The Relationship Between Theoretical Orientation and Accuracy of Countertransference Expectations

The systemic-family-individual approach: The heritage and continuation of Mara Selvini Palazzoli's work in integrative psychotherapy

Since the birth of family therapy, the Milan approach has been known as a foundational systemic model. Nevertheless, following the dissolution of the Milan group, Mara Selvini, alongside Matteo Selvini, Stefano Cirillo, and Anna Maria Sorrentino, began a new trajectory of clinical development, insufficiently examined within the American panorama. After her death, in 1999, the Selvini group continued to adapt and refine her systemic approach which is known today as the systemic-family-individual (SFI) approach. In this article, we delve into the constituents that constitute the SFI approach, elucidating how it furnishes therapists with a structured framework to guide clinical decision-making and the application of integrated theoretical concepts. Ultimately, the article exemplifies the SFI approach's practical application via a clinical case study, showcasing its efficacious navigation.

From symptoms to subjective and bodily experiences: the contribution of the Psychodynamic Diagnostic Manual (PDM-2) to diagnosis and treatment monitoring in eating disorders

PURPOSE

Atheoretical and descriptive conceptualizations of eating disorders (EDs) have faced substantial criticism due to their limited ability to assess patients' subjective characteristics and experiences, as needed to determine the most appropriate treatment options. The present article provides an overview of the clinical and empirical literature supporting the potential contribution of the Psychodynamic Diagnostic Manual (PDM-2) to both diagnostic assessment and treatment monitoring.

METHODS

Following a discussion of the most relevant shortcomings of current diagnostic models of EDs and a description of the rationale and structure of the PDM-2, evidence supporting the core PDM-2 dimensions of ED patients' subjective experiences (i.e., affective states, cognitive processes, relational patterns, somatic/bodily experiences and states) are examined, alongside their relevance to ED diagnosis and treatment.

RESULTS

Overall, the reviewed studies support the diagnostic importance of these patterns of subjective experiences in EDs, highlighting their potential role as either predisposing or maintaining factors to target in psychotherapy. A growing body of multidisciplinary evidence also shows that bodily and somatic experiences are central to the diagnosis and clinical management of ED patients. Moreover, there is evidence that a PDM-based assessment may enable closer monitoring of patient progress during treatment, with regard to both subjective experiences and symptom patterns.

CONCLUSIONS

The study suggests that current diagnostic frameworks for EDs would benefit from the addition of a person-centered perspective that considers not only symptoms, but also patients' full range of functioning-including their deep and surface-level emotional, cognitive, interpersonal, and social patterns-to improve patient-tailored interventions.

LEVEL OF EVIDENCE

Level V, narrative review.

Psychodiagnostic Chart-Child (PDC-C): a valid and clinically sensitive diagnostic tool for patient-tailored intervention planning

The reliable clinical-diagnostic evaluation of child patients is crucial. The present research sought to examine the validity of the Psychodiagnostic Chart-Child (PDC-C) in assessing children’s mental functioning and personality organization, according to the framework of the Psychodynamic Diagnostic Manual, Second Edition (PDM-2). A sample of 209 clinicians assessed 209 children (aged 4-11 years) who had been in their care between 2-12 months, using the PDC-C. Each clinician also completed a clinical questionnaire to provide demographic information, the Child Behavior Checklist to evaluate children’s behavioral problems and social competences, and the Childhood Personality Assessment Q-Sort measure to assess children’s emerging personality patterns. The findings suggest that the PDC-C is a valid diagnostic tool that considers children’s full range of functioning. Moreover, the measure has good sensitivity and appears clinically useful in differentiating between certain clinical populations according to psychological characteristics. The PDC-C could promote more accurate assessment during childhood and inform the development of individualized therapies. One of the advantages of the tool is its ability to capture individual variations in child functioning (illuminating strengths and psychological vulnerabilities), even within children in the same diagnostic group. Of note, additional research is needed to establish the utility of PDC-C ratings in predicting clinically relevant constructs and to monitor the processes and outcomes of interventions.