Compulsive Homicides in Historical Context
Louis B. Schlesinger in Sexual Murder, 2021
An important distinction can be made between academic researchers, who typically do not have much clinical experience, and those researchers who are practicing clinicians. For example, in the 1960s, a slew of studies supposedly demonstrated the lack of empirical support for the effectiveness of psychotherapy. As Brody (1972) stated, “There does not exist a body of research which would permit one to assert that psychotherapy in one or more of its several forms has been adequately shown to be effective” (p. 299). Yet, at the same time, patients treated with psychotherapy were getting better, more individuals were being treated, insurance companies were reimbursing for such treatment because of its obvious value, and psychotherapy’s effectiveness had clearly stood the test of time. Academic research without the insight of individuals who practice is often filled with errors that are not recognized by the researchers because of their limited perspective. Some researchers incorrectly believe that scientific rigor is based primarily on the statistical techniques used—the more complex and esoteric the techniques, the more “scientific” the research. However, the level and type of quantification employed should be consistent with what is being studied. Premature quantification not only is often unhelpful but also can limit the development of our knowledge.
Introduction Part 1
Paul Ian Steinberg in Psychoanalysis in Medicine, 2020
Psychoanalysis is expensive in terms of the commitment of time and money required for it. In addition, it requires much of analyst and patient in terms of developing the capacity to undergo intense experiences, thinking previously unthinkable thoughts and feeling previously unbearable emotions. However, psychoanalytic candidates (trainees) often offer low-fee psychoanalysis to patients whom they treat under supervision. Also, some psychoanalysts and psychoanalytic psychotherapists offer a sliding scale of fees according to the patient’s income. In some European countries, as well as in Canada and Australia, psychoanalytic psychotherapy, and to some extent, psychoanalysis, is provided by state-run medical insurance plans, and is either completely or largely covered by these plans in many jurisdictions. The demonstrated savings related to reduced emergency room and family medicine visits, and reduced need for medical investigations and surgical procedures, in patients who have undertaken psychotherapy and psychoanalysis obviate the cost of these treatments (Altmann et al., 2018).
Analyzing and integrating a body of knowledge: Systematic reviews and meta-analysis of evidence
Milos Jenicek in Foundations of Evidence-Based Medicine, 2019
The purpose of a quantitative, ‘classical’ meta-analysis is usually to assess the effectiveness of treatments, health programs and interventions, and less often to assess other cause–effect relationships. For instance, is there a relationship between intelligence and schizophrenia in young subjects? Does a full moon affect mental health and behavior? Is psychotherapy effective? Can hyperactivity in children be controlled pharmacologically or by dietary regimens? ‘Classical’ or quantitative meta-analysis addresses two basic questions: How is one variable related to another?How strong is the evidence for the relationship?
Older Veterans’ Treatment Preferences: Psychotherapy and Self-Management Treatment Modalities
Published in Clinical Gerontologist, 2023
Flora Ma, Chalise Carlson, Rowena Gomez, Christine E. Gould
The Technology Semi-Structured Interview Guide included pictures (i.e., sample intervention screenshots) of the treatment modalities including psychotherapy and self-management modalities (printed materials, DVD videos, mobile-apps, and Internet-based). Psychotherapy was described as psychotherapy with a counselor or therapist. Further, it was specified that psychotherapy could be delivered in-person, by phone, or via video telehealth. Participants were asked to rank the four self-management modalities preferences compared with psychotherapy to cope with emotional difficulties and to provide the rationale underlying their choice. For the purposes of this study, participants were grouped into two groups based on their first preferred treatment: psychotherapy or self-management. Interviewers asked participants’ opinions on their choice of ranked treatment preferences as qualitative feedback.
Conversational Artificial Intelligence—Patient Alliance Turing Test and the Search for Authenticity
Published in The American Journal of Bioethics, 2023
Oren Asman, Amir Tal, Yechiel Michael Barilan
Psychotherapy is provided by professionals, trained, supervised and certified by other professionals, all the way back to Freud and similar founding fathers. Even though methods and styles vary, patients know that psychotherapy involves authenticity—the personal attention of a therapist whose training and certification emanate from a professional tradition and is sanctioned by the law. Some psychoanalysts are of the opinion that therapy should be “goalless” and “just analyze” (Westenberger-Breuer 2007), thus highlighting the primacy of authenticity over utility. Regardless of the treatment methods and professional structures, research shows a robust association between patient-clinician alliance and outcomes of face-to-face psychotherapy, suggesting that symptom improvement and alliance work synergistically (Wampold and Flückiger 2023). Initial evidence from computer programs-based psychotherapy demonstrated that patient-rated alliance to a bot could predict treatment outcomes, whereas alliance with the therapist better predicted adherence to treatment (Zalaznik et al. 2021). It might seem that Conversational Artificial Intelligence’s (CAI) status is further moving from a digital tool toward a digital therapist (Sedlakova and Trachsel 2023). What is the difference?
Effective Psychotherapists: Clinical Skills That Improve Patient Outcomes. New York & London: Guilford Press, 2021. $32. IBSN: 978-1-4625-4689-3
Published in Psychiatry, 2023
EDWARD Silberman
Effective Psychotherapists deserves a place in the library of any practitioner of psychotherapy, including, if not especially, psychiatrists conducting supportive psychotherapy in the context of medication prescription and management. It is clear, concise, easy to read, evidence-based, and helpfully organized. Although centered on practice of clinical psychology and the psychology research literature, it is a timely publication for the field of psychiatry where medicalization may obscure essential interpersonal aspects of care (Carlat, 2010). For both beginning and experienced mental health practitioners, the concepts of the book provide valuable insight into the impact of clinicians’ attitudes and behaviors on their patients, and useful models by which to benchmark their own professional growth.
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