Pub Date : 2025-11-12DOI: 10.1016/j.evopsy.2025.09.001
Madeleine Azubuike (Psychologue clinicienne, Doctorante) , Fanny Marteau-Chasserieau (Maître de conférences en psychologie) , Nathalie Duriez (Professeur des Universités)
Objective
Psychotherapy is an immensely diverse field of practice, in which multiple models and protocols coexist. This diversity can be an asset but can sometimes hinder the path toward a common understanding of what works in psychotherapy. The aim of this article is to show that the therapeutic alliance construct can provide an integrative frame of reference when it comes to understanding the psychotherapeutic process.
Method
This narrative review of the therapeutic alliance concept embraces the diversity of theories and practices in psychotherapy. We draw on the contextual model (Wampold, 2001) and the therapeutic alliance model (Bordin, 1979).
Results
The reviewed studies mainly focus on individual psychotherapy for adult patients and are drawn from international literature from the past fifty years.
Discussion
We explore the epistemological and practical implications of these studies. One part of the research explores the links between alliance and psychotherapy outcomes, while another explores alliance as a therapeutic process.
Conclusions
The contextual approach and the alliance model can be used to provide a definition of psychotherapy that is common to different schools of thought. These concepts offer a framework for quality psychological care.
{"title":"The therapeutic alliance: A trans-theoretical paradigm for psychotherapy","authors":"Madeleine Azubuike (Psychologue clinicienne, Doctorante) , Fanny Marteau-Chasserieau (Maître de conférences en psychologie) , Nathalie Duriez (Professeur des Universités)","doi":"10.1016/j.evopsy.2025.09.001","DOIUrl":"10.1016/j.evopsy.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>Psychotherapy is an immensely diverse field of practice, in which multiple models and protocols coexist. This diversity can be an asset but can sometimes hinder the path toward a common understanding of what works in psychotherapy. The aim of this article is to show that the therapeutic alliance construct can provide an integrative frame of reference when it comes to understanding the psychotherapeutic process.</div></div><div><h3>Method</h3><div>This narrative review of the therapeutic alliance concept embraces the diversity of theories and practices in psychotherapy. We draw on the contextual model (Wampold, 2001) and the therapeutic alliance model (Bordin, 1979).</div></div><div><h3>Results</h3><div>The reviewed studies mainly focus on individual psychotherapy for adult patients and are drawn from international literature from the past fifty years.</div></div><div><h3>Discussion</h3><div>We explore the epistemological and practical implications of these studies. One part of the research explores the links between alliance and psychotherapy outcomes, while another explores alliance as a therapeutic process.</div></div><div><h3>Conclusions</h3><div>The contextual approach and the alliance model can be used to provide a definition of psychotherapy that is common to different schools of thought. These concepts offer a framework for quality psychological care.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages e31-e47"},"PeriodicalIF":0.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-03DOI: 10.1016/j.evopsy.2025.09.006
Clément Fromentin (Psychiatre, Psychanalyste), pour le bureau de la société
{"title":"Compte rendu de l’Assemblée Générale du 26 mai 2025","authors":"Clément Fromentin (Psychiatre, Psychanalyste), pour le bureau de la société","doi":"10.1016/j.evopsy.2025.09.006","DOIUrl":"10.1016/j.evopsy.2025.09.006","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages 763-766"},"PeriodicalIF":0.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-29DOI: 10.1016/j.evopsy.2025.10.003
Pascale Gavelle Doctorante UPCité (Psychologue clinicienne) , Marcela Gargiulo (Professeure de psychologie, Psychologue clinicienne à l’Institut de myologie) , Manuella De Luca (Professeure de psychologie clinique et psychopathologie, Responsable du service d’enseignement clinique, Membre de l’unité de recherche PCPP « Psychologie clinique, psychopathologie, psychanalyse » (URP 4056) Directrice de recherche dans l’école doctorale 3CH 261)
Objectives
Self-perception and the gaze of others are central in clinical work with children and adolescents who have visible differences, such as cleft lips and palates. Integrating their unique facial features into their self-image is a major part of their medical and surgical journey, and the process influences their psychological and social well-being. Our objective is to provide a theoretical foundation to the clinicians who care for these patients, with a view to helping clinicians better identify the factors that contribute to the development of self-image that integrates the face. This work is of particular importance in the field of craniofacial diagnoses and will serve both clinical needs and future research in this area of study.
