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Interactions between therapist and patient
144s S34 New frontiers o[ps)'chotherapy research: a quest[orthe future INTERACTIONS BETWEEN THERAPIST AND PATIENT:
B Cramer C Robert-Tissot Departement de psycniatrie, Clinique de psychialrie infanrile, 41 ch des Cretsde Champel, 1206Geneve, Swilzerland
Symposia
S34 New frontiers o[psychotherap)' research: a quest{orthe future NEW FRONTIERS OF PSYCHOTHERAPY RESEARCH: A QUEST FOR THE FUTURE
A Andreoli B. Cramer,1. Ouimon,E. BanRinger-Huber, C. RobertTissot, Unl14 d"urgences pyschlatrlques Hbpilat Canlonol, Micheli-
du-Crest 24, Geneva 24, Swilzerland. I. Clinical data: Psychotherapeutic processeshave beenincreasingly
considered as interactional and methodshave beendevisedaiming to capturethese interactivedimensions, Our researchconcernsprocesses duringmother-infant psychotherapy. These therapiesare often brief; theirsuccessdependsin part on the clinician's capacityto define rapidlya centralfocus, accordingto formulations close to Luborsky's CCRT. It also dependson the patient'scapacityto elaborateher conflicts. Two clinicalvignetteswill illustratehow a first session evolveswhenthe focus is easUy obtainedversus whenit is not obtained. Technicalconsiderationsconcerning the determinations of a therapeutic focus willbe proposed. 2. Research data: Our researchaimedto identifyprocessualvariables responsible for change in briefmother-infant psychotherapies. We looked for correlationsbetween early identification of focus and outcome. We also used an instrumentdevised by Czogalikin order to assessprofilesof patient-therapists interactions in terms of verbal interactions. Stylesof interactions, and of development of themeswill be presented;theircorrelationto easy and difficultevolutionwillbe illustrated in two cases.
S34 New frontiers o[psychotherapy research: a quest[orthe future INTERACTIVE RELATIONSHIP PATIERNS, REACTIONS OF THE THERAPIST AND PSYCHOTHERAPEUTIC CHANGE E Banninger-Huber. Univeristy of Zurich. Psychological Department, ZUrichberg str. 43. 8044Zurich, Switzerland
Pyschotherapy is a valuable treatmentand a specific ingredient of psychiatric trainingand clinical practice.In the present time of changingculturalparadiglM and mentalhealthpolicies. the medical relevance of psychotherapy isovertlt challenged by the rapid progress of scientific knowledge and increased need for evidence-based treatmentguidelines. Psychotherapy research isthe most imponant tool to survivethischallenge, and innovative studiesshould be directed to developnew assessment instruments, set up cost-effective psychotherapy and combined treatmentprogrammes, and to better understand processand changewithinpsychotherapy. This symposium willreview recentresearchetrons intended to meet these airM, as well as to convert researchprogressinto better care.
S35 Eating disorders SYMPOSIUM ON BATING DISORDERS. CLINICAL AsrECTS AND TREATMENT G.F M RUSSELL (Chunnan~ H -C STElNHAUSEN (V,cc-Ch"."an) OBJECTIVE: To present rc:ccnladvances In cbNcal (c.ru~s. outcome and trealmcnl In
IIlOfOxia nervosa (AN) and bulimia nervosa (BN).
In thisconoibution, thesignificance of psychotherapeutic interactionfor psychotherapeutic change is explored. The focus lies on affective regulation processes occurring in thecontext of guiltfeelings. One basic assumption of our approach is that in the context of narrative episodes inwhicha clientdescribes a situation of experienced guiltfeelings, typical interactive patterns are enacted with the therapist. These interactive patterns (so called traps) are elementsof a client'soffer of specific roles to the therapist and are characterized by typicalverbaland non-verbal behaviour. They implyspecificreactions of the therapist. e.g .• verbal confirmationsor legitimizing conunents. According to the therapist's reaction, successful or unsuccessful traps are differentiated. The significance of theseinteractive behavioursfor the therapeuticprocess is investigated. Whatis the "best"wayfor the therapistto cope with traps? What is the significance of successful or unsuccessful traps for therapeutic change? In order to study these questions.verbalas well as nonverbal aspects (especially facial expression) of the interaction of videotyped therapysessionswere analysedwith microanalytic methods. The investigation showsthat the evaluation of productivityof "abstinent" or "responding" therapeuticreactions and interventions has to take into account the actual affective relationship betweenclient and therapist. The succeeding course of the therapy sessionmust be considered.
MI"HODS; ThcIc: "'ngo rromclc:
to a metaanalysi. ofthe hte...... inANand ON. RESULTS ANDCONCLUSIONS; l. A proximal myopathy maycomptiOale seve~ AN, WIth a.rophyoflype D musc:l.
libra and&1)'OOgc. aranulCl bc~n the myolibrill. 2. Themean.......ry .... for ANi. 45%and forON48%. The monalily .... for AN ia 5.5%and for ON0.1%.
3. ANi. ollen ISIOOlated wi.h _"'YC
two disorden iaexplaod. 4. A I'UlSO of pl)'Cholosieal telts fe\leabchaf'KICrimc clinical rcaturc:•• co-morbility
andoutoorne inmal.pati.11lI with ONand binllC-catina disorder. 5.TheetrOdive.... of a self-help manual.... beenevaloatcd Recovery 0CCWTCd in 20'10 ON paliel1ll; theaddition 0( a
r.w thenpllt.guided selSio.. Improved .he
outoorne 10a nle .imilar lO00anitive-behaviour therapy.
