Academic literature on the topic 'Therapeutic alliance, psychotherapy process'

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Journal articles on the topic "Therapeutic alliance, psychotherapy process"

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Sanders, Avihay, Mark Hilsenroth, and J. Christopher Fowler. "Object representation quality, therapeutic alliance, and psychotherapy process." Bulletin of the Menninger Clinic 78, no. 3 (September 2014): 197–227. http://dx.doi.org/10.1521/bumc.2014.78.3.197.

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Kasimatis, Nikolaos, Dimitrios Moschonas, and Thalis Papadakis. "The effects of session frequency on group analytic psychotherapy process." Group Analysis 53, no. 3 (May 14, 2020): 327–42. http://dx.doi.org/10.1177/0533316420916715.

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The study examined the effects of session frequency (fortnightly versus weekly) on specific group processes, i.e. group cohesiveness, group climate, and therapeutic alliance in a naturalistic setting. Results indicated that fortnightly frequency sessions were associated with significantly higher levels of engagement, conflict, as well as therapeutic alliance-task within long term group analytic groups, whereas levels of cohesiveness, therapeutic alliance-goal and therapeutic alliance-bond did not differ significantly. The findings suggest that fortnightly frequency sessions versus weekly, do not seem to endanger therapeutic processes, indicating the need for greater experimentation and research to be carried out with regards to the actual effects of session frequency on treatment process as well as outcome.
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Marcolino, José Alvaro Marques, and Eduardo Iacoponi. "The early impact of therapeutic alliance in brief psychodynamic psychotherapy." Revista Brasileira de Psiquiatria 25, no. 2 (June 2003): 78–86. http://dx.doi.org/10.1590/s1516-44462003000200006.

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INTRODCTION: Therapeutic alliance is a key component of the psychotherapeutic process. This study estimated the impact of the therapeutic alliance as measured by CALPAS-P in an individual brief psychodynamic psychotherapy program. METHODS: To study the impact of the therapeutic alliance patients in psychotherapy answered to the CALPAS-P at the first and third session and to the Self-report Questionnaire (SRQ-20), to the Beck Depression Inventory (BDI) and to the Hamilton Anxiety Scale at the beginning and at the end of psychotherapy. RESULTS: The study of the impact of the therapeutic alliance in brief psychodynamic psychotherapy showed that higher TUI scores in the first session were significantly associated to the improvement on the BDI. Patients with best scores in the working alliance, measured at the third PWC session had also significant symptomatic changes. DISCUSSION: The study of the impact of the therapeutic alliance in brief psychotherapy indicated that patients who perceived that their therapists had the best capability to understand and to be involved in their issues had best results in reducing depressive symptoms and patients with higher capability to form the working alliance reached the best psychotherapy outcomes.
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Samardzic, Ljiljana, and Gordana Nikolic. "Transference patterns and working alliance during the early phase of psychodynamic psychotherapy." Vojnosanitetski pregled 71, no. 2 (2014): 175–82. http://dx.doi.org/10.2298/vsp1402175s.

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Background/Aim. Working alliance, as a collaborative part of the therapeutic relationship has been proven to be one of the most powerful therapeutic factors in psychotherapy in general, regardless many technical differences between numerous psychotherapeutic modalities. On the other hand, transference is the basic concept of psychodynamic psychotherapy, and, according to the psychoanalytic theory and practice, it forms a major part of the therapeutic relationship. The aim of our paper was to determine the differences between the groups of patients with low, middle, and high working alliance scores and the dropout group in transference patterns, sociodemographic and clinical parameters, during the early phase of psychodynamic psychotherapy. Methods. Our sample consisted of 61 non-psychotic patients, randomly selected by the method of consecutive admissions and treated with psychoanalytic psychotherapy in the outpatient clinical setting. The patients were prospectively followed during 5 initial sessions of the therapeutic process. The working alliance inventory and Core conflictual relationship theme method were used for the estimation of working alliance and transference patterns, respectively. According to the Working Alliance Inventory scores, four groups of patients were formed and than compared. Results. Our results show a significant difference between the groups of patients with low, middle, and high working alliance inventory scores and the dropout group on the variable - transference patterns in the therapeutic relationship. Conclusion. Disharmonious transference patterns are more frequent in patients who form poor quality working alliance in the early phase of psychotherapy, or early dropout psychotherapy. It is of great importance to recognize transference patterns of a patient at the beginning of the psychotherapeutic process, because of their potentially harmful influence on the quality of working alliance.
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Langhoff, Christin, Thomas Baer, Doris Zubraegel, and Michael Linden. "Therapist–Patient Alliance, Patient–Therapist Alliance, Mutual Therapeutic Alliance, Therapist–Patient Concordance, and Outcome of CBT in GAD." Journal of Cognitive Psychotherapy 22, no. 1 (March 2008): 68–79. http://dx.doi.org/10.1891/0889.8391.22.1.68.