Methods
This article explores key concepts in the literature, such as body image, self-image, self-perception, self-concept, and body satisfaction, both in general and specifically in children with cleft conditions. We reviewed French and international publications, seeking to clarify terms, highlight theoretical links, summarize assessment tools, and identify gaps.
Results
Our narrative review of the literature underscored the frequent overlap of the terms used and the lack of theoretical references and research when it comes to the topic of integrating the face into self-image. We examined the psychological challenges faced by children with cleft lips and palates as they form their identities and their relationships with their bodies and faces. Our work emphasizes the sensitivity of their gaze when turned toward their anatomical parts affected by the cleft and the risk of depression related to excessive discrepancies between the real face and the ideal face.
Discussion
An emphasis was placed on early life experiences, particularly the “mirror stage,” during which reciprocal gazes shared with caregivers provide children with an image of themselves. Emphasis was also placed on the impact of dissatisfaction with one's appearance and negative social interactions. All these factors occur at the crossroads of the work between psychologists, surgeons, and patients, such that surgery is truly restorative.
Conclusion
Recent research recommends using a mixed-methods approach, with interviews, questionnaires, and projective tests, to explore the integration of the face into self-image. It is also recommended that parental support occur from the moment of diagnosis, that a tailored approach to the child's surgical requests be provided, and that additional support be furnished following surgery.
{"title":"L’intégration du visage dans l’image de soi chez l’enfant et l’adolescent porteur de fente labio-palatine : Conceptualisation et évaluation","authors":"Pascale Gavelle Doctorante UPCité (Psychologue clinicienne) , Marcela Gargiulo (Professeure de psychologie, Psychologue clinicienne à l’Institut de myologie) , Manuella De Luca (Professeure de psychologie clinique et psychopathologie, Responsable du service d’enseignement clinique, Membre de l’unité de recherche PCPP « Psychologie clinique, psychopathologie, psychanalyse » (URP 4056) Directrice de recherche dans l’école doctorale 3CH 261)","doi":"10.1016/j.evopsy.2025.10.003","DOIUrl":"10.1016/j.evopsy.2025.10.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Self-perception and the gaze of others are central in clinical work with children and adolescents who have visible differences, such as cleft lips and palates. Integrating their unique facial features into their self-image is a major part of their medical and surgical journey, and the process influences their psychological and social well-being. Our objective is to provide a theoretical foundation to the clinicians who care for these patients, with a view to helping clinicians better identify the factors that contribute to the development of self-image that integrates the face. This work is of particular importance in the field of craniofacial diagnoses and will serve both clinical needs and future research in this area of study.</div></div><div><h3>Methods</h3><div>This article explores key concepts in the literature, such as body image, self-image, self-perception, self-concept, and body satisfaction, both in general and specifically in children with cleft conditions. We reviewed French and international publications, seeking to clarify terms, highlight theoretical links, summarize assessment tools, and identify gaps.</div></div><div><h3>Results</h3><div>Our narrative review of the literature underscored the frequent overlap of the terms used and the lack of theoretical references and research when it comes to the topic of integrating the face into self-image. We examined the psychological challenges faced by children with cleft lips and palates as they form their identities and their relationships with their bodies and faces. Our work emphasizes the sensitivity of their gaze when turned toward their anatomical parts affected by the cleft and the risk of depression related to excessive discrepancies between the real face and the ideal face.