B Cramer C Robert-Tissot Departement de psycniatrie, Clinique de psychialrie infanrile, 41 ch des Cretsde Champel, 1206Geneve, Swilzerland
Symposia
S34 New frontiers o[psychotherap)' research: a quest{orthe future NEW FRONTIERS OF PSYCHOTHERAPY RESEARCH: A QUEST FOR THE FUTURE
A Andreoli B. Cramer,1. Ouimon,E. BanRinger-Huber, C. RobertTissot, Unl14 d"urgences pyschlatrlques Hbpilat Canlonol, Micheli-
du-Crest 24, Geneva 24, Swilzerland. I. Clinical data: Psychotherapeutic processeshave beenincreasingly
considered as interactional and methodshave beendevisedaiming to capturethese interactivedimensions, Our researchconcernsprocesses duringmother-infant psychotherapy. These therapiesare often brief; theirsuccessdependsin part on the clinician's capacityto define rapidlya centralfocus, accordingto formulations close to Luborsky's CCRT. It also dependson the patient'scapacityto elaborateher conflicts. Two clinicalvignetteswill illustratehow a first session evolveswhenthe focus is easUy obtainedversus whenit is not obtained. Technicalconsiderationsconcerning the determinations of a therapeutic focus willbe proposed. 2. Research data: Our researchaimedto identifyprocessualvariables responsible for change in briefmother-infant psychotherapies. We looked for correlationsbetween early identification of focus and outcome. We also used an instrumentdevised by Czogalikin order to assessprofilesof patient-therapists interactions in terms of verbal interactions. Stylesof interactions, and of development of themeswill be presented;theircorrelationto easy and difficultevolutionwillbe illustrated in two cases.
S34 New frontiers o[psychotherapy research: a quest[orthe future INTERACTIVE RELATIONSHIP PATIERNS, REACTIONS OF THE THERAPIST AND PSYCHOTHERAPEUTIC CHANGE E Banninger-Huber. Univeristy of Zurich. Psychological Department, ZUrichberg str. 43. 8044Zurich, Switzerland
Pyschotherapy is a valuable treatmentand a specific ingredient of psychiatric trainingand clinical practice.In the present time of changingculturalparadiglM and mentalhealthpolicies. the medical relevance of psychotherapy isovertlt challenged by the rapid progress of scientific knowledge and increased need for evidence-based treatmentguidelines. Psychotherapy research isthe most imponant tool to survivethischallenge, and innovative studiesshould be directed to developnew assessment instruments, set up cost-effective psychotherapy and combined treatmentprogrammes, and to better understand processand changewithinpsychotherapy. This symposium willreview recentresearchetrons intended to meet these airM, as well as to convert researchprogressinto better care.
S35 Eating disorders SYMPOSIUM ON BATING DISORDERS. CLINICAL AsrECTS AND TREATMENT G.F M RUSSELL (Chunnan~ H -C STElNHAUSEN (V,cc-Ch"."an) OBJECTIVE: To present rc:ccnladvances In cbNcal (c.ru~s. outcome and trealmcnl In
IIlOfOxia nervosa (AN) and bulimia nervosa (BN).
In thisconoibution, thesignificance of psychotherapeutic interactionfor psychotherapeutic change is explored. The focus lies on affective regulation processes occurring in thecontext of guiltfeelings. One basic assumption of our approach is that in the context of narrative episodes inwhicha clientdescribes a situation of experienced guiltfeelings, typical interactive patterns are enacted with the therapist. These interactive patterns (so called traps) are elementsof a client'soffer of specific roles to the therapist and are characterized by typicalverbaland non-verbal behaviour. They implyspecificreactions of the therapist. e.g .• verbal confirmationsor legitimizing conunents. According to the therapist's reaction, successful or unsuccessful traps are differentiated. The significance of theseinteractive behavioursfor the therapeuticprocess is investigated. Whatis the "best"wayfor the therapistto cope with traps? What is the significance of successful or unsuccessful traps for therapeutic change? In order to study these questions.verbalas well as nonverbal aspects (especially facial expression) of the interaction of videotyped therapysessionswere analysedwith microanalytic methods. The investigation showsthat the evaluation of productivityof "abstinent" or "responding" therapeuticreactions and interventions has to take into account the actual affective relationship betweenclient and therapist. The succeeding course of the therapy sessionmust be considered.
MI"HODS; ThcIc: "'ngo rromclc:
to a metaanalysi. ofthe hte...... inANand ON. RESULTS ANDCONCLUSIONS; l. A proximal myopathy maycomptiOale seve~ AN, WIth a.rophyoflype D musc:l.
libra and&1)'OOgc. aranulCl bc~n the myolibrill. 2. Themean.......ry .... for ANi. 45%and forON48%. The monalily .... for AN ia 5.5%and for ON0.1%.
3. ANi. ollen ISIOOlated wi.h _"'YC
two disorden iaexplaod. 4. A I'UlSO of pl)'Cholosieal telts fe\leabchaf'KICrimc clinical rcaturc:•• co-morbility
andoutoorne inmal.pati.11lI with ONand binllC-catina disorder. 5.TheetrOdive.... of a self-help manual.... beenevaloatcd Recovery 0CCWTCd in 20'10 ON paliel1ll; theaddition 0( a
r.w thenpllt.guided selSio.. Improved .he
outoorne 10a nle .imilar lO00anitive-behaviour therapy.