Search

In this short response to the papers appearing in this special issue (Technology, AI Bots and Psychotherapy After Covid), psychotherapist and author Aaron Balick draws on the variety of themes that have arisen within the contributed papers to reflect on the wider issue of computer mediated human relations. In it he makes a distinction between the papers that focus on the therapeutic process mediated by technology and those that look more broadly at the paradigm of therapy practice in this context. Framing technology as a tool, the author pulls together both strands to explore what psychotherapy research may say about the broader issues of societies mediated by technology and how therapeutic research may contribute to these larger social issues. [ABSTRACT FROM AUTHOR]

In this article the author outlines his understanding of self-psychology as an independent psychoanalytic treatment paradigm created by the late Heinz Kohut and initially geared toward the psychoanalytic treatment of narcissistic disorders. Since then, self-psychology theory and practice have been enriched by new theoretical and clinical considerations and have been introduced into other forms of psychotherapy, counseling, and education, for example. One important conceptual contribution to developmental theory was Heinz Kohut's differentiation of separate narcissistic and "object love" related developmental tasks. Today, new paradigms as i.e. relational analysis stress the value of human relationships and of the value of mutual recognition. This warrants a revisiting of the clinical value of the self-psychological understanding of narcissism. According to the author it lies in the nature of unattended narcissistic needs that when unattended they take primacy over relational aspects and demand adequate attention in order to open up the space for mutuality, reciprocity et cetera. [ABSTRACT FROM AUTHOR]

Two principal resources will be used to discuss Darren Haber's paper Simulated Selfhood, Authentic Dialogue: An Intersubjective Systems Look at Treating Addiction. They are Intersubjective Self Psychology: A Primer and Narcissus in Wonderland: The Self Psychology of Addiction and its Treatment. Both of these resources provide a different and more complete way of understanding this excellent case presentation. [ABSTRACT FROM AUTHOR]

Partnership and engagement are mediators of change in the efficient uptake of evidence-based patient-centered health interventions. We reflect on our process of engagement and preparation of peer mentors in the development of peer-led psychotherapy intervention for HIV infected adolescents in active care at the Comprehensive Care Centre (CCC) at Kenyatta National Hospital. The program was implemented in two phases, using a Consultation, Involve, Collaboration and Empowerment approach as stepping stones to guide our partnership and engagement process with stakeholders and ten peer mentors embedded in the CCC. Our partnership process promoted equity, power-and-resource sharing including making the peer mentors in-charge of the process and being led by them in manual development. This process of partnership and engagement demonstrated that engaging key stakeholders in projects lead to successful development, implementation, dissemination and sustainment of evidence-based interventions. Feedback and insights bridged the academic and clinical worlds of our research by helping us understand clinical, family, and real-life experiences of persons living with HIV that are often not visible in a research process. Our findings can be used to understand and design mentorship programs targeting lay health workers and peer mentors at community health care levels. [ABSTRACT FROM AUTHOR]

Complex and enduring mental health problems require greater treatment resources, usually in the form of multidisciplinary support, including providing psychological therapies. This paper reports on an NHS, tertiary-level specialist psychotherapy service offering Psychodynamic therapies with longer-term, exploratory transdiagnostic approaches to support complexity and sustained personality functioning. This paper adopts a naturalistic study design evaluating the effectiveness of Psychodynamic therapy using pre- and post-outcomes across a 10-year period. A total of n = 474 participants self-report pre- and post-outcome measures were used as the marker of effectiveness along with therapist assessments during intake and engagement. The findings showed that Psychodynamic therapy was effective in reducing psychological distress based on service-user self-report and therapist assessments. While intake scores varied by socio-demographic factors, the rate of change across most groups was similar. There were several limitations relating to data quality and completeness which reflect the naturalistic design. Despite the limits of a naturalistic design, this study provides evidence of support for the place of Psychodynamic therapies within NHS mental health care, catering to those with complex and enduring mental health problems. [ABSTRACT FROM AUTHOR]

The very existence of truth, let alone its worth, is currently under attack from many quarters. In the wider culture, disinformation and other forms of misrepresenting the truth spread far and wide, as information conduits proliferate. This paper suggests some reasons for the "anti-truth" trend. Mainstream media have played a role, as have theoreticians from fields as diverse as philosophy, psychoanalysis, science, and literary criticism. "Anti-truth" trends are having a serious impact on psychological treatment, affecting its content and the conception of its goals. This paper suggests some problematic outcomes of this phenomenon for practitioners and patients in various forms of psychotherapy. [ABSTRACT FROM AUTHOR]