</div></div><div><h3>Discussion</h3><div>An emphasis was placed on early life experiences, particularly the “mirror stage,” during which reciprocal gazes shared with caregivers provide children with an image of themselves. Emphasis was also placed on the impact of dissatisfaction with one's appearance and negative social interactions. All these factors occur at the crossroads of the work between psychologists, surgeons, and patients, such that surgery is truly restorative.</div></div><div><h3>Conclusion</h3><div>Recent research recommends using a mixed-methods approach, with interviews, questionnaires, and projective tests, to explore the integration of the face into self-image. It is also recommended that parental support occur from the moment of diagnosis, that a tailored approach to the child's surgical requests be provided, and that additional support be furnished following surgery.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages 679-699"},"PeriodicalIF":0.6,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1016/j.evopsy.2025.09.002
Mathilde Cœur (Psychologue clinicienne, Doctorante) , Alexandra Laurent (Professeure en psychologie clinique et psychopathologie, Psychologue clinicienne) , Thomas Denise (Docteur en sociologie) , Laurent Martin-Lefevre (Médecin en médecine intensive et réanimation) , Nancy Kentish-Barnes (Docteur en sociologie) , Jean Reignier (Professeur en médecine intensive et réanimation)
Objective
Controlled DCD (Maastricht category 3: donation after circulatory death) is a procedure that brings together intensive care providers and procurement coordinators at the intersection between end of life and organ procurement. The aim of this study was to explore the experiences of intensive care and coordination staff with controlled DCD, with a view to identifying the psychological and relational issues encountered by healthcare professionals when applying this procedure.
Methods
We performed a qualitative, observational, and multicentric study using a focus group technique. We had three focus groups that included 23 healthcare professionals working in intensive care or procurement coordination who had participated in controlled DCD. The interviews were recorded and transcribed for thematic analysis.
Results
The qualitative analysis of the interviews highlighted three major dimensions of the focus groups’ experiences. (1) Clearly defined end of life: the technical nature of the procedure led professionals to focus on the organ rather than on the patient, generating feelings of guilt and discomfort. (2) Confused boundary between life and death: temporal overlap and rapid changes in the patient's status created ambiguities in identity and ethics. (3) Challenges in collaborations between intensive care providers and procurement coordinators: prescribed roles (care vs. retrieval) often appeared to be porous, requiring practical adjustments. Nevertheless, healthcare professionals relied on protective points of reference to maintain their professional bearings: attributing meaning to death via organ donation, the presence of relatives, temporal separation between end-of-life support and organ retrieval, and fostering cooperative practices between teams.
Discussion
Controlled DCD disrupts caregiving by introducing tension between the act of caring for the patient versus caring for the organ. This shift undermines professional identity, exposes teams to ethical conflicts, and fosters defensive distancing mechanisms. However, the presence of family, rituals, and attunement between teams are resources that helped restore the nature of caregiving and construct a subjective framework. Cooperation that respects task differentiation appears to protect healthcare professionals from the risk of desubjectivation and supports the creation of meaning from the procedure.
Conclusion
Our study shows that controlled DCD changes the nature of caregiving. However, healthcare professionals draw upon support resources that help them create meaning from the procedure and provide important avenues for reflection to aid teams in the procedure's application.
