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“Lechol Nefesh” (“For Every Soul”) is a Non Profit Organization established in Israel in 2010 by a group of members of the Israeli Psychoanalytic Society with the objective of setting up unique the...

In a previous study, it was found that several constructs derived from a positive definition of mental health had changed during psychotherapy. It remains unclear whether they change as part of a single process together with symptomatic change, as part of separate processes, or whether a change in one of the variables predicts change in another variable. Our objective in this study was to examine the relationship between the observed changes and to establish temporal precedence that constitutes a necessary condition for causation. Sixty-two clients who underwent psychotherapy in a naturalistic setting completed questionnaires at 5 time points throughout treatment. The change scores for each client in each of the variables were calculated. The correlations between the changes' scores were tested. To examine the time order, we used autoregressive cross-lagged modeling. A negative correlation was found between the symptoms change score and the happiness change score, r(60) = -0.53, p < .000. A positive correlation was detected between playfulness and happiness change scores, r(60) = 0.31, p = .014. Playfulness predicted subsequent levels of creativity, b = 0.66, t(121) = 2.1, p < .05. Honesty-humility levels predicted subsequent levels of creativity, b = 0.65, t(121) = 9.71, p < .001. The findings support the claim that the change in positive features of mental health is an independent process from symptomatic improvement. In addition, playfulness and honesty-humility temporally precede creativity, and thus might be part of a single change in a mental health construct that is positively defined. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objectives: This study comprised an examination of whether clients' playfulness, creativity, honesty, humor, and happiness changed during psychotherapy. Methods: Sixty-two clients who underwent psychotherapy in a naturalistic setting completed questionnaires at five time points throughout treatment. An HLM analytic approach was applied to account for the hierarchical nature of the data. Results: Mental distress declined during treatment, while playfulness and creativity increased significantly. Honesty decreased significantly in the course of the treatment, while no significant change was found in the level of affiliative humor or the level of happiness. Conclusions: Changes in personality variables that can serve as positive constructs defining mental health, namely playfulness, creativity, and honesty, might be a possible outcome of psychotherapy.

What are the specific ethical aspects of psychotherapy with patients who are themselves therapists (patient-therapists)? This chapter argues that the main difference between psychotherapy with patient-therapists and non-therapist patients is that in the former, the therapist is both the patient’s therapist and colleague. Potential multiple relationships may arise in such cases since the therapist and the patient are both members of the same professional community. In addition, therapists are faced with the challenges of maintaining boundaries between the therapeutic and other professional roles. The most complex dilemma in this situation concerns the therapist’s duty to report patient-therapists’ professional impairment, incompetency, ethical violations, or suspected illegal behavior. The authors suggest that the therapist’s primary ethical duty in this case is to the patient and that reporting should only be as a last resort. The chapter concludes with a call to professional organizations and other regulating bodies for establishing guidelines for managing such dilemmas.

The link between schizophrenia and anomalies in the distal upper limb is well documented. Preliminary studies have identified a number of biometric parameters of the hand by which schizophrenics can be distinguished from matched controls. The current study seeks to determine whether patients with schizophrenia can be singled out from a disparate group of other mental disorders by using the same parameters. We studied three groups, totaling 134 men: 51 diagnosed with schizophrenia, 29 with anxiety and mood disorders, and 54 comprising a control group. Seven parameters were studied: the proximal interphalangeal joint, the eponychia of the middle and ring digits, two dermatoglyphic features, and two constitutional factors. Examiners evaluated the parameters based on photographs and prints. An initial Mann Whitney comparison showed no significant difference between the control group and those identified with anxiety and mood disorders. We therefore accounted for them as a single group. In a discriminant analysis, an overall accuracy of 78.4% was established with a sensitivity of 80.4% (schizophrenics identified correctly) and a specificity of 77.1% (controls identified correctly). These results suggest that the biometric parameters employed may be useful in identifying patients with schizophrenia from a disparate group of other mental disorders.