Within the UK a polarised and politicised discourse exists that attempts to pitch transgender identities in opposition to discourses on sexual orientations. This suggests that interventions assisting clients in their understanding of one, would be detrimental on exploration of the other i.e., to be affirming of gender identity is to cause conversion of sexuality and vice versa. This paper attempts to address some of the problems with this oppositional critique and solve some of the practical problems that the theorist and/or clinician may encounter while attempting to help their clients within the realm of psychological therapies. It does so through Deleuzian ontologies of difference, coupled with Bhaskarian critical realism. We aim to present a (re)consideration of the biopsychosocial model of Health. The recent publication of the International Classification of Diseases 11th Edition and its reclassification of trans aetiology as a Disorder of Sexual Development has presented a conceptual shift from gender dysphoria towards a gender incongruence model (WHO 2022). The aim of this article therefore is to develop practice by enhancing the conceptual toolbox of the clinician and therapist working with Gender Sex and Relationship Diversities (GSRD). Thereby enabling them to better approach a wider diversity of clients safely. This paper explores current conversations and ideas around the phenomenon of trans gender identities and minority orientations. It aims to present an ethical model which can inform the clinical practice of therapists and is underpinned by a critical realist interpretation of biological, psychological and sociological aspects of the mind and body. Overall, the paper acts as a call to action against conversion practices which aim to position trans experience and sexual attraction in opposition to each other. [ABSTRACT FROM AUTHOR]

The paper has a twofold aim. First, it describes the complex process of gaining consent retrospectively for the publication of clinical material after the institution, where therapy was taking place, had closed down. The clinical material was derived from the psychotherapeutic work with an autistic young boy and his family. Details of the complicated process of gaining consent to publish this material are provided. The second aim of this paper is to discuss the important role of 'trust' when asking or granting consent for publication of clinical material. It is argued that trust at different levels (and amongst various people) plays a pivotal role in gaining consent for publication. [ABSTRACT FROM AUTHOR]

This paper explores the empathic nuances of the therapeutic process with a person experiencing ongoing psychosis associated with a diagnosis of schizophrenia, and with a history of severe relational trauma. Incorporating the self psychological principles of working with the therapist's and client's forward edge, utilizing experience-near empathic attunement, and the somatic psychotherapy essential for kinaesthetic conversation were essential elements for the ongoing integration of the client's self. This work demonstrates the development of a nuanced understanding of pathological accommodation with its internal self-organizing dynamics as well as offering examples of forward edge movement. Interweaving vignettes from a two-year period with the subjective and intersubjective somatically animated experiencing of the therapist, the puzzle of how to work with all parts of the client unfolds gently and carefully. This paper outlines how connections were made between the two participants, in a clinical sense and within the client, creating a sense-making structure within the nuclear self experience of the client. Real life clinical experiences of what somatic psychotherapy, undertaken within a relational, intersubjective psychodynamic process, looks and feels like are in short supply. The presentation of this case hopes to remedy that by demonstrating the body mind integration required to work this way. [ABSTRACT FROM AUTHOR]

This paper raises and addresses issues to do with leadership and child psychotherapy, beginning with a report on a systematic review of papers about leadership in the Journal of Child Psychotherapy (JCP). The authors establish that leadership is expressed implicitly rather than as an important issue in its own right with relevance to clinical work, service development and the ongoing viability of psychoanalytic child psychotherapy. When reviewing the limited literature available, the authors classify them into five types of article: tribute to leaders past; clinical leadership; threat to survival and call to action; organisational leadership; and exemplary papers describing professional leadership. The authors query why the leadership literature is sparse and inexplicit and respond by using the theme of 'dual citizenship' to explore the issue from a psychoanalytic and organisational perspective. The psychoanalytic perspective explores tensions and barriers that may be profession-specific in relation to leadership. The organisational perspective explores the wider literature on leadership, starting with the concept of 'wicked problems and clumsy solutions'. The authors introduce and describe a 'leadership stance' that is compatible with psychoanalytic practice in context. This requires opening up leadership activity to the same scrutiny and reflective practice as clinical work, which provides ways of containing organisational and career anxieties and perplexing clinical problems. This paper is a call to action in regard to integrating leadership into the training and the profession. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a survey exploring people's understandings and experiences of Spiritual Abuse (SA) in a Christian faith context. The online survey was completed by 1591 individuals from the UK, 1002 of whom identified as having experienced SA. Inclusion criteria were: membership of the Christian faith, being or having been, a Church attender or member of a Christian organisation and having heard of the term SA. Participants detailed features of an effective response to disclosures of SA, many of these are directly relevant to counselling and psychotherapy practice. The findings echo calls in previous research for including discussions of religion and faith in training and CPD for counsellors and psychotherapists. Finally, the paper suggests the establishment of a network of counsellors with training and knowledge about SA. [ABSTRACT FROM AUTHOR]

A comparison of the Boston Study Group and the Relationalist's theories of enactments in which I maintain that enactments can be viewed either as an unknowable past expressing itself in present action, or as a process shift coming out of incremental shifts in the fit in here and now interaction. Often, it is difficult to distinguish enactments from any ongoing analytic experience oscillating between defense and revelation on the part of the analyst, analysand, or both. Yet, I agree with Goldin that change is not simply moving along, fitting together better, and reaching a higher level of organization as in infancy. An analytic interchange cannot be understood "separately from the project of grasping experience into words." [ABSTRACT FROM AUTHOR]

