Processes and outcomes of psychotherapists' personal therapy: Replication and extension 20 years later.

In this replication and extension of a national survey of psychotherapists conducted in 1987, American psychologists (n = 219), counselors (n = 191), and social workers (n = 192) reported in 2007 on the processes and outcomes of their personal therapy experiences. Of the 85% who sought therapy at least once, women, men, and members of all three professions were equally as likely to have received personal treatment. Their top reasons for seeking therapy were marital–couple distress (20%), depression (13%), need for self-understanding (12%), and anxiety–stress (10%). Approximately 24% used psychotropic medication in combination with personal therapy. More than 90% of therapists reported positive outcomes across multiple domains. The modal lasting lessons from personal treatment related to therapist reliability, skill, and empathy. The results are tentatively compared with those obtained in 1987, thus chronicling the evolution of personal therapy among psychologists and social workers during the past 20 years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating self-help into psychotherapy: 16 practical suggestions.

Psychologists routinely recommend self-help to their patients but desire guidance on the optimal methods and resources for doing so. This article provides 16 suggestions, culled from both the research literature and clinical experience, for integrating self-help into psychotherapy. Among the clinical recommendations are broadening the definition of self-help, assessing clients' self-help histories, offering tangible support in linking clients with self-help, tailoring the self-help resource to the person (not only the disorder), assisting clients with the administration of difficult self-help programs, using self-help during waiting and maintenance stages, and addressing clients' reservations about its use. Psychologists' top-rated self-help books, autobiographies, and films are presented. By their behavior, psychologists can enhance the effectiveness of self-help within the context of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of psychotherapy: A Delphi poll.

Predicted psychotherapy trends in the next decade by using the Delphi poll. 36 therapists and researchers completed a 100-item questionnaire assessing possible changes in therapeutic interventions, psychotherapists, therapy modalities, theoretical orientations, research findings, and professional issues. Results indicate that therapy will become more cognitive behavioral, present centered, problem specific, and briefer; cathartic, aversive, and dynamic approaches are expected to decrease. Family and marital therapy are predicted to markedly increase; long-term individual modalities are expected to markedly decrease. Optimistic forecasts include an increase in women and minority therapists, accelerated services to underserved populations, coverage under national health insurance, and standard implementation of peer review. One emerging pattern suggests that psychotherapists' efforts at change will become more similar to self-change processes that are used by people in their natural environment. The impermanent nature of psychotherapy and the deleterious consequences of this impermanent condition are discussed. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autobiographies of mental health clients: Psychologists' uses and recommendations.

More than 80% of practicing psychologists recommend self-help books to their psychotherapy clients, but only 33% recommend autobiographies written by mental health patients. In this study, 362 psychologists (38% response) provided clinical information and evaluative ratings on such published autobiographical accounts. The effect of reading autobiographies during treatment was typically considered "somewhat helpful." The titles and evaluative ratings of 40 leading autobiographies are provided as a resource for the practitioner; the most valued were An Unquiet Mind, Nobody Nowhere, Darkness Visible, Out of the Depths, and Girl Interrupted. The clinical advantages of recommending published autobiographies to clients are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regulation of anti-HIV-1 activity of RANTES by heparan sulfate proteoglycans

The role of cell surface proteoglycans in CC chemokine-mediated anti-HIV-1 activity in T cells and macrophages was investigated. Enzyme digestion of heparan sulfate (HS), but not chondroitin sulfate, from the surface of PM1(CD26H) cells (a human T cell line selected for high CD26 expression) rendered them resistant to the antiviral effects of RANTES and macrophage-inflammatory protein-1beta at otherwise inhibitory chemokine concentrations. HIV-1 infection of macrophages, however, was inhibited only partially, even at high concentrations of RANTES, and this inhibition was not prevented by HS removal. Flow cytometry revealed that digestion of cell surface proteoglycans, including HS, prevented the binding of RANTES at 10 to 100 nM concentrations to PM1(CD26H) cells. However, the binding of RANTES to activated macrophages occurred only at higher concentrations (100-300 nM) and was mostly chondroitin sulfate, and not HS, dependent. These results support a role for HS in facilitating the interaction of CC chemokines with the cell surface and the consequent inhibition of HIV-1 infection. The absence of HS-dependent binding of RANTES at lower concentrations to macrophages is consistent with the resistance of these cells to the antiviral effects of chemokines.     

Abdominal compartment syndrome

PURPOSE: Two cases of abdominal compartment syndrome are described and the pathophysiology associated with it is reviewed. CLINICAL FEATURES: The first patient was a 46-yr-old man who sustained extensive blunt abdominal injuries following a fall. The second was a 54-yr-old man involved in a motor vehicle accident with blunt abdominal trauma. In both cases, the patients developed an extremely tense abdomen, increasing peak inspiratory pressures, hypercarbia and oliguria. Both demonstrated improvement in cardiac performance and ventilatory variables following an emergency decompressive celiotomy. CONCLUSION: Abdominal compartment syndrome results in impairment of organ function secondary to increased intraabdominal pressure. These patients require emergency decompressive celiotomy to relieve the symptoms. However, the incidence of intractable asystole and hypotension during this procedure is high and vigilance must be maintained during the release of the increased intraabdominal pressure.     

The future of psychotherapy: Delphi data and concluding observations.

Studied predictions of trends in psychotherapy over the next decade by 75 psychologists, using Delphi methodology. Directive, present-centered, problem-focused, and brief therapies were expected to increase, whereas historically oriented, comparatively passive, and long-term approaches were predicted to decrease. Self-help groups and social workers were expected to proliferate, while the proportion of psychotherapy provided by psychiatrists was expected to diminish. Integrative, systemic, and cognitive orientations will be in the ascendancy, as opposed to classical psychoanalysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A bibliography of mental patients' autobiographies: an update and classification system

OBJECTIVE: This article brings to the present earlier bibliographies of books written by former mental patients. These books provide an inside view of mental disorder that can be useful in teaching, public education, theory, and research, and they have played a catalyzing role in mental health reform and in theory development. METHOD: The authors list seven anthologies and 48 autobiographies of former patients published since 1980 and introduce a classification system intended to increase the research value of this important archive. RESULTS: Recent books of this genre show more individuals with a mood disorder and more therapists and more women as authors. CONCLUSIONS: The research potential of these books suggests the value of an electronic database for classifying and retrieving the information they contain.     

Personal integration: An N of 1 study.

The term 'integration' deliberately embraces a dual meaning: the integration of the major systems of psychotherapy and the integration of the clinician. In this article, I address the origins of my integrative orientation and explicate several ways in which I embody that orientation in my personal life and professional career. My ordinal position and family of origin predisposed me to integration from the "get go." My integrative leanings were crystallized by formal training, which modeled the transtheoretical spirit and were subsequently strengthened by early research and friendships in the integration movement. I sketch how my ongoing research and practice continue in the integrative tradition, though not always invoking that term, and advance several directions for rejuvenating the movement. Pluralism, pragmatism, and customizing to the individual circumstance characterize not only my theoretical orientation but also my personal life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)