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This commentary takes a meta-view of the articles in this module by Westerman (2021a), and by Critchfield, Dobner-Pereira and Stucker (2021a), which offer two overlapping but also different formulations of the same case. It raises the question of whether there is only one true formulation of a clinical case (correspondence theory), or whether any one of several would qualify as accurate (coherence theory). A third alternative is that the truth-value of a formulation is a function of its ability to predict which therapist interventions will most help the client (pragmatic theory). A study is described in which the relative accuracy of two different formulations of the same case was put to the test in predicting which therapist interventions led to client progress. I propose that the current authors compare the pragmatic value of their formulations in a similar manner.

Reflecting on my career as a psychotherapist has led me to consider 3 major areas that have affected the way I practice, namely, assimilative integration, the visions of reality, and brief psychodynamic therapy. Although starting out as a traditional psychoanalytic therapist, I became more integrative as I was exposed to other approaches and to patients with a variety of needs. As a result I developed a mode of integration, which I call assimilative. After applying the literary genres of tragedy, comedy, romance, and irony to psychoanalytic, behavioral, and humanistic psychotherapies, I found that they also could be used to describe any patient's multiple facets and psychological challenges. I demonstrate here how such visions helped in the treatment of a case of bipolar disorder. Upon recognizing the need for briefer forms of treatment, I developed an interest in conducting, conceptualizing, and researching brief psychodynamic therapy. I conclude the article by answering questions posed by the editors regarding how I have changed over time in conducting psychotherapy.

The focus of this article is the increasingly narrow range of therapeutic orientations represented in clinical psychology graduate training programs, particularly within the most research-oriented programs. Data on the self-reported therapeutic orientations of faculty at “clinical science” Ph.D. programs, Ph.D. programs at comprehensive universities in clinical and in counseling psychology, Psy.D. programs at comprehensive universities, and Ph.D. or Psy.D. programs at freestanding specialized institutions reveal a strong predominance of faculty with cognitive-behavioral orientations at the more science-focused programs, and a narrower range of orientations than in the more practice-focused programs. We discuss the implications of this trend for the future development of clinical psychology and provide suggestions for addressing the attendant concerns.

This commentary discusses the therapy of a trauma survivor from the perspective of psychotherapy integration. The case of Grace (Pass, 2012) illustrates the concept of assimilative integration in so far as it incorporates an expressive writing technique into Accelerated Experiential Dynamic Psychotherapy, which is itself a theoretical integration of psychodynamic and experiential approaches.

The goals of this paper are (a) to demonstrate how study of the therapeutic alliance in single cases of psychodynamic therapy can exemplify and instantiate theoretical concepts and lead to the development or refinement of psychotherapy theory, research and practice, as illustrated in the case of Ron and in Hans Strupp's classic analyses of pairs of comparable successful and unsuccessful cases; (b) to point out methodological challenges of case studies as a source of reliable and valid data; and (c) to illustrate the greater influence of clinical case studies compared to research reviews of the psychotherapy literature on the practitioner.

In this study, participants who failed to exhibit pendulum movement in response to Chevreul's Pendulum (CP) instructions had lower Stanford Hypnotic Susceptibility Scale, Form A (SHSS:A) scores and reported experiencing less subjective response to hypnosis than did their counterparts who exhibited CP movement. However, intensity scores on Shor's Personal Experiences Questionnaire (PEQ) did not differ between pass- and fail-CP groups. Additionally, pass-CP participants showed positive correlations between PEQ intensity scores and hypnotizability scores, while fail-CP participants showed negative correlations among these measures. These findings are consistent with the notion that CP failure may reflect a situation-specific unwillingness to become imaginatively involved rather than a general inability to do so. Additional analyses revealed that 5 of 10 participants who had failed the CP task scored 0 or 1 on the SHSS:A, while only 3 of 65 pass-CP participants scored 0 or 1.