This discussion compares interventions that are derived from reverie, bodily sensations, and dreams, with traditional transference interpretations. Using Seward's clinical vignettes, the author delineates subtle differences between projective identification, enactments, and the selfobject function. She suggests that body-mind-self experiences of the analyst bring the selfobject function to its most precise position. Furthermore, she argues that evocation of images, body sensations, and disclosed dreams are, in fact, interpretations and that such interventions do not strive to generate repetitions but to promote potential space and openness to disavowed areas of the mind. These interventions, says the author, are not better than traditional verbal interpretations or more correct but sometimes simply more useful to the patient. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionThe present paper focuses on therapist responsiveness during the initial therapy session with clients with borderline personality disorder (BPD), aiming to analyze therapist responsiveness at short intervals during the initial session and determine if it can predict therapeutic alliance from both therapist and client viewpoints.A sample of 47 clients participated in the study for 10 sessions of therapy. Therapeutic alliance from therapists’ and clients’ perspectives was rated after each session; external raters assessed therapist responsiveness during the initial session. Multiple linear regression models and linear mixed models with backward variable selection based on AIC were run to analyze whether specific therapist behaviors during session one predicted therapeutic alliance rated from therapists’ and clients’ perspectives.The results indicate that therapists normalizing and validating clients’ experiences during the first session are crucial for establishing therapeutic alliance for BPD clients; however, for therapists, the increase in variability of emotions verbalized by clients during the initial session negatively impacts therapeutic alliance.The study contributes to further understand the impact of therapists’ behavior at the beginning of therapy with BPD clients. Therapist responsiveness is crucial for therapy outcome but is methodologically challenging; therefore, efforts in this direction should be pursued. [ABSTRACT FROM AUTHOR]

The transition to parenthood, or the addition of another child to the family system is a life altering event for both mothers and fathers that can affect both parents individually and their relationship. For some parents, this includes perinatal suicidal ideation. Despite the prevalence of perinatal mood disorders, there are no systemic models designed specifically for couples who are at risk for suicide. This paper reviews the literature on the prevalence of perinatal suicidal ideation and proposes an integrative treatment model using aspects of Collaborative Assessment of Suicidality (CAMS), Attachment based family therapy (ABFT), and Emotionally Focused Therapy (EFT). [ABSTRACT FROM AUTHOR]

A gay identity offers a perspective outside heteronormative narratives characterized by exclusion as well as a radical position of difference. Being a psychotherapist, too, holds complex implications for identity. This paper explores the lived experience of gay male psychotherapists, a group whose voice is seldom heard. Based on interviews with six White South African gay male psychotherapists, a narrative analysis explores their experience of identity and voice. This paper highlights the ways in which the journey to occupying oneself as gay and the journey of becoming a therapist are intertwined. The complex power relations evoked in this experience are explored, and the position of the gay male therapist as "outside looking in" is interrogated as a position of marginality that both excludes and provides a unique vantage point from which to challenge exclusion. [ABSTRACT FROM AUTHOR]

This paper was developed as part of a panel for the International Psychoanalytic Association's (IPA) 53rd Congress in July 2023. In this paper I discuss treatment with students from the American University of Afghanistan as part of a team at New York University's Postdoctoral Program in Psychoanalysis and Psychotherapy. The paper reviews the themes that I identified while working with three students from the university. The themes include issues of identity and power, role confusion, and finally the question "am I doing a good thing?" Simultaneously, I discuss my own countertransferential process and disavowed material based on my own cultural background. [ABSTRACT FROM AUTHOR]

1) Systematically review meta-analyses and systematic reviews that (a) explored health/lifestyle factors affecting sleep, and/or (b) investigated behavioral/psychological sleep interventions in young people (10–25-years); 2) Evaluate the quality of published literature, and, if an intervention; 3) Examine method and effectiveness of mode of delivery, to inform current clinical practice and research direction. A systematic search of Embase (n = 45), MEDLINE (n = 67), Web of Science (n = 375), Google Scholar (n = 138), and hand-searching was conducted. After full review, 12 papers were selected, 2 systematic reviews without, and 10 with, meta-analyses. Six examined associations between sleep and lifestyle/health, and six examined cognitive-behavioral (n = 4), or school education (n = 2), programs. Electronic media use, type of day (week/end), sex, age, culture/geographical location, substance use, family environment, and evening light exposure were negatively associated with sleep, in young people. Only cognitive and/or behavioral interventions of at least 2 × 1-hr sessions improved sleep. This paper informs sleep recommendations for young people and advises that ≥ 2 × 1-hr sessions of cognitive behavioral or behavioral therapy is the minimum to improve sleep in young people. School-based sleep interventions do not produce long-term change. [ABSTRACT FROM AUTHOR]

