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Matthew J Cohen, Crystal E Schiller
Between 10% and 20% of women will experience depression in the perinatal period, which begins during pregnancy and extends into the first year after delivery. Perinatal depression (PD) is associated with significant emotional and social impairments that impact women, their children, and their partners. Although the majority of women with PD do not seek treatment, a considerable proportion of those who engage in treatment do not achieve remission. The couples and depression literature suggests that interpersonal processes are central in the development and maintenance of depressive disorders and thus, as researchers seek safe and effective treatments for perinatal populations, there may be therapeutic benefit in examining the role that partners play in women's recovery...
December 2017: Psychotherapy
Amy Wenzel
Cognitive-behavioral therapy (CBT) is a system of psychotherapy in which an individualized case formulation drives the strategic delivery of therapeutic interventions that target cognition, emotion, behavior, and the therapeutic relationship. It has the potential to be effective for women who have experienced pregnancy loss, as pregnancy loss often carries profound meaning that disrupts many layers of a woman's belief system, and the associated emotional consequences cannot always be managed using their typical repertoire of coping skills...
December 2017: Psychotherapy
Irving G Leon
Pregnancy termination for fetal anomaly is a unique reproductive loss with many issues distinct from spontaneous pregnancy loss, as typically addressed in the current literature. After providing a brief overview of this loss and the impact of stigma, some of the therapeutic tasks particular to this loss will be identified, including absorbing the impact of learning about the anomaly, defining what or who has been lost, deciding whether to continue or terminate the pregnancy, and deciding who to tell what. These therapeutic tasks are discussed using the available research literature, but primarily illustrated through clinical vignettes and therapist-client dialogue...
December 2017: Psychotherapy
Joann M O'Leary, Lindsey Henke
Pregnancy following the loss of a baby is a complex journey that often requires supportive intervention to support attachment to a baby that follows. This article offers guidance in supporting parents during their pregnancy that follows a perinatal loss. Content is based on using the continued bond/attachment theories in a therapeutic educational group setting and in individual therapy sessions in clinical practice. Practical guidelines in working with parents to support their parenting relationship with a deceased baby while risking attachment to a new unborn baby are offered...
December 2017: Psychotherapy
Janet Jaffe
The reproductive story offers a unique way to conceptualize pregnancy loss and infertility. This article describes the development of the reproductive story from early childhood on, and focuses on the devastating losses when the story does not unfold as originally hoped. Regardless of the type of reproductive trauma that clients experience, the underlying psychological constructs of grief are the same. The goal is to help clients work through their grief and loss, accept that their story can be edited and rewritten, and come away with a positive new ending...
December 2017: Psychotherapy
Rayna D Markin
This introduction article to the special section on psychotherapy for pregnancy loss reviews important societal and psychological issues, key clinical processes and recommendations, and future research directions. Differences and similarities among the articles in the special section are discussed along with each article's contribution to the higher order goal of viewing pregnancy loss through a psychological rather than solely medical lens. Each article in this section reviews different therapeutic modalities, interventions, and key clinical process issues when working with patients who have suffered the loss of a pregnancy...
December 2017: Psychotherapy
Ladislav Timulak, James McElvaney, Daragh Keogh, Elaine Martin, Peter Clare, Elena Chepukova, Leslie S Greenberg
Among psychological therapies for generalized anxiety disorder (GAD), cognitive-behavioral therapy has a dominant position as the most studied therapy. However, some researchers have recommended that to increase treatment options and broaden choice for clients, non-cognitive-behavioral therapy models for GAD should be examined. The present study was an exploratory study, assessing pre-post outcomes and 6-month follow-up of emotion-focused therapy for GAD, supplemented by qualitative posttherapy client accounts of helpful and unhelpful aspects of therapy and changes reported since therapy started...