Must the clinician choose between a practice that is strictly objective and data based and one that is purely subjective and experience based? Optimally, practitioners need to follow a model of evidence-based psychotherapy practice, such as the disciplined inquiry or local clinical scientist model, that encompasses a theoretical formulation, empirically supported treatments (ESTs), empirically supported therapy relationships, clinicians’ accumulated practical experience, and their clinical judgment about the case at hand. Some shortcomings of ESTs are reviewed, and a form of evidence for psychotherapy practice is presented that entails the accumulation of systematic case studies published online. Practitioners can contribute to such a database and be guided in their practice by those cases most relevant to their clients’ problems.

The real relationship in psychotherapy: The hidden foundation of change. C.J. Gelso (2011). Washington DC: American Psychological Association Press. As with most matters psychotherapeutic, it was F...

Psychoanalytic or psychodynamic therapy is a form of psychological treatment that attends to the playing out of transference and countertransference; the centrality of the therapeutic relationship or alliance as a key feature that allows therapy to progress and influences its outcome; the clarification and interpretation of resistance and defense; and the attainment of insight through the exploration of feelings, fantasies, and behavior. It can be open-ended and long term or time-limited and relatively brief. Techniques to make it briefer include a psychodynamic focus, a specified time limit, therapist activity, and goal setting. Empirical research has supported the efficacy of psychoanalytic therapy, especially the brief to medium-length varieties, for several disorders, such as depression and borderline personality disorder. Keywords: brief psychodynamic therapy; Freud, Sigmund; psychoanalytic therapy; psychotherapies; psychoanalysis; therapy

Luborsky et al.'s findings of a non-significant effect size between the outcome of different therapies reinforces earlier meta-analyses demonstrating equivalence of bonafide treatments. Such results cast doubt on the power of the medical model of psychotherapy, which posits specific treatment effects for patients with specific diagnoses. Furthermore, studies of other features of this model—such as component (dismantling) approaches, adherence to a manual, or theoretically relevant interaction effects—have shown little support for it. The preponderance of evidence points to the widespread operation of common factors such as therapist-client alliance, therapist allegiance to a theoretical orientation, and other therapist effects in determining treatment outcome. This commentary draws out the implications of these findings for psychotherapy research, practice, and policy.

The term resistance has an overly negative connotation, indicating a recalcitrant, oppositional tendency on the part of psychotherapy clients. This article emphasizes the inevitability and ubiquity of resistance and argues that it should be greeted as a therapist's friend, not as an enemy. It is the way in which clients present themselves to the world in general and to the therapist in particular. Five forms of resistance are presented, including: resistance to the recognition of feelings, fantasies, and motives; resistance to revealing feelings toward the therapist; resistance as a way of demonstrating self-sufficiency; resistance as clients' reluctance to change their behavior outside the therapy room; and resistance as a function of failure of empathy on the part of the therapist. Vignettes from the author's practice and from the cases presented in this issue are discussed in terms of these five modes of resistance and their treatment.

This article introduces the field of brief therapy and the special series on six varieties of it. The orientations covered are psychodynamic, behavioral, experiential, family/couples systems, strategic, and integrative. Most therapy conducted in the United States always has been and continues to be brief despite many clinicians' perceptions to the contrary. What allows a therapy to be time efficient, however, differs as a function of each therapy's theoretical orientation. The articles in this series focus on what features allow each therapeutic model to be short term, the techniques and theory of change it encompasses, relevant research, and likely future trends.

This issue of Journal of Psychotherapy Integration includes a set of articles that explore and apply the concept of assimilative integration. They do so from different theoretical perspectives, including psychodynamic, cognitive–behavioral, family systems, and Yogic/Buddhist, as well as from broad conceptual standpoints. The articles are followed by 3 commentaries that offer an appreciation and critique of assimilative integration and recommendations for its further development.

