Psychotherapeutic Setting Research Articles

Mindfulness meditation among South African psychologists: a pathway to ‘being’ amid existential suffering in contemporary South Africa

Mindfulness is currently regarded as a life skill as well as part of an approach to life that can generate beneficial intrapersonal and relational outcomes. Given the centrality of intrapersonal and relational outcomes in psychotherapeutic encounters, it seems logical that the practice of mindfulness by psychologists would be relevant to explore, especially in contemporary South African contexts where high levels of trauma, interpersonal distress, and resultant existential and intrapsychic struggles prevail. The study seeks to address an identified gap in existing research concerning the experienced relevance of long-term mindfulness meditative practice for counselling psychology and therapeutic practice generally, particularly in the South African context. Located within an interpretivist paradigm and interpretative phenomenological analysis, this study explored the mindfulness and mindfulness meditation practices of 11 South African counselling psychologists and the ways in which these practices informed their being in both personal and psychotherapeutic settings. Each participant was invited to participate in a semi-structured interview and reflexive journalling task as part of the research process. The findings centralise the being capacities afforded to psychologists through a mindfulness practice and identify how the related elements of non-judgement, nonattachment, and (re)connection enable enhanced relational encounters with clients. The findings contribute to the limited literature related to the value of psychologists’ mindfulness practices in relation to the way in which they manage their own responses to clients, as well as the potential for mindfulness practices to help clients manage presenting trauma responses.

Loneliness in times of global polycrises

Global polycrises comprise the synchronous or consecutive occurrence of various crises, with no intervening phases of stability, e.g., coronavirus disease 2019 (COVID-19) pandemic, inflation, war and climate crisis. This poses challenges for both society as awhole and its individual members. Polycrises are associated with enormous psychological stress, especially for vulnerable groups. Polycrises also impair social interaction, which can trigger or intensify subjectively stressful loneliness. The aim of this narrative review is to show how loneliness affects social behavior in times of global polycrises and what the consequences are. Loneliness is associated with both mental and physical morbidity and mortality as well as being asignificant barrier to recovery. Studies have shown that there is amutual detrimental influence between mental illness and loneliness. The social behavior of chronically lonely people is characterized by anegative cognitive bias, hypervigilance in the social context and adysregulated oxytocin system. Furthermore, the quality and quantity of these relationships are significantly impaired. The social consequences of loneliness are, for example, adecrease in social engagement and low voting participation. The phenomenon of loneliness clearly shows that crises can exacerbate latent problems and bring them to the surface; however, crises should also be seen as an opportunity to openly and constructively address shame-laden topics such as loneliness in public discourse and in psychotherapeutic settings.

Drop-out rates in animal-assisted psychotherapy - Results of a quantitative meta-analysis.

Animal-assisted psychotherapy is an emerging field with great potential and growing popularity. However, empirical research on its effectiveness is insufficient, and consistent evidence about patients' commitment is missing. The present meta-analysis addresses this gap by systematically comparing drop-out rates in animal-assisted psychotherapy and by relating the resulting across study drop-out rate to across study drop-out rates reported in meta-analyses on conventional psychotherapy. Fifty-seven studies published until August 2022 were identified as eligible for meta-analytic comparison, that is, they conducted animal-assisted psychotherapy on at least one group of psychiatric patients and reported drop-out rates. Potential moderating influences of the type of animal and patients' disorder were considered, as well as multiple other demographic and study design variables. The across study drop-out rate in animal-assisted psychotherapy was 11.2%. This was significantly lower than the across meta-analyses drop-out rate of conventional psychotherapy (d = -.45, p = .0005). Although effects of moderator variables could not be evaluated statistically due to too small and heterogeneous data sets, descriptive results suggest influences of the type of animal and patient disorder. However, study quality ratings identified serious shortcomings regarding proper research design, most critically concerning the report of effect size measures, the use of standardized intervention plans and Open Science practices. Drop-out constitutes a major problem of psychotherapeutic research and practice. By proposing that the inclusion of an animal in the psychotherapeutic setting can enhance patients' commitment and by outlining challenges and opportunity of animal-assisted psychotherapy, this meta-analysis offers a starting point for future research in this evolving field.

