Journal of Clinical Psychology最新文献

Expression of Concern: Grossarth-Maticek, R., Eysenck, H. J., Boyle, G. J., Heeb, J., Costa, S. D., & Diel, I. J. (2000). Interaction of psychosocial and physical risk factors in the causation of mammary cancer, and its prevention through psychological methods of treatment. Journal of Clinical Psychology, 56, 33–50 (https://doi.org/10.1002/(SICI)1097-4679(200001)56:1<33::AID-JCLP4>3.0.CO;2-2).

This Expression of Concern is for the above article, published online on December 17, 1999, in Wiley Online Library (wileyonlinelibrary.com), and has been published in agreement between the journal Editor-in-Chief, Timothy R. Elliott, and Wiley Periodicals, LLC. The journal was made aware of concerns raised by King's College about 26 papers co-authored by Hans Eysenck and R. Grossarth-Maticek. The institute found a lack of confidence in the data and implausibility of the results. The Editor-in-Chief and Wiley made several unsuccessful attempts to contact King's College to inquire about details of the investigation. The publisher then contacted King's College Research Integrity Officer. Communications resulted in neither a response nor any official statement regarding the paper and concerns by the institution. As a result, the journal has decided to issue an Expression of Concern to alert readers.

Posttraumatic nightmares (PTN) are a frequent symptom after a traumatic event and often play part in the psychopathology of patients with borderline personality disorder (BPD). Imagery rehearsal therapy (IRT) currently offers the best evidence for an effective treatment to reduce PTNs, although high drop-out rates are common. Art therapy in IRT may counteract this, by its indirect, nonverbal, and often playful approach that helps to break through avoidance. This case study focusses on the perception of a patient with BPD in an art therapy based IRT treatment for patients with PTNs. It tells the story of Aurelia, a 40-year-old woman who, within this treatment, processes traumatic contents of her childhood like physical and sexual violence, but also current interactional problems that manifest themselves in her nightmares. Following the IR-AT treatment for PTNs Aurelia noticed a reduction in her nightmares, was less afraid of them and felt calmer towards her trauma. She expressed herself in the art medium and by this developed more self-efficacy. Her process resulted in an integration of the trauma and a perceived decrease in borderline symptoms. Future research can build on this basis to further explore the mechanisms and effects of IR-AT for PTNs.

Sara was a 65-year-old Caucasian woman who requested art therapy after the death of her partner. She had experienced incest by her father and verbal abuse by her mother until she left home at 21. Her life was characterized by broken relationships due to alienating anger outbursts and an interrupted work history; she met three criteria for narcissistic personality disorder. Sara initially was socially isolated and intellectualizing. She desired recognition but was fearful of exposure. The Expressive Therapies Continuum (ETC) theoretical framework, which consisted of a gradual progression from cognitively-dominated sessions to more emotionally focused processing, guided the therapeutic work. The ETC theory encourages transparency and collaboration between therapist and client regarding therapeutic tasks and goals, and provides a framework for addressing and repairing ruptures in the therapeutic alliance. Art therapy began with the cognitive tasks which Sara completed relatively comfortably, then encouraged integration of emotion via expressive writing, diagrams, and body mapping. Through careful attention to repair of ruptures by directly discussing and adapting the direction and tasks of therapy, Sara slowly was able to experience emotions other than anger. She integrated cognitive and emotional insights about her life and developed empathy for her childhood self. At termination Sara had cultivated two friendships and met only one criterion of NPD. Limitations of this case study include a lack of research evidence for ETC-guided art therapy with NPD clients and by the retrospective approach. Future research efforts could provide this support by encouraging clinicians to conduct prospective case study research.

The following case study provides a description of the transference-focused psychotherapy (TFP) treatment of a young man diagnosed with narcissistic personality disorder (NPD). TFP is an individual, psychodynamic therapy developed to treat a range of personality disorders. TFP is evidence-based for the treatment of borderline personality disorder and has been adapted for the treatment of NPD. This case illustrates the application of the strategies and techniques of TFP to treatment of NPD as well as challenges clinicians may face in arriving at timely diagnosis of the disorder. Although no specific treatment for NPD has been empirically validated, TFP utilizes the therapeutic techniques identified across modalities for successful treatment of pathological narcissism. This report describes how treatment interventions such as goal setting, developing a therapeutic alliance, using a treatment contract and addressing treatment interfering behaviors contributed to this patient's improvement in self-reflection, formation of healthier and more flexible ideas about self and other, increased self-agency, tolerance of normative disillusionments and increase in empathy.

