This book provides an accessible comprehensive exploration of phenomenological theory and research methods and is geared specifically to the needs of therapists and other health care professionals. ...An accessible exploration of an increasingly popular qualitative research methodologyExplains phenomenological concepts and how they are applied to different stages of the research process and to topics relevant to therapy practiceProvides practical examples throughout
Purpose in Life Yager, Joel; Kay, Jerald
The journal of nervous and mental disease,
06/2023, Volume:
211, Issue:
6
Journal Article
Peer reviewed
Having a purpose in life is strongly associated with well-being and quality of life. Some individuals develop their sense of purpose early in life and can sustain lifelong ideals. In contrast, we ...identify four transdiagnostic syndromes where purpose in life is impaired: 1) deficiencies in generating purpose; 2) loss of purpose due to traumatic events such as catastrophic illnesses or bereavements; 3) conflicts due to crossed purposes; and 4) maladaptive purposes, such as life-limiting single-minded goals, dominating others, or exacting revenge. Several psychotherapies associated with positive and existential psychologies help patients construct, reconstruct, or retain a sense of purpose. However, given the strong links between a sense of purpose and beneficial health and mental health outcomes, the authors suggest that many patients in psychiatric treatment including psychotherapies will benefit from attention to these issues. This article reviews approaches for assessing and addressing purpose in life in psychiatric treatment, to enhance patients' healthy sense of purpose where this characteristic is impaired.
We report the successful psychotherapy and medical treatment of a patient with an atypical presentation of Capgras syndrome, in which the patient not only believed that his parents were impostors but ...also believed that the entirety of what others would consider consensual reality was in fact an impostor. He insisted that a complex delusional world in which he wished to reside was authentic reality. His delusions of misidentification waxed and waned in response to discernable social stressors, and at times, he seemed to have conscious insight into the delusional nature of his beliefs. This case raises questions about whether Capgras should be considered a stand-alone diagnosis or whether it should be placed within a wider spectrum of psychotic disorders. Excepting our current report, although there are numerous reports of the resolution of Capgras after treatment with neuroleptics, we are unaware of descriptions in the literature of the successful treatment of medication-resistant Capgras with a combination of individual psychotherapy and pharmacological management.
Drawing on a wealth of case vignettes, the book describes how to apply Problem-Focused Psychodynamic Psychotherapy (PrFPP) to symptoms, personality issues, behavioral problems, and relationship ...difficulties. It provides novice and experienced clinicians alike with the tools they need to help patients identify problem areas and understand how specific dynamics emerge in different contexts and overlap in contributing to issues.
Background
Post‐traumatic stress disorder (PTSD) is a distressing condition, which is often treated with psychological therapies. Earlier versions of this review, and other meta‐analyses, have found ...these to be effective, with trauma‐focused treatments being more effective than non‐trauma‐focused treatments. This is an update of a Cochrane review first published in 2005 and updated in 2007.
Objectives
To assess the effects of psychological therapies for the treatment of adults with chronic post‐traumatic stress disorder (PTSD).
Search methods
For this update, we searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR‐Studies and CCDANCTR‐References) all years to 12th April 2013. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). In addition, we handsearched the Journal of Traumatic Stress, contacted experts in the field, searched bibliographies of included studies, and performed citation searches of identified articles.
Selection criteria
Randomised controlled trials of individual trauma‐focused cognitive behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), non‐trauma‐focused CBT (non‐TFCBT), other therapies (supportive therapy, non‐directive counselling, psychodynamic therapy and present‐centred therapy), group TFCBT, or group non‐TFCBT, compared to one another or to a waitlist or usual care group for the treatment of chronic PTSD. The primary outcome measure was the severity of clinician‐rated traumatic‐stress symptoms.
Data collection and analysis
We extracted data and entered them into Review Manager 5 software. We contacted authors to obtain missing data. Two review authors independently performed 'Risk of bias' assessments. We pooled the data where appropriate, and analysed for summary effects.
