Counseling Approaches essay

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Abramson, R. (2010). Psychotherapy of psychoses: some principles for practice in the real world. The Journal Of The American Academy Of Psychoanalysis And Dynamic Psychiatry, 38(3), 483-502. Retrieved from EBSCOhost.

Abramson, R. (2010) explains that treatment of psychoses must include psychological treatments for the mind joined with the commonly employed biological treatments for the brain. There are various schools of psychotherapy, but psychoanalytic treatment is the only Western discipline devoted to comprehensive understanding of the subjective mind. Psychoanalytic authorities have written extensively on the psychodynamics involved in treatment of psychoses, but such approaches are limited by the realities of limited resources and number of therapists who have advanced training. Also, the techniques and understandings developed by prominent authors cannot always be implemented by many therapists who do not enjoy as robust a theoretic background. Presented here are five principles that are useful to keep in mind during the treatment of people with psychotic problems. These principles are: safety in the therapeutic situation, empathy as a means of understanding the patient and avoiding counter transference problems, validation in the therapeutic situation as enhancing safety and promoting ego strength in a fragile ego, being a "real person" with the patient rather than a taciturn traditional psychoanalytic "mirror," and "transmuting internalization" as the way in which the therapeutic process promotes the development of a stronger self able to live in conventional reality. These principles are easy to keep in mind and are compatible with cognitive and behavioral techniques as well as other psychoanalytic theories and approaches.

Anthony, M.M. (2011). Recent Advances in the Treatment of Anxiety Disorders. Canadian Psychology, 52(1), 1-9. doi:10.1037/a0022237

This article gives some background to the various advances that have been made in dealing with anxiety disorders. It is reported that despite the fact that evidence-based interventions exist for all of the anxiety disorders, many individuals obtain only partial relief from these treatments, and some do not benefit at all. Therefore, researchers are continually looking for ways to improve on established treatments and to better understand the factors that predict and determine who is likely to respond to which treatments.

Berghout, C., & Zevalkink, J. (2009). Clinical significance of long-term psychoanalytic treatment. Bulletin Of The Menninger Clinic, 73(1), 7-33. Retrieved from EBSCOhost.

The present study evaluated the clinical significance of long-term psychoanalytic treatment in four groups of about 60 patients in different phases of treatment (before, during, after, follow-up) with normative comparisons on four symptom questionnaires (SCL-90, BDI-II, STAI, IIP-64) and two personality assessment instruments (MMPI-2, Rorschach-CS). In each group, the proportion of patients with clinically elevated scores was calculated by comparing their scores with clinical and nonclinical reference groups for each instrument. The authors also calculated a combined percentage of clinically elevated scores based on the six instruments as a conservative estimate of improvement to nonclinical levels after long-term psychoanalytic treatment. Compared to pretreatment levels, the authors found a significant decrease in the percentage of clinical cases after treatment. For the personality assessment, these results became even more evident at follow-up. It appears that long-term psychoanalytic treatment was clinically significant for patients with chronic mental disorders. In the discussion, the authors point out that the evaluation of clinical significance at group level should be followed by an examination of individual changes over a longer period of time.

Dowd, E., Clen, S.L., & Arnold, K.D. (2010). The specialty practice of cognitive and behavioral psychology. Professional Psychology: Research and Practice, 41(1), 89-95. doi:10.1037/a0018321

Cognitive and behavioral psychology is a distinct specialty practice within professional psychology based on the application of basic learning and developmental principles, cognitive and social learning theoretical principles, or both to psychotherapeutic treatment. Defining hallmarks of the specialty include the use of interventions that have been subjected to scholarly investigation; the application of specific treatment strategies designed to modify cognitions, behaviors, or both; and the use of empirical outcome measures designed to track the impact of treatment on the client. In this article, we make the case for cognitive and behavioral psychology as a distinct and comprehensive psychological specialty devoted to therapeutic treatment. Because of practical limitations, a comprehensive review of all existing cognitive and behavioral procedures, treatment populations, and interventions is not possible, but we provide illustrative examples. We should initially note that the American Board of Professional Psychology confirmed that cognitive and behavioral psychology possessed specialty characteristics and accepted it into its family of specialties in 1992. Although there are considerable differences between the specific treatment methods used by practitioners adhering to a strict theoretical orientation (e.g., strictly behavioral vs. strictly cognitive), the cognitive and behavioral theoretical orientations have historically grown closer since the days of radical behaviorism.

