Tool In Psychotherapy Research Articles

The social collective and the social and cultural atom in the age of the social network

This article in the Zeitschrift fur Psychodrama und Soziometrie presents the use of the social collective as applied in a current psychotherapeutic practice. The significance and use of the social collective is one that has relevance in any field and is the cornerstone of the modern phenomenon of digital social networking. Dr. Jacob Levy Moreno was the originator of the concept and his ideas have influenced the development of the modern day social network. The earliest and smallest social atom is the mother and baby. While this social unit is the precursor to all others, new life can emerge wherever mutual positive tele flourishes. As the wave and particle in physics do not exist independently, neither does the twin concept of the social and cultural atom. The use of the latter as an evaluation tool in psychotherapy is powerful and along with the concept of the social collective, can be used to analyse patterns in any group or cultural context.

From Psychiatry to Flower Power and Back Again: The Amazing Story of Lysergic Acid Diethylamide.

Among the psychedelic drugs that enjoyed a period of popularity in psychiatric research during the 1950s and 1960s, lysergic acid diethylamide (LSD) is the most prominent one. Psychiatrists of that time had seen LSD not only as a tool for psychotherapy but also as a potential therapeutic for anxiety, depression, alcohol abuse, autism, and even schizophrenia. When it became a quasi-religious epitome of the Hippie counterculture in the mid 1960s, and cases of what we now call hallucinogen persisting perception disorder and acute psychotic "flashbacks" mounted, authorities moved to make LSD illegal. Although research was never actually forbidden, the field almost completely dried out until the early 2010s. Using today's tools of molecular pharmacology, functional imaging, and neuronal network theory, neuropsychiatry is now resurrecting LSD research-with implications that leave us with many medical and ethical questions. Few people are aware that this is a repurposed compound, originally developed in an effort to synthesize a new analeptic. On top of all potential LSD might have in psychiatry, it also serves as a reminder of the unexpected potential that discarded early-stage compounds can have.

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.

Evaluating an e-mental health program ("deprexis") as adjunctive treatment tool in psychotherapy for depression: design of a pragmatic randomized controlled trial.

BackgroundMajor depressive disorder (MDD) places a significant disease burden on individuals as well as on societies. Several web-based interventions for MDD have shown to be effective in reducing depressive symptoms. However, it is not known whether web-based interventions, when used as adjunctive treatment tools to regular psychotherapy, have an additional effect compared to regular psychotherapy for depression.Methods/designThis study is a currently recruiting pragmatic randomized controlled trial (RCT) that compares regular psychotherapy plus a web-based depression program (“deprexis”) with a control condition exclusively receiving regular psychotherapy. Adults with a depressive disorder (N = 800) will be recruited in routine secondary care from therapists over the course of their initial sessions and will then be randomized within therapists to one of the two conditions. The primary outcome is depressive symptoms measured with the Beck Depression Inventory (BDI-II) at three months post randomization. Secondary outcomes include changes on various indicators such as anxiety, somatic symptoms and quality of life. All outcomes are again assessed at the secondary endpoint six months post randomization. In addition, the working alliance and feasibility/acceptability of the treatment condition will be explored.DiscussionThis is the first randomized controlled trial to examine the feasibility/acceptability and the effectiveness of a combination of traditional face-to-face psychotherapy and web-based depression program compared to regular psychotherapeutic treatment in depressed outpatients in routine care.Trial registrationISRCTN20165665.

