Psychotherapeutic Tool Research Articles

Refining Suicide Prevention: a Narrative Review on Advances in Psychotherapeutic Tools.

Since psychotherapies for suicide prevention are receiving increasing attention, our purpose was to evaluate the related literature [meta-analyses and reviews on their effect on suicidal outcomes (A), perspective reviews concerning specific socio-demographic and clinical features (B), original studies with particular interest (C)] published over the last 3years. (A) Across different diagnoses, particularly, efficacious psychotherapies were cognitive behavioral therapy-based ones and interventions directly addressing suicidal thoughts and behaviors during the treatment. When the focus was restricted to specific diagnoses, results were different: for example, in borderline patients, dialectical behavior therapy and psychodynamic psychotherapies were the only efficacious interventions. (B) Family therapies for adolescents and treatments for elderly depressed patients with disability/cognitive impairment should be further developed. (C) General long-term effects seem to be present, but specific interventions and treatment duration should be considered. Results indicated the presence of a number of promising interventions.

Modernist Pills against Brazilian Alienism (1920–1945)

Psychoanalysis arrived in Brazil at the turn of the twentieth century and was frequently used as a new tool in the process of conservative modernization. As such, it was used by psychiatrists, eugenicists and hygienists in their projects. But avant-garde Brazilian writers appropriated it in a different manner. They saw psychoanalysis as a new form of cultural therapy that represented the new Brazilian ‘modernity’. The paper deals precisely with this project. With this aim in mind, it analyses several works of the leading authors of the Modernist Movement and their Manifestos, seeking to draw attention to the particular way in which psychoanalysis was appropriated as a psychotherapeutic tool capable of assisting in the creation of an identity for the country. For this analysis, the concept of circulation and of appropriation were chosen as theoretical reference.

Techniques for nothingness: Debate over the comparability of hypnosis and Zen in early-twentieth-century Japan.

This paper explores a debate that took place in Japan in the early twentieth century over the comparability of hypnosis and Zen. The debate was among the first exchanges between psychology and Buddhism in Japan, and it cast doubt on previous assumptions that a clear boundary existed between the two fields. In the debate, we find that contemporaries readily incorporated ideas from psychology and Buddhism to reconstruct the experiences and concepts of hypnosis and Buddhist nothingness. The resulting new theories and techniques of nothingness were fruits of a fairly fluid boundary between the two fields. The debate, moreover, reveals that psychology tried to address the challenges and possibilities posed by religious introspective meditation and intuitive experiences in a positive way. In the end, however, psychology no longer regarded them as viable experimental or psychotherapeutic tools but merely as particular subjective experiences to be investigated and explained.

Session Block: Of Mirrors, Lamps, and other Methods for the Writing up of Notes

Writing up session notes is essential to therapists’ practice, yet the literature on psychotherapeutic writing focuses almost exclusively on more complex tasks, such as preparing case studies or pieces for publication. Nonetheless, problems with writing up seem widespread: this article finds that 85% of trainees report difficulty. Such ‘session block’ has not before been defined. Given the absence of well‐accepted psychotherapeutic tools to overcome such block, and given that writing sessions is a challenge of representation – a phenomenon well described in the world of art – this article appropriates methods from aesthetic theory to address the problem. Applying first the Classical aesthetic metaphor of art‐as‐mirror, the pressure on therapists to produce a clear likeness of the session is explored, and the mirror metaphor is found to be as oppressive as it is widely accepted. By contrast, a revolutionary metaphor from the Romantic era, namely art‐as‐lamp, wherein the poet casts an inner creative light over the world, holds promise in overcoming countertransferential blocks and permitting an imaginative write‐up. This too, though, has drawbacks, and the article concludes by proposing a method which, by integrating metaphors, permits a free‐flowing write‐up of the session, both creatively rich and clinically accurate.

