A reflection on the blending of person-centered therapy and solution-focused therapy

This article provides a commentary on the article by Cepeda and Davenport (2006; see record 2006-05485-001) that proposes an integration of solution-focused and person-centered therapy. The commonalities of each approach are highlighted as well as the differences. The primary argument of the article is that the process orientation of person-centered therapy may conflict with the goals of solution-focused therapy. Markers for identifying when each approach might be appropriate are identified and the implications for the therapeutic alliance of combining the two approaches are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved).     

Becoming Solution-Focused

Summary

This preliminary paper addresses how therapists, students, and professionals go about the business of learning to accept the concepts and philosophy of becoming brief, solution-focused therapists. What is it that “clicks” for them to make that paradigmatic shift? This paper is a beginning exploration to this overarching question as we research therapists' experiences in moving from one model of therapy into the solution-focused approach. We incorporate an open dialogue between ourselves as we begin the process of exploring how individuals become solution-focused therapists. This paper is offered as a starting point. We hope to continue to collect data from a wide variety of individuals as they reflect on their personal journeys in becoming brief, solution-focused therapists.     

Person-centered therapy and solution-focused brief therapy: An integration of present and future awareness

The authors propose an integration of person-centered therapy, with its focus on the here and now of client awareness of self, and solution-focused therapy, with its future-oriented techniques that also raise awareness of client potentials. Although the two theories hold different assumptions regarding the therapist's role in facilitating client change, it is suggested that solution-focused techniques are often compatible for use within a person-centered approach. Further, solution-focused activities may facilitate the journey of becoming self-aware within the person-centered tradition. This article reviews the two theories, clarifying the similarities and differences. To illustrate the potential integration of the approaches, several types of solution-focused strategies are offered through a clinical example. (PsycINFO Database Record (c) 2011 APA, all rights reserved).     

Brief Solution-Focused Organizational Redesign : A Model for International Mental Health Consultancy

The use of a consultation model derived from brief solution-focused therapy is described. The model is derived from a reflective review of seven years of experience in international mental health consultancy projects. The theoretical background is described and is characterized as brief solution-focused organizational redesign (BSFOR). The model emphasizes the importance of a partnership approach to international consultancy projects in the mental health field.     

Solution-Focused Brief Therapy for the Treatment of Sexual Disorders

The purpose of this article is to describe the use of solution-focused brief therapy (SFBT) as an approach to sex therapy. SFBT has been used to treat most clinical problems and populations, but until now has not been offered as an approach to sexual problems. This article describes SFBT and discusses its applications to sex therapy. A case example is included.     

The framework of family therapy in clinical practice and research in Serbia

In the last two decades, Serbia has had to deal with multiple social and economic problems reflecting on society's demographics and seemed to weaken its core cell - the family. The paper describes the framework of family therapy in clinical practice and research, within the recent transition of the Serbian family. Family therapy treatment in Serbia uses the systemic family therapy (SFT) approach, applied according to the standards of the European Association for Psychotherapy. A large number of professionals who practise in Serbia hold European qualifications, setting high standards in education, clinical practice, and research. Although SFT is also available in the private sector, the majority of patients are still treated in state institutions. Family therapy is often used for adults and adolescents with psychosis and addictions in psychiatric hospital settings. However, in counselling centres it is used for marital and relationship problems. Interestingly, family therapy has recently started to emerge as a more frequent tool in consultation-liaison, particularly psycho-oncology but also in correctional institutions. The clinical practice and research interests are interlinked with changes in social settings.     

Cognitive Therapy for Children, Young People and Families: Considering Service Provision

Background:  This article presents a case for the development of cognitive therapy services for children, adolescents and their families.
Method:  The theoretical basis of cognitive therapy is described, and illustrated with a case. The article continues by exploring the context for service development, with a specific emphasis on evaluating the evidence-base for using cognitive therapy with children and adolescents. Consideration is also given to adapting cognitive therapy to the child's developmental level, and the evidence for the efficacy of cognitive-behavioural family approaches.
Conclusions:  The article concludes by arguing that there is a need to address mental health difficulties in young people by providing effective treatment approaches. The development of cognitive therapy services would support the further evaluation of this therapeutic approach.     

