ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Despite the central role of induced fantasies in systematic desensitization, the theoretical formulations by the behavior therapists have excluded consideration of the psychological matrix of these complex intrapsychic phenomena. Furthermore, Wolpe and many of his followers appear to have jettisoned most of the older approaches (such as insight-oriented or supportive psychotherapy) from their therapeutic armamentarium. This institutionalization of the technical procedures and theoretical underpinnings of behavior therapy may unnecessarily restrict the potential range of fantasy utilization and shut out other effective approaches.The present paper reports some observations of the utilization of fantasies in broad spectrum psychotherapy with 40 patients. After being instructed to observe and report their visual fantasies, each of the patients reported spontaneous fantasies that occurred either between therapy sessions or during the sessions. For example, it was found in 10 cases of “free floating anxiety” that a fantasy of some imminent danger was present and appeared to generate the anxiety. When the patient was trained to control these autonomous fantasies, he showed a dramatic reduction in his anxiety level.The contents of thespontaneousfantasies were used in a number of cases to clarify the individual's psychological problems and to pinpoint the precise nature of these problems.Inducedfantasies were also found useful in a much broader clinical context than the relatively narrow band demarcated by Wolpe. Induced fantasies were used to help pinpoint the specific nature of a current problem; to reduce unpleasant affect through repetition of the fantasy; and to modify the patient's overt behavior by stimulating structured or “guided” fantasies.The significance of visual fantasies in promoting therapeutic change is discussed in terms of modifying the cognitive processes. There appears to be a very close bond between the visual fantasies and the patient's affect. By modifying the patient's fantasies, or the underlying ideational systems, it is possible to damp down unpleasant affect, such as anxiety, depression, or hostility. Furthermore, by recognizing the obvious distortions of reality in the content of the fantasies, the patient can interpret his experiences in a more realistic way.

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

An explanation of the process of psychotherapy combined with the suggestion that the patient should improve in a few months has been shown to produce better therapy results. The present study sought to determine whether the explanation or the suggestion was the more powerful aid to improvement. It also attempted to determine whether these procedures increased the therapist's liking for and feeling of being able to help the patient.Thirty-six psychoneurotic patients were randomly assigned to four groups, who received different indoctrinations by a research psychiatrist. 1) The first group was assigned to a psychotherapist without further explanation. 2) Those in the second group were told firmly that they should feel and function better after 4 months of psychotherapy. 3) The third group had the process of psychotherapy explained to them by means of Orne's anticipatory socialization interview. This interview is a didactic preparation for psychoanalytically oriented psychotherapy explaining how treatment works, what the patient's role is, and what can be expected of the therapist. It offers a rationale for why the patient should discuss his past life. 4) The fourth group had the process of psychotherapy explained and, in addition, were told firmly that they should expect to feel and function better in 4 months of psychotherapy.The therapists were nine senior residents who knew that research in psychotherapy was taking place but were ignorant of and retrospectively unable to guess the procedure and aims. They were requested to see the patients for a minimum of 4 months. They completed questionnaires devoted to how much they liked the patient and how much they felt that they could help him after their first interview. Independent assessment before and after 4 months of treatment was made by a psychiatrist.At the end of treatment the patients who received an explanation of psychotherapy improved slightly but significantly (p< .05) more than those who did not receive it. Improvement was based on total social, sexual, and work adjustment, and there was no significant difference in symptomatic change or attendance in the groups. Suggestion that they would feel better in 4 months had no effect on outcome. Moreover, patients who received this suggestion were found by the therapists to be less likable than those who did not.

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Of the several possible components of a role induction interview this investigation examined “hope for improvement,” defining it in terms of a 4-week period when improvement could be expected. The hypothesis was that patients induced to expect improvement after 4 weeks of psychotherapy will report greater change at that point than other patients, whose expectations extend to a 4-month period. Fourteen psychoneurotic patients who appeared not to hold fixed time expectations regarding their rate of improvement, as revealed in a screening interview, were included in the study. All patients were administered a series of mock physiological tests; half of them were informed that the “tests” revealed they would experience improvement by the 4th week of psychotherapy and the remainder that improvement would be a gradual process over the 4-month psychotherapy period. All patients received a standard role induction interview and were assigned to one of four psychotherapists who saw the patients weekly. In addition to several scales for measuring the outcome of treatment, a relief expectancy questionnaire was administered prior to and immediately following the mock session.Outcome measures revealed no differences between the experimental and control groups at either the 4-week or termination points and the questionnaire findings demonstrated failure of time induction to produce anticipated shifts even immediately after that procedure. It is concluded that patients have quite definite prior expectations with respect to improvement, and these are not easily manipulated. The 4-week expectancy we sought to induce may be too abbreviated even for clinically naive patients. Also, the isolation of time for experimental emphasis may do violence to role induction as an integral process, and the effect may be dissolved in the surround of the many other principles presented in a general role induction procedure.