Music Therapy As a Tool of Psychotherapy in Adolescence Cancer Patients

ABSTRACT Aim: Adolescents cancer patients not only have substantial physical, cognitive, emotional and interpersonal problems but also added burden of a life threatening disease. Persistent body image concerns somatic preoccupation, disruptions in heterosexual relationships and deficit in social competence have all been documented in this age group. Integration of conventional and complementary modes of therapy can be helpful in case of psychological problems This study examines adolescent cancer patients and their parents perspectives about music and music therapy's role in their lives. Methods: We assessed 100 patients in their adolescence with their families in the Psycho oncology department of Netaji Subhas Chandra Bose Cancer Research Institute during July 2006 to December 2013. Among total patients 42% were ALL, 12% were NHL, 6% were Hodgkin disease, 12% were Rhabdomyosarcoma, 8% were PNET, 8% were Germ cell Tumor, 4% were brain tumor, 4% were Osteosarcoma and rest 4% were soft tissue and other patients. We examined their family functioning, mental health, self-esteem, and social competence. Music sessions for individuals and groups based on their needs and tastes were designed. The patients could listen music of their choice, play instruments themselves, writes songs or simply talk about music they liked. Results: Out of 100 patients 80% had excellent psychological functioning without serious social issues. They expressed a positive effect. Among them 10% expressed a little depression, 8% of the teenagers thought that their families were less attentive than the case with their counterparts. These adolescents were maladjusted to the society also. Two patients (2%) were reluctant to command. Majority of the patients who had psychological disturbances, responded well to Music therapy and agreed to proceed with their treatment except a few terminal cases. Positive effects may carry over into children's home lives and vicariously support families. Out of 20 patients psychologically challenged adolescents, 18 patients came back to normal state of mind after music therapy Conclusions: Hence we recommend psychotherapy strongly in their adolescent period in frequent intervals. Music therapy can be excellent tool for psychotherapy in the adolescent paediatric and cure strongly recommended Disclosure: All authors have declared no conflicts of interest.

EPA-1344 – Countertransference, schema modes and ethical considerations in cognitive behavioral therapy

Transference and countertransference could be significant sources of insight about the patient's, therapist's and supervisor's inner worlds. Transference phenomena are viewed as a reenactment in the treatment relationship of key elements of previous significant relationships. Countertransference occurs in CBT when the relationship with the patient activates automatic thoughts and schemas in the clinician, and these cognitions have the potential for influencing the therapy process. Countertransference also occurs during supervision and is an indispensable part of the supervisor's response to the supervisee. During the long-term CBT of the personality disorder or other complex cases, high intensity of transference and countertransference can develop. Schema therapy shares the view that schemas are crucial to understanding of personality disorders, but also can help to understand the emotional reaction of therapist. A mode is the set of schema operations that are in one moment functioning for a person. When therapist suspects that countertransference may be developing, he/she could try to identify her/his automatic thoughts and schemas. More comprehensive approach is to quickly identify in which mode him/her are at that moment and reflect it such reaction is for the patient benefit or not. Understanding therapist countertransference reactions and theirs management are a significant point of supervision. Selfreflection and realizing the countertransference can therapist help to overcome it and may be necessary for overcoming stagnation in therapy. Understanding own mode and their flipping into the therapeutic session is an important tool in psychotherapy and supervision.

EPA-1419 – Schema modes, transference and countertransference

Transference and counter transference could be significant sources of insight about the patient's, therapist's and supervisor's inner worlds. Transference phenomena are viewed as a reenactment in the treatment relationship of key elements of previous significant relationships. Counter transference occurs in CBT when the relationship with the patient activates automatic thoughts and schemas in the clinician, and these cognitions have the potential for influencing the therapy process. Counter transference also occurs during supervision and is an indispensable part of the supervisor's response to the supervisee. Schema therapy shares the view that schemas are crucial to understanding of personality disorders, but also can help to understand the emotional reaction of therapist. A mode is the set of schema operations that are in one moment functioning for a person. It is a circumscribed complex pattern of emotional, cognitive a behavioral experiences, which operate in typical situations. When therapist suspects that counter transference may be developing, he/she could try to identify her/his automatic thoughts and schemas. More comprehensive approach is to quickly identify in which mode him/her are at that moment and reflect it such reaction is for the patient benefit or not. Understanding therapist counter transference reactions and theirs management are a significant point of supervision. Self reflection and realizing the counter transference can therapist help to overcome it and may be necessary for overcoming stagnation in therapy. Understanding own mode and their flipping into the therapeutic session is an important tool in psychotherapy and supervision.

Computer-Assisted Cognitive-Behavioral Therapy

There has been a recent acceleration in the development and testing of programs for computer-assisted cognitive-behavioral therapy (CCBT). Programs are now available for treatment of depression, anxiety disorders, and other psychiatric conditions. Technology for delivery of CCBT includes multimedia programs, virtual reality, and handheld devices. Research on CCBT generally has supported the efficacy of computer-assisted therapy and has shown patient acceptance of computer tools for psychotherapy. Completion rates and treatment efficacy typically have been higher when clinicians prescribe and support the use of psychotherapeutic computer programs than when programs are delivered in a self-help format without clinician involvement. CCBT seems to have the potential to improve access to evidence-based therapies while reducing the demand for clinician time.

