Psychodynamic Counselling Research Articles

Facing death: Working with a couple facing multiple systems atrophy

The end of life raises anxieties in clients, their partners and carers, and their therapists; paranoid‐schizoid and depressive mechanisms are brought into play to manage these anxieties. Case material illustrates some of the threats facing couples where one has a terminal diagnosis. A psychodynamic counsellor or psychotherapist may be able to help carer partners to face, own, and tolerate their conflicts and dilemmas in such a way that the sense of support from a good object is strengthened. In this way, a carer partner can be helped to continue to care, both for their partner and themselves.

Impact Assessment of Counselling on Family of Children with Intellectual Disability in Cross River State, Nigeria

This study examined the impact of counseling on the families of children with intellectual disability (ID) in Cross River State, Nigeria. Three research questions were generated to guide the study while the Ex-post-Facto research design was adopted. A purposive sampling technique was used, and 100 parents of children with ID were selected from the Association for Intellectual and Developmental Disabilities of Nigeria (AIDDN), Cross River State Chapter. These parents have been exposed to psychodynamic counseling in the past. The instrument used for data collection was a structured questionnaire titled “Impact of Counseling on Parents of Children with ID (ICPCID)”. The instrument was validated by three experts, two in special education and one in measurement and evaluation. The reliability coefficient of 0.88 was obtained using Cronbach Alpha. The data collected were analyzed using simple percentages, frequencies, and mean scores. The findings revealed, among others, that counseling has a higher impact on the information needs of parents of children with ID. Counseling has a significant positive impact on the emotional stability of parents of children with ID. Counseling has a significant positive impact on stabilizing families of children with ID. Based on the findings, it was recommended, among others, that the Cross River State Government should establish a department of guidance and counseling under the State Ministry of Education that regularly caters for the counseling needs of parents of children with ID in the state.

Relationship between patient and therapist counter transference in transference and non-transference practices

The importance of therapists' emotional reactions, or Counter Transference (CT), in the therapeutic process has received attention in recent studies. The communication potential of CT has been highlighted by the systematic correlations these researchers have found between therapists' CT and numerous patient variables. To better understand the function of Transference Work (TW) in psychodynamic therapy and how it relates to therapist cognitive treatment (CT), we conducted a Randomized Controlled Trial (RCT). New study data has shown a consistent link among therapists' emotional response and Counter Transference (CT) in treatment, as well as a number of patient variables, illuminating the collaborative potential of CT. We looked into whether patient pretreatment interpersonal issues, the severity of personality dysfunction and the urge for psychodynamic therapy were associated with the therapist's transference work (TW) used in psychodynamic treatment in a Randomized Controlled Experiment (RCT) evaluating the role of TW. The second thing we looked at was whether or not the therapists employed TW in their sessions regarding these relationships. 100 outpatients received psychodynamic counseling (with or without TW). The Feelings Word Checklist-68 (FWC-68) was used to gauge their therapists' post-session emotional responses (CT). Patient characteristics differently predicted four FWC-68 subscales: insufficient, self-assured, extricate, and benevolent feelings. The level of pathology associated with PD. was connected with therapists in the non-TW group feeling less competent, according to some relationships that relied on the treatment situation. Patients' treatment desire was correlated with less troubling CT sentiments, including insufficient and distracted CT plus felt more self-assured CT. Depends on whether psychologists use transfer work in psychodynamic therapy, patient characteristics predict therapists' emotional Counter Transference in different ways.

Therapeutic Potential of Indian Medicinal Herbs and Current Therapeutic Approach used to Mitigate the Symptoms of Chronic Fatigue Syndrome: A Review

Abstract: Chronic fatigue syndrome (CFS) is a complex condition marked by severe exhaustion that lasts at least 6 months. The global prevalence of CFS ranging between 0.4% and 2.5% is growing. Women are affected by CFS more often than men. It is considered a common condition in developed countries. There is no approved treatment for CFS but symptoms can be managed and controlled persistent exhaustion causes significant impairment in daily routine activities. Lowered ATP synthesis, mitochondrial impairment, decreased oxidative phosphorylation, disruption of the hypothalamic–pituitary–adrenal (HPA) axis, and an imbalance of brain neurotransmitters play a major role in the pathophysiology of CFS. The purpose of the present study is to figure out the several plants that are used as a source of medication in chronic fatigue syndrome (CFS) and its current therapeutic approach. The Indian medicinal herbs described in this article are very efficacious in the management of chronic fatigue syndrome symptoms due to the presence of phytochemicals. This review article also covers the current therapeutic approach for chronic fatigue syndrome in a concise form that comprises CBT (Cognitive based therapy), GET (Graded exercise therapy), usage of immunoglobins, psychodynamic counseling, and yoga therapy that includes isometric yoga and yoga nidra are very beneficial in alleviating the symptoms of chronic fatigue syndrome. Antidepressants, immunomodulatory agents, and corticosteroids come under conventional medication for CFS. This article explores different Indian medicinal herbs, their pharmacological properties, and their potential role and current treatments for reducing the severity of symptoms of chronic fatigue syndrome.

