A Study of Brief Psychotherapy

ISBN-13: 9781461343974 / Angielski / Miękka / 2011 / 312 str.

D. Malan

Opis

The original aim of the present work, which was initiated by Dr. Michael Balint, was to explore Brief Psychotherapy carried out by psycho-analysts who are relatively skilled and experienced. To this has been added an attempt to reconcile the 'clinical' and 'objective' approaches to psychodynamic material, by treating clinical judgements exactly as rigorously as is appropriate, no more and no less. A review of previous work leads to little definite conclusion. A complete spectrum of views can be found, from the most 'conservative' (e.g. brief psychotherapy is only effective in the mildest and most recent illnesses; the technique used should be superficial-any attempt to go 'deeper' will lead to long-term therapy; and the results are only palliative) to the most 'radical' (seriously ill patients can be extensively helped by a technique containing most of the essential elements of long-term methods such as psycho-analysis). The present work is based essentially on the therapies of nineteen patients, treated by a team of therapists under the leader ship of Dr. Balint. The study is largely retrospective, but it is designed to fill some of the important gaps to be found in the literature: 1. Detailed case histories are given of all patients treated; 2. Particular attention is paid to long follow-up; 3. A method of assessing therapeutic results has been developed which is regarded as psychodynamically valid and is based on published evidence; 4. The relation is examined between outcome and (a) the characteristics of patients, (b) the characteristics of technique."

Spis treści

I Historical and Theoretical Survey.- 1. Introductory.- 2. Historical Approach.- The history of psycho-analysis.- The characteristics of the early short analyses, with special reference to therapeutic results.- Attempts to shorten psycho-analysis: Ferenczi.- 3. Review of Previous work on Brief Psychotherapy.- The quality of the evidence.- Selection criteria and therapeutic result.- Technique.- Length of treatment, termination, and follow-up.- Previous work: conclusion.- II The Present work.- 4. Preliminary.- Description of patients, therapists, and methods of working.- Course of the work.- Scope of the present study.- 5. The Assessment of Therapeutic Results.- 6. Assessment and Therapy forms.- Notes on the assessment and therapy forms.- The articled accountant.- The biologist.- The civil servant.- The clown.- The dog lady.- The draper’s assistant.- The falling social worker.- The girl with the dreams.- The hypertensive housewife.- The lighterman.- The neurasthenic’s husband.- The paranoid engineer.- The pilot’s wife.- The railway solicitor.- The storm lady.- The student thief.- The student’s wife.- The surgeon’s daughter.- Tom.- The unsuccessful accountant.- Violet’s mother.- 7. Psychodynamic Assessment and its Bearing on the Validity of Brief Psychotherapy.- Discussion of the psychodynamic method of assessment.- The bearing of this work on the validity of brief psychotherapy.- 8. The Therapeutic Results and the Problem of Relating them to other factors.- Discussion of the therapeutic results.- The scoring of the results for statistical purposes.- The relation between the clinical and the statistical approaches.- Statistical methods used.- Different forms of hypothesis.- 9. Selection Criteria.- Hypotheses.- Selection of patients.- Study of the evidence on Hypothesis A.- Evidence on Hypothesis B.- 10. The General Characteristics of these therapies with Special Reference to technique.- The ecological view.- Rapid and inevitable development of transference.- Inevitable development of transference interpretations.- Disturbing interpretations.- Interpretation of the infantile roots of neurosis.- Negative transference: termination.- Differences from analysis.- The ‘focal’ technique: ‘focal therapy’.- Dramatic therapy; traumatic memories.- 11. The Relation Between Transference Interpretation and Outcome: Clinical Approach.- Clinical evidence.- Transference interpretation and dependence.- 12. The Exploration of a more ‘Objective’ Quantitative Approach to the Relation Between Technique and Outcome.- Principles.- Scoring by two independent judges.- Results of the count of interpretations.- Comparison of the Th ratio with clinically judged transference orientation.- Correlation between outcome and NP and P ratios: the hypothesis of the therapist-parent link.- Transference and follow-up.- The meaning of the quantitative studies.- The status of the evidence.- Chapters 11 and 12: conclusion.- 13. Recapitulation and Conclusion.- General statement of the characteristics of patients, therapists, and technique.- Hypotheses and conclusions already presented.- A unifying factor.- Selection criteria.- A possible future selection procedure.- Relation to previous work.- The lengthening factors. The place of the present work in the history of psycho-analysis.- References.