IDEM-dépression : caractéristiques et évaluation d’un groupe ouvert combinant psycho-éducation et thérapie cognitivo-comportementale

IntroductionDepression is a highly prevalent mental illness that is associated with high rates of morbidity and functional impairment. At the psychiatric unit of the University Hospital of Strasbourg, France, we have developed an open group that combines psychoeducation and cognitive-behavior therapy (CBT), the information, discovery, exchange and mobilization for depression group (IDEM-depression). IDEM-depression is composed of 17 thematic, structured, and independent sessions, which address different aspects of depression (i.e., rumination, pharmacological treatments). Because of its flexible format, patients with varying degrees of depression severity (from remission up to severe depressive symptoms) and whose depression might be bipolar or unipolar, are able to participate in the group. Thus, the group is well suited to a large number of patients with major depression. In the present study we aimed at describing the IDEM-depression group and presenting results regarding patients’ overall satisfaction, assessed via two self-report questionnaires (the Client Satisfaction Questionnaire, the CSQ-8, and the IDEM ad hoc questionnaire), as well as its effect on mood following each session assessed via a visual analog scale (VAS) ranging from 0 up to 100. MethodSixty-five patients participated in 50 sessions of the IDEM-depression group in two hospitals in Alsace. 61% of the patients had bipolar disorder, and 41% of them were inpatients. Sessions took place on a weekly basis, lasted 2hours and were proposed by a CBT-trained clinical psychologist. Patients were asked to fill-out the VAS at the beginning and at the end of each session. Moreover, they were asked to fill-out the CSQ-8 and the IDEM ad hoc questionnaire when they left the group. Other than one session (“yoga and mindfulness”), all the sessions (16 out of 17) were structured on a Powerpoint© presentation. During the first hour information was given regarding the topic (i.e., rumination), and a shared CBT conceptualization of the topic was formulated by the participants and the psychologist. For most sessions, the first hour was therefore communication and information-based, whereas during the second hour participants were asked to participate in in-session behavioral experiments and/or to evaluate specific aspects of their behavior (thoughts, emotions, activity, mindful behavior) during the last few days. The therapist manual and the slides for each session are available via e-mail to the first author. ResultsRegarding the results, self-reported mood on the VAS was compared between the onset (225 VAS) and the end (225 VAS) of each session. Overall, results suggest that self-reported mood is significantly improved following the participation in sessions (t=−5. 87, P<0.001). Moreover, mean results on the CSQ-8 suggest that patients are highly satisfied with the group (M=24.46, SD=6.42). Among them, 82% reported a moderate-high satisfaction with the group. On the IDEM ad hoc questionnaire, patients reported an overall high satisfaction level regarding (i) the content of sessions, (ii) the duration of sessions, (iii) the frequency of sessions, (iv) how much they felt they could express themselves during sessions. In the qualitative comments of this questionnaire, patients reported that the group helped them to gain an understanding of the mechanisms involved in depression; to feel less isolated and guilty; and to learn about specific psychotherapeutic tools (i.e., mindfulness) and to try to implement them. ConclusionOur results suggest that an IDEM-depression group is well suited to a wide-array of clinical pictures associated with depression (varying severity, bipolar or unipolar, inpatients and outpatients). This is probably due to its open-group format which is particularly well-adapted to the dynamic symptomatology associated with major depression, and may stimulate decentering in patients who have different levels of severity of symptoms but participate in the same session. Moreover, its impact on mood improvement, and the high satisfaction level reported by patients, seem to be related to its CBT and psychoeducation-based content on the one hand, which has shown its efficacy in depression. On the other hand, IDEM's structured open-group format might have also contributed to the improvement in mood and the overall good satisfaction reported by patients, through the social support provided by the group, improved feeling of self-efficiency, and its effect on stigmatization. Thus, IDEM-depression group is an efficacious, flexible, low-cost, and easy to implement (in different clinical settings) psychotherapeutic option for major depression.

From Body Image to Emotional Bodily Experience in Eating Disorders

This paper is a critical analysis and overview of body image conceptualization and its scope and limits within the field of eating disorders (eds) up to the present day. In addition, a concept ofemotional bodily experienceis advanced in an attempt to shift towards a more comprehensive and multidimensional perspective for thelived bodyof these patients. It mainly considers contributions from phenomenology, embodiment theories and a review of the empirical findings that shed light on the emotional bodily experience in eating disorders. It proposes an ‘embodied defense’ that leads patients to experiencing their own bodies as objects. This proposal highlights the need for new psychotherapeutic tools in the treatment ofeds that take into account the bodily resonance of emotions and their use for improving adaptive responses to the environment: it calls for helping patients to recover the subjective experience of their bodies.

