Emotional arousal, client perceptual processing, and the working alliance in experiential psychotherapy for depression.

Early-, middle-, and late-phase client emotional arousal, perceptual processing strategies, and working alliance were examined in relation to treatment outcome on 4 measures in 32 clients who previously underwent experiential therapy for depression. Hierarchical regression analyses relating these variables to outcome indicated that results varied depending on the therapeutic process, phase of treatment, and outcome measure involved in the analyses. Mid-therapy arousal predicted improvements in self-esteem, whereas mid- and late treatment perceptual processing predicted reductions in client interpersonal dysfunction. Emotional arousal in conjunction with perceptual processing during mid-therapy predicted reductions in depressive and psychopathological symptomatology better than either of these variables alone. The implications of these findings for psychotherapy research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Insight: A Bridging of the Theoretical and Research Literatures.

Arm-chair theorizing and polemicizing has traditionally characterized discussions involving the concept of "insight" in psycho-therapy. This article attempts to examine some of the more controversial issues about "insight" in terms of relevant research studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive emotions in psychotherapy theory, research, and practice: New kid on the block?

This article introduces the Special Section, which explores the potential importance of positive emotions in our theory, research, and practice. The authors propose that the peripheral role that psychotherapy theory, research, and practice has allotted to the variable "positive emotion" can be understood in terms of the foundational axioms of our discipline. The authors argue that psychotherapy has implicitly adopted an attitude of caution and suspicion toward the potential therapeutic value of experiencing positive emotions, an all embracing attitude toward the therapeutic value of experiencing negative emotions, and an identity focused on healing psychological wounds at the expense of promoting psychological well-being. The authors trace the adoption of these axioms to Judeo-Christian ideas of human nature and to the identity formation process of psychotherapy, and the authors speculate on the sociopolitical forces that have promoted a shift in our theorizing in the last few decades. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special series.

Provides an introduction to the special series on research in utilizing competency-based criteria for training psychotherapeutic skills. The introduction of manuals for practicing psychotherapy reactivates an old debate about the value of competency-based education for the mental health disciplines. In a general way, this special series approaches and explores this debate. The articles included are of two types: (a) those that address general issues of criteria-based training and (b) those that explore standards for training in specific approaches. Altogether, the articles cover a variety of therapeutic approaches, including most of those that are applied by contemporary mental health practitioners. Moreover, the articles address the problems of negative effects, common versus specific variables, and the roles of cognitive and experiential learning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Theory, technique, and person: Technical integration in experiential constructivist psychotherapy.

From an experiential constructivist position, the distinction between the therapist as a person, the therapist's theory of psychotherapy, and techniques used within the therapy room is, in some ways, forced and arbitrary. Principles of experiential personal construct psychotherapy are presented along with illustrations of the ways many techniques from many other schools of therapy can be used by the therapist. After exploring some of the implications of this position, I describe four specific, theoretically relevant goals within experiential personal construct psychotherapy (initially connecting with the client, developing a felt understanding of the client's experience, establishing relational intimacy, and fostering creativity). For each of these goals, I illustrate some techniques, originally developed within other theories, which can be usefully integrated into experiential personal constructivist psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relational psychoanalytic enactments and psychotherapy integration: Dualities, dialectics, and directions: Comment of Frank (2002).

Dualities embedded within the relational psychoanalytic enactment concept encourage dialectical thinking and intervention. K. A. Frank's (2002) conceptualization of enactments as entailing structural, functional, and consequential interactions between the intrapsychic and the interpersonal valuably obviates the need to choose between these 2 domains (J. C Anchin, 1985). His incorporation of systems conceptions and the schema construct also renders boundaries between psychoanalysis and other paradigms increasingly permeable. Frank highlighted intrasession and extrasession enactments as intermutual contexts for collab6ratively synthesizing relational analytic and cognitive-behavioral techniques and their respective emphases on insight and action, thereby potentiating integration of structural and behavioral changes. His perspective also converges with contemporary interpersonal theory, research, and practice, fostering superordinate idiographic-nomothetic dialecticism, and with constructivist psychotherapy, spawning additional integrative directions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relational theory, constructivism, and psychotherapy integration: Commentary on Frank (2002).

This commentary provides a critique of K. A. Frank's (2002) article on the implications of the concept of enactment for psychotherapy integration. Although it commends Frank on his incisive overview of some of the more recent developments in psychoanalytic theory, this article argues that his contribution would be enhanced if he spelled out more clearly the radical implications of a 2-person psychology for nonpsychoanalytic clinicians. It also argues that the recent shift in both psychoanalytic and cognitive traditions toward a constructivist epistemology provides another potential focus for integration and that an analysis of the similarities and differences between constructivist thinking in these 2 traditions would be illuminating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Critical interventions in psychotherapy, from impasse to turning point.