Patient attachment and reflective functioning as predictors for therapist in-session feelings.

Therapists' in-session feelings in psychotherapy can be seen as indications of the development of the therapeutic relationship and the therapeutic process. To manage them appropriately, it is important to know to what extent they may be influenced by patients' pretreatment characteristics. This study aims to improve the understanding of therapists' emotional reactions in the psychotherapeutic setting by investigating if patients' pretreatment mentalization ability and attachment style predicted therapist in-session feelings. In a sample of 87 therapy dyads treated with interpersonal psychotherapy and cognitive behavioral therapy for depression, patient attachment was measured using self-reported Experiences in Close Relationships (ECR) and mentalization using Reflective Functioning (RF). ECR and RF were hypothesized to predict therapist feelings measured by the Feeling Word Checklist-24 at different treatment phases over the full course of treatment. Treatment method, patient age, gender, and pretreatment depression were evaluated as potential confounders. Multilevel modeling was used to analyze the data. Lower RF in patients predicted more negative therapist feelings in the mid- to late-treatment phases and less positive feelings in the late-treatment phase. Self-reported attachment anxiety or avoidance did not predict therapist feelings. Findings indicate that patients' ability to mentalize is important to consider when conducting psychotherapy, as it can influence therapists' feelings in the therapeutic process. Limitations of the present study's approach are discussed, and directions for future research are considered. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mastering minds: Unleashing the power of Neuro-Linguistic Programming in workplaces and schools

Neuro-Linguistic Programming (NLP) intricately examines the visual, auditory, and kinesthetic representation systems, traversing the transformative trajectory from superficial to profound linguistic structures. This comprehensive paradigm elucidates the sophisticated cognitive processes through which the brain interprets events, molding emotions and behaviors through filters such as values, beliefs, memories, decisions, and meta-programs. As a potent catalyst for excellence and success, NLP empowers individuals and organizations to realize their aspirational objectives, nurturing flexibility, creativity, and autonomous behaviors. In educational contexts, practitioners adeptly employ NLP techniques to navigate conflicts, enhance leadership acumen, and inspire personnel toward organizational goals. NLP assumes a crucial role as a foundational element for ongoing learning, development, and the cultivation of dynamic capabilities within professional environments. Its applications extend beyond conventional business domains, seamlessly integrating with behavior modification models employed in psychotherapeutic settings. In the realm of child psychiatry, NLP addresses neurodevelopmental disorders, such as oppositional defiant disorder, with the potential to mitigate triggers in educational milieus. The Behavior Modification Model, anchored in the ABC (antecedents, behavior, and consequences) framework, meticulously shapes behaviors through positive and negative reinforcement and punishment. NLP is a versatile professional instrument applicable across personal development, therapeutic interventions, and diverse organizational landscapes. It is pivotal in elevating communication effectiveness, facilitating conflict resolution, and propelling individual and collective success to new heights. Applying NLP in schools proves invaluable by elevating teaching methodologies, cultivating effective communication, and nurturing essential skills for conflict resolution and leadership. Integrating NLP in educational settings can offer a holistic approach to learning, providing support for educators and students alike in navigating intricate situations and fostering an environment of continuous improvement. Implementing NLP should be approached with a balanced understanding of both its potential benefits and the need for empirical validation and ethical considerations.

Effects of including a dog on treatment motivation and the therapeutic alliance in child and adolescent psychotherapy: study protocol for a randomized controlled trial

