Search

This paper describes the impasses occurring in the treatment of Obsessive-Compulsive Disorder, being the special object of our analysis the patient's representations. In particular we shall try to answer the following questions: how does the obsessive-compulsive patient evaluate the psychological help provided by the psychotherapist? Which are the peculiar evaluations that hinder or even nullify this kind of help? We shall answer starting from one of the most substantiated thesis in the field of clinical cognitivism, the one according to which the obsessive symptomatology can be traced back to evaluations due to an hypertrophic sense of responsibility (Arntz et al. 2007; Ladouceur et al. 1997; Lopatka & Rachman 1995; Mancini et al. 2004; Salkovskis 1985, 1989; Salkovskis & Forrester 2002; Shafran 1997) and more specifically to a fear of moral guilt (Basile e Mancini 2011; Gangemi et al. 2007; Mancini 2005; Mancini & Gangemi 2004; Mancini et al. 2008; Rachman 1993; Shafran et al. 1996; Shapiro & Stewart 2011). We shall maintain, consistently with the above-mentioned thesis and on the basis of the clinical observation, that it is possible to explain most of the resistances to change and of the relational deadlocks as effects of evaluations amenable to those very same psychological structures implied in the genesis of the obsessive symptomatology (Saliani & Mancini 2010) and we shall provide, through clinical examples and excerpts of self-dialogue reported by patients, a thorough description of these kind of evaluations occurring in the various phases of treatment. [ABSTRACT FROM AUTHOR]

This article describes the clinical case of a patient with Pathological Affective Dependence (PAD). The interest in reporting this case is related to some specific aspects of PAD: (a) the overinvestment in avoiding loneliness, meant as loss of nurture, unworthiness and sufferance, due to the cross-scope of not losing relationships; (b) the role of the intrapsychic conflict in explaining the psychological suffering, and (c) the intergenerational transmission of PAD. Giving the lack of an effective treatment for PAD, guideline to treat Dependent Personality Disorder (DDP) were considered adequate in this case. However, even if DDP shares some common traits with PAD, it does not totally overlap with it. From a clinical point of view, this treatment overlap between PAD and DDP, shows some limitations such as objectives and behavioural patterns not shared between the two disorders. As such, there is the need of creating a specific treatment protocol for PAD that takes into account objectives, believes, and maladaptive behaviours to prevent longlasting difficulties and pathological relapses. Such protocol in currently under validation with the authors of the PAD cognitive model. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work is to explore the issue of online psychotherapy as a means of intervention which has become necessary due to the COVID-19 emergency. Research was conducted with the aim of investigating, from the point of view of therapists and patients, the quality, self-efficacy and difficulties related to the online setting, highlighting their limitations and advantages. Method: Two macro-samples, a first composed by therapists (Tp) (n=364) and a second by patients (Pz) (n = 226) filled out a questionnaire built ad hoc, sent with a remote link that investigated different areas. Exploratory and parametric analyses were carried out on the two samples (Tp and Pz) obtaining different comparisons and correlations. Results: From the comparison made between the total sample of therapists and patients on a set of investigated variables (quality of interaction/communication, sharing, perception of setting, COVID selfdisclosure, perceived self-efficacy, impotence, frustration, optimism, willingness to continue online) it emerges that the group of therapists shows higher scores, with respect to the group of patients, on all the variables investigated, maintaining an optimistic attitude and a willingness to continue psychotherapy with online modality also following the quarantine. The comparison analysis between therapists with expertise and without, shows less impotence in the former than in the latter without previous experience in the online setting. Finally, interesting meaningful correlations emerge between the negative prejudice of the patients, the course of the therapy, the negative emotional experiences of the patient and the perception of the therapist during the therapy in online mode. Conclusions: This study highlights interesting results, highlighting the point of view of psychotherapists and patients on online psychotherapy. In this regard, there are some difficulties found in both therapists and patients. However, it highlights the difficulties encountered most in both therapists and patients. That is to say, the therapists' concerns about the perceived self-efficacy of the intervention, the quality of communication with their patients, greater in therapists without previous experience of online therapy. In addition, therapists see greater use of self-disclosure interventions than the COVID-19 issue and in response to perceived difficulties. Furthermore, the prejudice and negative beliefs of patients seem to have an influence on the perception of the quality of therapy. The study highlights the advantages of the online psychotherapy as functional to emergency management and as a possible alternative to the standard setting. It provides food for thought regarding the management of this type of setting emphasizing how the difficulties encountered are not only patients-experience-related but also therapists-experience-related, both forced by the emergency COVID-19 to adapt to this change of setting. [ABSTRACT FROM AUTHOR]