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In this paper I argue that close attention should be paid to thechanges that have been taking place in the National HealthService over the last 15 years as a result of governmentalinitiatives. The identification of the direction that the recenthealth reforms have been taking should allow us to drawsignificant conclusions regarding the possible fate that the NHSis facing in the not-too-distant future. The introduction of theinternal market in health care, the Private Finance Initiative,private Diagnostic & Treatment Centres and FoundationTrusts may indicate that the privatization of the NHS hasbegun in earnest. The relevance of such considerations to allNHS workers and users needs to be appreciated, as it may gosome way towards answering the important question of whatkind of NHS we will be having and using in the future. Theimplications for the NHS in general, and for psychotherapyservices in particular, of the insidious but invasive process ofprivatization inherent in the ongoing changes in the structureand funding of the NHS are discussed. [ABSTRACT FROM AUTHOR]

This discussion of Rothschild's case history of a multiple personality disorder (MPD) treatment situates the issue of integration versus multiple self states in terms of cultural values, psychoanalytic theory, and transference-countertransference experience of MPD patients and therapists. Views from autobiographies of multiple personalities are included, and some questions are raised about the relationship of “parts” to traumatic experience: When, and for whom, is integration a treatment goal? When is dissociation a characterological defense, and when do the parts each hold separate traumatic knowledge? How does this question bear on treatment—what gets integrated, the knowledge or the parts? Are termination and integration simultaneous? A recommendation is offered for a wider, more complex view of narrative and historicity in the understanding of narrative reconstruction. A concrete focus on veridicality can be a defense against the overwhelming nature of traumatic experience. A final view is offered which positions the author as more distant from integration as a goal than is Rothschild. [ABSTRACT FROM AUTHOR]

The social nature of dreaming is discussed. Those few remembered and shared dreams (out of the totality of experienced and soon-forgotten dreams) are eventually shaped by the particular culture that reads into dreams its own way of viewing private psychological experience. Psychoanalysis is one such culture. It is recommended that the dream, on its own terms and in its own images and stories, be allowed to lead the way in psychotherapy. The significance of the creations of the mind asleep is discussed in relation to Freud's and Jung's mission to create a depth therapy for the psychological maladies attendant to life in modern Western culture. Dr. Hoge's contribution is significant in its subtle and intelligent evocation of the rich complexities of the world of dreams. Her use of the dream within the dream opens into a consideration of the sleeping mind's capacity for play and for stretching the boundaries of psychotherapy. Her discussion of the intermixing of subjectivities in therapeutic dream discussion (“Was it her dream or mine?”) leads to a consideration of the relationship between psychoanalytic work with dreams and ancient healing methods that often include an interest in the healer's own dreams as locus of treatment. Finally, there is a discussion of the relation of dreams to the emerging electronic virtual world which replaces the real and natural world with its own designs. In such a world, the dream within a dream may serve as a metaphor for modern life itself. [ABSTRACT FROM AUTHOR]

I am postulating an irreconcilable discrepancy between psychoanalytic metapsychology and praxis. Metapsychology reaches for the abstract, for the general class of which the patient is an ostensible member—said class, somewhat tautologically, demonstrating the validity of the professed metapsychology. Yet, from the Interpersonal view, therapy depends on grasping the highly idiosyncratic way the patient plays out his or her life both in and out of the therapy room. Abstracting the patient concretizes the process and reduces information. As a consequence, the clinical material falls short of utilizing the rich, recursive patterning of the therapist's exchanges with the patient, failing to fully realize the uncanny enmeshment of unconscious gears that so defines the psychoanalytic mystique. [ABSTRACT FROM AUTHOR]

This article reports on a conversation about unintegration, disintegration and integration in relation to child psychotherapy. The discussion centered on Edna O'Shaugnessy's clinical material and its technical implications. The degree that mothers might be more or less active in providing continuity for the baby also prompted significant interest.

Mobile phones may provide a useful and engaging platform for supporting therapeutic services working with adolescents. This paper examines the potential benefits of the mobile phone for self-charting moods in comparison to existing methods in current practice. The paper describes a mobile phone application designed by the authors which allows adolescents to record moods on their personal mobile phones. The authors propose that a personal mobile device is more suitable for adolescents than other devices. A pilot study with a non-clinical adolescent group in schools comparing a mobile and a paper diary is presented, along with discussion and analysis of the results. The main finding of the study was that compliance was significantly higher on mobile phones than paper, and the task was not found to be any more difficult to complete using mobile phones than with paper charts. A number of salient issues requiring further research are also identified. [ABSTRACT FROM AUTHOR]

