How Canadian coordinators of graduate psychiatric education view psychologists.

Investigated the views toward psychologists as expressed by 16 Canadian coordinators of postgraduate education in psychiatry. The majority of Ss opposed psychologists holding senior administrative roles in departments of psychiatry and believed that psychologists should continue to be organized in divisions within departments of psychiatry. Considerable respect was evident for the clinical and academic skills that psychologists possess, and there was nearly unanimous support for psychologists holding academic appointments in departments of psychiatry. Most Ss approved of psychologists conducting psychotherapy as well as supervising psychiatric residents on psychotherapy cases and supported psychologists' involvement in the training of psychiatrists and vice versa. Views about eligibility of psychologists for senior administrative roles in psychiatry departments were related to views on other issues concerning psychologists. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consensus in the therapeutic relationship.

Analyzes the concept of consensus between patient and therapist in psychoanalytic psychotherapy. This topic has emerged in both psychotherapy research and analytic theory as an important construct and possible curative factor in psychotherapy. These independent lines of investigation are synthesized by considering consensus as a broader construct than simple agreement. Consensus is viewed as a creation of the dyad, based on an explicit and mutual effort to define the unique elements of the conscious and unconscious perspectives of patient and therapist. A theoretical understanding of the curative mechanisms of this process is proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy in the day clinic

Recently, the importance of psychiatric day hospital treatment is increasing in German psychiatry, as the regionalization and community-orientation of care advance and catchment areas become smaller. When a psychiatric department of a local general hospital is within easy reach of the patient's residence, the means for intensive treatment, as is available in a hospital, can be utilized during the day, while the patient spends a considerable amount of time (in fact, two thirds) in the familiar surroundings of his/her own home. This is applicable for many psychiatric conditions, including neuroses, personality disorders and psychosomatic diseases. As compared to conventional individual outpatient psychotherapy on the one hand and a distinct limited stay in a psychosomatic sanatorium far from home on the other hand, psychotherapy in a day hospital offers a promising additional way to provide effective and lasting professional help early and with a low threshold. The article summarizes the experience gained in a newly founded department of psychiatry and psychotherapy at a general hospital in one district of eastern Germany, where the staff is struggling to meet the needs of the catchment area in spite of a too small number of hospital beds.     

The cultural role of psychiatry.

Attempts to clarify the cultural role of psychiatry, with suggestions for improving both theory and practice. Historically, the dominance of medicine in psychiatry stems from the past 200 yrs. In addition, since Freud, psychological considerations have moved into the forefront. The combination of the 2 attitudes has created multiple roles for the psychiatrist with considerable confusion about which role to adopt. The earliest role was the purely custodial one, but then the somatic treatments came into vogue. Following Freud, psychotherapy entered the picture. However, it is argued that the greatest progress comes from assuming the transformational role—in which the psychiatrist recognizes that although in his/her everyday work, symptoms are alleviated by the best means available, in the larger sense the function of the profession is to transform society. Similar considerations apply to the clinical psychologist. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy fees and residency training

Many residents in psychiatry tend to ignore their patients' attitudes and behavior concerning payment of fees for psychotherapy. The authors report on a new fee policy program designed to earn additional revenue for a low-fee outpatient psychotherapy clinic; they stress the therapeutic importance of resident and patient attention to fee-related issues.     

The state of psychotherapy in the United States.

This article stems from the 2003 Society for the Exploration of Psychotherapy Integration (SEPI) international panel on the state of psychotherapy. I am pleased to be included in the printed version of this discussion. The state of psychotherapy in the United States is a huge topic. Does psychotherapy reach enough people and meet enough needs? What changes have occurred in response to political, financial, or cultural influences? Many of the subheadings deserve entire conference meetings to thoroughly consider the issues. However, in a time of significant transition for psychotherapy, a broad look at trends and influences may help keep the field of psychotherapy on a desired course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The technique of psychotherapy.

