The Functional Psychotherapy Approach: A Process-Outcome Multiple Case Study

Objective: The present work aims to conduct the first naturalistic empirical investigation of the process and outcome assessment of functional psychotherapy (FP) treatment. The FP model of psychotherapy is rooted in psychoanalysis and integrates the verbal communication approach founded on transference and countertransference dynamics with the analysis of bodily processes.Method: The study sample included ten patients recruited on a voluntary basis and treated by clinicians in their private practices. Each patient received FP with an average duration of 40 h (min 35 and max 42). Therapies had weekly sessions, were audio-recorded with the patient’s written consent, and lasted for an average of 10 months (min 9 and max 12). Outcome and process tools included the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Luborsky’s the Core Conflictual Relationship Theme (CCRT), used to assess therapeutic benefit, and the Metacognition Assessment Scale (MAS) and the Italian Discourse Attributes Analysis Program (IDAAP) system, used to evaluate therapeutic benefit and process. The MMPI-2 was used also in the follow-up assessment.Results: Results show that FP had a positive therapeutic outcome on the patients assessed in this study, and that the therapeutic benefits were maintained over time. Some specific features of the FP approach were found to contribute more than others to the observed therapeutic benefits.Conclusion: The current investigation constitutes a first step toward assessment of the therapeutic effectiveness of FP. Future developments should apply the methodology to a larger sample, possibly introducing different methodologies to enable detection of specific bodily oriented processes and techniques.

Errare Humanum Est (To Err Is Human): A Mentalizing Breakdown in the Therapeutic Work With an Adolescent

The therapeutic stance in therapies conceptualized by the two-person psychology (Wachtel, 2010) binds the therapist to genuine self-scrutiny. The concepts of transference and countertransference are viewed as jointly constructed endeavors between therapist and client, wherein the therapist needs to be aware of her contribution to difficulties arising in the therapeutic dyad. Different conceptualizations of this therapeutic technique have been eloquently described elsewhere throughout the years in terms of intersubjectivity (Stern, 2005; Aron, 2006), mentalizing (Fonagy and Bateman, 2006), mindfulness-in-action (Safran et al., 2001), rupture and repair (Newhill et al., 2003), and epistemic trust (Fonagy and Allison, 2014). These concepts will be presented interchangeably with a clinical vignette delineating a rupture in the therapeutic work with an adolescent. Finally, the article concludes with a discussion of identifying non-mentalizing modes (Allen et al., 2008) within the therapist to get back on track and restore epistemic trust (Fonagy et al., 2014) in the therapeutic relationship.

Transference and Countertransference Dynamics in a Multifamily Group for Transgender Adolescents

This article is an account of a pioneering multifamily group for transgender adolescents. Meetings were conducted in a Sexual Identity Consultation Service in a Child and Adolescent Psychiatry Department in Paris. In addition to enabling both teenagers and their parents to escape a certain form of isolation, this novel mental health care setting also reinforced the ability of participants to free associate and to cathect substitute objects. The author highlights specific characteristics of transference movements and countertransference reactions of the therapists in this framework. An additional goal is to promote these innovative groups and to recommend similar groups for transgender adolescents and their parents.

Working with adolescents virtually during the Covid-19 period

In this article, the author proposes to present her therapeutic work with adolescents during the Covid-19 period carried out remotely using Skype. Based on the theories that allow us to understand adolescence as a process of growth and transformation, it was possible to acknowledge the changes that took place in three adolescents in different stages of a relational therapy. The imposition of working virtually created a new way of practising psychotherapy, where the notions of transference and countertransference were essential for the understanding of the intra- and inter-psychic processes that take place in the internal world. Skype was the tool that made it possible to continue the relational presence for working with adolescents.