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The therapeutic alliance is seen as an important dimension in any type of psychotherapy. But patient, therapist, or observers can have different views on the therapeutic alliance. The question is which perspective best represents the therapeutic alliance, and what are the differences between these alternative views. In the present study, the therapist–patient alliance (TPA, the view of the therapist), patient–therapist alliance (PTA, the view of the patient), and mutual therapeutic alliance (MTA, the view of an observer) were measured simultaneously in cognitive behavior therapy of patients suffering from generalized anxiety disorder. Additionally, the concordance between patient and therapist ratings (TPC) was calculated. Cognitive behavior therapists attained high positive scores in all perspectives for all dimensions of the therapeutic alliance, such as empathy, cooperation, transparency, focusing, and assurance of progress. Correlations were consistently higher for ratings between therapist and patient than between observer and patient. A relation with outcome (Hamilton Anxiety Scale) was only found for observer ratings. It was concluded that cognitive behavior therapists can achieve good alliances with their patients. Different perspectives on the therapeutic alliance should be distinguished and taken into account separately in studies on the therapeutic process and outcome.
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Da Costa, Camila Piva, Carolina Stopinski Padoan, Simone Hauck, Stefania Pigatto Teche, and Cláudio Laks Eizirik. "What is the appropriate time to measure outcome and process factors in psychodynamic psychotherapy?" Trends in Psychiatry and Psychotherapy 41, no. 2 (June 2019): 112–20. http://dx.doi.org/10.1590/2237-6089-2017-0151.

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Abstract Introduction Different instruments and methods for measuring factors related to the progress and effectiveness of psychodynamic psychotherapy (PDT) have been widely discussed in the literature. However, there are no established guidelines on the most appropriate time to perform these measurements. Objectives The aim of this study is to problematize what is the appropriate time to measure the initial outcomes (symptoms, interpersonal relationships, quality, and social role) and process factors (alliance) in the early stages of PDT. Methods A naturalistic cohort study was conducted, following 304 patients during the first six months of psychotherapy. The therapeutic alliance was evaluated after four sessions; symptoms, interpersonal relationships, and social role were evaluated at intake and after 12 and 24 sessions. Results Our results indicate that four sessions were sufficient to measure the bond dimension of the therapeutic alliance, while more time is probably needed to adequately measure other aspects of the therapeutic alliance, such as tasks and goals. However, 12 sessions of treatment proved sufficient to detect improvements in all dimensions of the outcome instruments with moderate effect sizes, and those gains were stable at the 24th session. Conclusion According to our findings, 12 sessions seem to be sufficient to assess initial gains in PDT, although more studies are needed to evaluate the appropriate time to assess all aspects of the therapeutic alliance. Further studies are also required to evaluate the appropriate time to assess intermediate and long-term progress with regard to symptoms, interpersonal relations, social role and personality reorganization.
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Békés, Vera, and Leon Hoffman. "The “Something More” Than Working Alliance: Authentic Relational Moments." Journal of the American Psychoanalytic Association 68, no. 6 (December 2020): 1051–64. http://dx.doi.org/10.1177/0003065120983602.

