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In this chapter, we introduce readers to the varied groups of psychotherapists who participated in our study. In doing this, we have two aims in mind. The first is to provide a context for understanding variations in responses to the questions posed in the Development of Psychotherapists Common Core Questionnaire. Psychotherapists share certain basic characteristics, but they also differ in many ways from one another. A detailed description of our therapists' varied characteristics will help readers 27

The purpose of this work is to present the research program of a Clinical Center, the AIGLE Foundation in Buenos Aires, Argentina. It describes the potentialities and advantages of research in this context. It also describes the institute, the types of patients treated and its professional staff. The program covers four areas: determining the demand for psychotherapeutic care in the population at large, studying the conditions making participation in community mental health possible, analyzing and follow-up on the outcomes and studying the personal styles of the therapists. Finally, this work discusses the usefulness and applicability of these results for clinical practice.

Sonia was part of a clinical, naturalistic, and longitudinal research project I developed that began in 1998, with patients who consulted at the well-known AIGLE center in Buenos Aires, Argentina. In the project I selected patients with severe and complex psychological symptoms for whom previous treatments were reported by the patients to have been ineffective. The goal of the project was to employ Dr. Héctor Fernández-Álvarez's Integrative Psychotherapy Model to design a new treatment approach involving combined strategies that could successfully work with such individuals. At the time of intake, Sonia was a 44-year-old, divorced, morbidly obese woman living with her 18-year-old mildly retarded son in an apartment purchased for her by her affluent parents. When Sonia came for treatment, she could not manage her son or her own basic needs and finances and had frequent angry outbursts with her family members. She was diagnosed as having bipolar disorder or cyclothymia, trichotillomania, borderline personality disorder, borderline intellectual functioning, and was on medication for these conditions. This case study describes 10 years of treatment,including over 900 sessions, working on the development of Sonia's coping and interpersonal skills and on restructuring her most basic cognitions about herself and her relationships to others, particularly her family members. During the 10 years, the therapy was gradually reduced in intensity as Sonia made gradual but dramatic changes in her self-concept, her obesity, her relationship to her family, and her ability to work and independently manage her life. While because of her long history of previous treatments, Sonia did not consent to take any standardized assessment measures, she did agree to a collaboratively developed, individualized, 27-item List of Problems and Behaviors Questionnaire (LOPBQ). With a scoring range of 0 ("problem not solved at all") to 5 (problem "totally solved") on each item, Sonia went from an average item score of .33 to one of 4.19 over the course of the first 8 years; that is, from a score of 6.7% of a maximum score to 83.8% of a maximum score. The process by which this impressive change took place is detailed.

Even in well-delivered treatments, a significant proportion of patients with severe diagnoses will not achieve sustained remission. For example, research demonstrates that in Bipolar II disorder, while psychological interventions combined with pharmacotherapy yield much better results than pharmacotherapy alone, relapse rates remain very high. In this article, we show the successful treatment of Mrs. C., who was diagnosed with Bipolar II disorder and fell into the non-responders. The treatment integrated a novel approach grounded on a cognitive-behavioral theory with a systemic perspective. The psychotherapist, the psychiatrist, and a family therapist composed the teamwork and delivered the treatment in three phases. In the first phase, the psychotherapist conjointly with the psychiatrist aimed at reducing symptoms. In the second phase, the psychotherapist and the family therapist addressed the dysfunctional relationship patterns that negatively reinforced emotional dysregulation. Finally, in the third phase, the aim was to consolidate the achievements, changes, and good outcomes.