Video Games in Psychotherapy

Video games have found their way into the clinical care of youth in most medical fields, and academic interest in their use is increasing steadily. The popularity of video games among youth may qualify them as a useful tool in psychotherapy for children and adolescents. Limited literature on use of video games in mental health care suggests that they can help young patients become more cooperative and enthusiastic about psychotherapy. Recent experience suggests that video games may facilitate therapeutic relationships, complement the psychological assessment of youth by evaluating cognitive skills, and elaborate and clarify conflicts during the therapy process. Concerns about video game content, perceived effects on youth, and lack of familiarity with this medium may form a barrier in their use in therapy offices. Further research on the benefits of video game use in psychotherapy, including patient characteristics that may moderate outcomes, is needed. Finally, future collaborations between clinicians and video game developers may produce specific games to be used in psychotherapy.

Dreams in normal and pathological aging

Although most of scientific knowledge in dream research is based on young adult studies, this article provides a review of the effects of normal and pathological aging on dream psychology. It starts with preliminary comments about epistemological and methodological principles of dream research, its singularities in aged persons, and the modifications of sleep physiology with age. The whole literature agrees that dream recall progressively decreases from the beginning of adulthood - not in old age - and that dream reports become less intense, perceptually and emotionally. This evolution occurs faster in men than women, with gender differences in the content of dreams. The chronological modifications could be explained partly by changes in lifestyle and attitude towards dreams in early adulthood, but mainly by modifications of sleep physiology, particularly the decrease and qualitative changes of rapid eye movement (REM) sleep. Dreams have usually little subjective importance in the mental life of aged persons. However, working with dreams can be a valuable tool for psychotherapy in the aged. According to the few existing data, patients suffering degenerative dementia dream much less than healthy aged persons. In Alzheimer's disease, this could be linked to the decrease of REM sleep, and atrophy of associative sensory areas of the cerebral cortex. Most studied aspects of dreaming in degenerative cognitive disorders are REM sleep behavior disorders, and nightmares induced by cholinesterase inhibitors. More studies are needed to better characterize the evolution of dreams with age, particularly studies performed in sleep laboratory.

Is there a case for MDMA-assisted psychotherapy in the UK?

Much has been written in scientific and popular literature in recent years about the dangers surrounding the recreational use of the drug MDMA/ecstasy. What is little known and understood however is the history of the apparently safe and effective use of MDMA as a therapeutic tool for psychotherapy. In this paper the author explores this history and describes the recent re-emergence of scientific interest in MDMA and other psychedelic drugs. There are currently several new double-blind randomised controlled trials underway re-visiting the subject. By acknowledging the limitations of this new research and emphasising the importance of exercising appropriate but realistic caution, the author asks that the medical profession consider a dispassionate and open-minded debate to examine whether MDMA might have a legitimate place as an adjunct to psychotherapy in modern psychiatric practice.

Terapia sobre revisión de vida basada en la recuperación de recuerdos autobiográficos específicos en ancianos que presentan síntomas depresivos

Introduction the aim of this study was to examine the efficacy of a new model of life review based on retrieval of specific positive autobiographical memories to treat depressed older adults. Material and method forty-three adults aged 65-93 years with clinically significant depressive symptomatology and no dementia were randomly assigned to the treatment or control groups. The results indicated significant differences between the experimental and control groups after 4 weeks of practising autobiographical retrieval. Results in the post-test, individuals in the treatment group showed fewer depressive symptoms and retrieval of a greater number of specific events. The findings suggest that practice in autobiographical memory, based on retrieval of specific events, may be among the components of life review that account for its effectiveness and could be a useful tool in psychotherapy in older adults with depression.

