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American Journal of Psychotherapy

Saeed Shoja Shafti
Vital to the contemporary exercise of psychiatry is the biopsychosocial approach, with psychotherapy as its well-defined, and requisite, constituent. The key objectives of psychoanalysis and other related therapies are the amelioration of symptoms and modification of character by probing the unconscious. But the practice of psychoanalysis and similar insight-oriented techniques is in developing nations is different from developed countries due to cultural and educational reasons, along with a shortage of required facilities...
2016: American Journal of Psychotherapy
Sally E Riggs, Michael Garrett, Kyle Arnold, Erik Colon, Elise N Feldman, Pongsak Huangthaisong, Beatrice Hyacinthe, Heather-Ayn Indelicato, Eunkyung Lee
This report consists of the personal reflections of seven frontline clinicians who participated in a formal training program for the psychotherapy of psychosis implemented in a large public clinic setting. The training was part of a quality improvement initiative, consisting of 12 hours of didactic presentation followed by 30 hours of weekly peer-group supervision. The clinicians comment on ways of working with patients prior to the training, and how their views and techniques changed as a result of the training...
2016: American Journal of Psychotherapy
Gilles Fleury, Benjamin Fortin-Langelier, Imen Ben-Cheikh
The field of psychodynamic psychotherapy would benefit from a comprehensive model that integrates its constructs with neurobiology. Research on the autonomic nervous system activity during the psychotherapeutic process is necessary because it is key in affective experiences and defensive behavior. The current case study reports physiological findings on heart rate dynamics in a patient suffering from panic disorder during two therapeutic sessions in which we used Davanloo's Intensive Short-term Dynamic Psychotherapy...
2016: American Journal of Psychotherapy
Brad Bowins
Distress related to sexual orientation is a common focus in psychotherapy. In some instances the distress is external in nature as with persecution, and in others it is internal as with self-acceptance issues. Complicating matters, sexual orientation is a very complex topic producing a great deal of confusion for both clients and therapists. The current paper provides a four component model-sexual orientation dimensions, activation of these dimensions, the role of erotic fantasy, and social construction of sexual orientation-that in combination provide a comprehensive perspective...
2016: American Journal of Psychotherapy
Jeffrey Guina
The concept of earned security is important and has significant implications for psychotherapy. Understanding how individuals with insecure attachment styles can develop secure attachment styles through reparative relationships, such as the therapeutic relationship, can assist psychotherapists in helping patients to overcome the effects of early negative life experiences. Personality disorders are commonly associated with negative experiences, such as abuse, neglect, and other empathic failures. These disorders are particularly difficult to treat because of their pervasive nature and the resultant defense mechanisms that often thwart psychotherapy...
2016: American Journal of Psychotherapy
James P McCullough, Sarah W Clark, Daniel N Klein, Michael B First
Assessment of the variations of clinical course to aid in diagnosis, assessment of patients' functioning and to guide treatment planning has gained momentum in recent years. A specific scale is introduced to plot the temporal course to assist empirically-minded psychotherapists and researchers who treat the DSM-5 Disorders and who want to monitor the quality of the course of psychosocial functioning over time. A Timeline Course Graphing Scale to Chart the Quality of Psychosocial Functioning Affected by Symptom Severity (PFS) is described and accompanied by administration guidelines...
2016: American Journal of Psychotherapy
Emily Blake, Keith S Dobson, Amanda R Sheptycki, Martin Drapeau
Cognitive errors (CEs) are evidenced to be related to depressive thinking in major depressive disorder (Beck Et Al., 1979; Dozois & Beck, 2008). Studies using self-report questionnaires demonstrate that CEs are more prevalent in individuals with depression than in non-depressed individuals (Gupta & Kar, 2008) and that CEs are related to depression severity (Miranda & Mennin, 2007). The study discussed in this paper aimed to describe CEs in depressed patients and examined the relationship between CEs and severity of depression...
2016: American Journal of Psychotherapy
Frank Trimboli, Charles W Keenan, Rycke L Marshall
In this paper 12 common errors that occur in the course of psychodynamic psychotherapy are reviewed. Rationales for why we consider these to be errors are described, and vignettes are used to illustrate the errors, lastly, recommendations for alternate approaches consistent with effective psychodynamic psychotherapy are presented. The errors reviewed include concerns regarding the maintenance of appropriate limits and boundaries; decisions regarding the focus and form of treatment; no-suicide contracts; fee arrangements; missed sessions; psychological testing of psychotherapy patients; selecting appropriate patients for psychotherapy; and the importance of personal psychotherapy for the therapist...
2016: American Journal of Psychotherapy
Robert J Gregory, Shilpa Sachdeva
Dialectical behavior therapy (DBT) and dynamic deconstructive psychotherapy (DDP) are listed in the National Registry of Evidence-Based Programs and Practices based on their performances in randomized controlled trials. However, little is known about their effectiveness in real-world settings. In the present study, the authors observed the naturalistic outcomes of 68 clients with borderline personality disorder (BPD) who were treated at a medical university clinic by experienced therapists using either comprehensive DBT (n = 25) or DDP (n = 27), with 16 clients treated with unstructured psychotherapy serving as a control...
