Dynamic Therapies For Psychiatric Disorders: Axis I

478 Pages·1995·2.177 MB·English

by  Jacques P. Barber

Dynamic Therapies for
Psychiatric Disorders (Axis I)
Jacques P. Barber & Paul Crits-Christoph
e-Book 2016 International Psychotherapy Institute
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Copyright © 1995 Jacques P. Barber & Paul Crits-Christoph
To our children Natalie and Adam, and Alexander, Avery, and Nicholas who are
going to live in a world that will change even faster than the one we have known
Table of Contents
Contributors
Acknowledgments
Introduction: Why We Should Develop Psychodynamic Treatments for Specific
Psychiatric Disorders
Supportive-Expressive Dynamic Psychotherapy of Depression: A Time-Limited
Version
Brief Supportive-Expressive Psychodynamic Therapy for Generalized Anxiety
Disorder
Psychoanalytic Therapy of Schizophrenia
Supportive-Expressive Dynamic Psychotherapy for Treatment of Opiate Drug
Dependence
Dynamic Therapy for Post-Traumatic Stress Disorder
Psychodynamic Treatment of Alcohol Abuse
Treating the Eating Disorder Patient with Borderline Personality Disorder: Theory
and Technique
Emotion-Focused Treatment for Panic Disorder: A Brief, Dynamically Informed
Therapy
Supportive-Expressive Therapy of Cocaine Abuse
Psychodynamic Psychotherapy of Multiple Personality Disorder and Allied Forms
of Dissociative Disorder Not Otherwise Specified
Relational Therapy for Grief Disorders
Psychodynamic Psychotherapy with the HIV-Infected Client
Contributors
Jacques P. Barber, PH.D.
Assistant Professor, Center for Psychotherapy Research, Department of
Psychiatry, University of Pennsylvania
John Cacciola, PH.D.
Research Assistant Professor, Department of Psychiatry, University of
Pennsylvania Medical School
Katherine Crits-Christoph, PH.D.
Private Practice, Philadelphia; Clinical Assistant Professor, Center for
Psychotherapy Research, Department of Psychiatry, University of
Pennsylvania Medical School
Paul Crits-Christoph, PH.D.
Associate Professor and Director, Center for Psychotherapy Research,
Department of Psychiatry, University of Pennsylvania Medical School
Marylene Cloitre, PH.D.
Director of Psychology Training, Payne Whitney Clinic, Cornell Medical
School
Peter L. DeRoche, M.D., C.C.F.P., F.R.C.P.(C)
Assistant Professor, Department of Psychiatry, University of Toronto;
Director, Clinic for HIV-Related Concerns, Mount Sinai Hospital, Toronto
Tracy D. Eells, PH.D.
Assistant Professor, Department of Psychiatry and Behavioral Sciences,
University of Louisville
Jeffrey Faude, PH.D.
Private Practice, Philadelphia; Consultant, Center for Psychotherapy
Research, Department of Psychiatry, University of Pennsylvania Medical
School
Margaret Fichter, PH.D.
Lecturer, Department of Psychiatry, University of Pennsylvania Medical
School
Louise Gaston, PH.D.
Assistant Professor, Department of Psychiatry, McGill University; Director,
TRAUMATYS, Psychological Services Inc.
Barbara Goldsmith, PSY.D..
Private Practice, Philadelphia
LEORA HECKELMAN, PH.D.
Supervising Psychologist, Department of Psychiatry, Roosevelt Hospital,
New York
Anita V. Hole, PH.D.
Clinical Assistant Professor of Psychology, Department of Psychiatry,
University of Pennsylvania Medical School
Craig L. Johnson, PH.D.
Director of Psychology and Director, Eating Disorders Program, Laureate
Psychiatric Clinic and Hospital, Tulsa
Bertram P. Karon, PH.D.
Professor, Department of Psychology, Michigan State University
Richard P. Kluft, M.D.
Clinical Professor of Psychiatry, Temple University School of Medicine;
Director, Dissociative Disorders Program, the Institute of Pennsylvania
Hospital, Philadelphia
Jerome D. Levin, PH.D.
Director, Alcoholism Counselor Training Program, New School for Social
Research, New York
Lester Luborsky, PH.D.
Emeritus Professor of Psychology in Psychiatry, Center for Psychotherapy
Research, Department of Psychiatry, University of Pennsylvania Medical
School
David Mark, PH.D.
