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At least 19 recordsLinked to original sources
PubMed2000

Psychotherapy for bulimia nervosa and binging.

OBJECTIVES: The review aims to evaluate the psychotherapeutic treatments for those with binge eating syndromes, that have been tested in randomised controlled trials. Specifically, cognitive-behavioural(CBT) therapy is compared with waiting list or a non-treatment group, any other psychotherapy, CBT in a "pure self-help" form and CBT augmented by exposure and response therapy. As well, the reveiw aims to evaluate the evidence for the efficacy of other psychotherapies when compared to a no treatment control group and to evaluate the evidence for the efficacy of other psychotherapies when compared to a 'placebo' therapy. SEARCH STRATEGY: Handsearch of The International Journal of Eating Disorders since its first issue; database searches of MEDLINE, EXTRAMED, EMBASE, PSYCHLIT, CURRENT CONTENTS, LILACS, SCISEARCH, The Cochrane Collaboration Controlled Trials Register and the Cochrane Depression, Anxiety and Neurosis Group Database of Trials; citation list searching and personal approaches to authors communication are used. SELECTION CRITERIA: All studies that have tested any form of psychotherapy for adult patients with non-purging bulimia nervosa, binge eating disorder and/or EDNOS of a bulimic type, and which have applied a randomised controlled and standardized outcome methodology, are sought for the purpose of this review. DATA COLLECTION AND ANALYSIS: Data are entered into a spreadsheet programme, and into the REVMAN analysis program. Relative risk analyses are conducted of binary outcome data. The relative risk analysis is used rather than the odds ratio as the outcome measures proposed are not measuring a rare event (such as death) and the total number of studies is small. Standardized mean difference analyses are conducted of continuous variable outcome data, as the continuous outcome measures are not consistent across studies. Sensitivity analyses are conducted of a number of measures of trial quality. Data were not reported in such a way to do subgroup analyses, but the effect of treatment on depressive symptoms, psychosocial and/or interpersonal functioning, general psychiatric symptoms and weight is examined where possible. Chi-square tests for homogeneity are done, @ 5% level of significance, using a fixed effects model. Funnel plots to evaluate presence of publication bias are completed and available in a text file upon request. MAIN RESULTS: To date, 1360 trials have been generated by searching and 58 trials have been evaluated in detail. Because of a relatively high number of exclusions (n=12) the trial inclusion criteria were broadened to include those with non-blinded outcome assessment, providing 20 trials for analyses. Because of incomplete published and available data, at best up to 10 studies had data available for any single analysis. The maximum number of total patients included in a single analysis is 396. The majority of studies (18) evaluate patients with bulimia nervosa of a purging type. CBT is superior to waiting list controls with respect to abstinence from binge eating (RR 0.64 CI.53-.78). CBT is not superior to other psychotherapies with respect to abstinence from binge eating (RR.79, CI.54-1.17). CBT in a full or less intensive form is not significantly superior to CBT in a pure self-help form. Augmentation of CBT with exposure therapy is not more effective than CBT alone. NonCBT-psychotherapies also have significantly greater abstinence rates in comparisons with wait-list controls, but there is a paucity of such studies (RR 0.67, CI.56-.81, n=3 studies). Funnel plots suggest a bias towards publication of positive outcome studies only. REVIEWER'S CONCLUSIONS: There is small body of evidence for the efficacy of cognitive-behaviour therapy in bulimia nervosa and similar syndromes, but the quality of trials is very variable (e.g. the majority, 12, are not blinded) and sample sizes are often very small. More trials are needed, particularly for binge eating disorder and other EDNOS syndromes, and evalu

Adult↗
PubMed1995

[How can acceptance by psychiatric patients of group psychotherapy be improved? An empirical study of the effect of combined individual and group psychotherapy on attitude to group psychotherapy].

This study investigates whether the sceptic attitude of many psychiatric patients to group therapy can be improved by a combined individual and group therapy program. The investigation was made on 50 patients, most of them with neurotic disorders, partly with secondary alcohol or substance abuse as well as some schizophrenic patients. Before admittance to the psychotherapy program enquiries were made by means of a questionnaire, about what subject they would like to speak in the individual or group therapy sessions. The results differ significantly dependent on sociodemographic and illness related factors. A second examination after discharge reveals an ameliorated attitude concerning group therapy in nearly all central themes. Thus, one of the important goals of in-patient psychotherapy has been achieved to improve patients ability to receive out-patient group therapy.