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The importance of relational processes during psychotherapy and psychoanalysis has long been emphasized. Theoretical and empirical investigations have focused mostly on episodes in which the therapeutic relationship is taken over by transference, leads to enactments, or suffers ruptures, and much less on understanding the role of positive relational episodes in the change process during psychotherapy. Episodes of the latter type, conceptualized as Authentic Relational Moments (ARMs), are core experiences in the patient’s implicit relational learning in psychotherapy. ARMs are episodes in which the connection between patient and therapist is especially strong, deep, and genuine; their three main aspects are authenticity, understanding, and witnessing.
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Daniels, Jo, and Alison J. Wearden. "Socialization to the Model: The Active Component in the Therapeutic Alliance? A Preliminary Study." Behavioural and Cognitive Psychotherapy 39, no. 2 (November 22, 2010): 221–27. http://dx.doi.org/10.1017/s1352465810000792.

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Background: Therapeutic alliance has been found to be a significant predictor of outcome in psychotherapy yet what constitutes therapeutic alliance remains unclear. Examining the common constructs of therapeutic alliance, it is possible that there may be a conceptual overlap between active components of therapeutic alliance and socialization to the treatment model. Aim: To investigate the relationship between socialization to the model and therapeutic alliance. Method: Participants (N = 43) were taken from the active treatment arm in a RCT for the treatment of chronic fatigue syndrome (CFS/ME). Therapeutic alliance was measured using a 5-item questionnaire (brief CALPAS) and socialization to the model was extracted from therapy tapes using a novel coding system. Results: Key findings were that when patients and therapists agreed about goals of treatment, there were higher levels of concordance, less evidence of applying principles incongruent to the model, and less resistance during the treatment sessions. Conclusions: The outcome of this preliminary study contributes to the potential understanding of active components in the therapeutic alliance, and supports further research to achieve a more detailed picture of “non-specific” factors in therapy, including the active process of socialization in therapeutic alliance.
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Hernandez, Silvia, James Overholser, and Kevin McCarthy. "Clinical Recommendations for Addressing Impasses in Long-Term Psychotherapy." Archives of Psychiatry and Psychotherapy 24, no. 3 (October 15, 2022): 53–62. http://dx.doi.org/10.12740/app/146027.

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Many clients benefit from psychotherapy sessions that extend across months or years. However, there is a risk for therapeutic impasse in long-term psychotherapy in which the work can become repetitive or with limited gains over time. The current paper provides five transtheoretical principles to increase the impetus in long-term therapy. The five principles include: planful spontaneity, habitual creativity, pushing the limits of the therapeutic alliance, guided discovery, and specific broad goals. The therapist is encouraged to share responsibility for creative flexibility with the client in each session, including within the therapeutic alliance and the real relationship. The therapist can use a series of questions to promote a process of guided discovery. A clear focus on principles of psychology and goals that reflect maintenance of gains, development of strengths, and promotion of enrichment can ensure that the therapy continues to produce change over the length of the relationship.
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Ogrodniczuk, John S., William E. Piper, Anthony S. Joyce, and Mary McCallum. "Different Perspectives of the Therapeutic Alliance and Therapist Technique in 2 Forms of Dynamically Oriented Psychotherapy." Canadian Journal of Psychiatry 45, no. 5 (June 2000): 452–58. http://dx.doi.org/10.1177/070674370004500505.

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Objective: This study addresses several issues concerning patients' and therapists' perceptions of key therapy process variables. This includes examining whether patients and therapists differ in their perceptions of the therapeutic alliance and therapist technique, what the relation is between perceptions of the alliance and technique, and whether these perceptions are predictive of treatment outcome. Method: Patient and therapist perceptions of the therapy process were provided in a comparative trial of 2 forms of short-term individual dynamic psychotherapy. Patients (n = 144) were randomly assigned to each condition. Treatment outcome was assessed using a large, comprehensive battery of reliable measures. Results: The findings revealed several differences in the patients' and therapists' ratings of the alliance and technique in the 2 forms of therapy. Patient ratings of the alliance and technique were predictive of treatment outcome. Conclusion: The findings contribute to understanding the extent to which therapy participants share views of therapy processes and highlight the importance of the therapist's attending to the patient's perception of therapy.
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Dissertations / Theses on the topic "Therapeutic alliance, psychotherapy process"

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Goldman, Elizabeth Davis. "Chicken or egg, Alliance or Outcome: An attempt to answer an age old question." Ohio University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1220483624.

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Reynolds, D'Arcy James. "Session Impact and Alliance in Internet Based Psychotherapy." Miami University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=miami1248277605.