Private Practice, Philadelphia; Senior Supervisor, Center for Psychotherapy
Research, Department of Psychiatry, University of Pennsylvania Medical
School
Jennifer Q. Morse
Research Assistant, Center for Psychotherapy Research, Department of
Psychiatry, University of Pennsylvania Medical School
Carol Popp, m.d., PH.D.
Assistant Professor, Department of Radiology, Emory University
David Rudick, PH.D.
Private Practice, Philadelphia
Randy A. Sansone, M.D.
Associate Professor and Medical Director, Psychiatry Outpatient Clinic,
Department of Psychiatry, University of Oklahoma College of Medicine,
Tulsa
M. Katherine Shear, M.D.
Associate Professor of Psychiatry, Western Psychiatric Institute and Clinic,
University of Pittsburgh Medical Center
Michael A. Teixeira, PH.D.
Private Practice, Lansing; Visiting Assistant Professor, Department of
Psychology, Michigan State University
Anthony Velleco, PH.D.
U.S. Behavioral Health, Philadelphia
Donna Wolf-Palacio, M.S.W.
Private Practice, Philadelphia
George E. Woody, M.D.
Clinical Professor, Department of Psychiatry, University of Pennsylvania
Medical School
Acknowledgments
Our interest in collecting treatment guidelines for the dynamic therapy of patients
with specific diagnoses grew out of our collaborative work as part of the University of
Pennsylvania Center for Psychotherapy Research, a clinical research center for the study
of psychotherapy funded by the National Institute of Mental Health. Our center's
primary aim is to develop and evaluate the efficacy of psychotherapies tailored to
specific populations. In regard to dynamic therapies, we were aware of a variety of other
clinicians and clinical researchers who had also begun the process of tailoring some
version of dynamic therapy to a specific population; out of this context the present book
emerged.
Financial support was provided in part by grants from the National Institute of
Mental Health, the National Institute of Drug Abuse, and from the National Institute of
Mental Health Clinical Research Center. We would like to thank Jo Ann Miller, Steven
Francoeur, and Michael Wilde from Basic Books for their patience and for their help in
completing this book.
CHAPTER 1
Introduction: Why We Should Develop
Psychodynamic Treatments for Specific
Psychiatric Disorders
Jacques P. Barber, Paul Crits-Christoph, and Jennifer Q. Morse
This chapter presents briefly the background and rationale for what the book intends
to achieve. Developments in psychotherapy research and practice as well as changes in
the patterns of delivery and reimbursement for mental health care have led us to
conclude, along with many others, that psychodynamic psychotherapy is in a precarious
situation. What follows are the recent developments responsible for our concerns.
SOCIAL AND POLITICAL DEVELOPMENTS
With the emergence of managed health care, such as health maintenance
organizations (HMOs), and caps on reimbursement for inpatient and outpatient care,
psychotherapists have become more aware of the importance of being recognized by the
health alliances as providing a worthwhile, cost-effective service. In general, HMOs and
similar managed care organizations provide their patients with a small number of low-
fee therapy sessions. The aims of the treatment are mostly targeted at alleviating
symptomatic discomfort. It seems more than likely that the emphasis on specific
disorders or on specific symptoms will continue and that therapists will be encouraged to
use treatments that have been shown empirically to be effective for those disorders and
symptoms.
EMPHASIS ON EMPIRICALLY DEMONSTRATED EFFECTIVE
TREATMENT
There is consensus that psychotherapy in general appears to be effective (e.g., Smith
& Glass, 1977); thus, the general question of effectiveness is no longer seen as relevant.
Instead, the question has become, "What treatments are effective for what types of
patients?" Along these lines, researchers on cognitive and behavioral treatments have