A variety of new psychotherapy modalities has arisen in which the contact between patient and therapist takes place via the internet. The main objective of this systematic review is to investigate the types of online psychotherapy (OP) conducted nowadays, and to describe their main characteristics to psychodynamic psychotherapists who may wish to better understand the current scientific literature on the subject. The review used two databases, EMBASE and PsycINFO. Fifty-nine studies were retrieved and the main online psychotherapy modalities identified were self-therapy programmes using contact via email or chat; videoconference; and therapy exclusively via chat or email. The result of these studies suggests that OP is more effective than a waiting list control group. When compared with face-to-face therapies, OP showed similar effects. Most studies involved cognitive behavioural therapy; only two studies involved a form of psychodynamic psychotherapy. Different forms of communication allow patient and therapist to establish different relationships and therapeutic possibilities. OPs may be feasible treatment alternatives; however, it remains unclear, especially in relation to psychodynamic treatments, if therapeutic technique in OP, which involves changes in comparison with face-to-face therapies, would be useful in severe cases. Psychodynamic psychotherapists should adopt a posture of constant reflection on the changes taking place in the world and their impact on the minds of individuals, without, nevertheless, idealizing the 'new'. the therapist's location. Many people with mental health disorders fail to seek assistance or cannot afford to visit a doctor's office or mental healthcare centre, and the internet offers access to different therapeutic interventions.These studies throw light on the phenomenon, but online psychotherapies are considered new treatment modalities and are a rapidly expanding field. Most of the data presented in the aforementioned studies are contradictory and inconclusive. Systematic reviews on the subject assist the clinician and the researcher in knowing the state of the art on the subject and in positioning themselves more critically in terms of incorporating online treatment modalities in their practices. For psychodynamic psychotherapy in particular, it is necessary to critically discuss the effect of these technologies on the pillars of this theoretical approach, such as transference, countertransference and the analytic field. These concepts constitute the basis of psychodynamic practice and may be profoundly affected by a virtual relationship (Sfoggia et al., 2014). Therefore, we need to keep questioning the impact of online treatments in a psychodynamic psychotherapy setting.The main objective of this systematic review was to investigate the types of OP conducted nowadays, and to describe their main characteristics to psychodynamic psychotherapists who may wish to better understand the current scientific literature on the subject. The secondary objective was to describe the mai...

In this age of unprecedented expansion of media and information dissemination and sharing, the use of electronic means should be reconsidered. The use of new technologies should be studied to understand how it may affect the relationship between patient and therapist during psychotherapy or psychoanalytic treatments. This study offers a critical discussion of the effect of technologies on clinical practice, and vignettes are used to describe their impact on frame, anonymity, abstinence and therapeutic neutrality. Transfer and countertransference issues resulting from these changes are also discussed. The potential benefits of new technologies in psychotherapy are appreciated, but the authors draw attention to the need to reflect about the presence of the therapist in those technologies and the preservation of the therapeutic setting, so that a satisfactory progression of the work of the dyad is ensured. This study also discusses the use of technologies in the expansion of learning and application of the therapeutic technique to overcome geographic and time barriers, among others.

Introduction: Countertransference, the emotional reaction of a psychotherapist toward a patient, is an important technical element of psychotherapy. The purpose of this systematic review was to identify and describe the main findings of studies that evaluated countertransference in adult psychotherapy. Methods: A search was conducted of the databases Embase, PubMed, PsycINFO and Web of Knowledge to retrieve data published in any language at any time. Results: Of the 1,081 studies found in the databases, 25 were selected. Most were about psychodynamic psychotherapy, and results indicated that positive countertransference, that is, feelings of closeness to the patient, are associated with positive outcomes, such as symptom improvement and good therapeutic alliance. Conclusions: Although few studies were found in the literature, countertransference seems to be an important source of knowledge about several aspects, such as treatment outcomes, attachment style, therapeutic alliance, patient symptoms and diagnoses.