December 2017: Psychotherapy
Robert Johansson, Thomas Hesslow, Brjánn Ljótsson, Angelica Jansson, Lina Jonsson, Smilla Färdig, Josefine Karlsson, Hugo Hesser, Ronald J Frederick, Peter Lilliengren, Per Carlbring, Gerhard Andersson
Social anxiety disorder (SAD) is associated with considerable individual suffering and societal costs. Although there is ample evidence for the efficacy of cognitive behavior therapy, recent studies suggest psychodynamic therapy may also be effective in treating SAD. Furthermore, Internet-based psychodynamic therapy (IPDT) has shown promising results for addressing mixed depression and anxiety disorders. However, no study has yet investigated the effects of IPDT specifically for SAD. This paper describes a randomized controlled trial testing the efficacy of a 10-week, affect-focused IPDT protocol for SAD, compared with a wait-list control group...
December 2017: Psychotherapy
Bernhard Strauss, Susan Koranyi, Uwe Altmann, Tobias Nolte, Manfred E Beutel, Jörg Wiltink, Stephan Herpertz, Wolfgang Hiller, Jürgen Hoyer, Peter Joraschky, Björn Nolting, Ulrich Stangier, Ulrike Willutzki, Simone Salzer, Erik Leibing, Falk Leichsenring, Helmut Kirchmann
This study investigated whether partner-related attachment characteristics differentially predict premature treatment termination as well as posttreatment and 1-year follow-up outcome in patients with social anxiety disorder treated with a manualized cognitive-behavioral therapy (CBT) or short-term psychodynamic therapy (PDT) in the SOPHO-NET (Social Phobia Psychotherapy Network) trial. Participants were 412 patients with social anxiety disorder (57% female) with a mean age of 35.4 years (SD = 12.1) who were randomized to either CBT or PDT...
December 2017: Psychotherapy
Noah E Yulish, Simon B Goldberg, Nickolas D Frost, Maleeha Abbas, Nick A Oleen-Junk, Molly Kring, Mun Yuk Chin, Christopher R Raines, Christina S Soma, Bruce E Wampold
One explanation for differences in treatment effectiveness for targeted symptoms is that more-effective treatments are more focused on patients' problems than are less-effective treatments. This conjecture was examined meta-analytically. Comparisons of two treatments of adults with anxiety disorders were included. Effect sizes for targeted symptoms, nontargeted symptoms, and global outcomes (e.g., quality of life and well-being) as well as the relative focus on patients' problems and researcher allegiance were coded...
December 2017: Psychotherapy
David J Diamond, Martha O Diamond
Parenting after pregnancy loss is often complicated for people who have not effectively grieved the loss and worked through the trauma. Reproductive losses can trigger shame and self-doubt, damage the sense of self-as-parent, and inflict narcissistic injuries, which, in turn, may impede the resolution of grief. If not addressed, these unresolved feelings may be projected onto subsequent children, potentially disrupting attachment relationships and the child's sense of self. The reproductive story, a lifelong internal narrative that comprises the thoughts, feelings, and hopes about how parenting and adulthood will unfold, and forms the core of parental identity, can be used as a tool in helping parents understand the depth of their feelings, integrate current and past losses into the self, and resolve grief...
October 2, 2017: Psychotherapy
Andrés E Pérez-Rojas, Beatriz Palma, Avantika Bhatia, John Jackson, Earta Norwood, Jeffrey A Hayes, Charles J Gelso
Countertransference is an important aspect of the therapeutic relationship that exists in therapies of all theoretical orientations, and depending on how it is managed, it can either help or hinder treatment. Management of countertransference has been measured almost exclusively with the Countertransference Factors Inventory (Van Wagoner, Gelso, Hayes, & Diemer, 1991) and its variations, all of which focus on 5 therapist qualities theorized to facilitate management: self-insight, conceptualizing ability, empathy, self-integration, and anxiety management...
September 2017: Psychotherapy
Sarah Knox, Clara E Hill, Graham Knowlton, Harold Chui, Nathan Pruitt, Kevin Tate
Eighteen U.S.-based doctoral students in counseling or clinical psychology were interviewed by phone regarding experiences of crying in therapy. Specifically, they described crying as therapists with their clients, as clients with their therapists, and experiences when their therapists cried in the participants' therapy. Data were analyzed using consensual qualitative research. When crying with their clients, therapists expressed concern about the appropriateness/impact of crying, cried only briefly and because they felt an empathic connection with their clients, thought that the crying strengthened the relationship, discussed the event with their supervisor, and wished they had discussed the event more fully with clients...