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Uhlin, Brian. "Therapist In-session Rated Facilitative Interpersonal Skills (FIS-IS) in the Psychotherapy Process." Ohio University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1312482707.

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Wing, Edgar H. Jr. "The Relationship between Therapist Empathy, the Working Alliance, and Therapy Outcome: A Test of a Partial Mediation Model." Ohio University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1262266810.

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Schielke, Hugo Josef. "Systemic Alliance and Progress in Individual Therapy: The Influence of Indirect Client System Alliance on Process and Progress in Individual Therapy." Miami University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=miami1385655060.

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LOCATI, FRANCESCA. "Cyclical dynamics in the therapy room: The interactive role of the therapeutic alliance in psychotherapy process." Doctoral thesis, Università degli Studi di Milano-Bicocca, 2016. http://hdl.handle.net/10281/102821.

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The last decades have seen an exponential trend toward a relational reconsideration of psychoanalysis (Greenberg & Mitchell, 1983), that has drastically influenced aspects of both psychotherapy theory and research. On the theoretical side, indeed, the therapeutic process has been reformulated under an intersubjective perspective, and it is now conceived as a “specific psychological field” created by the interplay between the patient’s and therapist’s subjectivities (Stolorow, Brandchaft & Atwood, 2014). On the research side, the construct of therapeutic alliance as a relational dimension has become very important. Accordingly, recent conceptualizations define the therapeutic alliance as an “intersubjective negotiation process” (Safran & Muran, 2000) that interacts with the other variables of the therapeutic process (Roth & Fonagy, 2013), although little is still known about the precise dynamic involving these key dimensions. On these grounds, the present doctoral thesis aims to explore the role of the therapeutic alliance in the therapeutic process, by means of an intersubjective perspective in both group and single-case studies. The first part of the thesis investigates the interaction between therapeutic alliance, technical interventions and metacognitive functioning in groups of patients, by focusing in a first study on the earliest stage of the treatment and, in a second one, on the more advanced stages. Results of both studies show that technical interventions and therapeutic alliance are associated in specific interactive patterns that can be differentiated in three different levels of therapeutic alliance: a positive, a neutral and a negative level. Furthermore, in these interactive patterns, metacognitive functioning plays a specific role of mediator depending on the level of alliance. The second part of the thesis includes two single-case studies, involving a patient with an anxiety disorder diagnosis and with a deferential behavior toward the therapist. The first study specifically focuses on the patient’s collaborative alliance and its association with defense mechanisms, therapeutic relationship and therapist’s technical interventions. On the contrary, the second study focuses on the investigation of alliance ruptures and their interaction with transference patterns and defense mechanism. Results show that the intersubjective approach applied on the deferential behavior, on the one hand challenges the real authenticity of patient’s collaborative process, and on the other hand suggests that ruptures may provide a better understanding of the patient’s transference and defense mechanisms. Overall, this doctoral thesis indicates that the therapeutic process can be conceived as an interpersonal cyclical dynamic that involves both technical and relational factors. In this sense, the therapeutic alliance may be considered as a medium, by means of which other variables operate during the therapy.
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Goldman, Gregory A. "Quality of Object Relations, Security of Attachment, and Interpersonal Style as Predictors of the Early Therapeutic Alliance." Ohio University / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1132069514.

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Stone, Suzannah J. "The Role of Therapist Facilitative Interpersonal Skills in Predicting Alliance and Outcome in Psychotherapy." Ohio University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1625222441713288.

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Lilliengren, Peter. "Exploring therapeutic action in psychoanalytic psychotherapy : Attachment to therapist and change." Doctoral thesis, Stockholms universitet, Psykologiska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-106501.

