Letteratura scientifica selezionata sul tema "Psychodynamic psychotherapy"

Brief-term psychotherapy and the idea of doing psychodynamic psychotherapy are usually seen as contradictory. This article explores the principles which underpin psychodynamic psychotherapy. Special attention is paid to the concepts of transference and interpretation. The potential for and limits of applying psychodynamic principles in a time-limited way are explored. It is concluded that it is possible to apply psychodynamic principles in a time-limited way and that real dynamic change is possible following brief-term psychodynamic psychotherapy.

A brief description of the place of psychodynamic psychotherapy in the treatment of offenders is followed by an account of a forensic psychotherapy course run under the auspices of the British Postgraduate Medical Federation. The first year of a second year course leading to the diploma in Forensic Psychotherapy of the University of London is also described.

The authors provide an overview of psychiatry and psychodynamic psychotherapy in Thailand, including a discussion of practice patterns, trends, and the cultural context of the delivery of psychotherapy services in this Southeast Asian country. They discuss a way forward in psychodynamic psychotherapy training that is collaborative, self-sustaining, and leads to competence. They address how to culturally adapt psychodynamic psychotherapy and suggest areas of research that would advance the field. Lastly, they discuss psychodynamic pedagogical strategies that may be acceptable and effective in underserved areas.

Rationally selected Comprehensive System (CS; Exner, 1991, 1993, 2003) Rorschach variables and suitability for psychodynamic psychotherapy were investigated in four studies with different designs. The participants comprised three clinical samples (n = 52, 25, and 69) of patients applying for and/or selected for dynamic psychotherapy. With few exceptions the CS variables were the same in the studies, and in all the studies the Rorschach was independent of clinical ratings/assessments and/or selection of patients for treatment. The first study dealt with the relation between 17 rationally selected CS variables and suitability for psychotherapy as represented by ratings of Dynamic Capacity and Ego Strength and by selection of therapy applicants for psychotherapy. The second and third studies concerned CS score differences between groups of patients differing in suitability for dynamic psychotherapy. In the second study, differences for CS variables were predicted for three groups of dynamic psychotherapy patients with mixed diagnoses. In the third study, CS score differences between two groups, differing in suitability but similar in comprising personality disordered patients, were predicted and tested. In the fourth study, correlations were predicted between 18 pre-therapy CS variables and patient post-therapy satisfaction with therapy and also with therapist post-therapy ratings of their patients’ suitability for dynamic therapy.

For the four studies taken together, positive results were obtained for EA, FC, the D Score, Blends, Zf, F%, MQo, and AG. The results for m, SumT, WSUM6, X-%, S, and FrrF were negative, whereas the results for YFY, FD, COP, and PER were too weak to permit interpretation.

The main limitation of the research in this thesis is the lack of psychometric data concerning the clinical ratings whereas the strength is the ecological validity. The results are positive for some of the CS variables selected, mainly concerning control and cognition but also touching upon emotional integration and interpersonal forcefulness. The usefulness of the CS in psychotherapy assessment may be enhanced if only those CS variables that are found valid for the purpose are used and general personality descriptions are avoided.

Includes bibliography.
The aim of this study is to develop a framework for the assessment of children for short-term psychodynamic psychotherapy, with a particular emphasis on the training of child therapists. For this purpose the literature on brief child psychotherapy is reviewed, and selection criteria mentioned in the literature are collated and summarized. These criteria are then applied to 5 cases seen by trainees or newly qualified clinicians in order to assess their usefulness in a training setting. Potential sources of difficulty for inexperienced clinicians in the assessment for and process of this specialized form of child psychotherapy are considered, and guidelines as to how this approach could be usefully employed in a training institute are suggested. On the basis of the literature and case discussions, a format for the assessment of children for brief psychotherapy is devised in order to assist the trainee.