September 2017: Psychotherapy
Ravit Steinmann, Inbal Gat, Ofir Nir-Gottlieb, Ben Shahar, Gary M Diamond
Twenty-six clients who received 10 sessions of either attachment-based family therapy (ABFT) or individual emotion-focused therapy (EFT) for unresolved anger toward a parent were interviewed 6 months after completing treatment. Interviews were analyzed using the consensual qualitative research approach. Clients in both conditions reported improved relationships with parents, gaining a new perspective of their parent, increased compassion toward parent, less reactivity to anger, feeling cleaned-out, and acquiring new coping strategies...
September 2017: Psychotherapy
Keith C Russell, Harold L Lee Gillis, Dennis M Kivlighan
The development and factor analysis of the Adventure Therapy Experience Scale (ATES) is the first attempt found in the literature to empirically and quantitatively identify therapeutic factors theorized to affect change in the adventure therapy experience (Russell & Gillis, 2017). This study utilizes the ATES to explore how its inherent factors may impact treatment outcome utilizing a routine outcome monitoring process to empirically test how these factors may contribute to treatment outcome over time. The sample of 168 males 21...
September 2017: Psychotherapy
Frank E Yeomans, Jill C Delaney, Kenneth N Levy
Transference-focused psychotherapy (TFP) is a manualized evidence-based treatment for borderline and other severe personality disorders that is based on psychoanalytic object relations theory. Similar to other psychodynamic psychotherapies, TFP focuses on changing psychological structures, but also focuses on symptom and behavioral change, particularly the importance of being active (e.g., obtaining a job or involvement in similar activities). In TFP, the establishment of the treatment contract, also known as the treatment frame, is where goals such as work and other activities are agreed upon...
September 2017: Psychotherapy
Keely Gordon-King, Robert D Schweitzer, Giancarlo Dimaggio
Behavioral interventions are proposed as a critical treatment component in psychotherapy for personality disorders. The current study explores behavioral interventions as a mechanism of change in Metacognitive Interpersonal Therapy, an integrative psychotherapy for personality disorders. The goals and implementation of behavioral principles are illustrated through the single case study of Roger, a 57-year-old man diagnosed with avoidant personality disorder and depressive personality disorder. Transcripts of interviews and therapy sessions illustrate the role of behavioral interventions, including behavioral activation, in Roger's treatment...
September 2017: Psychotherapy
James F Boswell, Brittany R Iles, Matthew W Gallagher, Todd J Farchione
Considerable work and attention has supported the use of behavioral activation (BA) strategies in the treatment of depressive disorders. Although not often recognized, BA, both implicitly and explicitly, appears to be conceptually and empirically relevant to the treatment of diverse problem areas, including the anxiety disorders. This article addresses the role of BA strategies in transdiagnostic cognitive-behavioral therapy (CBT) for anxiety and related disorders, including in cases without comorbid depression...
September 2017: Psychotherapy
Todd J Farchione, James F Boswell, Julianne G Wilner
Behavioral activation (BA) is a treatment approach that uses functional analysis and context-dependent strategies to enhance environmental positive reinforcement for adaptive, healthy behavior, and decrease behavioral avoidance. BA has gained considerable support for the treatment of depression and can be broadly applied across a wide range of settings and clinical populations. In this article, we provide a brief description of BA as a therapeutic behavioral strategy for depression and present a clinical case example illustrating the integration of BA with other components of a transdiagnostic cognitive-behavioral treatment for emotional disorders...
September 2017: Psychotherapy
Golan Shahar, Aner Govrin
From the point of view of Cognitive-Existential Psychodynamics (Shahar, 2015a, 2016; Shahar & Schiller, 2016; Ziv-Beiman & Shahar, 2016), active techniques-primarily cognitive-behavioral therapy ones-might not only reduce distress but also bolster the therapeutic relationships and serve as powerful vehicles for self-discovery and growth. This, however, is contingent upon therapists' ability to view, and present to patients, the psychodynamic and existential nature of active techniques. Our focus herein is on behavioral activation, an intervention that consists of encouraging patients to participate in enjoyable and meaningful activities, in the face of depressive anhedonia...
September 2017: Psychotherapy
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