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Bundesgesundheitsblatt,... Apr 2008There are now several well evaluated (psychological) interventions available to treat depressive disorders. A large number of controlled randomized trials have been... (Comparative Study)
Comparative Study Review
There are now several well evaluated (psychological) interventions available to treat depressive disorders. A large number of controlled randomized trials have been conducted to establish scientific evidence for treatments' short- and long-term outcome. If the patient meets the diagnostic criteria for depression, a decision has to be made about referral to a psychiatrist or a psychotherapist for specialized treatment. Depending on severity of symptomatology (suicidality) as well as the range of individual problems, supportive counselling or specific psychotherapy is indicated. Specific psychotherapies for depression are in particular cognitive behaviour therapy (CBT) and interpersonal psychotherapy (IPT), to a less extent short-term psychodynamic psychotherapy (STPP) and client centred psychotherapy (CCPT). For these specific psychotherapies, empirical evidence is available about short-term (successful symptom reduction) and long-term (relapse prevention) outcome as monotherapy or in combination with antidepressive medication. Based on available outcome studies, 14 up-to-date treatment recommendations conclude this presentation.
Topics: Cognitive Behavioral Therapy; Counseling; Depression; Humans; Practice Guidelines as Topic; Psychotherapy; Psychotherapy, Brief; Randomized Controlled Trials as Topic; Referral and Consultation; Suicide; Time Factors; Treatment Outcome
PubMed: 18345471
DOI: 10.1007/s00103-008-0510-0 -
Acta Psychiatrica Scandinavica Nov 2009Psychotherapy is considered the primary treatment for borderline personality disorder (BPD). Currently, there are four comprehensive psychosocial treatments for BPD. Two... (Review)
Review
OBJECTIVE
Psychotherapy is considered the primary treatment for borderline personality disorder (BPD). Currently, there are four comprehensive psychosocial treatments for BPD. Two of these treatments are considered psychodynamic in nature: mentalization-based treatment and transference-focused psychotherapy. The other two are considered to be cognitive-behavioral in nature: dialectical behavioral therapy and schema-focused therapy.
METHOD
A review of the relevant literature was conducted.
RESULTS
Each of these lengthy and complex psychotherapies significantly reduces the severity of borderline psychopathology or at least some aspects of it, particularly physically self-destructive acts.
CONCLUSION
Comprehensive, long-term psychotherapy can be a useful form of treatment for those with BPD. However, less intensive and less costly forms of treatment need to be developed.
Topics: Borderline Personality Disorder; Cognitive Behavioral Therapy; Humans; Psychotherapy
PubMed: 19807718
DOI: 10.1111/j.1600-0447.2009.01448.x -
Psychodynamic Psychiatry Mar 2013The Y model of psychotherapy represents core components of all psychotherapies on the stem of the Y, and the specific components of psychodynamic psychotherapy and... (Review)
Review
The Y model of psychotherapy represents core components of all psychotherapies on the stem of the Y, and the specific components of psychodynamic psychotherapy and cognitive-behavioral therapy (CBT) on the arms of the Y. Familiarity with the Y model can help students cope with the confusion that emerges when trying to learn several different types of psychotherapy. The Y model also can be an important aid to teachers of psychodynamic psychotherapy. Use of the Y model helps students see how specific components of psychodynamic psychotherapy emerge from the core. It also helps students to compare psychodynamic psychotherapy with CBT (and other therapies). A student who has reached a point of confusion while doing psychodynamic psychotherapy can be invited to "zoom out" to the Y model, using it to examine this point of confusion, "zooming back in" for a fresh look at the patient-therapist interaction.
Topics: Cognitive Behavioral Therapy; Humans; Internship and Residency; Mental Disorders; Professional-Patient Relations; Psychotherapy
PubMed: 23480163
DOI: 10.1521/pdps.2013.41.1.111 -
Annals of Clinical Psychiatry :... Nov 2015Psychotherapies specifically designed for borderline personality disorder (BPD) are the most effective form of treatment for this population, but these modalities are... (Review)
Review
BACKGROUND
Psychotherapies specifically designed for borderline personality disorder (BPD) are the most effective form of treatment for this population, but these modalities are not easily accessible.