“Bridging the Gap”: A reflexive thematic analysis of the experiences of therapy trainees transitioning from psychodynamic counselling to cognitive behavioural therapy

AbstractThere is limited empirical research and insight into the experiences of therapy trainees who are being taught more than one psychotherapeutic approach during their training. Further understanding is warranted to ensure that a dual modality approach to training (that is, where therapists are trained in two paradigmatically distinct modalities) is experienced as worthwhile and acceptable to trainees and to better understand any challenges faced when transitioning between approaches. The aim of this study was to investigate trainees' experiences of transitioning from psychodynamic counselling to cognitive behavioural therapy (CBT) on a two‐year master's degree that offers a dual modality approach to training. Data were collected from a sample of 8 trainees using an online semistructured questionnaire. These data were analysed using Braun and Clarke's (2020) reflexive thematic analysis. Four main themes were identified: (1) perceived competence; (2) preparedness; (3) professional advantages; and (4) external challenges. The findings suggested considerable individual variation in the ease with which participants navigated the transition between therapeutic modalities. Those who found the transition easier used the structure of CBT to provide a framework and point of difference that allowed them to temporarily suspend their psychodynamic learning in order to embrace a new therapeutic approach. Others experienced the move to CBT as posing a threat to their developing identities as counsellors. Recommendations are made on how to prepare trainees for the transition including exploring the psychological impact of transitions, increasing opportunities for reflective practice and facilitating exploration of what it means to be a therapist trained in two distinct therapeutic modalities.

Effectiveness of psychodynamic-oriented counselling intervention in reducing psychological distress in university students seeking help

ABSTRACT The outcome of a psychodynamic counselling intervention for students seeking psychological help at a university counselling centre in Italy was evaluated by examining its effect on clinical symptoms of the students. The intervention consisted of four counselling sessions and a later three-month follow-up session. The sample (N = 160) was drawn from a population of 360 university students. An in-treatment group (n = 86) was compared to a waiting-list comparison group (n = 74). Post-test measures were administered one month after baseline for each group. The psychodynamic counselling intervention was found to be a valid method to reduce psychopathological symptoms and to improve psychological adjustment among university students.

Effectiveness of an online versus face-to-face psychodynamic counselling intervention for university students before and during the COVID-19 period

BackgroundThe COVID-19 pandemic has increased online counselling interventions, including those aimed at university students. The principal aim of the study is to evaluate the effectiveness of the online counselling intervention during the COVID-19 pandemic, also with regards to the effectiveness of the face-to-face intervention.Methods34 students (Mean age = 23.74; Female = 27) who requested online university counselling during COVID-19 have been compared with 81 (Mean age = 22.8; Female = 60) students who requested university face-to-face counselling before the pandemic. The psychopathological problems were assessed with the Symptom Checklist 90 Revised, attachment styles with the Attachment Style Questionnaire, adverse childhood experiences with Adverse Childhood Experiences Questionnaire, and life satisfaction with the Life Satisfaction Scale.ResultsAt the pre-intervention phase, psychological distress was similar in both groups with no differences in the General Severity Index of the SCL-90 R, and there were no significant differences for secure/insecure attachment, adverse childhood experiences, and life satisfaction. The online counselling intervention during the pandemic was effective in reducing psychological distress scales as depression (p = .008), obsessive–compulsive (p = .008), interpersonal sensitivity (p = .005), and anxiety (p = .011), and in the total scale of the SCL-90 R (p = .017). The face-to-face counselling intervention was effective in reducing psychological distress in all subscales and in the total scale of the SCL-90 R (p = .000) and in increasing the level of life satisfaction (p = .023). Attachment style did not moderate the effectiveness of the online and face-to-face interventions.ConclusionsStudents seeking counselling, both before and during the pandemic, show similar levels of psychological distress. The online counselling intervention was almost as effective as face-to-face counselling intervention with respect to psychological distress; it was not effective in increasing life satisfaction.

