FINDING THE SOMETHING IN NOTHING

Formless Infinity: Clinical Explorations of Matte Blanco and Bion. By Riccardo Lombardi. Translated by Karen Christenfeld, Gina Atkinson, Andrea Sabbadini, and Philip Slotkin. London/New York: Routledge, 2016. 282 pp.     

Therapists’ experiences of alliance formation in short-term counselling

While therapeutic alliance formation has been widely researched over many sessions of psychotherapy, the question of alliance formation in short-term counselling has been less explored. Given the increasing evidence in the literature for the positive impact of alliances on therapy outcomes, providing counsellors – who may work with clients for a limited number of sessions – with enhanced insight into alliance formation will be of value. This qualitative study investigated the experiences of eight counsellors forming alliances with clients over short periods. Semi-structured interviews were analysed using interpretive phenomenological analysis. Five major themes emerged, that while congruent with the alliance literature, add some details relevant to day-to-day practice. These themes included: the importance of strong alliances; the need for psychologically comfortable environments; the timing of alliance formation; and the impact of counsellor personal qualities – such as being real – in strengthening and maintaining alliances. In addition, an unexpected sixth theme revealed that body language was highly valued as an indicator of strong or weak alliances. Implications for increasing the use of body language to enhance counselling practice and education are discussed.     

Religion/spirituality,therapeutic landscape and immigrant mental well-being amongst African immigrants to Canada

This study explores the experiences of African immigrants’ religious place making and its relationship to health and well-being. Attention is paid to how religious places are seen as therapeutic and their impact on well-being of Ghanaian and Somali immigrants in Hamilton, Ontario. Our analysis of the interviews, emerging from the therapeutic landscape lens underscores the importance of immigrants’ religious places and activities in shaping health in their new destination. The results indicate that places of worship are significant for physical health, social, emotional, spiritual, mental and general quality of life amongst immigrants. Future research employing the therapeutic landscape theory may explore the links between health and place in specific religious places and activities.     

An investigation into the client at the heart of therapy

This paper reports on an exploration of the experience of the client at the heart of therapy. A grounded theory analysis of clients' experiences of therapy provided through a voluntary sector counselling service was undertaken, and generated four main categories: permission, engagement, transparency and restructuring. The results of the study are presented in a way that hopefully retains much of the richness of what people have reported about their experience of counselling. The findings of the study are discussed in terms of the idea that counselling can provide a setting where people can have common therapeutic requirements met.     

The experience of counselling for female clients with anorexia nervosa: A person‐centred perspective

Anorexia nervosa is a serious and potentially life‐threatening condition, which has been studied from a range of theoretical perspectives. However, the relevance of person‐centred theory and practice in relation to anorexia nervosa has not previously been explored in the literature. The purpose of this study was to understand the experiences of clients who had received counselling for anorexia nervosa, and to set these experiences against the backdrop of person‐centred theory. The study is based on intensive heuristic analysis of interviews with five clients who had completed counselling for anorexia nervosa within the previous three months. Collaboration between the researcher and the participants led to an identification of two of the six ‘core’ conditions identified by Rogers as being of real importance to clients with anorexia: unconditional positive regard and congruence. The context in which counselling is offered was also of crucial significance to these clients. Implications for practice are discussed.     

Beyond beliefs: Challenging obsessive thoughts and compulsive behaviours within a collaborative counselling relationship

Three clients with obsessive‐compulsive disorder were studied using a multiple case study approach. Clients' experiences of cognitive‐behavioural therapy, in particular the impact of having their beliefs challenged, and their responses to self‐monitoring tasks and behavioural experiments were investigated. Data included case notes made during therapy, pre‐ and post‐therapy questionnaires, and post‐therapy semi‐structured interviews. Qualitative analysis of the data identified clients' obsessive beliefs, general negative beliefs and meta‐cognitive beliefs, and explored any post‐therapy changes in these beliefs. The results demonstrated similarities between cases in obsessive beliefs (e.g. inflated responsibility for harm), general negative beliefs (e.g. feelings of failure), meta‐cognitive beliefs (e.g. the need to control thoughts) and affect (e.g. guilt). Questionnaire data from all three clients suggested no clinically significant post‐therapy changes in general negative beliefs and meta‐cognitive beliefs. However, idiosyncratic changes in obsessive beliefs were reported during therapy and at post‐therapy interview, and clients reported improved functioning and decreased levels of distress during therapy and at interview. Responses to challenge were uniformly positive, but reactions to self‐monitoring and behavioural experiments varied across cases. The implications of these findings for the treatment of obsessive‐compulsive disorder using cognitive behavioural techniques are discussed.     

促进当事人的改变：基于治疗性最近发展区的视角

作为心理治疗的有效区域,治疗性最近发展区是指当事人当前适应问题经验的能力和通过治疗师的协助能够达成的潜在能力之间的距离。早期的同化模型理论更注重对心理治疗改变过程的描述,治疗性最近发展区理论则能够进一步解释治疗师在不同阶段的帮助策略。在研究上,治疗性最近发展区理论建立在非传统的方法论基础上,通过不断累积个案的质性研究,帮助治疗师理解和解释不同咨询效果的互动过程,并使理论得到持续发展;在临床上,治疗性最近发展区为理解心理治疗过程中倒退现象提供了新视角,并能够有效指导在治疗过程中采取挑战性还是支持性策略。未来研究可从临床上探索经验丰富的治疗师的实践智慧,也可选取较大跨度的治疗对话序列,对不同流派的特点,从不同参与者的视角出发进行研究,进而深化对心理治疗过程机制的理解。     

运用比较治疗学的方法促进T2DM胰岛素治疗决策的最优化

2型糖尿病（T2DM）为内分泌科常见疾病,胰岛素是最主要的治疗药物之一,但胰岛素治疗方法诸多,各种方案的疗效参差不齐。为了促进2型糖尿病治疗决策的最优化,本文通过利用检索国内报道的相关文献,对文献中2型糖尿病的胰岛素治疗方法进行归纳总结,并且运用比较治疗学的研究方法进行比较分析,旨在寻求最有效的治疗方案。     

The concept of the death drive: A clinical perspective

This paper discusses Freud 's theory of the death drive in the light of clinical experience with severely self-destructive personality disorders, and contemporary object relations theory. Repetition compulsion, sadism and masochism, negative therapeutic reaction, suicide in depressed and in non-depressed patients, and destructive group processes are explored from this perspective. The paper concludes that the concept of the death drive is clinically relevant, but that this condition needs to be traced to the general dominance of aggressive affects as the primary etiological factor; only under severely pathological circumstances does this dominance lead to a focused drive to self-destruct.