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Use of extratransference interpretation in psychoanalytic psychotherapy  [PDF]
Joji? Boris R.
Vojnosanitetski Pregled , 2005, DOI: 10.2298/vsp0510779j
Abstract: Background. In psychoanalytic psychotherapy, the transference analysis takes the central position of the work. The work in the extratransference sphere and experience in a professional practice with extratransference interventions have not been reported much in the literature. Extratransference sphere includes less transferring relation to a psychotherapist, transference to other objects, or may refer to the external reality rather than the psychic reality or fantasy. Case report. We pointed out extratransference interventions. We demonstrated an application of a genetic interpretation and reconstruction, too, which could restore and establish the connections between the past and the present, in order to understand the influences of the current reality and the past, and helping us, further, to resolve the infantile conflicts. Conclusion. Interpretation of extratransference situations takes an important part of an analytical work and it is an essential category of the interpretation. Analytic understanding should include transference and extratransference spheres, fantasy and reality, past and present. Working with neurotic patterns and character resistance needs an optimal choice of intervention in the given moment of the analytic process. Extratransference interventions are an essential category of intervention, irreplaceable for its effectiveness in the analytic process.
A Follow-up Study in Psychoanalytic Psychotherapy of Couples
International Journal of Applied Psychology , 2012, DOI: 10.5923/j.ijap.20120205.02
Abstract: During 11 years we have been working on a research involving intervention with families seeking treatment in a counseling center-school and whose complaints are focused on their children. Using psychoanalytic psychotherapy with the couples, we have tried to achieve symptom remission in the children. The purpose of this study is to reflect on the maintenance, over time, of the psychological changes obtained in this kind of clinical practice, which encompasses both couples and families. Based on clinical-qualitative methodology and case study, two cases have been examined, with emphasis on the follow-up sessions for two couples who were undergoing psychoanalytic couple’s therapy for thirty-six and thirty months, respectively, with two additional follow-up sessions after the therapy was finished. The collection of clinical material to be analyzed according to the psychoanalytic references was made using excerpts from the session written notes taken by the therapist herself immediately after the sessions were over. As a result, this kind of intervention proved effective in clarifying latent marital conflicts and in fostering a healthy environment, one that could contribute to the emotional development of the child.
Tavistock Adult Depression Study (TADS): a randomised controlled trial of psychoanalytic psychotherapy for treatment-resistant/treatment-refractory forms of depression
David Taylor, Jo-anne Carlyle, Susan McPherson, Felicitas Rost, Rachel Thomas, Peter Fonagy
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-60
Abstract: INDEX GROUP: Patients with treatment resistant/treatment refractory depression. DEFINITION & INCLUSION CRITERIA: Current major depressive disorder, 2 years history of depression, a minimum of two failed treatment attempts, ≥14 on the HRSD or ≥21 on the BDI-II, plus complex personality and/or psycho-social difficulties. EXCLUSION CRITERIA: Moderate or severe learning disability, psychotic illness, bipolar disorder, substance dependency or receipt of test intervention in the previous two years. DESIGN: Pragmatic, randomised controlled trial with qualitative and clinical components. TEST INTERVENTION: 18 months of weekly psychoanalytic psychotherapy, manualised and fidelity-assessed using the Psychotherapy Process Q-Sort. CONTROL CONDITION: Treatment as usual, managed by the referring practitioner. RECRUITMENT: GP referrals from primary care. RCT MAIN OUTCOME: HRSD (with ≤14 as remission). SECONDARY OUTCOMES: depression severity (BDI-II), degree of co-morbid disorders Axis-I and Axis-II (SCID-I and SCID-II-PQ), quality of life and functioning (GAF, CORE, Q-les-Q), object relations (PROQ2a), Cost-effectiveness analysis (CSRI and GP medical records). FOLLOW-UP: 2 years. Plus: a). Qualitative study of participants’ and therapists’ problem formulation, experience of treatment and of participation in trial. (b) Narrative data from semi-structured pre/post psychodynamic interviews to produce prototypes of responders and non-responders. (c) Clinical case-studies of sub-types of TRD and of change.TRD needs complex, long-term intervention and extended research follow-up for the proper evaluation of treatment outcome. This pushes at the limits of the design of randomised therapeutic trials. We discuss some of the consequent problems and suggest how they may be mitigated.Current Controlled Trials ISRCTN40586372Worldwide, depressive disorders have consistently been shown to be the largest contributor to the burden of human disease [1,2]. This is connected with the fact that depres
