1. Freud developed psychoanalytic therapy to transform patients' misery into common unhappiness by helping them work through unconscious causes of their issues using techniques like free association and interpretation of transference. 2. Klein and subsequent theorists focused on transference and countertransference in the here-and-now. 3. Recent approaches like mentalization therapy aim to enhance patients' ability to think about mental states in relationships to improve symptoms like those seen in borderline personality disorder.
This document provides a critical review of psychotherapy efficacy research. It discusses various types of psychotherapy and important terms in research methodology. While efficacy research aims to establish causal relationships through controlled trials, its results often lack external validity and generalizability. Comparative studies generally find no significant differences between major psychotherapy approaches. The document concludes that common factors like the therapeutic alliance, rather than specific techniques, are crucial for effective therapy. More research is still needed to determine the most effective treatments for specific disorders.
What is biofeedback therapy and who can benefit? Biofeedback therapy is a non-drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure, or heart rate........
This document summarizes key aspects of psychotherapy. It discusses that psychotherapy can involve a few sessions or last for months/years. Therapists can be psychologists, social workers, counselors, nurses, or psychiatrists. Psychotherapy involves a trusting relationship between client and therapist and works through changing beliefs, attitudes, and encouraging new behaviors. Research shows psychotherapy is effective both in controlled settings and realistic settings, improving outcomes and reducing medical costs. While approaches differ, common factors like the therapeutic relationship and instilling hope are important. The future of psychotherapy may involve more cognitive-behavioral, culturally sensitive, and eclectic/integrative approaches.
This document summarizes various psychotherapy approaches and interventions. It discusses outcome research showing that on average, psychotherapy has an effect size of 0.85 and 50% of clients show marked improvement after 8 sessions. Longer treatment is associated with better outcomes, with 75% improved after 26 sessions and 85% after 52 sessions. Common therapy approaches described include cognitive-behavioral therapy, psychodynamic therapy, humanistic/existential therapy, and others. Key concepts and techniques from different theories are outlined.
This document discusses cognitive behavioral therapy (CBT) as a treatment for depression. It begins with definitions of depression and an overview of Beck's cognitive model of depression. It then describes the CBT approach, which aims to modify negative and distorted thoughts and behaviors. Therapists help clients develop a case formulation and use techniques like thought challenging to dispute negative automatic thoughts. The document concludes that numerous studies have shown CBT to be an effective treatment for depression and is comparable or superior to antidepressant medication alone.
This document provides an overview of various psychological therapies and biomedical therapies for treating psychological disorders. It discusses psychoanalysis, humanistic therapies, behavior therapies, cognitive therapies, group/family therapies, drug therapies, brain stimulation techniques, and psychosurgery. For each therapy, it briefly describes the approach, methods used, examples of disorders treated, effectiveness research findings, and commonalities across therapies. The document emphasizes that psychological disorders have biopsychosocial causes and preventing disorders involves addressing societal factors that negatively impact mental health.
The document discusses psychotherapy and its various types. Psychotherapy aims to help patients understand themselves better and modify problematic behaviors through verbal communication. It can be individual or group-based. Individual psychotherapy explores a patient's feelings and experiences on a one-to-one basis, while group psychotherapy involves carefully selected patients helping one another under therapist guidance. Different psychotherapy approaches include psychodynamic, humanistic, behavioral, and cognitive therapies.
Evolution of Psychotherapy: An OxymoronScott Miller
Reviews the history of psychotherapy outcome, documenting the lack of improvement and suggesting an alternative to focusing on diagnosis and treatment approach for improving outcome
This document provides a critical review of psychotherapy efficacy research. It discusses various types of psychotherapy and important terms in research methodology. While efficacy research aims to establish causal relationships through controlled trials, its results often lack external validity and generalizability. Comparative studies generally find no significant differences between major psychotherapy approaches. The document concludes that common factors like the therapeutic alliance, rather than specific techniques, are crucial for effective therapy. More research is still needed to determine the most effective treatments for specific disorders.
What is biofeedback therapy and who can benefit? Biofeedback therapy is a non-drug treatment in which patients learn to control bodily processes that are normally involuntary, such as muscle tension, blood pressure, or heart rate........
This document summarizes key aspects of psychotherapy. It discusses that psychotherapy can involve a few sessions or last for months/years. Therapists can be psychologists, social workers, counselors, nurses, or psychiatrists. Psychotherapy involves a trusting relationship between client and therapist and works through changing beliefs, attitudes, and encouraging new behaviors. Research shows psychotherapy is effective both in controlled settings and realistic settings, improving outcomes and reducing medical costs. While approaches differ, common factors like the therapeutic relationship and instilling hope are important. The future of psychotherapy may involve more cognitive-behavioral, culturally sensitive, and eclectic/integrative approaches.
This document summarizes various psychotherapy approaches and interventions. It discusses outcome research showing that on average, psychotherapy has an effect size of 0.85 and 50% of clients show marked improvement after 8 sessions. Longer treatment is associated with better outcomes, with 75% improved after 26 sessions and 85% after 52 sessions. Common therapy approaches described include cognitive-behavioral therapy, psychodynamic therapy, humanistic/existential therapy, and others. Key concepts and techniques from different theories are outlined.
This document discusses cognitive behavioral therapy (CBT) as a treatment for depression. It begins with definitions of depression and an overview of Beck's cognitive model of depression. It then describes the CBT approach, which aims to modify negative and distorted thoughts and behaviors. Therapists help clients develop a case formulation and use techniques like thought challenging to dispute negative automatic thoughts. The document concludes that numerous studies have shown CBT to be an effective treatment for depression and is comparable or superior to antidepressant medication alone.
This document provides an overview of various psychological therapies and biomedical therapies for treating psychological disorders. It discusses psychoanalysis, humanistic therapies, behavior therapies, cognitive therapies, group/family therapies, drug therapies, brain stimulation techniques, and psychosurgery. For each therapy, it briefly describes the approach, methods used, examples of disorders treated, effectiveness research findings, and commonalities across therapies. The document emphasizes that psychological disorders have biopsychosocial causes and preventing disorders involves addressing societal factors that negatively impact mental health.
The document discusses psychotherapy and its various types. Psychotherapy aims to help patients understand themselves better and modify problematic behaviors through verbal communication. It can be individual or group-based. Individual psychotherapy explores a patient's feelings and experiences on a one-to-one basis, while group psychotherapy involves carefully selected patients helping one another under therapist guidance. Different psychotherapy approaches include psychodynamic, humanistic, behavioral, and cognitive therapies.