Hart, S.L., & Hart, T.A. (2010). The Future of Cognitive Behavioral Interventions Within Behavioral Medicine. Journal of Cognitive Psychotherapy, 24(4), 344-353. doi:10.1891/0889-8391.24.4.344

The following article discusses that there are events when Cognitive Behavioral Therapy (CBT) may not necessarily work or be the most effective means to utilize. There are a number of limitations to the current literature on CBT in behavioral medicine. First, one shortcoming of the CBT research conducted to date (both in the psychopathology and behavioral medicine literatures is the emphasis on internal validity to the detriment of external validity. Another limitation of CBT research with behavioral medicine populations is in the shortage of data that provide support for the use of CBT to promote health behavior change. CBT does not always emphasize the role of motivation for health behavioral change; a key problem may be the lack of attention and approaches within CBT for patients who are unmotivated to change their health behaviors. The present paper will explore these current challenges for CBT within behavioral medicine, and will propose some potential solutions to these problems by examining alternative research designs and integrative treatment methodologies.

Hedman, E., Andersson, G., Ljotsson, B., Andersson, E., Ruck, C., Mortberg, E., & Lindefors, N. (2011). Internet-Based Cognitive Behavior Therapy vs. Cognitive Behavioral Group Therapy for Social Anxiety Disorder: A Randomized Controlled Non-inferiority Trial. PLoS Clinical Trials, 8(3), 1-10. doi:10.1371/journal.pone.0018001

Cognitive behavioral group therapy (CBGT) is an effective, well-established, but not widely available treatment for social anxiety disorder (SAD). Internet-based cognitive behavior therapy (ICBT) has the potential to increase availability and facilitate dissemination of therapeutic services for SAD. However, ICBT for SAD has not been directly compared with in-person treatments such as CBGT and few studies investigating ICBT have been conducted in clinical settings. Our aim was to investigate if ICBT is at least as effective as CBGT for SAD when treatments are delivered in a psychiatric setting.

Newman, M.G., Castonguay, L.G., Borkovec, T.D., Fisher, A.J., Boswell, J.F., Szkodny, L.E., & Nordberg, S.S. (2011). A randomized controlled trial of cognitive-behavioral therapy for generalized anxiety disorder with integrated techniques from emotion-focused and interpersonal therapies. Journal of Consulting and Clinical Psychology, 79(2), 171-181. doi:10.1037/a0022489

This journal article discusses how CBT is a potent intervention with significant short- and long-term impacts on a substantial percentage of clients with generalized anxiety disorder (GAD). As such, the addition of interpersonal and/or experiential interventions might be more beneficial for some individuals, for instance, those who show enough of particular types of interpersonal problems to interfere with their lives, and yet not too severe to be immune to change within a relatively short-term intervention. For clients without significant interpersonal problems, however, the addition of the same interventions might have been at best irrelevant, a possible waste of time and energy, or even a potential detraction from the benefits of the CBT (internally focused and coping oriented) segments they received before every segment of I/EP. Moreover, the exploration of emotional experience may be beneficial only for some clients. These speculations suggest that the addition of I/EP to the CBT protocol may be needed or effective for some clients, while being either no more effective than (or actually inferior to the addition of SL) for others. Future studies with the present data set are planned to investigate such aptitude by treatment interactions.

Salzer, S., Leibing, E., Jakobsen, T., Rudolf, G., Brockmann, J., Eckert, J., & ... Leichsenring, F. (2010). Patterns of interpersonal problems and their improvement in depressive and anxious patients treated with psychoanalytic therapy. Bulletin Of The Menninger Clinic, 74(4), 283-300. Retrieved from EBSCOhost.

Interpersonal relationships are prominent topics in psychoanalytic therapy. This is consistent with the fact that interpersonal problems and dissatisfaction with interpersonal relationships are very common among patients who suffer from mental disorders. In clinical practice, interpersonal problems are typically examined by analysis of transference and counter transference. However, aside from single-case analyses and case reports, interpersonal problems and the degree to which they show improvement after psychoanalytic therapy have not been examined empirically in sufficient detail. Several instruments and methods have been developed to examine different aspects of patients' interpersonal relationships, interactions, and concerns, including the structural analysis of social behavior, the core-conflictual relationship theme, and the plan formulation method.

Tizon, J. (2010). Mourning and psychosis: a psychoanalytic perspective. The International Journal Of Psycho-Analysis, 91(6), 1337-1361. doi:10.1111/j.1745-8315.2010.00282.x

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