BackgroundMotivation and a therapeutic alliance are crucial for successful therapy. It is assumed that dogs can increase motivation and help support therapeutic relationships. This is one of the reasons for including dogs in psychotherapy. While the positive effects of psychotherapy with dogs have been documented over the past years, little is known about the underlying mechanisms of animal-assisted psychotherapy. This study therefore aims to investigate whether and how the presence of a dog affects motivation and the therapeutic alliance in child and adolescent psychotherapy.MethodsThe study is a randomized controlled trial assessing motivation and the therapeutic alliance during the first five sessions of psychotherapy attended by children and adolescents with different psychiatric disorders. We will recruit 150 children and adolescents and randomly assign them to one of three conditions: (a) a dog is present but not integrated in the therapeutic narrative, (b) a dog is actively integrated in the therapeutic narrative, and (c) no dog is present. The children’s and adolescents’ evaluations of the therapeutic alliance and of their motivation will be assessed as the primary outcomes using standardized questionnaires before and after the first five therapy sessions as well as at follow-up. Further outcomes include the therapists’ evaluations of the therapeutic alliance and their motivation, treatment adherence of the children and adolescents, and treatment satisfaction of the children and adolescents, their parents, and of the therapists. Interventions are conducted by experienced therapists who regularly work with their dogs. Outcomes will be analyzed using general linear models, with the treatment group as a fixed factor and the baseline values as covariates.DiscussionThis study provides information on the possible motivation and alliance-enhancing effects of integrating a dog into child and adolescent psychotherapy. This is relevant for practice, as these two components are strong predictors of therapy outcome. Moreover, the study will contribute to a better understanding of how a dog should be incorporated into psychotherapeutic settings. This can lead to a more purposeful inclusion of dogs in psychotherapy for children and adolescents.Trial registrationThe trial was registered on ClinicalTrials.gov, NCT05384808, on 20 May 2022.

On artificial intelligence and global mental health

Artificial intelligence (AI) is affecting global societies and reshaping the status quo. AI technologies possess great potential to tackle some of mankind’s most pressing problems, although much of what can be achieved is still a matter of imagination and critical discussion (e.g., AI might also be a source of harm). In the present short communication, we outline AI’s potential for addressing several core issues in global mental health including its application in psychotherapeutic settings.

The ‘wave-particle’ child: reconnecting the disconnect in the concept of latency

ABSTRACT The aim of this paper is to re-examine psychodynamic understanding of middle childhood towards a conceptual reformulation of this critical developmental stage. We believe such a reformulation is necessary in the light of contemporary psychoanalytic thought and developmental findings outside of the psychoanalytic field. This is intended as a preliminary stage in the direction of a recalibration of the technique and language of child analytic treatment to fit the particular psychological challenges and needs of middle childhood. Historically, middle childhood (or latency) has been regarded as a period of psychosexual dormancy and psychic rigidity. We review contemporary developmental findings and suggest a shift in emphasis in psychodynamic thinking towards the psychic growth, developmental challenges and emotional fragility that also characterise middle childhood. We propose that the psyche of the school-aged child is at once wave and particle, constantly growing and evolving and yet simultaneously stable and structured. We also emphasise the complexity of psychosocial development in middle childhood beyond the triangular, into what we term the polygonal psychic space. The familiar structured games of middle childhood – card games, ball games, board games and today’s console games – reflect this complex and paradoxical developmental picture, but the traditional child psychotherapy paradigm remains biased towards the toys and make-believe games of early childhood. Adaptation of technique and clinical theory to middle childhood is critical, particularly given the recent steep rise in referrals of school-aged children to mental health clinics across the globe, and the relatively high treatment drop-out rate commonly seen, especially in boys. We suggest the game-play typical of middle childhood offers a safe and developmentally appropriate medium of play, through which the child can express and explore their intrapsychic and interpsychic world in a psychotherapeutic setting.

On the current psychotherapeutic situation for persons with pornography use disorder in Germany

