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Problem-Oriented Integrative Therapy: Maximizing Clinical Flexibility in Treating Complex Psychiatric Conditions. 以问题为导向的综合疗法：以问题为导向的综合疗法：最大限度地提高治疗复杂精神疾病的临床灵活性》。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-10-15 DOI: 10.1176/appi.psychotherapy.20240010
Joel Yager, Jerald Kay
{"title":"Problem-Oriented Integrative Therapy: Maximizing Clinical Flexibility in Treating Complex Psychiatric Conditions.","authors":"Joel Yager, Jerald Kay","doi":"10.1176/appi.psychotherapy.20240010","DOIUrl":"10.1176/appi.psychotherapy.20240010","url":null,"abstract":"<p><p>Although integrative therapies are increasingly popular in clinical psychology, their dissemination in the psychiatric literature has been limited. To care for patients living with complex psychiatric problems, the authors formulated a flexible, pragmatic, problem-oriented integrative therapy (PIT). The aims of this article are to increase psychiatric attention to the value of integrative therapies, authorize their use, and present the authors' PIT approach. PIT combines common factors, theoretical synthesis, and technical eclecticism. After delineating patients' problems and goals, clinicians apply discrete therapeutic elements derived by unbundling numerous theories and practices. Clinicians improvise and pivot their practice in response to patients' shifting problems and goals, as well as to advances in the field. Practicing PIT requires familiarity with numerous therapeutic theories and models and a willingness to continually expand skill sets. PIT's effectiveness may be assessed by comparing results obtained with PIT with those obtained via conventional psychotherapeutic modalities.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"200-206"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Guarding the Guidelines: Objectivity in Treatment Recommendations. 守护准则：治疗建议的客观性。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-11-06 DOI: 10.1176/appi.psychotherapy.20240009
John C Markowitz, Ari M Lowell
{"title":"Guarding the Guidelines: Objectivity in Treatment Recommendations.","authors":"John C Markowitz, Ari M Lowell","doi":"10.1176/appi.psychotherapy.20240009","DOIUrl":"10.1176/appi.psychotherapy.20240009","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"151-153"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implementing a Problem-Oriented Integrative Therapy: Flexible Care for Patients Experiencing Complex Psychiatric Conditions. 实施以问题为导向的综合疗法：为患有复杂精神疾病的患者提供灵活的护理。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-10-15 DOI: 10.1176/appi.psychotherapy.20240011
Joel Yager, Jerald Kay
{"title":"Implementing a Problem-Oriented Integrative Therapy: Flexible Care for Patients Experiencing Complex Psychiatric Conditions.","authors":"Joel Yager, Jerald Kay","doi":"10.1176/appi.psychotherapy.20240011","DOIUrl":"10.1176/appi.psychotherapy.20240011","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"207-211"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patients' Perceptions of Their Therapist: Effects of Race, Culture, and Cultural Competency on the Working Alliance. 患者对治疗师的看法：种族、文化和文化胜任力对工作联盟的影响。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-09-13 DOI: 10.1176/appi.psychotherapy.20230056
Mark R Lukowitsky, Jeffrey S Winseman, Elliot Feld, Steven M Kam, Victoria I Balkoski
{"title":"Patients' Perceptions of Their Therapist: Effects of Race, Culture, and Cultural Competency on the Working Alliance.","authors":"Mark R Lukowitsky, Jeffrey S Winseman, Elliot Feld, Steven M Kam, Victoria I Balkoski","doi":"10.1176/appi.psychotherapy.20230056","DOIUrl":"10.1176/appi.psychotherapy.20230056","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate the extent to which patients feel racially and culturally similar to their therapist, patients' perceptions of their therapist's cultural competence, and how these factors relate to the working alliance in a naturalistic treatment setting.</p><p><strong>Methods: </strong>Participants were 119 adult patients treated at a large outpatient clinic by clinicians with a range of professional backgrounds (e.g., psychiatric residents, psychologists in training, and staff therapists). Patients were asked to rate the level of racial and cultural similarity between themselves and their therapist and to provide their assessment of their therapist's cultural competency and of the working alliance.</p><p><strong>Results: </strong>Findings suggest that patients' ratings of perceived cultural and racial similarity were not significantly related to the working alliance. However, perceptions of racial and cultural similarity were significantly associated with perceived therapist cultural competence. Perceived cultural competence was also strongly related to the working alliance. Finally, patients' ratings of their therapist's cultural competencies in the areas of awareness and skill, but not knowledge, predicted a strong working alliance after analyses controlled for ratings of racial and cultural similarity.