Adaptational psychodynamics

BACKGROUND: Given increasing mental health needs in the VA, identifying strategies to deliver new services is critical. AIMS: This paper describes the process of navigating provider, patient and systems barriers of an initiative to increase choice, access and quality of psychotherapy at the VA by incorporating an evidence-based short-term, psychodynamic psychotherapy. METHODS: Brief Dynamic Interpersonal Therapy (DIT) was selected as a viable model for implementation...

Since the adoption of the Swiss psychiatrist and psychotherapist double title in 1961, the medical training in psychotherapy must obey specific requirements. In parallel to the clinical practice, the supervisions and the personal experience, 180 hours of theoretical training are required, in each of the psychotherapeutic orientations chosen by the medical doctor (psychodynamic, family / systemic and behavioural and cognitive therapies). Even though the effectiveness of these treatments is well established and there is no significant difference between psychotherapeutic schools in this respect, the choice of an orientation for psychotherapy training requires an adequate pedagogic process, both on the theoretical side, and in the ability to choose a suitable form of psychotherapeutic treatment adapted to the psychiatrist's conversational style...

Insecure and unresolved/disorganized attachment states of mind may impact affect regulation and interpersonal functioning that contribute to binge eating in women with binge-eating disorder (BED). Group psychological treatment may facilitate changes from insecure to secure and from unresolved-disorganized to non-unresolved/disorganized attachment states of mind. This study used attachment theory to understand better the psychopathology of BED and co-morbid overweight status and to understand better the treatment response of patients with BED who receive group psychotherapy...

The present research deals with the clinical and social problems present during linguistic and cognitive development of deaf children. Currently, the development of Theory of Mind represents an important research field in deafness studies. These international studies highlighted a significant alteration in the development of Theory of Mind in deaf children compared to normal hearing children, especially in cases of congenital or preverbal hearing loss. In particular, the research focuses on the skills of deaf children in recognising emotions and desires, through both perceptive and cognitive methods, by evaluation of psycho-cognitive skills of children with severe hearing loss using a set of questions to be administered to hearing loss patients...

This article demonstrates the utility of a theory-guided psychodynamic approach to the assessment of personality and personality pathology based on the object relations model developed by Kernberg (1984). We describe a clinical interview, the Structural Interview (SI; Kernberg, 1984), and also a semistructured approach, the Structured Interview of Personality Organization (STIPO; Clarkin, Caligor, Stern, & Kernberg, 2004) based on this theoretical model. Both interviews focus on the assessment of consolidated identity versus identity disturbance, the use of adaptive versus lower level defensive operations, and intact versus loss of reality testing...

Considerable overlap in symptoms between patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) complicates personality diagnostics. Yet very little is known about the level of psychodynamic functioning of both personality disorders. Psychodynamic assessment procedures may specify personality characteristics relevant for differential diagnosis and treatment planning. In this cross-sectional study we explored the differences and similarities in level of personality functioning and psychodynamic features of patients with severe BPD or STPD...

The medical care of refugees and asylum seekers requires culturally sensitive and diverse structuring of the healthcare. In the psychotherapeutic and psychosomatic treatment of these patients the culture-specific and social aspects and also the high ratio of patients with post traumatic stress disorders and somatoform disorders have to be considered. The principles of stabilizing psychodynamic traumatherapie of refugees will be introduced, which efficacy was determined by controlled study. The specific adaptations of the trauma-orientated psychotherapy to the specific situation of refugees and asylum seekers will be described...

Introduction: The Rating Scale for Countertransference (RSCT) - originally, Escala para Avaliação de Contratransferência (EACT) - is a self-administered instrument comprising questions that assess 23 feelings (divided into three blocs, closeness, distance, and indifference) that access conscious countertransferential emotions and sentiments. This paper describes the process of translation and cross-cultural adaptation of the RSCT into American English. Methods: This study employed the guidelines proposed by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force for Translation and Cultural Adaptation which define 10 steps for translation and cross-cultural adaptation of self-report instruments...

This investigation's goal was to assess the concurrent validity of the four scales of the Anaclitic and Introjective Depression Assessment (AIDA), a newly developed clinician-rated measure, and the Inventory of Interpersonal Problems Circumplex Scales (IIP-64). The AIDA is composed of Shedler-Westen Assessment Procedure items and is comprised of two primitive and two more mature scales of introjective and anaclitic personality types. Specific predictions of relationships were made and are discussed further in this paper...

Suspicious thinking in given situations can be useful and helps the adaptation as events occurring in the world also corroborate this. Factors participating in the development of paranoia can be listed as psychodynamic (projection), salience attributional, neurobiological (dopamine), impaired perceptual (hearing loss), sociocultural (minority, pseudocommunity), self-esteem (worrying, depression, mania), and cognitive (jump-to-conclusion) mechanisms. Along the spectrum of thinking, from the mild to the severe, enhanced worrying, salience attribution, overvalued concepts, suspicion/mistrust, paranoid ideations, and crystallized delusions may occur with different contents...