{"title":"Enjeux psychologiques du prélèvement d’organes Maastricht III au sein des équipes de réanimation et de coordination : étude prospective et qualitative","authors":"Mathilde Cœur (Psychologue clinicienne, Doctorante) , Alexandra Laurent (Professeure en psychologie clinique et psychopathologie, Psychologue clinicienne) , Thomas Denise (Docteur en sociologie) , Laurent Martin-Lefevre (Médecin en médecine intensive et réanimation) , Nancy Kentish-Barnes (Docteur en sociologie) , Jean Reignier (Professeur en médecine intensive et réanimation)","doi":"10.1016/j.evopsy.2025.09.002","DOIUrl":"10.1016/j.evopsy.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>Controlled DCD (Maastricht category 3: donation after circulatory death) is a procedure that brings together intensive care providers and procurement coordinators at the intersection between end of life and organ procurement. The aim of this study was to explore the experiences of intensive care and coordination staff with controlled DCD, with a view to identifying the psychological and relational issues encountered by healthcare professionals when applying this procedure.</div></div><div><h3>Methods</h3><div>We performed a qualitative, observational, and multicentric study using a focus group technique. We had three focus groups that included 23 healthcare professionals working in intensive care or procurement coordination who had participated in controlled DCD. The interviews were recorded and transcribed for thematic analysis.</div></div><div><h3>Results</h3><div>The qualitative analysis of the interviews highlighted three major dimensions of the focus groups’ experiences. (1) Clearly defined end of life: the technical nature of the procedure led professionals to focus on the organ rather than on the patient, generating feelings of guilt and discomfort. (2) Confused boundary between life and death: temporal overlap and rapid changes in the patient's status created ambiguities in identity and ethics. (3) Challenges in collaborations between intensive care providers and procurement coordinators: prescribed roles (care vs. retrieval) often appeared to be porous, requiring practical adjustments. Nevertheless, healthcare professionals relied on protective points of reference to maintain their professional bearings: attributing meaning to death via organ donation, the presence of relatives, temporal separation between end-of-life support and organ retrieval, and fostering cooperative practices between teams.</div></div><div><h3>Discussion</h3><div>Controlled DCD disrupts caregiving by introducing tension between the act of caring for the patient versus caring for the organ. This shift undermines professional identity, exposes teams to ethical conflicts, and fosters defensive distancing mechanisms. However, the presence of family, rituals, and attunement between teams are resources that helped restore the nature of caregiving and construct a subjective framework. Cooperation that respects task differentiation appears to protect healthcare professionals from the risk of desubjectivation and supports the creation of meaning from the procedure.</div></div><div><h3>Conclusion</h3><div>Our study shows that controlled DCD changes the nature of caregiving. However, healthcare professionals draw upon support resources that help them create meaning from the procedure and provide important avenues for reflection to aid teams in the procedure's application.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages 716-728"},"PeriodicalIF":0.6,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1016/j.evopsy.2025.10.005
Clément Fromentin (Psychiatre, Psychanalyste), pour le bureau de la société
{"title":"Séminaire d’Histoire de la Psychiatrie de Sainte-Anne 2025–2026","authors":"Clément Fromentin (Psychiatre, Psychanalyste), pour le bureau de la société","doi":"10.1016/j.evopsy.2025.10.005","DOIUrl":"10.1016/j.evopsy.2025.10.005","url":null,"abstract":"","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages 767-768"},"PeriodicalIF":0.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1016/j.evopsy.2025.10.004
Pascale Gavelle Doctorante UPCité (Psychologue clinicienne) , Marcela Gargiulo (Professeure de psychologie, Psychologue clinicienne à l’Institut de myologie) , Manuella De Luca (Professeure de psychologie clinique et psychopathologie, Responsable du service d’enseignement clinique, Membre de l’unité de recherche PCPP « Psychologie clinique, psychopathologie, psychanalyse » (URP 4056) Directrice de recherche dans l’école doctorale 3CH 261)
Objectives
Self-perception and the gaze of others are central in clinical work with children and adolescents who have visible differences, such as cleft lips and palates. Integrating their unique facial features into their self-image is a major part of their medical and surgical journey, and the process influences their psychological and social well-being. Our objective is to provide a theoretical foundation to the clinicians who care for these patients, with a view to helping clinicians better identify the factors that contribute to the development of self-image that integrates the face. This work is of particular importance in the field of craniofacial diagnoses and will serve both clinical needs and future research in this area of study.
Methods
This article explores key concepts in the literature, such as body image, self-image, self-perception, self-concept, and body satisfaction, both in general and specifically in children with cleft conditions. We reviewed French and international publications, seeking to clarify terms, highlight theoretical links, summarize assessment tools, and identify gaps.