A Follow-up Study of Characteristics of Young People that Dropout and Continue Psychotherapy: Service Implications for a Clinic in the Community

Background:  The paper reports the findings from a follow-up study of the factors that contribute to whether young people dropout or continue once-weekly psychotherapy at a voluntary sector psychotherapy service for young people aged 12 to 21 years.
Method:  The study uses data from an ongoing audit of the psychotherapy service that started in 1993; 882 young people were included in the study. Premature termination of treatment was defined as dropping out before the 21^st session. Continuation in treatment was defined as remaining in therapy after 20 sessions. Measures and areas of interest used in the study include diagnostic measures, the Youth Self Report Form and Young Adult Self Report Form, demographic characteristics and treatment related information.
Results:  Young people who continued in treatment were more likely to be older, have anxieties about sexual and relationship issues and have higher scores on self-reported anxiety-depression. Young people who dropped out of treatment were more likely to be younger, have higher self-reported delinquency scores, have a diagnosis of hyperactivity-conduct disorder and be homeless.
Conclusions:  The study of treatment termination has demonstrated the value of service audit and has led to a significant change in clinical practice.     

Solution-Focused Group Work: Collaborating with Clients Diagnosed with HIV/AIDS

This article looks at the current trends and challenges faced by persons diagnosed with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Given the lack of resources available to persons living with HIV/AIDS, a rationale for using solution-focused brief group therapy (SFBGT) is presented. The solution-focused approach builds on client resources to move them closer to their desired life despite having a life-threatening illness. SFBT is uniquely suited to facilitating positive outcomes with individuals living with HIV/AIDS. The overall aim of this article is to provide a theoretical explanation and justification of how SFBGT can effectively aid those diagnosed with HIV/AIDS to combat the obstacles they encounter. An example of a group format is also offered as a template for clinicians and practitioners.     

The Training Effects of Solution-Focused Brief Counseling on Telephone-Counseling Volunteers in Taiwan

This study investigates the effects of a solution-focused brief counseling training program on telephone-counseling volunteers in Taiwan, with an emphasis on promoting their counseling self-efficacy. There were 14 hotline volunteers recruited from Taipei Lifeline, they received 24 hours of solution-focused brief counseling training over 3 days. All participants were required to fill in an open-ended course feedback form after the solution-focused brief counseling training program and 1 month later. We used open coding to analyze the verbal data from the course-feedback forms. There were 6 features contributing to the effect of this solution-focused brief counseling training program that were found: helpful solution-focused brief counseling skills, the usefulness of solution-focused brief counseling’s stages, the establishment of basic knowledge of solution-focused brief counseling, enhancing the confidence and stability of telephone-counseling volunteers, the positive influence on volunteers’ personal life, and effective ways to learn and master solution-focused brief counseling. Using the research results, this study discusses solution-focused brief counseling training as it relates to telephone-counseling volunteers and suggests further research directions in relevant fields.     

Solution-Focused Approaches in Psychiatric I Mental Health Nursing

Multiple social and financial factors dictate that therapies of all kinds be oriented toward producing measurable changes in clients. Crisis intervention is one therapy approach that often produces measurable changes in clients. However, this approach may not be useful for individuals unable to identify a precipitating event, or who want change beyond returning to a previous level of functioning. This article reviews the basic tenets of solution-focused therapy in order to orient nurses to its potential utility for psychiatric/mental health practice.     

Psychostimulant effect of dopaminergic treatment and addictions in Parkinson's disease