Evolution of Psychotherapy: An OxymoronScott Miller
Reviews the history of psychotherapy outcome, documenting the lack of improvement and suggesting an alternative to focusing on diagnosis and treatment approach for improving outcome
UCSF Osher Center Grand Rounds - 12/17David Becker
This document summarizes a presentation on incorporating mind-body medicine techniques into clinical care for children and adolescents. It describes several techniques, including mindfulness, hypnosis, guided imagery and biofeedback. It reviews evidence that these techniques can help with conditions like irritable bowel syndrome, recurrent abdominal pain, asthma and chronic pain. It also discusses important "common factors" for effective use of these techniques, such as developing rapport, managing expectations, cultural adaptation, clinician effects, and using language strategically to create focused states and facilitate changes.
Therapeutic goals assumptions and steps of psychoanalytic therapyGeetesh Kumar Singh
Psychoanalytic therapy is a type of treatment based upon the theories of Sigmund Freud, who is considered one of the forefathers of psychology and the founder of psychoanalysis. This therapy explores how the unconscious mind influences thoughts and behaviours, with the aim of offering insight and resolution to the person seeking therapy.
Is IPT time limited psychodynamic psychotherapy? (Markovitz et al, 1998)Sharon
Interpersonal psychotherapy (IPT) and short-term psychodynamic psychotherapy (STPP) are compared across eight aspects: time limit, medical model, goals, interpersonal focus, techniques, termination, therapeutic stance, and empirical support. While IPT and STPP share some similarities, such as a focus on interpersonal relationships and support from the therapist, they differ in key ways. IPT has a strict time limit of 12-16 weeks, uses a medical model framework with a focus on diagnosing and treating the patient's psychiatric illness. In contrast, STPP does not have a fixed time limit and focuses more on underlying unconscious conflicts from early childhood and character defenses rather than diagnoses. The authors conclude that despite some overlaps,
This document provides an overview of different types of psychological therapies, including:
- Psychotherapy, which involves interaction between a therapist and client suffering psychological difficulties. The most popular is an eclectic approach combining techniques from different schools.
- Psychoanalysis, developed by Freud using techniques like free association and dream interpretation to understand the unconscious.
- Humanistic therapy focuses on self-fulfillment and takes a present/future orientation rather than past issues. Client-centered therapy uses empathy, acceptance and genuineness.
- Behavior therapies apply learning principles to change unwanted behaviors. Techniques include counterconditioning, systematic desensitization, exposure therapy, and operant conditioning using rewards.
- Cognitive therapy teaches more
There are two broad categories of therapy - somatic therapy which treats psychological disorders by treating the body, and psychotherapy which treats problems through psychological techniques. Researchers have found psychotherapy to be consistently more effective than placebo treatment through studies using double-blind techniques. While there are many different types of therapy, researchers contend that most psychotherapies are equally effective, suggesting there is a common underlying component that makes them successful.
CBT is a for of psychological therapy used to alter subjects thoughts to improve behaviors and or feelings. it is great tool to be used for psychological disease or chronic diseases. this presentation cover the basics aspects of CBT with some studies about use of CBT in pulmonary diseases.
1. Researchers evaluate the effectiveness of therapies through methods like meta-analyses of existing studies to identify the most effective treatments for issues like depression. Common factors like the therapeutic relationship contribute to positive outcomes.
2. While therapies like CBT are supported as effective, researchers still do not fully understand why they work. Prevention strategies aim to reduce mental illness at the primary, secondary, and tertiary levels through skills training, early identification and treatment, and relapse prevention.
3. Evaluating therapeutic effectiveness and identifying common success factors helps improve treatments, while prevention research works to reduce mental illness occurrence and severity.
Dr. Nasreen Khatri, a clinical psychologist and researcher at the Rotman Research Institute, a brain Institute fully affiliated with the University of Toronto and core CREST.BD member, describes current research and the clinical impact of cognitive behaviour therapy (CBT) in bipolar disorder. CBT is an evidence-based, collaborative, structured self-management talk therapy that helps individuals to monitor and manage symptoms of bipolar disorder by improving problem-solving skills. Learn about the evidence and considerations for CBT treatment for bipolar disorder in adults and how CBT can be used in combination with medication to optimize wellness and quality of life for people who have bipolar disorder.
Dr. Nasreen Khatri is a registered clinical psychologist who specializes in the assessment, treatment and research of mood and anxiety disorders. From 2004 to 2012, she led the Mood and Related Disorders Clinic and Cognitive Behaviour Therapy (CBT) service at Baycrest. In 2012, Dr. Khatri joined the Rotman Research Institute, a brain institute fully affiliated with the University of Toronto, where she studies how mood disorders impact the aging brain. Dr. Khatri’s research has been funded by the Canadian Institutes of Health Research (CIHR), the Alzheimer’s Society of Canada (ASC), and in 2013 she was awarded the Women of Baycrest Innovators in Research Award. In addition to her research and private practice, she has completed over 150 presentations, most recently for Bell Let's Talk Day. She has been cited in the media, including The Globe and Mail, The Wall Street Journal (US) and The Daily Mail (UK). She currently blogs for The Huffington Post on the topic of Mind your Mood: Depression and the Aging Brain. She serves on the Board of Trustees of The Psychology Foundation
Clinical Psychology Case Formulation and Treatment Planning: A PrimerJames Tobin, Ph.D.
The aim of this primer is to support the learning of clinical case conceptualization and treatment planning for graduate students in clinical psychology, other trainees in the mental health professions, and early-career psychologists and mental health workers.
The document discusses various psychological therapies including psychoanalysis, humanistic therapies, behavior therapies, cognitive therapies, group/family therapies, and biomedical therapies. It provides details on different approaches like psychoanalysis, person-centered therapy, cognitive-behavioral therapy, and evaluates the effectiveness of psychotherapy.
