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Affect-Focused and Exposure-Focused Psychotherapies. 以情感为中心的心理疗法和以暴露为中心的心理疗法。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 Epub Date: 2024-01-22 DOI: 10.1176/appi.psychotherapy.20230012
John C Markowitz, Barbara L Milrod
{"title":"Affect-Focused and Exposure-Focused Psychotherapies.","authors":"John C Markowitz, Barbara L Milrod","doi":"10.1176/appi.psychotherapy.20230012","DOIUrl":"10.1176/appi.psychotherapy.20230012","url":null,"abstract":"<p><p>The authors discuss the two broad domains of affect-focused and exposure-focused psychotherapies, defining the characteristics and potential advantages and disadvantages of each. The two domains differ in their theoretical approaches, structures, and techniques. Exposure-focused therapies have come to dominate research and practice, leading to the relative neglect of affect-focused therapies. When the two approaches have been examined in well-conducted clinical trials, they generally appear to be equally beneficial for treating common mood, anxiety, and trauma disorders, although further research may better define differential therapeutics. The authors argue for better training in affect awareness and tolerance across psychotherapies and use a brief case vignette to illustrate several aspects of these different approaches.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513857","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 and Dream Work: Mending Tears in the Fabric of Time. 创伤与梦想工作：修补时间结构中的撕裂。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI: 10.1176/appi.psychotherapy.20230051
Cory K Chen, Nicole Nehrig
{"title":"Trauma and Dream Work: Mending Tears in the Fabric of Time.","authors":"Cory K Chen, Nicole Nehrig","doi":"10.1176/appi.psychotherapy.20230051","DOIUrl":"10.1176/appi.psychotherapy.20230051","url":null,"abstract":"<p><p>Working with dreams in the context of trauma can open unique avenues for healing, in particular for patients who report feelings of numbness or a loss of meaning in their lives. Dream exploration can make facing aspects of trauma and dissociated experience more tolerable than explicitly addressing them at a conscious level. It can also reignite the capacities for reflection and meaning making disrupted by trauma. Dreams also reconnect patients to aspects of their history that can provide context for and meaning to experiences from which they have come to feel emotionally disconnected. Finally, dreams offer a way of regaining the capacity to connect with wishes, hopes, and desires that have become difficult to access because of trauma. In this article, the authors present case examples of patients with trauma and discuss how therapists worked with dream material to unlock new possibilities for these patients' lives.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477695","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
Advancing Research on and Treatment of Dissociative Identity Disorder With People With Lived Experience. 推进对具有亲身经历者的分离性身份识别障碍的研究和治疗。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 Epub Date: 2024-05-07 DOI: 10.1176/appi.psychotherapy.20230024
Matthew A Robinson, Juliann B Purcell, Laura Ward, Sherry Winternitz, Milissa L Kaufman, Kim A Baranowski, Lauren A M Lebois
{"title":"Advancing Research on and Treatment of Dissociative Identity Disorder With People With Lived Experience.","authors":"Matthew A Robinson, Juliann B Purcell, Laura Ward, Sherry Winternitz, Milissa L Kaufman, Kim A Baranowski, Lauren A M Lebois","doi":"10.1176/appi.psychotherapy.20230024","DOIUrl":"10.1176/appi.psychotherapy.20230024","url":null,"abstract":"<p><p>Dissociative identity disorder is a posttraumatic, psychobiological syndrome that develops over time during childhood. Despite empirical evidence supporting the validity of this diagnosis and its relation to trauma, the disorder remains a misunderstood and stigmatized condition. This article highlights expert consensus guidelines and current empirical research on the treatment of dissociative identity disorder. In addition, the authors describe the Lived Experience Advisory Panel (LEAP), which was designed to leverage the expertise of individuals with dissociative identity disorder to combat stigma and improve research, clinical programming, professional education, and public outreach related to the disorder. This article also describes how LEAP members have partnered with other researchers to create new knowledge through participatory action research in order to advance equitable service provision and effect positive change.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867330","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
