Добірка наукової літератури з теми "Psychotherapy; psychotherapist and patient case studies"

AbstractObjectiveIn seriously ill cardiac patients, several psychotherapy efficacy studies demonstrate little to no reduction in depression or improvement in quality of life, and little is known about how to improve psychotherapies to best address the range of patient needs. An interpersonal and behavioral activation psychotherapy was a key component of the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) multisite randomized clinical trial. Although depressive symptoms did improve in the CASA trial, questions remain about how best to tailor psychotherapies to the needs of seriously ill patient populations. The study objective was to describe psychosocial needs emerging during a clinical trial of a palliative care and interpersonal and behavioral activation psychotherapy intervention that were not specifically addressed by the psychotherapy.MethodDuring the CASA trial, patient needs were prospectively tracked by the psychotherapist in each visit note using an a priori code list. Preplanned analysis of study data using directed content analysis was conducted analyzing the a priori code list, which were collapsed by team consensus into larger themes. The frequency of each code and theme were calculated into a percentage of visits.ResultA total of 150 patients received one or more visits from the therapist and were included in the analysis. Participants screened positive for depressive disorder (47%), had poor heart failure-specific health status (mean Kansas City Cardiomyopathy Questionnaire score = 48.6; SD = 17.4), and multiple comorbidities (median 4.3). Common needs that emerged during the therapy included difficulty coping with fatigue (48%), pain (28%), and satisfaction issues with medical care (43%). The following broader themes emerged: social support (77% of sessions), unmet symptom needs (67%), healthcare navigation (48%), housing, legal, safety, and transportation (32%), and end of life (12%).Significance of resultsCoping with chronic symptoms and case management needs commonly emerged during psychotherapy visits. Future psychotherapy interventions in seriously ill populations should consider the importance of coping with chronic symptoms and case management.

Abstract Introduction. The basic purpose of this article is to present Jacob Levy Moreno’s psychodrama method as the psychotherapeutic technique useful in work with patients during individual and group psychotherapy. Material and Method: The author presents the analysis of case studies of patients treated in individual and group psychotherapy. He instances the examples of psychodramatic work on the stage as well as monodramatic and reports their importance in the process of patient psychotherapy. He discusses the effects of these act ivities in the context of changes in the emotional and interpersonal functioning of patients. Results: The given examples of monodrama and psychodramatic works illustrate the mechanisms of the changes offered by the method, e.g. insight, abreaction, acceptance of internal impulses, confrontation with the feelings of other people, training of alternative behaviors. In the article one can follow each subsequent step of analyzing intrapsychic conflicts of patients, which, thanks to the play on the stage, can be named and experienced by them. Conclusions: Psychodrama, used in the psychotherapeutic work of the group and in individual work with the patient (in the form of a monodrama), gives great opportunities to broaden the insight of the patient into very complicated internal mechanisms of conflicts and deficits. Psychotherapist - leader encourages patients to be creative and to spontaneous development of their blocked personality elements. The specificity of psychodrama is a relatively quick resolution of many years of ongoing conflict and permanent reparation of traumatic experiences, even from early childhood.

Abstract Interaction structures refers to the repetitive ways of interaction between the patient-therapist dyad over the course of treatment. This construct is operationalized by the repeated application of the Psychotherapy Process Q-Set (PQS) to psychotherapy sessions. Studies in this line of research have so far focused only on long-term treatment. The present study examines whether interaction structures can be detected empirically in short-term psychotherapies. All sessions (N = 31) of a successful case of brief psychodynamic psychotherapy were coded with the Psychotherapy Process Q-Set (PQS). The application of Q type factor analysis procedures with varimax rotation revealed five interaction structures: resistance, alliance, facing depression, expectation of change, and introspection and hearing. The analysis of variation of these structures over the course of the treatment showed that these interactions are nonlinear, may be positively or negatively protruding in different sessions, or be predominant at some treatment phase.

