Littérature scientifique sur le sujet « Psychother »

Korrigierte Zusammenfassung Ziel: Darstellung der Häufigkeit von selbstberichtetem diagnostiziertem Burnout-Syndrom und psychiatrische Komorbiditäten. Methode: Bundesweite Studie, n = 7987. Burnout-Syndrom: selbstberichtete ärztl./psychother. Diagnose. Psychische Störungen: diagnostisches Interview, n = 4483. Ergebnisse: Prävalenz: Lebenszeit 4,2 %, 12 Monate 1,5 %. Irgendeine psychische Störung: 70,9 % derer mit Burnout-Diagnose. Assoziierte Störungen: somatoforme, affektive, Angststörungen. Schlussfolgerung: Burnout-Diagnosen werden seltener berichtet als erwartet. Betroffene haben häufig eine manifeste psychische Störung.

AbstractA plethora of empirical data support a positive (or “brighter”) pathway to optimal human functioning as specified within Basic Psychological Needs Theory (Ryan and Deci in Psychol Inq 11(4):319–33, 2000). Yet, far less is known about the negative (or “darker”) pathway, a process evoking of human dysfunction and ill-being (cf. Vansteenkiste and Ryan in J Psychother Integr 23(3):263, 2013). Further, debate surrounds the independence and interplay between psychological need satisfaction and psychological need frustration and how these dynamic constructs are experienced within individuals. In this work, variable and person-oriented analyses were employed to: (i) investigate the relationships between the basic psychological needs and symptoms of stress, depression and anxiety as well as with life satisfaction; and (ii) identify different psychological need profiles and their relationship with psychological function. Participants (N = 2236; M Age = 42.16 years; SD = 7.8) were UK-based operational firefighters who completed an online survey. Results of regression analyses showed a moderating effect of psychological need satisfaction on the relationship between need frustration and negative psychological symptoms. Latent profile analyses revealed five distinct basic psychological need profiles that carry implications for human psychological functioning. Some support for an asymmetrical relationship between need satisfaction and need frustration emerged (Vansteenkiste and Ryan in J Psychother Integr 23(3):263, 2013), yet, examples of above average need satisfaction and frustration scores were also observed. Worker profiles where psychological need frustration prevailed over need satisfaction had the poorest psychological health.

Transference has been described as unconscious feelings that are transposed onto another significant individual ( Bloom. J Am Psychoanal Assoc. 1973 ;21:61-76). In the strictest sense, this occurs only in therapy settings, but in a more general sense, it occurs throughout life. Transference can be negative, positive, or sexualized. If unresolved it can create a sticky transference neurosis and impediments to progress (Koo. J Psychother Pract Res. 2001;10(1):28-36). Short-term dynamic therapy, as propounded by Dr Habib Davanloo, is structured to prevent the development of a transference neurosis and addresses the transference from the very beginning, including the first session itself. Following is a case of sexual transference which was addressed in the mid-phase of short-term psychodynamic psychotherapy.

There are three ethical reactions on the misfortune of other person: compassion, advice, practical help (M.M. Bakhtin). The foundation of all these forms of common- sense psychological support is in humane co-experiencing. Professional psychother- apy should take into account its cultural-historical soil that makes the category of co-experiencing significant for all therapeutic schools. In this article the place and the meaning of the category of co-experiencing in co-experiencing psychotherapy is considered. Co-experiencing is a constitutive category for the approach and is regarded as an internal creative work of the therapist, which is aimed at facilitat- ing the productive way of patient’s development of experiencing. Goals, subject and method of co-experiencing are being characterized. An analysis of links between categories of “co-experiencing” and “understanding” are given. A phenomena of “co-experiencing understanding” is being described.

Imposter phenomenon is defined as a self-perception of intellectual fraudulence despite achieving objective success and accomplishments. Imposter phenomenon has been rigorously explored among high-achieving career professionals. The present qualitative study is an attempt to explore imposter phenomenon experiences among female software engineers in the Indian Information and Technology sector. The data, derived through in-depth and semi-structured interviews, has been analysed through a hybrid of an inductive and a theoretical thematic analysis method. Clance and Imes’ (1978, Psychother: Theory Res Pract, 15(3):241) article, “The Imposter Phenomenon in High Achieving Women: Dynamics and Therapeutic Intervention,” has been used for screening the sample and also, as a theoretical lens. The study reveals that external attribution of success, fear of failure, anxiety, and devaluing accomplishments are core psychological processes associated with the imposter phenomenon experience. The current work further found that parenting patterns characterized by lack of praises, comparison among siblings, lack of trust in children’s potential, and strict gender values are significant antecedents of Imposter Phenomenon.