Reviews the book, Critical interventions in psychotherapy, from impasse to turning point by Haim Omer (see record 1994-98362-000). In his opening sentence the author postulates that, "Prolonged impasse is probably the toughest and most ubiquitous ordeal of psychotherapy." This relatively short volume is directed at the development of a technique, which the author calls "Critical Intervention(s)" for the resolution of such impasses. It also, very directly, makes a case for the psychotheapeutic pluralism rampant on the contemporary psychotherapeutic scene. The first seven of the eight chapters are devoted to the philosophy and then the actual technique of the critical intervention. There are case histories to make each point, and the histories consist of dialogues between patient(s) and therapist as well as dialogue between therapist, the consultant, and a group of colleagues who are part of the consultation statement developed out of this consultation. The therapist, then, is to present this statement to the patient(s). While the apparent focus of this book is the critical intervention, it is also clearly a platform for the author's views and feelings about both the pluralistic approach to psychotherapy and the "older" single frame of reference psychotherapies. While this book will have some interest for the solo practicing clinician, the utilization of the technique would be, at best, quite difficult given the necessity of calling together a consultant and group. For those with a single theory orientation to treatment the book will be of no value (other than as an interesting idea) since the technique depends upon pluralism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The "ins and outs" of enactment: A relational bridge for psychotherapy integration.

Patients' enactments--their reflexive attempts to influence interpersonal interactions in particular ways based on their psychodynamics, both with the therapist and with others outside the psychotherapy setting--provide an important avenue for advancing the complex task of integrating action-oriented techniques with in-depth exploration. This article, written from a relational psychoanalytic perspective, shows how enactments create a valuable bridge for thinking about and practicing psychotherapy integration. To be most effective, psychotherapists must deal both behaviorally and psychodynamically with enactments, using integrative interventions that simultaneously encourage constructive new and adaptive behaviors, promote important new mutative relational experiences with therapists and with others, and facilitate deep insight. Acting together, these processes contribute to structural, including behavioral, personality reorganization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commentary on "The 'Ins and Outs' of Enactment: A Relational Bridge for Psychotherapy Integration" by Frank.

This commentary reviews and critiques Kenneth A. Frank's (2002) article, in which he discusses the concept and nature of enactment and its power as a tool for integrating action -oriented, cognitive-behavioral treatments and insight-oriented psychodynamic treatments. Frank convincingly shows how enactments-both in and out of therapy-are pervasive, play a central part in personality difficulties, and can be used to effect change. Additionally, the concept of enactment is a valuable tool for psychotherapy integration. Suggestions are given for further, increasing the power of the concept through incorporation of the family systems perspective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Cultural Context and the Psychotherapeutic Process: Toward a Culturally Sensitive Psychotherapy.

Cross-cultural psychotherapy has striven to refine its intervention strategies during the last 2 decades. However, many authors have noted that these advances seem disconnected from each other and from traditional psychotherapeutic approaches. This article offers a conceptual framework that groups very diverse psychotherapeutic approaches into 3 broad categories according to some of their basic assumptions. Some cross-cultural psychotherapeutic models are also located within these 3 categories as a means to link different and apparently fragmented cross-cultural models to traditional psychotherapeutic models. It is argued that the proposed conceptual framework allows clinicians to intervene in a more effective manner than if these different psychotherapeutic models remained fragmented and disconnected. The proposed conceptual framework allows clinicians to benefit in a coherent manner from the advantages of different psychotherapeutic recommendations. Finally, the psychotherapeutic usefulness of this model is illustrated through a case presentation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Self-Relations in the Psychotherapy Process.

Reviews the book, Self-Relations in the Psychotherapy Process by J. Christopher Muran (see record 2000-16556-000). The self is alive and well and living in psychology, at least if the contributors to J. Christopher Muran's stimulating volume, Self-Relations in the Psychotherapy Process, are to be taken seriously. The self is a central construct in psychoanalytic, humanistic, and cognitive-behavioral theories, but nowadays even some radical behaviorists find the self to be an important concept. Thus, the present is a propitious time for a book that presents the major theoretical approaches to the self in psychotherapy and, fortunately for us, Muran, by gathering the views of leading psychodynamic, humanistic, cognitive-behavioral, and radical behavioral thinkers, has assembled a volume of almost uniformly high quality. Inspired by postmodernism, especially by the growing popularity of dialogic and perspectival epistemologies, Muran has a constructed this book as a set of six dialogues among contributors of varying theoretical persuasions, and although I doubt that dialogic and perspectival epistemologies are necessarily postmodern, I nevertheless find that this volume's dialogic structure makes for interesting reading and adds to its intellectual contributions. Because Muran's contention, with which I agree, is that the self is not an isolated entity but rather part of a relational matrix, it is perhaps necessary for this book to be structured dialogically. Whether postmodern or not, this book is an important one, one that conveys a great deal about what it means to be human as we enter the 21st century. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Philosophy and psychotherapy.

In the course of responding to Elliott's (2008) provocative article, the authors tour some precincts of the intellectual foundations of psychotherapy. In particular the authors review the philosophical underpinnings of contemporary research on psychotherapy and provide a context that allows for an examination and critique of Elliott's proposals for new research methods and new approaches to conceptualizing the data of psychotherapy research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Counseling and Therapy Skills.

