Reciprocity: A possible new focus for psychotherapy.

Reviews the role of reciprocity in human evolution and describes sources of reciprocity-related problems, including faulty upbringing and the complexity of the rules governing social relationships in the modern world. The use of reciprocity in therapy and with borderline conditions is illustrated via clinical examples, and it is suggested that the concept of reciprocity provides the therapist with a framework that simultaneously reaches back into childhood and out to the structure of society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couples psychotherapy: A psychodynamic model.

Psychoanalytic assumptions and goals need not be viewed or approached from a purely individual analytic perspective. Families and especially marriages offer a unique opportunity for systems-oriented intervention to add therapeutic depth by addressing psychodynamic interactions in vivo. Doing so requires integration in therapy, as well as in theory, of the manner in which individual psychodynamics manifest in primary interpersonal systems. A model is presented which aims at translating and instilling a useful degree of analytic insight in members of marital or family systems. Insight into transferential distortions and behavior is facilitated by introducing the metaphor of unconscious "hopes" and "expectations" in the interactive contexts of conjoint and individual sessions. It is suggested that such an expansion of systems-oriented approaches is a crucial step in adding depth and durability to change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal constructs and psychodynamic psychotherapy: A case study.

[Correction Notice: An erratum for this article was reported in Vol 24(1) of Psychoanalytic Psychology (see record 2007-00135-015). An error was made in the reproduction of figures 5 and 6. The corrected versions are provided with the erratum.] During a short term, psychoanalytically informed psychotherapy, a college student's salient constructs regarding her self and her object representations were elicited via the Role Construct Repertory Test. The course of this psychotherapy is traced and is examined with regard to the information provided by component analyses of these repertory grids. The aims of this article are to demonstrate the utility of an independent measure such as repertory grids for 1) additional understanding of the patient's modes of construing self and others; 2) establishing meaningful foci for a short-term treatment; 3) providing information for a more considered set of interpretive interventions regarding key conflicts; and 4) considering changes and outcome in light of the foci of the treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The reunion process: A new focus in short-term dynamic psychotherapy.

Short-term dynamic psychotherapy (STDP) has established itself as an effective treatment for common psychological disorders, but little attention has been given to cases of treatment failure or relapse. In this article, I present a case of relapsing panic disorder. I suggest that STDP has focused mainly on the memories of disturbing past experience, but we have not systematically explored the positive memories of early attachment experiences. The negative memories are explored and processed until they are revised, resulting in less disturbing versions of the original events and new meanings for the patient. In the language of memory research, the patient has now established more than one memory trace of a particular situation, and the therapist hopes that the newer version will have "trace dominance"; that is, it will be the memory that governs the patient's behavior. In a new model called the reunion process, the therapist helps the patient reactivate and strengthen these distress associated with negative memories and experiences. positive memories to revise the internal working models of early attachment figures. The process also involves the use of imagined attachment scenarios that never actually happened to compensate for gaps in historical experience. The result is a sense of reunion with the patient's parents, and the internalization of an affect-regulating process to calm the distress associated with negative memories and experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The therapeutic alliance in psychodynamic psychotherapy: Theoretical conceptualizations and research findings.

The construct of the therapeutic alliance is approached from the psychoanalytic tradition by reference to the ideas of Freud, R. Sterba, E. R. Zetzel, R. R. Greenson, and L. Luborsky. The transtheoretical approaches posited by E. S. Bordin and L. Gaston are also presented and the relation of alliance to the transference is discussed. The empirical evidence as to the role of the alliance in psychodynamically oriented psychotherapy is presented, and the construct is operationally defined by means of the major psychometric instruments. Factors that foster the development of strong alliances (patient and therapist factors), as well as those that hinder or result in its rupture are discussed in detail. The differential association of alliance to outcome depending on who measures the alliance (patient, therapist, or independent observer) and the timing of the measurement of the alliance (first, third, fifth, or later session) are considered. Last, there is a discussion of the criticisms of how research in this area is conducted, and suggestions for future researchers are made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The missed session: A neglected aspect of psychodynamic psychotherapy.

