Concise Guide to Brief Dynamic and

The seven therapeutic models highlight the importance of the interpersonal perspective as opposed to Freud's drive-oriented perspective. Updated chapters discuss supportive, time-limited, and interpersonal therapies; time-limited dynamic psychotherapy; short-term dynamic therapy for patients with posttraumatic stress disorder; and brief dynamic therapy for patients who abuse substances.

Hanna Levenson, Ph.D., is the Founder of the Levenson Institute for Training (LIFT) and Director of the Brief Psychotherapy Program at California Pacific Medical Center in San Francisco. She also maintains a private practice in San Francisco and Oakland, California. For 20 years she was Clinical Professor in the Department of Psychiatry at the University of California School of Medicine. Past positions include Director of Brief Therapy Training at the Veterans Administration Medical Centers in San Francisco and Palo Alto, California.

Stephen F. Butler, Ph.D., is Senior Vice President and Chief Science Officer at Inflexxion (formerly Innovative Training Systems), a research and consulting firm based in Massachusetts that develops scientifically based solutions in the areas of health education, prevention, and disease management. Before serving in this position, he held faculty appointments in the Vanderbilt University Psychology Department and the Psychiatry Department of the Medical College of Virginia. He was also Director of Psychology at Nashua Brookside Hospital, Nashua, New Hampshire.

Theodore A. Powers, Ph.D., is an Assistant Professor in the Department of Psychology at the University of Massachusetts Dartmouth. Previously, he was Clinical Director of the Short-Term Therapies Unit at Massachusetts General Hospital and an Instructor at Harvard Medical School.

Bernard D. Beitman, M.D., is Professor and Chairman in the Department of Psychiatry and Neurology at the University of Missouri--Columbia School of Medicine.

About the Authors

xv

Introduction to the Concise Guides Series

xvii

Introduction

1

(14)

Focus of the Book

1

(2)

Psychodynamic Orientation

1

(1)

Interpersonal Focus

2

(1)

Brief Psychotherapy

3

(3)

Brief Dynamic Approaches

4

(2)

Qualities That Define Brief Dynamic Therapy

6

(1)

Values and Attitudes

6

(3)

Specific Models Presented

9

(6)

Supportive Therapy: Treatment for Lower-Functioning Patients...and Others?

15

(22)

Definition of Supportive Psychotherapy

18

(1)

Selection of Patients

18

(1)

Goals of Treatment

19

(1)

The Therapeutic Alliance

20

(1)

Techniques of Supportive Therapy

21

(10)

Reducing Anxiety

21

(1)

Enhancing Self-Esteem

22

(1)

Respecting Defenses

23

(1)

Clarification, Confrontation, and Interpretation

24

(1)

Rationalization

25

(1)

Reframing

26

(1)

Encouragement

26

(1)

Advising

27

(1)

Rehearsal or Anticipation

28

(1)

Responding to Ventilation

28

(1)

Attention to, Not Interpretation of, Transference

29

(1)

Conclusion

30

(1)

Clinical Illustration

31

(1)

Empirical Findings

32

(2)

Relevance for Managed Care

34

(3)

Time-Limited Therapy

37

(18)

Basic Framework

37

(1)

Theory and Technique

38

(2)

Phases of Treatment

40

(4)

Intake/Selection

40

(1)

Honeymoon Phase

41

(1)

Negative Transference Phase

42

(1)

Termination Phase

43

(1)

Reverberations for the Therapist

44

(1)

Clinical Illustration

45

(7)

Empirical Findings

52

(1)

Relevance for Managed Care

52

(3)

Interpersonal Psychotherapy for Patients With Depression

55

(22)

Basic Principles

56

(2)

Selection Criteria

58

(1)

Goals

58

(1)

Strategies and Phases of Treatment

59

(8)

Initial Sessions

59

(3)

Intermediate Phase

62

(3)

Termination Phase

65

(2)

Clinical Illustration

67

(5)

Psychoeducation About the Sick Role

68

(1)

Here-and-Now Framework

68

(1)