This paper is a response to Tim Wright's article ‘Art Therapy and the Concept of Internal-Cohabitation’ ( Inscape , Volume 9, No.1 2004, pp. 26–37). Wright presented his work using a potentially universally applicable model of the mind(s). I begin to look at the complexity of his argument and open up some of the debates around the genesis of an ‘other’ mind. For example, is it an aspect of the self or not? If there is an ongoing, internal view different to the one identified as a relational self, how is it formed? And can this ‘other’ presence offer a benign hand in creativity? Whilst I do not endeavour to provide answers to these questions I support the notion that part of the art therapy work needs to involve an exploration of the validity of some analytic assumptions about ‘self’ and ‘other’ if there is to be a consistent, non-contradictory approach. [ABSTRACT FROM AUTHOR]

Major depressive disorder is a common, recurrent, disabling and costly disorder that is often severe and/or chronic, and for which non-remission on guideline concordant first-line antidepressant treatment is the norm. A sizeable percentage of patients diagnosed with MDD do not achieve full remission after receiving antidepressant treatment. How to understand or approach these 'refractory', 'TRD' or 'difficult to treat' patients need to be revisited. Treatment resistant depression (TRD) has been described elsewhere as failure to respond to adequate treatment by two different antidepressants. This definition is problematic as it suggests that TRD is a subtype of major depressive disorder (MDD), inferring a boundary between TRD and depression that is not treatment resistant. However, there is scant evidence to suggest that a discrete TRD entity exists as a distinct subtype of MDD, which itself is not a discrete or homogeneous entity. Similarly, the boundary between TRD and other forms of depression is predicated at least in part on regulatory and research requirements rather than biological evidence or clinical utility. This paper aims to investigate the notion of treatment failure in order to understand (i) what is TRD in the context of a broader formulation based on the understanding of depression, (ii) what factors make an individual patient difficult to treat, and (iii) what is the appropriate and individualised treatment strategy, predicated on an individual with refractory forms of depression? Expert contributors to this paper were sought internationally by contacting representatives of key professional societies in the treatment of MDD – World Federation of Societies for Biological Psychiatry, Australasian Society for Bipolar and Depressive Disorders, International Society for Affective Disorders, Collegium Internationale Neuro-Psychopharmacologium and the Canadian Network for Mood and Anxiety Treatments. The manuscript was prepared through iterative editing. The concept of TRD as a discrete subtype of MDD, defined by failure to respond to pharmacotherapy, is not supported by evidence. Between 15 and 30% of depressive episodes fail to respond to adequate trials of 2 antidepressants, and 68% of individuals do not achieve remission from depression after a first-line course of antidepressant treatment. Failure to respond to antidepressant treatment, somatic therapies or psychotherapies may often reflect other factors including; biological resistance, diagnostic error, limitations of current therapies, psychosocial variables, a past history of exposure to childhood maltreatment or abuse, job satisfaction, personality disorders, co-morbid mental and physical disorders, substance use or non-adherence to treatment. Only a subset of patients not responding to antidepressant treatment can be explained through pharmacokinetic or pharmacodynamics mechanisms. We propose that non remitting MDD should be personalised, and propose a strategy of 'deconstructing depression'. By this approach, the clinician considers which factors contribute to making this individual both depressed and 'resistant' to previous therapeutic approaches. Clinical formulation is required to understand the nature of the depression. Many predictors of response are not biological, and reflect a confluence of biological, psychological, and sociocultural factors, which may influence the illness in a particular individual. After deconstructing depression at a personalised level, a personalised treatment plan can be constructed. The treatment plan needs to address the factors that have contributed to the individual's hard to treat depression. In addition, an individual with a history of illness may have a lot of accumulated life issues due to consequences of their illness, and these should be addressed in a recovery plan. A 'deconstructing depression' qualitative rubric does not easily provide clear inclusion and exclusion criteria for researchers wanting to investigate TRD. MDD is a polymorphic disorder and many individuals who fail to respond to standard pharmacotherapy and are considered hard to treat. These patients are best served by personalised approaches that deconstruct the factors that have contributed to the patient's depression and implementing a treatment plan that adequately addresses these factors. The existence of TRD as a discrete and distinct subtype of MDD, defined by two treatment failures, is not supported by evidence. [ABSTRACT FROM AUTHOR]

Editorial. Presents an insight into articles published in the March 2003 issue of the 'International Journal of Psychotherapy.' Benefits of psychotherapy; Developments in the periodical; Features of psychodynamic theory; Pluralistic aspect of psychotherapy. [ABSTRACT FROM AUTHOR]

The rapid shift to telemental health (TMH) during the COVID-19 pandemic left mental health providers scrambling to adapt, raising concerns about the effect on the quality of the therapeutic alliance. This article explores the impact of TMH on the therapeutic alliance and how relational psychotherapists can support their patients and engage best practices in a way that helps all participants feel connected to the work. It defines the therapeutic alliance, explores the concepts of tasks, goals, and therapeutic bonds, and highlights the importance of developing a positive bond in the context of relational therapy. The paper also describes common challenges encountered while providing psychotherapy virtually, provides guidance on what contributes to a more positive attitude toward TMH interventions, offers a list of recommendations for improving the therapeutic alliance in TMH, and makes recommendations for future study. [ABSTRACT FROM AUTHOR]

