Louise Gaston

TRAUMATYS

Clinical stories of psychotherapy for PTSD: An Integrative dynamic approach

The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a structured interview that assesses the frequency and severity of each symptom of posttraumatic stress disorder (PTSD) in relation to a single traumatic stressor over a 1-month period, allowing the trained interviewer to infer a current or lifetime diagnosis congruent with the 5th Edition...

Clinical guidelines for treating post-traumatic stress disorder (PTSD) have recommended using cognitive-behavioural therapy (CBT) only. This is not surprising given that almost all randomized clinical trials were conducted by CBT researchers examining the efficacy of CBT. The two types of standardized CBT -- trauma-focused and non-trauma-focused –...

This the manual for the California Psychotherapy Alliance Scale (CALPAS). It includes the measure for psychotherapy (patient, therapist, and rater versions), group psychotherapy (patient and therapist versions), pharmacotherapy and child psychotherapy.

Both trauma-focused (TF) and non-trauma-focused (N-TF) therapies are associated with partial PTSD remission for about half of completers. However, there may be unique neural mechanisms underlying symptom reductions in TF vs. N-TF therapies. Multiple neuroimaging studies suggest that PTSD is associated with increased amygdala activation and decrease...

Les études de neuroimagerie indiquent que le trouble de stress post-traumatique (TSPT) est associé à une augmentation de l’activité de l’amygdale et à une réduction de l’activité du cortex cingulaire antérieur (CCA). Quoique les deux types de thérapie pour le TSPT, focalisée sur le trauma (FT) vs. non-focalisée (N-FT), ont été associées à court-ter...

With depressed elderly patients treated in behavioral (BT), cognitive (CT) or brief dynamic therapy (BDT), the prediction of outcome by alliance, technique (exploratory and supportive), and their interactions was examined. The alliance was rated on the CALPAS-R, and technique on the Inventory of Therapeutic Strategies (ITS). In BT, pretherapy depre...

Few studies have examined whether trauma-exposed individuals are consistent in their retrospective reports of how they reacted at the time of trauma exposure, and whether this phenomenon has any implications at the diagnostic level. In a series of three longitudinal studies (N = 113) with different timeframes, the authors prospectively investigated...

To develop new Minnesota Multiphasic Personality Inventory (MMPI) scales for diagnosing acute and chronic posttraumatic stress disorder (PTSD), 237 civilians with PTSD or panic disorder (controls) completed the MMPI-R. All 399 items were submitted to chi-square analysis to select those differentiating acute or chronic PTSD from controls. The analys...

The purpose of this study was to determine the influence of the therapeutic alliance on the efficacy of pharmacotherapy for depression. The sample consisted of 31 depressed outpatients treated with antidepressants. The alliance was measured by the patient and therapist versions of the California Pharmacotherapy Alliance Scale. Treatment outcome was...

The McGill Object Relations Scale (MORS) is an instrument for assessing levels of drive-based object relations along a continuum of positions representative of psychosexual development. Its theoretical foundations as well as empirical antecedents are presented, and its rating procedure is demonstrated through a case application. The MORS was applie...

In a treatment setting, a group of 165 subjects presenting with either acute or chronic posttraumatic stress disorder (PTSD) were compared to 72 subjects presenting with panic disorder only in order to determine whether the MMPI PTSD assessment strategy developed with Vietnam veterans could be validly used with civilians. Results indicated that the...

In contemporary psychosocial treatment research, the test of the efficacy of standardized treatment manuals predominates in respectability relative to naturalistic research on the process components of flexible treatments, though the latter strategy is necessary for the empirical identification of effective process components. Standardizing a treat...

Weinberger's article on common factors (this issue) highlights crucial aspects of the psychotherapy process. Toward the aim of building a theory of psychotherapy change, I further suggest that theoretical eclecticism would fuel our conceptual creativity, by encouraging therapists to openly learn all major theoretical systems and avoid identifying t...

