Introdução: O diagnóstico baseado unicamente na avaliação quantitativa dos sintomas e seu curso muitas vezes não é suficiente para o trabalho em psicoterapia psicodinâmica. Apesar disso, a literatura sobre diagnóstico psicodinâmico ainda é escassa, assim como os estudos empíricos na área. O Operationalized Psychodynamic Diagnosis-2 (OPD-2) tem o objetivo de ampliar o diagnóstico tradicional através da operacionalização de informações psicodinâmicas fundamentais para a compreensão dos fenômenos subjacentes à sintomatologia clínica. A construção multi-axial do OPD-2 possibilita que se abarque a complexidade e a inter-relação das condições e fatores que determinam os fenômenos e as patologias mentais do ponto de vista psicodinâmico. O OPD-2 é composto por 4 eixos psicodinâmicos e 1 eixo descritivo: I: vivência da doença e pré-requisitos para o tratamento; II: Relações interpessoais; III: Conflito psíquico; IV: Estrutura psíquica; V: Diagnóstico nosológico tradicional. Apesar de ser amplamente utilizado em vários países ainda não foram realizados estudos com o OPD-2 no Brasil. Objetivos: Esta dissertação apresenta a versão brasileira do OPD-2 e os estudos de validade de conteúdo, concordância inter-avaliadores e validade concorrente do instrumento. Método: A versão brasileira do instrumento foi criada através da adaptação da versão portuguesa. A avaliação do conteúdo do instrumento foi realizada por experts em psicoterapia psicodinâmica. A concordância inter-avaliadores foi avaliada utilizando-se 51 entrevistas de psicoterapia psicodinâmica. A validade concorrente comparou os itens do OPD-2 com os resultados do The World Health Organization Quality of Life - abbreviated version (WHOQOL-bref) e o Symptom Check-List-90-Revised (SCL-90R). Resultados: A avaliação de conteúdo considerou os itens claros quanto a linguagem e pertinentes teoricamente. Os eixos III e IV apresentaram maior índice de concordância inter-avaliadores. Os eixos I, III e IV obtiveram correlação significativa entre alguns itens com os resultados do SCL-90R e WHOQOL-bref. Conclusão: Este estudo demonstrou que o OPD-2 apresenta boas condições de avaliação de propriedades psicodinâmicas. Outros estudos com diferentes amostras e instrumentos devem ser realizados para verificação das propriedades psicométricas do OPD-2 no Brasil. / Background: Diagnoses based upon quantification of symptoms and their course is less suitable to psychodynamic psychotherapy, yet psychodynamic diagnoses are rarely scrutinized scientifically. The Operationalized Psychodynamic Diagnosis-2 seeks to enhance traditional diagnostic schemes through the operationalization of psychodynamic data relevant to the comprehension of psychological phenomena underlying clinical symptomatology. The multi-axial framing of OPD-2 allows the incorporation of the complexity and the inter-relations of conditions and factors determining mental phenomena and pathology from a psychodynamic perspective. OPD-2 has 4 psychodynamic and 1 descriptive axis: I: experience of illness and prerequisites for treatment; II: Interpersonal relations; III: Conflict ; IV: Structure ; V: Mental and psychosomatic disorders. Although largely used in a number of countries, there have been no studies with OPD-2 in Brazil. Objectives: We aimed to present the Brazilian version of OPD-2 and determine the content validity, inter-rater reliability and concurrent validity of the psychodynamic itens of the instrument. Methods: Experts in psychodynamic psychotherapy evaluated content and the inter-rater reliability was based on 51 dialogued interviews obtained during routine clinical practice in a specialized institution. Concurrent validity compared OPD-2 items with results from the World Health Organization Quality of Life - abbreviated version (WHOQOL-bref) and the Symptom Check-List-90-Revised (SCL-90-R). Results: Evaluation of content considered OPD-2 items as clear and theoretically pertinent. Axes III and IV had higher inter-rater concordance. Several items from axes I, III and IV correlated significantly with the SCL-90R and the WHOQOL-bref. Conclusion: OPD-2 is adequate to evaluate psychodynamic properties. Further studies with the OPD-2 in Brazil evaluating different samples and using distinct comparator instruments are needed to confirm and extend our findings.