Acceptability of an adventure video game in the treatment of female adolescents with symptoms of depression

While many adolescent patients resistantly engage in psychotherapy, they are attracted by new technologies and video games. A development and research project was implemented to design an online adventure video game as a psychotherapeutic tool for depressed adolescents and to evaluate its acceptability. The game design followed the narrative structure of the hero’s journey and ideas from the cognitive behavioral and interpersonal psychotherapy models for depression. Five psychotherapists and fifteen of their female adolescent patients with symptoms of depression tested the game. Some patients valued the video game in terms of learning helpful social and mental health-related behaviors. Therapists manifested that a video game like Maya could be a useful complementary tool for psychotherapy of adolescent girls. The study suggests that future developments of video games for mental health are worthwhile and it provides some ideas on how to incorporate psychotherapeutic notions in ludic environments.

Benefits and challenges in the use of art as an intervention for making sense of the cancer experience: a qualitative systematic review protocol.

How does art contribute as a psychotherapeutic tool in making sense of the cancer experience? What is the meaningfulness of integrating art (as either creator or consumer) for patients throughout the cancer experience?

IMPACT OF A RELATIONSHIP DEVELOPMENT GROUP ON STUDENTS INTERPERSONAL COMMUNICATION AND RELATIONSHIPS

Together with the increasing pace of modern society and technological improvements, it appears that students’ psychological needs, complaints and methods of communication have also changed. At the University of Pretoria (UP) between January and October 2012 the most frequent problems presented at Division Student Support (DSS) were stress, anxiety and depression relating to academic, personal and particularly interpersonal relationships. Unsatisfactory interpersonal relationships appeared to have a detrimental impact on academic performance, which could culminate in the termination of studies. This highlighted the need for more effective psychotherapeutic interventions to improve communication and interpersonal relationships. Traditional psychotherapeutic approaches no longer appeared to be as effective. Increasing numbers of students suggested group intervention as opposed to individual psychotherapy. It was postulated that a semi-structured relationships development group (RDG) grounded in the inter-psychic approach could address the contemporary needs of students. Such a group of seven UP students was formed in April 2013. Initial findings based on the feedback from these group members show the semi-structured RDG to be an impactful and effective short-term psychotherapeutic tool to improve the quality of communication and interpersonal relationships of students at South African institutions of higher education. This would allow students who may be at risk of academically underperforming to improve their academic results and in doing so improve the academic success and throughput rates at South African institutions of higher education. Further research is advocated to verify these findings at other South African institutions of higher education.

The Dual-Dialectical Conceptualization in Psychotherapy.

The current paper describes the dual-dialectical conceptualization, a theoretical psychotherapeutic conceptualization based on three major rules: duality, contradiction, and complementarity. The paper surveys these rules with respect to various theoretical approaches in philosophy and psychotherapy. The essential feature of this conceptualization lies in its reinterpretation of problems that patients habitually regard as being one dimensional (e.g., patients are "stuck" in a solely negative attitude). Within the conceptualization, problems are reframed as dual dimensional, thereby offering patients more options and freeing them to better contend with the problems. Introduction of a novel psychotherapeutic tool known as the differentiation/integration approach provides patients with freedom of choice and enables them to distinguish between alternatives in verbal expressions and psychotherapeutic themes.

Narrative Exposure Therapy for Treating PTSD With Psychotic Features

Posttraumatic stress disorder (PTSD) with secondary psychotic features is a syndrome that comprises PTSD symptoms followed in time by the additional appearance of psychotic features. Although diagnostic criteria for this condition are not available, the clinical description of this condition has been described especially in individuals who have experienced severe, chronic, multiple traumatic events. This case study presents the treatment of a survivor of torture with severe PTSD and concomitant psychotic features using the psychosocial approach as a theoretical framework of the clinical presentation and narrative exposure therapy (NET) as a psychotherapeutic intervention. NET could be a useful psychotherapeutic tool in relieving symptoms related to severe PTSD with secondary psychotic features. The overall implications involved in working with survivors of torture are also discussed.