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The overall aim of this thesis was to explore therapeutic action in psychoanalytic psychotherapy from different perspectives (patient, therapist, observer), using different methodological approaches (qualitative and quantitative). Study I explores patients’ views of therapeutic action with grounded theory methodology. The results indicated that talking openly in a safe therapeutic relationship led to new relational experiences and expanding self-awareness. Hindering factors included difficulties “opening up” and experiencing something missing in treatment. Study II investigates experienced therapists’ views of therapeutic action. The development of a close and trusting relationship was perceived as the core curative factor. Patients’ fear of closeness hindered treatment from the therapists’ perspective. Study III involves the development and psychometric examination of a new rating scale for patient-therapist attachment (Patient Attachment to Therapist Rating Scale; PAT-RS). Inter-rater reliability was good for three of the subscales (Security, Deactivation, Disorganization), but poor for one (Hyperactivation). Patterns of correlations with other measures suggest construct validity for the reliable subscales. Study IV examines the relationships between secure attachment to therapist, alliance, and outcome. Linear mixed-effects models, controlling for therapist effects, treatment length and patient-rated alliance, indicated that secure attachment to therapist relates to outcome. Further, the unique variance associated with secure attachment to therapist predicted continued gains in functioning during follow-up. The results of this thesis suggest that the development of a secure attachment to the therapist is a central mechanism of therapeutic change. The results are discussed in relation to established notions of therapeutic action in psychoanalytic psychotherapy. Two tentative process models that may be useful for clinical practice and future research are proposed.

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Epub ahead of print.

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Davis, Elizabeth Helen. "Detection of Rupture-Repair Sequences in Patterns of Alliance Development: The Effects of Client vs. Therapist Raters and Therapist Training Status." Ohio University / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1133405084.

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Books on the topic "Therapeutic alliance, psychotherapy process"

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Widening the scope of cognitive therapy: The therapeutic relationship, emotion, and the process of change. Northvale, N.J: Jason Aronson, 1998.

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Therapeutic engagement of children and adolescents: Play, symbol, drawing, and storytelling strategies. Lanham: Jason Aronson, 2008.

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S, Garfield David A., and Mackler Daniel 1972-, eds. Beyond medication: Therapeutic engagement and the recovery from psychosis. Hove: Routledge, 2009.

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D, Safran Jeremy, and Muran J. Christopher, eds. The therapeutic alliance in brief psychotherapy. Washington, DC: American Psychological Association, 1998.

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Safran, Jeremy D., and J. Christopher Muran, eds. The therapeutic alliance in brief psychotherapy. Washington: American Psychological Association, 1998. http://dx.doi.org/10.1037/10306-000.

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Kanfer, Frederick H. Guiding the process of therapeutic change. Champaign, Ill: Research Press, 1988.

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A, Lazarus Arnold, and Zur Ofer, eds. Dual relationships and psychotherapy. New York, NY: Springer, 2002.

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Therapeutic experiencing: The process of change. New York: Norton, 1986.

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Narcissistic states and the therapeutic process. New York: J. Aronson, 1985.

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1941-, Horvath Adam O., and Greenberg Leslie S, eds. The Working alliance: Theory, research, and practice. New York: Wiley, 1994.

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Book chapters on the topic "Therapeutic alliance, psychotherapy process"

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Lohr, Christina, Tania Pietrzak, and Gernot Hauke. "Therapeutic Alliance: Grounding Interaction in Space." In Embodiment in Psychotherapy, 231–44. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-92889-0_15.

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Lingiardi, Vittorio, and Antonello Colli. "Therapeutic Alliance and Alliance Ruptures and Resolutions: Theoretical Definitions, Assessment Issues, and Research Findings." In Psychotherapy Research, 311–29. Vienna: Springer Vienna, 2014. http://dx.doi.org/10.1007/978-3-7091-1382-0_16.

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Lepper, Georgia, and Nick Riding. "The therapeutic cycles model (TCM)." In Researching the Psychotherapy Process, 178–88. London: Macmillan Education UK, 2006. http://dx.doi.org/10.1007/978-1-137-03872-2_9.

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Dowling, Deirdre. "The therapeutic process." In An Independent Practitioner’s Introduction to Child and Adolescent Psychotherapy, 7–22. Abingdon, Oxon; New York, NY: Routledge, 2019. | Series: Independent psychoanalytic approaches with children and adolescents: Routledge, 2019. http://dx.doi.org/10.4324/9781315146812-2.

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Peluso, Paul R. "The Domain of Establishing and Maintaining the Therapeutic Relationship and the Therapeutic Alliance." In Principles of Counseling and Psychotherapy, 132–59. 3rd ed. New York: Routledge, 2022. http://dx.doi.org/10.4324/9781003088394-8.