This paper introduces the Special Symposium Issue on the Assimilation of Problematic Experiences and on the Assimilation Model. The main context of these studies is the process research trend in psychotherapy. Process research keeps a direct connection with outcome research and it tries to explore (in many different ways) how patients and therapists are involved and related in therapy and what kind of therapeutic activities, operations or variables are influencing the therapeutic change. In this process context qualitative studies are contributing greatly to give a more detailed explanation of the process of change. The Assimilation Scale and the Model developed by Stiles and his group are embbeded in this qualitative stance. So, in this introduction some of the main concepts and theoretical foundations of the Assimilation Model will be addressed as well the main conclusions of the papers edited. [ABSTRACT FROM AUTHOR]

The practice of equine-assisted therapy and learning (EAT/L) to deliver psychosocial interventions to young people is a rapidly growing field. However, recent reviews have cited a need for further documentation of a theoretical foundation and evidence of outcomes of these programmes. This paper is a theoretical discussion of psychotherapeutic theories and models that the authors understood as being relevant and giving substance to the application of EAT/L at a Therapeutic Horsemanship centre in the UK. It also describes and defines the practice of EAT/L at the centre. Philosophical and psychological theories/models of Non-Violent Communication, Object Relations, Play and Dramatherapy, Mindfulness practice, and Attachment Theory, all set within a person-centred and relationship-based approach employed at the centre were examined and illustrated in the form of client case material. The authors report the central role relationship plays between client-horse-therapist and horse-handler in the building of trust and resolution of the impact of trauma. The paper highlights a need to carry out well-designed empirical studies with different client groups in the field of EAT/L in order to gain more insight into this growing field. [ABSTRACT FROM AUTHOR]

Growing numbers of women are showing interest in clitoral reconstructive surgery after 'Female Genital Mutilation'. The safety and success of reconstructive surgery, however, has not clearly been established and due to lack of evidence the World Health Organization does not recommend it. Based on anthropological research among patients who requested surgery at the Brussels specialist clinic between 2017 and 2020, this paper looks at two cases of women who actually enjoy sex and experience pleasure but request the procedure to become 'whole again' after stigmatising experiences with health-care professionals, sexual partners or gossip among African migrant communities. An ethnographic approach was used including indepth interviews and participant observation during reception appointments, gynecological consultations, sexology and psychotherapy sessions. Despite limited evidence on the safety of the surgical intervention, surgery is often perceived as the ultimate remedy for the 'missing' clitoris. Such beliefs are nourished by predominant discourses of cut women as 'sexually mutilated'. Following Butler, this article elicits how discursive practices on the physiological sex of a woman can shape her gender identity as a complete or incomplete person. We also examine what it was that changed the patients' mind about the surgery in the process of re-building their confidence through sexology therapy and psychotherapy. [ABSTRACT FROM AUTHOR]

Creative methods in counselling are generally regarded as adjunctive techniques and procedures. In this paper I advocate for a deeper integration of creative methods within counselling and propose that one way forward would be to develop more inclusive frameworks for this practice. To this end, I consider some of the ways clinicians and theorists, particularly from the creative/expressive arts therapies, have sought to develop integrative approaches for imagination-based therapeutic practices. This overview also pays attention to attempts within talking therapies to develop more descriptive/functional models for the use of mental imagery that allow an integration across theoretical orientations. Some of the most relevant models and theoretical positions are then discussed in the light of their potential to inform frameworks for the use of creative methods in counselling. [ABSTRACT FROM AUTHOR]

Significant progress has been achieved in the last decades in studying two central questions in psychotherapy research: what treatment works for which patient and why does treatment work. This paper delineates central developments in the methods used to study each of these questions. Through targeted examples, the paper discusses several phenomena and trends in psychotherapy research. Regarding the question of what works for whom, the discussion focuses on the progress from the search for one moderator to guide clinical decision-making to the search for a set of such moderators and their interactive effects, to best answer this question. To answer the question why treatment is effective, the paper reviews the progress from a single snapshot of a process variable to approaching causality, that is, temporal relationships, higher dependability, and closer attention to the dynamics of change in process variables. Finally, methodological developments made it possible to combine these two questions so as to better capture the richness and complexity of therapeutic work. Two central products of this integration are discussed and demonstrated through the case of the working alliance. [ABSTRACT FROM AUTHOR]

This paper describes the sensual feeding exercise, a powerful therapeutic technique that reveals unconscious feelings operating within people's relationships. The exercise acts as a surrogate to sexual interaction, eliminating the pressure of genital sexual performance and thereby richly illuminating the emotional impediments to intimacy. Using this technique, the therapist instructs the members of a couple to feed one another, in a time and place of their choosing between therapy sessions. The couple has a spontaneous response to the exercise, different from the response elicited in discussing their sexual problem. The parallel between the process of feeding and the act of sex allows patients to learn a great deal about sexuality through non-threatening playful interaction. The paper reports on two treatment processes which led to greater emotional openness and expression in the couples' relationship, without improving sexual satisfaction. The sensual feeding exercise helpfully addressed the issue of sexual satisfaction by revealing the unconscious impediments to sexual expression. [ABSTRACT FROM AUTHOR]

