The essence of process-experiential : emotion-focused therapy

Process-Experiential/Emotion-Focused Therapy (PE-EFT; Elliott et al, 2004; Greenherg et al, 1993) is an empirically-supported, neo-humanistic approach that integrates and updates person-centered, Gestalt, and existential therapies. In this article, we first present what we see as PE-EFT's five essential features, namely neo-humanistic values, process-experiential emotion theory, person-centered hut process-guiding relational stance, therapist exploratory response style, and marker-guided task strategy. Next, we summarize six treatment principles that guide therapists in carrying out this therapy: achieving empathic attunement, fostering an empathic, caring therapeutic bond, facilitating task collaboration, helping the client process experience appropriately to the task, supporting completion of key client tasks, and fostering client development and empowerment. In general, PE-EFT is an approach that seeks to help clients transform contradictions and impasses into wellsprings for growth

The role of the individual in the coming era of process-based therapy

For decades the development of evidence-based therapy has been based on experimental tests of protocols designed to impact psychiatric syndromes. As this paradigm weakens, a more process-based therapy approach is rising in its place, focused on how to best target and change core biopsychosocial processes in specific situations for given goals with given clients. This is an inherently more idiographic question than has normally been at issue in evidence-based therapy over the last few decades. In this article we explore methods of assessment and analysis that can integrate idiographic and nomothetic approaches in a process-based era.Accepted manuscrip

Matrix Metalloproteinase-9 and Inflammation in Different Types of Multiple Sclerosis

Different clinical courses of multiple sclerosis, heterogeneity of its clinical implications, different effect of immunomodulatory therapy for the same clinical forms implies various pathogenetic mechanisms of central nervous system damage at this disease. Applicability of immunological and biochemical markers for the estimation of immunocorrecting and anti-inflammatory therapy efficacy is important. This research aims at improvement of pathological process stages diagnostics at multiple sclerosis and further therapy optimization depending on the activity of the inflammatory process. In the article matrix metalloproteinase-9 rate was assessed in 135 patients with multiple sclerosis of different course types and at different activity stages of the pathological process. The highest matrix metalloproteinase-9 rates were in patients with relapsing-remitting type at the stage of exacerbation, with the lowest rate being in patients with primary-progressive multiple sclerosis. Determination of matrix metalloproteinase-9 rate allows to assess the degree of inflammatory process expression and to monitor the efficacy of multiple sclerosis treatment

Investigating Habituation to Premonitory Urges in Behavior Therapy for Tic Disorders

Behavior therapy is effective for Persistent Tic Disorders (PTDs), but behavioral processes facilitating tic reduction are not well understood. One process, habituation, is thought to create tic reduction through decreases in premonitory urge severity. The current study tested whether premonitory urges decreased in youth with PTDs (N = 126) and adults with PTDs (N = 122) who participated in parallel randomized clinical trials comparing behavior therapy to psychoeducation and supportive therapy (PST). Trends in premonitory urges, tic severity, and treatment outcome were analyzed according to the predictions of a habituation model, whereby urge severity would be expected to decrease in those who responded to behavior therapy. Although adults who responded to behavior therapy showed a significant trend of declining premonitory urge severity across treatment, results failed to demonstrate that behavior therapy specifically caused changes in premonitory urge severity. In addition, reductions in premonitory urge severity in those who responded to behavior therapy were significant greater than those who did not respond to behavior therapy but no different than those who responded or did not respond to PST. Children with PTDs failed to show any significant changes in premonitory urges. Reductions in premonitory urge severity did not mediate the relationship between treatment and outcome in either adults or children. These results cast doubt on the notion that habituation is the therapeutic process underlying the effectiveness of behavior therapy, which has immediate implications for the psychoeducation and therapeutic rationale presented in clinical practice. Moreover, there may be important developmental changes in premonitory urges in PTDs, and alternative models of therapeutic change warrant investigation

Principles of Behavior Therapy and Behavior Modification (Chapter 5 from The Human Reflex)

This chapter examines the theoretical aspects of the application of behavioral psychology (technically, the experimental analysis of behavior) to the process of behavior therapy. Beginning with a brief history, we will then discuss the definition of behavior therapy and behavior modification, survey a conception of problem behavior that grows out of the behavioral approach, examine basic approaches to behavior therapy, look at specific behavior change techniques, discuss biblical parallels, and consider several areas of controversy

Hermeneutic single-case efficacy design

In this article, I outline hermeneutic single-case efficacy design (HSCED), an interpretive approach to evaluating treatment causality in single therapy cases. This approach uses a mixture of quantitative and qualitative methods to create a network of evidence that first identifies direct demonstrations of causal links between therapy process and outcome and then evaluates plausible nontherapy explanations for apparent change in therapy. I illustrate the method with data from a depressed client who presented with unresolved loss and anger issues

An exploration into the client at the heart of therapy : a qualitative perspective

Over 50 years ago Eysenck challenged the existing base of research into psychotherapy. Since that time, a large number of investigations have been conducted to verify the efficacy of therapy. Recently however, an increasing number of studies have cast new doubts on this research base. Instead of therapy being a function of the therapist, it is now becoming ever more apparent that the client plays a prime role in the therapeutic process. The qualitative studies presented in this paper provide some examples of research that demonstrates that clients are actively involved in their therapy, even making counselling work despite their counsellor. These studies suggest that clients may not experience therapy as beneficially as traditional outcome studies indicate. This raises a new challenge to researchers to more fully explore the client's experience of therapy, a challenge to which qualitative methods of inquiry would appear well suited

Pre-therapy process and outcome: A review of research instruments and findings

Pre-Therapy aims at stimulating psychological contact in persons suffering psychosis. We offer a review of Pre-Therapy research instruments and findings. The Pre-Therapy Rating Scale (PTRS, Prouty, 1994) and the Evaluation Criterion for the Pre-Therapy Interview (ECPI, Dinacci, 1997) have been the two most frequently used instruments for the assessment of psychological contact. PTRS scores seem more reliable than ECPI scores, but all manuals need revision. Particular attention is needed for the rating of nonverbal behavior. A preliminary evaluation of the structure of the PTRS indicates that it is two-dimensional rather than three-dimensional. The PTRS and the ECPI can be regarded as measures of communicative contact but also as measures of the meaningfulness of communication. Preliminary outcome studies suggest that pre-post and comparative effect sizes of Pre-Therapy are large for communicative contact, but the number of participants in these studies is generally low, as is the number of systematic case studies

When Perfect Fear Casts Out All Love : Christian Perspectives on the Assessment and Treatment of Shame

Shame reactions are often uncomfortable, even excruciating, for clients to work through in therapy. When not adequately treated, shame reactions can seriously disrupt the therapy process. This article seeks to equip Christian mental health professionals with practical strategies for effectively assessing and treating shame reactions. Theoretical perspectives on shame within a Christian context are also briefly discussed