In view of the increase in longevity, aging brings stressors that defy older adults’ life across the aging continuum.

This research aims at evaluating how person-centered therapy (’PCT’) facilitates the degree of self-esteem and congruence of older adults.

Information was gathered by a research tool composed of two parts: (a) a demographic questionnaire and (b) the Self-Esteem Scale (’SES’). The research sample comprised 40 elderly people between the ages of 65–93, from both genders, who completed eight sessions of PCT.

After the therapeutic process, results indicated an increase of the participants’ degree of self-esteem. It was verified a positive effect of PCT on older adults’ self-esteem, which was achieved by an increase of their congruence level.

The results of this study are discussed in the context of existing research on self-esteem and successful aging of older adults, focusing in particular upon the perceived tensions between the determination to experience congruence and the challenges of old age. Interventions with older adults may benefit from clearly understanding self-esteem as an important component for promoting successful aging and reducing health disparities. Recommendations for future research on older adults’ PCT impact on self-esteem, as well as suggestions for PCT and clinical practice with older adults are also presented.

Informed consent is required by law in medical treatment including dynamic psychotherapy, and has ethical implications. However, it is not clear whether informed consent as legally required is practiced, and what are therapists’ attitudes towards it.

This research examines common practice and therapists attitudes concerning application of informed consent to dynamic psychotherapy.

1. Examine therapists’ practice regarding application of different components, timing and methods of informed consent to dynamic psychotherapy.

2. Examine therapists’ attitudes towards this issue.

An anonymous online cross-sectional survey, completed by 177 psychodynamic oriented psychotherapists of diverse professions, experience, and other demographics.

Different Professional groups displayed statistically significant difference regarding application of informed consent to dynamic psychotherapy. Most specialist psychiatrists discuss most components of informed consent at the first session (therapy goals (59.1%), approach (72.7%), and alternatives (95.5%)) comparing to other therapists who provide this information later in therapy or not at all. Residents often don’t provide information concerning therapy approach (46.5%), and success chances (66.2%). Specialists had stronger positive opinion concerning the importance of informed consent.

Most therapists believe that applying informed consent to dynamic psychotherapy is important. However, opinions and practices differed regarding the components of informed consent, depending on professional background and experience. For example, specialist psychiatrists tended to implement more components at early stages of therapy than other professionals, maybe due to their medical and legal training. Residents provided less information concerning therapy alternatives and odds of success, maybe due to lack of experience, knowledge or confidence.

To demonstrate how an on-going psychotherapy practice can be turned into a perpetual research project by tracking progress (or lack thereof) of each patient through daily self-rating on 41 parameters. The author has treated 1,213 patients over the last 20 years, showing that psychiatric symptoms (such as anxiety, anger, physical symptoms, depression, and psychosis) can be predictably eliminated by transforming personality through ‘Breakthrough Intimacy’ - closeness between committed couples far greater than their previous maximum experience, usually without drugs and often within 6 months.

Lifetrack therapy works with the patient and his/her partner in three-way teamwork, bringing them far closer than ever before, guided by their own daily self-rating on 41 parameters that allow accurate graphic tracking via Internet of subtle changes in their personalities and dynamic mental status during each therapy session. The therapist actively helps the couple to think, feel, and act in such ways that their closeness will increase, provoking and overcoming waves of symptom spikes (defense) until they disappear by exhaustion, as the couples undergo personality transformations.

Of the 1,213 patients treated over the last 20 years, 50% reached a level of adjustment beyond their previous best level according to their own daily self-rating. Patients with partners (871) did 4 times better (61.4% vs 15.2%) than singles (342). Ot those who did not drop out of therapy during the first month, 78% of patients with partners (659) reached their previous maximum of 10, while only 11% of those without partners did so.

Diagnosis of breast cancer is a devastating psychological experience for a woman. Also treatments such as radiation therapy may cause psychosocial distress in these patients and threaten their quality of life (QOL). Among several approaches, spirituality has been shown to be significantly associated with improving the quality of life.

The aim of this study was to assess the role of psycho-spiritual therapy intervention in improving the quality of life of patients with breast cancer undergoing radiation therapy.

