Psychodynamic psychotherapy for children and adolescents: a critical review of the evidence base

For many years psychoanalytic and psychodynamic therapies have been considered to lack a credible evidence-base and have consistently failed to appear in lists of ‘empirically supported treatments’. This study systematically reviews the research evaluating the efficacy and effectiveness of psychodynamic psychotherapy for children and young people. The researchers identified 34 separate studies that met criteria for inclusion, including nine randomised controlled trials. While many of the studies reported are limited by sample size and lack of control groups, the review indicates that there is increasing evidence to suggest the effectiveness of psychoanalytic psychotherapy for children and adolescents. The article aims to provide as complete a picture as possible of the existing evidence base, thereby enabling more refined questions to be asked regarding the nature of the current evidence and gaps requiring further exploration.     

To be in touch

This study examined the constellation of interaction structures – repetitive patterns of interactions between patient and therapist over the course of treatment – that emerged in the psychodynamic therapy (PDT) of a child diagnosed with borderline personality disorder and treated by two doctoral student therapists. Identification of these interaction structures can inform therapists of what might be expected from patients with particular symptom or behaviour patterns and how interactions change over time. This study also examined each session’s adherence to three session prototypes: PDT, cognitive-behavioural therapy (CBT) and reflective functioning (RF) process. The Child Psychotherapy Q-Set (CPQ) is a 100-item instrument that assesses the processes within a single psychotherapy session. Items reflect a wide range of therapist attitudes and behaviours, patient attitudes and behaviours and interactions between therapist and patient. Experts used the CPQ to define PDT, CBT and RF process session prototypes. The results suggested that four distinct interaction structures could be identified and that their constellations differed between the two therapists and also differed over time within each treatment. Therapists were more structured and accommodating early on in their treatments and more interpretive later. Prototypical PDT process was more prominent in the sessions than RF process, which in turn was more prominent than CBT process. Unique therapeutic processes are at work in every dyad, despite holding the patient and theoretical orientation constant. An effective treatment in one dyad might not work in another due to therapist-specific and dyad-specific effects.     

Beyond silence: working with Phoebe

This paper gives an account of a three-year period of silence that took place during the course of the intensive psychotherapy of a pre-adolescent girl with a diagnosis of ‘major depression’. The meaning and significance of silence in the therapeutic context is explored, as well as the importance of the ‘safety’ (Quinodoz, ‘The psychoanalytic setting as the instrument of the container function’, International Journal of Psycho-Analysis, 73: 627–35, 1992) and containing function of the setting that allows patients with a similar pathology a much needed regression, eventually enabling the birth and development of mature ‘verbal’ object relationships. Challenges and changes in the countertransference during a silent period in the course of psychotherapy are also discussed.     

社会认同对集体行动的作用：群体情绪与效能路径*

为探究多元社会认同如何通过群体情绪、自我和群体效能路径,影响现实或网络集体行动参与,研究者分别以中日撞船事件、利比亚事件和就业性别歧视现象为背景蓝本,开展问卷调查和实验研究,结果发现：群体愤怒情绪主要对现实集体行动有显著影响,效能感对现实和网络集体行动皆有显著影响;与事件相关的、更大范畴的社会类别认同,通过情绪路径或效能路径影响集体行动参与,与集体行动组织方的认同则只通过效能路径影响集体行动参与;两类社会认同与两条路径之间是调节而非中介关系。不同事件背景与不同行动场域下的综合分析表明网络集体行动参与决策更具工具理性特征。     

Collective contributions to career efficacy in adolescents: A cross-cultural study

This study extended the concept of collective efficacy to supplement the variable of career self-efficacy to predict vocational exploration and commitment among adolescents. We developed a Collective Contributions to Career Efficacy Scale (CCCE) to measure adolescents' perceived contributions from parents, teachers, and peers on their career-related matters. A total of 1175 high school students from Hong Kong, Shanghai and Michigan participated in the study by completing the CCCE, the Career Decision Self-Efficacy Scale (CDSE-SF), and the Vocational Exploration and Commitment Subscale (VEC). Using multi-sample Structural Equation Modeling, we found that the effect of CCCE on VEC was mediated by CDSE. Although we found cultural differences in the overall level of the vocational measures among the Hong Kong, Shanghai, and American students, the mediation model was confirmed in all three groups of students.     

Voices of African Traditional Healers: Cultural Context and Implications for the Practice of Counselling in Sub-Saharan Africa

The healing paradigm implicit in many sub-Saharan African cultures is embedded in African cosmology, and thus the recognition of this is essential for understanding Traditional African Healing practices and implementing collaborative counselling practices. To this end, this article focuses on the cultural importance, or voice, of traditional healers in sub-Saharan Africa. The current article uses an ethnographic approach to analyse systematically the cultural context of indigenous healing practices in sub-Saharan Africa. The anthropological importance of Traditional Healing practitioners, the context of healing, and the changing legal and ethical status of Traditional Healers are addressed as pivotal in furthering the development of this crucial, yet under utilized resource. The authors propose that such cultural understanding is highly relevant to the work of professional counselors.     

Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis

ABSTRACT

Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to non-specific controls at post-treatment (k = 10, d = 0.71, 95% confidence interval [CI] [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [?0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [?0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [?0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.     

Advanced Brief Strategic Therapy: An overview of interventions with eating disorders to exemplify how theory and practice work

This paper aims at introducing some of the central aspects of the evolution that brief strategic therapy has undergone at the Centro di Terapia Strategica of Arezzo, Italy, towards advanced therapeutic strategies which differ from the original Palo Alto model. (Fisch, Weakland, &; Segal, 1982; Watzlawick, 1978 Watzlawick, P. 1978. The language of change: Elements of therapeutic communication, New York: Basic Books.  [Google Scholar]; Watzlawick, Beavin, &; Jackson, 1967; Watzlawick, Weakland, &; Fisch, 1974). We will focus on how the concept of self-deception is central to the formation and the persistence of psychological disorders; and how the usage of non-ordinary logics and the understanding of the individual's perceptive-reactive system are of key importance in unravelling such disorders, allowing the therapist to guide the patient towards an efficacious and efficient solution. Rather than attempting to describe and enlist the theoretical corpus that underlies brief strategic therapy, we have chosen to exemplify some focal concepts that connect theory to practice, and vice versa, by presenting the outline of some therapeutic protocols devised for solving eating disorders which can be specifically tailored for each individual patient.     

Promoting emotional well-being through the use of humour

Humour skills programmes are believed to assist in improving emotional well-being by increasing self-efficacy, positive thinking, optimism and perceptions of control, while decreasing negative thinking, perceptions of stress, depression, anxiety and stress. The study aims to evaluate a programme investigating this possibility. Volunteers from the community (37 females and 18 males, aged M?=?38 years) were randomly assigned to a humour group, a social group or a non-intervention control group. The programme, consisting of a manual and a booklet of measures assessing indices of well-being, was administered over an 8-week period. Data were collected at baseline, post programme and at 3-month follow-up. Results revealed that unlike the control and social groups, the humour group demonstrated a significant increase in several indices of emotional well-being. Specifically, increases occurred with self-efficacy, positive affect, optimism and perceptions of control, while decreases were found in perceived stress, depression, anxiety and stress levels.