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This paper reviews the current state of the theory and practice of family therapy. It proposes that the field is undergoing a radical metamorphosis in which its theory base is becoming characterised by less ideological ‘purity’, more attention to an evidence base and an integration within other treatment modalities. Like all such metamorphoses, this transformation of family therapy is not without its difficulties. In many ways, professional contexts, professional institutions and training programmes, at least in the UK, do not appear to have made the adjustment to this change. The paper will therefore highlight these contextual issues as a counter-point to the metamorphosis that is in process. [ABSTRACT FROM AUTHOR]

The reader of this commentary on Haley's paper by Stein will note that Stein refers to Haley as ‘the author of the critiqued paper’ or ‘ACP,’ rather than by name. This unusual style was occasioned by the Editor's decision that Stein should comment on the paper without any knowledge of its authorship, in order that the focus of Stein's comments be on the substance of that paper and that his comments not be influenced by who had written it. The admittedly somewhat awkward references to ‘ACP’ have been retained in Stein's comments in order to make that point clear-Ed. [ABSTRACT FROM AUTHOR]

abstract This paper reviews the place of the therapeutic community in the mental health field, using a sociological framework to understand some key factors that have shaped the field and its response to this approach to therapy. The therapeutic community treatment method in mental health has been contested over the years. It has challenged conventional professional frameworks, it has dealt with a difficult client group, and it has been hostile to or at least awkward about establishing its evidence base. In this paper I reflect on the 'politics of evidence' in contested fields. I draw on the analysis of 'fields' from the work of French sociologist Pierre Bourdieu, and the analysis of scientific knowledge from an area of the social study of science, 'actor-network theory'. I argue that evidence is not neutral in contested fields, and that the technology of trials is not balanced with a theoretically informed understanding of the phenomena under scrutiny (causality versus meaning). [ABSTRACT FROM AUTHOR]

Copyright of Journal of Analytical Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Over the last several decades single session psychotherapy has become a mainstream psychotherapeutic approach. A steadily increasing demand for psychotherapeutic services and a continuous reduction in mental health care resources worldwide are both largely responsible for this development. This paper describes single session psychotherapy and provides a brief review of the relevant literature. Single session psychotherapy delivered in walk-in settings is also discussed. Therapists who are unfamiliar with single session psychotherapy will find that this paper provides a concise introduction to the essential processes and outcomes of this psychotherapeutic approach. [ABSTRACT FROM AUTHOR]

Focuses on "Reconsidering Schreber: Contemporary Perspectives," a study day held at the Severnside Institute for Psychotherapy in July 2005. Background on how the speakers reappraised Freud's paper "Psychoanalytic Notes on an Autobiographical Account of a Case of Paranoia" which was based on Schreber's "Memoirs of My Nervous Illness"; Highlights of the event.

Focuses on the process of selecting the papers published in the 20th anniversary issue of the journal "British Journal of Psychotherapy." List of articles published in the previous issues of the journal.

Abstract: The paper proposes that frameworks typical to metaphysics and art could be used in clinical treatment in somatic and psychiatric contexts to ensure improved care. The concept of the “body electric” of somatic patients which I introduced in previous work is developed further and paired with the “mind electric” of psychiatric patients. Both are defined as a patient's personally generated metaphysical possibility of being healthy‐within‐illness which is experientially actualized. Both concepts are used here to explore the alternative and the serious challenges to treatment approaches focused on clinical categories, disease, provision, and promotion of standardized or “black‐box” therapies. An argument against the idea implied by the hope for such mass treatments and corresponding overreliance on science, namely, that health comes from fixing and regularizing, is developed based on cultural history and the evidenced fact that personally assumed health, just like art and metaphysics, is transgressive of scientific data, and accommodates the untrue, the impossible or the irregular as actual and normal. Because normality is created only with the help of disorder and from within it for chronic patients, clinicians should offer them the metaphysical care they need to produce and actualize their possibility of irregular normality or their body/mind electric. Better treatments can only be provided when scientific advances will be matched with advances in the humanistic competence of clinicians. [ABSTRACT FROM AUTHOR]