To be brief and effective, psychodynamic therapy relies on six features or techniques of practice. These include (a) patient selection, especially maturity of interpersonal or object relations, (b) formulation of an individualized clinical focus stated as intrapsychic conflict, maladaptive interpersonal patterns, or negative feelings about the self, (c) a deliberate time limit that adds a sense of intensity and urgency and sets in motion therapist and patient expectancies as to when change will occur, (d) active techniques of detailed inquiry, focusing, interpretation, and, in some models, confrontation, (e) emphasis on the termination stage, especially issues of separation, loss and limitations in life, and (f) goal setting, which requires setting priorities so that time is used most efficiently. This paper reviews and evaluates relevant research and presents emerging trends for future practice of brief psychodynamic therapy.

Psychotherapy is often considered to be an applied science consisting of a compendium of techniques or approaches validated by empirical research. Alternately, it is viewed as an art form requiring a creative, intuitive, and individualistic approach to clients and their problems. Psychotherapy, however, can also be regarded as a philosophically influenced practice whose underpinnings transcend its scientific, human engineering, or artistic dimensions. Keywords: psychotherapy; philosophy; philosophy of psychotherapy

The “visions of reality” refer to assumptions about the nature and content of human reality and have been used to describe different genres of literature as well as psychoanalytic, behavioral, and humanistic modes of therapy. In this paper, four visions—the tragic, romantic, comic, and ironic—are applied to a single case, spelling out the way in which each can direct the focus of a therapist's attention to different aspects of a client's problems. Each vision can also influence the process of therapy and its goals. Keeping the several visions in mind can broaden both the therapist's and the client's view of the client's life situation and problems, thereby opening up possibilities for integrative work. The paper also spells out the shift in visions of reality that is necessary when conducting brief versus long-term therapy.

This patient is enacting two chronic maladaptive patterns. In one he alternates between the role of victim and abuser while inducing the therapist to play the counterrole. He tries to master the abuse he suffered passively as a child by becoming abusive with the therapist and having her experience what it feels like to be mistreated. My effort would be to interpret this pattern even while acknowledging and absorbing some degree of his anger. In a second pattern he acts like an angry, demanding child in an effort to extract nurturance and special treatment from the therapist. I would help him explore this posture in terms of his deprived background and its maladaptiveness in his current life. Finally, I present vignettes from my own practice to demonstrate how I work with patients' anger when it is expressed indirectly rather than in Mr. P's very direct manner.

The Rutgers Psychotherapy Progress Scale (RPPS) was designed to measure goodness of client process as this concept is described in the psychoanalytic literature. The RPPS was applied to every other 5-minute block of material in the transcripts of two complete, brief (14—16 session) psychodynamic therapies that had different outcomes. The cases were 21- and 30-year-old females suffering from anxiety and relationship difficulties. The scale had adequate interrater reliability and internal consistency based on the average of 4 raters' scores. Regarding predictive validity, 6 of the 8 items and the total score were higher for the case with the better outcome. Concurrent validity was demonstrated in that 6 of the 8 items and the total score correlated as predicted with the Vanderbilt Psychotherapy Process Scale. The results were seen as providing preliminary support for the reliability and validity of a 6-item version of the scale. Die Rutgers Psychotherapy Progress Scale (RPPS) wurde entwickelt, um die Qualit...

This article aims to demonstrate the importance and inevitability of nonscientific issues in psychotherapy and psychopathology by addressing four closely related topics: the presence of a priori factors such as tacit assumptions and narrative forms; the inescapable presence of values; the way in which psychotherapy and psychopathology are partly defined by, and in turn shape, current societal and cultural outlooks; and the status of clients as agents independent of their status as objects of scientifically based healing. The way in which these factors operate is illustrated in the case of a 45-year-old woman suffering from depression, physical illnesses, and family problems. Implications for quantitative and qualitative research are suggested.