Missed sessions, whether initiated by the patient, therapist, or nature, are events in psychotherapy, not non-events. When appropriately handled, missed sessions provide valuable opportunities for therapeutic exploration. A clear cancellation policy, discussed early in therapy, offers a frame within which therapist and patient may understand the meanings of the missed session. An awareness of transference and countertransference contributes to therapeutic implementation of the cancellation policy and resulting maintenance of exploratory space. Therapists whose cancellation policies are unclear, too rigid, or too lenient render the therapy unsafe. Addressing the financial implications of a missed session before attending to motivations and feelings surrounding it is a clinical mistake. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of psychodynamic psychotherapy.

Discusses the current status and future outlook of psychodynamic psychotherapy. Important trends include (1) increasing attention to disturbances in infancy and early childhood; (2) focusing on more difficult patients; (3) focusing on the dyadic character of the therapeutic relationship; (4) recognition of the importance of the therapeutic alliance; (5) developments in neuroscience and pharmacotherapy; (6) more use of group, marital, and family therapy; (7) emphasis on brief therapy; (8) attempts to devise specific treatments for specific disorders; (9) the appearance of treatment manuals; and (10) the continued search for the mechanisms of change in personality and behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of psychodynamic psychotherapy.

Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, nonpsychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using homework in psychodynamic psychotherapy.

Homework refers to an assignment given by the therapist to the patient that is to be fulfilled between sessions. It is a typical intervention in cognitive-behavioral therapy, but less common in psychodynamic therapy. This article describes an assimilative, integrative model of psychodynamic therapy that incorporates homework and describes its use in a series of clinical cases. Although the indications for and impact of homework vary from case to case, conclusions are drawn as to the most effective approaches to incorporating homework in a psychodynamic model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The supervisory encounter: A guide for teachers of psychodynamic psychotherapy and psychoanalysis.

Review of book: The Supervisory Encounter: A Guide for Teachers of Psychodynamic Psychotherapy and Psychoanalysis by Daniel Jacobs, Paul David and Donald J. Meyer, New Haven, CT: Yale University Press, 1985, 285 pp. Reviewed by Alan Z. Skolnikoff. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists' evaluations of psychodynamic psychotherapy: A peer review analogue experiment.

Replicated a study by L. H. Cohen and D. Pizzirusso (in press) that evaluated peer review by American Psychological Association/Civilian Health and Medical Program of the Uniformed Services reviewers. In the present study, 54 National Register psychologists of either a psychodynamic or eclectic theoretical orientation evaluated 1 of 3 psychodynamic treatment reports that varied on reported patient progress levels to examine the effect of theoretical orientation on evaluations and if peer review activities can be carried out using reviewers who are more representative of the profession. The results of both studies were similar. Psychodynamic psychologists rated treatment as more satisfactory and were more generous in their future care reimbursement recommendations than eclectic psychologists. Results suggest that psychologist providers in general represent a source of competent personnel for peer review activities. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client experience of psychodynamic psychotherapy for bulimia nervosa: An interview study.

We examined 14 bulimic clients' experiences of individual psychodynamic psychotherapy through semistructured interviews, which were analyzed using qualitative methods. The results showed that the psychodynamic approach was a challenge to most of the clients. Yet, most clients profited from therapy both symptomatically and with regard to interpersonal relations and affect regulation. There were, however, marked differences in the clients' experiences. One subgroup rather quickly felt that the therapy met their needs, another initially felt challenged by the approach and the therapeutic attitude but ultimately succeeded in using this particular kind of therapy. A third group remained predominantly critical of their therapies. The clinical implications and possible explanations of the results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual psychodynamic psychotherapy of schizophrenia: Empirical evidence for the practicing clinician.

Practicing psychodynamically oriented clinicians need empirical evidence to support the use of individual psychodynamic psychotherapy for the treatment of individuals with schizophrenia. The purpose of this article is to provide psychodynamically oriented clinicians with that needed empirical evidence. A review of the meta-analytic research on the use of individual psychodynamic psychotherapy was conducted. It is concluded that strong empirical support exists for the use of individual psychodynamic psychotherapy in the treatment of schizophrenia. In addition, several suggestions are made to help clinicians apply the meta-analytic evidence to their daily clinical work. Limitations of the available evidence are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical and clinical focus of child and adolescent psychotherapy research.