Background: Chronic tinnitus during childhood/adolescence can be associated with impaired quality of life. Guidelines for managing paediatric tinnitus recommend assessment and interventions are often based upon the experiences and opinions of guideline committee members. Objective: To examine patient response tools used for the assessment and management of childhood tinnitus and how interventions had been evaluated. Design: A structured scoping review (i) identifying and critically appraising patient response measures (PRMs) assessing tinnitus in children/adolescents, and (ii) critically appraising evidence supporting reported interventions. Original papers written in English, involving paediatric participants ≤19 years, reporting (i) application of established PRMs to assess the experience of chronic tinnitus or (ii) application and evaluation of tinnitus interventions were included. Study sample: Papers written in English, identifying, or assessing the experience of chronic tinnitus (>3 months) as a primary complaint during childhood/adolescence in participants ≤19 years of age using a PRM and studies evaluating the application of non-pharmaceutical interventions for tinnitus in children/adolescents. Results: Six studies involving the assessment of tinnitus during childhood/adolescence using a PRM were identified and evaluated. Three established (previously named, described, and published) PRMs were applied of which none were developed specifically for children/adolescents. Three behavioural tinnitus interventions and three combination intervention strategies (coupling of psychological intervention with sound enrichment) had been applied to and evaluated within paediatric populations. Conclusions: Although clinicians are seeing children/adolescents with tinnitus, they are evaluating and managing children’s distress without appropriate PRMs, and little evidence exists to support clinical interventions. [ABSTRACT FROM AUTHOR]

This paper explores the journey taken by experienced psychotherapists as they embark on doctoral research, highlighting the adjustments involved in moving from being a clinician to becoming a researcher. Having touched on the complex relationship between psychotherapy and research as a whole, including how badly this has affected the development of a robust evidence base for many approaches, the paper describes the development of a post-qualifying research programme for those grafting research skills onto their clinical roles. The paper then considers how the kind of research undertaken by psychodynamic psychotherapists has shifted from being primarily focussed on single case studies – so remaining closer to the clinical writing of the past – to including both more general social science research methodologies and more precise psychoanalytic methodologies, capable of exploring in depth the processes at work in the therapeutic encounter. The main focus of the paper is on the impact on the students of undertaking their first research project. At the beginning of this process nearly all students underestimated just how much of a shift in their thinking it would involve, and the paper captures some of the key issues and powerful moments reported after their first year. They speak of the humbling impact of conducting a structured literature review and of the complexity of finding a truly researchable question and viable design, as well as the appreciation of the difference between clinical illustration and evidence. They speak of the impact of thinking about the ethical issues involved in research, and of the need to interrogate their design in order to minimise bias. One of the interesting – and to them surprising – effects is that the shift to research-mindedness feeds back into their clinical identities, in a way that is both challenging and invigorating, overall boosting their confidence as practitioners. [ABSTRACT FROM AUTHOR]

Abstract Objective: There is a growing interest in idiographic patient-reported outcome measures (I-PROMs) for routine outcome monitoring (ROM) and clinical feedback (CF) in psychotherapy, but to our knowledge, no systematic reviews of the empirical literature. Method: We conducted a systematic literature search for empirical papers investigating effects and experiences of I-PROMs for ROM/CF and found a total of 13 papers. There was only one experimental controlled effectiveness study. Results: We formulated a narrative summary of the data set as a whole. We conducted a secondary analysis of nine papers containing qualitative data on stakeholder experiences with I-PROMs and found three superordinate themes and eight subthemes, summarized as “I-PROMs can facilitate self-reflection for patients, assist in identifying and tracking therapeutic topics, and make patients more committed to therapy by giving them a greater sense of responsibility and empowerment. Formulating goals and problems can be difficult, and lack of progress can be demotivating. Time in therapy is precious and must be spent wisely. Effective use of I-PROMs is facilitated by flexibility and therapists’ use of clinical skills.” Conclusion: We discuss the limitations of the study and provide recommendations for future research and clinical practice. [ABSTRACT FROM AUTHOR]

Harmful sexual behaviour that occurs between siblings (HSB-S) is thought to be one of the most common forms of intrafamilial abuse. Despite an increase in academic papers, and acknowledgement of the prevalence of the problem, there is still a lack of specific assessment and intervention models. The aim of this paper is to provide an overview on the Assessment, Intervention and Moving On (AIM) HSB-S Practice Guidance. The framework draws on the literature and evidence-based models, as well as clinical practice illustrated by the four-case series summarised. Of the four-case series illustrated in the paper positive outcomes were observed. In addition, the intervention includes the practitioner guiding the family to write a structured narrative which supports them to restore family relationships and find a way of moving forward. This guidance will strengthen practitioner's skills and confidence in working with families impacted by HSB-S and provide hope for them that they can heal from this crisis. This paper provides a preview for the AIM HSB-S Practice Guidance illustrated by a case series. The framework will provide practitioners with a clear approach to assessment and intervention when working with families impacted by HSB-S. [ABSTRACT FROM AUTHOR]

