佛教思想对心理治疗观的影响

心理治疗的主要目的是减轻人们的心理痛苦。佛教如同任何宗教一样都有帮助人们减轻精神痛苦的作用。心理治疗源自西方的相对科学的体系,其理念重在以不同的方式帮助人们更好地适应环境,或更好地满足自己的需要。佛教中的理念引导人们应对心理痛苦的方式是接受放下,是一种人生态度。在心理治疗中渗入这一理念,会更有效地帮助来访者,至少在受佛教思想影响的中国文化背景下。本文将以心理治疗实践中的案例为例具体阐述佛教思想对心理治疗观的影响,并与心理动力学治疗和其他的心理治疗方法的一些理念进行比较。     

心理治疗与（精神）药物治疗之间关系的探讨（Ⅱ）

引言 :在心理治疗中是否应使用药物 ,如果使用药物应在什么情况下使用 ,药物治疗与心理治疗的关系如何 ,这些问题曾在专业人员中引起激烈的争论。本刊在上一期的讨论专栏中己对此问题进行过专题讨论 ,本期的讨论是上一期讨论的继续。杨彦春 (华西医科大学附一院精神科　副教授　 610 0 41)精神科医师与心理治疗师最具挑战性的问题之一是如何将现代药物治疗与心理治疗技术整合起来使对患者的治疗达到最大的疗效。药物治疗和心理治疗作为改变和影响心理和行为的方法作用于不同的层面 ,有着不同的作用机制 ,并由此形成各自不同的理论系统和技术…     

且游且渡——沙盘游戏中的过渡性客体

正沙盘游戏治疗是由多拉·卡尔夫发展创立的心理治疗方法,来访者在治疗师的陪伴下,通过在沙盘里摆放沙具,达到治疗目的。作为一种综合性的心理治疗体系,沙盘游戏被广泛地运用在了心理咨询、心理评估、心理治疗、心理教育,以及专业心理分析的诸多领域。沙盘小方寸,心灵大世界。在沙盘游戏中有时不期而遇的心理体验,和现代心理学的一些理论不谋而合,比如客体关系理论家温尼科特提出的"过渡性"(transitional)概念。     

诊断与评估在心理治疗与咨询中的意义与作用

心理诊断在咨询与心理治疗上的意义与作用 探讨心理诊断(psychodiagnosis)在咨询与心理治疗的临床作用之前,有必要先行说明心理诊断的含意及其与精神科诊断的区别.由于专业心理学界对于心理诊断看法的讨论十分有限,本文是笔者根据咨询与心理治疗教学与临床经验,所提出的个人观点,希望有助于心理诊断的澄清,更期盼读者给予指正.此外,为方便读者的阅读,本文将以"心理咨询"代替"心理谘商"一词.     

边缘性人格障碍治疗脱落引发的思考

目的验证心理动力学为背景的辩证行为心理治疗技术(Dialectical behavior therapy,DBT)对边缘性人格障碍患者的疗效。方法药物治疗和门诊心理治疗相结合。结果治理过程中出现移情与反移情,最终导致治疗关系恶化,在第8次治疗后患者攻击治疗师。结论边缘性人格障碍患者将不稳定的人际关系投射到治疗关系中,医生往往会替代现实中的客体被攻击和指责,现阶段的心理治疗还处于艰难状态。     

沙盘游戏本土化应用创新课程2019招生简章

正*二级心理咨询师*中级心理治疗师*副主任医师从事心理咨询、治疗及教育培训工作19年,秉持"为文化所融,为社会所需,为心理所释"原则,致力于沙盘游戏技术中国本土化融合的研究、创新、应用、推广和培训,以及分析心理学理论与实践的中国本土化研究与应用,擅长团体沙盘游戏发展与创新。招生对象学校校长、教务及管理工作者;有自身成长需要的心理学爱好者;     