Psicoterapia psicoanalítica del adolescente deprimido: principios técnicos Psychoanalytic Psychotherapy of the Depressed Adolescent: Technical Principles  [cached]
Alejandro Rojas-Urrego
Revista Colombiana de Psiquiatría , 2008,
Abstract: Introducción: Mientras la adolescencia significa, en esencia, "crecimiento", la depresión, en cambio, sería lo contrario: la tendencia al desfallecimiento, abatimiento, inhibición, inmovilidad, postración y, en ocasiones, incluso la nada. Desarrollo: A partir de un intento de articulación entre estos dos conceptos y las nociones de historia, estructura y coyuntura, el autor se propone subrayar la importancia del adecuado manejo psicoterapéutico de la depresión en la adolescencia. Considera, para comenzar, la multideterminación de este trastorno y, por consiguiente, los vértices de intervención posibles. Se centra en la psicoterapia psicoanalítica, apenas una de las modalidades psicoterapéuticas posibles en este contexto. Aborda algunas generalidades sobre la psicoterapia psicoanalítica y pasa enseguida a tratar tres temas no suficientemente estudiados en la literatura médica: las entrevistas iniciales, las indicaciones y, finalmente, la denominada terapia bifocal. Conclusión: En su conclusión, invita al lector a reflexionar sobre la importancia del encuentro terapéutico con el adolescente deprimido y sobre la trascendencia de analizar y de dar sentido a su depresión. Introduction: While adolescence in essence means growth, depression on the other hand would by definition be the opposing "movement": a tendency towards languor, abatement, inhibition, immobility, prostration, zero, sometimes even towards nothing. Development: In an attempt to articulate these two concepts and the notions of history, structure, and juncture, the author underscores the importance of an appropriate psychotherapeutic management of adolescent depression. To begin, he takes into account the fact that this disorder is multidetermined and in consequence, the existence of various vertexes of possible interventions. This paper focuses on psychoanalytic psychotherapy, one of several possible psychotherapeutic modalities available in this context. He discusses some of the generalities of psychoanalytic psychotherapy and then goes on to examine three themes not sufficiently explored in the literature: the initial interviews, the indications, and finally, what is known as bifocal therapy. Conclusion: To conclude, he invites the reader to ponder on the importance of the therapeutic encounter with the depressed adolescent and on the transcendence of analyzing and giving meaning to her depression
Apartheid's lost attachments (1): on psychoanalytic reading practice  [cached]
Derek Hook
Psychology in Society , 2012,
Abstract: This paper, the first of two focussed on the topic of libidinal attachments between white children and black domestic workers in narratives contributed to the Apartheid Archive Project (AAP), offers a series of methodological insights derived from a Lacanian type of psychoanalytic reading practice. A Lacanian reading practice is one which emphasizes the importance of symbolic juxtaposition, of recombining different facets of texts, and of attempting to locate what I term the "absent mediator" implied by tacit conjunctions and associations within texts. In this paper I focus particularly on a puzzling aspect shared by a series of contributions to the AAP, namely the role of animals in the narratives of white participants, which appear to emerge precisely when the question of a loving relation for a black person is posed. I argue that this narrative device is an attempt to make sense of a prospective relationship, particularly when such a relationship is effectively prohibited by the prevailing rules of interaction. In response to pressing questions of inter-racial loss and love, and in respect of an ambiguous inter-racial relationship, recourse to an animal provides a fantasmatic "solution", a model of how to manage a relationship that otherwise difficult to understand.
Revista Colombiana de Psicología , 2011,
Abstract: This article analyzes the persistent divorce between clinicalpractice and research in psychotherapy, examining theunderlying reasons in both contexts. With respect to clinicalpractice, the article discusses the characteristics of theteaching of psychotherapy, therapeutic schools as communities,and the fear of research. In the case of research in psychotherapy,the article analyzes research results regarding theeffectiveness of psychotherapy, the therapeutic alliance, andthe elements of the process. Finally, it presents some of thetransformations in research and its dissemination, which cancontribute to closing the gap between practice and science inpsychotherapy.