Objective: The use of qualitative methods for investigating causation has been controversial ever since the "paradigm wars" of the 1980s. Quantitative and experimental researchers have largely dismissed the relevance of qualitative research for causal investigations, while many qualitative researchers have rejected the concept of causation entirely. However, a growing number of scholars, in both research methods and philosophy, have proposed an alternative perspective, one that sees quantitative and qualitative approaches as having complementary strengths and limitations in understanding causation. In this article, we consider this perspective in relation to the study of causality in psychotherapy research. Method: This paper reviews and integrates key descriptions of the mechanisms for identifying causal processes using qualitative research. Results: An overview of how qualitative methods study causation is presented, considering its implications for both identifying causality and for generalizing causal conclusions. Conclusion: The paper holds relevance for establishing outcomes caused by psychotherapy treatments and for developing clinical practice guidance for the field. [ABSTRACT FROM AUTHOR]

To treat the impact of trauma, most current evidence supports the use of trauma-focused psychotherapy as the first line approach. However, millions of individuals exposed to trauma worldwide seek Complementary and Integrative Health (CIH) therapies in hopes of achieving wellness above and beyond reducing symptoms. But what is the evidence for CIH interventions? What are potential pitfalls? Given the growing popularity of and strong interest in CIH, EJPT is featuring research on these approaches in this special issue. The papers range from common interventions such as mindfulness to the use of service dogs and scuba diving to alleviate trauma related symptoms. A featured editorial highlights the importance of defining when, where, and how placebo responses work. Nonspecific elements of treatment such as positive expectations, therapeutic rituals, healing symbols, and social interactions are identified as factors influencing treatment response and scientists looking to add to the CIH evidence base are encouraged to consider the impact and methodological challenges these elements present. CIH interventions more specifically recognize and harness some of these factors in addition to intervention-specific factors such as attention or emotion regulation along with focus on overall wellbeing. The body of work in this special issue supports the emerging evidence for meditative and relaxation-based interventions and illustrates a creative but nascent state of the field. Cross-intervention mechanisms that may play a role in achieving wellness, such as arousal reduction, emotion regulation, posttraumatic growth, and positive affect are highlighted. The trauma field would benefit from accumulation of evidence for promising CIH interventions, evaluation of potential mechanisms, and examination of health and wellbeing outcomes. With the paucity of high-quality trials, it would be premature to recommend CIH interventions as first-line treatments. However, the emerging literature on CIH continues to advance our understanding of what works and how these interventions exert their effects. Complementary and Integrative Health (CIH) interventions for trauma that target holistic wellness above and beyond symptom reduction are increasingly used in the real world, though the evidence base lags. Papers in this issue support the emerging evidence for efficacy of mindfulness or other meditative or relaxation-based interventions. This special issue illustrates creative approaches but also the need for continued research establishing efficacy, evaluating more inclusive outcomes (e.g. a sense of wellbeing or ability to pursue valued life goals), and identifying potential mechanisms. [ABSTRACT FROM AUTHOR]

This discussion of papers by Sarnat and Berman on psychoanalytic supervision explores the complex nature of the contemporary psychoanalytic supervisory relationship. It considers how developments in psychoanalytic theory and practice, reflecting relational, intersubjective, attachment, and field theory influences over the past 30 years, have changed the ways in which many analysts practice and theorize supervision. Contemporary supervisors attend not just to the patient being presented, or to the therapeutic dyad, but to the supervisory relationship itself as part of the clinical/supervisory frame of reference. Similarities and differences between therapy and supervision are considered. [ABSTRACT FROM PUBLISHER]

This paper explores the parental representations of the child, through the case study of one participant in a mentalization-based intervention for parents of young children aged one – two years old, involved with the child welfare system as a result of their child's maltreatment. A single mother's representations of the child are analysed during the programme, through a qualitative lens. Narrative Processes Coding System (NPCS) and Thematic Analysis (TA) are used in combination, to elicit the mother's representations by identifying language modes and themes from her narratives about both her own and other children. The maternal representations of the child appeared to be less negative as the programme reached its end. The mother's reflexive language grew significantly in the middle phase of the programme and regressed during the last phase. However, the combined use of NPCS and TA showed an overall richer and less negative portrayal of the child during the ending phase. These findings suggest that during the course of the programme, the mother's journey through her representations of the child, was characterised by progressions and regressions. There was also an emotional richness in the last phase of the programme that indicates the mother's engagement in the group and her overall positive journey towards the development and the strengthening of a less negative representation of the child. Despite its limitations, this study hopes to provide insights for clinicians establishing and promoting interventions that aim to empower parents to clearly see their children. [ABSTRACT FROM AUTHOR]

The paper draws on fictionalised composite case histories to explore themes in psychotherapeutic work with gender questioning and transgender young people. Gender and transgender are examined from psychoanalytic, cultural and philosophical perspectives. It is argued that the meaning of gender and transgender as an identity is rooted in unconscious processes and patterns of relationship. An ethical argument is made for a therapeutic stance, which remains curious about and receptive to complexity in therapeutic work with gender questioning young people and their families. The need for the therapist to be aware of their own blind spots in work with gender questioning young people is discussed. [ABSTRACT FROM AUTHOR]