Background : Dopamine replacement therapy in PD has been associated with both behavioral addictions and dopamine addiction. Objectives : To investigate potential association between l ‐dopa induced neuropsychiatric fluctuations and addictions in PD. Methods : A cohort of 102 patients with PD suffering from motor complications of l ‐dopa treatment was prospectively analyzed. We evaluated dopamine addiction, behavioral addictions, and neuropsychiatric fluctuations using the Ardouin scale of behavior in PD. Results : Patients with (n = 51) or without (n = 51) neuropsychiatric fluctuations did not differ in age, disease duration, medication, or UPDRS III motor score during on and off drug condition. Patients with neuropsychiatric fluctuations had a higher H & Y stage in off‐drug condition. A multivariate model showed that dopamine addiction (odds ratio: 8.9; P = 0.02) and behavioral addictions (odds ratio: 3.76; P = 0.033) were more frequent in the presence of neuropsychiatric fluctuations. Behavioral addictions and dopamine addiction were more frequent in the presence than in the absence of on‐drug euphoria (46% vs. 13.9%; P < 0.001 and 27% vs 6.2 %; P = 0.003), while conversely, no association emerged between dopamine or behavioral addictions and presence of off‐drug dysphoria. Patients with neuropsychiatric fluctuations had a poorer quality of life and a more frequent history of anxiety disorder. Conclusions : The psychostimulant effects of dopamine treatment during on‐drug euphoria, rather than avoidance of off‐drug dysphoria, appear to drive both behavioral addictions and abuse of medication. © 2017 International Parkinson and Movement Disorder Society     

罗伊适应理论护理对卒中患者情绪障碍及神经功能缺损改善的影响

目的 探究罗伊适应理论护理对卒中患者情绪障碍及神经功能缺损改善的影响。方法 选择2014年6月-2015年2月我科收治的82例卒中患者为研究对象进行为期两周的护理,按其入院时间分为常规护理组与罗伊护理组。常规护理组接受常规药物及一般康复锻炼护理,罗伊护理组在其基础上增加基于罗伊适应理论的心理干预综合护理,包括心理支持、认知疗法、心理暗示、音乐疗法等。以焦虑自评量表(Self-rating Anxiety Scale,SAS)、抑郁自评量表(Self-rating Depression Scale,SDS)、神经功能缺损程度量表(Clinical Nerve Function Limitation Score,CNS)评分进行护理前后两组卒中患者情绪障碍及神经功能缺损的比较。结果 护理干预前两组患者情绪评分(SAS、SDS)与神经功能评分(CNS)比较,差异均无显著性(P0.05);护理干预后,罗伊护理组SAS、SDS及CNS评分显著低于常规护理组(P0.05),且罗伊护理组干预前后三项评分差异均有显著性(P0.05);常规护理组干预前后三项评分差异无显著性(P0.05)。结论 基于罗伊适应理论的心理干预能显著改善卒中患者情绪障碍及神经功能缺损,值得在临床推广。     

Adapting supportive psychotherapy for individuals with Borderline personality disorder who self-injure or attempt suicide

We have utilized supportive therapy (ST) with an outpatient population with borderline personality disorder (BPD) who also engage in nonsuicidal self-injurious and suicidal behavior. In recent years, ST has been described as an active psychotherapeutic approach that may have efficacy comparable to other psychotherapies. ST emphasizes the mobilization of strengths to enhance self-esteem and utilize adaptive defenses and positive coping skills. Patients with BPD who self-injure and attempt suicide require integration of tangible solution-focused approaches with standard ST in order to address negative thinking patterns, impulsive behavior, and affective dysregulation, along with crisis intervention during periodic crisis states. ST appears to be well tolerated by patients with BPD who have self-injurious behavior and may be efficacious in engaging BPD patients in treatment and in minimizing the frequency and intensity of self-injurious and suicidal behavior.     

Chronic Fatigue Syndrome: An Evaluation of a Community Based Management Programme for Adolescents and their Families

Background:  Young people with chronic fatigue syndrome (CFS), families and clinicians may differ in their attributions about CFS and consequently in their approach to treatment. Research that clarifies the best treatment approaches is clearly needed. We have sought to develop a model that engages young people and their families in a collaborative way. The approach adopts an optimistic and holistic stance using an active rehabilitation model paying attention to the integrated nature of the physiological and psychological aspects of the illness.
Method:  This small study set out to evaluate this approach from a service user perspective. Semi-structured interviews were carried out with young people and their parents separately in order to elicit their views on key treatment elements and their perceived degree of recovery.
Results:  Improvements are indicated in all key areas addressed and qualitative information suggests that families value this approach.
Conclusion:  Further research is needed to address treatment issues for families who choose not to opt into the service model.     