For the first time, the ICD-11 provides the diagnosis compulsive sexual behavior disorder (CSBD) that can be assigned for pornography use disorder (PUD). This study aimed to estimate the prevalence of PUD and associated consequences in Germany, to identify the psychotherapy demand among likely PUD (lPUD) cases and the treatment supply in different psychotherapeutic settings, to survey psychotherapists' level of expertise regarding PUD, and to identify predictors for psychotherapy demand. Four studies were conducted: 1. Online study in the general population(n = 2070; m = 48.9%, f = 50.8%, d = 0.2%), 2. Survey among practicing psychotherapists (n = 983), 3. Survey of psychotherapists in psychotherapeutic outpatient clinics (n = 185), 4. Interviews with psychotherapeutic inpatient clinics (n = 28). The estimated prevalence of lPUD in theonline study was 4.7% and men were 6.3 times more often affected than women. Compared to individuals without PUD, individuals with lPUD more often indicated negative consequences in performance-related areas. Among lPUD cases, 51.2% of men and 64.3% of women were interested in a specialized PUD treatment. Psychotherapists reported 1.2%-2.9% of lPUD cases among their patients. 43.2%-61.5% of psychotherapists stated to be poorly informed about PUD. Only 7% of psychotherapeutic inpatient clinics provided specific treatments to patients with PUD. While, among other factors, negative consequences attributed to lPUD were predictive for psychotherapy demand, weekly pornography consumption, subjective well-being, and religious attachment were not. Although PUD occurs quite often in Germany, availability of mental health care services for PUD is poor. Specific PUD treatments are urgently needed.

Appearance-related concerns in individuals with pathological skin picking-a comparison with individuals with dermatological conditions and skin-healthy controls.

Pathological skin picking (PSP) is an excessive behavior which characterizes Skin Picking Disorder. Individuals repeatedly pick their skin and cause skin lesions, but are unable to control the behavior, which can cause severe distress. Visible self-inflicted skin lesions can additionally affect individuals with PSP due to emerging appearance-related concerns. However, these concerns and their role in PSP have hardly been studied, especially not in comparison with individuals with dermatological conditions and skin-healthy controls. The present cross-sectional study (n = 453, 83.9% female, 15.9% male, 0.2% diverse) aimed at analyzing appearance-related concerns and mental health outcomes between four groups: Individuals with PSP and dermatological conditions (SP/DC; n = 83), PSP without dermatological conditions (SP; n = 56), dermatological conditions without PSP (DC; n = 176) and skin-healthy controls (SH, n = 138). We compared questionnaire data on dysmorphic concerns, appearance-based rejection sensitivity, and body dysmorphic symptoms, as well as PSP-symptoms and mental health outcomes (depression, anxiety, and self-esteem) between groups. The analyses showed a significant multivariate group effect in the appearance-related variables, F(6, 896) = 19.92, Wilks' Λ = 0.78, p < 0.001, and mental health outcomes, F(6, 896) = 16.24, Wilks' Λ = 0.81, p < 0.001. The SP/DC group had the strongest appearance-related concerns and mental health impairments, followed by the SP group, the DC group and the SH group. The SP/DC group and SP group only differed significantly with regard to dysmorphic concerns, but not in other variables. The DC group was less affected but still showed higher dysmorphic concerns and mental health impairments than skin-healthy controls. In contrast to the PSP groups, the other two groups did not exceed clinically relevant cut-off scores. The present study shows that individuals with PSP exhibit strong appearance-related concerns, regardless of the presence or absence of underlying or comorbid dermatological conditions. These findings shed new light on the importance of appearance-related concerns in Skin Picking Disorder and the role of PSP as a potentially overlooked risk factor in dermatological patients. Therefore, appearance-related concerns should be explicitly addressed in dermatological and psychotherapeutic settings. Future studies should also include longitudinal and experimental analyses to more clearly classify the role of appearance-related concerns in the etiology of PSP and Skin Picking Disorder.

The emergence and management of embodied dilemmas in psychotherapeutic interaction: a qualitative study

In this article we take an embodied and interactional perspective on how ethical dilemmas are being managed in situated interaction. Accordingly, we aim at linking ethical principles to real-life clinical practices in order to show how ethical dilemmas are less about abstract decision-making, and more about reasoning constrained by inter-bodily dynamics, affect and adaptive behaviour in situated interaction. We present two real-life cases of ethical dilemma management in a psychotherapeutic setting. We use the innovative method, Cognitive Event Analysis, to investigate the interaction in which the dilemmas emerge. The analytical findings, we claim, pave the way for a more embodied code of ethics, which, in turn, has consequences for the theoretical assumptions that inform the models and guide­lines for action in practice.&#x0D;