Affect-Focused Psychotherapies for Posttraumatic Stress Disorder. 针对创伤后应激障碍的情感焦点心理疗法。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 DOI: 10.1176/appi.psychotherapy.20240033
John R Keefe
{"title":"Affect-Focused Psychotherapies for Posttraumatic Stress Disorder.","authors":"John R Keefe","doi":"10.1176/appi.psychotherapy.20240033","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240033","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298479","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 Meta-Analysis of Interpersonal and Psychodynamic Psychotherapies for Posttraumatic Stress Disorder. 针对创伤后应激障碍的人际心理疗法和心理动力学心理疗法的元分析。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 Epub Date: 2024-08-06 DOI: 10.1176/appi.psychotherapy.20230043
John R Keefe, Duncan Kimmel, Erica Weitz
{"title":"A Meta-Analysis of Interpersonal and Psychodynamic Psychotherapies for Posttraumatic Stress Disorder.","authors":"John R Keefe, Duncan Kimmel, Erica Weitz","doi":"10.1176/appi.psychotherapy.20230043","DOIUrl":"10.1176/appi.psychotherapy.20230043","url":null,"abstract":"<p><strong>Objective: </strong>Established trauma-focused cognitive-behavioral therapies for posttraumatic stress disorder (PTSD) have remission rates of approximately 30%-40%. Alternatively, interpersonal psychotherapy (IPT) and psychodynamic psychotherapy (PDT) focus on disrupted attachment, mentalization, and social connection in PTSD and may help some patients. The authors conducted a meta-analysis on these interpersonal and affect-oriented approaches to treating PTSD.</p><p><strong>Methods: </strong>Building on a prior meta-analysis, the authors searched for randomized controlled trials (RCTs) comparing IPT or PDT with other established PTSD treatments or control conditions for adults diagnosed as having PTSD. Random-effects meta-analyses were conducted to assess outcome effect sizes and dropout rates. RCTs were rated via the Randomized Controlled Trial Psychotherapy Quality Rating Scale.</p><p><strong>Results: </strong>Ten RCTs (eight of IPT) comparing IPT or PDT with control (k=7) or active treatment (k=4) conditions were identified, nine of which were of adequate quality. IPT (k=5) and PDT (k=2), when analyzed together, were superior to control conditions overall (g=-1.14, p=0.011 [as was IPT alone: g=-0.88, p=0.034]) and to waitlist (g=-1.49) and treatment-as-usual (g=-0.70) groups. Effect sizes, however, may have been inflated by outliers or publication bias. IPT (k=3) and PDT (k=1), when analyzed together, were equally efficacious compared with other active PTSD treatments (primarily exposure-based psychotherapies), as was IPT alone, and had lower dropout rates (relative risk=0.63, p=0.049 for IPT and PDT analyzed together; relative risk<i>=</i>0.61, p=0.098 for IPT alone).</p><p><strong>Conclusions: </strong>Affect-focused therapies hold promise in the treatment of PTSD. IPT has demonstrated efficacy in multiple trials, whereas the evidence base for PDT is sparse.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894533","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
Clinical Case of Trauma-Focused Psychodynamic Psychotherapy for a Veteran With PTSD and Race-Based Trauma. 为一名患有创伤后应激障碍和种族创伤的退伍军人提供以创伤为重点的心理动力学心理治疗的临床案例。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 DOI: 10.1176/appi.psychotherapy.20230040
Michelle Kehn, Barbara Milrod, Cory K Chen
{"title":"Clinical Case of Trauma-Focused Psychodynamic Psychotherapy for a Veteran With PTSD and Race-Based Trauma.","authors":"Michelle Kehn, Barbara Milrod, Cory K Chen","doi":"10.1176/appi.psychotherapy.20230040","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20230040","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298480","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
Childhood Trauma and Panic Disorder: The Impact of History of Child Abuse on Illness Severity and Treatment Response. 童年创伤与恐慌症：儿童虐待史对疾病严重程度和治疗反应的影响》（The Impact of History of Child Abuse on Illness Severity and Treatment Response.