No description available.

Inledning: Syftet med denna studie är att undersöka likheter och olikheter mellan psykodynamisk psykoterapi och andlig vägledning utifrån upplevelsen hos de som har erfarenhet av att möta människor i både psykoterapi och andlig vägledning. Förhoppningen är att studien kan bidra till ökad förståelse för såväl likheter som olikheter de olika samtalsmetoderna, med psykologiskt perspektiv och med andligt perspektiv, emellan.Frågeställningar: Hur upplevs likheter och olikheter mellan psykoterapi och andlig vägledning, hur upplevs mötet med den hjälpsökande i psykoterapi och andlig vägledning, av dem som är utbildade till och erbjuder både psykodynamisk psykoterapi och andlig vägledning?Hur upplevs eventuella fördelar och svårigheter med de dubbla yrkesrollerna, som psykoterapeut och andlig vägledare?Metod: Fem kvalitativa intervjuer genomfördes. Intervjuerna analyserades med hjälp av tematisk analys med induktiv ansats i kodning, tematisering och analys av insamlat data.Resultat: Deltagarna beskrev att båda metoderna är samtalskurer, att kvalitén i mötet är viktig och att den hjälpsökande kommer till insikter om sig själv. Deltagarnas svar visade att gränsdragningen mellan psykoterapi och andlig vägledning ibland är enkel, ibland inte. Möjligheten att helt skilja andlig vägledning och psykoterapi åt beskrevs av deltagare ligga i synen på andlighet och gudstro. En önskan om dialog mellan professionella med såväl psykologiskt som andligt perspektiv, framkom.Diskussion: Deltagarna gav inte entydiga svar angående likhet och olikhet mellan psykoterapi och andlig vägledning. Deltagarnas syn på människan som bärare av både psykologiska och andliga erfarenheter kan medföra att de med dubbel kompetens befinner sig i ett gränsland mellan sekulär psykoterapi och konfessionell andlig vägledning. Medmänsklighet och empati framträder tydligt som de viktigaste komponenterna i samtalet med den hjälpsökande. / Introduction: The purpose of this study is to investigate the similarities and differences between psychodynamic psychotherapy and spiritual direction based on the experience of those who meet people both in psychotherapy and in spiritual direction, and to increase the understanding of both similarities and differences between the methods.Questions: How are similarities and differences between psychotherapy and spiritual direction experienced, how is the encounter with those seeking psychotherapy and spiritual direction experienced by those educated for and offering psychodynamic psychotherapy and spiritual direction?How are possible benefits and difficulties experienced with the dual roles, as psychotherapist and spiritual director?Method: Five qualitative interviews were conducted. The interviews were analyzed using thematic analysis with inductive approach in coding, thematization and analysis of collected data.Results: Study participants described that both methods are talking cures, that the quality of the interpersonal meeting is important and that the applicant seeks to gain insight about himself. Study participants described that the distinction between psychotherapy and spiritual direction was not always easy. The ability to differentiate spiritual direction and psychotherapy was described by participants lay in the view of spirituality. Study participants talked about the importance of dialogue between professionals with psychological and spiritual perspective.Discussion: Study participants did not provide unambiguous answers regarding similarity and dissimilarity between psychotherapy and spiritual direction. As the study participants hold the view of human beings as carrying both psychological and spiritual needs they risk ending up in a no man’s land between secular psychotherapy and confessional spiritual direction. Interpersonal warmth and empathy was described as the most important components of the meeting with the help seeking applicant.