This study examined changes in adolescents' internal representations of their relationship with their therapist and the extent to which these changes were related to changes in their representations of their relationship with their parents and to treatment outcomes. Method Thirty adolescents (aged 15–18 years, 70% women) undergoing psychodynamic psychotherapy participated in relationship anecdote paradigms interviews based on the core conflictual relationship theme method and completed outcome measures at the beginning of treatment and a year later. Results Adolescents' positive representations of their therapists increased throughout the year of treatment, whereas their negative representations did not change. There was an association between the development of the therapeutic relationship and improvement in the perception of the relationship with parents over the course of therapy. Increases in the level of positive representations and decreases in the level of negative representations of the therapist were associated with greater satisfaction with treatment but not with the other outcome measures. These results support the centrality of the therapeutic relationship in the process of change during adolescents' psychodynamic psychotherapy. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message The finding that positive representations of the therapist increased throughout treatment but that negative representations remained steady suggests that therapists who treat adolescents should expect and be able to hear adolescent clients' positive and negative internal representations of themselves. Therapists need to realize that although adolescents often experience negative emotions and perceptions in therapy as in other significant relationships, this does not necessarily block the development of positive emotions. The finding that changes in the representations of the therapist are associated with changes in the representations of parents is in line with psychodynamic theory, which posits that psychotherapy facilitates new interpersonal experiences and new insights through the exploration of the therapeutic relationship. Working in the ‘here and now’ may eventually impact the nature of other significant relationships, particularly with parents in the case of adolescents.

When psychoanalysis was born in Vienna at the end of the nineteenth century, the care for the institutionalized mentally ill was under the control of the medical jurisdiction. Physicians, charged w...

During 3 months in 2004, 38 recent referrals to a Community Mental Health Clinic in North Jerusalem, a substantially Ultra-Orthodox Jewish neighborhood, were evaluated by the Explanatory Model Interview Catalogue. This questionnaire, which includes a 13-item scale measuring stigma towards mental illness, was adapted and translated into Hebrew. Patients with a more religious upbringing expressed a greater sense of stigma towards mental illness; however, patients who now had a more religious affiliation did not. The 14 patients who had experienced a religious change toward a more religious affiliation reported a lower level of stigma than the 24 non-returnees. Even when controlling for religious upbringing, the partial correlation between stigma score and religious change was significant. Stigma was lower among younger but not older returnees. Findings from this study support the hypothesis that a stigma of mental illness may be a deterrent to the use of a public mental-health clinic for religious Jews in I...

The core conflictual relationship theme (CCRT) method was used in psychodynamic therapy with 10 adolescents to study change in interpersonal conflicts in the course of treatment. Relationship anecdote paradigm interviews were conducted at the beginning of therapy and before termination 8 to 9 months later. Adolescents were asked to describe 4 relationship episodes for each of the following significant others: parents, peers, and therapist. The CCRTs for the 3 relationships were different: The main wishes toward the parents were to be close and to be given independence; toward friends, to be close and to be open; and toward the therapist, to be helped and to be understood. The responses of other and self toward parents were significantly more negative than responses in other relationships. Responses of self and other in the therapeutic relationship were significantly more positive. At the end of therapy the interactions with parents were more positive, whereas those with the therapist grew more am...

The authors tracked patient progress in two cases of time-limited psychotherapy using the Rutgers Psychotherapy Progress Scale (RPPS; Spillman, 1991), which assesses in-session progress in psychodynamic therapy on six different dimensions. Two judges rated the transcripts of two female patients who were selected from the Jerusalem Short-Term Project (Shefler, Dasberg, & Ben Shakhar, 1995). The patients were treated by the same therapist, one with a successful outcome and the other with an unsuccessful outcome. Results showed that the patients differed in three dimensions on the global ratings: collaboration, clarity and vividness of speech, and emergence of significant material. The patient with the successful outcome became rapidly involved in treatment, and her RPPS scores continued to increase significantly throughout treatment. The patient with the unsuccessful outcome did not engage rapidly in treatment, and her RPPS scores dropped in the middle phase of therapy and picked up only toward ter...

The Hebrew University, IsraelABSTRACTExpert clinicians were given batteries of psychodiagnostic test results (Rorschach,TAT, Draw-A-Person, Bender-Gestalt, Wechsler) to analyze. For half, a batterycame along with a suggestion that the person su•ers from Borderline Personalitydisorder, and for half, that battery was accompanied by a suggestion that hesu•ers from Paranoid Personality disorder. In Study 1, the suggestion was madeindirectly, through a background story that preceded the test results. In Study 2,the suggestion was made directly, by the instructions given. The experts saw in thetests what they hypothesized to be there. In particular, the target diagnoses wererated higher when they were hypothesized than when they were not. #1998 JohnWiley & Sons, Ltd.