Reviews the book, The technique of psychotherapy by Lewis R. Wolberg (1954). Noting the dearth of concrete specific writings on psychotherapeutic technique "amidst the lush literature on psychiatry," the author made it his purpose to write a book which would delineate a "sound therapeutic structure irrespective of the specific 'kind' of psychotherapy done and without reference to the individual 'style' of the therapist." The writer compares briefly education, social casework, and counseling of normal people with psychotherapy and finds considerable overlapping in goals and means. He also finds that some of the undercurrent processes in "spontaneous cure" are similar to those in psychotherapy. After these preliminary considerations Wolberg attempts to classify the existing varieties of psychotherapy into three types: (a) supportive therapies; (b) insight therapies with re-educative goals; (c) insight therapies with reconstructive goals. The reviewer reports that while the presentation of the chief tenets of the various present-day therapies is too brief to teach a novice, it is so lively and stimulating that it certainly will whet his appetite and induce him to go to the original sources. The criticism of each "approach" is confined to a few objections presented, not as the author's own beliefs, but as opinions voiced by unspecified critics. This is a very important book to be read and enjoyed by all psychologists, practitioners, and theoreticians alike. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Split-Ego Experience of Africans: Ubuntu Therapy as a Healing Alternative.

Countries of a multicultural nature, such as South Africa, tend to experience challenges whenever psychotherapy is involved, because most training in psychotherapy is based on Western and European models of illness, health, and healing. Applying the Western- and European-based principles of illness and health to non-Western or non-European clients tends to result in conflict, which is explored in this article. Most African communities operate on the principle of ubuntu, a concept that broadly refers to communality, oneness, cooperation, and sharing. The article proposes an alternative psychotherapy called ubuntu therapy that is based on the ubuntu concept and is aimed at incorporating the African culture into psychotherapy. This article explores the values and traditions inherent in the ubuntu concept and their influence on the conceptualization of mental health problems. On the basis of these values, a model of conducting ubuntu therapy is presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recommendations for improving psychotherapy training based on experiences with manual-guided training and research: An introduction.

Teaching psychotherapy is a cardinal purpose of all postgraduate training programs in the mental health disciplines. These disciplines—psychology, psychiatry, social work, and counseling—are presumed to be built on a foundation of empirical knowledge. However, as noted in several of the following articles, this foundation does not firmly underlie the domain of psychotherapy training. Put bluntly, we have little evidence that our teaching methods (courses and supervision) change students' behavior in the direction of training objectives or foster effective therapeutic performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Professional psychology's 50-year centennial.

Presents an overview of the 50-yr history of professional psychology. It is argued that professional psychology became preeminent in psychotherapy because it applied its clinical and research skills to that area, while psychiatry fell prey to the expedient and more financially rewarding medication/hospitalization practice. It is suggested that if psychology integrates pharmacology and retains psychotherapy as preeminent, it will become the foremost mental health profession. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward unification of clinical science: The next wave in the evolution of psychotherapy?

This article presents evidence from converging lines of evidence to support the emergence of a new phase in the evolution of psychotherapy away from integration and toward unification. Clinical science has been rapidly advancing on a number of important fronts allowing for new theoretical modeling on which to base clinical science and the practice of psychotherapy. Although there is controversy about the value of identifying the common principles and component systems of human function and psychotherapy a growing number of clinical theorists and researchers are beginning to explore the value of articulating these to guide clinical practice. The concept of holism and a foundation in systems theory may be important keys to advancing our understanding of psychopathology, personality theory, and psychotherapy. This article presents an evolving unified component system model based on findings and developments in clinical science and psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Placebo effects. Issues for clinical practice in psychiatry and medicine

Placebo effects are integral to everyday clinical practice; therefore, they should be well understood by all health care practitioners. Despite the rich literature on the topic, placebo effects receive only passing mention in major textbooks of psychiatry and medicine. The authors clarify the placebo construct and offer a selective review of its history, definitions, mechanisms, and relation to experimental methodology and statistics. Also considered are the concept of nocebo, variation in placebo response rates, and some economic and ethical problems with placebos in clinical trials. Directions are suggested for future research.     