Introdução- Estudos sistematizados atualizados sobre a supervisão em psicoterapia de orientação analítica (POA) são escassos, consideram a percepção dos alunos ou supervisores separadamente e em geral não consideram o ensino entre médicos residentes de psiquiatria. Ainda, para que se exerça a função de supervisor nesta área não há exigências ou cursos obrigatórios e apesar das orientações relacionadas à supervisão analítica servirem de modelo, aspectos fundamentais do ensino da POA não são claramente descritos. Objetivos- O objetivo principal deste estudo é descrever a prática atual de supervisão em POA. Secundariamente, pretende-se estudar aspectos da “relação real” de supervisores e alunos, descrever possíveis fatores desta relação que influenciem no aprendizado e expor situações particulares da prática da supervisão nesta área. Participantes- Foram incluídas seis duplas de supervisores e alunos, graduados em medicina e psicologia, que tivessem concluído processo de supervisão há menos de um ano, enquanto cursavam o primeiro ou o segundo ano do curso de formação em POA em dois Centros de ensino de POA de Porto Alegre, RS. Método- Dois questionários com perguntas abertas e fechadas nortearam entrevistas realizadas com cada componente das duplas em estudo. Os instrumentos foram elaborados de maneira a contemplar a percepção dos supervisores e dos alunos a respeito dos tópicos de interesse dessa pesquisa. As entrevistas foram gravadas e transcritas na íntegra para posterior análise qualitativa pelo método de Bardin. Resultados e conclusões- Os resultados foram organizados em três categorias finais de resposta: 1) “Estrutura da supervisão” (contendo respostas relacionadas ao contrato, material de trabalho e avaliações); 2) “Relação real supervisor-aluno” (englobando aspectos da dupla 7 atual e outros relacionados ao aproveitamento da supervisão) e 3) “Percepções e contribuições dos supervisores” (compreendendo questões relacionadas à tecnologia, tratamento do aluno e as diferenças entre a supervisão em psicanálise e psicoterapia psicodinâmica). Os dados foram apresentados e discutidos de acordo com a literatura e sugestões de aspecto prático foram propostas para contribuir com o processo de ensino e aprendizado da técnica. / Introduction- Updated and systematized studies on psychoanalytic psychotherapy (POA) supervision are scarce. In addition, the perceptions of students and supervisors are considered separately, as well as, generally, not much is given to teaching among resident physicians of psychiatry. There are no mandatory requirements or courses to perform the role of supervisor in this field, and although the recommendations related to analytical supervision work as a guide, the fundamental aspects of POA teaching are not clearly described. Objectives- The main objective of this study is to describe the current practice of supervision in POA. In addition, aspects of the real relationship between supervisors and students, possible factors that influence learning and particular situations of the practice of analytical will be exposed. Participants- Six supervisors and six respective students- psychiatrists and psychologistswho completed the supervision process in less than a year ago (during the first or second year of training), linked to two outpatient POA schools located in the city of Porto Alegre, south of Brazil. Method- The interviews were audio recorded and transcribed. The participants were stimulated to express their ideas freely and the questions and comments made by the interviewer aimed to deepen the work topics of interest. Late, data were analyzed, according to Bardin´s Content Analysis methodology. Results and conclusions- The content analysis resulted in 8 intermediate categories and 3 final categories, namely: 1) supervision structuring, 2) real supervisor-supervisee´s relationship and 3) supervisor´s contributions. (including questions related to technology, report of experiences of practice as supervisors). The data were presented, discussed and practical suggestions were proposed to contribute to the process of teaching and learning the technique of POA.