This study examined changes in adolescents' internal representations of their relationship with their therapist and the extent to which these changes were related to changes in their representations of their relationship with their parents and to treatment outcomes.Thirty adolescents (aged 15-18 years, 70% women) undergoing psychodynamic psychotherapy participated in relationship anecdote paradigms interviews based on the core conflictual relationship theme method and completed outcome measures at the beginning of treatment and a year later.Adolescents' positive representations of their therapists increased throughout the year of treatment, whereas their negative representations did not change. There was an association between the development of the therapeutic relationship and improvement in the perception of the relationship with parents over the course of therapy. Increases in the level of positive representations and decreases in the level of negative representations of the therapist were associated with greater satisfaction with treatment but not with the other outcome measures. These results support the centrality of the therapeutic relationship in the process of change during adolescents' psychodynamic psychotherapy.The finding that positive representations of the therapist increased throughout treatment but that negative representations remained steady suggests that therapists who treat adolescents should expect and be able to hear adolescent clients' positive and negative internal representations of themselves. Therapists need to realize that although adolescents often experience negative emotions and perceptions in therapy as in other significant relationships, this does not necessarily block the development of positive emotions. The finding that changes in the representations of the therapist are associated with changes in the representations of parents is in line with psychodynamic theory, which posits that psychotherapy facilitates new interpersonal experiences and new insights through the exploration of the therapeutic relationship. Working in the 'here and now' may eventually impact the nature of other significant relationships, particularly with parents in the case of adolescents.

This study explored whether and how internal representations of adolescents' relationship with their parents--a fundamental concept in psychodynamic theory--changed in the course of a year of treatment and whether the observed changes were related to changes in symptoms. Seventy two adolescents (ages 15-18; 30 in treatment and 42 in a non-treatment "community group") underwent Relationship Anecdote Paradigm (RAP) interviews according to the Core Conflictual Relationship Theme method (CCRT; Luborsky & Crits-Christoph, 1998) and completed outcome measures at two time points. A novel data-driven approach to clustering CCRT categories was used to characterize internal representations. The potential contribution of this approach to the CCRT method is discussed. The results indicate that adolescents' internal representations of their relationships with their parents changed significantly throughout treatment, and were related to changes in symptoms.

The present study examined changes in the rigidity of interpersonal patterns and symptoms in adolescents (ages 15� 18) in a year-long psychodynamic psychotherapy. Seventy-two adolescents (30 in treatment and 42 in a non-treatment ‘‘community group’’) underwent Relationship Anecdote Paradigm (RAP) interviews according to the Core Conflictual Relationship Theme method (CCRT; Luborsky & Crits-Christoph, 1998), and completed outcome measures at two time points. Results: Adolescents in the treatment group became less rigid in their interpersonal patterns and improved significantly in their symptoms, whereas no such changes were observed in the community group. Levels of rigidity were not related to initial symptom distress; however, changes in rigidity were related to improvement in symptoms within the treatment group.

In this study we combined the events approach and Strupp's design in order to conduct a systematic comparison of two cases in Mann's Time-Limited Psychotherapy (TLP). Two patients treated by the same therapist, yet resulting in divergent outcomes, were drawn from the Jerusalem Time-Limited Psychotherapy Project. A change event in TLP that begins with a “central issue” marker was identified and the client performances and therapist operations leading to successful event-outcome were described. Using the event as the unit of analysis, in-therapy event processes were rated on the Vanderbilt Psychotherapy Process Scale (VPPS). A comparison of the VPPS ratings across the three phases of treatment (initial, middle, and termination) showed a rise in patient participation in the successful case, and a decline in patient exploration in the unsuccessful case. This context-specific approach seems to yield clinically relevant findings for the practice and training of TLP therapists.

"Psychologists base the opinions contained in their recommendations, reports and diagnostic or evaluative statements including forensic testimony on information and techniques sufficient to substantiate their findings". Do expert psychodiagnosticians rely in their professional final reports on the materials and raw data obtained from test materials? How ethical are they in their professional performances? In order to answer this question, expert clinical psychologists were given batteries of psychodiagnostic tests, accompanied by one of two different types of background information, suggesting either a Borderline Personality Disorder, or a Paranoid Personality Disorder. This background information was a full and strongly suggestive story in one experiment, and a mere hypothesis in another. All conditions manifested a confirmation bias: the psychodiagnostic reports were profoundly biased by the background suggestions. The present paper focuses on a content analysis of the reports, and shows that the experts referred very little if at all to the psychodiagnostic materials they received. They were found less professional and as a result- less ethical. The ethical relevance of these findings to the teaching and training of professional psychodiagnosticians is discussed, with an emphasis on the importance of teaching students and interns in clinical psychology to base their diagnostic reports on the test data.

