Computerised Cognitive Behavioural Therapy in an Adult Mental Health Service: A Pilot Study of Outcomes and Alliance

This pilot study aimed to explore the clinical outcomes and therapeutic relationship for clients of an adult mental health service using Beating the Blues, a computerised cognitive behaviour therapy (CCBT) package. Sixteen participants completed the programme and reported a significant reduction in Beck Depression Inventory scores posttreatment. Participants' mean item ratings on the relationship measure were above the neutral midpoint, but no association was found between the therapeutic relationship and outcome. The results are discussed in terms of the utility of CCBT as part of a stepped-care model and how further research might usefully explore the nature of the relationship formed between clients and CCBT programmes.     

The integrative attitude–a personal journey

The origins of clinical psychotherapy date from the beginning of last century and the development of broadly four foundational schools–psychoanalytic, cognitive-behavioural, humanistic and transpersonal psychologies. The imperative to integrate these schools, however, is relatively recent and in the last 25 years a professional integration movement has developed, exemplified by the formation of SEPI and the UKAPI, and ‘integrative psychotherapist’ is now the most popular nomenclature used in the profession. This article gives a brief history of the integration movement, reviews some issues raised by developments so far, and discusses the personal dilemma that integration evokes in the would-be integrative practitioner. Using my own journey I espouse an integrative attitude that is based on the nature of integration as an evolving personal process rather than an ideal, fixed, profession-wide position. I describe three interweaving modalities of integration I call constructive, complicit and contiguous integration, which form a developmental framework that aims to encourage the individual activity of questioning, inventing, researching and interrogating the discipline within its philosophical, professional and social context. In concluding, this article exhorts the profession to see integration as a personal journey, as a way of being that is constantly becoming and unfolding in relation with the therapist's training, experience and interaction with peers and clients. The result is indefinable and unnameable, and perhaps represents the soul of integrative psychotherapy.     

Between the street and the consulting room: The role of therapeutic frame in working with homeless clients

This paper explores the context of psychotherapy with people who are homeless and the kinds of dynamics and challenges that typically arise in this work. The paper specifically considers the process of therapy as it takes place with clients who have been recurrently homeless and who have difficulties with sustaining shelter that has its roots in deficits in early containment. Clinical case material from psychotherapy conducted with two homeless men is presented and the implications of the approach adopted are explored both in relation to policies around the provision of services for homeless people and the more specific issue of psychotherapy intervention.

It is argued that a clear, well-articulated set of expectations has to be developed around this work in order to protect it and to provide it with the greatest opportunity for providing the kind of safety that is required for the development of this work. It is argued that the most important issue here relates to the provision of a consistent therapeutic framework and a care around the development of the specific psychotherapeutic frame within, and in relation to, the other frames present in the person's life.     

Issues in using interpreters in therapeutic work with refugees. What is not being expressed?

‘Interpreting’ could be thought about as a legal equal opportunities or human rights issue. Whereas interpreters are likely to focus on the linguistic issues, and will be aware of the technical complexities of their work. Clinicians may worry about the impact on the therapeutic relationship of the interpreter's presence, how this will be managed and how it may depend on the match or mismatch of such factors as the client's gender, age and first or other language. This paper considers the issue on each of these levels to reveal the complexities and dilemmas of effective clinical work with interpreters, but also what can be achieved: the multiple layers of meaning concerning the client's experience and communication which can be elicited through effective working between interpreter and clinician.     

Integrating different types of knowledge in supervision

The present article examines ways to integrate two, often contradictory, types of knowledge in supervision, which are sometimes represented either by supervisors or supervisees, and sometimes by different parts in the supervisee. These types of knowledge are in a dialectic relationship: they may define each other and at the same time influence and shape each other, yet remain two separate sources for understanding the therapeutic experience. One type is the primary, vague, and intuitive knowledge about patients and therapist–patient interactions, derived from actual participation in the therapeutic relationship. The other type is knowledge derived from theory, experience acquired mainly outside of the specific therapy, and dialog with colleagues.     

Identification and Testing of Modes in Beliefs

Characterizing diversity in beliefs is of paramount importance in empirical research on human behavior. In game theory, the focus is on the hypothesis formation. We present a data set with ideal properties for characterizing such diversity. The data consist of hypotheses on the empirical distribution of opponent choices. Using nonparametric techniques, we identify modes in the data corresponding to subpopulations of behavioral types and find the statistical significance of these modes in the underlying population distribution.     

Humor and Its Contributions to Mental Health

Self control assistance includes steady doses of humorous comment and reflection. Getting past the perfect person syndrome en route to an emotionally healthier existence can be done by the appreciation of use of humor. Distinguishing between commercialized and rational humor allows for more permanent long range happiness and survival. To be able to laugh and learn at the same time are two bull's-eyes that promote more optimal emotional well-being. Humor ignites thirty-seven listed provisions in the service of emotional health. Fifteen precise dimensions of mental health that humor can pave the way toward are reviewed. Twenty-nine irrational beliefs about humor are fleshed out followed by nine types of rational humor. Stories and stormy anecdotes from the wiles of the author's practice of psychotherapy and parenting misdemeanors further document the topic under consideration.     

试论《周易》的原初意义与现代意义

文章首先阐述了考察《周易》价值的方法,然后运用这一方法全面考察了《周易》的原初意义与现代意义。作者认为,《周易》的产生标志着中华民族抽象思维能力的关键性跃迁;《周易》的内容折射着当时的自然、社会和人文状况,记载着古代先民对于当时复杂的自然、社会和人生问题的特别关注与初步思考;《周易》的人生智慧和行为原则,反映着趋利避害和预见未来的价值取向;《周易》的思维方式汇集着当时的思维工具和认识方法,表达着最初的终极关怀和哲学意识。而《周易》所提供的始源性材料,有助于我们从根源性上来把握中华文化及其当代特点;易学史的演变与发展则为我们更好地把握历史文化发展进程提供了重要的思想资料;《周易》所表达的人生智慧和思维方式对于当今人类把握现实与面向未来也具有极为重要的启示和借鉴意义。     

Therapist responses to requests for disclosure of therapeutic records: An introductory study

This paper describes a questionnaire survey of therapists in the UK who have been subject to requests for disclosure of client records as part of a legal process. Therapist responses are outlined in terms of the perceived effect of such disclosure on the client, therapist and the therapeutic relationship. Negative effects included the experience of exposure of sensitive client material in an adversarial legal system, of powerful emotional responses by therapists, and a sense of feeling professionally de‐skilled in an unfamiliar and often challenging legal environment. Positive effects for the client included the achievement of valued outcomes such as compensation, and, for the therapist, the facilitation of support for the client in this process. These findings are discussed in terms of a contrast between therapist perceptions of consensual and contested disclosure. In the former, therapist and client are in agreement about the restorative value and outcome of disclosure. In contested disclosure, the process is experienced as disrupting therapeutic privacy, undermining professional self‐confidence and introducing an unwelcome element of critical re‐evaluation of client motives for undertaking therapy.     

The Therapeutic Community Sing: Music Therapy Inpatient Group Process

Early psychoanalytic authors and music educators in both Europe and the United States pointed to the contemporary use of music therapy as a powerful modality in an inpatient psychiatric unit. The inpatient community sing is discussed in its capacity to address both individual and group goals. A clinical vignette from such a group is presented and discussed.