Objectives: The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality. Methodology: This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers. Assessments of each patient-therapist pair were conducted between their fourth and 10th sessions. Results: The CT distance domain exhibited a moderate negative correlation with TA, particularly its sub-dimension representing the patient's capacity for work in therapy. Moderate positive correlations were observed between CT distance and the splitting defense mechanism and between CT closeness and suppression defenses, in addition to moderate negative correlation between CT indifference and the fantasy defense mechanism. Another finding was higher scores for CT indifference in association with socioeconomic classes D and E. Conclusions: The quality of CT may provide a source of information about TA. A high degree of CT distance represents a low level of TA, particularly with relation to the patient's working capacity, although presence of the splitting defense mechanism can affect CT, to the extent that it constitutes a confounding variable. The concept of CT is useful to psychotherapists, providing a source of information about the patient's internal world and about certain elements of therapy, such as the quality of TA, which is important for good treatment results. Keywords:Psychotherapy, psychoanalytic therapy, psychoanalysis, countertransference, therapeutic alliance. ResumoObjetivos: O objetivo principal desta pesquisa foi avaliar a relação entre a contratransferência (CT) e a aliança terapêutica (AT) no início da psicoterapia psicodinâmica. O objetivo secundário é avaliar a associação da CT com as variáveis da dupla e da CT com as demais variáveis do paciente avaliadas, que foram os mecanismos de defesa, sintomatologia e funcionalidade. Metodologia: Trata-se de um estudo transversal com 30 pacientes do ambulatório de psicoterapia de dois serviços de psiquiatria, atendidos por 17 terapeutas. As avaliações ocorreram entre quarto e décimo encontros da dupla. Resultados: A dimensão da CT distância apresentou correlação negativa moderada com a AT, especialmente sua dimensão que representa a capacidade de trabalho em terapia do paciente. Foram verificadas correlações moderadas positivas entre CT distância e cisão e entre CT proximidade e supressão, além da correlação moderada negativa da CT indiferença com fantasia. Outro dado encontrado foi a presença de maiores níveis da CT indiferença diante de pacientes da classe socioeconômica D e E. Conclusões: A qualidade da CT pode servir de fonte de informações sobre a AT. A presença de ...

Determining the indications and contraindications for psychoanalytic treatment seems crucial to achieve therapeutic success and improve treatment effectiveness. In reviewing the classic literature on the topic, aspects such as age, diagnosis, motivation for treatment, present moment in life, ability to gain insight, psychic suffering when seeking treatment, defensive behaviors, and frustration tolerance are clearly analyzed by therapists/ analysts when indicating psychoanalytic treatments. However, traditionally, most criteria underlying such indications date back to a time when the therapeutic relationship was viewed merely as a therapist treating a patient, with no regard to the therapeutic relationship itself. The goal of this article was to critically review the relevance and current adequacy of indications for psychoanalytic treatment, in view of advancements in knowledge on the analytic field. Considering cases that do not evolve as expected according to the indications, patients who are better suited to certain therapists, and therapist-patient pairs that modify their interaction over the course of treatment, the main question remains on how to identify the necessary elements in evaluating a candidate patient for psychoanalytic treatment, as well as the significant elements of therapeutic action. Keywords: Psychoanalysis, psychoanalytic psychotherapy, indication, contraindication, analytic field. ResumoDeterminar critérios de indicação e contraindicação para tratamentos psicanalíticos parece um ponto técnico crucial para a obtenção de sucesso terapêutico e a elevação de seus índices de efetividade. Na revisão da literatura clássica sobre o tema, percebe-se que a idade, o diagnóstico do paciente, a motivação para tratamento, o momento de vida, a capacidade de insight, o sofrimento psíquico apresentado no momento da busca de tratamento, o estilo defensivo e a tolerância à frustração são alguns dos pontos analisados pelos terapeutas/analistas para indicar tratamentos psicanalíticos. Contudo, classicamente, tais indicações provêm de um período em que a relação terapêutica era vista meramente como um terapeuta atendendo um paciente, sem levar em conta a relação terapêutica propriamente dita. O objetivo deste artigo foi revisar criticamente a relevância e pertinência atual das indicações para tratamento psicanalítico, tendo em vista a evolução dos conhecimentos sobre o campo analítico. Considerando casos que não evoluem da maneira esperada segundo as indicações, pacientes que se adaptam melhor a determinados terapeutas e duplas que modificam sua interação ao longo do tempo de tratamento, a principal questão continua sendo como identificar quais seriam os elementos necessários na avaliação de um paciente candidato a tratamento psicanalítico, bem como os elementos significativos da ação terapêutica. Descritores: Psicanálise, psicoterapia psicanalítica, indicação, contraindicação, campo analítico.