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Peluso, Paul R. "The Domain of Establishing and Maintaining the Therapeutic Relationship and the Therapeutic Alliance." In Principles of Counseling and Psychotherapy, 160–88. 3rd ed. New York: Routledge, 2022. http://dx.doi.org/10.4324/9781003088394-9.

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Gelso, Charles J. "Building a Real Relationship and Forging a Working Alliance." In The Therapeutic Relationship in Psychotherapy Practice, 52–72. New York, NY : Routledge, 2019.: Routledge, 2018. http://dx.doi.org/10.4324/9781315658063-3.

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Smith-Adcock, Sondra, and Jenn Pereira. "The Counseling Process: Establishing a Therapeutic Alliance." In Counseling Children and Adolescents: Connecting Theory, Development, and Diversity, 98–120. 2455 Teller Road, Thousand Oaks California 91320: SAGE Publications, Inc., 2017. http://dx.doi.org/10.4135/9781071801307.n5.

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Safran, Jeremy D. "Impasse and Transformation: Negotiating Ruptures in the Therapeutic Alliance." In Cognitive Psychotherapy Toward a New Millennium, 81–84. Boston, MA: Springer US, 2002. http://dx.doi.org/10.1007/978-1-4615-0567-9_7.

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Hilsenroth, Mark J., Thomas D. Cromer, and Steven J. Ackerman. "How to Make Practical Use of Therapeutic Alliance Research in Your Clinical Work." In Psychodynamic Psychotherapy Research, 361–80. Totowa, NJ: Humana Press, 2011. http://dx.doi.org/10.1007/978-1-60761-792-1_22.

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Conference papers on the topic "Therapeutic alliance, psychotherapy process"

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Viana, Beatriz, Ricardo Machado, William B. Stiles, João Salgado, Patrícia Pinheiro, and Isabel Basto. "THE ASSIMILATION PROCESS OF PROBLEMATIC EXPERIENCES AND LONG-TERM OUTCOMES IN PSYCHOTHERAPY FOR DEPRESSION: COMPARING A RELAPSED AND A NON-RELAPSED CASE." In International Psychological Applications Conference and Trends. inScience Press, 2021. http://dx.doi.org/10.36315/2021inpact007.

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"Over the years, research has demonstrated that psychotherapy is an effective treatment in different psychopathological conditions. However, which are the mechanisms or processes involved in therapeutic change that could explain its efficacy are not yet clear. The Assimilation of Problematic Experiences Model describes change in therapy as a process that occurs through the gradual assimilation of problematic experiences in the self – higher levels of assimilation seem to be associated with a better outcome at the end of therapy. However, little is known about the contribution of this process to the maintenance of therapeutic gains after the end of therapy. In the current study we aimed to explore how the level of assimilation achieved throughout therapy is associated with relapse prevention after treatment. We analyzed two good outcome cases of Emotion-Focused Therapy, previously diagnosed with depression: one case that remained asymptomatic and another that relapsed one year and a half after the end of therapy. The Assimilation of Problematic Experiences (APES) was used to assess the assimilation levels achieved and the Beck Depression Inventory-II (BDI-II) was used to assess the intensity of depressive symptoms. Five therapeutic sessions and three follow-up sessions were rated using the APES. The results showed that higher APES levels were associated with lower intensity of symptoms at the end and after therapy termination, being associated with relapse prevention in depression. These results suggest that a complete assimilation of the problematic experiences may help clients to maintain therapeutic gains reducing the probability of relapsing in depression."
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Dimitrova, Lubomira. "The role of the psychotherapist in the application of the five steps of individual psychosomatic psychotherapy in the context of the three integration stages." In 8th International e-Conference on Studies in Humanities and Social Sciences. Center for Open Access in Science, Belgrade, 2022. http://dx.doi.org/10.32591/coas.e-conf.08.21223d.