The purpose of this study was to investigate the meaning of the psychodrama process as experienced by individuals who claim that it resulted in significant change. Using an existential-phenomenological approach, the study described the meaning of the experience for six adult co-researchers. The co-researchers were asked to describe their experiences before, during, and after their psychodramas. Two interviews were conducted and these were tape recorded and transcribed. The transcripts were analyzed and themes were formulated which were validated by the co-researchers and woven into an exhaustive description of the psychodrama experience. The exhaustive description was condensed into an essential structure. Both the exhaustive description and the essential structure were validated by all the co- researchers. The results support elements of both psychodrama and Gestalt theory, as well as current theories of group development. Implications for counselling and further research are discussed.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate

This dissertation uses a modified systematic literature review to look at working with parents and carers within child and adolescent psychotherapy, and to consider this tasks relationship to therapeutic outcomes for children and adolescents. The topic is important because psychotherapy with children and adolescents inevitably involves additional relationships. The literature indicates the way this undertaking has been regarded has varied through the history of psychodynamic child and adolescent psychotherapy. Numerous writers reflect on the ongoing neglect and absence of systematic thinking in relation to the task of work with parents and carers. This lack of attention is understood to have been influenced by the traditional model of child and adolescent psychotherapy where the source of the child or adolescent’s distress or difficulty was regarded as being primarily intrapsychic. What is now known regarding the current and active nature of the child or adolescent’s relationship with the parent or carer, and the power and persistence of the parent-child bond has resulted in an acknowledgement of the need for a more equitable balance of focus between internal and external factors. In acknowledging that the external can no longer be seen as peripheral there are compelling clinical reasons to work with parents and carers. This undertaking should not be seen as dependant on the therapist’s orientation or interest. The significant scope of possibilities for work with parents and carers within child and adolescent psychotherapy is explored; however there is a lack of data relating to the clinical effectiveness of these approaches. The future need is for systematic thinking, and the development of practice guidelines for this clinical task.

Includes bibliography.
The present study provides a description of selected core psychodynamic issues pertinent to a male transvestite patient. Case material from an ongoing 11 month psychodynamically-oriented psychotherapy is used for illustrative purposes. The theoretical roles of the 'core complex', castration anxiety; aggression and a particular ego style are thematically outlined and illustrated by a discussion of the therapeutic process. An attempt is made to demonstrate an increased capacity for depression, increased object-relatedness and disidentification from a symbiotically related female introject as the aim and partial gain of the therapy. The transference, case management difficulties and the therapeutic process of what has occurred as well as what is likely to, are considered. The unexpected outcome, in that the patient has ceased to fetishistically cross-dress, given the short space of therapeutic time is discussed. It is concluded that this be viewed tentatively. Finally, some thoughts are raised as to the utility of the psychoanalytic approach as against the general psychiatric-diagnostic approach.