Abstract: The physical spaces in which we conduct psychotherapy are an important yet underacknowledged aspect of psychotherapeutic work. Although a few contemporary publications have provided suggestions for the creation of welcoming, comfortable, and efficient practice spaces, considerations of what it means to transform a room into a therapeutic space have remained largely absent from recent literature. This paper reviews the existing literature on this subject and describes the ways in which the therapist's office is intimately tied to several processes of the therapy itself, by way of creating an adaptive environment that is able to meet the needs of both therapist and client over the course of their work together. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide a description of a significant process which takes place during a first psychiatric hospitalization and to shed some light on its context. This process involves a transformation of an individual considered mentally disturbed into a psychiatric patient which affects the person's identity. The ‘person’ becomes a ‘psychiatric patient’. Although it is self-evident that a patient never stops being a person, the context of the first hospitalization merits attention as it is the time when the patient is in most danger of being objectified and depersonalized. The paper describes a study of forty-six patients hospitalized for the first time on a psychiatric ward and their seventy-five parents. Their narratives from the beginning and the end of stay in hospital were compared and the language used during the introductory consultation and discharge consultation analysed. In this process an important role is played by patients' parents. The parents' narratives are seen to change in a direction of acceptance but at the same time a process of stigmatization is apparent. [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The concluding paper in this series provides brief reflections from a range of key individuals involved in the development and interpretation of CORE benchmarks for NHS primary care psychological therapy and counselling services. Michael Barkham firstly reflects on some of the research challenges facing the use of benchmarks derived from practice-based evidence, before acknowledging the potential for such data to help bridge the research-practice gap as we learn the best use of it. Geoff Mothersole considers similar challenges in using real world data, and explores some of the challenges that managers face in using benchmarks for improved service management practice. Barry McInnes increases the magnification in his reflective focus and looks at the juxtaposition of national guideline recommendations from evidence-based practice in contrast to those introduced by the growing practice evidence-base suggesting differential therapist effectiveness. The first of two final strategic reflective perspectives includes Richard Evans's summary of some of the hidden lessons from the benchmarking endeavour to-date, before my own personal concluding summary looking at lessons learned for the on-going strategic development of enhanced support for routine quality evaluation. [ABSTRACT FROM AUTHOR]

The author discusses and comments on Korf and Bosker's paper entitled, `The depressed patient in a biological world: on philosophical and diagnostic strategies'. The author opines that treating mental disorders as being either only biological or strictly psychological, which according to his analysis, renders an objective instead of subjective view. The author opines that such an analysis by clinicians hinder the scope of identifying and developing new treatments.

Seldom is the work of philosophers invoked by health professionals when examining aspects of care from a philosophical perspective. Instead, students of health care, especially nurses, have been introduced to ‘philosophies’ which are often superficially examined and poorly understood. This practice fails to develop in students an appreciation of the work of philosophers or to acquire the art of critical thinking. The introduction of models and theories of nursing in the past three decades has alerted nurses to the importance of possessing critical skills in order to identify sound theory and implement good practice. This paper goes beyond mere philosophising and examines aspects of mental health care from the perspectives of one of nineteenth century Europe’s most notable philosophers, Friedrich Nietzsche. It argues that understanding his work can enhance one’s ability to reflect on nursing practice, as well as bringing a new dimension to how we analyse ‘mental health’ problems. His work provides many insights into how we can improve our understanding of the effect of mental illness and mental health care on the individual, and how we conceptualise the process of care. This paper provides an overview of his life’s work, his impact on the history of ideas and develops some of the more provocative implications of his work for mental health care. [ABSTRACT FROM AUTHOR]

Introduces a series of articles on psychotherapy published in the March 2006 issue of the "Psychotherapy and Politics International." Assumption behind the publication of the journal; Adoption of psychotherapy training in universities and colleges; Overview of the articles.

