Examination regarding the tolerability of the homochord Acidum L(+)-lacticum at a dosage of sixty drops three times daily

In Germany, the commission D recommends in its current dosage guidelines from March 17, 2004, that homeopathic dilutions higher than 24x will be prescribed in a daily application of five drops once. This recommendation is decisive for the German Regulatory Authority. Even though the homochord Acidum L(+)-lacticum 4x/6x/12x/30x/200x contains dilutions above 24x, it is commonly used in clinical practice for over 30 years in a dosage of 60 drops three times daily. In order to explore the clinical safety and tolerability of Acidum L(+)-lacticum 4x/6x/12x/30x/200x at a dosage of 60 drops three times daily, as well as lower dosages, a therapist survey was designed to address the questions. Highly experienced and licensed therapists, including general and alternative practitioners, reported their usual dosage of homochord, incidences of drug reactions, initial homeopathic aggravations as well as the diagnoses that led to the prescription of Acidum L(+)-lacticum 4x/6x/12x/30x/200x. 167 therapist responses were analyzed. Only four therapists reported occurrences that classify as initial aggravation, (2.40 %), compared to 159 with no incidences (95.21 %). Four therapists made no statement. Nevertheless, there were no adverse drug reactions documented in the survey. Consequently, Acidum L(+)-lacticum 4x/6x/12x/30x/200x at a dosage of 60 drops three times daily or lower dosages may be construed to be clinically tolerable and safe. This evidence might lead to further re-evaluations of other homochords, and rigorous clinical trials for its safety and tolerability.

An Experimental Analogue Evaluation of Asian and Asian Americans’ Immediate Reactions to Therapist Microaggressions

Microaggressions are subtle, everyday exchanges that convey discriminatory messages. In psychotherapy, client reports of microaggressions are negatively associated with important therapeutic processes and outcomes. However, many studies are retrospective and correlational, and cannot establish the causal impact of specific therapist statements. In this study, Asian and Asian American participants recruited from Amazon Mechanical Turk ( N = 66) watched a brief animated counseling vignette, and were randomly assigned to four types of therapist responses to the client (control, subtle, moderate, and overt microaggressions). We assessed emotional reactions, perceptions of the session, and offensiveness of therapist statements. In general, moderate and overt microaggressions were rated much more negatively (Cohen’s d’s > 1.0) than subtle microaggressions or control statements (which were not significantly different from each other on any measure). We discuss implications for research, practice, and training.

A Dialectical Behavior Therapy Skills Group in a Psychoanalytic Community Service: A Pilot Study

This exploratory study reports on the implementation and effectiveness of a 20-week Dialectical Behavior Therapy (DBT) skills group provided to 8 outpatients (7 women, average age 33 years old) within a psychoanalytic community clinic. We report on the practical implementation of this DBT skills group, and describe how the theoretical/technical differences between DBT and psychoanalysis were negotiated by the two co-therapists. The effectiveness of the skills group was evaluated on standardized measures of borderline personality symptoms, depression, anxiety, interpersonal problems, quality of life, and mindfulness skills that patients completed before and after treatment. At post-treatment, patients evaluated the DBT skills group on a satisfaction questionnaire and therapists completed a countertransference measure. Pre–post outcome data indicated reduced symptom levels of anxiety, depression, and improved quality of life. Both therapists reported moderate therapist responses typically associated with borderline personality disorder psychopathology. Their therapist responses were not associated with symptom levels or change but were related to patient satisfaction. Accumulative pilot studies like these add to the practice-based evidence of DBT components offered within psychoanalytically-oriented community clinics. However, given the exploratory nature of this study, strong conclusions are precluded until further effectiveness research is conducted.

Finding a Common Ground: Therapist Responsiveness to Male Clients Who Have Acted Violently Against Their Female Partner

Men in treatment for intimate partner violence (IPV) do often present with problem formulations that do not fit the therapeutic endeavor of personal change and may, therefore, challenge therapists in their effort to build an alliance. However, the therapist’s initial contributions are also likely to influence whether the client finds it worthwhile to become involved in a working alliance. In a qualitative study of the in-session interactions between experienced therapists and men in IPV individual therapy, we looked for variations in therapist responsiveness to the client’s initial invitations to identify whether and, eventually, how the two parties were able to reach common ground for working together. We studied therapist–client interactions in 20 therapy cases, including 10 completed cases with good outcomes and 10 dropout cases. Two sessions during the early phase of the therapy and the final session were audiotaped and transcribed verbatim. The transcriptions were analyzed following the guidelines of constructivist grounded theory. The analysis revealed three interactional patterns: co-creative exploration, pull-avoid repetitions, and tiptoeing softly around, each of which was associated with a distinctive set of therapist strategies. Clients participating in the co-creative pattern appeared to experience the most successful treatment. Our findings suggest that a model of therapist responses to client invitations is valuable for the conceptualization of the therapeutic alliance during the early sessions of psychotherapy. The findings also highlight the importance of clarifying and expanding upon the client’s personal experience with his abuse to form a viable working alliance.

Client Attitudinal Stance and Therapist-Client Affiliation: A View from Grammar and Social Interaction

Although it is widely acknowledged in psychotherapy research that the de-velopment and maintenance of positive relational bonds are central to the therapeutic process, the ways that therapists and clients become affiliated through discourse and interaction has not received very much attention. Taking up this concern from a conversation analytic perspective, this paper explores how therapists and clients negotiate affiliation around clients’ affective and evaluative talk or attitudinal stance. In order to illustrate the application of our method, we have chosen to analyze audio- and video-recordings of two clinically relevant interactional contexts in which client stance constructions frequently occur: (1) client narratives; (2) client disagreements with therapists. We show that therapist responses to client attitudinal stances play an important role not only in securing affiliation and positive relational bonds with clients, but also in moving the interaction in a therapeutically relevant direction.