METHOD
Narrative review.
RESULTS
Although research shows that such therapies are effective, the best-known methods are lengthy, expensive, and difficult for patients to access.
CONCLUSIONS
This review recommends that interventions for patients with BPD should be briefer, less costly, and more accessible.
Topics: Borderline Personality Disorder; Health Services Accessibility; Humans; Psychotherapy
PubMed: 26554371
DOI: No ID Found -
Current Opinion in Pediatrics Aug 1999Meta-analytic studies demonstrate that psychotherapy works. This paper reviews the methodologic challenges that slow the research needed to explain what works, how, and... (Review)
Review
Meta-analytic studies demonstrate that psychotherapy works. This paper reviews the methodologic challenges that slow the research needed to explain what works, how, and for whom. The definition of psychotherapy is addressed briefly. Recognizing both the accomplishments and limitations of the recent focus on efficacy studies of highly specified therapies, researchers are turning to examining the effectiveness of psychotherapies. Effectiveness research examines issues of feasibility, ease in generalizing, and costs versus benefits. Research designers are interested in both moderators and mediators of treatment effect. Developmental theory and developmental psychopathology provide valuable focuses for research design. The paucity of research on process, on psychodynamic psychotherapies, and on combined treatments is noted. The paper concludes with a summary of recent psychotherapy research in several specific categories: prevention, autism, anxiety disorders, disruptive disorders, and depression.
Topics: Anxiety Disorders; Autistic Disorder; Child; Child Behavior Disorders; Child Psychiatry; Cost-Benefit Analysis; Depressive Disorder; Humans; Psychotherapy; Research Design; Treatment Outcome
PubMed: 10439205
DOI: 10.1097/00008480-199908000-00010 -
Behavior Therapy Nov 2016Personalized medicine is aimed at identifying which characteristics of an individual predict the outcome of a specific treatment, in order to get a better match between... (Meta-Analysis)
Meta-Analysis Review
Personalized medicine is aimed at identifying which characteristics of an individual predict the outcome of a specific treatment, in order to get a better match between the individual and the treatment received. We conducted a systematic review and meta-analysis of randomized trials comparing two psychotherapies directly in a group of depressed patients with a specific characteristic. We focused on the six most examined types of psychotherapy for adult depression. Our searches resulted in 41 studies with 2,741 patients who met inclusion criteria. These 41 studies examined 27 specific characteristics of patients. Power calculations indicated that we would need 4 studies for each characteristic to find a clinically relevant effect size set at g = 0.50 and 16 studies for an effect size of 0.24. Only 3 patient characteristics were found to have sufficient power and to significantly moderate treatment outcomes. Cognitive-behavioral therapy was found to be more effective than other therapies in older adults (g = 0.29), in patients with comorbid addictive disorders (g = 0.31), and in university students (g = 0.46). Risk of bias was considerable in most of the included studies. It was estimated that it will take another 326 years to have sufficient statistical power for showing an effect size of g = 0.50 of the 27 characteristics, and 1,372 years to show an effect size of 0.24. Although several dozens of studies have compared the effects of psychotherapies in specific target groups, we will need to develop more powerful alternatives to comparative outcome studies in order to identify personalized treatments for depression.
