The present paper presents a case study of long-term (121 sessions over three years), integrative therapy with "Cora," a client with a history of severe relational trauma that had led to difficulty in forming close relationships, and a history of hospitalization resulting from a series of suicide attempts. Despite these challenges, Cora reported a highly satisfactory outcome at the end of therapy. Using the format of a theory-building case study (McLeod, 2010;Stiles, 2007), qualitative analysis of session evaluations, session transcripts, and post therapy interviews were used to investigate how both the client and therapist understood the process of therapy and why it had been successful. Data from quantitative process and outcome measures were analyzed to provide contextual information. In spite of repeated challenges and difficult therapeutic situations, Cora and the therapist were able to establish a recurring pattern of interaction that they found relevant and productive and that was characterized by persistence. Other helpful aspects of the therapy process included acting with courage, and the use of symbolic representations of their accomplishments. The results contribute to our understanding of the process of therapy with clients who have been exposed to severe relational trauma. The discussion includes reflection on methodological issues associated with mixed-methods case study research in psychotherapy.

No abstract

The article focuses on presenting methods developed in a network stimulation program among a high‐risk group of middle‐aged women living in Oslo, Norway.The aim of the program was to initiate in the women a process of getting acquainted, and even making friends, ‐ and thus establishing new self‐sustaining social networks. In the long run we believed such new relations would increase the quality of life and improve the overall mental health of the participants.During the program period of one year different groups and social activities were established in the neighborhood. Out of 50 women in the experimental group, 26 became active participants. Evaluation of the process was made at certain stages during the entire program.After one year of group participation, the progress of the experimental group (n = 50) was compared to that of the control group (n = 50). The results show that the women participating in the intervention program have improved their social networks and increased their quality of life and self‐esteem compared to the control group. As to mental symptoms, it seems that their change depends on the degree of activity in the groups: the most active participants make friends, improve their existing networks, increase quality of life, and improve mental status. The passive participants, on the contrary, do not seem to have profited from the program so far. The full effect of the program will be evaluated in a later follow‐up.

This case study used test data from a patient with Dissociative Identity Disorder (DID; American Psychiatric Association, 2013 ) to illustrate how two main personality states of the patient ("Ann" and "Ben") seemed to function. The Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011 ) and the Inventory of Interpersonal Problems-Circumplex (IIP-64; Horowitz, Alden, Wiggins, & Pincus, 2000 ), administered to Ann and Ben in separate settings, exposed two diverse R-PAS and IIP-64 profiles. Ann's R-PAS profile suggested an intellectualized style of information processing with few indications of psychological problems. Ben's profile indicated severe perceptual, cognitive, and interpersonal difficulties combined with suspicion and anxiety. Ann's IIP-64 profile suggested minor interpersonal problems, whereas Ben's indicated serious relational difficulties. The findings were discussed in relation to the theory of trauma-related structural dissociation of the personality (van der Hart, Nijenhuis, & Steele, 2006 ), which implies an enduring split in the organization of the personality with more or less separate entities with their own sense of self, perception of the world, and ways of organizing emotional, cognitive, and social functions. The DID personality structure is seen as a defense strategy and as a pathway in the personality development producing serious psychological pain and symptoms.

Aim of the Study:The aim of this study is to examine the effect of yoga treatment of eating disorders (EDs).Methods:Adult females meeting the Diagnostic and Statistical Manual-IV criteria for bulimia nervosa or ED not otherwise specified (n = 30) were randomized to 11-week yoga intervention group (2 × 90 min/week) or a control group. Outcome measures, the Eating Disorder Examination (EDE)-Interview and Eating Disorders Inventory-2 (EDI-2) scores, were administered at baseline, posttest, and at 6-month follow-up. There was a dropout rate of 30% (posttest) and 37% (6-month follow-up).Results:The intervention group showed reductions in EDE global score (P < 0.01), the EDE subscale restraint (P < 0.05), and eating concern (P < 0.01) compared to the control group. The differences between the groups increased at 6-month follow-up. There were no differences between the groups in the EDI-2 score.Conclusion:The results indicate that yoga could be effective in the treatment of ED.