The Frontier of Brief Psychotherapy: An Example of the Convergence of Research and Clinical Practice

ISBN-13: 9781468422221 / Angielski / Miękka / 2012 / 388 str.

David H. Malan

Opis

When I was a psychiatric resident not long after the end of World War II, any patient with the wits to get himself to a psychiatric clinic was taken into long-term dynamically oriented psychotherapy. Regardless of his diagnosis or clinical need, he was seen once, twice, sometimes even more frequently a week in fifty-minute sessions. Face-to-face with the therapist, he was urged to free associate and to express his dreams, fantasies, and emotions to a usually passive listener in what often appeared to be a caricature of psychoanalysis. It was not psychoanaly- sis, of course (although the differences were sometimes hard to define), but the aims were the same-to resolve psychic conflicts through in- sight and to bring about an internal psychological change that would allow the individual to work more effectively and to make healthier and happier relationships. Enough patients improved with these techniques to reinforce our penchant for using them. We were somehow able to ignore the fact that because of the limitations of time many patients withered on the waiting list. And we were able to blame our frequent therapeutic f ilures, not to mention the damaging regressions our narrowly re- stricted techniques often induced, on the patient's unwillingness to cooperate. Procrustes's couch was as inflexible as his bed. Old customs die hard, and the mindless application of long-term therapy is still found in clinical situations where it is inappropriate or contraindicated. But change is in the air.

Spis treści

I The Place of Brief Psychotherapy in Psychotherapeutic Services.- 1 What Should Psychotherapists Be Doing?.- 2 The Practical Application of Brief Therapeutic Methods.- The Patient in Crisis 7. The Extension of Brief Methods to Patients Not in Crisis.- II Previous Work.- 3 BRIEF THERAPY SINCE 1960: I The Work of Sifneos.- Sifneos: Contributions to the Practice of Brief Psychotherapy 21. Sifneos on Selection Criteria 21. Sifneos on Technique 23. Sifneos on Outcome 24. Conclusion 25.- 4 Brief Therapy Since 1960: II.- The Different Forms of Brief Psychotherapy 27. Crisis Theory 29. Convergence of Crisis Therapy and Brief Psychotherapy 30. Technique: Planning and Focusing 32. The Conservative—Radical Spectrum in Terms of Focus 34. Selection Criteria 37. Views on Technique, with Special Reference to Transference 38. Number of Sessions, Time Limits, Termination, and the Work of Mann 40. Conclusion 42.- III The Present Work.- 5 Results of the Second Study of Brief Psychotherapy.- Nature of the Sample 48. Change in the Method of Scoring Outcome 48. Selection Criteria 49. Two Variables in the Initial Stages of Therapy—Motivation and Focality 50. Characteristics of Successful Technique 52. Two Further Correlations in the First Series that Were Not Confirmed in the Second 53. Significance of the Study as a Whole 54.- 6 The Psychodynamic Assessment of Outcome.- Discussion of Dynamic Hypotheses and Criteria of Improvement 58. The Outcome Scale 60. Reliability 63.- 7 Criteria for Rejection.- 8 The Clinical Material.- The Almoner 92. The Bird Lady 101. The Buyer 107. The Cellist 120. Mrs. Craig 127. The Dress Designer 135. The Gibson Girl 148. The Indian Scientist 157. The Military Policeman 165. Mrs. Morley 172. The Oil Director 177. The Personnel Manager 185. The Pesticide Chemist 198. The Receptionist 205. The Sociologist 214. The Stationery Manufacturer 221. Mr. Upton 229. The Zoologist 238.- IV The Principles of Brief Psychotherapy.- 9 Selection.- The Convergence of Statistical and Clinical Evidence 247. Intensive Brief Psychotherapy 248. The Assessment of Patients for Psychotherapy 248. Criteria for Acceptance for Intensive Brief Therapy 255. Summary of Selection Procedure 256. Time Limits 256.- 10 The General Aims of Psychoanalytic Therapy.- 11 Planning and Technique.- 12 Clinical Examples.- The Zoologist 267. The Magistrate’s Daughter 277.- V Extending the Limits of Brief Psychotherapy.- 13 The Use of More Than One Focus.- More Than One Focus 293. The Falling Social Worker, an Example of a Complex Therapy 295.- 14 Partial Foci in More Disturbed Patients.- Miss Persistence 299. The Stationery Manufacturer 305.- 15 Deeper Therapy in More Disturbed Patients.- The Hospital Porter 321. The Graduate Clerk 326.- 16 Some Contraindications.- VI Conclusion.- 17 The Present Position.- References.