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Social psychological studies of first impression formation have demonstrated that the communication of certain trait messages prior to actual meeting influences interpersonal perception upon meeting. Thus, being told an individual is “warm” or “cold” has been shown to affect the quality of interaction and perception in first impression formation. Extrapolating this finding to a normal population in a psychotherapy analogue study, it was found that the structuring of a tape recorded psychotherapist as “warm”vs.“cold” and “experienced”vs.“inexperienced” markedly influencedSs' perceptions of him. Both “warm” and “experienced” led to greater attraction to the therapist, greater openness to his influence, and more favorable evaluations of his work. The present study extended this design to a psychotic patient sample. In addition, an unstructured control group was employed. Findings supported the effects of “warm” structuring on attraction to the therapist, and the effects of both “warm” and “experienced” structuring on openness to therapist influence. While the overall findings showed greater variability and less robustness than was true for the normalSs, the interpersonal perceptions of psychotic patients were clearly influenced by these pre-meeting structuring messages. These findings appear to hold implications not only for the manner in which psychotic patients should most optimally be referred for psychotherapy, but also for procedures requiring interpersonal responsiveness within psychotherapy itself.

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

This report presents data about changes in symptoms and functioning among untreated and treated patients applying for service in 24 psychiatric outpatient clinics in New York State during the period of 1 year after intake. The results show that among patients with a poor prognosis—the uneducated, unmarried, unemployed, psychotic patients—the treated recovered more often than untreated patients. Among those with a good prognosis, in contrast, the untreated tended to improve more often than treated patients.

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The literature on the value of psychotherapeutic intervention in anorexia nervosa is hopelessly inconclusive. This is due to the fact that authors frequently fail to differentiate between the genuine anorexia nervosa syndrome and emaciation associated with various psychological problems, and that only therapeutic models based on traditional psychoanalysis are considered.Primary anorexia nervosais characterized 1) by a relentless pursuit of thinness with body image disturbances of delusional proportions, 2) by a deficit in the accurate perception of bodily sensations, manifest as lack of hunger awareness and denial of fatigue, and 3) by an underlying all-pervasive sense of ineffectiveness. This personality structure is conceived of as the outcome of childhood experiences lacking in appropriate confirming responses to child-initiated clues. These patients are singularly unresponsive to the traditional psychoanalytic therapy. A psychotherapeutic appreach was formulated with emphasis on correcting the deficits that have resulted from the faulty early transactional patterns. Interpretations are strictly avoided. Emphasis is on evoking awareness of feelings, thoughts, and impulses that originate in the patients themselves.The treatment history of a young man who had been unsuccessfully in conventional psychiatric treatment for 6½ years, and who responded well to the new approach, will be used as an illustration. The changes in the interaction with his family, and in his body awareness and self-concept will be presented in detail.

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

This paper sought to delineate the effect of phenothiazine treatment on paranoid symptom change, as this may be circumscribed by the patients' pretreatment adaptive styles. Two criterion groups of patients with paranoid symptoms distinct in terms of their modes of cognitive and social adaptation were defined: a positive propensity group, marked by social isolation, low belligerence, and undifferentiated cognitive functioning, and a negative propensity group, marked by social participation, belligerence, and more differentiated cognitive functioning. In earlier work it had been noted that paranoid patients with positive propensity characteristics would show symptom reduction in response to placebo treatment, whereas patients with negative propensity characteristics failed to show such a response.In the present paper, the further hypotheses were examined that patients with paranoid symptoms having a negative propensity style will show a significant reduction in paranoid symptomatology under conditions of phenothiazine treatment relative to placebo; that symptom reduction will be greater for chlorpromazine than for promazine, and greater for promazine than for placebo; and finally, that in a group of paranoid patients identified as having a positive propensity style, the effect of phenothiazine treatment cannot be differentiated from that of placebo. The data of the study were consistent with these hypotheses.The clinical significance of reduction in paranoid symptoms for the two classes of paranoid patients was discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1970

数据来源: OVID