Ward community groups have been mostly lost from acute psychiatric in-patient settings in recent years with changes related to care in the community and altered therapeutic expectations. This paper outlines the re-introduction of ward community groups to such a setting and, by using the quantitative measure of patient complaints and qualitative observations, offers evidence for their usefulness as a therapeutic medium, beneficial to the acute psychiatric in-patient ward, and as a container for disturbed states. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Analytical Psychology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly rational grounds. We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views. [ABSTRACT FROM AUTHOR]

AIMS: This paper focuses on attitudes towards and use of self-chosen treatment among people prescribed antidepressants and discusses the implications for practitioners involved in medicines management. BACKGROUND: In the wide-ranging debate around the extension of non-medical prescribing in the UK the relationship between complementary and alternative therapies and prescribed medication has received little attention. Research indicates that self-treatment, including use of complementary and alternative therapies is burgeoning, yet there is uncertainty about the degree to which practitioners should be knowledgeable about therapies or be capable of advising clients on their use. Complementary and alternative therapy use is common among people with depression and greater knowledge of their use may be appropriate if health practitioners are to be able to support and inform people with depressive symptoms. METHODS: Qualitative methodology was adopted and 60 people from four primary care practices in the West Midlands, UK were interviewed individually and their self-reported treatment journeys documented. RESULTS: Almost two-thirds of participants had attempted to use self-chosen therapies during their recent illness though few had discussed their use with health service practitioners. Use of a range of self-chosen therapies was supported by a belief that they were natural, combined with a desire to avoid consulting health practitioners. Reasons for non-use of such therapies included confidence in health practitioners and caution about the possibility of drug interactions. CONCLUSIONS: Health practitioners require an awareness that people with mental health problems are using a range of self-chosen treatments and might consider the appropriateness of initiating discussions on self-chosen treatments with clients. This area requires greater debate and if necessary identification of an appropriate knowledge base. RELEVANCE TO CLINICAL PRACTICE: Assessment of common mental health problems should include discussion of patients' previous and current self-treatment. Such discussions will assist in identifying attitudes and beliefs towards health service treatment and provide a basis for selecting appropriate interventions. [ABSTRACT FROM AUTHOR]

Presents abstracts of several articles on psychiatry. "Thirty Years of Abdominal Pain"; "Vulnerability, Affect, and Depth in Group Psychotherapy"; "The Evolution of psychotherapy in Western Europe."

This overview of the March 2003 conference on the U.S. national buprenorphine implementation program is developed to inform the practitioner about the positive experience that has been accumulated worldwide on the use of buprenorphine for office-based practice. The first paper delineates the challenges for American psychiatry in moving buprenorphine forward into general practice. Most psychiatrists are unprepared to work with opiate-dependent patients or to use buprenorphine. The international successes with office-based buprenorphine from France and Australia are presented in the next papers, followed by presentations on several U.S. studies using buprenorphine in the community for detoxification and office-based maintenance. These experiences have thus far confirmed buprenorphine's utility and promise for opiate addiction treatment in the U.S. Finally, two national monitoring programs have been implemented to assess the public health impact of this new treatment opportunity. This opportunity has a three-year window, however, and a critical need will be to attract a sufficient number of physicians into prescribing buprenorphine/naloxone in order to allow our patients increased access to this treatment. [ABSTRACT FROM AUTHOR]

Abstract The purpose of the present paper was to investigate the efficacy of augmentation of clomipramine (CMI) by tandospirone in 36 untreated outpatients with major depressive disorder. Twelve patients were treated with CMI and tandospirone (T group), 12 with CMI and diazepam (D group) and 12 with CMI alone (C group) for 6 weeks. No statistically significant differences in the percentage improvement of the Hamilton Depression Rating Scale (17 items; HDRS-17) and the Hamilton Anxiety Rating Scale (14 items; HARS-14) scores were shown among the three treatment groups. However, at 2 weeks, the percentage improvement of HDRS-17 score in the T group tended to be higher than that in the D and C groups, although there was no statistically significant difference among the three treatment groups. No change in plasma prolactin level or adverse events was induced by the addition of tandospirone. These results suggest that 6 weeks of treatment with tandospirone or diazepam was not effective for augmentation of CMI in major depressive disorder patients. However, augmentation of antidepressants by tandospirone administration for a few weeks might induce early expression of antidepressive effects. [ABSTRACT FROM AUTHOR]

This article presents information on the application of role playing, as a research technique, in a test of Sarbin's self role congruency theory. The present study attempts to provide further confirmation of Sarbin's congruency theory, in this case within a setting analogous to psychotherapy. It was believed that by using Ss who were playing the roles of therapist and clients it would be possible to obtain information relevant to the effects of self-role congruency and incongruency in the psychotherapeutic interaction. A secondary purpose of the study was to provide data on the validity of pencil and paper tests that purport to measure role-playing aptitude. Forty nine male Ss from various undergraduate classes volunteered to role play either a therapist or a client in a half-hour role-playing session designed to simulate psychotherapy.