The main purpose of this thesis is to explore experiences of two different psychological interventions based on art psychotherapy in women with a psychological or physical illness. The two interventions are art psychotherapy and art therapy. The difference between these two interventions is that the art therapist works with the transference in art psychotherapy but not in art therapy. The thesis consists of two studies of art psychotherapy: An art psychotherapy intervention is evaluated in Study 1 (papers III and V) which examines a group of patients diagnosed with depression and Study 2 (paper II) which examines experiences in a group of six patients diagnosed with vulva vestibulitis. An art therapy intervention is evaluated in the third study (papers I and IV); where experiences in patients diagnosed with breast cancer are examined. In Study 1, forty-three (n=43) depressed women were randomly assigned to either an intervention group or a control group (verbal psychotherapy). The aim was to examine the outcome of time limited psychodynamic art therapy compared to time-limited psychodynamic verbal therapy for patients with depressive symptoms. Interviews were performed before, immediately after, and three months after the termination of psychotherapy, and self-rating scales which focus on stress reactions, depression and symptoms as well as an observer rating scale on depression were used. The interviews and the art sessions were video-recorded, and the verbal psychotherapy was tape-recorded. The results showed that the art and verbal psychotherapies were comparable. The conclusion was that short-term psychodynamic art psychotherapy could be a valuable treatment for depressed women. In an in-depth content analysis, the method of scribbling was further investigated and exemplified with the therapies of two participants. In this study, the patients’ pictures and verbal expressions of progress, along with considerations of how to interpret the pictures were in focus. When leaving therapy the two patients took advantage of the paper, made complete forms, symbolised in words what they have expressed in pictures; in pace with psychotherapy the themes alter towards separation, individuation, and attempt to relate in a new way. The conclusion was that limelimited psychodynamic art therapy suggests giving a safer place for the self as the cohesion is firmer with better boundaries. Study 2 is a pilot study, which involved six young patients newly diagnosed with vulva vestibulitis. The aim of the study was to investigate pain at vestibulum, mental health, and self-image after fifteen sessions of art psychotherapy. Five of the patients were judged to have less pain three months after termination of therapy. The conclusion was that art psychotherapy with its openness seemed to affect young women in their experiences of vulva vestibulitis in a positive direction. Study 3 examined the potential benefit of art therapy for women with primary breast cancer. The sample comprised forty-one (n=41) patients who were randomly assigned either to an art therapy group or to a control group. The art therapy was going on during five weeks radiation treatment, one session per week. The aim was to investigate the outcome of art therapy, to quantify and compare the participant coping s, self-image, and the symptoms with the participant in the control group. Interviews were performed before, immediately after, and six month after inclusion. A set of self-rating scales was used: Coping Resources Inventory, the Structural Analysis of Social Behavior, and Symptom Check List – 90. The result showed that the patients in the art therapy group rated their coping s and especially their social s, higher than the control group, and that the average patients in the art therapy group improved in depressive symptoms and symptoms of anxiety, and that the general psychiatric symptoms improved as well. A linear regression analysis showed a tendency that the coping s increased in the art therapy group and decreased in the control group or even stagnated in the social domain. A second report on self-image, symptoms, treatment, and social variables showed that art therapy was related to lower ratings of depression, anxiety, and general symptoms after treatment; chemotherapeutic treatment predicted lower depressive symptoms and general symptoms in contrast to axilliary surgery and hormonal treatment. The results showed that art therapy could be valuable complementary therapy in routine oncology practise. The conclusion is that art therapy can have a positive long-term effect on the crisis following the primary breast cancer and its consequences. Conclusion: The results show that time-limited psychodynamic art psychotherapy is valuable for depressed women; that it is a valuable complement for women with vulva vestibulitis; and that art therapy is a valuable complement in the care and cure of women with primary breast cancer.

The purpose of this research was to inquire into the subjective experience of participants of psychodynamic group art therapy.This investigation was designed to record participants' responses and understanding of their art-making and their artwork in therapy. The qualitative methodology of phenomenography was chosen to record the art-making process. The sample included three women from a women's centre and six university students. A single interview was conducted with each of the nine participants and included their artwork from the group art therapy. Group art therapy committed to a participant's personal development was effective in contributing to a resolution of personal conflicts, whereas group art therapy committed to professional development was effective in stimulating group dynamics, but the participants were guarded when discussing the personal content of their artwork.
Master of Arts (Hons) (Art Therapy)