Introduction A 21-year-old woman diagnosed with bipolar disorder was hospitalized in the Mental Health Day Hospital of Salamanca during the Covid pandemic. The patient engaged with 4 different jobs and a master’s degree, beginning with verbose speech, dysphoria, global insomnia, grandiose delusions, extremely high energy and thinking she has the vaccine. She works the following objectives:illness insight, risk factors, psychopathological stabilization, social skills, slowing down of activities and taking responsibilities. Objectives The objective is do a follow-up of the patient during her hospitalization in the Mental Health Day Hospital and to carry out a structured search in PubMed and Up-to-Date about psychotherapy and bipolar disorder. Methods 3-month follow-up of a 21-year-old woman diagnosed with bipolar disorder during her hospitalization in the Mental Health Day Hospital in Salamanca and a structured search in PubMed and Up-to-Date in April 2021 in English, French and Spanish, including the last 10 years with the keywords “psychotherapy”, “psychotherapies” and “bipolar disorder “.77 studies were analyzed: 12 included, 65 excluded. Results Several randomized trials highlight the efficacy of group psychoeducation and cognitive-behavioural therapy in relapse prevention, improving illness insight, medical adherence and less hospitalizations. Therapeutic alliance plays a significant role in the process. Our patient improved her knowledge of her illness and treatment, her social skills and reconnected with her relatives and slowed down her activity. She then was referred to her community mental heath center psychiatrist. Conclusions The insight in bipolar disorder plays an important role in medical adherence and prevention of relapses. Therapeutic alliance improves their insight, their functionality in their daily life and enables close monitoring. Medical treatment should be accompanied by psychotherapy for a complete approach of the treatment. Disclosure No significant relationships.

I n t r o d u c t i o n . Non-psychotic mental disorders are most prevalent mental disorders with the high relapse rate and onset in the early adulthood the most active period of life, psychosocial factors play essential role in their ethiopathogenesis. Psychotherapy as method influencing one’s mind and through the mind affecting ones organism is considered to play an essential role in the treatment system of this patients group as well as in medico-psychological support of the patients with somatic illnesses.Obj e c t i v e definition of the modern psychotherapy content as independent medical specialty based on the modern data base of its efficacy research systematization, evaluation of its further perspectives development for the provision of the healthcare for the targeted population of the patients with non-psychotic mental disorders as well as organization of the medico-psychological support for the patients with somatic illnesses, taking into account the possibilities offered by digital technologiesМ e t h o d s . WHO, PubMed, Scopus, Pubmed, Medline, Web of Science, Russian Science citation index Science Citation Index search was conducted on non-psychotic mental disorders epidemiology, COVID-19 pandemic impact on mental health, psychotherapy efficacy and psychotherapeutic treatment settings, possibilities of digital technologies implementation in modern psychotherapy.R e s u l t s . The prevalence of non-psychotic mental disorders is constantly growing in the las years, they make a serious impact in the non-communicable diseases burden, with the increase of the treatment costs. The COVID-19 pandemic is characterized by decrease of mental health well-being, growth of the anxiety and depressive disturbances, also because of the somatogenic disorders included in the post-covid syndrome.The recent studies persuasively demonstrated the efficacy of psychotherapy in the non-psychotic mental disorders treatment, combination of psycho- and pharmacotherapy is defined as the golden standard treatment, the ratio of them should be determined personalized in each individual case. Digital technologies active development, computerized psychotherapeutic programs implementation open new possibilities for the research of the psychotherapeutic treatment mechanisms as well as make psychotherapy more available for the different population groups and can substantially decrease treatment costs in the future.Mental health care provision optimization should be aimed at the greater psychotherapists involvement as the main specialists for diagnostic and complex treatment of non-psychotic mental disorders treatment, development of psychotherapeutic offices network, they could be a center of this patient group healthcare system, as well as for patients recovering from novel coronavirus infection with psychoneurological complains, and can be used for the medico-psychological support of the patients with somatic illnesses.Conclusion. Psychotherapy today is recognized as an effective non-psychotic mental disorders treatment method, in the future it can be used as an epigenetic modulator in the personalized medicine framework, it can be considered as an essential part of the medical-psychological support of the patients with somatic illnesses.

