Principles of change

Despite increasing awareness of the promise of psychotherapy integration, many therapists continue to operate from circumscribed theoretical orientations. Theoretical orientations, whether psychoanalytic, cognitive-behavioral, experiential, or any other, offer a framework from which to consider the origin and maintenance of problematic behavior. The means through which such behavior is reduced take the form of clinical procedures or techniques. Techniques, such as analysis of transference,...

Case Illustration

At present, descriptive psychiatric diagnosis and clinical case formulation are largely independent activities. The former is aimed at classification (a nomothetic approach) whereas the latter is aimed at understanding an individual patient (an idiographic approach). The SWAP bridges these activities. It generates dimensional diagnosis scores for each PD included in DSM-IV (as well as for the additional PDs proposed in the DSM-IV appendix) and it generates richly detailed clinical case...

A slightly different view of common factors

Most common factors approaches seem to be arguing that all forms of treatment employ the common factors equally. This then accounts for outcome equivalence or the Dodo verdict. Following Weinberger (1995) and Weinberger and Eig (1998), we have a somewhat different point of view. We take the schools at their word in terms of what they emphasize. That means that the different schools of therapy differ in their instantiation of the various common factors. Each school emphasizes one or two of the...

The development of a new approach to the treatment of emotional disorders

After considering the shared etiologic pathways, structural commonalities, and treatment response to similar psychological and pharmacologic interventions across anxiety and depressive disorders, Barlow (1988) proposed that, in line with emotion theorists such as Izard (1971), a more singular, coherent approach to the treatment of emotional disorders was most likely to result from emotion theory. Consistent with this notion and the concurrent work of Lang (1968), Rachman (1981), and Wilson...

Theory Research and Practice

SAFRAN More than half a century of psychotherapy research has yielded compelling evidence implicating the quality of the therapeutic alliance as one of the most robust predictors of overall treatment success (Horvath & Symonds, 1991 Martin, Garke, & Davis, 2000). This is a finding replicated multiples times across treatment modalities. Other findings indicate that poor outcome cases demonstrate greater evidence of negative interpersonal process (e.g.,...

Strategies for working with resistant ambivalence

Our search for ways of working with resistant ambivalence was guided by this last assumption. We particularly sought less directive approaches that were based on empathy and support. We found two well-developed treatment approaches that seemed particularly appropriate, both of which have a supporting body of research associated with them Motivational Interviewing (MI) (Miller & Rollnick, 2002) and Two-Chair work used in Emotion-Focused Therapy (EFT) (Greenberg, Rice, & Elliott, 1993...

Info

Methodcentric Reasoning and the Empirically Supported Treatment Debates MARK A. BLAIS AND MARK J. HILSENRoTH In his 1957 American Psychological Association Presidential address, entitled The Two Disciplines of Scientific Psychology, Lee Cronbach warned of a growing division within the field that threatened to pit groups of psychologists against one another (Cronbach, 1957). This division resulted from psychologists identifying primarily with a research methodology rather than with the broader...

Drew Westen

These may be the most acrimonious times between clinicians and researchers in the history of our field. The relationship has never been an easy one, generally characterized on both sides by feelings of superiority and occasional public snipes. But the present era represents the confluence of three forces that have changed the nature of the relationship. The first is the near-ubiquity of managed care, which has been a disaster for mental health. Managed care has been problematic in many areas of...

Efficacy effectiveness and the clinical utility of evidencebased practice a reprise

The past three decades have witnessed clear, evidence-based gains in the effectiveness of psychological treatments for both mental and physical disorders. Advocates for behavioral and cognitive-behavioral treatments can now assert their documented effectiveness as treatments of choice for the anxiety and mood disorders (Chambless & Ollendick, 2001 Roth & Fonagy, 1996), while cognitive-behavioral treatments for alcohol abuse, eating disorders, and several other common psychopathologic...

Recent efforts to integrate the efficacy and effectiveness models

The efforts to integrate the efficacy and effectiveness models reviewed in this section of the chapter reflect both awareness of the limited impact of psychotherapy research findings on clinical practice to this time and recognition that responsibility for this problem stems in substantial part from the failure to extend the results of efficacy research to community settings. NIMH Initiative Intervention Research Centers Norquist, Lebowitz, and Hyman proposed in 1999 that the National Institute...

References

Ackerman, S., & Hilsenroth, M. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23, 1-33. Ackerman, S., Hilsenroth, M., Baity, M., & Blagys, M. (2000). Interaction of therapeutic process and alliance during psychological assessment. Journal of Personality Assessment, 75, 82-109. Alexander, F. (1963). The dynamics of psychotherapy in the light of learning theory. American Journal of Psychiatry, 120,...

A working model of resistant ambivalence

Resistant ambivalence refers to patterns of behavior in which people express some desire to change, believe that the change will improve their lives, believe that effective strategies are available, have adequate information about executing those strategies, but nonetheless do not employ them sufficiently for change these patterns are usually accompanied by negative affect (Engle & Arkowitz, 2006). In our search across different therapies for common themes relating to resistant ambivalence,...

Rc480a78 2007

Visit the Taylor & Francis Web site at http www.taylorandfrancis.com and the Routledge Web site at http www.routledge-ny.com The Art and Science of Psychotherapy An Introduction xvii Stefan G. Hofmann and Joel Weinberger 1 Discovering What Works in the Community Toward a Genuine Partnership of Clinicians and Researchers 3 2 Methodcentric Reasoning and the Empirically Supported Treatment Mark A. Blais and Mark J. Hilsenroth 3 An Integrative, Principle-Based Approach to Psychotherapy 49 John...