Inledning: Avslut kan väcka olika känslor. Unga vuxna ska lämna barndomen och tonårstiden för att starta sitt eget vuxenliv. Psykisk ohälsa har ökat bland unga, en del söker psykoterapi, men många hoppar av. För att möjliggöra för fler unga vuxna att fullfölja psykoterapeutisk behandling behöver förståelsen öka kring målgruppens behov. Syfte: Syftet med studien var att undersöka legitimerade psykoterapeuters perspektiv på den avslutande processen i psykodynamisk psykoterapi med unga vuxna. Metod: Kvalitativ metod användes. Semistrukturerade intervjuer genomfördes med fem legitimerade psykoterapeuter. Materialet strukturerades med tematisk analys. Resultat: Kännetecknande för den avslutande processen i terapier med unga vuxna var att det blev individuellt olika; hastiga eller planerade avslut, ibland avhopp. Hur avslutningsprocessen blev var beroende av problematik och personlighetsstruktur snarare än ålder men adolescensens utvecklingsuppgifter och individens anknytningshistoria påverkade. Psykoterapeuter tog ansvar, var uppmärksamma, hjälpte aktivt unga i den avslutande processen. Mentalisering och metakommunikation användes för att begripliggöra avslutet. Diskussion: Resultatet diskuteras utifrån psykoterapeuternas kliniska erfarenheter och förståelse av den avslutande processen med unga vuxna. Betydelsefulla faktorer i deras upplevelser diskuteras i förhållande till teori och tidigare forskning. Vald metod diskuteras och förslag ges till vidare forskning / Introduction: Endings can evoke different emotions. Young adults should leave childhood andadolescence to start their own adult life. Mental illness has increased among young people, some seek psychotherapy, but many drop out. To enable more young adults to complete psychotherapeutic treatment, there is a need to increase understanding of the target group´s needs. Purpose: The purpose of the study was to investigate licensed psychotherapists perspective on the final process of psychodynamic psychotherapy with young adults. Method: Qualitative method was used. Semi structured interviews were conducted with five licensed psychotherapists and the collected material structured with thematic analysis. Results: Characteristic of the final process in therapies with young adults was that it became individually different; hasty or planned endings, sometimes dropout from therapy instead of ending. How the final process became was more dependent on problems and personality structure than age, but the development tasks of the adolescence and the individual's attachment history affected. Psychotherapists took responsibility, were attentive and actively helped young people in the final process. Mentalization and metacommunication were used to comprehend the termination. Discussion: The results were discussed based on the psychotherapists' understanding and clinical experience of the final process with young adults. Significant factors in their experiences are discussed in relation to theory and previous research. The chosen method is discussed, and suggestions are given for further research.

Inledning: Psykoterapisamtal kan vara till hjälp för att minska lidande när en människa drabbas av dödlig sjukdom. Terapier med patienter med dödlig sjukdom kan väcka starka känslomässiga reaktioner hos terapeuten. Forskning gjord inom det psykodynamiska fältet utgår övervägande från fallstudier, varför denna kvalitativa intervjustudie skulle kunna tillföra ytterligare kunskap om hur de känslomässiga upplevelserna beskrivs av psykodynamiska terapeuter. Syftet med studien var att undersöka den psykodynamiska psykoterapeutens upplevelse av terapisamtal med patienter som drabbats av dödlig sjukdom, för att skapa en förståelse för de känslomässiga reaktionerna hos terapeuten.  Frågeställningar: Hur beskriver psykoterapeuten de känslomässiga upplevelserna i det terapeutiska samtalet med patienter med dödlig sjukdom?Vad upplever den psykodynamiska psykoterapeuten är betydelsefullt i samtalen med patienter med dödlig sjukdom?  Metod: En semistrukturerad kvalitativ intervjustudie av fem legitimerade psykodynamiska psykoterapeuter med erfarenhet av terapier med patienter med dödlig sjukdom. Materialet bearbetades med hjälp av tematisk analys.  Resultat: Studien visar att terapisamtal med patienter med döende patienter väcker starka känslomässiga reaktioner hos terapeuten där känslor av hjälplöshet var framträdande. Terapeutens hantering av de starka känslomässiga reaktionerna och relationen till sin egen dödlighet inverkade på hur terapeuten påverkades av samtalen. I en nära och känslomässig relation och med en flexibel terapeutisk ram kunde terapeuten möta patientens starka känslor i processen mot döden, där också en känsla av tacksamhet uppstod hos terapeuten.  