Contemporary Psychotherapy

In Memoriam: Abraham W. Wolf, Ph.D.

David H. Rosmarin: Spirituality, Religion, Cognitive-Behavioral Therapy: A Guide for Clinicians

David A. Treleaven, Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing

Comparing Metacognition and Mentalization and Their Implications for Psychotherapy for Individuals with Psychosis Abstract Over the past couple of decades, researchers have investigated the relationship between psychosis and social cognitive deficits and how these deficits might be targets for psychosocial treatments. Two important constructs related to social cognition are metacognition and mentalization, which have been developed into distinct therapeutic models for individuals with psychosis. Though metacognition and mentalization are conceptually similar, this review aims to provide a clearer delineation of each term by reviewing the definition and the application to the treatment of individuals with psychosis. We examined key theoretical papers, case studies, and clinical trials on mentalization and metacognition. Metacognition and mentalization share much in common though subtle conceptual distinction reveal key differences theoretically that have therapeutic implications. While emerging from divergent intellectual traditions, mentalization and metacognition complement one another and more trials are needed to examine the technical differences between these therapeutic approaches and the possibilities for both theoretical and technical integration.

Successful Treatment of Halitophobia with Cognitive Behavioural Therapy: A Case Study Abstract Halitophobia is a condition characterized by an excessive preoccupation with the belief of having halitosis. Cognitive Behavioural Therapy (CBT) was successfully used to treat a man in his 20 s who presented with important anxiety, avoidance and safety behaviours, isolation, and depressed mood. Progressive in-vivo exposure to fearful situations with the systematic prevention of avoidance and safety behaviours resulted in a significant improvement in the patient's anxiety and depression levels. This case suggests that CBT techniques, usually performed in anxiety disorders and in obsessive–compulsive disorder, can be adapted to halitophobia.

Expanding the Conceptualization of Outcome and Clinical Effectiveness Abstract There is a need for studies that advance our knowledge of therapist effectiveness, expanding the definition of what constitutes therapeutic success. In the present study, four aspects of clinical outcome were analyzed using a sample of highly experienced psychotherapists (mean years of experience as therapy practitioners = 30) who also serve as clinical teachers. The four aspects were: (1) overall change in different outcome domains, including long-term outcome; (2) outcome with clinically distressed clients (i.e. clients above the level of clinical disturbance at pretreatment); (3) level of drop-out; and (4) the degree to which clients re-entered treatment during the follow-up period. Participants were 48 clients treated by 18 therapists. Treatments were open-ended, 'therapy as usual', mostly within the setting of independent private practice. Outcome measurements included the OQ-45.2 and IIP-64, with repeated measurements during therapy and extended long-term follow up (up to 3.5 years). Cohen's d effect sizes and multilevel growth trajectories were estimated for patient change in symptomatic and interpersonal distress. The findings indicate that these therapists obtain very good outcomes overall, particularly with clients above cut-off for clinical disturbance. Moreover, there was a high level of maintenance and increase of treatment gains over time. No clients dropped out. Overall, the findings suggest that a sample of highly experienced therapists obtains particularly good outcomes as defined in more comprehensive terms than what is typical in psychotherapy research. Implications for the understanding of therapeutic success and clinical expertise are discussed.

Family-Based Treatment for Pediatric Obesity: Case Study of an Adaptation for a Non-Psychiatric Adolescent Population Abstract Pediatric overweight and obesity, a highly prevalent condition posing risks extending into adulthood, is considered a major public health concern. Findings from the pediatric obesity treatment literature support the efficacy of parental involvement across multiple formats. Family-based treatment is an outpatient intervention for adolescents with eating disorders that enlists parents as the primary agents of symptom management during the acute stages of illness, titrating down their involvement as severity of the disorder decreases. We adapted family-based treatment for pediatric obesity, modifying the original model to recognize that children and adolescents with obesity do not exhibit the developmental regression seen in eating disorders and to reflect the non-psychiatric nature of obesity. Thus, family-based treatment for pediatric obesity modulates the degree of parental involvement as a function of chronological developmental stage, not severity of the condition. To illustrate the implementation of this treatment, we present a case report of a 15 year old with an 8 year history of overweight and a greater than 30-pound weight gain prior to treatment. Through this case study, the three phases of family-based treatment for pediatric obesity and 6 month post treatment follow-up results are presented through the lens of response from this adolescent and her family. We present this case report to illustrate the implementation of the intervention's adolescent module, and the potential impact of the approach in the treatment of adolescents with obesity and their families.

The Relationships Between Client Resistance and Attachment to Therapist in Psychotherapy Abstract Through the lens of contemporary views on client resistance and attachment theory, which underpins the role of security in psychotherapy, the present study examines the relation between client resistance and client attachment to therapist. Forty-six clients and 19 therapists in long-term psychotherapy completed the Client Attachment to Therapist Scale and a therapist-reported questionnaire for client resistance, respectively, in three different times including the therapist's summer holidays, so as to take into consideration the role of the therapist's temporary absence as a real relationship component. Results indicate that resistance is negatively associated with clients' secure attachment to their therapists, while it is positively associated with insecure attachment patterns. Also, holidays in psychotherapy were found to intervene in the interrelation between client's resistive behaviors and attachment security. These preliminary findings indicate the interpersonal and statelike character of client resistance, a conceptual shift that augments clinical work as clients and their resistances are seen in more benevolent terms.

Cognitive Behavioural Therapy for Mild-to-Moderate Transdiagnostic Emotional Dysregulation Abstract Recent research has found that emotional dysregulation is a transdiagnostic feature across a range of common mental health difficulties and within the general population. However, existing treatment for emotional dysregulation is typically long-term, intensive or focused on personality constructs. The aims of this paper are to (1) present a transdiagnostic cognitive model of emotional dysregulation (2) present a short-term cognitive behavioural therapy intervention for mild-to-moderate presentations of emotional dysregulation.

Valued Living Before and After CBT Abstract Whether and to what degree psychotherapy leads to changes in patients' value-based actions is not well documented. In this study we examined whether cognitive behavioral therapy, without explicit values work, enhanced value-oriented action. We also explored the role of change in valued action for subsequent life satisfaction and continued change after therapy. Additionally, data on the reliability and validity of the Valued Living Questionnaire (VLQ) are reported. We analyzed the pre-, post-, and 6-month-follow-up-data of 3687 patients of a university psychotherapy outpatient clinic, most of which suffered from reliably diagnosed anxiety and mood disorders. Questionnaires included the VLQ (with 10 items each on the "importance" and "consistency" of values), symptom scales (Beck Depression Inventory; Brief Symptom Inventory), and the Satisfaction with Life Scale. Over the course of therapy significant improvements in value-oriented action were found (d = .34), especially in treatment responders (d = .51). Increase of value-oriented action significantly explained satisfaction with life at end of treatment, even after controlling for symptom reduction. Temporally preceding improvement on the VLQ predicted further symptom reduction until follow-up. Data indicate that psychotherapy positively affects valued living, even when it is not explicitly targeted in treatment. Valued living may have a role in the course and maintenance of therapeutic change.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com