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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↗
PubMed2004

[Predictors of successful psychotherapy referral in a psychotherapy outpatient clinic and subsequent psychotherapeutic outcome].

OBJECTIVES: Many patients are referred to psychotherapy by outpatient units of psychiatric hospital departments. This study investigates predictors of success and outcome of subsequent psychotherapy in this group of patients. METHODS: Two years after referral, 140 out of an initial sample of 215 patients of a psychotherapy outpatient unit were followed up by means of a telephone interview and questionnaires (GHQ, IIP). In addition, their therapists were interviewed. RESULTS: 57.1% of the patients actually began psychotherapy; of these, 67.5% completed or were continuing the treatment. Predictors of referral success were younger age, female gender, higher levels of depression, a less competitive, subassertive, nurturant, and expressive personality style, and a preexisting high motivation for psychotherapy. In the total sample of 140 patients there was a significant improvement of psychopathology (0.54 < d < 0.99), interpersonal problems (0.25 < d < 0.33), and subjective experience of symptoms (d = 0.26). Patients who began psychotherapy did not show a significantly better outcome after two years compared to those who were non-compliant. CONCLUSIONS: Randomized-controlled studies are not comparable to regular outpatient treatment. Patients who did not begin psychotherapy despite referral might have been stabilized by the initial brief intervention they received at the psychotherapy outpatient unit, and consequently did not feel the need for any additional psychotherapy. This group of patients should be identified before being referred and offered a short-term psychotherapy at the outpatient unit.

Adult↗
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↗
PubMedDate not supplied

[Psychotherapy service utilization and psychotherapy motivation in a representative community sample of the elderly -- results of the zurich older age study].

OBJECTIVE: To study the extent of real and potential psychotherapy service utilization in the older (65 - 96) population. METHOD: We used the Zurich Older Age Study on PTSD, complicated grief and depressive disorders which consists of a random sample of 712 older adults based on a two-stage screening design. Utilization of psychotherapy was assessed by a checklist on service utilization for psychological problems/disorders. Potential psychotherapy motivation was assessed by means of a validated Questionnaire on Psychotherapy Motivation (FPTM-23). RESULTS: Around 5 % indicated to have used psychotherapy since age 65 (either alone or in combination with pharmacological treatment) and 10 % of participants indicated use of any therapeutic treatment for psychological problems with women twice as frequent as men. Potential psychotherapy motivation was medium highly pronounced and varied only slightly between the sexes. Predictors of high psychotherapy motivation are the extent of suffering as well as the absence of rejection of psychological need for assistance. DISCUSSION: The frequency numbers of psychotherapy service utilization and motivation indicate their moderate extents in old age. Limitations of the study are discussed, e. g., the possibly higher density of service providers in an urban population like the city of Zurich.

Age Factors↗
PubMed2004

Testing psychodynamic psychotherapy skills among psychiatric residents: the psychodynamic psychotherapy competency test.

OBJECTIVE: Training in psychodynamic psychotherapy remains a core requirement of psychiatric residency training programs, yet no standard measures of competency exist to document residents' knowledge and skills in this area. To address this issue, the authors developed a written test of applied knowledge of psychodynamic psychotherapy technique and theory, the Psychodynamic Psychotherapy Competency Test. Their goal in this article was to evaluate the validity of this test. METHOD: The test was given to a group of 36 psychoanalytic experts and 206 residents in their second, third, and fourth psychiatric postgraduate years from 10 programs located in different parts of the United States. Program directors provided information on the number of hours of psychodynamic didactic teaching, supervision, and resident-conducted psychodynamic psychotherapy and rated the psychodynamic psychotherapy skills of residents in their fourth postgraduate year on the basis of cumulative supervisor reports. RESULTS: There were significant differences in test performance between residents and faculty experts and between residents in their second and fourth postgraduate years: more advanced residents and experts had progressively better scores. The mean scores of fourth-year residents in different programs differed significantly, but the scores of second-year residents did not. Higher test scores were positively associated with both number of hours of resident-conducted psychotherapy and number of hours of supervision. Among fourth-year residents, test scores correlated significantly with program director evaluations. CONCLUSIONS: This initial study supports the validity of the Psychodynamic Psychotherapy Competency Test as well as the feasibility of testing psychotherapy skills in a standardized fashion.

Adult↗
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↗
PubMed2004

Implications of psychotherapy research for psychotherapy training.

This review article considers implications of psychotherapy research for psychotherapy training. It considers 8 themes that characterize the research literature. The themes involve outcome findings, common factors, empirically supported therapies, patient treatment matches, therapy manuals and practice guidelines, brief therapies, combinations of medication and psychotherapy, and group therapies. Each theme represents a controversial issue that has implications for the content of contemporary psychotherapy curricula. To assist trainees in becoming well-informed therapists, themes and implications such as these should be covered as part of their introduction to learning about the psychotherapies. To understand the themes and implications, as well as new findings that continually emerge from the research literature, trainees also need to be familiar with basic research methods and evaluative criteria, subjects that can also be covered as part of their introduction to the psychotherapies. As their training proceeds, research findings can be integrated with the development of their clinical skills in a broad range of psychotherapies.

Education↗
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↗
PubMed2004

Effect of psychotherapy and relaxation on the psychosocial and somatic course of Crohn's disease: main results of the German Prospective Multicenter Psychotherapy Treatment study on Crohn's Disease.

OBJECTIVE: Few studies have been published on the influence of psychotherapy on the physical and psychosocial course of Crohn's disease (CD). METHODS: The present study, a prospective, randomized multicenter investigation conducted with 108 of 488 consecutive CD patients, was designed to investigate the influence of short-term psychodynamic therapy and relaxation in addition to a standardized glucocorticoid therapy on the somatic course of the disease as well as on patient psychosocial status. Based on the same standardized somatic treatment, the psychotherapy and control groups were compared after a 1-year treatment period and a follow-up of another year with regard to somatic course and psychosocial situation. RESULTS: A total of 81 (75%) of 108 randomized patients completed the psychosocial follow-up. The comparison between the therapy groups after 1 year showed no significant differences in the four main target criteria of psychosocial status (depression, anxiety, psychosocial-communicative status and health-related quality of life). The mean Beck's Depression Inventory (BDI) score at admission was 12.3 in the psychotherapy group and 8.7 in the control group. At the 1-year follow-up, the scores for depression have been 7.8 (psychotherapy group) and 7.8 (control group). In the 2-year follow-up, 84 patients were classified into four groups on the basis of somatic course; 23% of the control group and 30% of the psychotherapy group showed episode-free courses, 29% and 17% respectively underwent surgery due to failure of immunosuppressive or medical therapy, and a further subranking showed no significant differences between the two groups (P=.125). At the 1-year follow-up, the scores for depression of patients with an active episode respective remission were 14.6 vs. 5.8. From the patient's point of view, at the end of the 2-year follow-up, the overall subjective evaluation of the effectiveness of psychotherapy was positive. CONCLUSION: The patients included showed no psychosocial disturbances of clinical relevance. Although a tendency toward fewer surgical interventions, fewer relapses and reduction of depression was noted, the analysis was unable to demonstrate any benefit from psychosocial intervention on hypothesized parameters of psychosocial status and somatic course. Further studies should be performed to identify patient subgroups that may benefit from psychosocial intervention.

Adult↗