Dissociative Identity Disorder (DID) is a highly disabling diagnosis, characterized by the presence of two or more personality states which impacts global functioning, with a substantial risk of suicide. The International Society for the Study of Trauma and Dissociation (ISSTD) published guidelines for treating DID in 2011 that noted individual Psychodynamically Informed Psychotherapy (PDIP) was a cornerstone of treatment. This paper systematically reviews the evidence base for PDIP in the treatment of adults with DID according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirty-five articles were located and reviewed: seven prospective longitudinal publications, 13 case series and 15 case studies. Results suggested that PDIP has been widely deployed in DID to reported good effect with a range of treatment protocols and using multiple theoretical models. Despite the positive findings observed, the evidence base remains at the level of observational-descriptive design. Creative approaches in recent years have been developed, which add empirical weight to the use of PDIP as an effective treatment. The elevation to observational-analytic designs in the Evidence-Based Medicine hierarchy has yet to take place. Bearing in mind the challenges of research in PDIP, suggestions are offered for how the evidence base might develop. [ABSTRACT FROM AUTHOR]

Empathy is a foundational construct in person-centered psychotherapies because it promotes clients' self-exploration and growth. However, as the construct of empathy drew attention from various disciplines, the definitions of empathy became ambiguous. Thus, the purpose of this paper is to articulate the conceptual understanding of empathy competence for the specific discipline of the counseling profession. I review the development of the conceptualization of empathy in the counseling literature and propose a theoretical framework, Process of Interpersonal Empathy (PIE), in the hope of providing a consistent definition to address counselors' empathy competence. The PIE illustrates counselors' empathy competence as a collection of multidimensional ingredients functioning in a process with active engagement by both the counselor and the client. The ingredients of the PIE include conceptualization, emotional awareness, and interpersonal empathy. Additionally, I discuss how each ingredient plays a role in counseling relationships. The formation of the PIE provides several implications for counseling researchers, counselor educators, and supervisors. [ABSTRACT FROM AUTHOR]

This paper is a commentary on the articles in this Technology, AI Bots and Psychology Special Issue. The Special Issue presents a range of conceptual, practice-based and empirical reflections on digitally mediated therapy. This includes looking back to a significant shift in digital engagement due to the COVID-19 pandemic, along with anticipations regarding the landscape of future therapeutic practices mediated by digital technologies. I will discuss key themes resonating across the Special Issue, along with attending to some of the nuance and diversity of the potential and real implications of a greater integration of digital technologies in current and future therapeutic practice. [ABSTRACT FROM AUTHOR]

This article examines the potential impact of AI technology on psychotherapy and counseling. It discusses the use of AI chatbots as companions, including for romantic and sexual purposes, and raises questions about the changing nature of therapy in the digital age. The article explores the concept of "technical thinking" and its effects on human psychology and therapeutic practices. It also discusses the history of therapy using communication technologies and the emergence of AI bots in the field. The article concludes by considering the role of traditional therapy in the digital age and the potential benefits and drawbacks of online therapy. Additionally, it highlights a recent study that found face-to-face communication to be more important for mental health during lockdowns, but also acknowledges the positive impact of digital text-based communication. The author emphasizes the need for further research on the effects of the digital age on psychological therapies and invites submissions to their journal. The article provides summaries of several papers included in the journal, covering topics such as online therapy, the impact of technology on the therapeutic relationship, and the experiences of students in remote learning. The author concludes by emphasizing the importance of considering the effects of the digital age on both psychotherapy provision and individuals involved in therapy. [Extracted from the article]

Digital technology has a ubiquitous presence in psychotherapy. While we recognize its immediate impact on our work, we are less attuned to its symbolic—yet highly consequential—implications for our field, much less its penetrating grip on the human psyche. The eight papers to follow offer us a beginning blueprint that invites us to revisit and re-calibrate our conception of psychotherapy in the digital age. They identify limitations and potential benefits of relating through the screen across multiple theoretical, clinical and training contexts, including a commentary on AI and the future of our field. Rather than shrinking ourselves to adjust to the screen's limits, we need to expand our understanding of its impact both inside and outside of the therapeutic context. [ABSTRACT FROM AUTHOR]

Adopting psychotherapeutic technique as a technological matter in which something is learnt, deployed and applied, the article considers how the relationship between therapist and client is increasingly dominated by thinking of a technical manner. By exploring this notion through an existential lens, the conversation is expanded beyond our usual practical use of technique as a technology of change, and instead considers the implications of systematising conversations to yield outcomes and maximise results. In essence, the paper explores how we condition inquiry, and how this inquiry may in turn condition us. Bringing to the forefront, the importance of acknowledging our relationship with method and technique, as part of an ethical engagement with our practice. [ABSTRACT FROM AUTHOR]