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The process of psychotherapy of psychosomatic disorders requires key intervention skills from the psychotherapist. The transition through the five steps of therapy occurs against the background of the three integration stages in the communication on the axis “client-therapist” and respectively “therapist-client”. It is possible for the process of going through the five steps to be repeated for each of the three integration stages, and it is also permissible for it to go smoothly in parallel with the client reaching “separation” from the therapeutic environment. The psychotherapist’s ability to observe these mental phenomena that occur during therapy gives the client security. The goal is to “eradicate” the cause of the symptom, not just cure it.
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Lebedev, A. A. "ПОЗИТИВНАЯ АРТ-ПСИХОТЕРАПИЯ НА МОДЕЛИ КЛИНИЧЕСКОЙ СИСТЕМНОЙ АРТ-ТЕРАПИИ." In ПЕРВЫЙ МЕЖКОНТИНЕНТАЛЬНЫЙ ЭКСТЕРРИТОРИАЛЬНЫЙ КОНГРЕСС «ПЛАНЕТА ПСИХОТЕРАПИИ 2022: ДЕТИ. СЕМЬЯ. ОБЩЕСТВО. БУДУЩЕЕ». Crossref, 2022. http://dx.doi.org/10.54775/ppl.2022.17.85.001.

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Positive art-psychotherapy, implemented within the frame of clinical systemic art therapy (CSAT) of borderline mental disorders as an integral part of the sanogenetic approach, makes a significant contribution to improving its therapeutic and organizational capacities. Increasing of the level of positive emotional experiences during an art therapy session is an important identification tag, therapeutic mechanism and criterion for the effectiveness of this approach, it is registered by participants in a special form for a comprehensive self-assessment of the psycho-emotional state (CSPES). This phenomenon, which we denote as the “positive emotional delta”, plays a key role in solving problems of therapeutic non-compliance (premature breaks of art-therapy), optimizing and improving overall efficiency of CSAT. In particular, this applies to the formation of a sustainable motivation for further studies, constructive group cohesion and safety atmosphere, intensification of group dynamics and therapy training, as well as other psychotherapeutic mechanisms. Methodological techniques, which implement a positive approach in our CSAT model, include special art-therapy and verbal techniques as well as organizational and technical activities. The main art techniques are “Resource episodes from life” and “Personal story in pictures”. Verbal interventions are aimed at developing positive psychological attitudes and appropriate interpretation of the art-therapeutic process and its results (positive internal picture of treatment, health, “militant optimism” and other principles of “psychotherapy of healthy people”, reframing, humour). Organizational and technical activities include step-by-step art-therapy program, principles of its optimal practical implementation (uniform load distribution, “throbbing” emotional load, tactical flexibility), as well as monitoring and evaluation of its effectiveness (form “CSPES”, verbal self-reporting of participants). Позитивная арт-психотерапия, реализуемая в рамках клинической системной арт-терапии (КСАТ) пограничных психических расстройств в качестве одной из составляющих саногенетического подхода, вносит весомый вклад в повышение ее терапевтических и организационных возможностей. Важным идентификационным признаком, терапевтическим механизмом и критерием эффективности данного подхода является прирост уровня положительных эмоциональных переживаний в процессе арт-терапевтического сеанса, регистрируемый участниками с помощью специального бланка комплексной самооценки психоэмоционального состояния (КСПЭС). Данный феномен, обозначаемый нами как «позитивная эмоциональная дельта», играет ключевую роль в решении проблем терапевтического нонкомплаенса (преждевременных обрывов арт-терапии), оптимизации и повышении общей эффективности КСАТ. В частности, это относится к формированию устойчивой мотивации к продолжению занятий, конструктивной атмосферы групповой сплоченности и безопасности, интенсификации процессов групповой динамики и терапевтического обучения, а также других психотерапевтических механизмов. Методические приемы, с помощью которых реализуется позитивный подход в нашей модели КСАТ, включают специальные арт-терапевтические и вербальные техники, а также организационно-технические мероприятия. К основным изобразительным техникам относим "Ресурсные эпизоды из жизни" и «Личную историю в картинках». Вербальные интервенции направлены на формирование позитивных психологических установок и соответствующую трактовку арттерапевтического процесса и его результатов (позитивная внутренняя картина лечения, здоровья, «воинствующий оптимизм» и другие принципы «психотерапии здоровых», рефрейминг, юмор). Организационно-технические мероприятия включают поэтапную арт-терапевтическую программу, принципы ее оптимальной практической реализации (дозированность, «пульсирующая» эмоциональная нагрузка, тактическая гибкость), а также мониторинг и оценку ее эффективности (бланк «КСПЭС», вербальные самоотчеты участников).
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