The author, a middle-aged woman, was originally diagnosed with "Congenital Absence of Vagina"-at age thirteen. Since that time, she underwent four exploratory and corrective surgeries, without ever receiving a correct diagnosis that explained her condition, Mayer- Rokitansky-Kiister-Hauser Syndrome (MRKH). The author describes personal experiences with the medical profession and her emotional response to the diagnosis and treatment. The author made contact with an MRKH Internet support group and conducted a survey of its members. This paper discusses the qualitative results of this survey, confirming the need for awareness of atypical reproductive issues. This paper concludes with recommendations on the medical and psychological treatment of MRKH. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotherapy & Counselling is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Journal of Clinical & Experimental Hypnosis is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Journal of Psychoanalysis is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The concept of digital therapeutics is becoming increasingly popular. At the end of 2019, NHS England announced that over 300,000 patients were using some form of digital therapy, ranging from CBT and psychoeducation to counselling and psychotherapy. With the advent of the COVID-19 crisis the numbers are now far higher, with most therapists expected, even required, to offer their services via online platforms such as Zoom or Skype. But in the rush to capitalise on the convenience and accessibility of online therapy, it seems as if something, somewhere, has gone missing. In this paper, I will try to characterise and articulate the sense of loss that frequently attends online work, drawing on the work of Freud and the German philosopher and cultural critic Walter Benjamin. [ABSTRACT FROM AUTHOR]

Robert Waelder and W.R. Bion share an interest in articulating elemental landmarks within the psychotherapeutic terrain wherein primitive ideation may become transformed into a reclaimed reality orientation. The present paper extends their interest through clinical and literary example. It surfaces an aspect of Bion’s therapeutic calculus, implicit but unstated, in the temporal arrival at multiple and continuously changing “d” structures within the ongoing process of therapy. By recognizing the joint contribution of therapist and patient within these creations in time of arrival at approximations to the depressive position, the authors illustrate the weaving of “white hole” matrices, affording temporary relief from the dread of annihilative anxiety that reclaim the patient’s capacity for non-psychotic self-orientation. [ABSTRACT FROM AUTHOR]

This paper reviews the current state of psychotherapy supervision in psychiatric training programmes. A focused literature search was carried out that examined three questions concerning the content, process and outcome of psychotherapy supervision. Results indicate that although requirements for training have broadened somewhat, methods of instruction in supervision have remained the same for many decades. In addition, there is a lack of discussion on what supervision outcomes should be assessed. This paper explores these areas and provides some suggestions for the future of psychotherapy supervision that are evidence-based and generalizable to an international audience. It is time to arrive at an international consensus about guidelines for psychotherapy supervision in psychiatry training programmes. This paper attempts to provide a starting place for psychotherapy supervisors and educators so that we can advance the field forward. [ABSTRACT FROM AUTHOR]

This paper examines the notion that marginalized clients through their socio-cultural and geo-political histories are positioned “outside” the masculine cultural metaphors and conventional theoretical epistemologies of counselling, psychology and psychotherapy. In other words, these minoritized clients are “outside the sentence” of the texts and contexts of therapy. The discursive practice of therapeutic reconstitution and restoration produces a particular set of vocabularies and sentences that facilitate transformation and psychic equilibrium consistent with the process of individuation and self actualization. However, for marginalized groups, such as black and other visible minority, women, deaf, gay and lesbian clients the hegemonic masculine narratives of counselling psychology and psychotherapy only make it possible for these clients to be “outside the sentence”, not just grammatically and metaphorically of the therapeutic project, but in the external reality of how the practice is clinically governed. In other words, the social and cultural marginalization outside the clinic room is in a dialectical relationship with the therapy dyad. For the minoritized client being “outside the sentence” produces the effect of being “inside” another process, i.e., the history of subjugation, domination, diaspora, and displacement. This paper explores this issue and argues that the only way for counselling, psychology and psychotherapy to bring the diversity client “within the sentence” of therapy is to assign and re-inscribe the history, memory and pain of “the Other” voices to the “inside” of the therapeutic space, to interrupt and disrupt the hegemonic masculine narratives, thus transforming “non-sentences” into sentences and paragraphs, and eventually into essays of the discursive subject. [ABSTRACT FROM AUTHOR]

This paper gives an account of the developments in the intensive psychotherapy of a seven-year-old boy with global development delay. It also describes the adaptations to technique and the changes in the setting that were required to support the work, which was undertaken in a special school. The importance of the regularity of sessions in helping to establish object constancy; physical and mental boundaries in relation to me/not me; inside and outside is also explored. A central theme of the paper is how close observation can inform the understanding of the emotional states of disabled children, particularly those with little language. The paper draws links between the early communications of mothers and infants and the therapeutic relationship, with reference to music therapy. It describes banging as a form of communication and traces the development of banging into more coherent nursery rhymes arguing that this development is an internalisation of the rhythm of the therapy and of the growing understanding between the child and therapist. [ABSTRACT FROM AUTHOR]