The aim of this paper is to explore the theoretical and clinical features of burdening guilt according to control-mastery theory (CMT), an integrative, relational cognitive-dynamic theory of mental functioning, psychopathology, and psychotherapy. CMT posits that burdening guilt stems from the belief that one's emotions, needs, and way of being are a burden to significant others. After having introduced some research data about the belief of being a burden to others, we will point out how CMT explains this belief in light of a coherent theory of development, emphasizing its connection with early traumatic or adverse experiences with caregivers that give rise to the formation of pathogenic beliefs. These beliefs are mostly unconscious, and influence the way people make sense of themselves and their reality, giving rise to symptoms, inhibitions, and maladaptive personality traits that obstruct the achievement of healthy and adaptive goals. We will then compare burdening guilt with omnipotent responsibility guilt and self-hate, highlighting the points of contact and the differences between these types of interpersonal guilt. Subsequently, we will point out the "double nature" of burdening guilt, describing how it represents both a self-blame for what one is, and the expression of the need to take care of important others. Finally, we will propose a clinical vignette to illustrate some manifestations of burdening guilt in the therapeutic context. [ABSTRACT FROM AUTHOR]

The aim of this narrative review is to integrate the published literature on mental health provider bias against less recognized groups who may be marginalized due to their sexual identities or sexual and relationship practices. These include asexual-identified individuals, individuals who practice consensual non-monogamy (CNM), and those who engage in sexual practices that include bondage and discipline, dominance and submission, and sadism and masochism. We situate these findings regarding provider bias within broader themes emerging from the literature on affirmative mental health care provision for members of these sexually stigmatized groups. We identified the relevant literature by searching PsycINFO, as well as Google Scholar, given the novel topic areas. We summarize and evaluate published articles and then present our analysis of the broader themes, strengths, and limitations that emerged among these three developing literatures. Finally, we discuss implications for future research and clinical practice to aid clinicians who wish to minimize bias against these relatively understudied groups. These recommendations are summarized as follows: avoiding normative assumptions, countering pathologization, and taking responsibility for training. This paper describes current research on bias among mental health providers against asexual clients, as well as clients who practice consensual non-monogamy or kink. Clinicians are encouraged to avoid assumptions and seek out to training to address their own biases about clients with these identities and practices. [ABSTRACT FROM AUTHOR]

The future and vibrancy of psychoanalysis rests on increasing the accessibility to training for early career clinicians. By recognizing and addressing the numerous barriers to the immersive experience of psychoanalytic training, we can foster strong candidate groups. This paper recounts one institute's process of creating multiple points of access and substantive mentorship for new clinicians, aiming to nurture involvement over time with institute members and its professional offerings. Valuing both individual developmental trajectories and attracting diverse applicants across disciplines while attending to the significant obstacles many potential trainees face, generated increased interest and matriculation in both psychotherapy and psychoanalytic training programs. [ABSTRACT FROM AUTHOR]

We aimed to identify assistive technologies that are promising for addressing loneliness in people living with dementia in long-term care. A scoping review was conducted. EBSCO, PubMed, Cochrane Library, and ProQuest were searched from 2000 to 2020. The included studies were selected by three independent researchers and summarised, compared, and categorized according to technology type. Publications were eligible for inclusion when they reported on psychosocial interventions aiming to reduce loneliness and/or social isolation in people with dementia in long-term care settings. Twenty-four papers were included (20 original research papers and four reviews). Most studies were conducted in Australia and Europe. The studies aimed to investigate two different types of assistive technology: social robots, and multimedia computer systems. Most studies focussed on behaviour, engagement, and mood as primary outcomes. Only one study directly aimed to alleviate loneliness. Even though only one study addressed loneliness directly, it became clear that assistive technologies used to apply psychosocial interventions have the potential to impact loneliness in people with dementia in long-term care. However, it remains unclear why loneliness was not included as an outcome and how loneliness could become a key outcome in evaluating assistive technologies. Loneliness among older adults is associated with health risks, such as the development of dementia, depression, and increased mortality. Ambient Assisted Living (AAL) technologies have been studied to address loneliness for older adults; however people with dementia are often excluded from such studies. This diverse group of technologies is shown to have a promising impact on outcomes, such as social engagement, quality of life, and mood, but loneliness was studied less often. More research is needed to discover the potential of assistive technologies for people with dementia living in long-term care. [ABSTRACT FROM AUTHOR]

Psychosexual therapy has undergone numerous developments since the introduction of behavioural therapy for sexual difficulties by Masters and Johnson in the 1960s. We argue that theory and practice from Compassion Focused Therapy (CFT) offers a novel and relevant development to existing approaches to psychosexual theory and practice. CFT presents a theory driven, flexible, transdiagnostic and integrative way of understanding, formulating and treating general mental health problems. In this paper we propose that the underlying theory from CFT integrates well with existing approaches to psychosexual therapy, and offers some helpfulways of formulating sexual problems to present a coherent rationale for treatment strategies. We also argue that some additional CFT treatment strategies already used in general mental health settings are appropriate and helpful for those experiencing sexual difficulties. This paper outlines how CFT can be theoretically integrated with existing psychosexual therapy. [ABSTRACT FROM AUTHOR]