Background Awareness of synchronicity may be an opening to more general spiritual awareness. Empirical research analyzing the process of increased synchronicity awareness and investigating shifts in personal spirituality and mental health is limited. Might synchronicity awareness be a porthole for a more general sense of personal spiritual awareness, namely the experience of directly lived daily events as spiritually meaningful? Purpose This study evaluated a six-week synchronicity discussion group, Synchronicity Awareness Intervention (SAI), delivered to emerging educators and human service professionals. Its aim was to increase awareness of synchronistic events and to support spiritual awareness. Participants Final enrollment consisted of 12 females and 1 male, with a mean age of 26.8 years (SD=5.29). Religious denominations were 38.5% Catholic, 30.8% Protestant, 15.4% Hindu, 7.7% Buddhist, and 7.7% Atheist. Research Design The study used a pretest-posttest within subject design. This report focuses on the postintervention qualitative data collected through semi-structured interviews. Findings Data suggested that SAI was associated with increased awareness of synchronicity and suggested beneficial effects of synchronicity awareness on personal spirituality and mental health. Results showed that the program was well received and highly rated by the participants, indicating that it was an acceptable form of a spiritually informed psychother-apeutic discussion group. Conclusions This preliminary study showed promising support for the feasibility, acceptability, level of engagement, and potential helpfulness of an SAI in a group setting. Synchronicity awareness may support spiritual awareness and improve mental health.