Adult↗
PubMed1996

[Body-centered psychotherapy IKP (Institute of Body-Centered Psychotherapy): holistic psychotherapy].

Body centered Psychotherapy IKP is treated in this article under the aspect of a holistic approach. First the theory and the system of science are summarised and shown as to which amount they are changing concerning knowledge of details and wholeness. It is pointed out that the actual paradigma "to the depth" has to be completed by that of "wideness". The way of holistic-multirelational thinking, stating a diagnosis and doing therapy is demonstrated along a case study going on at the background of a therapeutic encounter-relationship which is emotionally warm (Gestalt-approach).

Adaptation, Psychological↗
PubMed2000

Individual psychodynamic psychotherapy and psychoanalysis for schizophrenia and severe mental illness.

BACKGROUND: People with schizophrenia and severe mental illness may need much support from health care professionals, in most cases over a long period of time. Research on the effects of psychotherapy for schizophrenia shows mixed results. Although pharmacological interventions remain the treatment of choice for schizophrenia patients, it is also of interest to look at the effects of treatment methods focusing on psychosocial factors affecting schizophrenia. OBJECTIVES: To review the effects of individual psychodynamic psychotherapy and/or psychoanalysis for people with schizophrenia or severe mental illness. SEARCH STRATEGY: Electronic searches of Biological Abstracts (1985-1999), CINAHL (1982-1999), The Cochrane Library CENTRAL (Issue 1, 1999), The Cochrane Schizophrenia Group's Register (1999), Dissertation Abstracts On disc (1866-1999), EMBASE (1980-1999), MEDLINE (1966-1999), PsycLIT (1974-1999), and Sociofile (1974-1998) were made. Authors of included trials were contacted for information on further trials. SELECTION CRITERIA: All randomised trials of individual psychodynamic psychotherapy or psychoanalysis for people with schizophrenia or severe mental illness (however defined) were selected. DATA COLLECTION AND ANALYSIS: Data were independently extracted by at least two reviewers. For dichotomous data relative risks (RR) were calculated and for continuous data weighted mean differences (WMD) between groups were calculated. MAIN RESULTS: No trials of a psychoanalytic approach were identified. Data are sparse for all comparisons involving a psychodynamic approach. There is no evidence of any positive effect of psychodynamic therapy and the possibility of adverse effects seems never to have been considered. The psychodynamic approach may be more acceptable to people than a more cognitive reality-adaptive therapy. REVIEWER'S CONCLUSIONS: Current data do not support the use of psychodynamic psychotherapy techniques for hospitalised people with schizophrenia. If psychoanalytic therapy is being used for people with schizophrenia there is an urgent need for trials.

Humans↗
PubMed1978

Paul Schilder and group psychotherapy: the development of psychoanalytic group psychotherapy.

Group Psychotherapy began in 1905 with Pratt who assembled tuberculosis patients for a class treatment. Application of psychoanalytic concepts to group psychotherapy varied from Pratt's rejection of Freud and psychoanalysis to Louis Wender's descriptive and educational use of psychoanalysis in his group psychotherapy in 1936. At about the same time (1936) Paul Schilder actually interpreted the resistance, transferences, and dreams in his group psychotherapy sessions. Accordingly, Schilder would have to be recognized as the first to conduct a psychoanalytic group psychotherapy. Schilder's many contributions to group psychotherapy appeared in a few papers written before 1941. Precursors of current mainstream group psychotherapy can be found in them and they are still used as references.

History, 20th Century↗
PubMed1980

Teaching psychotherapy. Learning objectives in individual psychotherapy.

This paper constitutes an initial attempt to establish specific end-point objectives for the teaching (and learning) of individual psychotherapy skills. A working framework for teaching psychotherapy, which includes intrapsychic as well as interactional phenomena, is articulated. The framework also tries to achieve an integration of basic concepts of psychotherapy and specific skills for clinical practice. It draws on concepts derived from communication theory, psychoanalytic theory, adaptational theory (ego theory), learning theory, and transactional theory. In presenting these objectives three classes of skills are articulated: perceptual, conceptual, and executive. The end-point objectives are discribed for the following categories: 1) therapeutic stance, 2) history and mental status, 3) models and concepts, 4) communication channels, 5) patient's affect, 6) therapist's affect, 7) acceptance of affect, 8) interpretation, 9) transactions and 10) reinforcement and adaptation. This framework is truly eclectic in nature and effects a healthy compromise between the technique oriented "ABC's of psychotherapy" school and proponents of the view that psychotherapy is an art that cannot be taught. By drawing from more than one model it encourages the student to recognize early the distinction between theoretical formulation and ideological commitment in psychotherapy. It presents these objectives in the form of an instrument that can, with continuous refinement and testing, be used to evaluate student's progress in a psychotherapy training program.