2016: American Journal of Psychotherapy
Joshua N Hook, C Edward Watkins, Don E Davis, Jesse Owen, Daryl R Van Tongeren, Marciana J Ramos
As a core component of multicultural orientation, cultural humility can be considered an important attitude for clinical supervisees to adopt and practically implement. How can cultural humility be most meaningfully incorporated in supervision? In what ways can supervisors stimulate the development of a culturally humble attitude in our supervisees? We consider those questions in this paper and present a model for addressing cultural humility in clinical supervision. The primary focus is given to two areas: (a) modeling and teaching of cultural humility through interpersonal interactions in supervision, and (b) teaching cultural humility through outside activities and experiences...
2016: American Journal of Psychotherapy
Sara J Tai
This paper provides a basic introduction to using method of levels (MOL) therapy with people experiencing psychosis. As MOL is a direct application of perceptual control theory (PCT), a brief overview of the three main theoretical principles of this theory--control, conflict, and reorganization will be outlined in relation to understanding psychosis. In particular, how these principles form the basis of problem conceptualisation and determine what an MOL therapist is required to do during therapy will be illustrated...
2016: American Journal of Psychotherapy
David Kimhy
Olfactory hallucinations (OH) are experienced by a substantial minority of people with schizophrenia, often leading to social anxiety, depression and suffering. Yet, despite their prevalence and clinical significance, OH in schizophrenia are under-researched and poorly understood, with scarce information about potential treatments. To address this gap in the literature, the author describes a case report of successfully using Cognitive-Behavioral Therapy for psychosis (CBTp) to address OH, related delusions, as well as mood and social functioning difficulties in a male patient with schizophrenia...
2016: American Journal of Psychotherapy
Alfred Margulies
Lost and falling, the feeling that life is disorienting: none of us escapes the experience. For those clinicians who venture on to inpatient wards, lost-ness takes on a special urgency. But what does it mean to "find" another? Surely feeling lost is at the heart of our existential search for grounding. And so how does one find oneself? And why is another so important in this self-search? This paper explores two brief encounters on an inpatient ward where the lost-ness of psychosis and despair cover the shock of unbearable feelings...
2016: American Journal of Psychotherapy
Danielle Knafo
I describe the analytic treatment of Mr. C, a highly intelligent man who began therapy claiming to have schizophrenia. He entered treatment on the verge of suicide, convinced of his utter isolation, and gradually, he confronted his lifelong paranoia, and learned to trust his analyst and the therapeutic process. Among his embodied realizations was the remarkable insight that paranoia kept him anchored to the world, attached to others, and thus, offset schizophrenic detachment. Paranoia also helped him maintain an optimal distance from others who could hurt him or discover his "true nature...
2016: American Journal of Psychotherapy
Andrew C Lotterman
The paper describes how standard psychotherapy techniques need to be modified to suit the specialized needs of patients diagnosed with schizophrenia. Patients with psychosis often have lost their ability to use words to describe their inner states. As a result, traditional forms of psychotherapy which depend so crucially on the use of language are compromised. The goal of treatment at the start is to help the patient recover his ability to use language to describe his inner life. Eventually, this enables the patient to make use of more traditional forms of psychodynamic treatment...
2016: American Journal of Psychotherapy
Michael Garrett
Psychotherapy has gained wide acceptance as a primary treatment for nonpsychotic psychological disorders but has yet to find the same acceptance in the treatment of psychosis. One reason for this is the idea that schizophrenia is a genetically determined brain disease unlikely to respond to psychological treatments. A second reason is the difficulty most people have in relating the symptoms of psychosis such as hallucinations and delusions to their own mental processes. This paper relates the manifestations of psychosis to ordinary mental life, and describes how psychotic symptoms arise as meaningful expressions of unbearable psychological pain in the aftermath of adverse life events...
2016: American Journal of Psychotherapy
Eleanor Longden, John Read
Despite increasing evidence for the role of psychosocial factors in the onset and continuance of psychosis, the experiences involved are still largely considered the result of a biogenetic anomaly for which medication is the first-line treatment response. This review summarizes the extensive literature demonstrating that adverse events involving trauma, loss, stress, and disempowerment have a central etiological role in psychosis. Evidence is further presented to show that many neurological changes traditionally considered indicative of a disease process can in fact be accounted for as secondary effects to the physiology of stress or the residual of long-term neuroleptic prescription...
2016: American Journal of Psychotherapy
Michael Garrett
Beginning with Paul Federn--a contemporary of Sigmund Freud--every generation of psychotherapists for the past hundred years has included a small number of determined clinicians who have worked psychotherapeutically with psychotic patients, and written about their work. This special issue of the American Journal of Psychotherapy contains seven papers by clinicians in this generation who are using psychotherapy in the treatment of psychosis.
2016: American Journal of Psychotherapy
Catherine Hickey
Davanloo's Intensive Short-term Dynamic Psychotherapy has been the subject of various reviews. The first article in this series focused on a review of Davanloo's early work as well as a discussion of some of his most recent research findings. A case from the Montreal closed circuit training program was reviewed. This second article will focus on Davanloo's views on the transference neurosis and how its development should be avoided at all costs. There will be further exploration of the case presented in Part I from the Montreal closed circuit training program...
2015: American Journal of Psychotherapy
Catherine Hickey
Davanloo's Intensive Short-term Dynamic Psychotherapy has been the subject of various reviews. Davanloo has published extensively on his early work, but there have been no publications on his most recent work-most notably his Montreal Closed-circuit training program. This program focuses on his most recent discoveries and techniques and is a unique, videotaped supervisory program. It focuses on self-assessment and peer-assessment. It is also a unique format in which to review Davanloo's theoretical conceptions of resistance and the transference component of the resistance...
2015: American Journal of Psychotherapy
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