Although it is generally acknowledged and accepted that case formulations are useful in psychotherapy treatment, there is significantly little research illustrating how case formulations are useful in treatment. Research also suggests that case formulations are seldom used in practice after initial training (Eells, 1997; Sim, Gwee, & Bateman, 2005). This research was premised on a particular case study which appeared to highlight shifts in psychotherapy treatment in the sessions directly after the writing or revising of the case formulation, thus prompting the inquiry into the influence of the case formulation on therapeutic work. The research utilised a qualitative methodology and focused on a single case which was a 19 year old university student who expressed a problem with binge eating. The data was drawn from five original and revised case formulations. The participant was seen for 27 therapy sessions, over which time five case formulations were developed and revised. The findings in this study highlight the process of how a psychodynamic case formulation can influence therapeutic work, as reflected in three broad themes of adherence to the case formulation, the confidence of the therapist, and using the formulation as an intervention. The study contributes to arguments for the revival of the case formulation as a necessary therapeutic tool.
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Позитивная динамическая психотерапия – это российский психодинамический метод с экзистенциальными аспектами, обогащенный транскультуральным подходом и поведенческими техниками. Наибольшее влияние на экзистенциальную психотерапию в ХХ веке оказала философия М. Хайдеггера и С. Л. Франка. Взгляды этих философов во многом были противоположны и образовали два смысловых полюса экзистенциализма. И. И. Мечников сформулировал базовое понимание роли оптимизма и счастья как важного условия долголетия, а вслед за ним – А. И. Яроцкий, В. Ф. Чиж, С. Л. Франк, В. Н. Мясищев, И. А. Ефремов и др. рассматривали «счастливую жизнь» как явление, прежде всего, психологическое, определяемое факторами физической, психической и социальной активности, наличием творческой деятельности и альтруистической направленности личности. В данном контексте важна проактивность: 1) наличие «жизненной доминанты» – главного дела в жизни, которым пронизана вся жизнь человека; 2) глубокой перспективы – долгосрочного горизонта планирования; 3) достижение большой альтруистической цели, имеющей общественное значение. В русле психотерапевтической антропологии изучение традиционных мистериальных психотехнологий является перспективным в плане разработки прикладных психотерапевтических методик. Традиционные культуры содержат мистериальную традицию, в рамках которой экзистенциальные переживания способствуют взрослению, личностному росту и долголетию. Нейрофизиологи В. Б. Слёзин и Г. Гуттманн доказали, что уникальные трансовые состояния возникают после использования различных «архаических техник экстаза»: молитв и ритуальных поз. Профессор Слёзин открыл феномен четвертого состояния человека – «молитвенное бодрствование» – полное отключение электрической активности коры головного мозга при полном сознании. Проведенный профессором Г. Гуттманн анализ «потенциала DC» испытуемых лиц доказал, что транс, вызванный по методу антрополога Ф. Гудман, вызывает специфическое измененное состояние сознания – «paradoxical arousal». С 2010 года, авторы, в рамках развития метода позитивной динамической психотерапии в русле концепции психотерапевтической антропологии проводят культуральную адаптацию методики Ф. Гудман. Накопленный к настоящему моменту клинический опыт использование ритуальных архаических трансов в психотерапевтической практике свидетельствует о перспективности данного подхода. Positive dynamic psychotherapy is a Russian psychodynamic method with existential aspects, enriched with a transcultural approach and behavioral techniques. The greatest influence on existential psychotherapy in the twentieth century was the philosophy of M. Heidegger and S. L. Frank. The views of these philosophers were largely opposite and formed two semantic poles of existentialism. I. I. Mechnikov formulated a basic understanding of the role of optimism and happiness as an important condition for longevity, and after him – A. I. Yarotsky, V. F. Chizh, S. L. Frank, V. N. Myasishchev, I. A. Efremov and others considered "happy life" as a phenomenon, primarily psychological, determined by factors of physical, mental and social activity, the presence of creative activity and altruistic personality orientation. In this context, proactive activity is important: 1) the presence of a "life dominant" – the main thing in life, which permeates the whole life of a person; 2) deep perspective – long-term planning horizon; 3) achieving a large altruistic goal of public importance. In line with psychotherapeutic anthropology, the study of traditional mystery psychotechnology is promising in terms of the development of applied psychotherapeutic methods. Traditional cultures contain a mystery tradition in which existential experiences promote adulthood, personal growth, and longevity. Neurophysiologists V. B. Slezin and G. Guttmann proved that unique trance states arise after the use of various "archaic ecstasy techniques": prayers and ritual poses. Professor Slezin discovered the phenomenon of the fourth state of man – "prayer wakefulness" – a complete shutdown of the electrical activity of the cerebral cortex with complete consciousness. The analysis of the "DC potential" of the subjects conducted by Professor G. Guttmann proved that trans caused by the method of anthropologist F. Goodman causes a specific altered state of consciousness – "paradoxical arousal". Since 2010, the authors, as part of the development of the method of positive dynamic psychotherapy in line with the concept of psychotherapeutic anthropology, have been conducting cultural adaptation of the F. Goodman method. To date, the clinical experience gained using ritual archaic trances in psychotherapeutic practice indicates the promise of this approach.