Affect↗
PubMed1998

Psychotherapy--an active agent: assessing the effectiveness of psychotherapy and its curative factors.

In the last two decades there has been a remarkable expansion in research on psychotherapy in two areas: (a) assessing the effectiveness of psychotherapy compared to wait-list, no-treatment patient groups and groups treated with pharmacotherapy; (b) investigating curative factors in the therapeutic process: the extent of the psychotherapist's experience and kinds of interventions and errors in handling techniques. The first section of the review deals with the first of these areas and the second with the other. The following are the main research findings: 1. The effectiveness of psychotherapy compared to wait-list and non-treatment groups has been proven by so many research papers that there is hardly any need t do so again; 2. Psychotherapy was found to be effective in treating focused psychiatric disorders such as OCD, depression and anxiety disorders (with preference to cognitive-behavioral approaches) over psychodynamic approaches, and in some instances in preference to pharmacotherapy). Psychotherapy was also effective in less focused disorders, such as personality disorders and mixed neurotics (with preference to psychodynamic approaches over cognitive-behavioral approaches); 3. The advantages of patients receiving psychotherapy over those who did not receive it persisted in follow-up studies of one year's duration or more; 4. Psychotherapy was more effective than "psychotherapeutic placebo" (the encounter between therapist and patient where systematic psychotherapeutic work using one out of the three main psychotherapeutic approaches is experimentally prevented), which in turn was more effective than wait-list or non-treatment groups; 5. Psychotherapeutic maintenance of one session a month was effective in preventing relapse; 6. Experienced psychotherapists are more effective than beginners; 7. Empathy, the ability to identify the central thread of the session, and encouragement of the patient to reflect were found to be the key factors in techniques most associated with therapeutic success.

Combined Modality Therapy↗
PubMed1992

The impact of culture on psychotherapy: Korean clients' expectations in psychotherapy.

The impact of culture on clients' expectations for psychotherapy has not been adequately studied. This is the first study to explore Korean clients' expectations in psychotherapy. A 120-item instrument was used to collect data on expectations for psychotherapy held by 25 Korean clients of the Asian Mental Health Clinic. Six hypotheses regarding expectations for therapist's discipline, characteristics, techniques, goals, and roles in psychotherapy were examined. The findings indicate that the model that Koreans have for a psychotherapeutic relationship is similar to the special teacher-disciple relationship in Korea. The study demonstrated that psychiatric nurses are held in high regard by Korean clients. Education of Koreans to Western psychotherapy concepts and procedures is essential. Recommendations were made for different treatment modalities integrating Western concepts of psychotherapy with Korean cultural concepts of mental health.

Community Mental Health Services↗
PubMed2000

Varieties of long-term outcome among patients in psychoanalysis and long-term psychotherapy. A review of findings in the Stockholm Outcome of Psychoanalysis and Psychotherapy Project (STOPP).

This paper reports the main findings of a large-scale study of subsidized psychoanalysis and long-term psychotherapy. More than 400 people in various phases, before, during and after subsidized psychoanalysis or long-term psychodynamic psychotherapy, were followed up for a period of three years with personal interviews, questionnaires and official statistics. Our analyses revealed progressive improvement the longer patients were in treatment--impressively strong among patients in psychoanalysis--on self-rating measures of symptom distress and morale. Improvement, however, was equally weak in both groups on a self-rating measure of social relations. Dosage factors (treatment duration and session frequency in combination) partly accounted for the outcome differences between those referred to psychoanalysis and those referred to long-term psychotherapy. Attitudes and ideals among therapists and analysts concerning the goals and means of psychotherapy were also associated with patient outcome, although in rather complex ways. A significant part of the outcome differences between patients in psychoanalysis and in psychotherapy could be explained by the adoption, in a large group of therapists, of orthodox psychoanalytic attitudes that seemed to be counterproductive in the practice of psychotherapy but not in psychoanalysis. It is suggested that this effect may be a negative transfer of the psychoanalytic stance into psychotherapeutic practice and that this may be especially pronounced when the attitudes are not backed up by psychoanalytic training.