This paper examines the phenomenon of looking together in art therapy. It argues that the triangular relationship - on which much of art therapy theory is premised - takes as a priori the capacity of the patient to look together with the therapist at the art object. This capacity, however, cannot be taken as a given but is based on early childhood development, emerging out of the mother-infant relationship where in ordinary growth, the infant's looking at the mother develops into looking with her. This paper explores the development of joint attention skills in relation to art therapeutic practice drawing together child developmental and psychoanalytic perspectives. [ABSTRACT FROM AUTHOR]

This paper outlines the existential-phenomenological (E-P) approach to psychotherapy and considers some of its core concepts, the stance taken to understanding sexuality and the implications for therapeutic practice with gay male clients. Three previously published case studies are reviewed to provide illustrations of the approach, and the paper concludes by arguing that a non-pathologising view of sexuality is useful in assisting clients in therapy and in assisting therapists and services in understanding their clients without problematising them. [ABSTRACT FROM AUTHOR]

This paper highlights challenges made to the model of mandatory individual personal therapy for therapists in training in order to widen the debate. A requirement for individual personal therapy for therapists in training is more congruent with some therapeutic modalities than others. The views expressed in this paper have been reached after consideration of needs across different modalities and awareness of the available research evidence. ‘Counselling’, ‘psychotherapy’ and ‘therapy’ are used interchangeably. [ABSTRACT FROM AUTHOR]

This paper will consider, first, the ambiguity of the title as an introduction to and structuring of the following paper and, following this, the historical Freud's legacy in regard to psychotherapy will be discussed. The invention of the Freudian classic will subsequently be examined including such aspects as apparent paradoxes and inconsistencies, the confusion of psychoanalytic method and one technique of treatment and then the integration into the healing arts and the claim of psychoanalysis to be something other than psychotherapy. The discussion will then focus on the history of psychoanalysis in post-war Germany, considering whether it was a successful one and looking at the integration of psychoanalysis into public health care–both the profits and the losses.In discussing ‘A new paradox as a way out of the dead-end’ in referring to Freud's legacy, what is meant is for psychoanalysis not to be a clinical psychology and a part of medicine, but a general depth psychology which gives the fundamentals of a general psychology and an encompassing method and allows a variety of techniques of treatment.Following this will be an outline of psychoanalytic method, specifically: (1) attitude/identity as insufficient concepts, but pointing to method, that is equally private, personal and professional: a form of life; (2) the abstract meaning of method, the aspect of activity combined with the corpus of theory, together forming a scientific project.In conclusion, I shall consider Freud's legacy: psychoanalytic and psychotherapeutic training which is centred around methodical education. [ABSTRACT FROM AUTHOR]

This is an article based on a presentation given at the United Kingdom Council of Psychotherapy (UKCP) conference 2004. Our modern attempt to re-include the body in psychotherapy brings with it the inevitable danger that we import the culturally dominant objectifying construction of the body into a field which may represent one of the last bastions of subjectivity, authenticity, and intimacy in an increasingly virtual world. The paper addresses the question how embodied subjectivity can be found within a relational matrix pervaded by disembodiment and self-objectification. The ubiquitous objectification of the body in our culture and in the field of psychotherapy is illustrated in the paper. It is described as a manifestation of an underlying experience of dis-embodiment. Two ways of re-including the body in psychotherapy are then distinguished: one based on a “third-person” “medical model” stance and the other on a “first-and-second-person” “intersubjective-relational” model. By formulating these two contradictory and complementary ways of using the body in terms of the therapist's implicit relational stance, attention is drawn to what is considered an underlying paradox inherent in all types of psychotherapy. I am hoping that practitioners from across the approaches will be able to recognize and relate to both sides of the dilemma, and through this to both ways of re-including the body in psychotherapy. As the medical model stance was the prevalent default position of what we may therefore call traditional body psychotherapy, and the relational one has become available only in the last decade, a case illustration is used to trace some of my own development as a therapist through the shadow aspects and pitfalls of an exclusive reliance on the first towards an integration of the two and to an appreciation of their necessarily conflicted co-existence in the paradoxical core of the therapeutic position. [ABSTRACT FROM AUTHOR]

Drawing on contemporary evidence in the counselling and psychotherapy research field, this paper argues that there is growing support for a relationship-orientated approach to therapeutic practice. The paper reviews findings from a range of meta-analytical and individual studies which provide strong evidence for the centrality of relational factors to the successfulness of therapy, and then goes on to examine the specific variables that appear to be linked to positive therapeutic change. Having considered some of the empirical evidence that challenges this position and highlighted the importance of individual differences, the paper concludes by arguing that we need to develop and expand our understanding of the kind of relational factors and processes that most facilitate therapeutic change. [ABSTRACT FROM AUTHOR]