INTRODUCTION: Countertransference, the emotional reaction of a psychotherapist toward a patient, is an important technical element of psychotherapy. The purpose of this systematic review was to identify and describe the main findings of studies that evaluated countertransference in adult psychotherapy.METHODS: A search was conducted of the databases Embase, PubMed, PsycINFO and Web of Knowledge to retrieve data published in any language at any time.RESULTS:Of the 1,081 studies found in the databases, 25 were selected. Most were about psychodynamic psychotherapy, and results indicated that positive countertransference, that is, feelings of closeness to the patient, are associated with positive outcomes, such as symptom improvement and good therapeutic alliance.CONCLUSIONS: Although few studies were found in the literature, countertransference seems to be an important source of knowledge about several aspects, such as treatment outcomes, attachment style, therapeutic alliance, patient symptoms and diagnoses.

Стаття присвячена психолінгвістичній проблематиці: сфері психологічної діяльності, що має переважно дискурсивний характер і побудована на використанні різних способів мовленнєвого впливу, конструюванні дискурсів як реалізації прикладних потреб психолога в його професійно-мовленнєвій діяльності; висвітленню можливостей дискурсивного впливу, пов’язаного з різними аспектами його побудови й отриманими ефектами, конкретними видами дискурсів у тих чи тих умовах роботи психотерапевта й психоконсультанта. Описується можливість зміни свідомості й поведінки особистості людини під впливом потенціалу психологічного дискурсу та спроможність його здійснювати мовленнєве втручання в психічні регулятори життєдіяльності особистості, буття й психокомунікативної взаємодії в соціальному просторі; визначається дискурс як породжений психологом концепт, що конституює соціальні стосунки, образ «Я» й «Інших», формує соціальну ідентичність, уявлення, судження, настанови, перетворює неадаптивні й недоречні патерни поведінки та ригідні стереотипи свідомості людини на адаптивні й творчі, кардинально змінюючи старі й формуючи в неї нові смисли; подаються виокремлені автором статті приклади різних видів дискурсів, а саме: дискурс-роз’яснення, дискурсімперфект, дискурс-перенос, дискурс-генетичне витлумачення, дискурс-перетлумачення, Ядискурс, дискурс-перезавантаження, дискурс-переототожнення, дискурс-самовираження почуттів тут-і-зараз. Література References 1. Бьюдженталь Д. Искусство психотерапевта. 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The article reflects the results of the work of the psychiatric and psychotherapy services of the Hospital for war veterans converted into an infectious hospital in the context of the new coronavirus infection (COVID-19) pandemic. The aim of our study was to determine the frequency and nature of mental disorders in patients treated in hospital for a new coronavirus infection (COVID-19) between April and June 2020. The case histories of patients who received psychotherapy or psychiatric care in addition to the treatment of the underlying disease were studied retrospectively. The study included 557 patients, 266 men, 291 women, the average age was 62.36+18.65 years. The work used clinical and psychological methods using the international classification of diseases 10 revision (ICD-10), the diagnosis of a new coronavirus infection (COVID — 19) was carried out in accordance with the Temporary guidelines of the Ministry of health of the Russian Federation. As a result of data evaluation, it was revealed that the proportion of patients requiring consultation or treatment by a psychiatrist or psychotherapist was 557 (7,10%) patients of the total number of hospital admissions, of which emergency psychiatric care was indicated in 58 (10,41%) of cases. The transition of the hospital to an infectious diseases hospital mode has set new challenges for the psychiatric and psychotherapy service, which required organizational measures, therapeutic issues and confirmed the need for participation of mental health specialists in providing full-fledged medical care in the treatment of somatic disorders.