Interpersonal Formulation

68

(1)

Exploring Options

69

(1)

Problem Areas

69

(2)

Therapist Confidence

71

(1)

Termination

72

(1)

Empirical Findings

72

(2)

Relevance for Managed Care

74

(3)

Time-Limited Dynamic Psychotherapy

77

(20)

Conceptual Framework

78

(5)

Assumptions

78

(2)

Goals

80

(1)

The Cyclical Maladaptive Pattern

81

(2)

Inclusion and Exclusion Criteria

83

(1)

Treatment

84

(3)

Clinical Illustration

87

(6)

Empirical Findings

93

(1)

Relevance for Managed Care

93

(4)

Short-Term Dynamic Therapy for Patients With Posttraumatic Stress Disorder

97

(24)

Theory of Change

97

(2)

Patient Selection

99

(2)

Goals of Treatment

101

(3)

Acknowledging and Accepting the Traumatized Self

102

(1)

Regaining Mastery

102

(1)

Integrating the Traumatic Information

102

(1)

Viewing Trauma as a Challenge

103

(1)

Techniques of Therapy for Patients With Stress Response Syndromes

104

(7)

Intrusion-Denial Phases

104

(6)

Content Themes

110

(1)

Personality Styles

111

(1)

Transference and Countertransference

111

(2)

Clinical Illustration

113

(4)

Empirical Findings

117

(1)

Relevance for Managed Care

118

(3)

Brief Dynamic Psychotherapy for Patients With Substance Abuse Disorders

121

(28)

Conceptualizing Substance Abuse as a Psychiatric Disorder

122

(4)

Patient Selection

126

(1)

Therapist's Attitude Toward Patients With Substance Abuse Disorders

126

(1)

Twelve-Step Programs and Group Counseling

127

(2)

Role of Various Psychoactive Substances

129

(3)

Supportive-Expressive Therapy for Cocaine Abuse

132

(8)

Core Conflictual Relationship Theme

132

(2)

Treatment Goals

134

(4)

Transference and Countertransference

138

(2)

Clinical Illustration

140

(3)

Transference Implications

140

(1)

Mr. H's Core Conflictual Relationship Theme

141

(2)

Empirical Findings

143

(2)

Relevance for Managed Care

145

(4)

Time-Limited Group Therapy

149

(28)

Why Groups?

150

(2)

Why Time-Limited Groups?

152

(1)

Group Dynamics and Group Therapy

153

(1)

Types of Groups and Theoretical Perspectives

153

(3)

An Illustrative Model of Time-Limited Group Psychotherapy

156

(14)

Interpersonal-Developmental-Existential Approach to Time-Limited Group Psychotherapy

156

(1)

Focus

157

(1)

Screening and Pregroup Preparation

158

(5)

Technical Considerations

163

(1)

Stages of Group Development

164

(6)

Empirical Findings

170

(2)

Relevance for Managed Care

172

(5)

The Reciprocal Relationship Between Pharmacotherapy and Psychotherapy

177

(18)

Obsessive-Compulsive Disorder and the ``Worry Circuit''

179

(1)

Psychopharmacology During the Stages of Psychotherapy

180

(1)

Pharmacotherapy Highlights Key Dysfunctional Patterns

181

(6)

Medication Compliance and a Key Cognitive Pattern

181

(3)

As-Needed Ingestion Illustrates a Key Interpersonal Pattern

184

(1)

Transference and Countertransference

185

(1)

Benzodiazepine Disinhibition Reveals Dysfunctional Patterns

185

(2)

Pharmacotherapy Alters Marital and Family Dynamics

187

(2)

Medication Helps to Save Family Integrity

187

(1)

Medications as Markers for Marital Difficulties

188

(1)

Request for Pharmacotherapy for Spouse Helps Highlight a Marital Pattern

188

(1)

Catalysts for Change

189

(1)

Combined Treatment in the Era of Managed Care

190

(5)

Index

195

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Concise Guide to Brief Dynamic and Interpersonal Therapy

Summary

Author Biography

Table of Contents

Supplemental Materials