Attention to the self can take place even within the context of a brief or time-limited psychodynamically oriented therapy. The case presented here demonstrates how one can, and why one should, treat the whole person and not solely the symptoms of depression following a significant loss. The aspect of the client's sense of self that was most prominent was her need to depend excessively on her boyfriend rather than being more autonomous within a mature give-and-take relationship. She was treated in a 12-session time-limited therapy developed by James Mann that deals with the human inevitability of experiencing significant interpersonal separations and losses. In line with this model, the therapy focused on the client's chronically endured emotional pain, employing an empathic, exploratory, and interpretive style. The termination stage of therapy allowed the client to reexperience feelings of loss and separation with the opportunity to come to terms with them in a new, more constructive way. © 1997 John Wiley & Sons, Inc.

This article critiques major trends in the psychotherapy integration movement from the postmodern perspectives of contextualism and pluralism. A contextualist position asserts that psychotherapeutic concepts and interventions can be understood only within the linguistic, theoretical, and ideological frameworks in which they are embedded. Therefore, they take on new meanings when extracted from their original context and are incorporated into an eclectic therapy. Pluralism holds that there is no single theoretical, epistemological, or methodological approach that is preeminent and no one, correct integrative system toward which the field of psychotherapy is evolving. In light of this critique, we argue that the goal of the integration movement should be to maintain an ongoing dialogue among proponents of different theories and world views, thereby allowing for the clarification of differences as well as the judicious Integration of alternative perspectives and techniques. The article also spells out the implications of contextualism and pluralism for psychotherapy theory, practice, and research.

Excerpts of therapist-patient dialogue are presented to demonstrate three important elements of a successful session of psychodynamic therapy. These are the provision of insight through the use of transference, a focus on patient affect, and the therapist's attention to aspects of the therapeutic alliance. The article, in addition to explicating the clinical process in psychodynamic therapy, gives a theoretical explanation for the emphasis on each of these three elements and provides research support for their application.

The term resistance has an overly negative connotation, indicating a recalcitrant, oppositional tendency on the part of psychotherapy clients. This article emphasizes the inevitability and ubiquity of resistance and argues that it should be greeted as a therapist's friend, not enemy. It is the way that clients present themselves to the world in general and to the therapist in particular. Five forms of resistance are presented including: resistance to the recognition of feelings, fantasies, and motives; resistance to revealing feelings toward the therapist; as a way of demonstrating self-sufficiency; as clients' reluctance to change their behavior outside the therapy room; and resistance as a function of failure of empathy on the part of the therapist. Vignettes from the author's practice and from the cases presented in this issue are discussed in terms of these five modes of resistance and their treatment. © 1996 John Wiley & Sons, Inc.

To unify or not to unify applied psychology: that is the question. In this article we review pendulum swings in the historical efforts to answer this question���from a comprehensive, positivist, ���top-down,��� deductive yes between the 1930s and the early 60s, to a postmodern no since then. A rationale and proposal for a limited, ���bottom-up,��� inductive yes in applied psychology is then presented, employing a case-based paradigm that integrates both positivist and postmodern themes and components. This paradigm is labeled ���pragmatic psychology��� and, its specific use of case studies, the ���Pragmatic Case Study Method��� (���PCS Method���). We call for the creation of peer-reviewed journal-databases of pragmatic case studies as a foundational source of unifying applied knowledge in our discipline. As one example, the potential of the PCS Method for unifying different angles of theoretical regard is illustrated in an area of applied psychology, psychotherapy, via the case of Mrs. B. The article then turns to the broader historical and epistemological arguments for the unifying nature of the PCS Method in both applied and basic psychology.

This study tested the reliability of the Plan Compatibility of Intervention Scale (PCIS) and its ability to predict patient progress within two different psychodynamic Plans or formulations: Cognit...