The present study evaluated the characteristics of research on child and adolescent psychotherapy. Published studies (N?=?223) of psychotherapy from 1970 to 1988 were codified to characterize research, clinical, and methodological characteristics. The major results indicate that (1) treatment research focuses almost exclusively on the impact of treatment techniques with scant attention to influences (child/adolescent, parent, family, therapist) that may moderate outcome and (2) several characteristics of the children/adolescents and methods of treatment delivery and approaches depart markedly from those evident in the practice of treatment. Priorities for treatment research to place clinical practice on firmer empirical footing are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moving targets: Patients' changing complaints during psychotherapy.

Used standardized assessment procedure recommended by J. Mintz (1977) to follow up 44 22–58 yr old patients in time-limited marital or family therapy in an investigation of Ss' changing complaints during psychotherapy. Ss were divided into 2 groups: those who were contacted for target-complaint assessment twice (Weeks 1 and 10) and those who were contacted 4 times (Weeks 1, 4, 7, and 10). At termination of treatment, Ss completed global outcome ratings on their success, satisfaction, and improvement with regard to target complaints. It was hyothesized that (1) S-rated improvement on new target complaints would significantly raise the multiple correlation with outcome criteria compared with initial complaints only and (2) the 2 interim measurements of target complaints would not constitute a therapeutic intervention (although previous researchers have contended that defining target symptoms is therapeutic in itself). Results support the hypotheses. ANOVA revealed that membership in either the 2- or 4-contact assessment group was unrelated to the pooled global outcome rating. Across treatment, 56% of Ss listed new target complaints in addition to those mentioned at Week 1. S-rated improvement on these new issues accounted for a significant increment in outcome variance and was the single best predictor of therapy outcome. Findings are discussed in terms of implications for comparative-competitive psychotherapy studies and process and outcome research. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Metaphor in psychodynamic psychotherapy with borderline and non-borderline clients: A qualitative analysis.

Conducted an intensive, qualitative analysis of borderline and non-borderline client's and therapist's experiences of metaphoric expression in a single psychotherapy session. Open-ended interviews were conducted with 2 therapists and 4 clients (aged 24–38 yrs; 2 borderline and 2 non-borderline) who were actively engaged in psychoanalytically-oriented, long-term psychotherapy. The intensive analyses of inquiry interview transcipts revealed 3 important categories of metaphor functions that were shared by all 4 psychotherapy dyads: (1) metaphors illuminate clinical issues, (2) metaphor functions to depict clients' self and object relationships, and (3) therapist metaphor stimulates an intensification of client experiential engagement in therapy. Patterns differentiating the borderline and non-borderline dyads in relation to metaphor use were discussed in the context of 2 core categories: the Representation Mode of Interaction and the Literal Mode of Interaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The attrition dilemma: Toward a new strategy for psychotherapy research.

Presents an analysis of the attrition dilemma in psychotherapy research and reviews the methods used to compensate for data loss. It is argued that attrition is not ultimately a problem of bias but a problem of lack of information. A reformulation is offered that integrates single-case studies with traditional group comparison methodology in an attempt to find optimal causal relations of treatments to outcomes. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific and nonspecific factors in psychotherapy: A problematic paradigm for psychotherapy research.

Discusses the specific/nonspecific hypothesis—a paradigm that has guided psychotherapy research for the last 3 decades—and suggests that underlying this hypothesis is the assumption that research can ultimately separate and assess the relative contributions to psychotherapeutic outcome of specific and nonspecific factors. This assumption, in turn, has held the promise that specific, active ingredients of psychotherapy could be identified. Categorical rejection of the specific/nonspecific hypothesis is advocated. It is suggested that the identity of psychotherapy with its interpersonal context must be acknowledged. In this way, the goal of psychotherapy research shifts from the search for active ingredients toward efforts to identify fundamental principles of human interaction that underlie the interpersonal conditions essential for therapeutic change. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)