This paper examines the variety of ways in which psychotherapy and residential care are integrated in the concluding phase of an intensive short-term treatment program for severely disturbed adolescents. It considers the manner in which decisions are made about termination, approaches to discharge planning, typical issues encountered in the therapy process, techniques for coordinating the work of the therapist and the residential team, ways of addressing crises around termination, the discharge process, and means of facilitating the work of outpatient treatment providers. [ABSTRACT FROM AUTHOR]

Objective: In this paper, we test the reliability and validity of two novel ways of assessing mentalizing in the therapy context: the Reflective Functioning scale (RF) applied to code psychotherapy transcripts (In-session RF), and the Exploring scale of the Patient Attachment Coding System (PACS), which measures in-session autonomy and is linked with secure attachment in psychotherapy. Method: Before treatment, 160 patients in different types of psychotherapy and from three different countries were administered the Adult Attachment Interview (AAI), which was rated with the RF scale. One early psychotherapy session for each patient was independently rated with the In-session RF scale and with the PACS Exploring scale. Results: Both scales were found to be reliable and to have concurrent validity with the RF scale rated on the AAI, with the PACS Exploring scale found to be a better predictor of RF on the AAI. Conclusions: These results suggest that the PACS Exploring scale might be a practical method for assessing RF in psychotherapy research and a way for researchers and clinicians to track patients' RF on an ongoing basis. These results also provide information regarding the ways in which differences in RF manifest during psychotherapy sessions. Clinical or methodological significance of this article Researchers and clinicians can assess patients' mentalizing based on any single psychotherapy transcript, in many therapeutic modalities The Exploring scale of the Patient Attachment Coding System can yield a reliable measure of reflective functioning based on any single psychotherapy transcript, in many therapeutic modalities Client differences in mentalizing manifest in part independently of the therapist's contributions [ABSTRACT FROM AUTHOR]

This paper examines the cultural situation and special responsibility of dance movement therapy, delineating certain philosophical and cultural-theoretical interpretations of the 'corporeal turn' and 'therapeutic turn' of contemporary culture. It aims to show how dance movement therapy's theoretical horizon is inseparable from the body-mind integration of contemporary philosophies, and how corporeal turn is present in consumer culture, including some of its destructive forms of idealisation and malign regression. The question of how DMT is able to turn malignant regression to the body into benign regression is addressed, and an analysis of the correlating postmodern idea of resilience is offered. Finally, DMT groups are interpreted as social microcosms, and the way Hungarian psychodynamic movement and dance therapists apply their group therapeutic method for the development of democratic culture in the Civil Group Project is described. [ABSTRACT FROM AUTHOR]

Background: Technology could answer the substantial need in human resources available for supporting those who suffer from mental illness, by providing scalable methods to train and engage non-professionals to those who need their support. 7 Cups of Tea (7COT) platform was chosen for this study, because it provides a good case study for examining this kind of solution. Aim: The aim of this paper was to provide empirical findings regarding users' satisfaction with online emotional support provided by trained volunteers and how it is perceived in comparison to psychotherapy. Methods: An online survey was conducted among a convenience sample of 7COT users. Results: The findings showed high user satisfaction with the support provided by 7COT listeners and, on average, users who indicated to receive psychotherapy in their past marked the listeners' support to be as helpful as psychotherapy. Relating to psychotherapy and online emotional support advantages, different advantages were found. The findings suggest that receiving support from volunteers makes users feel that the support is more genuine. Conclusion: The paper provides preliminary evidence that people in emotional distress may find non-professionals support delivered through the use of technology to be helpful. Limitations and implications are discussed. [ABSTRACT FROM AUTHOR]

Prof. Richard Layard's influential advocacy for greater provision of ‘evidence-based’ psychological therapies, based in part on an economic rationale, has lead to greatly increased provision of cognitive behavioural therapy (CBT) and short-term therapies for depression, through the Increasing Access to Psychological Therapies (IAPT) initiative, whilst longer-term psychodynamic treatments are under threat, criticised as lacking an evidence base. This paper argues for the continuing provision of intensive thrice-weekly psychoanalytic psychotherapy treatments, time-limited to two years. It does so by describing such a treatment within an NHS psychotherapy department with a patient with a long history of severe personality pathology, including significant levels of perversity. The paper describes the patient's difficulties and his movement through the treatment, focussing on his difficulties making genuine emotional contact, his destructiveness of such contact, his acting out in the treatment, his perversity and the vital working through of the ending. The shifts the patient made are described, and follow-up information on the patient is given. The paper discusses the unique benefits of time-limited treatment and intensive psychoanalytic treatments for this ‘hard-to-help’ group of patients, and the economic rationale that can be made for such treatments. [ABSTRACT FROM PUBLISHER]