This article discusses the much-misunderstood Tarasoff decision that requires psychotherapists to protect third parties from patients' violent acts. Through a normative approach, the paper analyzes four important issues: what to do when potential victims are unknown; what to do about the fact that the patients' potential for violence may be incorrectly perceived; the value of warning potential victims; and, the problem of discharging potentially violent patients from the hospital. The author proposes that the courts adopt a more flexible substantial departure test in most cases that involve psychiatric negligence. [ABSTRACT FROM AUTHOR]

This paper describes a family in which bulimia nervosa has been present in four children. Discussion about the possible reasons for the development of bulimia in this family includes the importance of secrecy as a boundary-making function in family systems. [ABSTRACT FROM AUTHOR]

This paper describes a programme for inpatients with severe personality disorders as well as acute exacerbation of Axis II pathology. The goal of the programme was to quickly stabilize participants with respect to self-injurious behaviour and return them to the community. The programme consisted of frequent coordinated cognitive group therapy sessions with supporting written and audiovisual materials. The groups were open-ended and heterogenous, and employed educational and experiential-affective components. An extended group case example is presented in order to illustrate the operation of the programme. The range of typical participants is described, including their diagnoses, treatment plans, and homework assignments. Some comments on the personal and professional difficulties encountered by therapists working with this population ate described as well as some suggestions for alleviating those difficulties. [ABSTRACT FROM AUTHOR]

Fairy-tales, like mythologies, can be found all over the world containing the same motif and chains of motifs. In this paper I have presented some theories on the occurrence of this archetypal phenomenon ranging from the old migration theory to Sheldrake's theory of morphogenetic fields. I have then tried to show how fairy-tale-motifs can appear in various ways in analytical therapy, often in hidden forms. We find them in patients' dreams as well as in their fantasies and associations. If the therapist is open to them they will also appear in his or her amplifications. He or she might then take note of the fairy-tale or point it out to the patient; in the latter case it might provide better access to the patient's problems and complexes as fairy-tales have an emotional completeness because of their pictorial character. Finally I have described the favourite fairy-tale of one of my patients and related it to his symptoms, his central complex and his personal ways of experiencing and behaving. This survey of how fairy-tales can be used in therapy with children and with adults far from exhaustive. [ABSTRACT FROM AUTHOR]

This paper develops the assumptions that underlie a transactional approach to psychotherapy by utilizing Bentley's ideas about the environed organism. It emphasizes that not only is interpersonal interaction significant therapeutically but the situational aspect of persons and behavior (living, working, neighborhood, and community circumstances) contribute to the process of client change and growth. [ABSTRACT FROM AUTHOR]

Three variations of the multiple baseline design (MBD) have been identified in the behavioral literature: MBD across behaviors, subjects and situations. This anaylsis proposes an important variant of the MBD across behaviors, namely the MBD across exemplars. In this variant, two or more components (exemplars) of the behavior class form the baselines of the design. The implicit rule of the MBD across exemplars can be seen in several published papers in the behavioral literature. The value of recognizing this variant of the MBD across behaviors is its usefulness as an alternative experimental intervention in clinical settings where the possibility of a convincing research design might not otherwise be seen. [ABSTRACT FROM AUTHOR]

This article focuses on the usefulness of reception and recall checks in the development and implementation of client pretherapy orientation procedures. Although high scores on such measures do not indicate that the ideas presented in the orientation have been fully grasped or internalized, they do demonstrate that clients have been able to attend to and, in a basic sense, to understand, or receive, the material. Retention of the information can be assessed by readministration at a later point. It is hoped that the employment of manipulation checks of this kind can facilitate the identification of processes through which orientations work.

Although recent studies indicate greater sustained improvement in psychiatrically hospitalized children when their parents are actively involved in the treatment program, to date no study has examined the direct benefits of group intervention for parents themselves. The present paper describes the impact of an experimental parent-group program on parents' self-esteem, attitudes toward their children, and knowledge regarding childrearing techniques. Overall, supportive group functions are rated by parents as having greater personal relevance and therapeutic impact than educative ones. [ABSTRACT FROM AUTHOR]

This article focuses on psychic equivalents and the language of child psychotherapy. The therapist uses the child's own words for urine, faeces and other parts of the body, as well as for sexual intercourse, in order to communicate with him as directly as possible about his instinctual, body experiences and the fantasies around them. Therapists often deals with play, elaborating fantasies that stem from the period of infant development when fantasy and body sensations and functions are experienced as the same thing.

