AMERICAN JOURNAL OF PSYCHOTHERAPY最新文献

{"title":"Clinical Pearls: Good Psychiatric Management for Borderline Personality Disorder and Transference-Focused Psychotherapy.","authors":"Teresa D Carreno, Richard G Hersh, Kenneth N Levy","doi":"10.1176/appi.psychotherapy.20230052","DOIUrl":"10.1176/appi.psychotherapy.20230052","url":null,"abstract":"<p><p>Good psychiatric management (GPM) for borderline personality disorder is a generalist strategic case management approach used by helping professionals of different training backgrounds to work with patients with borderline personality disorder. GPM includes a flexibly administered once-weekly psychotherapy for which a brief introductory course in GPM alone is considered sufficient preparation. GPM integrates concepts from specialized evidence-based treatments for borderline personality disorder, including transference-focused psychotherapy (TFP). This article describes the TFP elements that John Gunderson acknowledged as influential to his development of GPM. A basic introduction to TFP is provided, and elements in GPM that interweave with TFP's theoretical foundation are elucidated and then illustrated in a clinical vignette that captures the GPM clinician's interventions influenced by these ideas. The vignette is then used to illustrate clinical tools informed by TFP principles and common to both GPM and TFP.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"70-75"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773462","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}

{"title":"On Common Things That Join Us: Good Psychiatric Management.","authors":"Lois W Choi-Kain","doi":"10.1176/appi.psychotherapy.20240072","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240072","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":"78 1","pages":"1-3"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634899","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}

{"title":"Revisiting Cultural Humility in Psychotherapy Supervision: A Descriptive Status Report.","authors":"C Edward Watkins, Joshua N Hook, Hansong Zhang, Melanie M Wilcox, Stephanie Winkeljohn Black, Cirleen DeBlaere, Don E Davis, Jesse Owen","doi":"10.1176/appi.psychotherapy.20240008","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240008","url":null,"abstract":"<p><strong>Objective: </strong>The first substantive article to address cultural humility in psychotherapy supervision appeared in a 2016 issue of this journal. The aim of this review is to update that 2016 article, providing a conceptual-practical and empirical status report about cultural humility's increasing integration into psychotherapy supervision.</p><p><strong>Methods: </strong>A hybrid database-snowballing search process was used. Database searches were conducted by using PubMed and PsycInfo with the words \"cultural humility\" and \"supervision.\" Backward and forward snowballing were also used to identify possible missed articles for inclusion.</p><p><strong>Results: </strong>Twenty-nine articles on cultural humility and supervision, all appearing since the original 2016 article, were identified. Seventeen articles were conceptual-practical, whereas 12 articles were empirical research studies. The conceptual-practical articles provided support for a cultural humility-supervision nexus via proposed models, supervision interventions, and case examples (e.g., demonstrating the facilitation of culturally informed work with minoritized supervisees). The research articles were similarly supportive, providing empirical data that indicated cultural humility's beneficial impact on supervision (e.g., making rupture repair more likely).</p><p><strong>Conclusions: </strong>Since 2016, the host of supervisors who conceptualize about, practice, and research cultural humility in supervision have seemingly converged on one point: cultural humility is a supervision enhancer, contributing to both positive supervision processes and outcomes. It indeed appears that, where supervisor cultural humility goes, so too goes a strengthened supervisory alliance, heightened supervisee satisfaction, and increased supervisee self-disclosure. Based on this status report, the authors contend that supervisors could greatly benefit from learning about cultural humility and incorporating it into their supervisory practice.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240008"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459991","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}

{"title":"The Private Loss of Dr. M.","authors":"Anita Kumar Chang","doi":"10.1176/appi.psychotherapy.20240058","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240058","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240058"},"PeriodicalIF":2.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415821","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}

{"title":"Benefits of Using Intensive Short-Term Dynamic Psychotherapy in Psychiatric Practice.","authors":"Anna Hofner, Jordan Bawks","doi":"10.1176/appi.psychotherapy.20240040","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240040","url":null,"abstract":"<p><p>Psychiatry residency programs in the United States and Canada currently require trainees to demonstrate competency in psychodynamic therapy. Developed by Habib Davanloo, intensive short-term dynamic psychotherapy (ISTDP) is a brief psychodynamic therapy with emerging evidence to support its efficacy as an evidence-based, cost-effective treatment for various common psychiatric disorders and personality pathologies. Davanloo's metapsychology of the unconscious offers a way to understand the psychodynamic processes that maintain patients' psychiatric symptoms. Some key clinical processes unique to ISTDP facilitate conceptualization of patients' problems and allow for effective interventions. ISTDP skills can be especially helpful when working with populations with complex and treatment-resistant conditions that are commonly encountered in psychiatric secondary- and tertiary-care settings. This article aims to examine the value of ISTDP training for psychiatrists. First, the benefits of being able to offer formal treatment with ISTDP are examined. Second, the unique skills acquired through ISTDP training, which can be used in general psychiatric care, are reviewed. Finally, the personal and systemic benefits of ISTDP training, including clinician self-monitoring, management of burnout, and team leadership, are discussed.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240040"},"PeriodicalIF":2.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415820","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}