Neuroprogression and Cognitive Functioning in Bipolar Disorders - Eleonora Lo...Eleonora Lombardi
Bipolar disorder (BD) has been associated with impairments
in a range of cognitive domains including attention, verbal learning, and mental flexibility. These deficits are increased during the acute phases of the illness and worsen over the course of BD. This review will examine the literature in relation to potential mechanisms associated with cognitive decline in BD. Scopus (all databases), Pubmed, and Ovid Medline were systematically searched with no language or year restrictions, up to January 2015, for human studies that collected cross-sectional and longitudinal cognitive data in adults with BD and matched healthy controls (HC). Selected search terms were “bipolar,” “cognitive,” “aging,” “illness duration,” “onset,” and “progression.” Thirty-nine studies satisfied the criteria for consideration. There is evidence that cognitive function in BD is negatively associated with features of illness progression such as number of mood episodes, illness duration, and hospitalizations. Aging does not appear to affect cognitive functioning to a greater extent than in HC. Furthermore, the small number of longitudinal studies in this field does not allow to reaching firm conclusion in terms of which sub-populations would be more prone to cognitive decline in BD. The decline in cognitive abilities over the course of the BD seems to be associated with the number of episodes and number of hospitalizations. No meaningful interaction of age and bipolar disorder has been found in terms of cognitive decline. Future large-scale longitudinal studies are necessary to confirm these findings and assist in the development of preventive interventions in vulnerable individuals.
This document discusses various types of psychotherapy including supportive psychotherapy, insight-oriented psychotherapy, behavioral therapies, cognitive therapies, and psychoeducation. Supportive psychotherapy aims to help patients cope with problems in the present through building rapport and considering problem solutions. Insight-oriented psychotherapy focuses on uncovering unconscious wishes and defenses that cause maladaptive behaviors. Behavioral therapies use techniques like relaxation training, graded exposure, and thought stopping to modify abnormal behaviors. Cognitive therapies identify and challenge maladaptive thinking patterns.
Brief therapy, sometimes also referred to as short term therapy (usually 10 to 20 sessions) , is a generic label for any form of therapy in which time is an explicit element in treatment planning.
1) Preliminary results from the Norwegian TF-CBT study show that TF-CBT was more effective than TAU in reducing children's PTSD, depression, and anxiety symptoms.
2) Parental emotional reactions and post-trauma cognitions may mediate treatment outcomes. Parents in both groups reported less distress and depression over time, and changes in parental distress were related to child outcomes. Changes in children's post-trauma cognitions also predicted symptom reduction.
3) A stronger therapeutic alliance was associated with better outcomes for children receiving TF-CBT but not TAU, suggesting alliance may be an active ingredient in TF-CBT specifically.
Anxiety is a subjective state characterized by emotional distress and apprehension that stimulates physiological stress responses. It can be experienced situationally as state anxiety or reflect a personality trait as trait anxiety. Anxiety is an important concept for nurses to understand as it is commonly experienced by hospitalized patients, for example those undergoing medical procedures, awaiting test results, or receiving long-term cancer treatment. Unmanaged anxiety in patients can negatively impact health outcomes, while nurse anxiety can also influence patient care. Previous studies have examined different scales for measuring patient anxiety and the impact of reduced nurse-patient interaction times on identifying anxious patients. As advanced practice nurses, recognizing and diagnosing anxiety is important for building trust, improving compliance, and enhancing health.
Psychotherapy involves a trained professional using psychological methods to help clients with psychological problems, without medical treatment. It involves a unique relationship and disclosure of highly personal information. Key aspects of therapies discussed in the document include establishing ethical standards in psychotherapy, psychoanalysis which aims to resolve unconscious conflicts, techniques used in psychoanalysis like free association and dream interpretation, and interpersonal psychotherapy for depression which focuses on social relationships and communication of feelings.
This document provides an overview of different types of psychotherapy and therapies for treating mental disorders. It discusses the following:
1. The major types of psychotherapy discussed include psychoanalytic/psychodynamic therapy, humanistic/client-centered therapy, behavior therapy, cognitive therapy, and various combinations of individual, group, and family psychotherapy.
2. Biomedical therapies like drugs, brain stimulation, and lifestyle changes are also reviewed as ways to directly impact the body and reduce disorder symptoms.
3. Key schools of psychotherapy covered in more depth include psychoanalysis, humanistic therapy, behavior therapy using conditioning principles, and cognitive therapy focused on changing thoughts.
Research on Psychotherapy: A Presentation at the 2013 Evolution of Psychother...Scott Miller
A summary of the findings from research on psychotherapy presented on a panel discussion with David Barlow and Steven Hayes at the 2013 Evolution of Psychotherapy conference in Anaheim, California
This study examined the effectiveness of brief emotion-focused therapy (EFT) for students presenting with worry and anxiety issues. Nine students received up to 12 sessions of EFT. Quantitative measures found significant reductions in generalized anxiety and worry symptoms. Qualitatively, clients reported increased resilience, self-acceptance, and decreased anxiety. Helpful aspects included the therapeutic relationship and experiential work. While more research is needed, brief EFT showed promise in reducing anxiety symptoms for students.
Cognitive therapy outcome for the treatment of schizophreniaJohn G. Kuna, PsyD
This document discusses cognitive therapy for the treatment of schizophrenia. It begins by defining schizophrenia and its symptoms according to the DSM-5. It then outlines the diagnostic criteria. The document focuses on treatment, describing cognitive behavioral therapy techniques used, including normalization, developing alternative explanations, guided discovery, and behavioral experiments to challenge delusions. Key aspects of CBT for schizophrenia discussed are a strong therapeutic alliance, problem-focused and time-limited therapy, and collaborative empiricism.
The document discusses various psychological treatments for mental disorders. It covers different types of psychotherapy like psychoanalysis, psychodynamic therapy, humanistic therapy, behavior therapy, and cognitive therapy. It also discusses biological therapies using psychotropic medications, electroconvulsive therapy, transcranial magnetic stimulation, and deep brain stimulation. Specific treatments are most effective for certain disorders: cognitive-behavioral therapy for anxiety/OCD, many options for depression, lithium/antipsychotics for bipolar disorder, and antipsychotics for schizophrenia.
This document provides an overview of cognitive behavioral therapy (CBT). It explains that CBT was developed in the 1960s by Aaron Beck and is based on the theory that thoughts, feelings, and behaviors are interconnected, and that by modifying dysfunctional thoughts people can experience improvements in their emotional state and behaviors. The document outlines the basic principles of CBT, including that it is a semi-structured, time-limited, collaborative approach focused on skill development and cognitive change through techniques like identifying and modifying thoughts and beliefs. Research evidence demonstrates CBT is an effective treatment for a wide range of mental health and medical conditions.