A subgroup of older patients with a strikingly consistent pattern of symptoms and historical detail is presented with an outline for treatment. Deviation from standard approaches to treatment for eating disorders is discussed as a consequence of managing not only severe eating disorder symptoms, but also severe dissociative and personality disorders. Based on the work of Putnam (1989) and case material, an outline of treatment if presented that includes: (1) diagnosis, (2) history and alter identification, (3) initial stabilization, (4) acceptance of diagnosis, (5) communication between alters, (6) metabolism of trauma, and (7) integration. The integration of cognitive-behavioural, psychodynamic, and feminist-relational techniques is discussed as a way to help these patients overcome both eating and dissociative disorder symptoms. Though treatment of this subgroup is considerably longer and more intensive than standard approaches (e.g. twice weekly for several years), case studies reveal that prognosis is generally good if patients remain in treatment. Other indicators of good prognosis include the patient's ability to remain or return to premorbid levels of employment. [ABSTRACT FROM AUTHOR]

Discusses the issue of confidentiality of the psychotherapeutic process during the British Confederation of Psychoterapists (BCP) conference, A Question of Confidence: Privacy Under Pressure in March 2003. Legislation affecting mental health; Intention of BCP conference; Reason for the decision of BCP to focus on the protection of confidentiality.

Interest in the relationship between autism and violence has increased in recent years; however, no link has clearly been established between them. Researchers remain curious if autistic people with certain traits (e.g., a history of trauma) are at greater risk of violence than those individuals with autism alone. In this article, we detail two individuals with homicidal ideation (HI) admitted to inpatient psychiatric units who were found to have a diagnosis of autism without language impairment. These cases illustrate the need for mental health providers to consider autism in their differential diagnosis when evaluating an individual with HI. Broadly, we consider how an autistic individual could be susceptible to developing HI and explore treatments specific to autistic individuals that may be helpful in such cases. [ABSTRACT FROM AUTHOR]

Objective: Depression is common among patients diagnosed with cancer. Patients with cancer and depression use more health care services compared with nondepressed cancer patients. The current study seeks to estimate the added cost of depression in cancer patients in the first year after cancer diagnosis.Methods: Health care charges were obtained for 2051 depressed and 11 182 nondepressed patients with an International Classification of Diseases, Ninth Revision, diagnosis of cancer in the 2014 calendar year from the University of California San Diego Healthcare System. The annual health care charges for cancer patients with and without depression were analyzed using generalized linear models with a log-link function and gamma distribution, covarying for age, sex, race/ethnicity, comorbid diseases, and presence of metastatic disease. Total cost data were broken down into several categories including ambulatory care, emergency department visits, and hospital visits.Results: Depressed cancer patients had total annual health care charges that were 113% higher than nondepressed cancer patients (B = 0.76; P < .001). The estimated mean charges for depressed patients were $235 337 compared with $110 650 for nondepressed patients. Depressed cancer patients incurred greater charges than nondepressed patients in ambulatory care (B = 0.70; P < .001), emergency department charges (B = 0.31; P < .001), and hospital charges (B = 0.39; P < .001).Conclusions: Depressed cancer patients incur significantly higher health care charges across multiple cost categories including ambulatory care, emergency department visits, and hospital visits. Future research should investigate if interventions for detecting and treating depression are effective for reducing health care use and costs in cancer patients. [ABSTRACT FROM AUTHOR]

Abstract: I contend that painting, like psychoanalytic psychotherapy, is an intersubjective process able to connect hearts and minds of painters and viewers alike, because the creative process of making a painting brings painters into more complex and more animated relationship with themselves. My own painting process is largely nonverbal. Interactions between me and my evolving artwork‐in‐process reveal experiences, thoughts, and feelings not yet formulated in words, and so, not available explicitly to conscious awareness until visual representation allows questions of meaning and intention to be thought about and elaborated in the usual, verbal sense. I describe how my particular painting practice provides an experiential frame for the creative process of self‐articulation that goes on in psychotherapy, as well as how the physical and mostly nonverbal dialogue experienced in the painting studio served as a source of listening attitudes and self‐regulation in my work with a patient's inhibited self‐expression and thwarted artistic ambitions. [ABSTRACT FROM AUTHOR]