Using Control-Mastery and Jungian Theories to Treat Nightmare Disorder: A Case from Thailand

This case example describes the use of Control-Mastery Theory and Jungian dream theory to interpret a Thai woman's dreams and treat her nightmare disorder. We posit that therapy enabled the client to identify and challenge unconscious beliefs that had been preventing her from pursuing romantic relationships and ultimately life goals. The case illustrates dream interpretation as a psychotherapeutic tool and highlights the importance of considering cultural context to help make sense of a client's dreams and waking-life beliefs, feelings, and behaviors. The quality and rigor of the case example were enhanced by the use of the Messer (2007) Pragmatic Case method.

Diálogo socrático en logoterapia

In this article a detailed application framework called Socratic Dialogue as the main psychotherapeutic tool of Logotherapy, delving into the methodology, the attitude of the therapist and the fields of intervention is made about the person. Numerous examples of approaches, key questions and remarks are included. It goes to authors such as V. Frankl, E. Lukas, J. Fabry, E. Martinez, among others, in relation to which this form of therapeutic conversation is in order to mobilize the freedom of each client.

Adaptation to Physical Disabilities: The Role of Meaning in Life and Depression

Depression is one of the most frequent psychological symptoms in people with physical disabilities, as the acquisition of a physical disability is a stressful situation, demanding an individual’s adjustment to a new distressing reality. While some individuals manage to adapt to their physical disability’s implications, others fail to accept this new situation, manifesting depressive symptoms. One factor that seems to facilitate adaptation process to physical disabilities and thus prevent from depression prevalence is meaning of life. Viktor Frankl has emphasized the importance of experiencing meaning of life in the maintenance of physical and psychological health, especially in painful and distressing situations. The present study focused initially on the assessment of meaning in life and depressive symptomatology in individuals with physical disabilities. Moreover, the relationship of meaning in life and depression with adaptation to physical disability was examined. A sample of 522 participants with various types of physical disabilities completed three questionnaires on depressive symptomatology, meaning in life and adaptation to disability. Our assumptions regarding the negative relationship between meaning of life and depression were confirmed. Additionally, meaning of life was found, as expected, to play in important role in facilitating individuals’ adaptation to their physical disabilities, a finding indicating the great utility of Frankl’s existential theory as a psychotherapeutic tool for people with physical disabilities.

Expectations, experiences and attitudes of patients and primary care health professionals regarding online psychotherapeutic interventions for depression: protocol for a qualitative study

BackgroundIn the year 2020, depression will cause the second highest amount of disability worldwide. One quarter of the population will suffer from depression symptoms at some point in their lives. Mental health services in Western countries are overburdened. Therefore, cost-effective interventions that do not involve mental health services, such as online psychotherapy programs, have been proposed. These programs demonstrate satisfactory outcomes, but the completion rate for patients is low. Health professionals’ attitudes towards this type of psychotherapy are more negative than the attitudes of depressed patients themselves. The aim of this study is to describe the profile of depressed patients who would benefit most from online psychotherapy and to identify expectations, experiences, and attitudes about online psychotherapy among both patients and health professionals that can facilitate or hinder its effects.MethodsA parallel qualitative design will be used in a randomised controlled trial on the efficiency of online psychotherapeutic treatment for depression. Through interviews and focus groups, the experiences of treated patients, their reasons for abandoning the program, the expectations of untreated patients, and the attitudes of health professionals will be examined. Questions will be asked about training in new technologies, opinions of online psychotherapy, adjustment to therapy within the daily routine, the virtual and anonymous relationship with the therapist, the process of online communication, information necessary to make progress in therapy, process of working with the program, motivations and attitudes about treatment, expected consequences, normalisation of this type of therapy in primary care, changes in the physician-patient relationship, and resources and risks. A thematic content analysis from the grounded theory for interviews and an analysis of the discursive positions of participants based on the sociological model for focus groups will be performed.DiscussionKnowledge of the expectations, experiences, and attitudes of both patients and medical personnel regarding online interventions for depression can facilitate the implementation of this new psychotherapeutic tool. This qualitative investigation will provide thorough knowledge of the perceptions, beliefs, and values of patients and clinicians, which will be very useful for understanding how to implement this intervention method for depression.