Lehrberatung – der Übergangsraum zwischen Weiterbildung und Beraterpraxis

Educational and experiential counselling is an essential component of the advanced training of counsellors. It combines the theory and practice of individual psychology, analytical selfunderstanding, and practical counselling. This article sheds light on the role and self-conception of the supervising counsellors and describes their approach to practical guidance and supervision in depth. It outlines how the counsellors in training can use educational and experiential counselling as a transitional space to master psychodynamic counselling and to develop their personal style. In addition, the importance of the counsellor-client relationship for the success of counselling is described theoretically and illustrated with a practical example.

On ‘The Hatred of Learning from Experience’: A Work Journal Revisited

In January 1999, I started a two‐year course in psychodynamic counselling. One of the course requirements was to produce several work journals each term. They could be on any topic the student wished to think about or explore that pertained to the course, be it clinical or theoretical work, or professional/personal development. Three months later, I wrote one on Bion's (1962) concept of ‘the hatred of learning from experience’, after a seminar on his work. In Section 1, I present the work journal itself, in which I described my difficulties with anxiety about the course in relation to this concept: how I felt I needed to be a perfect student who ‘knew everything’; my intolerance of making mistakes; and my hatred of not knowing; in tandem with my envy of others' knowledge. In Section 2, I describe my current understanding of what I was rather desperately attempting to work out in the journal – taking into consideration both my emerging feelings, in light of my own history and state of mind, together with what I had come to understand – that the course was poorly structured and did not provide an adequately safe framework for clinical work and learning. This resulted in my decision to leave. In Section 3, I write about the arduous but ultimately rewarding process of returning to training, eventually culminating in my qualification as a psychodynamic psychotherapist. My final thoughts are presented in Section 4.

Effectiveness of a university counseling intervention based on a psychodynamic approach.

The study examined the effectiveness of a brief psychodynamic counseling intervention on psychological distress and general life satisfaction in a sample of 124 students by comparing pre- and posttreatment data. The authors also tested the moderating role of pretreatment attachment styles. Results showed that most participants (57%) can be classified as a nonclinical population, whereas only a minority of participants belong to a clinical population (17%) and a subclinical population (26%) according to the Symptom Checklist 90 Revised (SCL-90-R). Psychodynamic counseling intervention was shown to be associated with a decrease in the Global Severity Index and the anxiety and depression subscales of the SCL-90-R. Clinical effectiveness was greater for participants belonging to the clinical group. General life satisfaction increased significantly for all students. The authors found no moderation effect of attachment styles. Brief psychodynamic counseling intervention was associated with a reduction of psychological distress and an increase in life satisfaction.

Uncertainties, mysteries, doubts: a consideration of negative capability in psychodynamic counselling with young people

This paper addresses the notion of Negative Capability, a phrase coined by the poet John Keats and picked up by the psychoanalyst Wilfred Bion. It explores what each man meant by this phrase, where the concept fits within contemporary psychoanalysis, how it relates to psychodynamic practice, and why it is, I believe, crucial to counselling adolescents. Bion’s reference is brief but the quality he identified—the ability to tolerate therapeutic experiences of uncertainty—has been widely endorsed by clinicians, taken up by the British School of Psychoanalysis in particular. I discuss the ways in which I have attempted and struggled to exercise Negative Capability in my practice, with a focus on the challenges and implications of this approach for my young clients; the paper weaves together the two psychoanalytic perceptions of Negative Capability and adolescence. Keats’s concept is significant to Bion’s metapsychology, as many have noted, linked to his theories of alpha function and the growth of thought, the abandonment of memory and desire, ultimate truth and transformation, and container/contained. With recourse to this last idea, I look at how I tolerated radical uncertainty through the vicissitudes of my own adolescence. I explore Fink’s claim that, contrary to what is perhaps commonly believed of psychotherapy, achieving conscious understanding of the unconscious causes of a symptom is not the primary aim of psychoanalysis or counselling, let alone what effects change or is in every case possible. I support Coltart’s emphasis on Bion’s belief that cultivating faith—in the process of therapy, one’s own therapeutic capacity, the client’s capacity to change, the very possibility of psychic transformation—is key to sustaining the difficult, disquieting, and sometimes almost intolerable therapeutic experience of Negative Capability, a quality I have come to consider critical to my work with young people.