Case Formulation in Psychotherapy: Revitalizing Its Usefulness as a Clinical Tool

Case formulation has been recognized to be a useful conceptual and clinical tool in psychotherapy as diagnosis itself does not focus on the underlying causes of a patient's problems. Case formulation can fill the gap between diagnosis and treatment, with the potential to provide insights into the integrative, explanatory, prescriptive, predictive, and therapist aspects of a case. Despite the acknowledgment that case formulation is a basic, necessary, and key clinical skill, it is still largely undertaught and underlearned. Some of the issues faced in the development of a case formulation include that of immediacy versus comprehensiveness, complexity versus simplicity, observation versus organization, and the need for cultural sensitivity toward each individual patient. The authors propose five aspects of case formulation beneficial to therapists and residents in training. The authors argue that case formulation remains an important and indispensable integrative tool for therapists and residents in training who are involved in psychotherapeutic interventions.

Psychotherapy and Eclecticism

Back to table of contents Previous article Next article LettersFull AccessPsychotherapy and EclecticismJohn C. Markowitz, M.D.John C. MarkowitzSearch for more papers by this author, M.D.Published Online:1 May 2005https://doi.org/10.1176/appi.ps.56.5.612-aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: In the Practical Psychotherapy column in the March issue Dr. Goin (1) argues for "informed eclecticism … a knowledgeable integration of the several available psychotherapy tools." She contrasts this to "eclectic" psychotherapy, which often turns out to be "a potpourri of different activities, fuzzy and unstructured."Alas, the latter definition doubtless more accurately describes psychotherapeutic eclecticism in practice. There is good reason for this. The evidence base for psychotherapy depends on carefully defined, manualized treatments that are monitored for therapist adherence. Research generally shows that adherence to one specific model yields better results than a muddied, mixed (read "eclectic") approach (2,3). That treatment purity matters makes sense, particularly in the context of short-term treatments. Therapists should equip patients with a kit of finely honed "tools" for handling symptoms and situations, rather than a hodgepodge of responses.Moreover, no one is really "knowledgeable" about how best to combine differing treatments. Little evidence is available with which to inform eclecticism. Hence, although mixing techniques is a constant temptation in therapy sessions, it is best avoided. The risk inherent in eclecticism is that therapists will fall into idiosyncratic approaches, as they did in the pre-empirical past. It's important that psychiatric residents be trained in carefully defined treatments (psychodynamic, cognitive, and so forth) so that such eclecticism—a euphemism for entropy—is minimized.Dr. Markowitz is a research psychiatrist at New York State Psychiatric Institute and clinical professor of psychiatry at Weill Medical College of Cornell University in New York City.

Life Review Therapy Using Autobiographical Retrieval Practice for Older Adults With Depressive Symptomatology.

The aim of this study was to examine the efficacy of life review based on autobiographical retrieval practice for treating depressed older adults. Forty-three adults aged 65-93 with clinically significant depressive symptomatology and no dementia were randomly assigned to treatment or to no treatment. The results indicated significant differences between experimental and control groups after 4 weeks of autobiographical retrieval practice. At posttest, those in the treatment condition showed fewer depressive symptoms, less hopelessness, improved life satisfaction, and retrieval of more specific events. The findings suggest that practice in autobiographical memory for specific events may be among the components of life review that account for its effectiveness and could be a useful tool in psychotherapy with older adults.

Synergetics of hypnoid relaxation

The Autogenic Training (AT) is a well established relaxation technique and psychotherapy tool. We report the use of nonlinear routines, the Multi-scaled Time-Frequency-Distribution (mTFD) for the graphical display of vegetative rhythms, and Post-Event-Scan (PES) for the direct visual identification of coupling between physiological subsystems. Applying these methods to time series of respiration, arterial blood pressure, and cutaneous forehead blood content fluctuations in controls (n = 11) or AT-experts (ATE, n = 11) induced psychomotor drive reduction during orthostatic stress allowed the instantaneous identification of a 0.15 Hz-rhythm. This rhythm prevailed in ATE significantly longer resulting a significantly robust 1 : 1 coupling between cutaneous blood content fluctuations and respiration. Consequently, we hypothesize that the "0.15 Hz-rhythm" in the cutaneous blood content fluctuations described previously which was associated with the subjective experience of profound psychomotor relaxation reflects an order-order transition in peripheral signals of central nervous origin. Results produced with the aid of these analytic tools support the efficacy of the AT induced, synergetic relaxation response.