The open psychotherapy clinical seminar at the Maudsley Hospital is a weekly teaching event in which psychiatric trainees can present a case from their general psychiatric work to a forum chaired by a consultant psychotherapist. The seminar has a history stretching back to the 1960s when Heinz Wolff, Henri Rey and Murray Jackson taught in the Maudsley Psychotherapy Unit. The seminar is currently chaired by Nicholas Temple. It draws on a tradition of teaching psychotherapy which owes much to the pioneering work of Michael Balint. The psychotherapy training seminar which he developed is well described in the appendix to The Doctor, his Patient and the Illness (Balint, 1957). A trainee presents a case with particular emphasis on his or her feelings about the patient. The trainee's counter-transference is used as the raw material for the seminar's discussion of the patient. Balint adopted this method for teaching psychotherapy to a variety of professionals including social workers, general practitioners, and medical students. As Pedder (1986) pointed out, it is a model which has been very influential in British psychotherapy training.

This study reports an analysis using the conversation analytical (CA) approach of the use of laughter within a corpus of cognitive therapy sessions. The results relating to eight first encounter sessions reveal that a client’s laughter may accompany disagreement as well as agreement with the therapist. In both cases, the therapist does not reciprocate the client’s laughter and replies by investigating the client in question’s condition, and this approach to the client’s laughter produces significant results in therapeutic work. This article focuses on the asymmetry that characterizes the roles of the psychotherapist and the client in psychotherapy sessions and, in particular, on the part that laughter plays in this type of scenario.

The purpose of this case study is to explore the issue of contempt in the therapeutic relationship. The aims are twofold; namely, to illustrate to what extent the case studied throws light on existing theories on contempt in psychotherapy, and to enquire about which stance adopted by the therapist is most appropriate in the therapeutic interaction with a contemptuous client. It investigates the validity of using the case study method in examining both the content and the process of this particular course of psychotherapy. Literature on contempt in psychotherapy is reviewed, as well as the foundation-stone on which it rests, namely, the Kleinian approach to envy . The concepts of the superego and false self are also drawn upon in understanding this particular client's dynamics. The client's therapy is then presented and explored, in order to gain insight into how a psychotherapist's understanding of the contemptuous client can clarify the process of therapy. It highlights the limitations and potentialities that exist in working in this sphere of resistance, and raises questions relevant to therapists faced with these clients. The case study shows how theory in this area is helpful in understanding the contemptuous client, and that the ability of the therapist to endure and survive the contempt of the client is a crucial factor in working with the contemptuous individual.

The overall objective of this study was to delve into the intricacies of the therapeutic process and the therapeutic relationship from an attachment perspective. A single retrospective child case study was conducted, which entailed the construction of a narrative synopsis of the process. The hermeneutic approach of a Reading Guide Method was applied, and through a repeated re-reading of the narrative, pertinent themes emerged that shed light on therapy as a process in motion. Specifically, the motion of the therapeutic process manifested through a scrutiny of the therapeutic relationship in view of the participant’s attachment style. The results of this study revealed the capacity of the participant to move away from an avoidant and somewhat ambivalent organisation of defences by virtue of establishing a secure base and exercising her faculty for emotional and self-expression. Accordingly, it can be established that in view of psychotherapy from an attachment perspective, the seemingly imperceptible vicissitudes of change are indeed appreciable.

The case study method was used to trace the therapeutic process of a 23 year old woman, over a period of 12 sessions. The focus of the study was her issue with abandonment which emerged as the central theme in therapy. Hillman's archetypal approach was used as a framework in understanding the process and resolution of her feelings of abandonment. According to Hillman, the therapy process activates the archetypal abandoned child. For a successful therapeutic outcome the process of de-literalisation must occur in order for the patient to move from literal acting out to symbolic containment. Core moments in the therapeutic process were used, together with an interpretation from Hillman's approach, to illustrate the various themes around the issue of abandonment. The present case study illustrates how the theory in area was relevant in practice with this particular case.