UCSF Osher Center Grand Rounds - 12/17David Becker
This document summarizes a presentation on incorporating mind-body medicine techniques into clinical care for children and adolescents. It describes several techniques, including mindfulness, hypnosis, guided imagery and biofeedback. It reviews evidence that these techniques can help with conditions like irritable bowel syndrome, recurrent abdominal pain, asthma and chronic pain. It also discusses important "common factors" for effective use of these techniques, such as developing rapport, managing expectations, cultural adaptation, clinician effects, and using language strategically to create focused states and facilitate changes.
Therapeutic goals assumptions and steps of psychoanalytic therapyGeetesh Kumar Singh
Psychoanalytic therapy is a type of treatment based upon the theories of Sigmund Freud, who is considered one of the forefathers of psychology and the founder of psychoanalysis. This therapy explores how the unconscious mind influences thoughts and behaviours, with the aim of offering insight and resolution to the person seeking therapy.
Is IPT time limited psychodynamic psychotherapy? (Markovitz et al, 1998)Sharon
Interpersonal psychotherapy (IPT) and short-term psychodynamic psychotherapy (STPP) are compared across eight aspects: time limit, medical model, goals, interpersonal focus, techniques, termination, therapeutic stance, and empirical support. While IPT and STPP share some similarities, such as a focus on interpersonal relationships and support from the therapist, they differ in key ways. IPT has a strict time limit of 12-16 weeks, uses a medical model framework with a focus on diagnosing and treating the patient's psychiatric illness. In contrast, STPP does not have a fixed time limit and focuses more on underlying unconscious conflicts from early childhood and character defenses rather than diagnoses. The authors conclude that despite some overlaps,
This document provides an overview of different types of psychological therapies, including:
- Psychotherapy, which involves interaction between a therapist and client suffering psychological difficulties. The most popular is an eclectic approach combining techniques from different schools.
- Psychoanalysis, developed by Freud using techniques like free association and dream interpretation to understand the unconscious.
- Humanistic therapy focuses on self-fulfillment and takes a present/future orientation rather than past issues. Client-centered therapy uses empathy, acceptance and genuineness.
- Behavior therapies apply learning principles to change unwanted behaviors. Techniques include counterconditioning, systematic desensitization, exposure therapy, and operant conditioning using rewards.
- Cognitive therapy teaches more
There are two broad categories of therapy - somatic therapy which treats psychological disorders by treating the body, and psychotherapy which treats problems through psychological techniques. Researchers have found psychotherapy to be consistently more effective than placebo treatment through studies using double-blind techniques. While there are many different types of therapy, researchers contend that most psychotherapies are equally effective, suggesting there is a common underlying component that makes them successful.
CBT is a for of psychological therapy used to alter subjects thoughts to improve behaviors and or feelings. it is great tool to be used for psychological disease or chronic diseases. this presentation cover the basics aspects of CBT with some studies about use of CBT in pulmonary diseases.
1. Researchers evaluate the effectiveness of therapies through methods like meta-analyses of existing studies to identify the most effective treatments for issues like depression. Common factors like the therapeutic relationship contribute to positive outcomes.
2. While therapies like CBT are supported as effective, researchers still do not fully understand why they work. Prevention strategies aim to reduce mental illness at the primary, secondary, and tertiary levels through skills training, early identification and treatment, and relapse prevention.
3. Evaluating therapeutic effectiveness and identifying common success factors helps improve treatments, while prevention research works to reduce mental illness occurrence and severity.
Dr. Nasreen Khatri, a clinical psychologist and researcher at the Rotman Research Institute, a brain Institute fully affiliated with the University of Toronto and core CREST.BD member, describes current research and the clinical impact of cognitive behaviour therapy (CBT) in bipolar disorder. CBT is an evidence-based, collaborative, structured self-management talk therapy that helps individuals to monitor and manage symptoms of bipolar disorder by improving problem-solving skills. Learn about the evidence and considerations for CBT treatment for bipolar disorder in adults and how CBT can be used in combination with medication to optimize wellness and quality of life for people who have bipolar disorder.
Dr. Nasreen Khatri is a registered clinical psychologist who specializes in the assessment, treatment and research of mood and anxiety disorders. From 2004 to 2012, she led the Mood and Related Disorders Clinic and Cognitive Behaviour Therapy (CBT) service at Baycrest. In 2012, Dr. Khatri joined the Rotman Research Institute, a brain institute fully affiliated with the University of Toronto, where she studies how mood disorders impact the aging brain. Dr. Khatri’s research has been funded by the Canadian Institutes of Health Research (CIHR), the Alzheimer’s Society of Canada (ASC), and in 2013 she was awarded the Women of Baycrest Innovators in Research Award. In addition to her research and private practice, she has completed over 150 presentations, most recently for Bell Let's Talk Day. She has been cited in the media, including The Globe and Mail, The Wall Street Journal (US) and The Daily Mail (UK). She currently blogs for The Huffington Post on the topic of Mind your Mood: Depression and the Aging Brain. She serves on the Board of Trustees of The Psychology Foundation
Clinical Psychology Case Formulation and Treatment Planning: A PrimerJames Tobin, Ph.D.
The aim of this primer is to support the learning of clinical case conceptualization and treatment planning for graduate students in clinical psychology, other trainees in the mental health professions, and early-career psychologists and mental health workers.
The document discusses various psychological therapies including psychoanalysis, humanistic therapies, behavior therapies, cognitive therapies, group/family therapies, and biomedical therapies. It provides details on different approaches like psychoanalysis, person-centered therapy, cognitive-behavioral therapy, and evaluates the effectiveness of psychotherapy.
Neuroprogression and Cognitive Functioning in Bipolar Disorders - Eleonora Lo...Eleonora Lombardi
Bipolar disorder (BD) has been associated with impairments
in a range of cognitive domains including attention, verbal learning, and mental flexibility. These deficits are increased during the acute phases of the illness and worsen over the course of BD. This review will examine the literature in relation to potential mechanisms associated with cognitive decline in BD. Scopus (all databases), Pubmed, and Ovid Medline were systematically searched with no language or year restrictions, up to January 2015, for human studies that collected cross-sectional and longitudinal cognitive data in adults with BD and matched healthy controls (HC). Selected search terms were “bipolar,” “cognitive,” “aging,” “illness duration,” “onset,” and “progression.” Thirty-nine studies satisfied the criteria for consideration. There is evidence that cognitive function in BD is negatively associated with features of illness progression such as number of mood episodes, illness duration, and hospitalizations. Aging does not appear to affect cognitive functioning to a greater extent than in HC. Furthermore, the small number of longitudinal studies in this field does not allow to reaching firm conclusion in terms of which sub-populations would be more prone to cognitive decline in BD. The decline in cognitive abilities over the course of the BD seems to be associated with the number of episodes and number of hospitalizations. No meaningful interaction of age and bipolar disorder has been found in terms of cognitive decline. Future large-scale longitudinal studies are necessary to confirm these findings and assist in the development of preventive interventions in vulnerable individuals.