On the therapeutic potency of Kaiser's techniques: Some misunderstandings?

Recent publications (e.g., D. M. Paltin, 1993) have stressed the absence of specific technique in H. Kaiser's (e.g., 1930, 1931, 1934) writings on psychotherapy, suggesting that his approach consists of a mere humanistic, nondirective stance. The author demonstrates that this position is a skewed representation of Kaiser's views on psychotherapy. After a short historical perspective, the six most important principles of technique, which can be found throughout Kaiser's writings, are discussed. Finally it is shown how Kaiser himself may have originated some of these misunderstandings about his technique. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The broad role of Ego Functions Assessment

The need for accurate assessment and accountability is of paramount professional concern to psychiatry. The authors state that ego functions assessment (EFA) is reliable and valid quantitative technique, useful for these purposes in a variety of psychiatric settings. They suggest the various uses of EFA in five such areas: Professional Standards Review Organizations (PSRO) and third-party funding, forensic psychiatry and legal responsibility, the monitoring of psychotherapeutic drugs, research and planning in psychotherapy, and psychological testing. The authors condlude the EFA is a dynamically sophisticated and easily learned form of mental status examination and that its refinement by extensive use and simplification is likely.     

Foreword.

The purpose of this special issue was to collect data and to bring to the attention of the psychological community the need for well-integrated high-impact psychological science and services in the overall health system. The reader will note by scanning titles of the various articles that this special issue is not a systematic review of literature. However, the articles contain valuable insights about the current state of the art on how psychotherapy interfaces with the general health system and the mental health system in particular. It must be noted that psychotherapy is a broad gauge concept involving a variety of applications and interventions which promote better health. It is evident from the contents herein that there is an evolution in the health care field regarding the incorporation of psychotherapy. That is, psychotherapy is becoming more a technique targeted toward specific problems or specific populations and subject to detachment from its scientific base. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The concept of psychological regression: Metaphors, mapping, Queen Square, and Tavistock Square.

The term “regression” refers to events in which an individual changes from his or her present level of maturity and regains mental and behavioral characteristics shown at an earlier point in development. This definition has remained constant for over a century, but the implications of the concept have changed systematically from a perspective in which regression was considered pathological, to a current view in which regression may be seen as a positive step in psychotherapy or as a part of normal development. The concept of regression, famously employed by Sigmund Freud and others in his circle, derived from ideas suggested by Herbert Spencer and by John Hughlings Jackson. By the 1940s and '50s, the regression concept was applied by Winnicott and others in treatment of disturbed children and in adult psychotherapy. In addition, behavioral regression came to be seen as a part of a normal developmental trajectory, with a focus on expectable variability. The present article examines historical changes in the regression concept in terms of mapping to biomedical or other metaphors, in terms of a movement from earlier nativism toward an increased environmentalism in psychology, and with respect to other historical factors such as wartime events. The role of dominant metaphors in shifting perspectives on regression is described. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Schizophrenic autism. 1. Historical evolution and perspectives

Cardinal importance has often been attached to the term 'autism' within the scope of schizophrenic symptomatology since its introduction by E. Bleuler in 1911. However, this term has been used purely intuitively in most cases, giving rise to a great deal of speculation about autism and its role within different psychiatric disorders, speculation which could not then be examined empirically for lack of intersubjective definition. This article reviews and examines the historical concept of autism, and finally makes and discusses proposals for future perspectives on autism.     

Symposium on relationships between religion and mental health: Introductory remarks.

"We are witnessing a conspicuous change in the climate between religion and science in recent years." In psychology this has been evidenced in seminars on religion and psychiatry, work shops on pastoral care and psychotherapy, grants to universities for developing mental health curricula for theological students, creation of an Academy of Religion and Mental Health, and the establishing of an APA committee to study relationships between religion and mental health. "The hitherto existing chasm between religion and psychology is somewhat unusual because… both concern themselves with human nature and behavior." This symposium spotlights: expanding links between psychology and religion, religious experience and psychological conflict, the nature of religious controls, and moral issues in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)