Diskussion: Studien belyser på vilket sätt terapeuten påverkas av arbetet med patienter med dödlig sjukdom och hur terapeuten handskas med starka känslomässiga upplevelser. Betydelsen av psykoterapeutens personliga förhållningssätt och flexibla ram och vilka resurser och erfarenheter den psykodynamiska psykoterapeuten behöver för att kunna utföra detta arbete. / Introduction: Psychotherapy can be helpful in reducing suffering when a person is affected by a fatal disease. Psychotherapy with patients who suffer from fatal diseases might provoke strong emotional reactions within the therapist. Research within the field of psychodynamic therapy is predominantly based on case studies, which is why this qualitative interview study could add further knowledge about how the emotional experiences are described by psychodynamic therapists. The purpose of this study was to explore the psychodynamic psychotherapist's experience of therapies with patients who suffer from fatal disease, in order to get an understanding of the therapist's emotional reactions.  Questions: How does the psychotherapist describe the emotional experiences of the psychotherapy with patients suffering from a fatal disease? What does the psychotherapist consider to be important in psychotherapies with patients carrying a fatal disease?  Method: A semi-structured qualitative interview study was conducted with five licensed psychodynamic psychotherapists with experience in psychotherapies with patients who suffer from a fatal disease. A thematic analysis was used to organize the material.  Results: The study shows that psychotherapy with patients who suffer from a fatal disease evoke strong emotional reactions in the therapist, where feelings of helplessness were prominent. The therapist's coping with strong emotional reactions and the relationship to his own mortality affected how the therapist was affected by the therapies. In a close and emotional relationship and with a flexible therapeutic framework, the therapist was able to meet the patient's strong feelings in the process towards death, where a feeling of gratitude also arose in the therapist.  Discussion: The study discusses how the therapist is affected by the work with patients with a fatal disease and how the therapist deals with strong emotional reactions. The importance of the psychotherapist's personal approach and flexible framework and what resources and experiences the psychodynamic psychotherapist needs to be able to undertake these psychotherapies.

Thesis (M.A.)--University of South Africa, 2002.

The purpose of this research is to explore individual behaviour towards authority. The psychodynamic and phenomenological paradigms are used. Unstructured interviews, conducted on five female consultants, produced themes that provide possible insight into individual behaviour towards authority. These themes were; 'daddy and mommy's little girl', need for attention, approval, to not disappoint and sibling rivalry; anxiety and the use of defense mechanisms; conditions for acceptance and/or comfort; dependency for support; clear and/or rigid boundaries; split in experience towards authority; fear of authority; power struggle; and counterdependency. These themes suggest that individual's project and transfer feelings, fantasies, expectations and wishes of their experiences with their parents, their earliest authority figures, onto other authority figures, for example, their managers. The hypothesis generated was "past experiences with authority figures influences individual experiences and hence behaviour towards present authority figures". / Psychology / M.A. (Industrial Psychology)

Inledning: Eftersom den psykodynamiska psykoterapin har kraftig konkurrens från andra terapiformer, samtidigt som kraven på effektivitet, snabbhet och evidens från hälso- och sjukvårdsetablissemanget är starka, är det viktigt att som psykodynamiker delta i diskursen kring den psykodynamiska psykoterapins vetenskapsteoretiska status. Hur kan man karakterisera den psykodynamiska psykoterapin om den dels inte är identisk med psykoanalys, dels heller inte automatiskt kan inordnas i det medicinsk-biologiska paradigmet? Uppsatsen har som syfte att definiera och undersöka om psykodynamisk psykoterapi kan betraktas som behandling och/eller en moralisk etisk praxis. Frågeställningar: Psykodynamisk psykoterapi – är den en egen humanvetenskap? Hur kan man definiera och se på behandling och behandlingsmål i