This document discusses various types of psychotherapy including supportive psychotherapy, insight-oriented psychotherapy, behavioral therapies, cognitive therapies, and psychoeducation. Supportive psychotherapy aims to help patients cope with problems in the present through building rapport and considering problem solutions. Insight-oriented psychotherapy focuses on uncovering unconscious wishes and defenses that cause maladaptive behaviors. Behavioral therapies use techniques like relaxation training, graded exposure, and thought stopping to modify abnormal behaviors. Cognitive therapies identify and challenge maladaptive thinking patterns.
Brief therapy, sometimes also referred to as short term therapy (usually 10 to 20 sessions) , is a generic label for any form of therapy in which time is an explicit element in treatment planning.
1) Preliminary results from the Norwegian TF-CBT study show that TF-CBT was more effective than TAU in reducing children's PTSD, depression, and anxiety symptoms.
2) Parental emotional reactions and post-trauma cognitions may mediate treatment outcomes. Parents in both groups reported less distress and depression over time, and changes in parental distress were related to child outcomes. Changes in children's post-trauma cognitions also predicted symptom reduction.
3) A stronger therapeutic alliance was associated with better outcomes for children receiving TF-CBT but not TAU, suggesting alliance may be an active ingredient in TF-CBT specifically.
Anxiety is a subjective state characterized by emotional distress and apprehension that stimulates physiological stress responses. It can be experienced situationally as state anxiety or reflect a personality trait as trait anxiety. Anxiety is an important concept for nurses to understand as it is commonly experienced by hospitalized patients, for example those undergoing medical procedures, awaiting test results, or receiving long-term cancer treatment. Unmanaged anxiety in patients can negatively impact health outcomes, while nurse anxiety can also influence patient care. Previous studies have examined different scales for measuring patient anxiety and the impact of reduced nurse-patient interaction times on identifying anxious patients. As advanced practice nurses, recognizing and diagnosing anxiety is important for building trust, improving compliance, and enhancing health.
Psychotherapy involves a trained professional using psychological methods to help clients with psychological problems, without medical treatment. It involves a unique relationship and disclosure of highly personal information. Key aspects of therapies discussed in the document include establishing ethical standards in psychotherapy, psychoanalysis which aims to resolve unconscious conflicts, techniques used in psychoanalysis like free association and dream interpretation, and interpersonal psychotherapy for depression which focuses on social relationships and communication of feelings.
This document provides an overview of different types of psychotherapy and therapies for treating mental disorders. It discusses the following:
1. The major types of psychotherapy discussed include psychoanalytic/psychodynamic therapy, humanistic/client-centered therapy, behavior therapy, cognitive therapy, and various combinations of individual, group, and family psychotherapy.
2. Biomedical therapies like drugs, brain stimulation, and lifestyle changes are also reviewed as ways to directly impact the body and reduce disorder symptoms.
3. Key schools of psychotherapy covered in more depth include psychoanalysis, humanistic therapy, behavior therapy using conditioning principles, and cognitive therapy focused on changing thoughts.
Research on Psychotherapy: A Presentation at the 2013 Evolution of Psychother...Scott Miller
A summary of the findings from research on psychotherapy presented on a panel discussion with David Barlow and Steven Hayes at the 2013 Evolution of Psychotherapy conference in Anaheim, California
This study examined the effectiveness of brief emotion-focused therapy (EFT) for students presenting with worry and anxiety issues. Nine students received up to 12 sessions of EFT. Quantitative measures found significant reductions in generalized anxiety and worry symptoms. Qualitatively, clients reported increased resilience, self-acceptance, and decreased anxiety. Helpful aspects included the therapeutic relationship and experiential work. While more research is needed, brief EFT showed promise in reducing anxiety symptoms for students.
Cognitive therapy outcome for the treatment of schizophreniaJohn G. Kuna, PsyD
This document discusses cognitive therapy for the treatment of schizophrenia. It begins by defining schizophrenia and its symptoms according to the DSM-5. It then outlines the diagnostic criteria. The document focuses on treatment, describing cognitive behavioral therapy techniques used, including normalization, developing alternative explanations, guided discovery, and behavioral experiments to challenge delusions. Key aspects of CBT for schizophrenia discussed are a strong therapeutic alliance, problem-focused and time-limited therapy, and collaborative empiricism.
The document discusses various psychological treatments for mental disorders. It covers different types of psychotherapy like psychoanalysis, psychodynamic therapy, humanistic therapy, behavior therapy, and cognitive therapy. It also discusses biological therapies using psychotropic medications, electroconvulsive therapy, transcranial magnetic stimulation, and deep brain stimulation. Specific treatments are most effective for certain disorders: cognitive-behavioral therapy for anxiety/OCD, many options for depression, lithium/antipsychotics for bipolar disorder, and antipsychotics for schizophrenia.
This document provides an overview of cognitive behavioral therapy (CBT). It explains that CBT was developed in the 1960s by Aaron Beck and is based on the theory that thoughts, feelings, and behaviors are interconnected, and that by modifying dysfunctional thoughts people can experience improvements in their emotional state and behaviors. The document outlines the basic principles of CBT, including that it is a semi-structured, time-limited, collaborative approach focused on skill development and cognitive change through techniques like identifying and modifying thoughts and beliefs. Research evidence demonstrates CBT is an effective treatment for a wide range of mental health and medical conditions.
The document discusses several major models of psychotherapy:
1) Psychodynamic model (Sigmund Freud), Cognitive-Behavioral model (Albert Ellis, Aaron Beck), Existential-Humanistic model (Carl Rogers, Rollo May), and Multicultural model.
2) Key techniques discussed include free association, dream analysis, cognitive restructuring, Socratic questioning, reflection, and confrontation used in therapies like psychoanalysis, CBT, person-centered therapy and rational emotive behavior therapy.