The therapeutic use of labyrinths

AbstractLabyrinths are ancient sacred spaces. A labyrinth is a single winding path which has been used by many cultures and religions throughout history as a decorative symbol on coins pottery and floors, as roads along which the dead were taken to burial sites, as a path walked to ensure good fishing catches, to protect from evil forces envisaged as wolves and trolls, in courtship rituals, to enable focusing and meditation and prayer.This paper reflects upon their history. It considers the use of finger labyrinths as a tool in psychotherapy and offers some brief case illustrations. Finger labyrinths are small hand held designs, using the pattern identical to the full scale models. They are usually carved in wood, with a groove to mark out the path so that it can be followed with the eyes closed and using a finger to trace it. Grooved labyrinths dating back to Neolithic times, have been found carved on rocks. Labyrinths marked out on the land or in buildings such as cathedrals, are large enough to be walked. Some are a few metres across, others may be very large, covering several acres. Copyright © 2003 Whurr Publishers Ltd.

New and old tools in psychotherapy: The use of technology for the integration of the traditional clinical treatments.

The proliferation of computer-mediatedcommunication has led to theexperimentation with these tools inpsychotherapy. This article examinesthe possible integration betweentraditional and new tools inpsychotherapy, showing pros and consof the use of technology. In particular,the article focuses on the concept ofe-therapy and the technology itrequires. An analysis of the mostfunctional tools and software nowavailable is also presented, with aparticular focus on shared hypermedia,new Internet tools in which differentusers who are simultaneously browsingthe Web can communicate and surftogether.

The VEPSY updated project: virtual reality in clinical psychology.

Many of us grew up with the naive assumption that couches are the best used therapeutic tools in psychotherapy. But tools for psychotherapy are evolving in a much more complex environment than a designer's chaise lounge. In particular, virtual reality (VR) devices have the potential for appearing soon in many consulting rooms. The use of VR in medicine is not a novelty. Applications of virtual environments for health care have been developed in the following areas: surgical procedures (remote surgery or telepresence, augmented or enhanced surgery, and planning and simulation of procedures before surgery); preventive medicine and patient education; medical education and training; visualization of massive medical databases; and architectural design for health care facilities. However, there is a growing recognition that VR can play an important role in clinical psychology, too. To exploit and understand this potential is the main goal of the Telemedicine and Portable Virtual Environment in Clinical Psychology--VEPSY Updated--a European Community-funded research project (IST-2000-25323, http://www.vepsy.com). The project will provide innovative tools-telemedicine and portable-for the treatment of patients, clinical trials to verify their viability, and action plans for dissemination of its results to an extended audience-potential users and influential groups. The project will also develop different personal computer (PC)-based virtual reality modules to be used in clinical assessment and treatment. In particular, the developed modules will address the following pathologies: anxiety disorders; male impotence and premature ejaculation; and obesity, bulimia, and binge-eating disorders.

Prospects in psychotherapy research

The point of departure for this discussion is a critical review of the philosophy of randomized controlled trials (RCT) and their specific errors when applied to psychotherapeutic methods. There is a gap between the highly artificial settings of psychotherapy RCT and naturalistic psychotherapy procedures, which are grounded more in personality than in technique, less regulated, and mostly eclectic. Although RCT are necessary for general assessments of efficacy, they should be complemented by efficiency studies and evaluation of whole health care systems which include psychotherapy. We argue against overstretching the analogy of good clinical practice (GCP) research for the purpose of admitting new psychotropic drugs to psychotherapy research. A rational approach to psychotherapy for indication, quality ascertainment, and allocation of resources needs research which is methodologically explicable, replicable, and relevant to practice. The Cochrane Collaboration is a means of distributing such knowledge and making it work for practitioners. However, Cochrane also sheds light on psychological and practical obstacles which must be overcome before public health care systems can utilize new scientific results. The discussion of disorder-specific psychotherapy versus general psychotherapy ends by emphasizing the importance of more detailed psychopathology and pathopsychology of dysfunctions that cannot be sufficiently explained in manuals. Such dysfunctions--not necessarily specific for diagnoses or abnormality at all--can then be matched to specific psychotherapy tools. Further innovations can be expected from neurosciences, and some of the most promising paradigms are discussed. Finally, the lasting importance of hermeneutics is stressed not only with regard to the generation of new hypotheses but also to guiding the psychotherapeutic process.