Copyright of Psychotherapy Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Online psychological therapy, or e‐therapy, has proliferated. e‐Therapy enables clinicians to reach clients otherwise unable to access health services. This should be particularly valuable to services, such as Clinical Neuropsychology, that are scarce or unavailable outside major metropolitan centres, but little is known regarding the potential for online neuropsychological therapy. This discussion paper focuses on memory interventions for older adults, and aims to determine whether it is feasible to create an effective online memory intervention. Method: The approach used was to review the literature regarding e‐Health generally and factors associated with effective online delivery, as well as specific issues related to Internet usage and current memory interventions for older adults. Regard was given to ethical considerations and practical suggestions were made about the way forward to implement online memory interventions for older adults. Results: There is good evidence that memory interventions for older adults improve memory and increase functional independence. Barriers to online delivery of memory interventions are identified and recommendations for practice provided. Conclusions: Despite various barriers, translation of memory interventions to an online format appears feasible, and would enable delivery to many older adults who would be otherwise unable to access these services. [ABSTRACT FROM AUTHOR]

Peer support promotes the overall wellness of people with mental illness by establishing mutual partnerships throughout their different stages of recovery. In health research, investments in patient-oriented research have become prioritized. However, peer-contributed research remains relatively rare, especially in the study of psychosis. Our research team chose to include a peer research assistant in the elaboration and refinement of a novel personalized and patient-oriented psychotherapy for voice hearers, using virtual reality (Avatar Therapy (AT)). This paper details the case of a partnership between a mental health service user and clinical researchers by showcasing Mr X, the first to follow the therapy for his input and our peer support worker for future patients, in his journey toward recovery. Before AT, Mr X was unable to advance due to his voices. His participation was to initially gain from his personal expertise and invite his critique to improve AT. However, what he gained from AT was much more; his voices diminished by 80-90% and he was able to reduce his medication on four occasions. Also, he followed a university-level peer helper program and became employed. Mr X is an inspirational case of how AT may have a positive impact on one’s life. [ABSTRACT FROM AUTHOR]

A psychological model of classic psychedelic-assisted psychotherapy informed by contemporary scientific data is presented in this paper. It is suggested that classic psychedelic-occasioned mystical experience is characterized by profound awe, a discrete emotion experienced in the presence of a vast stimulus requiring accommodation of mental structures. Awe, in turn, promotes the small self, a construct that, in the extreme, is analogous to those of unitive experience and ego dissolution. The small self is conceptualized as key to understanding the downstream effects of mystical experience occasioned in the context of classic psychedelic-assisted psychotherapy. With this novel theoretical framework in mind, a number of clinical implications and recommendations are provided so as to advance this incipient field of study. [ABSTRACT FROM AUTHOR]

Moroccans make up a large immigrant population but no prior research has been carried out with them. This paper focused on understanding depression and its management among Moroccan women through exploration of their view of the cause, presentation and treatment of depression, as well as that of their carers and mental health professionals. This study was conducted in a Moroccan psychiatric hospital. Data was collected using audiotaped, semi-structured interviews carried out by psychiatrists, lasting 30 minutes. Participants included: (1) outpatients with a diagnosis of depression, (2) relatives of patients and (3) psychiatrists and psychologists. A total of 30 interviews were conducted in French/Arabic and translated into English. The analysis involved NVivo. The results highlight delayed presentations in the majority of patients and physical symptoms of depression with an emphasis on anger. Most patients and relatives ascribed depression to a social problem, with an emphasis on depleted patience. Patients’ expectations of management depicted a bio-psycho-spiritual-social model of illness. Although half of all patients mentioned the evil eye as a potential cause, few saw traditional healers. Patient socioeconomic conditions and insufficient psychological training render psychotherapy an unexploited tool. This study reflects the importance of educating professionals with regards to diagnosis and therapy in non-Western cultures. [ABSTRACT FROM AUTHOR]

Objectives:Mindfulness-based cognitive therapy (MBCT) has been successful in reducing depressive symptoms in people with chronic-recurrent depression. However, the research evaluating the efficacy of this approach, and other innovative treatments for mood disorders, has mainly been with people under 65 years. This paper aims to help redress this imbalance by exploring older people's own reflections of their experience of MBCT. Methods:A qualitative approach was used to explore 13 participants' experiences of MBCT; participants were interviewed pre and post-intervention and again after six months. To see whether the standard course requires any adaptations for older participants, the two MBCT course facilitators were interviewed post-intervention. Results:Thematic analysis identified five overarching themes and showed that older people reported positive changes in their mental health and well-being and reported being ‘released from the past’. The facilitators reported that they needed to be aware of later life issues, such as loneliness and potential physical limitations, but otherwise only minor adaptations were needed to the standard MBCT course for older people. Conclusion:MBCT is an acceptable approach for people aged 65 years and over and further research should explore potential mechanisms of change including changes in meta-cognitive awareness and self-compassion. [ABSTRACT FROM PUBLISHER]