This presentation deals with the response of rabbis to ultra-orthodox people suffering from religious symptoms of obsessive-compulsive disorder. The symptoms are consistent with religious practice and patients justify their compulsive behaviors by the dictates of the codes of law.Will rabbis see their primary role as protection of the codes of law rather than alleviation of the suffering of the faithful? Will they see the person as someone who is meritoriously meticulous or in need of help? The writings of two eminent rabbis, and advice related by contemporary patients in Jerusalem, Israel are presented. The most arresting example of guidance is provided by Rabbi Nahman of Bratslav (1772-1810) who declared that he himself suffered from excessive religious practices typical of religious OCD until he overcame them. The accounts of rabbis and patients have features similar to the cognitive-behavioral treatment of choice for this disorder. The guidance of a rabbi is based on authority, and detailed knowledge of religious law, while a mental health therapist is an expert on OCD. The latter cannot give religious guidance, and has no authority within the ultra-orthodox community, and is only afforded a role with the rabbi's acquiescence. The role of the patient's rabbi is likely to be crucial in management. Religious guidance without professional help may often only have short-term benefit in this generally chronic condition, although studies have not been carried out.

In the era of deinstitutionalization, increasing numbers of schizophrenia patients reside and receive rehabilitational treatment within the framework of community hostels. The quality of staff-patient relationships is a crucial determinant of the rehabilitational process outcome.This study examined the characteristics of 56 schizophrenia hostel residents, measured the degree of staff criticism and rejection expressed towards these patients and assessed the contribution of residents and staff characteristics to the induction of staff rejection. Measures included assessments of patients' symptoms using the Positive and Negative Syndrome Scale (PANSS), staff attitudes using the Patient Rejection Scale (PRS), and patients' living skills using the Independent Living Skills Survey (ILSS).Young, relatively inexperienced instructors represented 60% of the hostels staff. Residents' symptoms and staff rejection levels were overall low. However, significantly increased rejection was expressed towards patients who were more symptomatic, as measured by PANSS total and positive symptoms scores and had diminished job-related and health care living skills. Staff older age and longer professional experience were correlated with higher rejection scores.Relatively small sample size and catchment area.These findings highlight the need for a better definition and understanding of schizophrenia residents selection criteria and treatment goals in community hostels. Moreover, they suggest that improvements in this area should be coupled with the provision of specialized staff training aiming at the achievement of more flexible staff attitudes. Within this framework, the PRS may serve as a practical, cost-effective tool for monitoring crucial aspects of staff-patients relationships.

Of 28 ultra-orthodox Jewish psychiatric referrals with obsessive compulsive disorder, 26 had religious symptoms, while 18 had non-religious symptoms. On average, each patient had three times more religious symptoms than non-religious symptoms. In only nine cases did the patients view their non-religious symptoms as the main difficulty, and all of these nine cases were ultra-orthodox from birth. There was no significant difference between the distress, resistance, sense of irrationality and hours spent daily of religious and non-religious symptoms. Further, there was no significant difference between the age of onset, age when felt to be a disturbance, and duration until help was sought. They were more likely to turn for help initially to a religious authority for a religious symptom and a mental health worker for a non-religious symptom. It may be concluded that the religious and non-religious symptoms of obsessive compulsive disorder in ultra-orthodox Jews are not experienced in markedly different ways by the sufferers. Two limitations to the study are the sample size, and the selection bias in that all had sought professional help, of itself likely to reflect their attitude to obsessive compulsive disorder.

This study tested the reliability and validity of Goal-Attainment Scaling (GAS) in assessing outcome in Mann's Time-Limited Psychotherapy (TLP). Judges constructed GAS scales for 33 patients on five dimensions: severity of symptoms, self-esteem, same-sex friendships, romantic relationships, and work performance. Patients in the treatment group received 12 sessions of TLP, whereas controls were in a waiting list for the same period of time (12 weeks) before starting time-limited psychotherapy. Judges rated all patients on GAS before beginning therapy, at termination, and follow-up. Mean interrater reliability of scores between pairs of judges was r = .88. Convergent validity of the GAS was confirmed by moderate to high correlations with the Health-Sickness Rating Scale (r = .70, p < .001), the Target Complaints Scale (r = .50, p