{"title":"Repairing Cultural Ruptures in Psychotherapy: Strategies to Enhance the Therapeutic Alliance.","authors":"Nicholas Boswell, Ruby Barghini, Seamus Bhatt-Mackin, Aimee Murray, David Topor, Alyson Nakamura, Laurel Pellegrino, Anne E Ruble","doi":"10.1176/appi.psychotherapy.20240045","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240045","url":null,"abstract":"<p><p>Ruptures to the therapeutic alliance are an inevitable part of therapy. The ability to repair these ruptures is an essential therapist skill. Racial, ethnic, and cultural differences between therapists and patients can increase the likelihood of rupture to the therapeutic alliance, potentially leading to unilateral treatment termination by patients. Therapists therefore need skills to work effectively with patients who have diverse, intersectional identities. In this article, the authors give therapists tools to help protect against ruptures and to repair ruptures when they occur by integrating three complementary models: taking a stance of cultural humility to decrease assumptions, identifying and directly broaching cultural topics, and implementing a six-stage cultural repair model. A case example is used to illustrate these tools and techniques in practice. These skills can improve collaboration and decrease the inherent power imbalance in the therapeutic relationship.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"0"},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123625","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}

{"title":"Intensive Short-Term Dynamic Psychotherapy for Complex, Chronic, and Treatment-Resistant Conditions.","authors":"Allan Abbass, Joel Town","doi":"10.1176/appi.psychotherapy.20240024","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240024","url":null,"abstract":"<p><p>Over the past 50 years, intensive short-term dynamic psychotherapy (ISTDP) has been developed, implemented, and evaluated with respect to the treatment of a broad spectrum of complex, chronic, and treatment-resistant conditions. This therapy was developed specifically to treat a range of patients, including those who are highly defensive, those who experience the repression of emotions, and those who have cognitive-perceptual disruptions along with primitive defenses. These three groups of patients are characterized by patterns of attachment trauma and deficits related to neglect. Among the many categories of mental illness with these features that ISTDP can treat, personality disorders, treatment-resistant depression, and somatic symptoms have been the most frequently studied. In this article, the authors provide an overview of the ISTDP treatment method with regard to complex, chronic, and treatment-resistant conditions and summarize evidence for its effectiveness for diverse patient populations. On the basis of the available evidence, ISTDP warrants consideration as a tool for the management of diverse populations who have chronic and complex conditions and have not responded to other treatments.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240024"},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061099","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}

{"title":"Psychodynamic Psychopharmacology and Christianity: Understanding Patients' Relationships With Medications.","authors":"Spencer M Gardner, Breyauna M Spencer","doi":"10.1176/appi.psychotherapy.20240006","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240006","url":null,"abstract":"","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240006"},"PeriodicalIF":2.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014103","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}

{"title":"A Pilot Study for an Interactive Activity Educating First-Year Medical Students on How (Not What) to Prescribe.","authors":"Kaylie O'Connell, David Mintz","doi":"10.1176/appi.psychotherapy.20240004","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240004","url":null,"abstract":"<p><strong>Objective: </strong>Pharmacotherapy outcomes may be influenced as much by psychosocial factors as by medication. Comprehensive discussion of such factors may contribute to better patient outcomes and may counter aspects of a curriculum that prioritizes efficiency and that has the potential to undermine clinician empathy. This pilot study aimed to explore the benefits of teaching psychosocial aspects of prescribing and student acceptance of such teaching.</p><p><strong>Methods: </strong>First-year medical students (N=22) at Quinnipiac University were surveyed after completing an online module explaining psychosocial principles of pharmacology and participating in role-plays.</p><p><strong>Results: </strong>Nineteen participants (86%) strongly agreed that how they prescribe was as important as what they prescribe, and 17 participants (77%) strongly agreed that they would benefit from additional education.</p><p><strong>Conclusions: </strong>An interactive activity can enhance first-year medical students' interest in and knowledge of the impact of integrating psychosocial factors into medical education on treatment adherence.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240004"},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956882","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}

{"title":"Exploring Therapeutic Outcomes Through Dyadic Interactions: The Role of Patient-Avatar Dynamics in Avatar Therapy.","authors":"Alexandre Hudon, Sabrina Quilliam, Kingsada Phraxayavong, Stéphane Potvin, Alexandre Dumais","doi":"10.1176/appi.psychotherapy.20240016","DOIUrl":"https://doi.org/10.1176/appi.psychotherapy.20240016","url":null,"abstract":"<p><strong>Objective: </strong>Despite the efficacy of current therapies, a significant proportion of patients with schizophrenia, a complex mental disorder marked by both positive (present) and negative (absent) symptoms, are considered to have treatment-resistant schizophrenia. Avatar therapy (AT) allows patients to interact with a three-dimensional representation of their most distressing voices in a virtual reality setting. The therapy shows promise in reducing impairments and improving quality of life through the establishment of a therapeutic alliance and the exploration of dyadic interactions (verbal exchanges) between patients and their avatar. The purpose of this study was to investigate differences in dyadic interactions throughout the immersive sessions of AT and to clarify the relationship between these interactions and therapeutic success by analyzing dyads as predictive indicators of positive outcomes in AT.</p><p><strong>Method: </strong>Mean frequencies for the 10 most prevalent dyads identified in previous AT research were reported for 35 patients. A logistic regression model was implemented, and these dyads were used to predict variances in Psychotic Symptom Rating Scales-auditory hallucination scores 1 month after the completion of AT.</p><p><strong>Results: </strong>Variances in mean frequencies were reported for the dyads. A positive relation between the avatar (provocation)-patient (self-affirmation) dyad and the therapeutic outcome was found to be significant (OR=2.29, p=0.049).</p><p><strong>Conclusion: </strong>This research is pioneering in its in-depth examination of therapeutic interactions in AT, with a particular focus on dyadic interactions. Future studies should prioritize the quality rather than quantity of these interactions to more accurately forecast their effects on potential indicators of positive outcomes in AT.</p>","PeriodicalId":46822,"journal":{"name":"AMERICAN JOURNAL OF PSYCHOTHERAPY","volume":" ","pages":"appipsychotherapy20240016"},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839966","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}