The Danish National Multicenter Schizophrenia Project: Assessment of Psychotic Patients for dynamic Psychotherapy (APPP)

Abstract

Clinicians need guidance in selecting schizophrenic patients for individual psychodynamic psychotherapy. The purpose of the present study was to investigate whether a 17-item questionnaire (APPP) for quantification of suitability for psychotherapy could predict continuance, adherence and outcome from individual dynamic psychotherapy with patients with schizophrenic psychoses. Therapists rated 72 first-episode patients with schizophrenic psychoses in the initial interview. The scores were then correlated to the course of therapy and change in symptoms. APPP was tested to have good psychometric characteristics and had a satisfactory interrater reliability ((ICC,2)=0.70), when four raters scored eight videotaped interviews with eight different patients. The scale scores were highly correlated to "therapeutic alliance" measured by the Working Alliance Inventory (WAI) and the Active Engagement Scale (AES). APPP suitability gave a good early prediction of adherence to therapy (continued in therapy at least 12 months and a satisfactory number of sessions), but had no predictive value of symptomatic improvement or improved social function after 1 year.

Stages of recovery in psychosis: Converging qualitative research and psychoanalysis

“…In addition, some pretreatment factors were identified as predictors of clinical improvement in psychodynamic psychotherapy for psychoses. These include, in particular, a good therapeutic alliance 42 that can be assessed before treatment is started 43 . Recently, years of psychiatric treatment, number of psychiatric hospitalizations, number of suicide attempts, and the experience of a partnership were found as negative predictors.…”

“…These include, in particular, a good therapeutic alliance 42 that can be assessed before treatment is started. 43 Recently, years of psychiatric treatment, number of psychiatric hospitalizations, number of suicide attempts, and the experience of a partnership were found as negative predictors. Actual work or study activities were found as positive predictors related to clinical improvement in a psychodynamic day treatment program.…”

Ομαδική Ψυχοθεραπεία Σε Ασθενείς Με Χρόνιες Σοβαρές Ψυχικές Διαταραχές

“…Να επισηµάνουµε εδώ πως έχει καταδειχθεί ότι ειδικά για δυναµικού προσανατολισµού ψυχοθεραπεία, όσον αφορά τους ψυχωτικούς, είναι καλό, για να µειωθεί ο αριθµός των πρόωρα αποχωρήσαντων να διαθέτουν οι ασθενείς: κίνητρο, κατανόηση ανάγκης για ψυχοθεραπεία, ικανότητα µοιράσµατος προσωπικού υλικού, συναισθηµατική επαφή, ιστορικό δηµιουργικότητας, ικανότητα για προσοχή, εναισθησία, ικανότητα ψυχολογικής διαθεσιµότητας, αυτο-παρατηρητικότητα, πρωτοβουλία και ενεργητικότητα, ενδιαφέρον για την άποψη του θεραπευτή, εµπιστοσύνη στον θεραπευτή, και, όσον αφορά την συναισθηµατική κατάσταση και τις συνθήκες αντι-µεταβίβασης του θεραπευτή να εκτιµούνται: η σφαιρική κρίση καταλληλότητας, η έλξη προς τον ασθενή, η κατανόηση του ασθενή, και τα αισθήµατα απελπισίας, ζωντάνιας ή κουράγιου που τυχόν ανακινούν στον θεραπευτή (κλίµακα APPP, Valbak K. et al, 2003).…”