La Dialectical Behavior Therapy (DBT) è un programma di trattamento cognitivo-comportamentale strutturato, complesso e ricco, messo a punto per pazienti con Disturbo Borderline di Personalità (BPD) e gravi comportamenti disfunzionali (tentativi suicidari, autolesività, instabilità relazionale, comportamenti impulsivi). DBT ha dimostrato la sua efficacia in numerosi studi: i tentativi suicidari e i comportamenti disfunzionali si sono ridotti, mentre la regolazione emotiva e il funzionamento generale dei pazienti sono migliorati. La ricerca presentata i prefigge di valutare l’efficacia e i meccanismi d’azione di DBT, esaminando sia la dimensione di outcome, sia la dimensione di processo. La prima parte dell’elaborato è dedicata alla presentazione del modello DBT. Se ne discutono i fondamenti teorici, gli accordi alla base del trattamento, le modalità del programma terapeutico e le strategie di intervento. La seconda parte dell’elaborato è una valutazione dell’efficacia di DBT, rispetto alle variabili target. Lo studio è di tipo longitudinale ed è stato condotto seguendo le linee guida internazionali. DBT è stata messa a confronto con un programma di trattamento comparabile per tipologia di pazienti, obiettivi e complessità. Il campione è composto da 95 pazienti ambulatoriali, valutati ogni tre mesi. Poiché ci si attendeva che il contributo della variabilità individuale fosse rilevante, sono stati utilizzati modelli lineari gerarchici con effetti casuali. I risultati hanno mostrato che i tentativi suicidari, i comportamenti autolesivi, la disregolazione emotiva e comportamentale sono diminuiti in entrambi i gruppi dopo un anno; i modelli hanno mostrato come i soggetti differissero nella quota di cambiamento. Inoltre, i risultati sul campione dei completer hanno suggerito che il setting di gruppo e l’intensità del trattamento potrebbero agire quali specifici meccanismi terapeutici. La terza parte dell’elaborato si compone di una serie di studi di processo con un disegno single case, inseriti nel filone della ricerca process-outcome: si tratta della valutazione di due coppie terapeutiche, una con esito favorevole ed una con esito parziale. Le pazienti erano due giovani donne con diagnosi di BPD, differenti per profilo di personalità e comportamenti disfunzionali; hanno seguito un programma DBT standard con il medesimo terapeuta, un clinico esperto. Sono state esaminate le sedute durante il primo anno di trattamento. Si sono considerate tanto la dimensione tecnica quanto quella relazionale del processo terapeutico, esaminando entrambe da una prospettiva macroanalitica e microanalitica. I risultati hanno mostrato come alcuni aspetti siano riscontrabili in ambedue le coppie terapeutiche: l’aderenza al modello di trattamento e l’atteggiamento del terapeuta orientato alla collaborazione. D’altra parte, sono emerse specificità relative alle coppie terapeutiche. Nel trattamento della paziente con esito positivo, è presente un clima relazionale globalmente positivo, terapeuta e paziente riescono ad affrontare in modo proficuo anche le incomprensioni. Invece, nel trattamento della paziente con esito parziale, terapeuta e paziente faticano a trovare una sintonizzazione e a lavorare in modo sinergico, rimanendo bloccati in dinamiche problematiche e senza riuscire a conseguire pienamente gli obiettivi prefissati. Nel loro insieme, i risultati hanno confermato l’efficacia e la complessità di DBT. Più precisamente, hanno messo in luce le sovrapposizioni e le differenze tra DBT e altri modelli teorici, in particolare con gli interventi che promuovono il funzionamento riflessivo. Inoltre, i risultati hanno confermato l’importanza di una relazione collaborativa tra terapeuta e paziente. In sintesi, è possibile concludere che i meccanismi dell’azione terapeutica in DBT possono essere compresi solo alla luce delle dinamiche del processo terapeutico entro cui si verificano.
Dialectical Behavior Therapy (DBT; Linehan, 1993, 2014) is a structured, complex and comprehensive cognitive-behavioral treatment program for patients with Borderline Personality Disorder (BPD) and severe dysfunctional behaviors (repeated suicidal attempts, self-harm behaviors, relational instability, other impulsive behaviors). Up to now, DBT proved its effectiveness in several studies: suicide attempts and dysfunctional behaviors decreased, while emotional regulation and general functioning improved. The present research aimed at assessing the effectiveness of DBT and its mechanisms of action, evaluating both outcome and process dimensions. The first part of the thesis is dedicated to the presentation of the DBT model, examining its theoretical foundations, the agreements underlying the treatment, the modalities of therapeutic program, and the strategies of intervention. The second part of the thesis is an evaluation of the effectiveness of DBT, examining the course over time of the target variables. The study is longitudinal, single-blind, with a two-arm parallel design, conducted following the international guidelines for the outcome studies on intention-to-treat samples. DBT was compared with another treatment program comparable by patient type, objectives, and complexity of interventions. The sample was comprised by 95 outpatients, assigned to groups with the minimisation procedure and assessed every three months. Since the individual variability was expected to be consistent, Hierarchical Linear Models with random effects were used. Results showed that suicidality, self-harm, emotional and behavioral dysregulation decreased in both groups after one year; unconditional growth models indicated that subjects differed in the elevation and in the rate of change. Moreover, results on the completers’ subsample suggested that the group setting and the intensity of treatment could represent specific therapeutic mechanisms. The third part of the thesis is composed by process studies with a single-case design, in the strand of the process-outcome research: the empirical evaluation of two therapeutic couples, one with a favorable outcome and one with a partial outcome, was conducted. The patients were two young women with a diagnosis of Borderline Personality Disorder, different for personality profile and dysfunctional behaviors at the beginning of treatment; they followed a DBT standard program with the same therapist, a male experienced clinician. Sessions over the first year of treatment were examined (N1 = 38; N2 = 37). The technical and the relational dimensions of the therapeutic process were assessed and examined through a macroanalytic and microanalytic perspective. Results showed that some aspects are present in both couples: namely, the adherence to the treatment model and the attitude of the therapist oriented towards collaboration. On the other hand, specificities relating to each therapeutic couple emerged. In the treatment of the patient with positive outcomes, there was a globally positive relational climate; furthermore, therapist and patient can deal even with episodes of misunderstanding. Instead, in the treatment of the patient with partial outcomes, therapist and patient struggled to find an attunement and to work in synergy, remaining trapped in problematic relational patterns and without fully achieving the therapeutic objectives previously agreed. Taken together, results confirmed the effectiveness and the complexity of DBT. More specifically, they shed light on overlaps and differences between DBT and other theoretical models, in particular interventions promoting reflective functioning. Furthermore, the importance of a collaborative relationship between therapist and patient was confirmed. Overall, results suggested that mechanisms of action in DBT can be understood only in light of the dynamics of the therapeutic process in which they occur.