The piloting of a brief relational psychodynamic protocol (psychodynamic addiction model) for problem gambling and other compulsive addictions: A retrospective analysis

AbstractThe paper describes a treatment pilot for gambling and compulsive addiction within an NHS problem gambling clinic. The pilot study used a brief relational psychodynamic treatment protocol specifically designed to meet the needs of a group of patients who had not responded to CBT and who had other addictions or co‐morbidities. Seventy‐two (n = 72) patients were offered 12 sessions of therapy by four psychodynamic counsellors. Results were assessed using scores from a pre‐ and post‐treatment patient health questionnaire, the generalised anxiety disorder—7 (GAD‐7) and the Problem Gambling Severity Index (PGSI). Weekly feedback and supervision from counsellors and patients were used to assess the treatment model. The results highlighted that the psychodynamic addiction model was associated with reduced depression (Mean = 14.9; SD: 6.7), anxiety (Mean = 11.5; SD: 5.9), and gambling severity (p < .001), suggesting that a relational psychodynamic treatment is needed for complex patients with compulsive addiction, where CBT had not been successful. These results also highlight the importance of the therapeutic relationship as a critical factor in the treatment of patients with compulsive addiction problems.

Working psychodynamically and psychosocially with women who have been raped

In this paper, I analyse aspects of the experience of some female University students who have been raped drawing on a Kleinian psychoanalytic perspective and Layton’s concept of ‘normative unconscious processes’. I suggest that Klein’s writing provides a theoretical basis for thinking about the projective and introjective processes that may be at play between perpetrator and ‘victim’. Here, I focus upon Kleinian conceptualisations of castration anxiety, fragmentation, envy, greed and guilt. In terms of ‘normative unconscious processes’, I explore how castration anxiety (in a more symbolic sense of powerlessness), fragmentation, envy, greed and guilt may also operate within social discourses around sexual violence. Specifically, I draw upon Freyd’s concept of DARVO and Payne’s Rape Myth Acceptance Scale which both explain ‘victim blaming’ in terms of the social reversal of the positions of perpetrator and ‘victim’. I illustrate this social process with reference to representations of rape within the mainstream media. My hypothesis is that, although the ‘psychic’ and the ‘social’ are two contrasting positions theoretically, it is possible to draw on both of them to make sense of the experience of working with rape clinically.The clinical context of this paper is my work as a psychodynamic counsellor at a modern London-based University. I draw on composite case studies of women who have been raped, drawing on both ‘psychic’ and ‘social’ perspectives. I seek to explore how the ‘psychic’ and the ‘social’ can be integrated in different ways depending upon the clinical situation. I suggest that they can be mutually enriching ways of working. Through approaching how the ‘psychic’ and the ‘social’ might interrelate from a clinical viewpoint, I conclude that the idea of ‘working psychosocially’ is of most use when approached as a flexible concept that different clinicians may draw on in different ways with different patients.

Illness perception and high readmission health outcomes.

This review identified associations between illness perception and health outcomes of patients with a medical diagnosis included in the Hospital Readmissions Reduction Program. Inclusion criteria were English language, use of quantitative methodology, health outcomes specified, and identifiable effect size and statistical significance of the relationship. Most of the 31 studies in this review showed that favorable illness perception has been associated with better health outcomes, while unfavorable illness perception has been associated with worse outcomes. A multifaceted approach might include behavioral, clinical, educational, and psychosocial components to improve one’s illness perception through educative, cognitive-behavioral, or psychodynamic counseling.

Group Psychodynamic Counselling as a Clinical Training Device to Enhance Metacognitive Skills and Agency in Future Clinical Psychologists.

Metacognitive skills and agency are among the main psychological abilities a clinical psychologist should have. This study aimed to assess the efficacy of group psychodynamic counselling as a clinical training device able to enhance metacognitive skills and agency in final-year undergraduates in clinical psychology within an educational context. Thirty-three final-year students of clinical psychology participated in an experiential laboratory lasting two months. Participants completed measures regarding metacognitive skills and agency at pre-, post-treatment, and 3-month follow-up assessment. The results suggested that group psychodynamic counselling made students feel more capable of recognizing emotional states, understanding causal relationships, inferring mental states of others in terms of beliefs, desires, intentions, and expectations, and thinking critically. Furthermore, the group psychodynamic counselling helped students to feel more able to derive pathways to desired goals and to motivate themselves via agency thinking to use those pathways. Thus, the study confirmed the efficacy of group psychodynamic counselling as a clinical training device able to enhance metacognitive skills and agency in future clinical psychologists.