Following in the Footsteps of Sisyphus:

Following in the Footsteps of Sisyphus:

Symptômes résiduels et récidive dans le trouble dépressif majeur

The persistence of residual symptoms after treatment of a major depressive episode is found in approximately a third of all cases. Definitions of partial remission of a major depressive episode with residual symptoms are either criteriologic, like the DSM, which require a defined number of symptoms with functional effect ; or quantitative, with a score localized in a defined range on a depression evaluation scale. The persistence of residual symptoms following a major depressive episode and the risk of a new episode are closely linked as outlined in guidelines created by expert groups and savant societies as well as clinical studies done in this field. Among the risk factors to predict further depressive episodes, the weight of persisting residual symptoms may be higher than the number of previous depressive episodes. In case of residual symptoms, the therapeutic proposals rely on pharmacological or psychotherapeutic tools are essentially of two types: nonspecific potentialization of previous antidepressive treatments or additional treatment specifically targeting each patients residual symptoms. A strong consensus exists on necessity of maintaining the therapeutic efforts until disappearance of residual symptoms, this objective must be pursued in a definite and continuous way by the practitioner.

Cognitive behavioural therapy in palliative and end-of-life car

Anxiety and depression are often overlooked symptoms in patients with terminal conditions. There appears to be a link between anxiety and depression and a higher incidence of physical symptoms. Any psychological distress, whatever the cause, requires assessment and treatment. The role of counselling in palliative and end-of-life care (EoLC) is well established. Cognitive behavioural therapy (CBT) is a psychotherapeutic treatment tool that aims to enable individuals to change negative thought processes and behaviour. This article examines whether CBT can be adapted and utilised to reduce patients’ symptoms of low mood, anxiety and pain in the palliative care setting. CBT has the potential to be effective for this patient population, as it focuses on the ‘here and now’. Emerging evidence indicates that palliative care practitioners can be trained effectively to undertake CBT with their patients/clients. Nurses working with patients in palliative and EoLC settings should be familiar with CBT so that they can refer patients who might benefit to a practitioner competent in it use. Conflicts of interest: none

Symboldrama, a Psychotherapeutic Method for Adolescents with Dissociative and PTSD Symptoms: A Pilot Study

A total of 15 clinically referred adolescents who had been sexually or physically abused participated in this pilot study of the use of symboldrama psychotherapy. Symboldrama is a psychotherapeutic method that uses imagery as the major psychotherapeutic tool. All adolescents reported to be suffering from a high level of dissociative symptoms and other symptoms such as anxiety, depression, posttraumatic stress, and anger after their traumas. The objective of the study was to test the hypothesis that symboldrama psychotherapy in addition to psycho-education of the non-offending parent would significantly reduce the reported symptoms. Before treatment, the participants answered three questionnaires: (a) the Life Incidence of Traumatic Events Scale, (b) the Trauma Symptom Checklist for Children, and (c) the Dissociation Questionnaire–Swedish version. After treatment, the participants once again filled out the Trauma Symptom Checklist for Children and the Dissociation Questionnaire–Swedish version. The scores from before and after treatment were compared, and the results showed that the symptoms had been statistically significantly reduced.

A CAPOEIRA COMO INSTRUMENTO E RECURSO TERAPÊUTICO PARA PESSOAS COM SOFRIMENTO PSÍQUICO

Based on the principles of psychiatric reform, new resources and professional therapeutic stepped in to compose the work of teams of health, aiming to construct other possible reatments besides the doctor-centered. The aim of this paper is to report the experience of university extension for the use of Capoeira Angola as a tool and therapeutic agent in treating people with psychological distress, users of psychotropic drugs, seeking assistance at the Centers for Psychosocial Support. The paper also provides, within the approach of Somatic Psychology, some of the features that Capoeira was able to offer as a psychotherapeutic tool.