В настоящее время знания, полученные когнитивной наукой, приоткрыли содержание человеческого сознания и понимания метапознавательных процессов. Метапознание, как показано, занимает центральную роль в как в предмете психотерапетической работы, так и в эффективности деятельности и обучения. Однако, зачастую эти достижения не используются в практической работе, а в целом ситуация напоминает попытку двух людей, находящихся по разные стороны от забора сделать подкоп, но копают они в разных местах. Целью данного доклада выступает увязать между собой некоторые достижения когнитивной науки с практическими областями психотерапевтической работы и понять, чем в настоящее время эти достижения могут быть полезны в практике. В этом контексте важным видится обсуждение характера и значимости метакогниций со стороны клиента и терапевта, супервизанта и супервизора. В истории взаимоотношений психологии и психотерапии можно заметить ряд закономерностей. В конце 1950-х годов психоаналитики активно занимались изучением закономерностей формирования психической деятельности, и практическим путем была сформулирована концепция У.Биона о формировании психики и значение в этом процессе проективной идентификации. Одна из основных идея этой концепции заключалась в следующем – нормальное развитие психической деятельности происходит путем тестирования аффектом реальности и последующая индукция изменений. Позднее в ленинградской школе психологии в 1980-х –1990-х годах Б.Ф. Ломов, Л.М. Веккер, Б.Г. Ананьев и другие при экспериментальном изучении образа восприятия приходят к похожим выводам – формирование дифференцированосинтезированного образа восприятия происходит через активное взаимодействие с элементами реальности. Тем самым сформировалась доказательная база для теории, существующей в практической психотерапии. В наше время происходит похожая ситуация – в когнитивной психологии активно разрабатываются исследования сознания и метапознания, что может выступить доказательной базой для существующих в психотерапии современных концепций. Однако, в силу того, что традиционно психотерапия разрабатывалась преимущественно врачами и в рамках медицинских дисциплин, в психотерапию перекочевали те же проблемы с доказательностью, что и в медицине. В итоге мы видим неутешительный вывод, наблюдаемый в метанализах современных исследований эффективности психотерапии – за 129 концепции появившиеся за последние 30 лет не показали большей эффективности, чем ранее существующие. Вкупе с этим, нельзя забывать в целом о проблеме доказанной эффективности психотерапии. Таким образом, видится особая значимость в учете результатов когнитивной психологии в психотерапевтической работе и разработка психотерапевтических концепций на базе доказательной психологии. Рассматривая значение метакогнитивного познания в процессе психотерапии и супервизии, можно обратить внимание на такие понятия как, стратегии поведения в когнитивно-поведенческой терапии, внутриличностиная структура в психодинамических концепциях и индивидуальный опыт в феноменологических концепциях. Каждое из этих понятий, по сути, используется для описания ментальной репрезентации, которые сейчас активно изучаются в рамках исследований метапознавательных процессов. В ряде теоретических моделей, например модель Е.Ерткина, особую значимость имеют взаимодействие метакогнитивного знания (ментальной репрезентации), метакогнитивных навыков (способов переработки информации и знаний о себе) и метакогнитивных переживаний (реакции на предыдущие процессы переработки). Особо ярко взаимодействие этих 3-ех компонентов мы видим в рамках супервизионного процесса, когда супервизант приносит метакогнитивные переживания о клиенте, уже интегрированные в знания о клиенте, о себе или находящиеся в этом процессе. Там, на супервизии, группа или супервизор помогают специалисту пройти цикл между этими тремя компонентами, для углубления понимания клиента, возникновения метакогнитивных переживаний нового уровня и разряжения этих переживай. Таким образом, понимание разнообразия организации всех трех компонентов у разных людей и в целом необходимо для эффективного супервизора. В противном случае риск превращения супервизии из способа преодоления трудности во времяпрепровождение оказывается очень высоким. Эти выводы можно также применить и к психотерапевтической работе. В свете описанного, хочется привлечь внимание коллег к взаимоотношениям исследований в психологии и психотерапевтическими концепциями. Автору видится, что взаимосвязь этих областей может помочь преодолеть застой, который наблюдается в психотерапии последние 10-15 лет, и дать почву для решения проблем эффективности и доказательности в психотерапии. The knowledge gained by cognitive science has now opened up the content of human consciousness and understanding