Results
Our narrative review of the literature underscored the frequent overlap of the terms used and the lack of theoretical references and research when it comes to the topic of integrating the face into self-image. We examined the psychological challenges faced by children with cleft lips and palates as they form their identities and their relationships with their bodies and faces. Our work emphasizes the sensitivity of their gaze when turned toward their anatomical parts affected by the cleft and the risk of depression related to excessive discrepancies between the real face and the ideal face.
Discussion
An emphasis was placed on early life experiences, particularly the “mirror stage,” during which reciprocal gazes shared with caregivers provide children with an image of themselves. Emphasis was also placed on the impact of dissatisfaction with one's appearance and negative social interactions. All these factors occur at the crossroads of the work between psychologists, surgeons, and patients, such that surgery is truly restorative.
Conclusion
Recent research recommends using a mixed-methods approach, with interviews, questionnaires, and projective tests, to explore the integration of the face into self-image. It is also recommended that parental support occur from the moment of diagnosis, that a tailored approach to the child's surgical requests be provided, and that additional support be furnished following surgery.
{"title":"Integration of the face into self-image by children and adolescents with cleft conditions: Conceptualization and evaluation","authors":"Pascale Gavelle Doctorante UPCité (Psychologue clinicienne) , Marcela Gargiulo (Professeure de psychologie, Psychologue clinicienne à l’Institut de myologie) , Manuella De Luca (Professeure de psychologie clinique et psychopathologie, Responsable du service d’enseignement clinique, Membre de l’unité de recherche PCPP « Psychologie clinique, psychopathologie, psychanalyse » (URP 4056) Directrice de recherche dans l’école doctorale 3CH 261)","doi":"10.1016/j.evopsy.2025.10.004","DOIUrl":"10.1016/j.evopsy.2025.10.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Self-perception and the gaze of others are central in clinical work with children and adolescents who have visible differences, such as cleft lips and palates. Integrating their unique facial features into their self-image is a major part of their medical and surgical journey, and the process influences their psychological and social well-being. Our objective is to provide a theoretical foundation to the clinicians who care for these patients, with a view to helping clinicians better identify the factors that contribute to the development of self-image that integrates the face. This work is of particular importance in the field of craniofacial diagnoses and will serve both clinical needs and future research in this area of study.</div></div><div><h3>Methods</h3><div>This article explores key concepts in the literature, such as body image, self-image, self-perception, self-concept, and body satisfaction, both in general and specifically in children with cleft conditions. We reviewed French and international publications, seeking to clarify terms, highlight theoretical links, summarize assessment tools, and identify gaps.</div></div><div><h3>Results</h3><div>Our narrative review of the literature underscored the frequent overlap of the terms used and the lack of theoretical references and research when it comes to the topic of integrating the face into self-image. We examined the psychological challenges faced by children with cleft lips and palates as they form their identities and their relationships with their bodies and faces. Our work emphasizes the sensitivity of their gaze when turned toward their anatomical parts affected by the cleft and the risk of depression related to excessive discrepancies between the real face and the ideal face.</div></div><div><h3>Discussion</h3><div>An emphasis was placed on early life experiences, particularly the “mirror stage,” during which reciprocal gazes shared with caregivers provide children with an image of themselves. Emphasis was also placed on the impact of dissatisfaction with one's appearance and negative social interactions. All these factors occur at the crossroads of the work between psychologists, surgeons, and patients, such that surgery is truly restorative.</div></div><div><h3>Conclusion</h3><div>Recent research recommends using a mixed-methods approach, with interviews, questionnaires, and projective tests, to explore the integration of the face into self-image. It is also recommended that parental support occur from the moment of diagnosis, that a tailored approach to the child's surgical requests be provided, and that additional support be furnished following surgery.</div></div>","PeriodicalId":45007,"journal":{"name":"Evolution Psychiatrique","volume":"90 4","pages":"Pages e11-e30"},"PeriodicalIF":0.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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