A prescriptive eclectic approach with Ms. Katrina

  • University of Scranton
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This article illustrates a prescriptive eclectic approach with Ms. Katrina, a complex and challenging woman, by demonstrating the process of customizing psychological treatments and therapeutic relationships to her specific needs as defined by a multitude of diagnostic and particularly nondiagnostic considerations. Given the wealth of clinical and historical information provided, we would initially concentrate on assessing Ms. Katrina's objectives, preferences, and resources while cultivating a validating and collaborative alliance. We would then systematically select and implement a series of cascading, iterative treatment decisions: setting, intensity, format, strategies, somatic treatments, and therapeutic relationships. Three priorities in this case are the coordination of an intense, integrative treatment involving multiple modalities, formats, and clinicians, the need to actively enlist Ms. Katrina's participation and strengths in her psychotherapy, and the centrality of therapist self-care when treating angst-inducing disorders.

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C. Norcross has made significant contributions in the areas of the transthe-oretical model of change, psychotherapy integration, and empirically supported psychotherapy relationships. This interview explores the contributions of pragmatic philosophy and his personal upbringing to his work as a psychotherapy researcher and practitioner. Dr. Norcross discusses the status of the psychotherapy integration movement, the work of the Task Force on Empirically Supported Psychotherapy Relationships, and future trends in psychotherapy over the next 25 years. He emphasizes the importance of a methodological rigor that recognizes the unique characteristics of the psychotherapy relationship. He describes his current interest in the psychotherapy of psychotherapists, illustrating it with his personal challenges in balancing work and home. KEY WORDS: psychotherapy; psychotherapy research; person of therapist; pragmatism; integration; therapeutic relationship. We must find a theory that will work; and that means something extremely difficult; for our theory must mediate between all previous truths and certain new experiences. It must derange common sense and previous belief as little as possible, and it must lead to some sensible terminus or other that can be verified exactly.-William James PRAGMATISM Abraham Wolf (AW)-You have written widely in the areas of psychotherapy integration, stages of change, and empirically supported psychotherapy relationships , among others. What do you see as the common thread?
The case of Katrina, a 25-year-old, married woman with a history of multiple psychiatric hospitalizations due to recurrent, impulsive suicide attempts, pervasive suicidal ideation, depression, and intrusive memories of sexual abuse, was presented to several experienced clinicians of various theoretical backgrounds. Regardless of the diagnostic label they assigned to the case or their theoretical orientation, the clinicians largely agreed on two levels of intervention: (a) the use of dialectical behavior therapy (DBT) and situational analysis in combination with other cognitive behavior therapies (CBTs) and interpersonal and behavioral interventions to address Katrina's current problems; and (b) interventions focused on Katrina's in-session behaviors and the use of the therapeutic relationship to provide Katrina with an opportunity to learn new, more adaptive coping skills in a safe and accepting environment.In this case conference, we invited several experienced clinicians—Nancy Caldwell, Kenneth Chase, Gerald Davison, Robert Kohlenberg, James McCullough, Shelley McMain, John Norcross, and Mavis Tsai—to share their wisdom and skill in applying their therapeutic approaches to the case of Katrina. Their response papers summarized Katrina's presenting problems; explicated their assessment plans; outlined case conceptualization; and suggested initial treatment plans.The information presented to the therapists was collected over 1 month, during four intake sessions at an outpatient clinic. Sources of information include intake interviews, her hospital records, testing report, and reports obtained from her couples therapist. The patient's name and identifying information have been changed to protect confidentiality.
This volume provides accurate texts of all the poems by Yeats published in his lifetime or scheduled for publication as of his death on January 28, 1939, including those omitted from earlier collections.