This dissertation is an interview based qualitative research study into reflecting team practice. The central question posed is "What can therapists learn from reflecting on their own and their clinets’ experience of therapy?" Interviews with three clients and two therapists were recorded and transcribed for research purposes. Interview questions were derived from key themes identified in the literature: becoming a client; the experience of self; the experience of the therapeutic relationship; the experience of speciic therapeutic practices; and the experience of outcomes. Drawing on White and Epston (1990) the author develops a decentred approach to research practice that is congruent with the values and philosophy of reflecting teams and narrative therapy.
Thesis (M.Clin.Sc.) -- University of Adelaide, Dept. of Psychiatry, 2005

The development of the concept of irreverence is examined in terms of its historical, theoretical and metatheoretical contexts. The underlying assumptions of the concepts of neutrality, curiosity, and irreverence are distinguished and contextualised. Neutrality is discussed with reference to Milan systemic therapy and first- and second-order cybernetics, while curiosity is examined in the light of constructivist and narrative approaches to psychotherapy. It is argued that these two concepts represent two sides of a dualism, which is transcended through irreverence. Irreverence is interpreted as a postmodern stance, involving the questioning and relativising of therapists' basic assumptions. The pragmatic components of an irreverent stance, namely self-reflexivity, orthogonality, flexibility and accountability, are explored with reference to related concepts in the work of other authors. Throughout the text metalogues are used in an attempt to engage reader and author in a collaborative enterprise of acknowledging and reevaluating their own basic assumptions.
Psychology
M.A. (Clinical Psychology)

Ziel der im Oktober 2015 in der Tagesklinik für Psychiatrie und Psychotherapie Görlitz durchgeführten prospektive Katamnesestudie war es, den Übergang der Patienten/innen von der Therapie in den Alltag, evtl. Unterstützungsbedarfe sowie mögliche Schnittstellenprobleme zu evaluieren. Dies geschah zum einem vor dem Hintergrund des Entlassungsmanagements als Aufgabe des Sozialdienstes und zum anderen mit Blick auf die sich verändernde Versorgungs- und Finanzierungsstruktur durch den Paradigmenwechsel im deutschen Gesundheitswesen sowie in Psychiatrie und Psychosomatik. Hierfür konnten 37 Studienteilneh-mer/innen, bis zu 21 Monate nach ihrer Behandlung, für die Erhebung gewonnen werden. Die Ergebnisse der Studie liefern Hinweise über die Zufriedenheit mit der Behandlung, zur Bewältigung des Übergangs und filterten darüber hinaus weitere Bedarfe der Patienten/innen. Ein überwiegender Teil der Studienpopulation (71%) war ‚sehr zufrieden’ oder ‚zufrieden’ mit der Behandlung und der Mehrheit der Patienten/innen gelang darüber hinaus der Übergang aus der Therapie zurück in den Alltag ‚gut’ (62,16 %). Obwohl die Mehrzahl der Patienten/innen den Übergang von der Therapie zurück in den Alltag ‚gut’ bewältigt haben, konnten spezifische Prädiktoren des Übergangs aus den Ergebnissen gefiltert werden, welche diesen positiv und negativ beeinflussen. Positive Prädiktoren sind die allgemeine Zufriedenheit mit der Behandlung und im speziellen die Zufriedenheit mit dem Sozialdienst und den Psychologen/innen und Psychiater/innen. Darüber hinaus gelang den Patienten/innen der Übergang gut, welche den Entlassungszeitpunkt als ‚genau richtig’ empfanden. Des Weiteren konnte ein positiver Zusammenhang zwischen der weiteren Einnahme von den in der Tagesklinik verschriebenen Medikamenten und der aktuellen Lebensqualität festgestellt werden. Obwohl viele Patienten/innen (83,78 %) weiter Unterstützungsangebote nach der Entlassung wahrnahmen, wünscht sich ein Großteil (67,57) bereits während der Therapie eine Vermittlung und Begleitung zu anderen, externen Hilfsangeboten oder weitere Beratungsgespräche durch den Sozialdienst (45,95 %). Aus diesem Grund wurden über die Forschung hinaus Optionen einer effektiven und an den Bedürfnissen der Patienten/innen ausgerichteten Entlassungsplanung durch den Sozialdienst diskutiert und spezifische Kooperationsempfehlungen ausgesprochen.

