社会快感缺失认知过程的跨诊断研究进展

社会快感缺失具有广泛的跨诊断和亚临床特征,包括孤独感、内向性、社交焦虑和社会功能受损等。传统医学模型聚焦于社会快感缺失相关疾病的诊断和神经生理机制,促进了社会快感缺失药物和神经靶向治疗。然而社会快感缺失广泛地存在于健康人群和亚临床人群中,只有寻找有效的心理咨询和治疗方案,才会对亚临床人群社会快感缺失的缓解和社会功能的提升提供帮助。认知过程模型聚焦于积极效价系统,强调对积极奖赏刺激注意、记忆、心理意象等认知过程的提升,该模型将是社会快感缺失心理咨询与治疗的有效途径。     

以叙事医学实践促教学医院医学人文教育

叙事医学可以作为大学教学医院进行医学人文教育的重要手段。医学院可以进行细读训练,进入临床后,通过阅读和书写平行病历培养医学生的叙事能力。临床带教教师在医学人文教育中具有关键的示范作用,通过叙事性问诊、用叙事的方法与患者和家属建立关联,用叙事方法协助患者和家属做出临床决策,以及提供案例、点评升华其中的价值元素等叙事性带教方法,实现医学人文教育的言传身教, 这也是医学人文教育的重要组成部分。

     

曼陀罗绘画疗法对负性情绪的调节效应

从使用结构曼陀罗和非结构曼陀罗的曼陀罗绘画疗法实证研究中,对绘画性质、结构、形状及绘画内容等因素对不同群体在负性情绪的效应进行对比分析,就曼陀罗绘画疗法对负性情绪的影响机制进行探讨,突出揭示了曼陀罗绘画疗法导致认知内部的深层变化,通过自我表达、自我发现和意义感来促进积极的心理效应,以及保护性、秩序感、整合性等治疗机制。未来需要确立统一规范的训练方法,通过更多的随机对照试验来验证不同形式曼陀罗绘画疗法在不同人群中的干预效果,减少研究中的混淆因素,以便更好地推动曼陀罗绘画疗法在情绪治疗中的发展。

     

阿德勒心理治疗的回顾及展望

通过对阿德勒心理治疗理论及其发展历程的梳理,发现阿德勒心理治疗大致经历了初步发展、快速发展和当代发展三个阶段。阿德勒心理治疗已经形成一套行之有效的治疗体系和相对成熟的操作流程,发展成为专业的心理服务项目,发展出四步骤治疗程序,融合动力学、人本主义和认知-行为治疗等方法,形成家庭治疗、游戏治疗、团体治疗、短程治疗等模式,加强心理诊断和培训督导,注重治疗效果,关注多元文化背景,被广泛应用在家庭教育、学校教育、心理障碍、生涯发展咨询等诸多领域。

     

Who's afraid of the Wolfe couple: the interlocking traumatic scene

Fulfilling intimate relationships require a constant emotional and psychological struggle to disentangle strangleholds created by the interpenetration of unresolved complexes stemming from previous disappointing relational experiences. These complexes may manifest as an encrypted pattern of engagement that each partner brings to the marriage, like a 'malignant dowry'. The dowry box, once opened, releases its nefarious contents to create an extremely complex and entangled drama I call the 'interlocking traumatic scene'. Partners unconsciously entrap each other to play a part in such a scene with double (sometimes multiple) roles for each antagonist. The imaginal space between the two characters can be seen as a projection screen, upon which are superimposed two separate shadow plays, one on each side of the screen. A third play, which is a co-created product of these two individual traumatic scenes, can also be observed. Three plays are performed simultaneously. The defensive systems that the two individuals bring to the equation dovetail together, but the actual interlocking mechanism itself deadlocks in such a way that it seems to have its own malignant presence, a 'malevolent third' (after Ogden 1994). I outline therapeutic interventions using the metaphor of the therapist as 'anti-director' and I introduce my concept of the conjoint selected fact (after Bion 1963 after Poincaré 1952).     

National Survey of Client's Perceptions of Chinese Psychotherapist Practices

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for cross-cultural psychotherapists to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients.     

Clinicians’ Attitudes Toward Therapeutic Alliance in E-Therapy

Although therapeutic alliance is a crucial factor in face-to-face therapies, no data exist on clinicians’ attitudes towards alliance in E-therapy. The study explored clinicians’ perceived importance of alliance in E-therapy, clinicians’ confidence in their skills to develop alliance in E-therapy, and whether attitudes towards alliance in E-therapy are associated with intended E-therapy practice. Clinicians (n = 106) responded to an online survey. The majority of clinicians considered alliance to be extremely important in both face-to-face therapy and E-therapy. However, clinicians’ ratings of the importance of alliance in face-to-face therapies were significantly higher than their ratings of the importance of alliance in E-therapy. Clinicians reported less confidence in their skills to develop alliance in E-therapy than in face-to-face therapy. Intended E-therapy practice correlated with confidence in one's ability to develop alliance in E-therapy and with previous E-therapy practice.     

Editorial

With the aim of increasing knowledge about processes of change in psychodynamic individual child psychotherapy, sessions that could be called turning points were analysed.     

Clinical Commentary

This paper describes a lengthy period of psychotherapy with a child. This treatment began only after a prolonged contact with other child and adolescent mental health services during which the child's difficulties, which had initially seemed to be ordinary behavioural problems, had proved puzzlingly intractable to a variety of interventions. Subsequent psychotherapy revealed a profound disorder of development which lay bath the Surface presentation. In a climate where Asperger's syndrome is often felt to be untreatable, this paper argues that some children, at least, can benefit from psychotherapy and can be helped towards real mental growth. Asperger's syndrome in children bears some striking similarities to narcissistic personality disorder as described in the adult psychoanalytic literature and this paper discusses some of the theoretical and clinical implications of the innate origins of Asperger's syndrome.     

The Effectiveness of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in a Frontline Service Setting

The goal of the current study was to test the generalizability of cognitive behavioral therapy (CBT) for generalized anxiety disorder (GAD) in a frontline service setting. Twenty‐nine patients who presented to treatment clinics with problematic worry were provided CBT for GAD. Among the intent‐to‐treat sample, there were no significant changes in worry or depression from pre‐ to posttreatment. Treatment completers showed significant pre‐ to posttreatment reductions on measures of worry and depression. The magnitude of change was smaller than has been reported in randomized control trials (RCTs). Although the frontline service setting differed from RCT settings in multiple ways, treatment completers nonetheless achieved moderate to large decreases in self‐reported worry and depression.