Topics: Cognitive Behavioral Therapy; Depressive Disorder; Humans; Person-Centered Psychotherapy; Precision Medicine; Psychotherapy
PubMed: 27993344
DOI: 10.1016/j.beth.2016.04.007 -
Evidence-based Mental Health Feb 2021The emblem of success in psychotherapy research and practice has long been innovation. Although such ingenuity is commendable, it has nonetheless perpetuated... (Review)
Review
The emblem of success in psychotherapy research and practice has long been innovation. Although such ingenuity is commendable, it has nonetheless perpetuated fragmentation across the field. At least four decades ago, it was suggested that achieving consensus on what constitutes psychotherapy's theoretical, empirical, and practical 'core' might allow the discipline to evolve beyond its siloed state, as is reflective of mature science. Yet, division remains the rule versus exception, owing in large part to power struggles among disparate schools of therapy and quarrels over whether theory-specific or theory-common factors most account for therapeutic change. We outline here a vision for psychotherapy's future that is defined by consensus rather than disintegration. Namely, we reiterate the need for the field to invest in clinical strategies that transcend ostensibly incompatible theoretical models. We also argue that psychotherapy research should build on the growing evidence for such clinical strategies in an effort to establish core, evidence-based principles of therapeutic change. We then discuss how establishing consensus will require reconciliation among the mounting evidence for flexible, principle-informed practice with the current realities of training, dissemination, and implementation paradigms. Finally, we articulate ways in which practicing clinicians will serve a vital role in carrying out, and amending as needed, actionable efforts toward psychotherapy consensus.
Topics: Consensus; Humans; Psychotherapy
PubMed: 33234505
DOI: 10.1136/ebmental-2020-300208 -
International Review of Psychiatry... Feb 2007Mental health teams in different configurations and settings are under increasing pressure to offer formal psychotherapies as well as psychologically informed management... (Review)
Review
Mental health teams in different configurations and settings are under increasing pressure to offer formal psychotherapies as well as psychologically informed management to large numbers of 'difficult' patients with severe and complex presentations. This pressure has arisen variously from consumers, governmental agencies and commissioning bodies. Although these teams are an important resource, they receive limited training, supervision or support in models of psychotherapy, especially those incorporating a relational dimension and offering a coherent 'common language'. This commonly results in impairment of collective team function, including the quality and consistency of assessments, and may result in stress, splitting and 'burn out' for team members. This situation is due in part to their burden of casework and responsibility but also to prevailing, largely symptom-based and biomedical, models of mental disorder which tend to minimize the importance of psychosocial dimensions in either aetiology or treatment. Formulating and delivering appropriate, evidence-based and robust models of psychotherapy in generic team settings represents a significantly different challenge from that posed by delivery of psychotherapy in specialist settings. Approaches to this important challenge are discussed and summarized drawing on general considerations and the limited direct research evidence, and are illustrated by a cognitive analytic therapy (CAT)-based training project.
Topics: Borderline Personality Disorder; Clinical Competence; Cognitive Behavioral Therapy; Evidence-Based Medicine; Humans; Inservice Training; Mental Disorders; Models, Psychological; Patient Care Team; Practice Guidelines as Topic; Prognosis; Psychiatric Nursing; Psychoanalytic Therapy; Psychotherapy; Research; Treatment Outcome; Workload
PubMed: 17365159
DOI: 10.1080/09540260601109380 -
Australasian Psychiatry : Bulletin of... Dec 2014This paper aims to provide a succinct overview of the factors common to empirically validated psychotherapies for borderline personality disorder (BPD), including the... (Review)
Review
OBJECTIVE
This paper aims to provide a succinct overview of the factors common to empirically validated psychotherapies for borderline personality disorder (BPD), including the treatment structure required.
CONCLUSION
Individual psychotherapy remains the cornerstone of treatment for BPD. Factors common to empirically validated modalities of therapeutic treatment have been identified. These need to be provided within an individualised and structured treatment framework. Improved outcome of treatment for BPD can then be achieved.
Topics: Borderline Personality Disorder; Humans; Psychotherapy
PubMed: 25319122
DOI: 10.1177/1039856214555531 -
Psychotherapie, Psychosomatik,... Dec 2013
Review
Topics: Biofeedback, Psychology; Cognitive Behavioral Therapy; Diagnosis, Computer-Assisted; Humans; Mental Disorders; Monitoring, Physiologic; Motivation; Psychotherapy; Technology; Therapy, Computer-Assisted; Video Recording; Virtual Reality Exposure Therapy
PubMed: 24285273
DOI: 10.1055/s-0033-1343289