This paper describes the rationale and treatment principles of an in-hospital psychotherapeutic programme for pregnant women with pre-eclampsia or HELLP syndrome, and their partners. This psychotherapeutic programme focuses on making improvements in the experience of early parenthood, through improving reflective capacity under stress, emotional availability, bonding with the infant, and supporting the overall transition to parenthood. The medical and psychosocial consequences of pre-eclampsia and HELLP syndrome, which can result in the preterm birth of infants, are numerous, and can be detrimental to the early parent-infant relationship. Parents may experience anxiety, guilt, depression and post-traumatic stress, and it is important to address these problems preventatively, from pregnancy onwards. This programme is innovative in its offer of continued in-hospital support to pregnant women and their partners, at the obstetric as well as at the neonatology ward. In addition, a small and descriptive study of the programme is presented in this paper. We perceived that the participating parents were committed to attending the sessions, which addressed their major concerns regarding parenthood. No participants dropped out of the programme before discharge. Mentalization-based psychotherapeutic work was done during PLUS consultations, and parents showed a need to express, reflect upon and process the concerns they experienced during the frightening period of hospitalisation. [ABSTRACT FROM AUTHOR]

This discussion of the paper merging and emerging: A nonlinear portrait of intersubjectivity during psychotherapy focuses on how the original paper demonstrates the usefulness of the concepts of nonlinear dynamics systems theory (NLD) to clinical psychoanalysis. Diagnosis conceptualize in NLD terms successfully resists the pressure to reduce complex situations to overly simple few word phrases. The phenomena of transference and repetition are redescribed as resulting from an iterative process that is evident in complex adaptive systems. The model of psychoanalysis in terms of coupled oscillators is demonstrated to be clinically useful as is the concept of emergence which overcomes some of the less useful aspects of the reductionist program. The idea of studying boundaries per se, as opposed to their function of separating individuals, arises naturally from the study of fractals and promises to clarify the oversimplified discussions of these matters in the psychoanalytic literature. The original author has successfully demonstrated how useful NLD conceptualizations can be to the clinical psychoanalyst. [ABSTRACT FROM AUTHOR]

In taking up the matter of intersubjectivity in Kleinian-Bionian theories Brown creatively reimagines the clinical situation, transcending demarcations of analytic schools to arrive (though never fully arrive) at new understandings of interaction. I discuss Brown's engaging paper from my own emerging concept of enactivity, drawing distinctions between this approach and Bion's approach and extending the enactive to a consideration of enactive fields that, like Brown's paper, draws on the seminal reinterpretation of Kleinian theory by the Barangers. In writing of the field as an emergent process of becoming I rely on Merleau-Ponty's notion of 'singing the world' to illustrate my developing understanding of the possibilities for interaction in the Kleinian-Bionian tradition. My comments on Brown's clinical case material focus on what appears to me to be the intersubjective aspects of his approach. [ABSTRACT FROM AUTHOR]

I am very pleased to be given the opportunity to discuss Professor Seligman's paper. I find the paper beautifully written and extremely interesting. It touches on many relevant issues in terms of developmental psychology, differential psychopathology, and clinical technique. In this discussion I try to concentrate on one important clinical point: What constitutes psychic change? Seligman's technique to create “corrective engagements” by bringing “actions” like changes in the payment contract and “metaphors” like the Joan of Arc story and book, did facilitate intellectual development and some kind of emotional resonance, but I think they also acted more as a kind of comforters (Winnicott, 1985) that neutralized the emotional explosions and implosions (Kleimberg, 2006) that Harriet would have had to endure to truly have an experience of disillusionment, separation, and identification with the object if she were to truly develop an emotional symbolic function that would facilitate long-lasting states of mentalization and reflective functioning. I value Seligman's contribution enormously. He is opening up a valuable window to explore and think about areas of psychopathology that are difficult to understand and treat. At the same time, I want to be cautious about introducing new psychoanalytic techniques that can be misused by our colleagues by assuming that these new techniques have produced or can produce the necessary deep, internal, and long-lasting psychic change that we all struggle to achieve with all patients, particularly with these difficult narcissistic and character disorder borderline ones. This type of technique could be useful for patients who we feel have no chance of being helped with our current analytic repertoire and perhaps by accepting at the same time that achieving this type of fragile and incomplete type of mentalization is as much as can be expected from them. [ABSTRACT FROM AUTHOR]

The article focuses on the activity of making paper bag books as a creative intervention for elementary school children experiencing high-conflict parental divorce. Research shows that school-based interventions for children can help counter the adverse effects of divorce. It states that the paper bag book activity aims to offer a compassionate environment for meaningful connections and perceived commonality among students with similar traumatic experiences. Furthermore, the child-made paper bag books can help empower the child to express his or her innermost feelings.

The following is a discussion of a case presentation by Katherine (Kate) Oram in celebration of the 50th anniversary of the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. The discussion focuses on the issue of aggression expressed by the patient and the analyst from the perspective of interpersonal theory. How aspects of unspoken anger and resentment are woven through an abiding connection and development of trust is addressed. The relevance of aggression to the particular features of this case's termination and posttermination phase are explored as well. [ABSTRACT FROM PUBLISHER]