Élaboration méthodologique dans la conception d’un dispositif thérapeutique de groupe en institution

ObjectivesThis article highlights how the creation of a group psychotherapeutic setting in an institution constitutes a subject of elaboration before the clinical experience itself. Our hypothesis is that the psychotherapeutic dimension and the dynamic power of a group are determined by the conception that clinicians have of their setting. MethodUsing the examples of several clinical situations (in an institutional setting) that we either created or inherited, we have distinguished different fields or objects of analysis. These objects are in mutual interface and make the therapeutic project a creation of the clinician. ResultsDifferent relationships can thus constitute internal obstacles to the creation and implementation of different types of therapy. We will distinguish: – the relationship of clinicians to their team and to their institution; – the relationship of the therapeutic project to the institutional framework; – the relationship of the therapeutic project to the different groups to which clinicians belong; – that of clinicians to their customary field of practice. DiscussionThe examples proposed here show how, according to the conditions of specific arrangements between clinicians, their professional affiliations, their team and the institutional situation, different points may appear as elements of suffering, confusion, or conflicts to be elaborated, discriminated, or resolved. ConclusionThe elements that make up the clinician's conception of their therapeutic initiative do not necessarily need to be explored before the project's implementation but potentially constitute objects of elaboration that might appear before or in the early stages of the clinical experience.

Psykologers opplevelse av hvordan deres politiske verdier påvirker terapi: en tematisk analyse

Background: Political values are essential to our sense of self and belonging. Yet the political orientation of clinical psychologists has either been neglected in psychological research or been investigated only in the United States several decades ago. This study therefore aimed to explore political values among psychologists and how they perceive the effect of political values on therapy in Norway. Method: Five clinical psychologists currently in active practice were recruited for semi-structured interviews. Results and discussion: A thematic analysis yielded several distinct themes. Political beliefs appear to play a part in therapy, and may influence both what the therapist thinks about the client and the choice of therapy. Nonetheless, the informants reported that talking about political beliefs in a psychotherapeutic setting was unusual and even uncomfortable for them. Conclusion: We therefore ask whether it is time to break the taboos associated with political values in and around psychotherapy, and conclude that further research should be devoted to this sensitive but vital topic. Keywords: politics, values, psychotherapy, therapeutic alliance, empathy, semi-structured interviews

«Jeg tror det er en illusjon at det ikke skal skinne igjennom»: En tematisk analyse av hvordan psykologer opplever at deres politiske verdier påvirker terapi

Background: Political values are essential to our sense of self and belonging. Yet the political orientation of clinical psychologists has either been neglected in psychological research or been investigated only in the United States several decades ago. This study therefore aimed to explore political values among psychologists and how they perceive the effect of political values on therapy in Norway. Method: Five clinical psychologists currently in active practice were recruited for semi-structured interviews. Results and discussion: A thematic analysis yielded several distinct themes. Political beliefs appear to play a part in therapy, and may influence both what the therapist thinks about the client and the choice of therapy. Nonetheless, the informants reported that talking about political beliefs in a psychotherapeutic setting was unusual and even uncomfortable for them. Conclusion: We therefore ask whether it is time to break the taboos associated with political values in and around psychotherapy, and conclude that further research should be devoted to this sensitive but vital topic. Keywords: politics, values, psychotherapy, therapeutic alliance, empathy, semi-structured interviews

Validation and application of the Non-Verbal Behavior Analyzer: An automated tool to assess non-verbal emotional expressions in psychotherapy