‘Making Room for the Other(s)’: A consideration of psychodynamic counselling with women with Asperger’s Syndrome

This paper explores psychodynamic therapy with young women with Aspergers Syndrome through the use of a composite case study. It seeks to make sense of a female patient’s obsession with a figure from celebrity culture – ‘Tom’ from ‘Britain’s Got Talent’. The potential use of ‘Tom’ by the patient as an idealised object, an autistic object, a transitional object and a transformative object is considered. Drawing on Rosenfeld’s concept of pathological narcissism and Meltzer’s concept of ‘aesthetic reciprocity’, the paper seeks to make sense of both the defences that the patient utilises and the impact of the deficits she has experienced. Attention is given to the development of the therapy through the use of play and work in the transference. Gradually, the patient becomes more able to tolerate separateness and in doing so becomes more connected to her own internal world and the feelings of others. In so doing, she becomes more aware of her actual social marginalisation and gains a greater sense of awareness of her diagnosis.

Group psychodynamic counselling with final-year undergraduates in clinical psychology: A clinical methodology to reinforce academic identity and psychological well-being

Educational institutions should ensure that students develop a professional identity, as well as safeguarding their well-being and activating awareness and change processes. The aim of this study was to assess the efficacy of group psychodynamic counselling as a means of reinforcing academic identity – considered the forerunner of professional identity – and psychological well-being in a group of final-year undergraduates studying clinical psychology. Thirty-three final-year-students of clinical psychology who participated in six group psychodynamic counselling sessions were compared with sixteen final-year students of clinical psychology who had never participated in an intervention of this kind. The results suggested that group psychodynamic counselling made students feel more capable of managing their lives and more open to new experiences as well as encouraging them to perceive their relationships as more positive and satisfying, to believe that their life is meaningful, and to achieve greater self-acceptance. The in-depth exploration also prompted students to consider their commitment to their choice of career. Group psychodynamic counselling also reinforced students’ educational choice, as the likelihood of students becoming less committed to this choice was reduced after the intervention. Thus, the study confirmed the efficacy of group psychodynamic counselling as a means of reinforcing both academic identity and promoting well-being and demonstrated that it is a tool clinical psychologists and university teachers could use to activate self-reflection and change within educational settings.

Sarcoma survivors' perspectives on their body image and functional quality of life post-resection/limb salvage surgery.

Sarcomas often occur in patients' extremities and treatment typically involves bone resection/limb salvage surgery. Such treatments leave survivors with physical disfigurements, functional disabilities, and/or emotional traumas. Our post-surgery psychological intervention investigated how these experiences impinge on sarcoma survivors' lives. Twenty-three survivors aged 19-60years (M=36years) participated in a tri-disciplinary (rehabilitative exercise, plastic surgery and psychological) intervention. Of these, 17 participated in psychodynamic counselling, 10 completed a mental-health questionnaire and seven kept a reflective journal. An exemplar case study research design was employed and data were subjected to interpretative phenomenological analysis. The findings reveal that survivors typically experience a number of body image issues and mobility difficulties, which they are reluctant to share with their oncologist in case they are viewed as being ungrateful or vain. In instances where such issues remain unaddressed, then sarcoma survivors have a tendency to adopt avoidant coping strategies and social isolation practices. These practices negatively impact on their mental health and functional quality of life. Hence, it is suggested that a short three part (body image, mobility, and coping strategy) screen be devised and used at all sarcoma 2-year follow-up assessment consults to identify which survivors are in need of psychological assistance.

How are recent changes to primary care mental health provision within the NHS affecting psychodynamic counsellors’ construction and management of their professional identities? A Foucauldian perspective

The research used Foucauldian techniques to explore how counsellors currently working for the NHS construct and manage their professional identities in the face of changes imposed on them by the institution. Semi-structured interviews were carried out with four counsellors and one doctoral student, all with substantial experience working for the NHS. A Foucauldian Discourse Analysis revealed four main subjectivities that were made available; feeling like part of a process at times; the NHS imposes limitations on their practice; feeling able to retain their professional standards despite the limitations and lack of influence; feeling proud of, and satisfied with the work they do. Places in which the participants explored ways of constructing a professional identity were also explored.

Emotional Dysregulation: The Clinical Intervention of Psychodynamic University Counselling

The present work aims to discuss the psychodynamic treatment provided in a Counselling Centre for University Students. We present the methodology and procedure of Counselling University Services psychodynamically oriented: the treatment consists of four weekly sessions and a fifth session three months later (follow-up). We will focus on a very frequent clinical topic reported by university students: emotional dysregulation. We will provide two clinical vignettes and report the main effects obtained by psychodynamic counselling on developing adaptive psychological functioning related to an increase in socialization and behavioural autonomy, as well as a greater definition of identity. Finally, in the light of the reflections illustrated, we underline the importance of promoting university counselling services to help students find more functional strategies in their emotion regulation process: from the capacity to read one’s emotional states and to give them meaning, to the development of the more adaptive behavioural responses to cope with the developmental tasks and the inevitably linked academic performance.