Reevaluating ruptures and repairs in alliance: Between- and within-session processes in cognitive–behavioral therapy and short-term psychodynamic psychotherapy.

2020 ◽  
Vol 88 (9) ◽  
pp. 859-869 ◽  
Author(s):  
Elad Zlotnick ◽  
Asher Y. Strauss ◽  
Penina Ellis ◽  
Maayan Abargil ◽  
Orya Tishby ◽  
...  
2016 ◽  
Vol 38 (2) ◽  
pp. 71-79 ◽  
Author(s):  
Fernanda Barcellos Serralta ◽  
John Stuart Ablon

Abstract Introduction: The Psychotherapy Process Q-Set (PQS) prototype method is used to measure the extent to which ideal processes of different psychotherapies are present in real cases, allowing researchers to examine how adherence to these models relates to or predicts change. Results from studies of short-term psychotherapies suggest that the original psychodynamic prototype is more suitable for studying psychoanalysis and long-term psychodynamic psychotherapy than its time-limited counterparts. Furthermore, culture probably influences how therapies are typically conducted in a given country. Therefore, it seems appropriate to develop Brazilian prototypes on which to base studies of short-term psychodynamic and cognitive-behavioral processes in this country. Objective: To develop prototypes for studying processes of short-term psychotherapies and to examine the degree of adherence of two real psychotherapy cases to these models. Methods: Expert clinicians used the PQS to rate a hypothetical ideal session of either short-term psychodynamic psychotherapy (STPP) or cognitive-behavioral therapy (CBT). Ratings were submitted to Q-type factor analysis to confirm the two groups. Regressive factor scores were rank ordered to describe the prototypes. These ideal models were correlated with ratings of actual therapy processes in two complete psychotherapy cases, one STPP and the other CBT. Results: Agreement levels between expert ratings were high and the two ideal models were confirmed. As expected, the PQS ratings for actual STPP and CBT cases had significant correlations with their respective ideal models, but the STPP case also adhered to the CBT prototype. Conclusion: Overall, the findings reveal the adequacy of the prototypes for time-limited therapies, providing initial support of their validity.


2019 ◽  
pp. 199-216
Author(s):  
Swapnil Gupta ◽  
Rebecca Miller ◽  
John D. Cahill

This chapter addresses the considerations particular to deprescribing benzodiazepines and stimulant medications. Included are considerations around deprescribing those medications that a patient may be invested in taking either because the medications provide immediate relief or because they can improve occupational functioning in the short-term. Addiction and problem use (due to rewarding effects) of psychotropic medications are beyond the scope of this book and are amply addressed elsewhere. Addressed are psychoeducation needs, the acknowledgment of how much relief the medications bring, and the recognition of how severe and prolonged withdrawal symptoms can be. Accounts from patients experiencing prolonged withdrawal are included as well as suggestions around tapering speed and flexibility adapted to the patient’s response and supported by other measures such as cognitive behavioral therapy (CBT) for anxiety, CBT for insomnia, and connection with support groups.


2007 ◽  
Vol 21 (4) ◽  
pp. 334-345 ◽  
Author(s):  
Gail Myhr ◽  
Jeanne Talbot ◽  
Lawrence Annable ◽  
Gilbert Pinard

The Suitability for Short-Term Cognitive Therapy Rating Scale (SRS) defines 10 criteria to assess suitability for short-term cognitive-behavioral therapy (CBT). This study examines the relationships between pretreatment SRS scores and outcome of 113 patients treated with short-term CBT for a wide range of disorders. Using the reliable change index (RCI) as a measure of outcome, 65 individuals (57.5%) of the sample experienced statistically reliable improvement. Married status, employed status, female gender, and anxiety disorder as a primary diagnosis were positively correlated with posttreatment RCI. Awareness of emotion and security operations were the SRS items most strongly correlated with outcome. Also correlated were the two alliance potential items (in-session and out-of-session evidence) and the acceptance of personal responsibility for change. Hierarchical multiple linear regression analysis resulted in a three-variable model where married status, primary anxiety disorder, and mean SRS score accounted for 20% of the variance in RCI scores. We conclude that the SRS adds predictive value to the assessment of potential to succeed in CBT.


2019 ◽  
Vol 41 (2) ◽  
pp. 149-158
Author(s):  
Guilherme Pacheco Fiorini ◽  
Vera Regina Röhnelt Ramires

Abstract Introduction This study developed Brazilian psychodynamic psychotherapy (PDT) and cognitive-behavioral therapy (CBT) prototypes for children with internalizing disorders (ID) and externalizing disorders (ED). Method Eighteen Brazilian experts in PDT (n = 9) and CBT (n = 9) rated the 100 items of the Child Psychotherapy Q-Set (CPQ) describing a hypothetical typical session based on their respective theoretical backgrounds for children with ID. They then rated the same items describing a hypothetical typical session for children with ED. A Q-type factor analysis with varimax rotation was performed. Results Expert correlations were high within each theoretical approach and each diagnostic category. The factor analysis identified three independent factors. CBT ratings concentrated on one factor, while PDT ratings loaded onto one factor describing treatment of children with ID and another factor describing treatment of children with ED. Conclusion The sole CBT prototype reflected a general conceptualization of this approach and was undifferentiated regarding treatment of children with ID and ED. The PDT prototype for children with ID provided evidence of a process focused on interpretation, while the PDT prototype for children with ED characterized a supportive process with attention to the therapeutic relationship. This infers greater variation in the PDT setting for children with different conditions.


CNS Spectrums ◽  
2003 ◽  
Vol 8 (5) ◽  
pp. 339-339 ◽  
Author(s):  
Edna B. Foa ◽  
Martin E. Franklin

It has been a pleasure to assemble this month's issue of CNS Spectrums about cognitive-behavioral therapy (CBT) for anxiety disorders in which the successful treatments of five disorders are discussed. As is evident from the five papers in this issue, most patients with pathologic anxiety can be helped with available treatment, either short-term CBT or medication. Also apparent in these papers is that the work has not been completed: some patients do not benefit from the available treatments at all, and most who do respond still remain somewhat symptomatic.


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