Effective ingredients in psychotherapy: Prediction of outcome from process variables.

Examined the impact of (a) exploration of the psychodynamic roots of patients' conflicts, (b) warmth and friendliness of the therapist-offered relationship, and (c) positiveness of patients' attitudes toward working in therapy on the outcome of brief therapy with 35 college males exhibiting symptoms of depression, anxiety, and social introversion. Symptoms were confirmed by elevated scores on the Depression, Psychasthenia, and Social Introversion scales, respectively, of the MMPI. Analyses of process ratings for audiotaped segments from 4 sessions throughout the course of therapy revealed that the activities of therapists of differing theoretical orientations and of professional vs untrained, "inherently helpful" therapists could be distinguished. Although patients' attitudes toward the therapist and patient involvement in the therapy process did not differ as a function of the type of therapist, the process dimension that most consistently predicted therapy outcome was patient involvement. Exploratory processes and therapist-offered relationship had a lesser influence on outcome. (71 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Basic ingredients or common factors in psychotherapy?

Discusses and evaluates some previous presentations concerning the essential and necessary conditions for positive change in psychotherapy, particularly H. R. Strupp's (see PA, Vol. 51:Issue 6) paper. The conception of essential conditions for change is compared with views concerning hypothesized common or nonspecific factors in psychotherapy, and some apparent similarities are delineated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the external validity of two psychotherapy analogues.

Investigated the similarity between 2 live psychotherapy analogs and real psychotherapeutic interviews. 23 therapists participated in 2 different types of analog situations and in initial intake sessions with real clients. In both of the analogs, a recruited S presented a real personal problem to the therapists in helping interactions. Audiotapes of the real and analog interviews were rated on 10 dependent variables, which were different dimensions of therapist and client behaviors. Different results were obtained for each analog. The major findings concern mean differences between the analog and real interviews and the linear relationships between the real and analog interviews. Additional findings, including significant interactions between the type of interview and the experience level of the therapist, are also discussed. Results indicate that the generalizability of the analogs is contingent on the dependent variables in question, the type of relationship to be predicted, and the experience level of the therapists. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the practice of psychotherapy by the nonmedically trained.

Freud in his writing indicated that medical training was not necessary for psychoanalytic qualification. The problem (of the practice of psychotherapy by the nonmedically trained) is still very much with us; and it may be profitable to re-examine the arguments pro and con for allowing nonmedically trained individuals to perform psychotherapy. The positions of persons opposed to nonmedically trained psychotherapy are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Where oh where are the specific ingredients? A meta-analysis of component studies in counseling and psychotherapy.

Component studies, which involve comparisons between a treatment package and the treatment package without a theoretically important component or the treatment package with an added component, use experimental designs to test whether the component is necessary to produce therapeutic benefit. A meta-analysis was conducted on 27 component studies culled from the literature. It was found that the effect size for the difference between a package with and without the critical components was not significantly different from zero, indicating that theoretically purported important components are not responsible for therapeutic benefits. Moreover, the effect sizes were homogeneous, which suggests that there were no important variables moderating effect sizes. The results cast doubt on the specificity of psychological treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the cognitive structure of interpersonal problems treated in psychotherapy.

Examined problems in the general form "I can't . . . (do something)" that were mentioned in intake interviews by 28 patients about to begin psychotherapy. Each complaint was simplified to highlight the problem behavior, and 50 undergraduates classified the problem behaviors into semantic categories. From the results of this classification, a matrix was formed to show how often each 2 problem behaviors were classified together. This matrix was then subjected to a multidimensional scaling, which yielded three dimensions: (a) the degree of psychological involvement between the S and the other person; (b) the nature of the involvement (friendly to hostile); and (c) the S's intention to influence, change, or control the other person. In addition, a cluster analysis was performed to show the major clusters of problem behaviors (i.e., intimacy, aggression, compliance, independence, and sociability). Implications for psychotherapy research are also discussed. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the road to psychotherapy integration: A student's journey.

This article presents the integrative journey of a doctoral student across two continents. The development and aspirations of a student integrationist from the "get go" are outlined, and some thoughts on the future of the integration movement are offered. The role of self-direction, integrative role models, flexible training environments, and the support of the integrative community in one's integrative development are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the advantages of assuming that the techniques of psychotherapy are ineffective.

Contends that there are benefits to be gained from assuming that the specific techniques of psychotherapy are not the effective ingredients. The outcome literature is briefly reviewed, and 2 conclusions are reached: (1) Outcome is unrelated to the amount of training and experience of the therapist; and (2) outcome is unrelated to the specific techniques used. It follows that whatever is effective in therapy is to be found in the nonspecific factors common to the development of any relationship. This perspective can benefit the training of students by reducing their anxiety as they acquire clinical skills. It also has the advantage of reducing the dependencies often found in the therapeutic situation. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual psychotherapy. Institutional psychotherapy. Individual approach

In the psychiatric management of patients where the author works the following factors are given careful consideration: a) source of referral, b) previous information about the illness, c) the content of the first session, d) obstacles for further treatment and e) theoretical basis for the psychotherapy sessions. Bellak and Small outlines are followed to structure brief and emergency psychotherapy at the author's institution.     

