Psychotherapy in a neoliberal world

The neoliberal regime has significant consequences for the psychotherapies. In particular, the idea that individuals is deserving of support from society and government when they need it – for example in managing the inevitable stresses of the life cycle – is being displaced by an ideology of total individual responsibility. Psychotherapies framed around relational conceptions of the self find themselves particularly out of key with this dominant way of thinking. Governmental approaches to developmental needs become more instrumental, measurement-oriented and ‘disciplinary’ in this situation. Market incentives and disciplinary sanctions are introduced to ensure that institutions and their personnel conform to governmental directives. There is pressure on psychotherapists to adapt to this instrumentalised environment to survive. However, ‘expressive individualisation’ was also stimulated by the cultural liberation of the 1960s, and survives alongside the ‘possessive individualism’ of neoliberalism. This alternative culture has not been entirely suppressed, and therapies continue to be sought which offer the possibility of self-understanding and growth, although the pressure is for such therapies to become luxury goods. What is at risk under neoliberalism is the idea that society should support the self-development and self-understanding of all its citizens, as an aspect of a modern kind of democratic citizenship.     

Joining and leaving a new religious movement: A study of ex-members’ mental health

The impact of membership in new, often socially contested, religious movements (NRMs) on mental health of members and ex-members is still a controversial question in the psychological literature. In the present study, we interviewed 20 ex-members of various NRMs who also completed questionnaires measuring several cognitive (need for closure, world assumptions) and affective-emotional (parental and adult attachment, social relationships, depression) constructs. Ex-members were then compared with current NRM members and with individuals not involved in NRMs. It appeared that NRM membership compensated for some previously existing vulnerabilities reported by members (insecure attachment in childhood, few social relationships, negative life events). However, this supportive effect did not persist after the destabilizing experience of disaffiliation. Yet, ex-members remained strong believers and were very inclined to spirituality.     

What members of Alcoholics Anonymous really believe

Many mental health professionals work with people who are members of Alcoholics Anonymous (AA) or may benefit from AA attendance. This article provides practical information about AA that professionals can use to understand and work with people in AA. It is a summary of a survey of 187 members of AA as well as synthesising the literature on AA. Specifically, it describes what AA is, the twelve steps and principles that underlie them, common AA expressions and how they can be used in therapy, common concerns about AA, and how to get more information about AA. Implications of how AA's steps and language can be incorporated into therapy, how therapy can facilitate working the steps of AA, and how to address consumers’ (or professionals’) concerns about AA are addressed.     

Treatment of Chronic Major Depression Using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP)

This article presents data from an ABAB single case design study of a 60-year-old Caucasian male diagnosed with chronic major depressive disorder. The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) was utilized throughout treatment, and both BDI scores and diagnostic interviews revealed states of partial, and ultimately full remission during the course of treatment. A focus was ultimately placed on generalizing what the patient learned in-session to his outside life. Additionally, the unique design of this case illustrated that the patient experienced a moderate reduction in depressive symptoms, prior to the long-term alteration of his coping style. A stable change in his coping style was necessary before full and sustained recovery was evidenced.     

Analytic Group Psychotherapy: A Uniquely Effective Crisis Intervention

This paper describes the author's experience doing crisis intervention with survivors of the 9/11 attack on the World Trade Center in New York City. It focuses on enhancing the understanding of and potentially expanding the theory and technique of analytic group therapy as applied to this unique situation.Private practice in     

Practicing Rational Emotive Behavior Therapy and Religious Clients

REBT is a process of: (1) identifying dysfunctional emotions and behaviors which inhibit more effective pursuit of what clients experience as their deepest and most abiding desires; (2) relating these dysfunctions to irrational beliefs; (3) inducing clients to reduce the controlling role played by these beliefs in their lives and (4) adopting more self-helping beliefs and practices related to their goals thus reducing their dysfunctional emotions and behaviors and increasing their joyful living. This article discusses how this can be done from within an individual's supernatural belief system, whether that system is theistic or nontheistic.     

Can men talk about problems with weight? The therapeutic implications of a discourse analytic study

This paper discusses the implications for counsellors of a discourse analytic study examining men's talk about body weight. It is argued that research in the area of problems with body has neglected the growing pressures on men to manage body as a feature of self. This research perpetuates the dominant discursive construction of men's relationship to body as unproblematic — a construction that may present many barriers to men in seeking help for any distress encountered. An analysis of men's talk is discussed in terms of the expectation that body is not problematic and the observable downplaying of any concerns acknowledged. The accountability of body as a site of regulation also emerges within the extracts presented. It is argued that this property within the accounts resonates with work highlighting the growing pressures on men to exercise control over body. The contradictions between the two discourses identified are discussed in terms of their therapeutic implications. It is postulated that male distress emerging from the growing pressures to maintain body weight may be neglected within primary care and therapeutic domains if discourses formulating such difficulties as not relevant to men remain dominant.     

论心理学两种研究范式的整合趋向

本文从方法学的视角分析了心理学研究的两大基本范式。文中讨论了量的研究与质的研究在本体论、认识论、价值论方面存在的差异,探讨了量的研究与质的研究整合的逻辑依据与历史依据。量的研究与质的研究存在各自的优缺点,它们的整合是必要的,也是可能的。文中进一步探讨了量的研究与质的研究整合的基本方式,包括次序式整合、平行式整合、交叉式整合等。     

Personality Disorder Attributes as Supplemental Goals for Change in Interpersonal Psychotherapy

Interpersonal Psychotherapy (IPT) is a manualized, short-term (usually 12–16 sessions) based on the assumption that psychological disorders often emerge secondary to social and interpersonal problems that require active intervention to achieve symptom remission. The time-limited nature of IPT compels therapists to establish the goal of diminishing, on a weekly basis, a small number of focused interpersonal problems with a decided emphasis on proximal rather than historic conflicts and associated patterns of behavior. This strategy discourages the adoption of diffuse therapy goals and directions that have more opportunity to emerge in long-term, unstructured treatment modalities. The role of traditional personality testing in short-term therapy, when it occurs, is to identify and quantify symptom clusters that warrant attention as dependent measures in the treatment process. The role of personality factors in the genesis or maintenance of psychological disturbance is rarely addressed. The present article explores theoretical and pragmatic objections to the use of personality testing in IPT. A method is proposed for the limited but systematic incorporation of personality testing in the IPT treatment process using the Millon Clinical Multiaxial Inventory (MCMI-III). While unreasonable to expect personality transformation through short-term therapy, the partial attenuation of maladaptive behavioral, attitudinal, and emotional reactions to stressors could prove exceedingly helpful to short-term treatments such as IPT.