Logotherapy-Enhanced REBT: An Integration of Discovery and Reason

Viktor Frankls Logotherapy and Albert Elliss Rational Emotive Behavior Therapy (REBT) are at seemingly opposite ends of the psychotherapeutic spectrum. However, a close review of the assumptions and philosophy of each school of therapy reveals that these two systems are compatible. We propose that a Logotherapy-enhanced REBT can increase human achievement and happiness by balancing the individual discovery of meaning with the pursuit of reason. This integrated and enhanced therapy will help human beings participate in positive life experiences and take greater responsibility for change. Fruitful and beneficial aspects of a Logotherapy enhanced-REBT are explored with respect to cognitions, emotions, and the reduction of rumination. Conclusions are drawn, limitations are discussed, and future recommendations are outlined.     

Contemporary Psychotherapy: Promoting Personal Responsibility for Therapeutic Change

An assortment of factors in modern society can be involved in the etiology and treatment of mental illness. Theories about etiology usually underlie, and therefore guide, most strategies for treatment. Although a comprehensive bio-psycho-social approach to mental illness can help to foster the collaboration of an interdisciplinary treatment team, a heavy emphasis on biological factors or cultural deprivation may reduce the client's feelings of personal responsibility for change. Contemporary psychotherapy can help clients reduce their tendency to attribute blame to biological predispositions or external societal factors. Instead, it is more helpful to cultivate attributions for personal responsibility for change, growth, and maturation.     

Effectiveness Research: Transporting Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) From the Lab to School-Based Health Clinics

This paper describes the process of modifying and transporting an evidence-based treatment, Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), from a university setting to school-based health clinics. It addresses conceptual issues involved in the shift from efficacy to effectiveness research as well as operational issues specific to the transport of IPT-A into school-based health clinics. Consideration is given to the rationale for an IPT-A effectiveness study, methodological concerns, and the timing of the move from the lab to the community. The authors identify challenges and barriers to initiating effectiveness and transportability research and provide suggestions for overcoming these barriers. Recommendations for conducting research in school-based practice settings are provided.     

The concept of placebo

This paper attempts to define the concept of placebo as it is used in the clinical context The author claims that X is a placebo if and only if X has such a property d_p, that whenever in a therapeutic situation T a stimulus S appears, then in attending conditions A, it will cause a beneficial reaction R in the patient. Formally, the same structure may be used to define any pharmacologically active drug. The main difference between the drug and a placebo is in the range of possible substitutions for X and the property d. For the active drug there is only one possible substitution for X and property d and it can be scientifically explained why, and how the drug works. In the case of a placebo a set of possible substitutions for X and d is open, and so far it is impossible to offer any scientifically valid explanation of the action mechanism of placebo.     

Therapeutic Use of Humor in Antisocial Personalities

Therapeutic use of humor in patients with antisocial personality disorders is scarcely studied until now. However, therapeutic use of humor could contribute to a growth of social-emotional and moral awareness and capacities, enhancement of self-insight and reality testing, and associated therapeutic progress in these patients. Suggestions are made for a) adequate and safe use of humor in the therapeutic context, and b) effective selection of patients. More research is needed into the effects and adequate strategies of therapeutic humor in different categories of antisocial patients. Furthermore, it is also necessary to investigate how humor could be integrated well in various psychotherapeutic approaches     

From I: A/M to “Who am I?”—Aggregation/Massification and Trauma-Based Affects and Object Relations in Groups: A Response to Earl Hopper

Hopper's portrayal of the fourth basic assumption of Incohesion: Aggregation/Massification has two components: (1) a revision of Turquet's theory of BA Oneness to incorporate the polarity of aggregation and massification stemming from annihilation anxiety; and (2) a conception of the difficult patient as having an encapsulated psychosis. Hopper's theory of the encapsulated psychosis offers an important but incomplete perspective in explaining borderline and narcissistic pathology, as well as psychological trauma. In this response to Hopper, I suggest that the fourth assumption is in fact a still more primitive state of boundary opening and closing. I also see a need to differentiate trauma as such from borderline pathology, and further hold that the relationship between Hopper's British Independent theory and trauma theories based on dissociation needs to be clarified.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

Psychotherapy Process Measure Research and the Evaluation of Psychotherapy Orientation: A Narrative Analysis

This article discusses the need for a systematic method that enables researchers to evaluate integrative therapy approaches using a range of therapy process measures. The Narrative System Process Coding (NPCS; Angus, Hardtke, & Levitt, 1996) is proposed as such a method, and is applied with the Experiencing Scale (Klein, Mathieu, Gendlin, & Keisler, 1970) and the Levels of Client Perceptual Processing (LCPP; Toukmanian, 1986) to three brief good outcome integrative therapy modalities to illustrate this need. The study found higher Experiencing Scale scores to be most strongly related to an experiential approach to therapy and to the NPCS internal narrative processes. Higher LCPP scores were most strongly related to the NPCS reflexive narrative process and to a perceptual-processing approach. The discussion initiates a discourse on the importance of explicating process measures' origins when comparing different therapy approaches in order to allow for the meaningful consolidation of process research findings.     

Ferenczi's Rise and Fall from “Analytic Grace”: The Ferenczi Renaissance Revisited

In the last 20 years a Ferenczi Renaissance has been slowly building. There has been a rediscovery of the significance of Sándor Ferenczi, who can be considered the clinical genius of psychoanalysis. The politics of psychoanalysis led to the suppression of Ferenczi's ideas, removing his influence from psychoanalysis for about 50 years. Ferenczi's ideas and methods significantly deviated from his mentor, Sigmund Freud; he offered an alternative theory, The Confusion of Tongues and a new method, Relaxation Therapy. Ferenczi's pioneering contributions to analytic therapy include: the introduction of empathy into the analytic relationship; the curative function of the relationship in the analytic encounter; the role of activity in analytic therapy; the importance of non-interpretative behavior by the analyst; the function of the experiential and emotional dimensions in analytic therapy; analyst self-disclosure; and mutual analysis.     

Resistance as a Problem for Practice and Theory

Resistance is one of the most problematic and potentially counterproductive concepts in the entire field of psychotherapy. It is at the same time one of the most crucial, pointing toward perhaps the single most important factor—or, more accurately, set of factors—in determining the success or failure of the therapeutic enterprise. Drawing on the articles by Davis and Hollon, Prochaska and Prochaska, Reid, and Eagle in this issue, as well as on the author's own perspective, this paper explores this seeming contradiction in order to point toward an integrative resolution of the differing perspectives on resistance and related phenomena.