Presents a panel discussion of the therapeutic alliance as viewed from different theoretical orientations. The purpose was not to debate and reach consensus on what is the "true" definition of the alliance. Instead, it was to explore some of the similarities and differences of the alliance as it is seen from the cognitive-behavioral, psychodynamic,...

A previous clinical trial provided the opportunity to examine the roles and interaction of alliance and technique in both short- and long-term analytic psychotherapy. Two separate teams of trained clinical judges rates either alliance on the CALPAS or therapist interventions on the ITS. Outcome included symptomatology and interpersonal problems. In...

try to present a balanced view [of the therapeutic alliance] by providing evidence for the utility of the alliance concept while acknowledging controversies / review concepts that describe the therapeutic relationship / explicate the concept of the therapeutic alliance and review methods of measuring the alliance / present the research linking the...

The qualities of a new measure of therapists' interventions, the Inventory of Therapeutic Strategies (ITS), were examined in cognitive and brief dynamic psychotherapy. In contrast to other inventories, the ITS focuses on three types of therapist intentions (exploratory, supportive, and work-enhancing), and it also takes into account the content and...

In this study, the authors examined whether reports of client satisfaction in psychotherapy are biased by client tendency to provide socially desirable answers. This question was explored in the context of dynamic, eclectic, and cognitive/behavioral modalities of psychotherapy, which were provided in private practice settings. The Client Satisfacti...

For older depressed adults treated in behavioral, cognitive, or brief dynamic therapy, we examined alliance-outcome associations over and above initial symptomatology and in-treatment symptomatic change, as therapy progressed. Patients and therapists completed the California Psychotherapy Alliance Scales, CALPAS, after the 5th, 10th, and 15th sessi...

There is increasing evidence that persons suffering from major mental disorders are entering the criminal justice system. It was hypothesized that inadequate community care may be a contributing factor. The present investigation followed 112 chronically mentally disabled persons for two years. Half the participants resided in supervised apartments,...

Aspects of the reliability and criterion-related validity of the patient version of the California Psychotherapy Alliance Scales (CALPAS-P) were examined. The sample consisted of 147 patients consulting in private practice. Ss completed the 24-item CALPAS-P designed to assess 4 alliance dimensions. They also filled out questionnaires on symptomatol...

Using a dismantled time-series design, 18 subjects with psoriasis symptoms on the scalp were randomly assigned to four groups and six dropped out: meditation (N = 5); meditation and imagery (N = 4); waiting list (N = 5); and no treatment control group (N = 4). Treatment lasted 12 weeks, with 4 weeks pre- and post-baseline periods. An assessment con...

The impact on the mentally disordered of living in supervised residences remains unclear. The present investigation followed a group of supervised apartment residents and a matched comparison group for two years. Symptomatology, psychosocial functioning, stress, social support, quality of life, and life satisfaction were measured at six month inter...

Reviews definitions of the alliance (ALI) concept and proposes 4 relatively independent ALI dimensions that are complementary and compatible. These include (1) the therapeutic ALI, (2) the working ALI, (3) the therapist's empathic understanding and involvement, and (4) the patient–therapist agreement on the goals and tasks of treatment. There is ev...

Quatre projets d'appartements surveillés sont évalués sur une période de deux ans. La description de leur fonctionnement quotidien permel d'observer I'implantation de ces programmes communautaires et de mieux comprendre leur impact. Les données recucillies indiquent que plusieurs evenements difficiles se produisent au sein de ces ressources et que...

Used archival data from a study by L. Thompson et al (see record 1987-32037-001) to examine the association between patient expectations of various change processes (ECPs) and outcome across behavioral, cognitive, and brief dynamic therapy. 56 elderly patients (mean age 67.18 yrs) with major depression received from 16 to 20 sessions of individual...

Older adults who met criteria for major depressive disorder were randomly assigned to behavioral, cognitive, or brief dynamic therapy. Symptoms were equally reduced across the three treatment conditions. Early in treatment, alliance ratings were obtained from both therapists and patients and were related to outcome. We calculated one therapist alli...