</p><p><strong>Conclusions: </strong>This study suggests the importance of heightening mental health clinicians' awareness of the influence of culture on the therapeutic relationship and the important role of a therapist's cultural competencies (specifically, awareness and skill) in the working alliance, which may matter more to patients than perceptions of racial or cultural similarity.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"154-159"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Novel Approach to Examining Working Alliance Instability During Psychotherapy for Borderline Personality Disorder. 在对边缘型人格障碍进行心理治疗的过程中，研究工作联盟不稳定性的新方法。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-10-07 DOI: 10.1176/appi.psychotherapy.20230032
Haruka Notsu, Yogev Kivity, Kenneth N Levy, Stéphane Kolly, Ueli Kramer
{"title":"A Novel Approach to Examining Working Alliance Instability During Psychotherapy for Borderline Personality Disorder.","authors":"Haruka Notsu, Yogev Kivity, Kenneth N Levy, Stéphane Kolly, Ueli Kramer","doi":"10.1176/appi.psychotherapy.20230032","DOIUrl":"10.1176/appi.psychotherapy.20230032","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to quantify the instability of psychotherapy process variables by using a novel data-analytic approach. The study explored instability of the working alliance over 10 treatment sessions and its relationship with self-esteem.</p><p><strong>Methods: </strong>Data were extracted from a randomized controlled trial, conducted in Switzerland, of a short-term intervention for borderline personality disorder. Sixty clients diagnosed as having borderline personality disorder were randomly assigned to receive either 10 sessions of good psychiatric management-brief version (GPM-BV) or GPM-BV combined with a relational principle called motive-oriented therapeutic relationship. Square successive differences were calculated for client and therapist ratings of alliance instability. Multilevel models were used to test within- and between-person associations of alliance instability with self-esteem.</p><p><strong>Results: </strong>Although some preliminary analyses showed an association between a more stable alliance and higher self-esteem at the start of psychotherapy, the alliance did not become more stable over time. Alliance instability was not associated with self-esteem at either the within- or between-person level.</p><p><strong>Conclusions: </strong>This study highlights the advantages, procedures, and challenges of applying square successive differences to psychotherapy research data. The results suggest that the working alliance develops in complex ways and indicate the importance of continuing to use novel methods to capture dynamic psychotherapy processes.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"160-166"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychotherapy Supervision: An Invitational, Clarifying, Educational, Empowering, and Transparent (ICEE-T) Written Agreement. 心理治疗督导：邀请、澄清、教育、赋权和透明（ICEE-T）书面协议。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-08-30 DOI: 10.1176/appi.psychotherapy.20230048
C Edward Watkins, Ioana-Eva Cădariu, Loredana-Ileana Vîşcu, Rima Viliūnienė
{"title":"Psychotherapy Supervision: An Invitational, Clarifying, Educational, Empowering, and Transparent (ICEE-T) Written Agreement.","authors":"C Edward Watkins, Ioana-Eva Cădariu, Loredana-Ileana Vîşcu, Rima Viliūnienė","doi":"10.1176/appi.psychotherapy.20230048","DOIUrl":"10.1176/appi.psychotherapy.20230048","url":null,"abstract":"<p><p>The authors make the case for using a written instead of a spoken supervision agreement at supervision's outset in order to provide clarity and education about supervision, supply an accessible document that supervisees can readily reference, sidestep memory issues that negatively affect the supervision process, and enable dyadic collaboration that sets an immediate positive tone for supervision. The invitational, clarifying, educational, empowering, and transparent (ICEE-T) supervision agreement approach is described, with emphasis on the essential elements to put in place at the outset of supervision. A written agreement, which is valuable at any supervisee developmental stage, can be invaluable when working with novice supervisees (e.g., because of the anxieties and self-doubt of first-time supervisees) and is explored with that group foremost in mind.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"195-199"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Countertransference to Advance Therapeutic Efficacy. 利用反移情疗法提高治疗效果。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-07-02 DOI: 10.1176/appi.psychotherapy.20230035
Jean Vogel