心理与药物治疗学生考试焦虑的疗效观察

目的 探讨单纯心理治疗、单纯药物治疗以及心理、药物合并治疗学生考试焦虑的疗效。方法 将符合入组标准的69例求助者随机分为3组,分别给予心理治疗、药物治疗及心理合并药物治疗,于考试前2周,考试前1天及下学期考前1天,分别进行HAMA及SAS量表评定。结果．心理治疗组及药物治疗组考试前1天与干预前比较HAMA、SAS评分差异显著,而下学期考前1天同干预前比较无明显差异。心理合并药物治疗组考试前1天及下学期考试前1天,同干预前均有明显差异。结论 对于学生考试焦虑的治疗以心理合并药物治疗的近期及远期效果均优于单一治疗方法,应作为首选。     

不同职业背景心理咨询和治疗从业者的伦理行为

目的:了解不同职业背景心理咨询和治疗从业者的伦理行为,加强心理咨询和治疗职业伦理教育。方法:以前期编制的心理咨询或治疗伦理问题调查问卷(咨询师版),对全国西北、华北、华东、中南、东北、西南每个行政区的3～4个城市共690名心理咨询和治疗从业者进行调查,并分析精神科医师、临床心理治疗师、学校心理咨询师三种职业背景从业者的伦理行为状况。结果:三种职业背景的从业人员中,以精神科医师的从业年限最长(10年的占16.7%),对于每一个来访者平均的治疗次数最多(10占20.1%),平均每次咨询时长最短(≤30分钟的占3.4%)。伦理行为调查中,在胜任力方面,三组人员各有70%都"感到力不从心、难以胜任";67.7%的精神科医师和62.5%的学校心理咨询师害怕自己不能够满足患者的需要;在知情同意和保密方面,17.4%的精神科医师"在走廊、电梯等公共场所与同事讨论来访者治疗方案";84.5%的临床心理治疗师"在治疗前向来访者讲明收费标准和规定";双重关系条目中,超过30%的精神科医师、临床心理治疗师和学校心理咨询师"特别喜欢某些来访者";14.1%的精神科医师对某些来访者产生性幻想;在咨询设置方面,有31.4%的精神科医师、25.0%的临床心理治疗师和20.1%的学校心理咨询师在咨询期间接听电话。不同性别、从业年限的心理咨询和治疗从业者"害怕不能满足患者需要"等部分条目差异有统计学意义。结论:本研究显示,不同职业背景心理咨询和治疗从业者都存在一定比例的违背伦理要求的行为,精神科医师出现违背伦理行为的比例较高。提示需要根据不同职业不同特点有针对性的进行伦理教育。     

酒精使用障碍心理治疗效果的网状Meta分析

目的：应用网状Meta分析方法比较药物治疗与不同心理治疗联合药物疗法在酒精使用障碍(AUD)中的临床疗效，并对不同方法降低复饮率、复饮天数及改善患者焦虑抑郁的效果进行排序。方法：计算机检索并筛选中国知网、PubMed等数据库中关于心理治疗AUD的随机对照试验（RCT）。借助软件Gemtc和Stata进行网状Meta分析。结果：共纳入14个RCT，总计1117例AUD患者：试验组558例，对照组559例。分析结果提示，降低复饮行为的效果排序：厌恶疗法>家庭干预>认知行为疗法>综合心理护理干预>正念干预>森田疗法>简短心理干预>单纯药物治疗。降低复饮天数的效果排序：认知行为疗法>简短心理干预>单纯药物治疗>正念干预。降低焦虑效果的排序：正念干预>综合心理护理干预>单纯药物治疗>厌恶疗法。降低抑郁效果的排序：综合心理护理干预>正念干预>厌恶疗法>单纯药物治疗。结论：与单纯药物治疗AUD相比，结合心理治疗后均有更好的效果，且不同的心理治疗方法有着不同的优势。     