3) The cognitive-behavioral and rational emotive behavior therapy models make use of techniques like systematic desensitization, modeling, and disputing irrational beliefs through logical arguments.
1.Freeman, S. (2011). Improving cognitive treatments for delus.docxjeremylockett77
1.
Freeman, S. (2011). Improving cognitive treatments for delusions. Schizophrenia Research, 132, (2–3), 135-139. doi:10.1016/j.schres.2011.08.012
generation CBT for psychosis was successful but the strength of the treatment was weak and as the author states similar to those of clozapine (an antipsychotic used as a last resort for psychosis). Therapy is not up to date as it should be for delusions as delusion are understood quite well and therapy needs to catch up. The treatment of CBT for psychosis is similar to CBT treatment for anxiety.
Pay attention to single symptoms in psychosis
2.
Munro, Alistair (May 1992) Psychiatric Disorders Characterized by Delusions: Treatment in Relation to Specific Types. Psychiatric Annals, 22, 5, ProQuest Central pg. 232
3.
Ho-wai So, S., Roisin Peters, E., Swendsen, J., Garety, P.A., & Kapur, S. (2014) Changes in delusions in the early phase of antipsychotic treatment – An experience sampling study. Psychiatry Research 215, 568-573
Summarize including the research question addressed in the source, if applicable, and major findings.
Evaluate the usefulness of the source for your literature review, making sure to directly state why the source is informative for your specific topic
Three dimensions of delusions are always present in factor analyses and they are a conviction, distress, preoccupation, and disruption to life. More studies need to be done to learn how delusions respond to antipsychotic. Conviction has been least amenable to change shows the studies. Many studies ponder the question, “why does conviction exist?” There have been studies that show that reasoning bias including “Jumping to conclusion (JTC)” bias and by patients being inflexible contributes to the maintenance of delusions. JTC has also shown that the dimension of conviction of delusions and the severity of delusions is influenced by JTC. Delusions improve during the first few weeks of treatment and some studies show improvement in the first few hours.
It was hypothesized that delusion distress and preoccupation would reduce significantly over two weeks of antipsychotic treatment; but not a conviction. Female participants showed a higher response on all four delusion dimensions compared to the male participants. 57% of the participants showed the JTC bias. The no-JTC group showed a larger improvement in conviction and distress and with their delusions in general.
This study is important for my literature review and further studies because the three dimensions of delusions: distress, preoccupation, and conviction are important for the clinical implications of treatment. If we take into account these three dimensions it will benefit further research and treatments.
4.
The efficacy of a new translational treatment for persecutory delusions: study protocol for a randomized controlled trial (The Feeling Safe Study)
Freeman et al. (2016) Trials, 17:134. doi:10.1186/s13063-016-1245-0
Summarize including the research questi ...
A Single Case Experiment For Cognitive-Behavioral Treatment Of Auditory Hallu...Richard Hogue
This document describes a single-case experiment that evaluated the impact of a new cognitive treatment for schizophrenia. The treatment integrated rational-emotive therapy and cognitive therapy for hallucinations and delusions. It was found to significantly reduce anxiety and depression, and increase quality of life and insight in a 37-year old female patient with schizophrenia. Gains were maintained at 3, 6, and 12 month follow-ups. The treatment shows promise for simultaneously targeting hallucinations and delusions.
The document discusses the history and types of therapy. It describes how maltreatment of the mentally ill led to the humane movements started by Pinel and Dix. The major types discussed are psychotherapy, biomedical therapy, psychoanalysis, humanistic therapies like person-centered therapy, behavioral therapies using techniques like exposure therapy and systematic desensitization, cognitive therapy, and group/family therapies. Effectiveness is difficult to measure but research finds therapy more helpful than no therapy.
This document summarizes research into using psilocybin-assisted psychotherapy to treat anxiety and depression in patients with terminal illnesses. Several studies have found psilocybin can help reduce anxiety and depressive symptoms for months after a single session. Psilocybin appears to occasion mystical or spiritual experiences that patients report as being highly meaningful. Ongoing research at Johns Hopkins University and NYU involving over 100 participants total has found psilocybin can safely relieve anxiety and depression in cancer patients when administered in a controlled medical setting with psychological support. However, larger samples and more research are still needed to fully understand psilocybin's therapeutic potential and mechanisms of action.
CBT in Clozapine resistant schizophrenia - Journal reviewEnoch R G
This document summarizes a randomized controlled trial that examined the effectiveness of cognitive behavioral therapy (CBT) for individuals with clozapine-resistant schizophrenia. The trial compared CBT plus treatment as usual to treatment as usual alone over a 21-month period. It was hypothesized that CBT would reduce symptoms of schizophrenia, improve quality of life, and improve user-defined recovery compared to treatment as usual alone. The trial recruited participants through inpatient mental health services in five sites in the UK and was approved by the National Research Ethics Committee.
This document discusses various approaches to psychotherapy and evaluating their effectiveness. It covers psychoanalysis, humanistic therapies, behavior therapies, cognitive therapies, group/family therapies, and biomedical therapies. It examines the relative effectiveness of different therapies for treating specific disorders. While some alternative therapies like light therapy for SAD have shown promise, others like EMDR have not proven effective under scientific scrutiny. Overall, outcome research finds that the vast majority of patients benefit more from psychotherapy than receiving no treatment.
Comparing Psychotherapy with Other Approaches.docx4934bk
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1. The document discusses the historical development of cognitive behavioral therapy (CBT), outlining three phases: behavior therapy roots, cognitive therapy roots, and the merging of behavior and cognitive therapies.
2. Key concepts of CBT are explained, including core beliefs, dysfunctional assumptions, and negative automatic thoughts, as well as the cognitive triad.
3. Different types of CBT are mentioned, including rational emotive behavior therapy, cognitive therapy, dialectical behavior therapy, and mindfulness-based CBT.
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This document provides an overview of psychotherapy. It begins by defining psychotherapy and tracing its origins back to the 1800s. Sigmund Freud is noted as developing one of the early forms of psychotherapy, psychoanalysis. The document then discusses various aspects of psychotherapy like definitions, goals, stages, techniques, types according to depth/number of patients/purpose, indications, contraindications, limitations, and requirements of a psychotherapist. It also covers individual psychotherapy in detail including its definition, aims, modes, types, techniques, indications, benefits, and disadvantages. The document concludes with a brief discussion of group therapy including its definition, types, models, selection of clients, group size, session duration/frequency, and benefits.