{"title":"Use of Countertransference to Advance Therapeutic Efficacy.","authors":"Jean Vogel","doi":"10.1176/appi.psychotherapy.20230035","DOIUrl":"10.1176/appi.psychotherapy.20230035","url":null,"abstract":"<p><p>Countertransference is a basic tenet of psychodynamic theory. Although it was initially considered an unwelcome phenomenon in psychiatry, attitudes have shifted, and many mental health professionals now consider it to be a useful therapeutic tool. In this article, the author discusses countertransference as defined by the International Psychoanalytical Association's Inter-Regional Encyclopedic Dictionary of Psychoanalysis (IRED) and examines its clinical impact by using constructed vignettes of psychodynamic psychotherapies to illustrate theoretical points. As IRED delineates, countertransferences may exist at the conscious or unconscious level. In addition, the author suggests that countertransference may also exist at the preconscious level. Clinicians' examination of all levels of countertransference has the potential to be revelatory and facilitate therapeutic action, whereas unexamined countertransference can interfere with effective treatment. For this reason, self-reflection on the part of psychiatrists is essential.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"180-184"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Considerations for Psychological Debriefing in the Context of Prolonged Disaster Response. 在长期救灾过程中进行心理汇报的注意事项。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-07-15 DOI: 10.1176/appi.psychotherapy.20230033
Hannah Pressley, Aliza Polkes, Cassondra L Feldman
{"title":"Considerations for Psychological Debriefing in the Context of Prolonged Disaster Response.","authors":"Hannah Pressley, Aliza Polkes, Cassondra L Feldman","doi":"10.1176/appi.psychotherapy.20230033","DOIUrl":"10.1176/appi.psychotherapy.20230033","url":null,"abstract":"<p><p>First responders face greater exposure to potentially traumatic events compared with the general public, which can lead to an increased likelihood of developing mental health concerns. The challenges of disaster relief take a physical and mental toll on first responders. Critical incident stress debriefing (CISD), the widely accepted gold-standard treatment for psychological debriefing, is often applied to offset this toll among first responders. CISD is a manualized seven-stage group intervention that was developed to provide support and aid in coping and to allow individuals who respond to emergencies and disasters to continue working. Substantial evidence has been found for its effectiveness. However, there is a general dearth of evidence about the field of prolonged disaster response, and research is hampered by the difficulties of executing a controlled study in the context of an emergency scenario.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"185-188"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trauma-Focused ACT: A Practitioner's Guide to Working With Mind, Body, and Emotion Using Acceptance and Commitment Therapy. 以创伤为重点的接纳与承诺疗法》（Trauma-Focused ACT：使用接纳与承诺疗法处理心灵、身体和情感的从业者指南》。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-11-06 DOI: 10.1176/appi.psychotherapy.20240018
Brandon Neisewander, Christopher Moreau
{"title":"Trauma-Focused ACT: A Practitioner's Guide to Working With Mind, Body, and Emotion Using Acceptance and Commitment Therapy.","authors":"Brandon Neisewander, Christopher Moreau","doi":"10.1176/appi.psychotherapy.20240018","DOIUrl":"10.1176/appi.psychotherapy.20240018","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"215-216"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Umwelt-A New Strategy for Mentalizing Patient Experience. Umwelt--患者体验心理化的新战略。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-12-12 Epub Date: 2024-08-06 DOI: 10.1176/appi.psychotherapy.20240003
Jonathan Hunter
{"title":"<i>Umwelt</i>-A New Strategy for Mentalizing Patient Experience.","authors":"Jonathan Hunter","doi":"10.1176/appi.psychotherapy.20240003","DOIUrl":"10.1176/appi.psychotherapy.20240003","url":null,"abstract":"<p><p>There is an inevitable limit to understanding the internal experience of patients with whom therapists work in psychotherapy. The farther their experience is from that of their therapist, the more challenging this endeavor can be. Accepting that therapists cannot exactly know a patient's internal experience invites them to explore novel ways of appreciating another person's way of perceiving relationships, deriving meaning from them, and using their experience to motivate behavior. The concept of <i>umwelt</i> can be used as a metaphor to help therapists imagine the internal world of their patients, as shaped by patients' developmental, interpersonal, and traumatic experiences. <i>Umwelt</i> refers to the unique worldview created by a species' idiosyncratic perceptual organs and survival strategies. This first Psychotherapy Musings describes the concept of <i>umwelt</i>, applies it to the case of a patient with difficult-to-treat mental health problems, and explicates the benefit of this novel perspective.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"212-214"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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