This was a randomized controlled trial study undertaken in a radiotherapy clinic, Isfahan, Iran. Between October 2010 and February 2011, 68 patients under radiation therapy were randomized to either spiritual therapy intervention group or control group who received routine management and educational programs. Before and after 6 weeks of spiritual therapy sessions, the quality of life was evaluated using Cancer quality-of-life questionnaire (QLQ)-C30 and breast cancer specific questionnaire (BR-23). MANCOVA, T-test and Paired T-test were used for analysis using Predictive Analytic Soft Ware (PASW, version 18) for windows.

In all sixty five patients actually completed the 6 week intervention and were evaluated for the outcome. The mean Global health status score/QOL reached from 44.37(SD = 13.03) to 68.63(SD = 10.86), (p = 0.00). There was a statistically significant difference in all functional scales of QLQ-C30 after intervention. (p < 0.05)

The results of this trial showed that the psycho-spiritual therapy program can improve the overall QOL of women with breast cancer; therefore it could be adopted in comprehensive care programs for women with breast cancer.

CORE (Clinical Outcomes for Routine Evaluation) has been designed in the UK as an outcome measure for psychological therapies. It is a generic self-report measure of global distress with high internal and test-rest reliability (Evans et al., 2000). It is used widely within the National Health Service as an initial screening tool and for assessing response to treatment and is mandatory for all patients receiving psychological therapies at South London & Maudsley Trust, but anecdotal evidences suggest otherwise.

To provide an overview of CORE collection at the Maudsley Psychotherapy Service.

A list of all patients who were referred for individual psychodynamic therapy and discharged between June and November 2010 was obtained and their electronic clinical notes were reviewed.

A total of 258 patient records were analysed. 149 were excluded due to incorrect or missing data. Of the data sampled, the mean age was 39.4 years with a 3:1 female to male ratio. CORE collection at assessment was 79% but only 24% during/at the end of therapy. Possible reasons for CORE not being collected during therapy were identified as patient refusal (2%) and premature termination of therapy (31%). Junior doctors were the treating therapists in 65% cases where no CORE was collected during therapy.

Current trust policy in regards to CORE collection is not being met. Recommendations include increasing awareness among therapists, sending the CORE questionnaires routinely to all patients in active therapy and upon discharge and completing the audit cycle once recommendations have been implemented.

Substantial empirical support for cognitive behavioral therapy (CBT) effectiveness in treatment of various psychiatric disorders has been demonstrated. However, we do not have a complete and accurate understanding of how CBT supervisors themselves acquire competence in CBT or of the methods of CBT supervision they use.

1. • Become familiar with styles and techniques used by CBT supervisors

2. • Become familiar with educational needs of CBT supervisors

Learn about supervisory practice of CBT supervisors and determine their learning needs.

We piloted an anonymous self-administered questionnaire survey to CBT supervisors. The survey included questions on kind of training CBT supervisors have had both in CBT and in CBT supervision, supervisory methods they currently use and their perceived educational needs.

12 supervisors were invited to participate, and 7 responded (58% response rate). Only 43% have attended a formal teaching/supervision course.

Modeling of the structure of CBT session during the supervision was done always or often by 57% of respondents. More then 50% of responders never or rarely observed trainee's therapy session. 100% of the respondents were interested in receiving further training in CBT supervision with 86% of the respondents believing that this training should be done through a formal course.

Surveyed CBT supervisors have expressed a strong need to receive further training in CBT supervision through a formal course. The needs assessment will serve as a platform for the development of a faculty development program for CBT supervisors.

The majority of studies on the effectiveness of psychotherapy have reported results for relatively short follow-up times.

In this study the effectiveness of short- and long-term psychotherapy was compared during a very long follow-up.

A total of 326 psychiatric outpatients with mood or anxiety disorder were randomly assigned to solution-focused therapy (12 sessions), short-term psychodynamic (20 sessions) and long-term psychodynamic psychotherapy (240 sessions) in Helsinki Psychotherapy Study. The patients were followed from start of treatment and assessed 11 times during a 7-year follow-up. Symptom Check List (anxiety, depression, and general symptom scale), Work-subscale of the Social Adjustment Scale, and use of auxiliary treatment (psychotherapy, psychotropic medication, and psychiatric hospitalization) were used as outcome measures.