Motivational interviewing and clinical psychiatry.

OBJECTIVES: Our objectives were as follows: (1) to survey the literature on motivational interviewing (MI), "a client-centered yet directive method for enhancing intrinsic motivation to change by exploring and resolving client ambivalence" and a well-established method of brief intervention, especially in the field of addictions treatment; (2) to review hypotheses about its mode of action; and (3) to discuss its possible impact on clinical psychiatry, in particular, on teaching communications skills. METHOD: Literature reviews and metaanalyses of numerous clinical trials of MI for addictions treatment have already been published and are briefly summarized. So far, no literature survey exists for MI applied to psychiatric patients. This review is limited to a synthesis of the articles relevant to psychiatry and to comments based on our team's experiences with MI. RESULTS: There is no evidence that MI achieves better results than other established techniques for treating addictions; it may simply work faster. The explanation for the method's rapid effectiveness remains speculative. Outcomes concerning the application of MI to psychiatric patients, although preliminary, are promising. Methods of assessing the integrity of MI treatment are more developed than in most psychotherapies, which permits the learning progress of trainees to be measured. CONCLUSIONS: MI offers a complement to usual psychiatric procedures. It may be worthwhile to teach it, not only for addictions but also for other broad treatment issues, such as enhancing patients' medication compliance and professionals' communication skills. Questions remain concerning MI's feasibility in psychiatry settings.     

The rates of co-occurring behavioural addictions in treatment-seeking individuals with obsessive-compulsive disorder: a preliminary report

Abstract

Objectives: To assess the rates of co-occurring putative ‘behavioural addictions’ in patients with obsessive-compulsive disorder (OCD).

Methods: Twenty-three international centres specialising in the treatment of OCD were invited to participate in a survey of the rates of behavioural addictions and other relevant comorbidity within their samples.

Results: Sixteen of 23 (69.6%) invited centres from 13 countries had sufficient data to participate in the survey. The use of validated diagnostic tools was discrepant, with most centres relying on a ‘clinical diagnosis’ to diagnose behavioural addictions. The final sample comprised of 6916 patients with a primary diagnosis of OCD. The reported rates of behavioural addictions were as follows: 8.7% for problematic internet use, 6.8% for compulsive sexual behaviour disorder, 6.4% for compulsive buying, 4.1% for gambling disorder and 3.4% for internet gaming disorder.

Conclusions: Behavioural addictions should be better assessed for patients with OCD. The absence of diagnostic scales developed specifically for behavioural addictions and overlapping obsessive-compulsive phenomena such as compulsive checking of information on the internet may explain the relatively high rate of problematic internet use in this sample. The study encourages better efforts to assess and to conceptualise the relatedness of behavioural addictions to obsessive-compulsive ‘spectrum’ disorders.     

A survival analysis for recurrent events in psychiatric research

Objectives:  Time to first recurrence, as analyzed by the Kaplan–Meier (KM) survival analysis, is a commonly applied statistical method in psychiatric research. However, many psychiatric disorders are characterized not by a single event, but rather by recurrent events, such as multiple affective episodes. This study aims to demonstrate a method of survival analysis that takes multiple recurrences into account.
Methods:  We examined data on sex differences in a sample of 181 patients undergoing prophylactic treatment with lithium or carbamazepine (serum level assayed) for bipolar disorder (ICD-10). The classical KM method was compared with an approach developed by Peña, Strawderman and Hollander (PSH) that uses recurrent event data to estimate survival function.
Results:  The results obtained with the multiple events method differed considerably from those acquired using the standard KM analysis. When taking recurrent event data into account, the probability of remaining well was lower and survival times were longer. In addition, whereas the standard KM analysis indicated that male patients had a higher likelihood of remaining well, the alternative method revealed that both sexes were similarly likely to remain well.
Conclusions:  Survival analysis techniques that take recurrent events into account are potentially important instruments for the study of psychiatric conditions characterized by multiple recurrences. In many cases, the standard KM analysis appears to provide only a rough approximation of the course of illness.