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This document provides an overview of modern psychotherapies, including traditional therapies from the past as well as current approaches used in Pakistan. It discusses Muslim spiritual healing methods, rituals of black magic, and various modern psychotherapy techniques including psychodynamic therapy, behavior therapy, cognitive therapy, family therapy, group therapy, and humanistic approaches. Key aspects like transference, countertransference, exposure therapy, and ethical issues are summarized.
3. Freud’s aim in therapy
Freud (1895, SE2:305)
Aims to transform the patient’s ‘hysterical misery into common
unhappiness’ so that they are ‘better armed against that
unhappiness’
Freud (1914, SE12:145-56)
Aims to help patients remember and work through, rather than
repeat, the otherwise more or less unconscious cause of their ills
Case examples
(a)Hysteria (Dora, SE7)
(b)Phobia (Little Hans, SE10)
(c)Obsessional neurosis (the ‘rat man’, SE10)
(d)Melancholia (SE14)
4. Freud’s method of therapy
Freud (1912, SE12:111-20,115)
Warns against the counter-transference – recommends ‘therapists, like surgeons, to adopt a stance of
emotional coldness’ in their work with patients
Freud (1913, SE12:121-44 in Gay 1995:363-78)
Psychoanalytic treatment includes
• Trial period
• Time & money
• Analyst sitting behind the patient lying on a couch
• Fundamental rule of free association
• Attention to the transference (negative & positive)
• Timing of interpretations
• Attention to the patient’s response to interpretations
Freud (1915-1917, SE16:448-63)
Contrasts his method with ‘cosmetic cure’ provided by psychiatry
Freud (1923, SE18:235-59,239)
Recommends psychoanalysts to adopt an attitude of ‘evenly suspended attention’ so as ‘to catch
the drift of the patient’s unconscious with [their] own unconscious’.
Freud (1937, SE:255-69)
Emphasizes timing and testing interpretations in terms of what the patient subsequently says and does.
BUT Livingstone Smith (Psychoanalysis in Focus 2003:34) objects that the patient’s response interpretations
may be a suggestive effect of their positive transference to the psychoanalyst.
5. Kleinian & Post-Kleinian therapy
• Focus on the here-and-now transference (see e.g. Strachey,
IJPA, 1934/1969, 50:275-92)
• Justification of this focus in terms of Isaacs’s (IJPA, 1952)
Kleinian theory of ‘phantasy’
• Post-Kleinian attention to the counter-transference (e.g.
Heimann, IJPA, 1950, 31:81-4; Bion’s 1967 book, Second
Thoughts)
• See also
• Hinshelwood (1989) A Dictionary of Kleinian Thought
• Sayers (2007) Klein and Bion chapters in Freud’s Art
6. Evaluating psychoanalytic therapy
(1) Eysenck (1952)
• Eysenck (1952, J Consulting Psych, 16:319-24)
• ‘Patients treated by means of psychoanalysis improve to the extent
of 44%; patients treated eclectically improve to the extent of 64%;
patients treated only custodially or by general practitioners improve
to the extent of 72%. There thus appears to be an inverse
correlation between recovery and psychotherapy; the more
psychotherapy, the smaller the recovery rate.’
• http://psychclassics.yorku.ca/Eysenck/psychotherapy.htm
• Livingstone Smith (Psychoanalysis in Focus 2003:60-4)
• criticises Eysenck‘s lack of control for
• (1) criteria of recovery;
• (2) therapist personality characteristics;
• (3) therapist-patient fit;
• (4) sufficient application of treatment method studied;
• (5) external and internal reliability;
• (6) averaging over positive together with negative effects
7. Evaluating psychoanalytic therapy
(2) Leichsenring (2005)
• Leichsenring (2005, IJPA 86:841-68)
• Studies published between 1960 to 2004 with at least one randomised control
trial (RCT) provide evidence for the efficacy of psychodynamic psychotherapy
with
• depressive disorders (4 RCTs)
• anxiety disorders (1 RCT)
• post-traumatic stress disorder (1 RCT)
• somatoform disorder (4 RCTs)
• bulimia nervosa (3 RCTs)
• anorexia nervosa (2 RCTs)
• borderline personality disorder (2 RCTs)
• Cluster C personality disorder (1 RCT)
• substance-related disorders (4 RCTs)
• Outcome of psychodynamic psychotherapy is related to the competent delivery
of therapeutic techniques and to the development of a therapeutic alliance.
• Controlled quasi-experimental effectiveness studies provide evidence that
psychoanalytic therapy is
• (1) more effective than no treatment or treatment as usual, and
• (2) more effective than shorter forms of psychodynamic therapy.
8. Psychoanalytic therapy and
cognitive behaviour therapy (CBT)• Westbrook & Kirk (2005 Behaviour Research & Therapy 43:1243-61)
• find 50% of sample treated with cognitive behaviour therapy (CBT) in routine clinical NHS practice improved
• Depression Report (2006 http://cep.lse.ac.uk/research/mentalhealth )
• find 1 in 6 people are diagnosable as having depression or chronic anxiety disorder. CBT provides a cost-
effective treatment which is equally effective short term and more effective long term than
psychopharmacological treatment. 50% more patients (than untreated controls) with 16 once weekly hour-
long CBT sessions will have lost their psychiatric symptoms; those with anxiety are unlikely to relapse, those
with depression & CBT are less likely to relapse than those with only psychopharmacological treatment.
• Layard et al (2007 Nat. Inst. Economic Review 2002:908)
• advocate increase in availability of CBT trained therapists as relatively cheap compared to the cost of
untreated psychological disorders
• Improving Access to Psychological Therapies (IAPT)
• Programme launched in May 2007; favours CBT over other psychotherapies
• Leader (2008, The New Black)
• argues against antidepressants and CBT and in favour of treatment returning to Freud’s theory that what
needs to be addressed in treating depression is enabling the patient to become conscious of its cause in
unconsciouss loss
• See also http://www.guardian.co.uk/science/2008/sep/09/psychology.humanbehaviour/print
• J. Milton (2001) Psychoanalysis and cognitive behaviour therapy. IJPA, 81:431-47
9. Relational psychoanalysis
• Ogden (1994, The analytic third, in Subjects of Analysis, BF704)
• emphasizes psychoanalytic attention to the transference-countertransference relation of patient and
psychoanalyst in treatment as the analytic third
• Aron (2006, IJPA, 87(2):349-88) argues
• (a) attention to the counter-transference and the analytic third is useful in understanding and
resolving clinical impasses and stalemates.