The primary aims are to consider whether a range of paternalistic medical interventions can be justified in the treatment of factitious disorder ( FD) and to show that the particularities of FD and its management make it an ideal phenomenon to highlight the difficulties of balancing respect for self-determination, responsibility and duty of care in psychiatry. FD is usually classified as a mental disorder involving deliberate and hidden feigning or inducement of illness, in order to achieve patient status. Both the nature of the disorder and the approach to treatment are controversial and under-researched. It is argued that FD should be classified as a mental disorder; may well expose the patient to extreme risk; can warrant paternalistic interventions, in order to fulfil duty of care. Moreover, treatment of FD is inherently paternalistic and therefore raises interesting questions about justifications and type of paternalistic interventions in psychiatry both for FD and in general. A brief account of key questions concerning psychiatry and paternalism is followed by some case histories of FD, the clinical dilemmas posed and the question of how this disorder might warrant paternalistic interventions. In order to answer this question, two things are considered: the legitimacy and character of FD as a mental disorder; possible frameworks for and types of paternalistic interventions. To conclude, it is argued that there are no compelling reasons for rejecting the use of paternalistic interventions for FD, but that further investigation of FD and type and frameworks for psychiatric paternalism, in relation to FD and other mental disorders, are urgently needed. [ABSTRACT FROM AUTHOR]

Neuroscience has made tremendous progress delineating the cellular and molecular processes important for understanding neuronal development and behavior, but this knowledge has been slow to translate to new treatments for psychiatric illness. To accelerate this transfer of knowledge to the human condition requires the wide-scale adoption of biomarkers that can bridge preclinical and clinical discoveries, and serve as surrogate measures of efficacy before commencing expensive phase III studies. Several biomarker methodologies, including imaging, electroencephalography (EEG), and blood transcriptomics/proteomics, are now showing promise. From an industry perspective, we highlight the utility of quantitative EEG as one example of a translatable biomarker applicable to psychiatric drug development and discuss recent insights into glutamate system dysfunction in schizophrenia and depression gained through translational studies of the drug ketamine. [ABSTRACT FROM AUTHOR]

Key content An overview of current information available on premenstrual syndrome ( PMS), which is in accordance with the new RCOG Green-top Guideline., Definition of PMS and explanation about the different types of premenstrual disorders., How to accurately diagnose PMS., Discussion about various treatment options available in accordance with the current literature., Learning objectives Develop an understanding of the pathophysiology behind PMS., How to diagnose PMS accurately and understand the different classifications of PMS., How to treat PMS, including the different treatment options available and discussion about side effects and benefits., Ethical issues Discussion about the long-term risks of Gn RH analogue use, and the impact of long-term estrogen deficiency following a bilateral salpingoophorectomy., Misdiagnosed PMS in patients with underlying psychiatric and medical conditions. [ABSTRACT FROM AUTHOR]

Relating therapy is a form of psychotherapy that is based upon relating theory. Relating theory is briefly compared with attachment theory and certain aspects of psychoanalysis. The interpersonal octagon (Birtchnell, 1994) represents a person's eight relating positions. People need to acquire the capability to relate effectively in each one of these. Competent relating is called positive and relating that falls short of this is called negative. Ways are described by which patients are helped to shed their negative relating and become more capable of relating positively. The Person's Relating to Others Questionnaire (Birtchnell et al., in press) measures negative relating within the eight positions of the octagon. It identifies a person's areas of negative relating and measures change in such relating over the course of psychotherapy. Interrelating therapy is an extension of relating therapy that is applicable to couples. The Couple's Relating to Each Other Questionnaires (Birtchnell et al., 2006) is a set of four questionnaires by which each of two partners can rate how s/he relates negatively to the other and how s/he considers that the other relates negatively to her/him. It is used to measure change over the course of couple therapy. [ABSTRACT FROM AUTHOR]

