A professional journal of practice based on psychotherapeutic methods
A quarterly publication 27th year, issue 4, November 2018
István Tiringer, Gábor Szőnyi
Questions of practice
Dóra Antal-Uram: „I’m a blazing wound” – Low intensity cognitive-behaviour therapy in internal medicine
Peter Schultess: Psychotherapy should be distinguished from transpersonal psychology and esotericism (translated by Vera Muth)
David Boadella: Boundaries to the transpersonal: A response to Peter Schulthess (translated by Vera Muth)
Steve Pearce, Lisle Scott, Gillian Attwood, Kate Saunders, Madeleine Dean, Ritz De Ridder, David Galea, Haroula Konstantinidou, Mike Crawford: Democratic therapeutic community treatment for personality disorder: randomised controlled trial (translated by Fruzsina Marsalkó and László Somogyi)
„The way we work”
Ágnes Fazekas: Katica – or the story of an interrupted(?) therapy. Commentaries by Elvira Kácsándi ♦ István Ormay ♦ Judit Sári
Rita Takács: The life-changing role of counselling for students of computer science
Establishment and development of the ELTE Computer Science Department Student Support Centre
An interview by Krisztina Pál and Márta Takácsy with the professors of the post-graduate training in online-counselling of the Károli Gáspár Calvinistic University
Krisztina Pál: Private psychotherapy offices
About communicating psychotherapy research on the boarder of scholarship and method marketing
Resolution of the Ethics Committee of the Psychotherapy Council Association
Discussion – “Necessity is virtue” – Gábor Szőnyi (introduction) ♦ József Krékits
Interviews – Gábor Szőnyi and István Tiringer interviewed Károly Ozsváth
Conferences – Gábor Imre ♦ Ágnes Sarolta Nagy ♦ Orsolya Páll ♦ Krisztina Pál ♦ Márta Takácsy ♦ Lili Valkó
Book reviews – Szilvia Karsai ♦ Mária Koltai ♦ Zsuzsanna Szabó ♦ Judit Székelyhidi ♦ Márta Takácsy ♦ Teodóra Tomcsányi
List of professional books and periodicals
Questions of practice
„I’m a blazing wound” – Low intensity cognitive-behaviour therapy in internal medicine
We present the case of a 21-year-old male with Crohn’s disease treated with low intensity cognitive behaviour therapy as an adjuvant management of comorbid psychiatric symptoms.
The physician referred the patient for a psychodiagnostic evaluation to the clinical psychologist. The evidence based, illness-specific clinical scales and questionnaires and personality inventory strengthened the diagnosis of disruptive mood dysregulation disorder (F34.8), avoidant personality disorder (F60.6) and psychological and behavioural factors associated with disease classified elsewhere (F54.0). The main indication for cognitive behaviour therapy includes the patient’s maladaptive behavioural patterns (avoidance, inactivity, non-adherence, procrastination and poor anger management) and cognitive distortions (such as catastrophizing, magnification, overgeneralization). These symptoms can be associated with medication non-adherence. Improving cognitive patterns via the elimination of cognitive distortions, biases such as catastrophizing can lead to an improved quality of life. Increasing adaptive coping such as assertiveness, self-efficacy, problem-solving and anger management can ameliorate the patient’s symptom management and promote a better treatment adherence. This case report outlines the tools of low intensity cognitive behavioural interventions, the possibilities and difficulties of managing comorbid psychiatric disorders in somatic states. We aim to outline the challenges in establishing rapport.
Keywords: Crohn’s disease – cognitive behaviour therapy – non-adherence – low intensity psychosocial interventions
Psychotherapy should be distinguished from transpersonal psychology and esotericism
Boundaries to the transpersonal: A response to Peter Schulthess
In our previous issue (Pszichoterápia, 27/3) we published the „Guidelines for psychotherapists on the issue of differentiating between psychotherapy and esoteric, spiritual and religious methods” of the Austrian Ministry of Health. In this issue we publish the argumentation of Peter Schulthess for those guidelines, together with the discussion of David Boadella.
Schulthess analyses the difference between spiritual states, together with the applied technics and methods and the psychotherapies. While it is indisputable that we can reach with certain medicaments, music, meditation or other tools greater consciousness, the seminal question remains: do those practices and technics belong to the psychotherapies?
In the distinction Schulthess emphasizes that esoteric methods avoid scientific reflection and evaluation. He does not see problematic if a psychotherapist has special interest in esoteric-transpersonal phenomenon and methods. But it is problematic if the therapist unifies the role of the therapist and of the helper applying esoteric technics in oneself. His standpoint is that psychotherapeutic training and competence does not empower us to build such operations into the practice which are outside of the psychotherapies.
In his disagreement, David Boadella circumscribes those transpersonal methods which are inside the community of the psychotherapies, although he shares some of Schulthess’ points. He also discusses the plasticity of the boarder which separates psychotherapies from fake therapies. Finally, he stresses the importance of professional ethics, and warns against power regulations.
Democratic therapeutic community treatment for personality disorder: randomised controlled trial
Steve Pearce, Lisle Scott, Gillian Attwood, Kate Saunders, Madeleine Dean, Ritz De Ridder, David Galea, Haroula Konstantinidou, Mike Crawford
Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent.
Aims of the study are to test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder.
Method: An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317). The intervention was DTC and the control condition was crisis planning plus treatment as usual (TAU). The primary outcome was days of in-patient psychiatric treatment. Secondary outcomes were social function, mental health status, self-harm and aggression, attendance at emergency departments and primary care, and satisfaction with care. All outcomes were measured at 12 and 24 months after randomisation.
Results: Number of in-patient days at follow-up was low among all participants and there was no difference between groups. At 24 months, self- and other directed aggression and satisfaction with care were significantly improved in the DTC compared with the TAU group.
Conclusions: DTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion.
Key-words: democratic therapeutic community treatment – randomized controlled trial – personality disorder – number of in-patient treatment days – treatment satisfaction