Emotions play a key role in psychotherapy. However, a problem with examining emotional states via self-report questionnaires is that the assessment usually takes place after the actual emotion has been experienced which might lead to biases and continuous human ratings are time and cost intensive. Using the AI-based software package Non-Verbal Behavior Analyzer (NOVA), video-based emotion recognition of arousal and valence can be applied in naturalistic psychotherapeutic settings. In this study, four emotion recognition models (ERM) each based on specific feature sets (facial: OpenFace, OpenFace-Aureg; body: OpenPose-Activation, OpenPose-Energy) were developed and compared in their ability to predict arousal and valence scores correlated to PANAS emotion scores and processes of change (interpersonal experience, coping experience, affective experience) as well as symptoms (depression and anxiety in HSCL-11). A total of 183 patient therapy videos were divided into a training sample (55 patients), a test sample (50 patients), and a holdout sample (78 patients). The best ERM was selected for further analyses. Then, ERM based arousal and valence scores were correlated with patient and therapist estimates of emotions and processes of change. Furthermore, using regression models arousal and valence were examined as predictors of symptom severity in depression and anxiety. The ERM based on OpenFace produced the best agreement to the human coder rating. Arousal and valence correlated significantly with therapists' ratings of sadness, shame, anxiety, and relaxation, but not with the patient ratings of their own emotions. Furthermore, a significant negative correlation indicates that negative valence was associated with higher affective experience. Negative valence was found to significantly predict higher anxiety but not depression scores. This study shows that emotion recognition with NOVA can be used to generate ERMs associated with patient emotions, affective experiences and symptoms. Nevertheless, limitations were obvious. It seems necessary to improve the ERMs using larger databases of sessions and the validity of ERMs needs to be further investigated in different samples and different applications. Furthermore, future research should take ERMs to identify emotional synchrony between patient and therapists into account.

Increasing Stress Resilience in Difficult Times: Integrating Proven Practices from Biofeedback and Psychotherapy

People across the country are experiencing significant levels of stress across most areas of life, including economic (jobs and inflation), health (epidemics), social and relationship issues, and international conflicts and political strife. People want to cope better but the amount of information available on stress management is staggering, confusing, and sometimes contradictory. Drawing from empirically supported intervention research that integrates biofeedback and psychotherapy approaches, three simple practices can help clients build stress resilience: balancing life demands with equanimity, becoming more aware but less worried, and actively engaging in flexible coping strategies. These three practices are straightforward to learn and easy to do as part of daily life. Although these approaches are typically administered individually in psychotherapeutic settings, there is significant potential in using a community approach to intervention. Most importantly, these techniques are proven, cheap, and have no side effects and can be easily administered using online website instruction and smartphone assessment technology.

Mindfulness in psychotherapy: The experience of psychotherapists who incorporate mindfulness into their practice.

Mindfulness is most commonly defined as the ability to bring one's attention to experiences occurring in the present moment, with complete acceptance and without judgment. The diverse benefits of mindfulness as a therapeutic tool have been widely explored. Nevertheless, when mindfulness is incorporated into psychotherapy it may influence the relationship between the therapist and the patient in diverse manners. This influence appears in the literature as relational mindfulness pertaining to mindfulness practiced in relationship to other people. The present article attempts to delineate the diverse influences of relational mindfulness within the psychotherapeutic setting through Qualitative analysis of in-depth interviews conducted with eight psychotherapists recruited from an institution for the teaching of mindfulness for psychotherapists. Analysis revealed influences on the therapist's worldview, on technique, on the presence of the therapist and, on the therapeutic alliance. These aspects are discussed from a psychoanalytic and a cognitive-behavioral framework. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Composition of treatment alliance in bipolar disorder: A cross-sectional study of patients' perspectives.