A reduction in psychiatric symptoms and improvement in work ability and functional capacity was noted in all treatment groups. The short-term therapies were more effective than long-term psychotherapy during the first year, whereas the long-term therapy was more effective after 3 years of follow-up. No significant differences were observed between long- and short-term therapies during the 4 last years of follow-up.A total of 80% of the patients in the short-term therapy groups and 60% in the long-term therapy group used auxiliary treatment.

Short-term psychotherapy gives faster benefits than long-term psychotherapy, but in the long run no notable differences in symptoms or working ability are seen. Considerably auxiliary treatments are taken after the end of the intervention implying further need of treatment. These findings should be repeated in other populations.

Treatment of young woman, 30 years old, display of case.

Patient NN, 30 years old, not married, came once a week, for two years. Specific behaviour methods for the treatment of frigidity were made: methods of stimulation and methods of masrturbation (Lo Piccolo J. programme). Result of the treatment was complete transformation on the psyghical level and marriage with good sexual life.

Intensive stress caused by academic pressure and psychosocial challenges for the freshmen leads to the high prevalence of adjustment disorders. Integrated psychotherapy for students is a part of a complex multistage programme of mental health promotion in University.

To identify adjustment disorders and stress factors among students in one of the Moscow Universities and to provide an appropriate mental heath care using an integrated psychotherapy.

To investigate the factors of mental health improvement under the psychotherapy in adjustment disorders.

20 1st year students were examined by structured interview, Spilberger scales, J, Amirkhan test on type of coping strategies. For the rehabilitation purposes an integrated schema consisting of elements of CBT, Interpersonal psychotherapy, Gestalt therapy, psychodynamics was used.

Positive dynamic in 15 cases were associated with improving skills of self regulation, activating of interpersonal interaction and with actual needs and individual purposes identifying.

The importance of emotional identification by patients as well as positive thinking, more differentiated attitude to the stress situations and working out the effective stress coping strategies were specified as facilitating factors. More confident behavior which was one of the most therapeutic requests has also meaning for enriching of person's resources.

A recent meta-analysis also concluded that psychotherapeutic approaches are beneficial for adult with a history of CSA and maintained for at least six months follow-up. The results suggest that different characteristics of therapy moderate the therapeutic outcome. We found in a randomized study of systemic versus psychodynamic group therapy, that the short-term outcome for patients who received systemic group psychotherapy was significantly better than the outcome for patients who received psychodynamic group psychotherapy. The current study assessed the group milieu in both groups.

This randomized prospective study included 106 women: 52 assigned to psychodynamic group psychotherapy and 54 assigned to systemic group psychotherapy. The Group Environment Scale (GES) was filled in the mid phase of therapy and analysed in three dimensions and 10 subscales.

The systemic group was characterized by statistically significant highest scores on Relationship (ES = 1.27) and System Maintenance / Change Dimension (ES = 1.08), while the scores for Personal Growth Dimension were comparable in the two groups. Group S had statistically significant higher scores on the following subscales: Cohesion (p < 0.05), Leader support (p = 0.001), Expressiveness (p < 0.001), Task Orientation (p = 0.01) and Order and Organization (p < 0.001).

Substantial differences in the group milieu were seen. The systemic group turned out to be evaluated as the most structured therapy and also to be most supportive of expressiveness. The results will be discussed according to the therapeutic philosophy.

Retrospective memories of stressful events during childhood have been related empirically with a wide range of symptoms in adulthood.

To clarify the possible link between memories of childhood stressful events and adult heart focused anxiety.

To investigate whether retrospective stressful memories are associated with cardiac anxiety and if this association is mediated through hostility in adulthood.

A community sample of 300 individuals (100 men - 200 women, mean age 33, SD = 12,5 ranged 18–75), completed the Cardiac Anxiety Questionnaire, the Hostility and Direction of Hostility Questionnaire and a questionnaire regarding retrospective memories of stressful experiences during childhood.