Brief therapy is by far the most frequently employed kind of therapy in the United States, with fewer than 10% of clients receiving more than 20 sessions. Brief and effective therapy typically relies on six features or techniques of practice: (1) client selection, (2) formulation of an individualized clinical focus, (3) a deliberate time limit (or sensitivity to time) that sets in motion therapist and patient expectancies as to when change will occur, (4) active techniques, (5) attention to the termination stage, and (6) goal setting that requires setting priorities so that time is used efficiently. This chapter describes six brief therapies, each stemming from a different theoretical tradition: psychodynamic, cognitive-behavioral, couple/family systems, experiential, strategic, and integrative. The models are described under the following headings: Historical Introduction, Selection Criteria (including diagnosis, problems treated, and focus), Techniques of the Therapy, Theory of Change, Supporting Research, and Current Trends and Future Directions. In general, there is good empirical support for several of the therapies covered. One current prominent trend in the field of brief therapy, as in the field of psychotherapy in general, is the integration of techniques drawn from one therapy and assimilated into another. Keywords: brief therapy; short-term therapy; time-limited therapy; focus; goal-oriented

After 5 years of conceptualizing, investigating, and writing about corrective experiences (CEs), we (the authors of this chapter) met to talk about what we learned. In this chapter, we summarize our joint understanding of (a) the definition of CEs; (b) the contexts in which CEs occur; (c) client, therapist, and external factors that facilitate CEs; (d) the consequences of CEs; and (e) ideas for future theoretical, clinical, empirical, and training directions. As will become evident, the authors of this chapter, who represent a range of theoretical orientations, reached consensus on some CE-related topics but encountered controversy and lively debate about other topics. (PsycINFO Database Record (c) 2013 APA, all rights reserved)

To cope with the current diversity and centrifugal trends in our field, the National Conference on Graduate Education in Psychology recently proposed that each department and school of psychology conduct a self-study to clarify its goals, values, and curricular emphases. This article provides a blueprint to enable programs in any area of applied or professional psychology to engage in such a process of intensive self-scrutiny. The model adopted is based chiefly on four features of organizational development: open systems theory, the distinction between process and task emphases, democratic values, and action research. A case example is provided to illustrate how application of the model helps to insure the active collaboration of faculty, students, and alumni, resulting in a ready acceptance and implementation of recommended curricular changes.

Lazarus sostiene que los esfuerzos de integración de las psicoterapias a nivel teórico han fomentado una desafortunada proliferación de enfoques que rivalizan entre ellos, similar a la que ya existía entre las escuelas de psicoterapia no-integradoras tradicionales. Messer considera que este florecimiento de teorías integradoras es inevitable, e incluso deseable, y es consistente con una visión construccionista social de la realidad. Lazarus aboga por el eclecticismo técnico, regido más por observaciones que por teorías, como alternativa a la integración teórica. Este autor considera útil aprovechar técnicas validadas en distintos marcos de referencia. Messer argumenta que las observaciones están cargadas necesariamente de contenido teórico, y que las técnicas importadas de otras escuelas de terapia son asimiladas y modificadas por el nuevo contexto clínico y teórico en que son empleadas, por lo que debieran ser validadas de nuevo.

This paper illustrates the application of an adjudicated form of Hermeneutic Single Case Efficacy Design (HSCED), a critical-reflective method for inferring change and therapeutic influence in single therapy cases. The client was a 61 year-old European-American male diagnosed with panic and bridge phobia. He was seen for 23 sessions of individual Process-Experiential/Emotion-Focused Therapy. In this study, affirmative and skeptic teams of researchers developed opposing arguments regarding whether the client changed over therapy and whether therapy was responsible for these changes. Three judges representing different theoretical orientations then assessed data and arguments, rendering judgments in favor of the affirmative side. We discuss clinical implications and recommendations for the future interpretive case study research.

This study tested (a) the reliability and stability of the Mt. Zion Plan Formulation Method (PFM), a system for deriving psychodynamic formulations, when applied in a new setting, and (b) PFM's adaptability to a different theoretical perspective. Five Rutgers University clinicians were trained in using PFM in conjunction with Fairbairnian object relations theory, which stresses dependency and separation anxiety as central dynamic issues, rather than Mt. Zion's cognitive-psychoanalytic theory, which emphasizes guilt over leaving or surpassing others