Reviews the book, Counseling and Therapy Skills by David G. Martin (1983). The stated goal of this book is "to communicate more than an academic understanding of the principles of therapy: to give the reader skills that can actually be applied in the counseling setting" (p. vii). The first six chapters focus on the concept of empathy, listening skills, facilitative responding, confrontation, giving control to the client, and relationship issues. The second part book consists primarily of illustrations of therapy by five therapists (including the author). This material is followed by four chapters on the special topics of behavioural interventions, assessment, ethical issues, and how to conduct initial and final interviews. The author concludes with a theoretical section of four chapters in which he briefly discusses contributions by some of the "schools" of therapy, and then addresses the relationship between anxiety and distress, some theoretical principles underlying therapy, and the research evidence on the effectiveness of empathic responding. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Self and others: Object relations theory in practice.

Reviews the book, Self and others: Object relations theory in practice by N. Gregory Hamilton (see record 1988-97224-000). Hamilton's book, Self and Others, is useful because it attempts to render much of the complexity of understanding object relational approaches more negotiable. Without question, the book is addressed to the beginner or relative beginner (i.e., the person who wishes to get an introduction to object relations). However, because of its elementary focus, the book can be especially valuable for clinicians, residents, and related mental health trainees who are in the process of learning about object relations theory. Too often it seems introductory books on object relations either assume a knowledge the reader does not possess or become so overly mired in discussing the intricacies of theoretical controversy (e.g., Kohut versus Kernberg) that they leave the beginning student of psychoanalysis in a state of bewilderment. Such is not the case with Self and Others. Hamilton's book, while not being without its limitations, does have some interesting features to offer for beginning instruction in object relations theory. The book attempts to show how object relations theory can be applied in practice. Some interesting and instructive definitions, case examples, and discussion are provided, and they all can prove of value to the interested student of object relations theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some disparate thoughts on the idea of a unified psychotherapy.

Psychotherapy unification is considered from a number of perspectives. Some origins of human tendencies to value unification are explored including innate "binding" phenomena in the brain and the effects on human thought of our ubiquitous use of metaphor. Possible disadvantages of premature attempts to unify disparate psychotherapy techniques are considered. An argument is advanced favoring case-by-case reconsiderations of "unifying" options. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing a model of change in the experiential treatment of depression.

In this study, we measured emotional processing and the alliance across 3 phases of therapy (beginning, working, and termination) for 74 clients who each received brief experiential psychotherapy for depression. Using path analysis, we proposed and tested a model of relationships between these 2 processes across phases of therapy and how these processes relate to predict improvement in the domains of depressive and general symptoms, self-esteem, and interpersonal problems after experiential treatment. Both therapy processes significantly increased across phases of therapy. Controlling for both client processes at the beginning of therapy, working phase emotional processing was found to directly and best predict reductions in depressive and general symptoms, and it could directly predict gains in self-esteem. Within working and termination phases of therapy, the alliance significantly contributed to emotional processing and indirectly contributed to outcome. Surprisingly, beginning therapy alliance (measured after Session 1) also directly predicted all outcomes. Furthermore, only clients’ beginning therapy process predicted reductions in interpersonal problems. Therefore, although the proposed theory of change was supported, clients’ beginning therapy processes may constrain clients’ success in experiential treatment and in particular their outcomes in some problem domains related to depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competency in integrative psychotherapy: Perspectives on training and supervision.

Increasingly, many psychotherapists identify with an integrative approach to psychotherapy. In recent years, more attention has been directed toward the operationalization and evaluation of competence in professional psychology and health care service delivery. Aspects of integrative psychotherapy competency may differ from competency in other psychotherapy orientations, although convergence is more often the case. Despite the potential differences, there exist very few formal training programs or guidelines to systematically guide clinicians in developing a competent integrative practice. This paper attempts to distill the essential elements of competent integrative psychotherapy practice and focuses on how these might be developed in training and supervision. We address most of these complex issues from a specific integrative perspective: principle-based assimilative integration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concepts, processes and procedures: An introduction to the special issue on integration of concrete operating procedures.

Mahrer (1989b) described integration on the basis of concrete operating procedures as one of the more promising approaches to psychotherapy integration. In an attempt to examine this integrative approach, therapists from a variety of theoretical orientations were invited to share examples of how they had integrated into their preferred therapeutic approach interventions that were originally developed outside that framework. The articles in this special section provide illustrations of integration of specific procedures into four different theoretical frameworks. Although the articles discuss the incorporation of a wide variety of different types of interventions, as a group they suggest (a) that therapist operating procedures are understood more in terms of providing resources for an active collaborating client than as creating an impact upon the client, (b) that all therapist activities including procedures aimed at achieving problem resolution instantiate the therapeutic relationship, thus blurring the distinction between working on the relationship and working on client issues, and (c) that it is both possible and valuable for therapists to be flexible and creative in integrating new procedures into their therapeutic work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)