The publications and critical commentary constitute a body of work spanning the period from 1988 to 2012. This has seen: the professionalisation of the field of counselling and psychotherapy, the development of a wide range of approaches; and an exponential growth of training programmes associated with these changes. The thesis constitutes the response of a systemic psychotherapist and academic engaging with the expanding formal knowledge of the field as it informs intervention with clients and the training of practitioners. This is to be understood as an extended exercise of praxis in the dialectical application of theory to challenges encountered in practice. From this a number of themes have emerged which have made an original contribution to the knowledge base of the subject area. These are: the development of a model for working with process; the application of systemic approaches to intervention with individuals; crosscultural work; a critical response to the ‘post-modern turn’; and a cross-modality approach to training. This response to an unfolding epistemological context opens the way to establishing a cross-modality position; one that argues for a ‘respectful co-existence’ which is appreciative of differences between theories and models but cautious in the face of claims to orthodoxy and supremacy.

Dissertação de Mestrado em Psicologia Clínica
O Psychotherapy Process Q-Set tem o intuito de compreender os diferentes factores envolvidos no processo terapêutico. Este instrumento é ateórico, i.é., não é influenciado pelo modelo teórico dos avaliadores. O PQS tem sido utilizado nomeadamente para investigar diferenças entre fases de psicoterapia e para identificar os factores do processo terapêutico que melhor predizem os outcomes terapêuticos, nomeadamente a relação terapêutica. Contudo, não há, ainda, evidências de estudos do dito instrumento no âmbito da psicoterapia existencial. Desta feita, pretende-se fazer uma análise dos itens do Psychotherapy Process Q-Sort que mais sobressaem numa psicoterapia existencial, determinar se a relação terapêutica é alvo de modificações ao longo do período de psicoterapia e, portanto, diminuir o hiato entre a psicoterapia existencial e a investigação em psicoterapia. Para tal, é feita uma análise a uma amostra de quatro díades, decorrentes de sessões de psicoterapia existencial. Através de gravações aúdio, são analisadas um total de quarenta e oito sessões, respectivamente doze de cada díade. Os resultados indicaram que os itens que mais se destacam enquanto (mais e menos) característicos parecem confirmar certas características e dimensões da psicoterapia existencial, nomeadamente que a exploração sistemática, por parte do terapeuta, da visão do mundo do cliente, isto é, a validação da experiência subjectiva e emocional do cliente sem uma atitude julgadora, parece enfatizar ainda mais o estabelecimento de uma relação de apoio e empatia, fundamental para o processo terapêutico. ------ ABSTRACT ------ Psychotherapy Process Q-Set aims to understand the different factors involved in the therapeutic process. This instrument is atheoretical. In other words, it is not influenced by psychotherapists’ model. PQS has been used to investigate differences among particular phases of psychotherapy and to identify factors of the therapeutic process that best predict therapeutic outcomes, particularly therapeutic relation. However, there is little evidence of studies with this instrument within the existential psychotherapy. Thus, it’s intended to make an analysis of the items in Psychotherapy Process Q-Sort which protrude more in existential psychotherapy and to determinate if the therapeutic relationship is subject of change over the period of psychotherapy. It is also an aim to thereby reduce the gap between the existential psychotherapy and research in psychotherapy. To this end, an analysis is made to a sample of four dyads, resulting from existential psychotherapy sessions. A total of forty-eight sessions are analyzed through audio recordings, respectively twelve of each dyad. Results indicated that PQS items that stood out as (more or less) characteristic seem to confirm certain characteristic features and dimensions of existential psychotherapy, namely that the systematic exploitation, by the therapist, of the world view of the customer, ie validating client’s subjective emotional experience without a judgmental attitude, seems to emphasize further the establishment of an empathic and supportive relationship wich is vital to the therapeutic process.