The management and treatment of mentally disordered offenders is significantly hindered by our lack of detailed knowledge of this population. The present investigation attempted to identify five groups of male, mentally disordered offenders that are distinctive with respect to treatment needs: career criminals, chronic schizophrenics, violent psych...

Proposes the generalized least squares method, a time-series multiple-regression analysis, to simultaneously assess treatment efficacy and process correlates of outcome and to test alternative hypotheses of treatment efficacy. This approach can be applied to small samples by capitalizing on repeated measurements. Criteria for qualitative analysis a...

The California Therapeutic Alliance Rating System, CALTARS, was used by judges to rate four therapy sessions for each of 52 subjects treated in brief dynamic psychotherapy for pathological grief. A principal-components analysis provided support for the theoretically proposed domains of alliance. The interrater reliability at the treatment level was...

The prediction of the therapeutic alliance from patient pretreatment characteristics was investigated with a sample of elderly depressed outpatients treated in behavioral, cognitive, and brief dynamic psychotherapy (N = 60). For the sample as a whole, a higher degree of patient defensiveness was related to a lower patient contribution to the allian...

In previous works, stress has been found to be related to psoriasis but only retrospectively and/or by means of nonstandardized measures. In our study the relationship between psoriasis and stress was examined prospectively over a period of 20 weeks by means of standardized measures. A multivariate statistical method indicated a positive correlatio...

Les programmes communautaires visent à aider les bénéficiaires à s'intégrer de façon permanente au sein de la collectivité. Pour ce faire, ces programmes doivent être constitués de multiples composantes qui visent à réduire ou à éliminer les difficultés présentées par ces personnes. Ces composantes sont : des chimiothérapies; des interventions visa...

Community services for persons suffering from major psychological disorders have often been developed without prior consideration of the results of studies measuring the effectiveness of such programs or of the problems presented by this population once they leave hospital. In this article we attempt to develop a conceptual framework useful for pla...

Community programmes are designed to help clients establish themselves permanently in the community to succeed, these programmes must include several treatment components each addressing a specific problem presented by the clients. These components include : drug therapy, an intervention to encourage clients to take medications as prescribed ; an i...

Evaluates the originality and value of 4 principal feminist therapies and theories proposed by I. G. Foder (1974), the Feminist Counseling Collective (1975), B. R. Dubois (1976), and J. B. Miller (1976). Their originality is analyzed by examining the extent to which the theory and the therapy depart from the Freudian, humanist, and behavioral model...

The present study concerns an anti-stress intervention involving a social and health services clientele. This category of the population represents the individuals who are statistically the most affected by stress. The anti-stress intervention used consists in assisting the individual to work towards the modification of his "stressors" and to permi...

Résumé La présente étude porte sur une intervention anti-stress auprès de la clientèle des services sociaux et de santé. Cette catégorie de la population représente les personnes qui sont statistiquement les plus touchées par le stress. L'intervention anti-stress utilisée consiste à amener l'individu à travailler à la modification de ses «stresseur...

Investigated the effectiveness of an individualized imagery technique in treating psoriasis and assessed its additional impact over and above the use of a meditative technique. Using a dismantled time-series design, 18 Ss (aged 20–50 yrs) were randomly assigned to meditation, meditation and imagery, or waiting list groups. Treatment lasted 12 wks,...

Evaluated the effectiveness of an imagery and meditation technique for reducing the severity of psoriasis symptoms in a 25-yr-old female using an A-B-A design. The S participated in a baseline period of 4 wks, a treatment of 15 wks, and a return to baseline of 4 wks. A 4-wk follow-up was conducted 12 wks after the treatment. During each phase, a de...

Thèse (M. Ps.)--Université de Montréal, 1982. "Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de maître en psychologie (M. Ps.)." Microfilm du manuscrit.