Problem: Individual psychodynamic psychotherapy has become more widely available to people who have intellectual disabilities in recent years and a literature on its use has developed. However, there does not appear to be a clear exposition of the process and practice of this treatment approach when used with this population. Method: Case studies and technical papers relating to the process and practice of individual psychodynamic psychotherapy with people with intellectual disabilities published between 1981 and 2010 were examined to ascertain how the model was being used. Practice was delineated into the nature of the therapeutic frame and the action of therapists within sessions. Outcome: The nature of the therapeutic frame was discussed with reference to the available literature, noting the need for flexibility around settings and session duration whilst maintaining the consistency of the frame required, ensuring provision of a secure base. The action of therapists was considered in three stages: information gathering, formulation/ recontextualisation and communication of interpretations. Discussion: Common practice was identified whilst acknowledging the paucity of descriptive practice in the literature, particularly with regard to the formulation of material into interpretations. Areas for development are identified to develop a literature to assist with developing practice and training. [ABSTRACT FROM AUTHOR]

This paper explores certain primitive defensive mechanisms found with addicted patients and introduces one of these, an intra-psychic mechanism, termed mimetic fusing. The descriptive concept of mimetic fusing is introduced in order to illuminate the processes by which a primitive self appears to repeat attempts to assimilate and detoxify introjections that are felt to be threatening and that generate intense anxiety. It is suggested that in the absence of an adequate container (Bion, 1962. A theory of thinking. International Journal of Psycho-Analysis, 43(4-5)), mimetic fusing may develop as a defensive mechanism to assimilate aggressively imbued introjections that threaten to overwhelm a fragile self-structure. The author suggests that mimetic fusing may represent a desperate defensive strategy that ultimately leads to the increased use of other basic defences such as splitting, the anti-container, anti-time and projective identification. Case material, taken from work with an addicted patient in longer term weekly psychotherapy, is included to illustrate the theoretical points under discussion. [ABSTRACT FROM AUTHOR]

This paper is written from a psychodynamic clinician's perspective, juxtaposing a psychoanalytic-attachment model of depression with recent developments in neuroscience. Three main components of the attachment approach are described: the role of loss, of childhood trauma predisposing to depression in later life, and failure of co-regulation of role of primitive emotions, such as fear, despair, and helplessness. Blatt's distinction between anaclitic and introjective depression is delineated and related to hyper- and de-activation of the attachment dynamic. Recent advances in evolutionary, sociological, epigenetic, biochemical, and neuro-imaging studies of depression are reviewed. A dynamic model of depression is proposed, linking interpersonal and intra-psychic perspectives with neuro-anatomical models. The final section of the paper considers the specific role of psychodynamic approaches to the treatment of refractory depression. These include length of treatment, capacity to rework implicit memories, and focus on transference and counter-transference. [ABSTRACT FROM AUTHOR]

This article addresses a number of confusions still present in person-centered and experiential literature regarding Rogers' therapeutic conditions. The article frames the conditions in a relational perspective; clarifies what Rogers wrote about the conditions, their necessity and sufficiency (Rogers, 1957, 1959a); argues that the term “the core conditions” is confusing and unhelpful; and discusses the three “lost conditions”. [ABSTRACT FROM PUBLISHER]

Self-injury among female adolescents has become an important clinical issue in social work practice. Anxiety has been cited as one of the primary reasons that self-injury occurs in this population. This paper explores the role of empathy in mitigating anxiety and helping with emotional regulation and highlights the need to empathically monitor the self-systems of female clients who self-injure. This paper considers issues of gender and family structure within this population and explores transference and countertransference as important processes that can help to develop empathy in the therapeutic relationship. A case study is presented to highlight these important processes. Implications for social work practice are discussed. [ABSTRACT FROM AUTHOR]

This paper is an account of time-limited dance movement psychotherapy in an inner-city London school during my final year of training for an MA in Dance Movement Psychotherapy. I describe the treatment of a traumatised 9-year-old boy using psychoanalytic theories, in particular Winnicott's ideas. This patient suffered at an early age from the drastic separation of his father and, when he was 6 years of age, various dramatic events led to the hospitalisation of his mother due to psychiatric problems. The impending ending of the therapy and the trainee's repetition of a 'neglectful transference' triggered powerful memories of traumatic past separations, which aroused deep-seated anxieties in the patient and trainee alike. The work towards a 'good enough' ending in the new therapeutic relationship was of great value to the patient's recovery. Parallels are drawn with the trainee's feelings of ending her dance movement psychotherapy course. [ABSTRACT FROM AUTHOR]

This paper argues and tries to demonstrate that, alongside neuroscience and relational psychotherapy, body psychotherapy can and should draw on a third important source beyond its own tradition: the social sciences and social theory of embodiment. After establishing and outlining the enormous body of relevant material, hardly used so far within our discipline, I move on to the theoretical underpinnings of this material, and in particular social constructionist approaches to embodiment. From this, I explore some of the fundamental theoretical approaches used in the social sciences, based on the work of Michel Foucault and of Maurice Merleau-Ponty, and try to show their implications for body psychotherapy. [ABSTRACT FROM AUTHOR]