Introduction This study examined the validity and reliability of the Patient Health Questionnaire-9 ( PHQ-9) and Patient Health Questionnaire-2 ( PHQ-2). The optimal cutoff score when screening for depression among Chinese college students was also determined. Methods A total of 959 participants completed the PHQ-9 and the Beck Depression Inventory ( BDI) questionnaire. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders was used to diagnose depression. Statistical tests were performed to determine the reliability, validity, and receiver operating characteristic curve of the data. The concurrent validity was tested by examining associations between PHQ-9 and BDI. The sensitivity and specificity, as well as the positive and negative predictive values, were calculated for different cutoff scores of PHQ-9 and PHQ-2. Results The internal consistency values of PHQ-9 and PHQ-2 were 0.854 and 0.727, respectively. The test-retest reliability values of PHQ-9 and PHQ-2 were 0.873 and 0.829, respectively. The scores of PHQ-9 ( r = 0.790) and PHQ-2 ( r = 0.651) were significantly associated with that of BDI. PHQ-9 had an optimal cutoff score of 11, which indicated a sensitivity of 0.89 and a specificity of 0.97, with an area under the curve of 0.977 (95% confidence interval: 0.966-0.988). The PHQ-2 demonstrated satisfactory sensitivity (0.81) and specificity (0.96) at the cutoff score of 3, and its area under the curve was 0.939. Discussion The PHQ-9 and the PHQ-2 are valid and reliable tools to screen depression in Chinese college students. For screening purposes, cutoff scores of 11 and 3 are recommended for PHQ-9 and PHQ-2, respectively. [ABSTRACT FROM AUTHOR]

Since the international movement for patients' rights began, law has played an ambiguous role in mediating conflicts over responsibility for the mentally ill. In Greece, this contention has been shaped by reforms designed to shift psychiatric treatment from custodial hospitals to outpatient settings, challenging patients to help care for themselves. This article addresses one of the normative techniques deployed by Greek therapists to foster patients' responsibility in treatment: the therapeutic contract. By formalizing patients' and therapists' responsibilities to one other, contracts attach legalistic determinants to treatment that are said to have their own therapeutic efficacy. I examine the experiences of two patients in northeastern Greece who entered therapeutic contracts at moments of crisis in their treatment. Failures in these cases expose a conflict between the ethics of contract and the ethics of care. I argue that this conflict is intrinsic to the transactional model of public service relationships in liberal states. [ABSTRACT FROM AUTHOR]

In the last decade, over half a dozen local and international humanitarian organizations have established psychosocial programs to ameliorate the suffering of victims of violence in Kashmir. Many promote nonpharmacological trauma healing, such as counseling and psychotherapy, in contrast to the pharmacological treatments preferred by state mental health services. Although anthropologists have critiqued humanitarianism for its inadequate attention to local contexts, in this article, I attempt to go beyond this critique by focusing on the locals or 'nationals' who staff these organizations. Kashmiri psychosocial workers mediate between formal, international guidelines of psychosocial treatment, on the one hand, and local understandings of biomedical efficacy and care, on the other hand. I specifically show how counselors appropriate medical and psychiatric expert practices in their everyday work, not to increase their own prestige but to make their practice more legible to their patients or clients. As such, one of the unintended effects of psychosocial programs in Kashmir is the perpetuation of a medical model of care. Rather than being caused by a lack of knowledge of the local context, however, I argue that such borrowings are central to how psychosocial practices have been vernacularized in Kashmir. [ABSTRACT FROM AUTHOR]

The transtheoretical model, in general, and the stages of change, in particular, have proven useful in adapting or tailoring treatment to the individual. We define the stages and processes of change and then review previous meta-analyses on their interrelationship. We report an original meta-analysis of 39 studies, encompassing 8,238 psychotherapy patients, to assess the ability of stages of change and related readiness measures to predict psychotherapy outcomes. Clinically significant effect sizes were found for the association between stage of change and psychotherapy outcomes ( d = .46); the amount of progress clients make during treatment tends to be a function of their pretreatment stage of change. We examine potential moderators in effect size by study outcome, patient characteristics, treatment features, and diagnosis. We also review the large volume of behavioral health research, but scant psychotherapy research, that demonstrates the efficacy of matching treatment to the patient's stage of change. Limitations of the extant research are noted, and practice recommendations are advanced. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 67:143-154, 2011. [ABSTRACT FROM AUTHOR]