精神病学的两条路、两条轨与两个轮:读曾文星教授述评有感之一

文化是人类长期积累的物质和精神产品的总和。不同人〔族〕群之间的文化具有可交流性,同时也有各自的独特性,这种独特性对个体心理活动的形式和内容以及行为模式的影响是无法忽视的,在某种社会文化语境下成长的个体,他的心理活动和行为模式都会打上独特的文化烙印。在我国,现代意义上的心理治疗理论和技术主要是来自西方,如何将这些理论和技术做适合我国文化背景的改造,是我国心理治疗行业发展过程中无法回避的问题。为此,本刊特别邀请本刊顾问曾文星教授以"文化-心理-治疗-健康"为主题撰写系列述评,就如何对心理治疗做适合我国文化的改造做系统、深入的阐述。曾教授欣然接受了邀请,并很快完成第一批共3篇述评的撰写。在编辑加工过程中,为了既能保留曾教授独特的语言风格和一些用词习惯,又便于我国内地读者更全面地了解相关背景,编辑部另外邀请了赵旭东教授以"读后感"的形式撰写述评,一同配发。本刊希望曾文星教授的系列述评,以及赵旭东教授(本刊欢迎更多的读者来参与)的读后感,对推动我国心理治疗的发展,起到一定的推动作用。     

The Clinical Implications of Attachment Theory

The work of John Bowlby, although influential in developmental psychology and social psychiatry, has had relatively little impact within his parent discipline of psychoanalytic psychotherapy. The paper traces Bowlby's relationship with the British Psychoanalytic Society, contrasting his ideas with those of Klein. Drawing on recent findings in developmental psychology stimulated by Attachment Theory, it outlines the clinical relevance of the concepts of the secure base and narrative, and reviews notions of defence and the Oedipal situation from the attachment perspective. Attachment Theory is not a new 'school' of psychotherapy but addresses principles which underlie all effective therapies. An extended case study is described illustrating these points.     

Online Psychotherapy: Transference and Countertransference Issues

This paper arises from the shift, following the start of the 23 March 2020 lockdown in Britain, from clinic-based to online psychotherapy within National Health Service (NHS) psychological treatment services. The paper draws on previously published observations about privately funded online psychotherapy. It also provides a snapshot of my own and my clinical psychology colleagues’ experience of providing clinic-based and online NHS-funded psychotherapy before and soon after the March 2020 lockdown began. I use these impressionistic data to illustrate transference and countertransference issues involved in online psychotherapy. In addition, I note problems relating to its setting or frame, and ways in which this form of treatment can obstruct empathic mirroring and the patient's experience of being contained. I conclude by noting limitations of this study based as it was on the immediate reaction of myself and my colleagues to the transition from providing clinic-based to online psychotherapy, not on interviews with patients about their experience of this transition nor on any measure of the relative effectiveness of online compared with clinic-based psychotherapy.     

Normal suggestion. An analysis of the phenomenon and its role in psychotherapy

In the present paper, it is argued that suggestive forms of influence are ubiquitous in human interaction, and represent a neglected phenomenon in clinical psychology and psychotherapy. This phenomenon, which is referred to as ‘normal suggestion’, is analysed as an interpersonal priming process, whereby one person (the ‘suggestor’) influences another (the ‘suggestant’) to respond, feel, or think in a way that is congruent with the suggestor's feelings, intentions, beliefs, or desires. Suggestion may be intentional or unintentional on the part of the suggestor, but it always relies on automatic information processes in the suggestant. The paper discusses the psychological processes which take place in the suggestant, and in the suggestor. A theoretical framework is sketched where each social situation (including each psychotherapeutic treatment) is assumed to be characterized by a certain ‘suggestive climate’, as a function of the frequency with which various ideas, intentions, feelings, etc, are primed. It is also assumed that each person has a certain ‘suggestibility profile’ as a function of his or her cognitive-affective meaning structures. Finally, it is argued that it is impossible to engage in suggestion-free psychotherapy, and that the recognition of this basic fact may improve psychotherapeutic practice and minimize the potentially damaging influence of suggestion in psychotherapy. © 1998 John Wiley & Sons, Ltd.     