of metacognitive processes. Metacognition has been shown to occupy a central role in both the subject matter of psychotherapy and in the effectiveness of activity and learning. However, these advances are often not used in practical work, and the overall situation resembles an attempt of two people on opposite sides of a fence trying to dig, but they are digging in different places. The purpose of this paper is to connect some achievements of cognitive science to practical areas of psychotherapy work and to understand how these achievements can currently be useful in practice. In this context, a discussion of the nature and significance of metacognitions on the part of client and therapist, supervisor and supervisee seems important. In the history of the relationship between psychology and psychotherapy, it is possible to notice a number of regularities. At the end of the 1950s, psychoanalysts were actively engaged in studying patterns of mental activity formation, therefore W. Bion's concept of mental formation and importance of projective identification in this process was formulated on basis of practical work in this field. One of the basic ideas of this concept was the following – the normal development of mental activity occurs through affect testing of reality and the subsequent induction of change. Later in the Leningrad school of psychology in the 1980's and 1990's B.F. Lomov, L.M. Vekker, B.G. Ananyev and others reached similar conclusions during the experimental study of the perceptual image – the formation of a differentiated and synthesized perceptual image occurs through active interaction with elements of reality. This formed the evidence base for the theory that exists in practical psychotherapy. Nowadays, a similar situation is occurring – studies of consciousness and metacognition are being actively developed in cognitive psychology, which can serve as an evidentiary base for current concepts existing in psychotherapy. However, due to the fact that psychotherapy was traditionally developed mainly by doctors and within the framework of medical disciplines, the same problems of evidence as in medicine have migrated to psychotherapy. As a result, we see the disappointing conclusion observed in metaanalyses of contemporary research on the efficacy of psychotherapy – the concepts that have emerged over the past 30 years have shown no greater efficacy than previously existing ones. Coupled with this, the problem of proven efficacy of psychotherapy in general cannot be forgotten. Consequently, it is seems especially important to take into consideration the results of cognitive psychology in psychotherapeutic work and to develop psychotherapeutic concepts on the basis of evidence-based psychology. Considering the importance of metacognition in the process of psychotherapy and supervision, should be paid attention to such concepts as behavioral strategies in cognitive-behavioral therapy, intrapersonal structure in psychodynamic concepts and individual experience in phenomenological concepts. Each of these concepts is essentially used to describe mental representations, which are now being actively explored in metacognitive research. In a number of theoretical models, such as E.Ertkin's model, the interactions of metacognitive knowledge (mental representation), metacognitive skills (ways of processing information and knowledge about oneself), and metacognitive experiences (reactions to previous processes of processing) are of particular importance. We see a particularly pronounced interaction of these 3 components in the supervisory process when the supervisor brings metacognitive experiences about the client that have already been integrated into, or are in the process of being integrated into, knowledge about the client, about the self. There, in supervision, the group or supervisor helps the professional to go through full cycle between these three components to deepen understanding of the client, emerge new level metacognitive experiences and defuse these 130 experiences. Thus, understanding the diversity of organization of all three components in different people and in general is necessary for an effective supervisor. Otherwise, the risk of turning supervision from a way of overcoming difficulty into just a conversation very high. These conclusions can also be applied to psychotherapeutic work. In the light of the above, I would like to draw colleagues' attention to the relationship between research in psychology and psychotherapy concepts. The author believes that the interrelation of these fields can help to overcome the stagnation observed in psychotherapy in the last 10-15 years and provide the ground for solving problems of effectiveness and evidence in psychotherapy.