Childhood stressful memories were associated with higher levels of both heart focused anxiety and hostility (r = .005). Elevated levels of cardiac anxiety were also correlated with a hostile attitude (r ≤.001). Regression models revealed that paranoid hostility fully mediated the link between stressful memories and heart focused anxiety for women (β = 2,918, p = .004), after adjustments. No such mediation was proved in men, thus both retrospective stressful memories during childhood and hostile attitudes were independent contributors for anxiety of heart function. No significant differences were found among both sexes, as far as heart focused anxiety (t =−.964, p = .336) and total hostility (t = .342, p = .733) are concerned.

Findings are consistent with the hypothesis that, in women, childhood stressful memories influences adult levels of cardiac anxiety sensations by fostering paranoid hostility. In men, findings suggest that these memories and hostility are both important independent predictors of adult cardiac anxiety sensitivity.

Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-line treatment for psychological trauma. However its neurobiological bases have not been disclosed yet.

Electroencephalography was used for the first time to fully monitor neuronal activation during whole EMDR sessions including the autobiographical script. Nine clients with major psychological trauma were investigated during the first EMDR session and during the last one performed after processing the index trauma. Comparisons between the EEG of the first and last EMDR session and between the EEG of the clients at the first session and those of 9 controls undergoing the same EMDR procedure were performed.

During both script listening and bilateral stimulation EEG showed significantly higher activity in the prefrontal limbic cortex (Brodmann Areas, BA 9–10) at the first as compared to the last EMDR session. The opposite comparison showed a shift of the prevalent activity towards temporal, parietal and occipital cortical regions (BAs 20, 21, 22, 37, 17, 18, 19) with leftward lateralisation. The comparison between the 9 clients and the 9 controls confirmed the maximal activation in the limbic cortex in the clients before processing the trauma.

The implemented methodology made possible to image for the first time the specific activations associated with the therapeutic actions contemplated by EMDR. The findings suggest cognitive processing of traumatic events following successful EMDR therapy supporting the evidence of distinct neurobiological patterns of brain activations during bilateral ocular stimulation associated with a significant relieve from negative emotional experiences.

PUBMED data base was searched for articles using the key words “supervision in CBT”.

The task of supervision is to increase the value of the therapeutic process in the client's best interest. Supervision is educational process in the truest sense of the word, including an opportunity to select one's own supervisor. This is a very important procedural aspect since the therapist identifies with his/her supervisor, either consciously or unconsciously. Establishing the supervisor-supervisee relationship is based on principles similar to those in the therapeutic relationship. There is important parallel reflecting the therapist-client relationship. This is because any changes in the supervisory process are analogically transferred onto the therapist-client relationship. Additionally, supervision is oriented towards increasing the therapist's competencies. The CBT therapist's basic skills involve good theoretical knowledge, professional behaviour towards clients, ability to use specific therapeutic strategies for maintaining the therapeutic relationship, sensitivity to parallel processes and accomplishment of changes, and adherence to ethical norms. Given the fact that during supervision, the supervisee may be in any stage of his/her training, supervision must take into consideration where the therapist is in his/her training and development and what he/she has or has not learnt.

By IGA MZ CR NT 11047-4/2010.

PUBMED data base was searched for articles using the key words “therapeutic relations”, “transference”, “countertransference”, “cognitive behavioral therapy”, “cognitive therapy”, “schema therapy”, “dialectical behavioral therapy”.

Transference. The therapist should pay attention to negative or positive reactions towards him/her but should not deliberately provoke or ignore them. He/she should be vigilant for signs of strong negative emotions, such as a disappointment, anger, and frustration experienced in the therapeutic relationship by the patient. Similarly he/she should be alert to exaggerated positive emotions such as love, excessive idealization, praise or attempts to divert the attention of therapy onto the therapist. These reactions open space for understanding the patient's past and actual relations outside the therapy. Countertransference. The therapist should be aware of countertransference schemas as they apply to him/her. He/she should monitor his/her own feelings that indicate countertransference. Further, the assistance of and discussion with supervisors and colleagues is useful in regard to countertransference even in experienced therapists.

Both the literature and our experience underscore the importance of careful examination of transference and counter-transference in CBT.

By IGA MZ CR NT 11047-4/2010.