When one introduces a new psychotherapy model to professional colleagues, one must do 3 things: (a) define the patient for whom the program has been developed; (b) describe hoiv the model addresses the pro blemns of the patient, which entails some description of the techniques; and (c) present any efficacy data that are available that justify the usefulness of tile new program with the target population. Accordingly, Part 1 of tile article describes tile chronically depressed adult, (lie target individual for whoimi the cognitive behavioral analysis system of psychotherapy (CBASP; J. P. McCullough, 1984, 2000, 2001, 2003a) has been specifically developed. liz Part II, the reader is shown how GBASP tries to modify the multiple psychopathological pro blemns of the patient. In Part III is a summary of data obtained from a recently completed ,nultisite, national clinical trial in which 681 chronically depressed outpatients were comparatively treated with CBASP, nefazodone serzone., and their co,nbination. Among completers of the study (n = 519; 76%) during a 12-iveek acute phase, 55% responded to serzone, 52% responded to cBASP, and 85% responded to combination treatment.
The purpose of this article is to outline a prescriptive eclectic model of psychotherapy training. We begin with an overview of our approach to integration and describe our current efforts in training psychotherapists. Ten core, research-based principles for facilitating psychotherapist development are then advanced. We conclude by presenting two ideal models—depending on the consensus and control of the training faculty—for preparing integrative therapists.
Provides an introduction to the special section of the present issue of Psychotherapy: Theory, Research, Practice, Training. This special section was designed to examine the process by which psychotherapists consciously attempt to differentially employ or customize their interpersonal stance. This section, furthermore, may broaden the meaning of psychotherapy integration to denote selection not only of specific clinical procedures but also of relationship stances. The articles in this section complement and balance an earlier section in this journal devoted to prescriptive matching of therapeutic interventions to clients suffering from a discrete disorder. The intent of these articles is to summarize disparate efforts to determine the therapeutic "relationship of choice." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
More than 80% of practicing psychologists recommend self-help books to their psychotherapy clients, but only 33% recommend autobiographies written by mental health patients. In this study, 362 psychologists (38% response) provided clinical information and evaluative ratings on such published autobiographical accounts. The effect of reading autobiographies during treatment was typically considered "somewhat helpful." The titles and evaluative ratings of 40 leading autobiographies are provided as a resource for the practitioner; the most valued were An Unquiet Mind, Nobody Nowhere, Darkness Visible, Out of the Depths, and Girl Interrupted. The clinical advantages of recommending published autobiographies to clients are reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Imbroglio: Rising to the challenges of borderline per-sonality disorder
  • J M Cauwels
Cauwels, J. M. (1992). Imbroglio: Rising to the challenges of borderline per-sonality disorder. New York: Norton.
The courage to heal (revised ed.) NewYork Suicide: Guidelines for assessment, management, and treatment Interpersonal diagnosis and treatment of personality disorders
  • References Bass
  • E Davis
Received: August 25, 1999 References Bass, E., & Davis, L. (1992). The courage to heal (revised ed.). NewYork: Harper. Bongal, B. (Ed.). (1992). Suicide: Guidelines for assessment, management, and treatment. New York: Oxford University Press. Benjamin, L. S. (1996). Interpersonal diagnosis and treatment of personality disorders (2nd ed.). New York: Guilford.
Determining the therapeutic relationship of choice in brief therap) Objective psychological assessment in managed health care: A practi-tioner's guide
  • J C Norcross
  • L E Beuder
Norcross, J. C., & Beuder, L. E. (1997). Determining the therapeutic relationship of choice in brief therap),. In J. N. Butcher (Ed.), Objective psychological assessment in managed health care: A practi-tioner's guide. New York: Oxford University Press.
Lost in the mirror: An inside look at bo~lerline per-sonality disorder
  • R A Moskovitz
Moskovitz, R. A. (1996). Lost in the mirror: An inside look at bo~lerline per-sonality disorder. Dallas: Taylor.
Prescriptive eclec-Summary: The Case of Katrina
  • J C Norcross
  • L E Beutler
Norcross,J. C., Beutler, L. E., & Clarkin,J. E (1998). Prescriptive eclec-Summary: The Case of Katrina
The relationship of choice: Matching the therapist's stance to individual clients
  • Norcross