Change is not always linear: the study of nonlinear and discontinuous patterns of change in psychotherapy

The study of discontinuities and nonlinear change has been a fruitful endeavor across the sciences, as these shifts can provide a window into the organization of complex systems and the processes that are associated with transition. A common assumption in psychotherapy research has been that change is gradual and linear. The research designs and statistics used to study change often reflect this assumption, but some recent research reveals other patterns of change. We briefly review relevant literature on dynamical systems theory and on life transition and post-traumatic growth to highlight the significance of nonlinear and discontinuous change across areas of psychology. We describe recent applications of these ideas and methods to the study of change in psychotherapy and encourage their use to complement more traditional clinical trial designs.     

一例动力学短程心理治疗的个案分析与讨论

目的探讨有效运用动力学短程心理治疗的操作要点。方法个案分析,文献研究。结果来访者获得有效治疗;动力学短程心理治疗应注重首次访谈与开放式结束的治疗作用,尽早洞悉与揭示来访者的病态信念和失效关系模式,及时捕捉移情的闪现,恰当设置治疗目标和相信来访者自身的康复能力。结论动力学短程治疗是一种高效、实用的心理咨询与治疗方法。     

Prescott lecky's concept of resistance and his personality

Prescott Lecky was an academic psychologist who pioneered in a psychology and psychotherapy of the self during the 1920s when American academic psychology was almost completely behavioristic and experimental. Specifically, Lecky stressed the proce, s of resistance as an individual's device for maintaining the consistency and integrity of his self-concept. The present paper shows from biographical d Lta, especially an early recollection, that resistance was powerful factor in Lecky's own personality. His theory thus may be seen in part as an attempt to cope with a potential difficulty with which he was well familiar. But, one may infer, he failed in his own case: Resistance impeded Lecky from publishing, and even attaining his Ph. D., and thus rendered his life quite tragic. This is offered as a further example of Adler's and Ellenberger's contentions that a psychologist's theory is generally in accord with his personality or style of life.     

Identifying the faces in the mirror: untangling transference and countertransference in self psychology.

Experienced psychotherapists realize that there are many levels of meaning behind much that is said during the therapeutic hour. The challenge for the competent professional is to become wise enough to learn what to ignore and sensitive enough to know what to emphasize. Sorting this out is at the heart of the practice of good psychotherapy. In this article, we will briefly share our thoughts on this rich but complicated interpersonal interaction using Kohutian self psychology theory to understand the role of countertransference in the process of conducting psychotherapy.     

Addressing the Needs: Guidelines for Training Psychologists to Work with Children,Youth, and Families

A need exists for criteria for training psychologists who work with children, youth, and families. Recognizing that the provision of competent services is directly related to training for those services, a set of recommendations was adopted by the Executive Committee of the Division on Child, Youth, and Family Services. This paper outlines these recommended experiences and coursework with their rationale for child development and lifespan developmental psychology, child and adult psychopathology, mental retardation and developmental disabilities; specialized child assessment techniques; child psychotherapy and behavior change; parent, family, and school intervention techniques; specialized clinical practice in child, parent, and family therapy; research methods in child psychology; ethics and legal issues related to children, youth, and families; and subspecialties within psychology for children, youth, and families. Examples of training programs meeting these recommended training criteria are discussed.     

Prevention and harm reduction for chemical dependency: a process perspective.

Clinical psychology is often on the periphery of treatment and prevention efforts to stop substance abuse and dependence. This article describes the current status of prevention research and practice, outlines a process perspective on the initiation and cessation of drug use and abuse, and offers some new ideas about how psychology can and should become involved in the prevention of chemical dependency. Psychologists are faced with the precursors and consequences of chemical dependency on a daily basis. With improved training and increased awareness, and aided by a process perspective, psychology and psychologists can play an important role in preventing the onset of chemical dependency, creating early interventions to stop the process of initiation, and becoming more involved in treatment and harm-reduction efforts. Psychologists have the basic training and the biopsychosocial orientation that could make them effective agents for primary, secondary, and tertiary prevention of chemical dependency.