Reply to Humphreys: On the compatibility of twelve-step programs and psychotherapy.

Comments on K. Humphreys's (see record 1994-34917-001) article discussing the limitations of integrating psychotherapy and 12-step programs. Humphreys's arguments based on the approaches' purported differences in helping values are not logically demonstrated or empirically determined. Therapists should be trained to deal with spiritual issues and perspectives in a respectful and knowledgeable way. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of the psychotherapy supervisor.

Presents a 4-stage model of psychotherapy supervisor development. The 4 stages are role shock, role recovery and transition, role consolidation, and role mastery. Tasks, crises, and stage-specific characteristics inherent in each of the stages are identified. Theoretical, research-related, and practical implications of the model are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief psychotherapy.

This article discusses brief psychotherapy in terms of the work developed at the Tavistock Clinic and relates this to current theories in the field. I describe my own individual method basing its effectiveness on a revised theory of memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive psychotherapy.

Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms. The authors have tested the effects of these interventions in a variety of settings. In informal student and clinical settings, people not uncommonly reported them to be "life-changing." Delivered on the Web, positive psychology exercises relieved depressive symptoms for at least 6 months compared with placebo interventions, the effects of which lasted less than a week. In severe depression, the effects of these Web exercises were particularly striking. This address reports two preliminary studies: In the first, PPT delivered to groups significantly decreased levels of mild-to-moderate depression through 1-year follow-up. In the second, PPT delivered to individuals produced higher remission rates than did treatment as usual and treatment as usual plus medication among outpatients with major depressive disorder. Together, these studies suggest that treatments for depression may usefully be supplemented by exercises that explicitly increase positive emotion, engagement, and meaning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Monitor psychotherapy.

Suggests that G. W. Albee's (see record 1977-29846-001) implication that psychotherapists are "anti-intellectual" caused Albee to miss the opportunity to examine the role of psychology in confronting changing social norms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socialized psychotherapy.

The philosophy of a general right to mental health services is examined in the light of the current crisis in the health care delivery system. The impact of probable public policy decisions on funding of psychotherapy services is discussed, and alternative responses to possible problems are reviewed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Survival in the 1980s: On the theory and practice of brief psychotherapy.

Proposes that the opening of the 1980's has produced serious socioeconomic strains on the profession of psychotherapy. Governmental support for the training and practice of psychotherapists has shrunk rapidly due to both the conservative philosophies of the party in power and the complexities of an economy plagued by both recession and inflation. At the same time, employers, unions, and insurance companies, eager to contain rapidly escalating premiums for group health insurance, are steadily eroding reimbursement funds available to patients who wish to enter psychotherapy. These social developments are likely to have far-reaching effects on the profession of psychology, creating irresistible imperatives for practitioners to develop more effective strategies for short-term psychotherapy. While behaviorally oriented psychotherapists should not find this challenge too difficult, those with other theoretical allegiances will be hard pressed. It is suggested that principles from psychoanalytic personality theory and from systems theory should be integrated. The new approach is illustrated with case examples. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual psychotherapy. Institutional psychotherapy: theoretical-practical aspect

The author describes his experience in institutional psychotherapy, at the Clínica Hospital of Villahermosa, Tabasco. He mentions factors in the patient, in the psychiatrist, in the institution and in the culture, as fostering the success or the failure of institutional psychotherapy. He shows the effectiveness of this type of treatment in this enviroment and describes ways of improving this kind of work.     

Health care policy, psychotherapy research, and the future of psychotherapy.

In a quest for accountability in the delivery of health services, health care policymakers in both government and private sectors are creating clinical practice guidelines, many of which heavily emphasize medical and pharmacological approaches. Yet, there are now sufficient data to support the efficacy of psychotherapeutic procedures for a wide variety of specific disorders, and it seems now is the appropriate time to communicate these findings to health care policymakers and the public at large. At the same time, data must be developed on the delivery of these interventions by frontline clinicians in the settings where they practice. The emergence of practice research networks may accomplish this latter goal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing psychotherapy dropouts: Maximizing perspective convergence in the psychotherapy dyad.

Reviews 3 decades of research addressing premature termination of psychotherapy. Client, therapist, interpersonal dyadic, and administrative variables have been extensively investigated. Because of a variety of methodological problems, this literature is highly contradictory, and results are difficult to reconcile, with only socioeconomic status (SES) and ethnicity emerging as consistent predictors of dropout. Treatment matching studies have evaluated the effects of maximizing similarity (or convergence) and minimizing perspective divergence within the therapeutic dyad. Research looking at interactive and multidimensional factors such as working alliance, client satisfaction and expectations, client likability, and pretreatment preparation has proven useful. This research suggests that psychotherapy dropouts might be minimized if differences between therapists' and patients' perspectives on therapeutic enterprise are acknowledged and recognized as legitimate targets for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)