den psykodynamiska psykoterapin? Metod: Litteraturstudie med en hermeneutisk ansats. Resultat: Det finns olika sätt att se på den psykodynamiska psykoterapin när det gäller dess vetenskaplighet. Frågan om psykodynamisk psykoterapi är behandling i gängse medicinsk bemärkelse, har heller inget enkelt entydigt svar. Till synen på behandling hör också målet med densamma. Hur man betraktar behandlingsfrågan blir också vägledande för hur man ser på behandlingsmålet. En skiljelinje går mellan uppfattningen om den psykodynamiska psykoterapin som vetenskap och/eller teknik. Diskussionen om psykodynamisk psykoterapi är en vetenskap eller flera, har betydelse för dess ställning i den vetenskapliga världen. Diskussion: Valet av litteraturstudie som metod avgjordes på grundval uppsatsens syfte och karaktär. Det är möjligt att se den psykodynamiska psykoterapin i annat vetenskapligt ljus än det positivistiska t.ex. fenomenologiskt och hermeneutiskt. Psykodynamisk psykoterapi kan ses både som en vetenskap och en teknik samt som en etisk verksamhetspraxis. Slutsatsen för uppsatsarbetet är att man kan se på den psykodynamiska psykoterapin som en moralisk, etisk behandlingsmetod som med både hermeneutiska och fenomenologiska metoder/tekniker söker uppnå inre frihet, självkännedom och ansvarstagande för medvetnare livsval hos subjektet. Behandlingsmålet blir då att minska neurotiskt och annat lidande hos subjektet samtidigt som lidandets omedvetna ursprung integreras.

<p>The objective of this work was to investigate reflective-functioning (RF) as a measure of process in two independent studies that included three types of brief psychotherapy. RF is defined as the ability to recognize the existence and nature of mental processes taking place in the self and in others (e.g., intentions, beliefs, desires, and wishes). Theorists have suggested the ability for RF is crucial for predicting social causality and low RF has been found related to mental disorders. It has recently been suggested in the literature that improved ability for RF might be an important component of successful psychotherapy outcome, especially with respect to achieving structuralchange. RF was in this work investigated during the process through discourse analysis of the patients’ narratives of self-other interactions in the treatment sessions. The Psychotherapy Process Q-set (PQS) was implemented in order to isolate specific components of the process (process correlates) that identified high and low RF and to investigate the links between the process correlates and outcome. The first study investigated 29 cases of cognitive-behavioral therapy(CBT) and 35 cases of interpersonal psychotherapy (IPT) with an average treatment length of 16.2 sessions in a sample from the National Institute of Mental Health (NIMH) randomized clinical trial Treatment of Depression Collaborative Research Program (TDCRP). The sample in the first study consisted of 128 sessions in total, were one session from the early part (on average the 4th session) and one session in the later part of the treatment (on average the 12th session) were rated for RF. The second study investigated a sample of 30 cases of brief psychodynamic psychotherapy (BPDT) with an average treatment length of 15.8 sessions in a naturalistic designand obtained from the Mount Zion Psychotherapy Research Group. In total, the second study included 90 sessions of BPDT, and RF was assessed during the 1st, the 5th, and the 14th session of each treatment. The results from these two studies suggested that the patients’ ability for RF, as measured through the discourse from therapy sessions, is stable (in CBT and BPDT) or decreased(IPT) during the treatments. Furthermore, the process correlates defining high RF had a relation with good outcome, and process correlates defining low RF had a relation with poor outcome.The process correlates identified during the PQS-analysis suggested that both high and low RF was linked with personality characteristics in the patients. For example, high RF was linked to patients’ ability for introspection, expression of negative emotions, and commitment to treatment.Low RF was linked to patients’ expression of passivity, defensiveness, and suspiciousness. This work supported theorists’ suggestions that brief treatments are supportive in their nature and therefore do not promote structural changes (e.g., changes in RF). It is suggested that the abilityfor RF as assessed pre-treatment might be a useful predictor for success in brief psychotherapy and could therefore be used as a patient inclusion criteria for such treatments.</p>