This study aimed to relate the emotions of two fathers regarding their incestuous behaviour. The epistemological framework is social constructionism. The `case-study approach' was chosen as the most suitable method to gain access to the information. Qualitative in-depth interviews with the fathers were conducted to collect data about their emotional experiences regarding their incestuous behaviour and Hermeneutics was used as method of data analysis. The emotional experiences of the participants regarding their incestuous behaviour were reconstructed in the form of prominent themes. Themes that seemed to re-occur in both participants' stories were identified and discussed as common themes. These themes included; ambivalence, powerlessness and guilt. This study provides a rich understanding of the emotional experiences of incestuous fathers. These experiences seem to be unstated or insufficiently emphasised in the traditional empirical, cause and effect, linear modernist literature.
Psychology
M.A. (Clinical Psychology)

Major depressive disorder (MDD) is one of the most common psychiatric disorders affecting children and adolescents. The diagnostic criteria require the history of one or more depressive episodes in the absence of a history of mania. In contrast to adults, youth may experience predominantly irritable rather than sad mood. The assessment of depression should include a psychiatric evaluation, medical history, and focused laboratory studies to rule out medical and/or substance-related causes. The evaluation should also consider potential precipitants such as recent losses, interpersonal problems, or trauma. The patient should be asked directly about suicidal ideation, plans, and past attempts. Psychotherapy alone or in combination with antidepressant therapy is effective for the treatment of pediatric depression. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are the most well-studied psychotherapies. Selective serotonin reuptake inhibitors (SSRIs) are the first-line medication class and should be considered in moderate to severe cases of depression.

This chapter provides an overview of the use of IPT for patients with eating disorders. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. The chapter discusses the adaptations of IPT that have been used for the treatment of eating disorders and evaluates their performance in research studies. The assumption for testing IPT with eating disorders is that they occur in response to distress at poor social and interpersonal functioning and consequent negative mood, to which the patient responds with maladaptive eating behaviors. For anorexia nervosa, few data provide evidence for the benefit of IPT. For bulimia and binge eating disorder, however, IPT is considered a viable option for treatment and is recommended in numerous guidelines. A case example of a woman with bulimia nervosa is provided.

Abstract: Multiple studies have found that psychiatric disorders, like mood disorders and substance use disorders, are highly comorbid among adults with either disorder. Integrated treatment refers to the treatment of two or more conditions and the use of multiple therapies such as the combination of psychotherapy and pharmacotherapy. Integrated therapy for comorbidity per numerous studies has consistently been superior to the treatment of individual disorders separately. The purpose of this QI project was to identify the effectiveness of Cognitive Behavioral Therapy (CBT) instead of current treatment as usual for treating Substance Use Disorder (SUD) or mental health diagnosis independently. It is a retrospective chart review. The review examines CBT's efficacy for engaging individuals with co-occurring mood and substance u se disorders in treatment by enhancing adherence and preventing disengagement and relapse. Methods: Forty adults aged 26-55 with a DSM-IV diagnosis of a mood disorder of Major Depressive Disorder and/or anxiety and concurrent substance use disorder (at least weekly use in the past month). Participants received 12 sessions of individual integrated CBT treatment delivered with case management over a 12-week period. Results: The intervention was associated with significant improvements in mood disorder, substance use, and coping skills at 4, 8, and 12 weeks post-treatment. Conclusions: These results provide some evidence for the effectiveness of the integrated CBT intervention in individuals with co-occurring disorders. Of note, all psychotherapies are efficacious; however, it would be more advantageous to develop a standardized CBT that identifies variables that facilitate treatment outcomes specifically to comorbid disorders of substance use and mood disorders. It is concluded that there is potentially more to be gained from further studies using randomized controlled designs to determine its efficacy.