• (b) certain forms of self-disclosure are best understood as attempts to create a third point of
reference, thus opening up psychic space for self-reflection and mentalization.
• (c) that a clinical case example plus several briefer examples suggest modifications to the
psychoanalytic stance recommended by Freud so as to give the patient greater access to the inner
workings of the psychoanalyst's mind.
• (d) this introduces a third that facilitates the gradual transformation from relations of
complementarity to relations of mutuality.
• Note: this shifts the aim of psychoanalysis from treating symptoms to facilitating the patient's
capacity for thinking about and 'mentalizing' feelings
• Tublin (2011, Contemporary Psychoanalysis, 47(4):519-46)
• criticizes relational psychoanalysis for
• (a) lack of codification of its technical principles
• (b) advocating a broad menu of sanctioned interventions and excessive freedom in the
psychoanalyst's approach to treatment
• (c) conflicting with the need for structure and discipline in conducting coherent and purposeful
psychoanalytic treatment.
10. Mentalization-based therapy
Fonagy & Bateman (1)
• Fonagy & Bateman (2006, J Clin Psych, 62:411-30)
• Note problematic early attachments in patients with borderline
personality disorder (BPD)
• This causes BPD patients to be readily provoked by later
intimate relationships into decoupling their mind from that of
others
• This contributes to the following symptoms in BPD patients:
• (1) rapid shift from first meeting to great intimacy
• (2) lack of the usual barrier between self and other resulting in
entangled relationships
• (3) excessive idealization of the new intimate relationship
• (4) unstable emotion, including violent outbursts &/or
suspiciousness
• (5) lack of emotion-laden memories causing chronic feelings
of emptiness.
11. Mentalization-based therapy
Fonagy & Bateman (2)
• Fonagy & Bateman (2006, J Clin Psych, 62:411-30)
• recommend enhancing mentalization by activating the attachment system through
• (1) discussing current attachment relationships
• (2) discussing past attachment relationships
• (3) encouraging and regulating the client's/patient’s attachment to the therapist by creating
a setting which helps them regulate their feelings
• (4) engendering attachment links between clients/patients in group therapy
• (5) gradually activating negative emotions through the therapist encouraging confrontation
of adverse/traumatic experiences
• (6) encouraging retrieval of emotion-laden episodic memories
• (7) focusing on the client’s/patient’s mentalization about relationships that have relatively
low levels of involvement
• (8) only gradually focusing on the client’s/patient’s thinking about relationships closer to
their core self
• Note Mentalization-based therapy (MBT) is similar to transference-focused
psychoanalysis in focusing on mental states in an attachment situation. Evidence that
attachment-related mentalization improves with transference-focused but not with
supportive therapy.
• See also Sugarman (2006) Mentalization, insightfulness & therapeutic action, IJPA,
87:965-87; and 'Mentalization' entry on Wikipedia
13. READ
J. Shedler (2010) The efficacy of psychodynamic psychotherapy.
American Psychologist, 65(2):98-109 (available on Moodle)
WRITE DOWN
One essential ingredient, according to Shedler (2010), of effective
psychoanalytic or non-psychoanalytic therapy
ESSAY TITLE
Evaluate psychoanalytic approaches to therapy.
Pre-Seminar Assignments
14. Shedler summarised
• Shedler (2010) American Psychologist 65(2):98-109
• Distinctive features of psychodynamic psychotherapy
• Focus on feelings rather than cognitions
• Attention to attempts to avoid upsetting feelings
• Identification of recurring themes & patterns
• Discussion of past experience (developmental focus)
• Focus on interpersonal relations
• Focus on the therapy relationship
• Exploration of fantasy life
• Findings re benefits of psychodynamic psychotherapy
• Benefits increase with time while the benefits of non-psychodynamic therapies tend to decay for the most
common disorders
• Benefits of psychodynamic psychotherapy with depression, anxiety, panic, somatoform, eating,
substance-related, and personality disorders
• Effective active ingredients in cognitive therapy (CBT) are the same as those emphasized in
psychodynamic psychotherapy i.e. unstructured, open-ended dialogue; identifying recurring themes in the
patient’s experience; linking the patient’s feelings and perceptions to past experiences; drawing attention
to feelings regarded by the patient as unacceptable (e.g. anger, envy, excitement); pointing out defensive
manoeuvres; interpreting warded-off or unconscious wishes, feelings, or ideas; focusing on the therapy
relationship; drawing connections between the therapy & other relationships.
• Conclusion
• Value of psychodynamic psychotherapy lies in fostering inner capacities enabling people to live life with
greater sense of freedom.
15. Group 1
• Effective ingredients of therapy
• Actively exploring avoidances e.g. being late for therapy sessions; cf Freud’s theory of
unconsciously intended forgetting; e.g. shifting the topic of conversation
• Exploring patterns within the individual e.g. recurring dreams;
• Talking about past experiences e.g. with early attachment figures as a way of moving on
rather than sticking with blame of the past; BUT what about the argument against
psychoanalysis (of e.g. Sartre) that we are morally responsible for the choices we make in
the present
• Focus on feelings – this links up with attachment theory approaches to psychoanalytic
psychotherapy – other factors also affect the ability of people to reflect on their feelings –
• Focus on inter-personal relationships – as means of relating the past and the present –
and as means of assessing change as effect of therapy – unlike psychopharmacological
treatment
• Problems and advantages of psychoanalytic therapy
• Focus on the past might not be relevant to patients with e.g. PTSD, still birth victim,
psychotic conditions (e.g. schizophrenia, manic-depressive psychosis)
16. Group 2
• Effective ingredients in psychoanalytic and non-psychoanalytic
therapy
• Therapeutic alliance & the problem of the transference & counter-
transference
• Focus on feelings rather than on thoughts – and this makes therapy
quite difficult at times
• Identification of recurring themes and patterns in, for instance, the
transference
• Long term follow up shows effectiveness of psychotherapy due,
perhaps, to it helping them understand issues that come up for the
patient through teaching the patient to think psychologically about
himself or herself
• This is open to making mistakes about one’s psychology; or quick-
fix psychological formulae; or it can make one over self-centred and
introspective
• Read Janet Malcolm, Psychoanalysis: The Impossible Profession or
read one of Darian Leader’s recent books