Adult↗
PubMedDate not supplied

[Long-term effects of inpatient psychotherapy: explanatory and transfer forms of the psychotherapy experience into everyday life].

We describe the longterm effects of inpatient psychotherapy based on biographic interviews with 46 ex-patients two years after their treatment in a psychotherapy ward which is part of a psychiatric hospital. The concept of the treatment is based on cognitive behavior therapy. In a structural hermeneutic analysis of the interviews we found 4 different types of dealing with the experience of psychic disorder and psychological treatment and, combined with it, transfer of the knowledge about psychological disorder and treatment into everyday life: 1 the "development"-type-psychotherapy as a method to reframe the individual development. 2 the "deficit"-type-psychotherapy as a system to learn how to deal with individual deficits, 3 the "deviance"-type-psychotherapy as an instrument to renormalize deviation, 4 the "overburden"-type-psychotherapy as a private area to recover and regenerate.

Adaptation, Psychological↗
PubMed1997

Treatment of major depression with psychotherapy or psychotherapy-pharmacotherapy combinations.

BACKGROUND: Few reliable correlates of treatment response in depression have emerged despite nearly 40 years of research. We examined the correlates of recovery in a "mega-analysis," or meta-analysis of original data, of 595 patients with major depressive disorder enrolled in 6 standardized treatment protocols. METHODS: All patients (mean age, 44 years; 31% male and 69% female) met criteria for nonbipolar, nonpsychotic primary major depressive disorder and were treated for 16 weeks with either cognitive behavior therapy or interpersonal psychotherapy alone (psychotherapy alone; n = 243) or interpersonal psychotherapy plus antidepressant pharmacotherapy (combined therapy; n = 352). The impact of treatment type, severity, study, and other covariates on recovery rates or time to recovery were examined by means of chi 2, log-rank tests, the Cox proportional hazards model, and sensitivity analyses. RESULTS: Whereas combined therapy was not significantly more effective than psychotherapy alone in milder depressions, a highly significant advantage was observed in more severe recurrent depressions. Poorer outcomes were also observed in women and older patients, although these effects were dependent on inclusion of particular studies. CONCLUSIONS: Mega-analysis is a powerful method for comparing the efficacy of treatments and examining correlates of response. Using this method, we found new evidence in support of the widespread clinical impression that combined therapy is superior to psychotherapy alone for treatment of more severe, recurrent depressions.

Adult↗
PubMed1999

[Influence of psychotherapy motivation on the course of psychotherapy].

The motivational characteristics of psychotherapy inpatients should be of crucial importance for treatment effectiveness. In the present study on 219 patients from two psychosomatic-psychotherapeutic treatment centers, four dimensions of motivation for psychotherapy (illness experience; lay etiology; treatment expectations; openness to psychotherapy) were assessed using the Questionnaire for the Measurement of Psychotherapy Motivation (Fragebogen zur Messung der Psychotherapiemotivation; FMP) and related to pre-post changes in symptomatology. In these analyses, psychological symptoms (SCL-90-R) as well as interpersonal problems (IIP) were considered as indicators of treatment effects. The results support the expectation that (a) a psychosocial causal attribution of illness symptoms and (b) a marked general openness to psychotherapy at the pretreatment interview predict more positive treatment outcomes. Implications of the results for the indication of pretreatment interventions are discussed.

Adolescent↗
PubMed2001

[How myths and prejudices about psychotherapy hamper the ongoing process of psychotherapy-integration].

Some frequently encountered myths and prejudices about psychotherapy are addressed, which severely hamper the integration of different forms of psychotherapy. Discrepant positions and polarities can be described as (a) individualized problem analysis vs. standardized disorder specific treatment planning, (b) one-sided pay attention to deficits vs. one sided take into consideration resources and coping-styles, (c) therapeutic technique vs. therapeutic alliance, and (d) biographical analysis vs. analysis of current life circumstances. The attempt to create balance between these biased polarities and perspectives is considered to be characteristic of modern psychotherapy approaches. Only research strategies including an encompassing perspective, a disorder specific as well as a comparative approach to study the different effects of different schools of psychotherapy will provide answers to the fundamental questions of present psychotherapy research.

Humans↗