Main results
We include 70 studies involving a total of 4761 participants in the review. The first primary outcome for this review was reduction in the severity of PTSD symptoms, using a standardised measure rated by a clinician. For this outcome, individual TFCBT and EMDR were more effective than waitlist/usual care (standardised mean difference (SMD) ‐1.62; 95% CI ‐2.03 to ‐1.21; 28 studies; n = 1256 and SMD ‐1.17; 95% CI ‐2.04 to ‐0.30; 6 studies; n = 183 respectively). There was no statistically significant difference between individual TFCBT, EMDR and Stress Management (SM) immediately post‐treatment although there was some evidence that individual TFCBT and EMDR were superior to non‐TFCBT at follow‐up, and that individual TFCBT, EMDR and non‐TFCBT were more effective than other therapies. Non‐TFCBT was more effective than waitlist/usual care and other therapies. Other therapies were superior to waitlist/usual care control as was group TFCBT. There was some evidence of greater drop‐out (the second primary outcome for this review) in active treatment groups. Many of the studies were rated as being at 'high' or 'unclear' risk of bias in multiple domains, and there was considerable unexplained heterogeneity; in addition, we assessed the quality of the evidence for each comparison as very low. As such, the findings of this review should be interpreted with caution.
Authors' conclusions
The evidence for each of the comparisons made in this review was assessed as very low quality. This evidence showed that individual TFCBT and EMDR did better than waitlist/usual care in reducing clinician‐assessed PTSD symptoms. There was evidence that individual TFCBT, EMDR and non‐TFCBT are equally effective immediately post‐treatment in the treatment of PTSD. There was some evidence that TFCBT and EMDR are superior to non‐TFCBT between one to four months following treatment, and also that individual TFCBT, EMDR and non‐TFCBT are more effective than other therapies. There was evidence of greater drop‐out in active treatment groups. Although a substantial number of studies were included in the review, the conclusions are compromised by methodological issues evident in some. Sample sizes were small, and it is apparent that many of the studies were underpowered. There were limited follow‐up data, which compromises conclusions regarding the long‐term effects of psychological treatment.
This SEA-workshop was concerned with moments in our interactions with clients where we felt that we were acting in 'bad faith'. The workshop engaged with the question of the extent to which it is ...possible to be a therapist without playing the role of 'the therapist'.
Dans cette section, qui fait suite à l’article « Le phénomène pathique et la rencontre thérapeutique » publié dans le même numéro, nous aborderons la question de savoir comment développer une ...formation à la psychothérapie qui tienne rigoureusement compte de l’implication du soignant dans le champ même où s’exercent son savoir et son savoir-faire. L’apprentissage de la psychothérapie aurait pour fondement un savoir- être : une initiation vivante et pensante à la condition humaine et à sa nature pathique fondamentale. Dans son cheminement, l’étudiant doit pouvoir compter sur l’expérience de formateurs engagés qui le soutiennent et le guident, et sur une solidarité active du groupe de condisciples, pour faire face au déconcertant, au périlleux, mais aussi au transformateur de l’expérience pathique.
Notre dispositif de formation à la psychothérapie est intérieurement travaillé par notre façon de penser « l’objet » du soin : l’humain qu’à la fois nous sommes et avons à traiter. La première partie ...de cette étude qui fait l’objet du présent article vise à commenter ce nœud qui fait la singularité de la psychothérapie. Qu’est-ce qui, dans l’existence humaine, nous expose à la (psycho)pathologie ? Qu’est-ce qui, dans la rencontre interhumaine, peut s’avérer soignant ? En référence à la pensée phénoménologique, les auteurs examinent le statut singulier du phénomène pathique autour duquel s’articulent psychopathologie et psychothérapie. Le « pathique » renvoie à la vulnérabilité multiforme qui marque notre condition humaine. Il signe aussi notre ouverture, notre sensibilité fondamentale à ce qui se produit dans la rencontre ; comme tel, il est constitutif de la fonction thérapeutique. Dans une seconde partie, nous aborderons la question de savoir comment développer une formation à la psychothérapie qui tienne rigoureusement compte de cette implication du soignant.
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