling design is needed next to more closely examine the process‐measure approach to training.  相似文献   
323.
    
Cognitive therapy could be more widely promoted in South Africa given the great disparity between the need and provision of psychological therapies. Three possible objections to the promotion of cognitive therapy are considered: uncertainty surrounding the effectiveness of cognitive therapy in South African contexts; uncertainty surrounding the applicability in multicultural contexts; and suggestions that cognitive therapy is decontextualised and therefore objectionable in a country facing major social challenges. A systematic review of the literature indentified 15 outcome studies, and suggests that cognitive therapy is a viable and much-needed approach in South Africa.  相似文献   
324.
    
The improving access to psychological therapies (IAPT) programme, which started with two pilot sites, has dramatically changed the provision of mental health services for depression and anxiety disorders in the National Health Service. The IAPT initiative has focused on the provision of cognitive behaviour therapy but incorporated a small systemic therapy service in the Newham pilot site. The outcomes of this systemic service are presented in this article. Most clients seen by the service suffered from depression and anxiety disorders. The response rate for the evaluation questionnaires was high. For the depression and anxiety measures the recovery rate was above 50 per cent and the effect sizes were large. Most of the clients were satisfied with the service. A trend towards employment was identified. The outcomes are discussed in comparison with those of the cognitive behaviour therapy service and recommendations for the process of further studies are made.  相似文献   
325.
    
A non‐experimental pilot study examined child, mother and family outcomes of a 10‐session multi‐family group intervention designed to reduce risk and promote resilience for mothers with depression and their families. Positive changes following the Keeping Families Strong intervention included mother‐reported decreases in child behaviour and emotional problems, improvements in the quality of family interactions and routines and improvements in their own well‐being and support from others. Children (9–16 years) reported decreased internalizing symptoms, improved coping, increased maternal warmth and acceptance and decreased stressful family events. Attendance and mother‐reported satisfaction were high, indicating the perceived value of the intervention.  相似文献   
326.
    
Many real‐life decisions (e.g. promises, plans and agreements) involve a time interval between when the decision is made and the main outcome is revealed. Nearly all regret studies focus on anticipated or experienced post‐outcome regret. We argue that regret is also frequently experienced in the pre‐outcome period, and that this ‘pre‐outcome regret’ has other sources than regret experienced after the outcome is known. Regret experienced in the pre‐outcome period has an important function post‐outcome regret (usually) cannot have, namely to motivate the decision maker to reconsider the ongoing decision process and reverse the initial decision. Pre‐outcome regret should for these reasons be distinguished from post‐outcome regret, and studied separately. In two scenario studies, participants were asked to imagine their regret after agreeing to perform an inconvenient task. In both, more regret was reported before than after the event, even when they had imagined a ‘worst case’ outcome. In the third study, participants described a difficult choice from their own life. Again, regret was perceived as higher in the pre‐outcome period than afterwards. In a fourth study, participants reported regret ‘online’ during an economic game (a version of the ultimatum game). They regretted their decisions more before than after they knew the outcome. We conclude that experienced pre‐outcome regret is often stronger than post‐outcome regret, and typically increases during the pre‐outcome period. We suspect that the absence of JDM studies of pre‐outcome regret is a legacy of the dominant gambling metaphor within decision research. Copyright © 2010 John Wiley & Sons, Ltd.  相似文献   
327.
    
The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6–11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All testing was completed before the beginning of the individual psychoanalytic psychotherapy. The same measures were repeated after 12 months of intervention. The 23 children who received individual psychoanalytic psychotherapy were compared with a control group who did not receive any kind of intervention. In the clinical group, the results indicated a statistically significant reduction of anxiety symptoms (0.002) and school problems (0.031), improvement in interpersonal relationships (0.022), and positive change in the following CBCL scales: withdrawn (0.010), thought problems (0.022), anxiety and depression (0.017), internalising (0.008) and total (0.003). An effect size of 0.696 was calculated based on the CBCL total scale before and after the intervention. The results revealed that child psychoanalytical psychotherapy is mostly effective in the treatment of female children who present internalising disorders.  相似文献   
328.
    
This article reports outcomes of Trauma Affect Regulation: Guide for Education and Therapy (TARGET), a group and milieu intervention, in three juvenile detention facilities, controlling for site, length of stay, ethnicity, number of arrests, mental health and traumatic stress problems, and cohort effects. Linear multiple regression results showed that every session of TARGET received in the first seven days of detention was associated with 54% fewer disciplinary incidents and 72 fewer minutes of disciplinary seclusion ( p < .001) for each youth during the modal stay (14 days) in detention. TARGET group participation was unrelated to recidivism, but recidivism declined significantly following implementation of TARGET. Implementing TARGET in juvenile detention facility milieus might improve safety, reduce punitive sanctions, and potentially reduce recidivism.  相似文献   
329.
    
Posttraumatic stress disorder (PTSD) represents an often chronic and debilitating mental illness resulting from exposure to trauma. Although the most compelling evidence for the treatment of PTSD is cognitive behavioral therapy (CBT), many patients experience residual functional impairment, or relapse, suggesting that this approach does not work for all cases of PTSD. Repeated severe trauma, particularly during development, might increase the risk for a more intricate clinical profile, called complex PTSD (CPTSD), which might contribute to poorer treatment response. The following provides a comprehensive summary of the evidence examining whether CPTSD symptomatology is related to poorer treatment outcome of CBT, reviews the literature on the treatment of CPTSD, and offers insights into current issues and future directions of the construct.  相似文献   
330.
    
Six client/therapist dyads (three therapists each working with two clients) were studied to determine how the real relationship unfolds over the course of time-limited treatment and how this unfolding relates to the development of the client/therapist working alliance, client transference, and therapist countertransference. We also examined how these indices of the relationship fluctuate as a function of treatment outcome. Results indicate that in general for all six dyads, therapists’ and clients’ ratings of the real relationship and working alliance were strong throughout treatment. However, patterns of real relationship and working alliance over the course of treatment varied between dyads categorized as more vs. less successful. Therapists’ countertransference was low, as was client transference, but differences in ratings were evident when the dyads were classified by outcome.  相似文献   
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