BACKGROUNDTreatment alliance has an impact on several key patient outcomes in all psychiatric disorders, including bipolar disorder (BD). It has been suggested that the construct of treatment alliance is different among patients from routine psychiatric settings compared to psychotherapeutic settings. However, research on the composition of treatment alliance in psychiatric disorders, such as BD, is relatively limited.AIMTo determine whether a broader construct of treatment alliance was prevalent among outpatients with BD.METHODSThis is a cross-sectional study, conducted in the psychiatric unit of a multi-specialty hospital in north India over 12 mo (September 2018 to September 2019). A consecutive sample of 160 remitted adult outpatients with BD on mood stabilizers for at least a year were selected. The principal instrument to assess treatment alliance was the Working Alliance Inventory-client version (WAI-Client). Other potential constituents of the alliance explored were perceived trust in clinicians assessed by the Trust in Physicians (TRIP) scale, perceived support from clinicians assessed by the Psychosocial Care by Physicians (PCP) scale, and perceived treatment satisfaction assessed by the Patient Satisfaction Questionnaire (PSQ). Associations between scores on all scales were determined by correlational and multiple regression analyses. Exploratory factor analysis of combined items of all scales was conducted using a principal components analysis.RESULTSScores on all the three WAI-Client subscales were significantly correlated with each other (r = 0.66-0.81; P < 0.0001). The total TRIP scores were associated with the total WAI-Client scores (r = 0.28; P < 0.01). The total TRIP scores and the total PCP scores were also significantly associated with the WAI-Client scores on the Task subscale (r = 0.28-0.29; P < 0.01). The total TRIP scores were significantly associated with the total PSQ scores (r = 0.45; P < 0.0001). Factor analysis yielded two independent and coherent factors, which explained 69% of the variance in data. Factor-1 (“alliance and support”), which explained about 41% of the variance, was comprised of a combined WAI-Client goal-task-bond component as well as the PCP support items. Factor-2 (“trust and satisfaction”), which explained about 28% of the variance, consisted of all the TRIP trust and the PSQ treatment satisfaction items.CONCLUSIONA broader construct of treatment alliance in BD was found. Apart from collaborative components, this construct included patients’ perceptions regarding trust in clinicians, support from clinicians, and treatment satisfaction.

Does LSD Have Any Therapeutical Value In Mental Disorders? A Non-Systemic Review

IntroductionLysergic acid diethylamide (LSD) a semi synthetic hallucinogen, was first synthetized by Albert Hofmann in 1938 and its psychological properties were not discovered until 1943. There was a brief renaissance of its use in psychiatry, specifically in assisted psychotherapy for the treatment of alcoholism, neurosis and psychosomatic disorders. However, research with LSD and others psychedelics substances rapidly came to an end with its broad international prohibition in the 1970´s.ObjectivesThis work aims to provide an understanding on the potential benefits of LSD in mental disorders, as well as its mechanism of action and effects on human brain.MethodsA non-systematic review was performed on PubMed database, using the key words “LSD, mental disorder, neuroimaging, cerebral plasticity, psychedelics, substance use disorder”. Websites of the Berkley Foundation and Multidisciplinary Association For Psychedelic Studies (MAPS) were also searched.ResultsSignificant evidence has emerged that LSD may have a role in the treatment for some mental disorder, including drug and alcohol dependence and anxiety associated with life threatening diseases. Evidence based on modern neuroimaging technique suggest that LSD alters the brain blood flow, electrical activity, and network communication patterns. Preclinical evidence also demonstrated that psychedelics affect neuroplasticity after acute and chronic administration.ConclusionsBased on the available evidence LSD when administered safely in a methodologically supervised psychotherapeutic setting can have a potential use for certain psychiatric conditions, suggesting that larger controlled studies are warrantedDisclosureNo significant relationships.

The Use of Interpretive Dynamic Transactional Analysis Psychotherapy (IDTAP) in Facilitating Structural Integration When Working With Reenactments of Developmental Trauma in the Psychotherapeutic Setting

The author considers how through reenactments, early developmental trauma and potential impairments in personality functioning may manifest in the psychotherapeutic relationship and how such reenactments may be underpinned by the individual’s need to control the intrapsychic dynamics through the use and control of interpersonal relationships. Some of the common transference manifestations are considered along with how they present fertile ground for resolution of the underlying internal conflicts. The article addresses this mainly through the theory and clinical examples from clients presenting with some level of personality impairment. In terms of psychotherapeutic technique, the author falls back on what he refers to as interpretive dynamic transactional analysis psychotherapy (IDTAP). There is a particular focus on reenactments of the destructive internal parts embedded in the client’s attachment to the internal bad object. The dangers of the therapist’s intention to provide the reparative relational experience are addressed along with the importance of analysis and resolution of the idealizing transference. The importance of the therapist’s function to endure and contain the negative countertransference is also discussed. Some potential interventions aimed at improving personality functioning are considered as are the implications of working with extratransference.