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 Epub Date: 2024-08-06 DOI: 10.1176/appi.psychotherapy.20230060
Sarah J Kay, John R Keefe, Barbara L Milrod, Jacques P Barber
{"title":"Childhood Trauma and Panic Disorder: The Impact of History of Child Abuse on Illness Severity and Treatment Response.","authors":"Sarah J Kay, John R Keefe, Barbara L Milrod, Jacques P Barber","doi":"10.1176/appi.psychotherapy.20230060","DOIUrl":"10.1176/appi.psychotherapy.20230060","url":null,"abstract":"<p><strong>Objective: </strong>Patients who have experienced child abuse often have complex clinical presentations; whether a history of child abuse (HCA) affects psychotherapy outcomes is unclear. The authors examined relationships between HCA, clinical baseline variables, and change in these variables after three different psychotherapies for panic disorder (PD).</p><p><strong>Methods: </strong>Two hundred adults with PD (with or without agoraphobia) were randomly assigned to one of three treatments across two sites: panic-focused psychodynamic psychotherapy (PFPP), cognitive-behavioral therapy (CBT), or applied relaxation training (ART). Differences in demographic and clinical variables between those with and without HCA were compared. The primary analysis addressed odds of meeting clinical response criteria on the Panic Disorder Severity Scale (PDSS) between treatments, as moderated by HCA. This effect was examined via continuous outcomes on the PDSS and psychosocial functioning (Sheehan Disability Scale).</p><p><strong>Results: </strong>Compared with patients without HCA (N=154), patients with HCA (N=46) experienced significantly more severe symptoms of PD (d=0.60), agoraphobia (d=0.47), and comorbid depression (d=0.46); significantly worse psychosocial impairment (d=0.63) and anxiety sensitivity (d=0.75); greater personality disorder burden (d=0.45)-particularly with cluster C disorders (d=0.47)-and more severe interpersonal problems (d=0.54). HCA significantly moderated the likelihood of clinical response, predicting nonresponse to ART (B=-2.05, 95% CI=-4.17 to -0.30, OR=0.13, z=-2.14, p=0.032) but not CBT or PFPP. HCA did not interact with treatment condition to predict slopes of PDSS change.</p><p><strong>Conclusions: </strong>The results of this study highlight the importance of HCA in formulating treatment recommendations. Increased awareness of HCA's effects on severity of PD and treatment responsiveness among patients with PD may improve outcomes.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894534","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
Compassion-Focused Therapy for the Treatment of ICD-11-Defined Complex Posttraumatic Stress Disorder. 治疗 ICD-11 定义的复杂创伤后应激障碍的同情疗法。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-09-01 Epub Date: 2024-04-29 DOI: 10.1176/appi.psychotherapy.20230019
Michaela B Swee, Allison G Corman, Jessica M Margolis, Alexandra M Dick
{"title":"Compassion-Focused Therapy for the Treatment of <i>ICD-11</i>-Defined Complex Posttraumatic Stress Disorder.","authors":"Michaela B Swee, Allison G Corman, Jessica M Margolis, Alexandra M Dick","doi":"10.1176/appi.psychotherapy.20230019","DOIUrl":"10.1176/appi.psychotherapy.20230019","url":null,"abstract":"<p><p>The most effective treatments for <i>ICD-11</i>-defined complex posttraumatic stress disorder (CPTSD) remain unknown. Further research is needed to determine whether such treatments for CPTSD are the same as or different from-or require integration with-existing gold standard treatments for posttraumatic stress disorder (PTSD). Individuals with CPTSD experience the hallmark symptoms of PTSD (i.e., reexperiencing symptoms, avoidance symptoms, and the pervasive sense of perceived threat) and pervasive disturbances in self-organization, including affective dysregulation, negative self-concept, and difficulties with interpersonal relationships. Compassion-focused therapy (CFT) is a transdiagnostic approach that was originally developed to treat shame and self-criticism. CFT helps individuals learn how to regulate their emotions, shift their emotional response style from shaming and self-critical to wise and understanding, and engage in more compassionate and rewarding patterns of relating to self and others. This article describes CFT's possible application in the treatment of CPTSD and delineates areas for future research.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853135","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
Tailoring Interpersonal Psychotherapy for Gender-Expansive Journeys. 为充满性别挑战的旅程量身定制人际心理疗法。
IF 2.3
AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2024-08-30 DOI: 10.1176/appi.psychotherapy.20230055
Shaina Siber-Sanderowitz, Anne R Limowski
{"title":"Tailoring Interpersonal Psychotherapy for Gender-Expansive Journeys.","authors":"Shaina Siber-Sanderowitz, Anne R Limowski","doi":"10.1176/appi.psychotherapy.20230055","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20230055","url":null,"abstract":"<p><p>This article introduces an innovative adaptation of interpersonal psychotherapy tailored to the needs of individuals identifying as gender diverse and navigating the complexities of gender transition. The few available therapeutic models designed for this population are reviewed, and the novel intervention, grounded in clinical insights and empirical research, is presented. Key components of this adaptation include expanding the interpersonal inventory with targeted processing questions and developing a disclosure timeline-a structured tool designed to guide patients through gender transition-while bolstering social support, reducing distress, and improving interpersonal effectiveness. An illustrative case vignette is included to elucidate the practical applications of this approach and to underscore essential therapeutic considerations.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113258","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 : 2024-08-30 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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-30","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
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