The Wechsler intelligence tests (currently Wechsler, 2008 , 2014) have traditionally been part of the multimethod test battery favored by psychodynamically oriented assessors. In this tradition, assessors have used Wechsler data to make inferences about personality that transcend cognition. Recent trends in clinical psychology, however, have deemphasized this psychodynamic way of working. In this article, I make a conceptual and clinical case for reviving and refining a psychodynamic approach to inference making about personality using the Wechsler Verbal Comprehension subtests...

Aim: Even though there is substantial evidence that play based therapies produce significant change, the specific play processes in treatment remain unexamined. For that purpose, processes of change in long-term psychodynamic play therapy are assessed through a repeated systematic assessment of three children's "play profiles," which reflect patterns of organization among play variables that contribute to play activity in therapy, indicative of the children's coping strategies, and an expression of their internal world...

Suggestion in hypnosis has been applied to the treatment of functional neurologic symptoms since the earliest descriptions of hypnosis in the 19th century. Suggestion in this sense refers to an intentional communication of beliefs or ideas, whether verbally or nonverbally, to produce subjectively convincing changes in experience and behavior. The recognition of suggestion as a psychologic process with therapeutic applications was closely linked to the derivation of hypnosis from earlier healing practices. Animal magnetism, the immediate precursor of hypnosis, arrived at a psychologic concept of suggestion along with other ideas and practices which were then incorporated into hypnosis...

Objective: To describe the defense strategies used by nurses working in long-stay institutions for the elderly when faced with work environment distress. Methodology: Descriptive, exploratory and qualitative research performed through interviews held with 27 nurses at long-stay institutions for the elderly between April and September 2013. Data analysis was performed through content analysis and the theory known as work psychodynamics. Results: The strategies used were: considering death as something natural, understanding death of those in critical condition as the end to a sufferable condition, understanding the patient's resistance as a symptom of disease and senility, limit the reach of work problems in their personal life, and restrict the affective involvement with patients...

INTRODUCTION: Defense mechanisms have been seen to greatly change over time and across different definitions made by different theoretical currents. Recently with the definition provided by the DSM IV, defense mechanisms have integrated the concept of coping as a defensive factor. These mechanisms are no longer considered just through a psychodynamic approach but also through a cognitive and behavioral one. In recent years, new theories have therefore integrated these two components of the defensive operation...

This study explores the effectiveness of psychodynamic psychotherapy in improving facets of object relations (OR) functioning over the course of treatment. The sample consisted of 75 outpatients engaged in short-term dynamic psychotherapy at a university-based psychological services clinic. Facets of OR functioning were assessed at pre- and posttreatment by independent raters using the Social Cognition and Object Relations Scale-Global rating method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011 ; Westen, 1995 ) from in-session patient relational narratives...

This study explores whether object relations (OR) functioning improves over the course of psychodynamic psychotherapy, and whether this improvement is related to symptom decrease as well as therapist technique. The sample consisted of 75 outpatients engaged in short-term psychodynamic psychotherapy at a university-based psychological service clinic. OR functioning was assessed pre- and post-treatment by independent raters using the Social Cognition and Object Relations Scale from in-session patient relational narratives...

Although anxiety disorders on the surface may appear simple, they often represent complex problems that are compounded by underlying factors. For these reasons, treatment of anxiety disorders should be individualized. This article describes cognitive hypnotherapy, an individual comprehensive treatment protocol that integrates cognitive, behavioral, mindfulness, psychodynamic, and hypnotic strategies in the management of anxiety disorders. The treatment approach is based on the self-wounds model of anxiety disorders, which provides the rationale for integrating diverse strategies in the psychotherapy for anxiety disorders...

A systematic case study approach was taken to explore the impact of client and therapist relational patterns on the development of the therapeutic alliance and symptom reduction in two cases of psychodynamic psychotherapy treated by the same therapist. The cases were selected from a larger sample and represent two distinct trajectories of alliance development: improvement versus deterioration. The comparison was based on participants' ongoing narratives about each other and about significant others, using the Relationship Anecdote Paradigm (RAP) interview...

BACKGROUND: Autonomic imbalance establishes an important model to understand organically unexplained physical complaints. Our study aimed to investigate whether the functioning of the autonomous nervous system corresponds with somatoform symptoms and predicts the outcome of brief psychotherapy in these patients. METHOD: As a part of multicenter study assessing effects of brief psychodynamic interpersonal therapy on multisomatoform disorder (PISO-study), 106 patients participated in a stress experiment investigating autonomic reactivity during application of the Stroop-test...