abstract The Young People's Consultation Service (YPCS) is a four-session, self-referral, psychodynamically-oriented psychotherapeutic consultation service for young people aged between 16 and 30, at the Tavistock and Portman NHS Foundation Trust in London. Aim: It was hypothesized that clients would show an improvement on outcome measures at the end of the four sessions. It was also hoped that the data would identify characteristics of the clients who show the most benefit. Method: A review of the case-notes of all clients attending the service between January 2003 to April 2006 was carried out, and details were entered into a database, including demographic information, presenting issues and attendance. Clients were given the Youth Self-Report form (YSR) () or the Young Adult Self Report form (YASR) (), according to age, before the start of the intervention and at the end of the four sessions. Outcome data were analysed, comparing pre- and post-treatment scores on the YSR/YASR. Results: A total of 236 clients attended the service during the study period. Pre- to post-comparison data on the YSR/YASR was available for 24 clients. Of those, YSR/YASR scores reduced significantly on all subscales and severity reduced over time in all cases. In addition, there was a trend towards moving from the clinical to the non-clinical range, reaching statistical significance on the Internalizing and Total subscales. A number of YPCS clients showed both statistically significant and clinical improvement on the Internalizing and Externalizing scales of the YSR/YASR, with a greater number showing improvement on the Internalizing scale. Conclusions: Improvements were found on all subscales of the YSR/YASR at the end of the four session intervention. A greater number of clients showed improvement on the Internalizing subscale, suggesting that this form of very brief psychotherapy is most effective for clients with emotional problems. [ABSTRACT FROM AUTHOR]

This study investigates the effects of clinician personal therapy on therapeutic alliance early in treatment. Therapists who had received personal therapy assessed 30 outpatients, and therapists who had not undergone personal therapy assessed 30 outpatients. These groups of patients were matched on key demographic, diagnostic and psychiatric severity data. Results demonstrated no significant group differences on patient-rated alliance. Significant differences were observed for the therapist-rated alliance variables of therapist confidence, goal and task agreement, as well as overall alliance, with higher scores from those therapists who had received personal therapy. In addition, significant differences were found in the number of therapy sessions attended, with the treatments of those therapists who had received personal therapy being twice as long. The impact of personal therapy in relation to structured training and a therapeutic model of assessment on graduate clinicians' ability to form positive collaborative relationships with their patients is discussed. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mental illnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy for mentally ill children, adolescents and adults. Method: This article reviews the ‘trajectory’ of psychosocial interventions in pediatric psychiatry, and makes some general predictions about where this field is heading over the next several decades. Results: Driven largely by scientific advances in molecular, cellular and systems neuroscience, psychotherapy in the future will focus less on personal narratives and more on the developing brain. In place of disorders as intervention targets, modularized psychosocial treatment components derived from current cognitive-behavior therapies will target corresponding central nervous system (CNS) information processes and their functional behavioral consequences. Either preventive or rehabilitative, the goal of psychotherapy will be to promote development along typical developmental trajectories. In place of guilds, psychotherapy will be organized professionally much as physical therapy is organized today. As with other forms of increasingly personalized health care, internet-based delivery of psychotherapy will become commonplace. Conclusion: Informed by the new field of translational developmental neuroscience, psychotherapy in the future will take aim at the developing brain in a service delivery model that closely resembles the place and role of psychosocial interventions in the rest of medicine. Getting there will be, as they say, interesting. [ABSTRACT FROM AUTHOR]

A trait approach to personality has many implications for psychotherapy. Given that traits contribute to the expression of symptoms of common psychiatric disorders, are moderately heritable, and relatively stable (yet also dynamic to some extent), long-term change in symptoms is possible but is likely to be limited. Analogous to the manner in which genes set the reaction range for phenotype, standing on certain traits may set the patient's “therapeutic range.” On the other hand, some of the same traits that may limit the depth of therapeutic benefits might also increase their breadth. In addition, taking the patient's standing on different traits into account can inform the choice of therapeutic strategy and targets and can affect the formation of the therapeutic alliance and compliance with self-help exercises. Finally, other aspects of personality beyond traits, such as ego development and narrative identity, also appear to have important implications for psychotherapy. [ABSTRACT FROM AUTHOR]