| 1. |
- Ankarberg, Peter, et al.
(författare)
-
Treatment of depression with antidepressants is primarily a psychological treatment
- 2008
-
Ingår i: Psychotherapy. - : American Psychological Association (APA). - 0033-3204 .- 1939-1536. ; 45:3, s. 329-339
-
Tidskriftsartikel (refereegranskat)abstract
- Depression treatment with antidepressants is generally described as evidence-based. However, generalizations to practice recommendations seem to us to rest on the tacit assumption that treatment outcome in research trials is the sum of three factors: specific effects of the drug, expectancy effects (placebo), and spontaneous recovery. Because randomization isolates the specific effects of the drug, trials showing significant drug effects are used as evidence for prescribing the drug regardless of context. Drawing on Wampold's (2001) description of two metamodels of psychotherapy, the authors argue that available empirical evidence indicates that depression treatment with antidepressants is primarily a psychological treatment. This conclusion has far-reaching consequences for the scientific status of contemporary treatments for depression. It also affects what the doctor should focus on in a treatment with antidepressants and how to act when the patient is treatment resistant. In order to achieve the results obtained in clinical trials, the quantity and quality of support from the doctor is more important than pharmacological concerns, such as adequate doses of medicine. When faced with a treatment resistant patient, relationship factors rather than pharmacological factors should be in focus
|
|
| 2. |
- Falkenström, Fredrik, et al.
(författare)
-
Self-analysis and post-termination improvement after psychoanalysis and long-term psychotherapy
- 2007
-
Ingår i: Journal of the American Psychoanalytic Association. - 0003-0651 .- 1941-2460. ; 55:2, s. 629-674
-
Tidskriftsartikel (refereegranskat)abstract
- Long-term follow-up studies of long-term psychoanalytically oriented psychotherapy or psychoanalysis are extremely rare, and few have focused on the post-treatment process itself. In the Stockholm Outcome of Psychoanalysis and Psychotherapy project, one of the results was that patients in psychoanalysis continued to improve after termination to a higher degree than patients in long-term psychotherapy. In this study 20 patients selected from the project were interviewed on two occas ions, one and two years after termination, in order to explore how they described their post-treatment processes. The interviews were studied qualitatively using a multiple case study design, and categories of different types of post-treatment development were created from these case studies. Results indicate that the variation within treatment groups is large, and that development may continue in several ways after termination. The most striking difference between psychoanalysis and psychotherapy was not, as hypothesized, in the self-analytic function, but in various self-supporting strategies described by former analysands but not by former psychotherapy patients. However, only self-analysis was significantly correlated with post-termination improvement across both treatments. Three patients improving after termination and three deteriorating are described in detail as illustrations. Some methodological constraints of the design limit the generalizeability of results.
|
|
| 3. |
- Falkenström, Fredrik
(författare)
-
The psychodynamics of self-observation
- 2007
-
Ingår i: Psychoanalytic dialogues. - : Informa UK Limited. - 1048-1885 .- 1940-9222. ; 17:4, s. 551-574
-
Tidskriftsartikel (refereegranskat)abstract
- A framework for thinking about self-observation in relational psychoanalytic terms is described, in which three different levels of self-observation are distinguished. These levels are differentiated according to the kind of intrapsychic relationship enacted (monadic, dyadic, or triangular). Each level of observation is discussed separately with focus on the dynamic forces inhibiting or facilitating self-observation within each level. Dyadic and triangular levels of self-observation are well known in psychoanalytic theories, but a monadic, or one-dimensional level in which the ego is not split, is also described. This form of observation and the psychodynamics involved is discussed in relation to Bion's concept "O" and theory from Buddhist psychology. Finally, the interrelatedness of levels is described, and a brief case description from a session of psychoanalytic psychotherapy is used to illustrate how the three levels of observation interact. © 2007 The Analytic Press, Inc.
|
|
| 4. |
|
|