Autonomy and Intervention in Medical Practice  [PDF]
Jianli Song
Open Journal of Philosophy (OJPP) , 2018, DOI: 10.4236/ojpp.2018.83021
Abstract: Autonomy and intervention are two terms of Political philosophy, and they have always been essentially located polar opposites of each other. But in medical practice, it is problematic to stress alone that either side. We should get rid of abstract liberal individual right thinking and reconsider the relationship between the patients and the physicians in all kinds of real situations. Only if we truly worship and praise for the life, including more moral and humanistic concern in abstract right discourse, the more elastic the ethical decision model will be aroused in current medical practice.
Bridging Music and Psychoanalytic Therapy
Deborah Salmon
Voices: A World Forum for Music Therapy , 2008,
Abstract: The author draws upon theory, training and clinical experience in palliative care music therapy and verbal psychoanalytic therapy. Elements common to both music and psychoanalytic therapy are explored; the centrality of listening, the boundaries and fluidity of time, the importance of containment and expression of affect, the capacity to facilitate mourning, and the inherent creativity of each. Contributions from analytic music therapy are considered. Two case vignettes are presented; the first integrates psychoanalytic thinking into music therapy work with a dying woman; the second, from verbal psychotherapy practise, illustrates mourning being facilitated by the spontaneous use of a song., The question of training music therapists to do depth work using psychoanalytic concepts is raised, particularly in respect to the use of words and recognition of transference and countertransference phenomena. Finally, the author reflects on her experience of music therapy and psychotherapy work each enriching and deepening the other.
Interpersonal psychotherapy (IPT) for late-life depression in general practice: uptake and satisfaction by patients, therapists and physicians
Digna JF van Schaik, Harm WJ van Marwijk, Aartjan TF Beekman, Marten de Haan, Richard van Dyck
BMC Family Practice , 2007, DOI: 10.1186/1471-2296-8-52
Abstract: Motivation and evaluation of patients, GPs and therapists were recorded and organizational barriers described alongside a randomized controlled trial. IPT, given by mental health workers, was compared with usual general practitioner (GP) care. Included were patients (≥55 years) who met the DSM-IV criteria for major depressive disorder.Patients were motivated for the psychotherapy intervention: of the 205 eligible patients, 143 (70%) entered the study, and of the 69 patients who were offered IPT, 77% complied with the treatment. IPT proved to be an attractive therapy for patients as well as for therapists from mental health organizations. General practitioners evaluated the intervention positively afterwards, mainly because of the time-limited and structured approach. Organizational barriers: no IPT therapists were available; an IPT trainer and supervisor had to be trained and training materials had to be developed and translated. Additionally, there was a lack of office space in some general practices; for therapists from private practices it was not feasible to participate because of financial reasons. IPT was superior to usual care in patients with moderate to severe depression.As we succeeded in delivering IPT in primary care practice, and as IPT was superior to usual care, there are grounds to support the implementation of IPT for depressed elderly patients within general practice, as long as the practices have room for the therapists and financial barriers can be overcome. Consolidation may be achieved by making this intervention available through practice nurses or community psychiatric nurses who deliver IPT as part of a more comprehensive depression management program.Depression among elderly primary care patients is common. Of the older patients who visit a primary care clinic 5–10% has a depressive disorder [1,2]. Depression causes suffering and is associated with serious disability, reduced quality of life and general functioning. The course of depression
Revalidation: Are we meeting training needs? Training and its influence on the practice of child psychiatry and psychotherapy  [cached]
Kishore Arun,Shaji K,Praveenlal K
Indian Journal of Psychological Medicine , 2010,
Abstract: Revalidation and renewal of registration are issues of concern to most psychiatrists. Keeping up-to-date with current knowledge is an essential part of the renewal of license to practice. Training needs of psychiatrists are addressed in postgraduate courses and the gaps in training and updating of knowledge addressed through continuing medical education programs. This study aims to look at whether the training needs of psychiatrists working in the state of Kerala are being met. Two aspects of training and practice, child and adolescent psychiatry and psychotherapy, were assessed using a questionnaire. A significant number of respondents had not received any training in either of these areas in their postgraduate training. This did not affect their practice; most respondents continued to practice psychotherapy and see child patients despite not being trained. These two areas can thus be identified as lacunae in the curriculum as well as a need which should be addressed through Continuation Medical education programs.
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