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'.
Heidegger Being and Timers notions of anxiety, authenticity and existentiell modification can be understood as a process of self-knowledge and personal change. It is argued that Heidegger himself ...exemplifies that process, a relevant one to the practice of psychotherapy.
The paper considers individual approaches to the provision of emergency psychiatric care in emergency situations. The authors believe that emergency psychological, psychiatric and psychotherapeutic ...care is an important component of the healthcare system and plays an important role in providing timely assistance to people facing crisis situations, including mental disorders, suicidal thoughts, traumatic events and other problems. The main task of emergency psychological, psychiatric and psychotherapeutic care is to provide quick and effective assistance in an emergency situation when every minute matters and can save a life. In addition, emergency psychological, psychiatric and psychotherapeutic care can also help prevent the development of mental health-related diseases and provide patients with access to the necessary resources and treatment. It is important to note that urgent psychological, psychiatric and psychotherapeutic care should be available to everyone who needs it, regardless of age, gender, social status and other factors. At the same time, it is important to take into account the cultural and ethical characteristics of each patient and provide them with an individual approach and high-quality care
Aspects of educational theory are employed to explore the concepts that students must navigate when studying counselling and psychotherapy. Assessment and evaluation strategies are considered in ...relation to the phenomenological exploration of life worlds, in a not-knowing approach. Attention is paid to issues of diversity, inclusion and exclusion.
Working online through the Covid epidemic lockdowns has shown many of us that embodied practice is not only possible online, but welcome. I explore how the therapist's Focusing can offer an ...opportunity to be-with the client in embodied connection, regardless of physical or online emplacement, and particularly how felt sense can support us to approach 'edgy' material. I welcome comment and response, especially around the embodied possibilities in online work and from those with more Focusing experience than my own.
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