Cognitive processing therapy (CPT) is a first-line treatment for posttraumatic stress disorder (PTSD). The primary goals of CPT are to identify and challenge dysfunctional cognitions resulting from the trauma to promote a more balanced set of beliefs and reduce manufactured emotions; encouraging expression of natural emotions further promotes symptom improvement. Between-session assignments (homework) are an integral part of learning and practicing the skills developed during CPT, and these assignments are theorized to reinforce the proposed mechanisms of symptom change. This article begins with a brief description of the theoretical foundations of CPT and an overview of the session content of the CPT protocol, followed by a case study illustrating the use of CPT with the written account (CPT + A) with a survivor of childhood sexual assault. Although the client demonstrated some avoidance, her successful completion of practice assignments throughout treatment allowed her to identify and examine thoughts contributing to feelings of guilt and self-blame as well as negative beliefs about the world. She was able to reduce her assimilated and overaccommodated stuck points to form a more balanced view of the trauma, and also process her natural emotions, resulting in a significant reduction of PTSD symptoms. The role of homework at each session and how the assignments addressed the proposed mechanisms of change in CPT are discussed, and recommendations to increase clients’ engagement in practice assignments in CPT are provided.

Dance Movement Therapy is gradually becoming recognized as a treatment option in Mental Health Care. However, the working mechanisms can be difficult to comprehend without experiential knowledge of this therapy form. This article aims to offer insight into the clinical application of Dance Movement Therapy for Sanne, a woman with a history of interpersonal relationship difficulties, problems with self-regulation, low self-efficacy and diagnosed with Borderline Personality Disorder and co-morbid Complex Post Traumatic Stress Disorder. This case illustration describes treatment interventions during two months of bi-monthly Dance Movement Therapy as an additional treatment alongside weekly group therapy and bi-monthly individual Psychotherapy. Post treatment, Sanne demonstrates improvements in self-regulatory behavior, interpersonal relationships and self-efficacy as well as an experience she describes as being whole. This article highlights the implications for practitioners of embodied forms of therapy as well as multidisciplinary teams who wish to better understand how the use of opposites within Dance Movement Therapy may be used as an additional intervention for people with Borderline Personality Disorder and co-morbid complex Post Traumatic stress Disorder.

The introductory quote articulates, in a funny and thoughtful way, some interesting ideas about homework relevant to psychotherapy. Although not explicitly stated, the reader gets the impression that there is something slightly negative about homework, which may resonate with some peoples' experiences with school homework growing up. Homework may, for example, create pressure and evoke anxiety due to fear of evaluation, failure, and control. “Besides homework” in passing at the end of the quote, suggests that homework is neither interesting nor important, and perhaps more than anything else, compulsory, directed, and evaluated, with a potential to be “failed”. While educational experiences vary, and some clients who value performing to a high standard and derive a feeling of satisfaction from it may appreciate the educational link, this is certainly not universal as nesting the process of homework, as with all in-session processes within a case formulation is recommended (Kazantzis et al., 2017, and see previous Journal of Clinical Psychology special feature, Vol. 71,5). At least, homework is not “something to take home to think about”, which is unfortunate, and at least sometimes an unhelpful association for a process in psychotherapy. Clearly, there is something in the quote for everyone working within the helping professions to take home and think about.

In the “Introduction” to this issue of the Journal of Clinical Psychology: In Session, we summarized some of the strongest research support for adopting between-session homework (BSH) into clinical work with clients in psychotherapy (Ryum et al., 2023a; see also recent reviews in Kazantzis et al., 2016; Ryum et al., 2023b, 2023c), and argued that it may be considered a common (Kazantzis & Ronan, 2006) or transtheoretical method (Ryum & Kazantzis, 2023) that is highly relevant for clinical training and practice across treatment approaches. We emphasized that the process of facilitating client engagement with specific tasks relies on productive in-session dynamics and therapist skills and competence in selecting, planning, and reviewing BSH, to ensures a skillful integration. Here, we summarize and comment on the six case studies presented in this issue, with special attention to in-session dynamics and the changing nature of BSH over the course of treatment, and also delve into the question of how BSH ties in with proposed change mechanisms across treatment modalities. In sum, we advocate for the position that BSH is something clients can take home from psychotherapy, not only to think about, but to integrate and generalize into their daily lives in ways that promote symptom improvement, positive change, and growth.

This issue of the Journal of Clinical Psychology: In session provides an excellent showcase of a series of in-depth case studies illustrating