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Crowe M, Manuel J, Carlyle D, Lacey C. Psilocybin-assisted psychotherapy for treatment-resistant depression: Which psychotherapy? Int J Ment Health Nurs 2023; 32:1766-1772. [PMID: 37589380 DOI: 10.1111/inm.13214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023]
Abstract
This perspective paper explores the choice of psychotherapy for psilocybin-assisted psychotherapy for treatment-resistant depression. There is evidence to support the use of some psychotherapies in treating 'treatment-resistant' depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta-synthesis of the experience of psilocybin. The paper will examine whether three one-to-one psychotherapies identified as effective in the treatment of treatment-resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short-term dynamic psychotherapy align with that experience, although others are currently being trialled.
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Affiliation(s)
- Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jenni Manuel
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
- Māori and Indigenous Health Institute, University of Otago, Christchurch, New Zealand
| | - Dave Carlyle
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
- Māori and Indigenous Health Institute, University of Otago, Christchurch, New Zealand
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2
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Tobiassen AH, Sundal T, Stänicke E, Folmo EJ. The cultural change narrative as a core component of therapeutic change. Front Psychiatry 2023; 14:1149984. [PMID: 37867772 PMCID: PMC10587421 DOI: 10.3389/fpsyt.2023.1149984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Research indicates a similar effect of Mentalization-based treatment (MBT) and Dialectical behavior therapy (DBT) for borderline personality disorder (BPD). However, there is a paucity in studies investigating the change narrative received from and developed in these treatments. The aim of the present study is to investigate similarities and differences in the change narratives provided by MBT and DBT, and how these narratives reflect the rationale, explanations, and procedures of the provided treatment. Methods The study is a qualitative analysis of seven interviews conducted by the authors. Three of the participants had received MBT, and four of the participants had received DBT. This study presents an Interpretative Phenomenological Analysis (IPA) of the change narratives received in two specialized treatments for BPD. Results The main findings from the IPA were that the change narratives described by the participants reflected the treatment they received. The DBT participants highlighted explicit learning of tools and techniques, with predictable and safe therapists. In contrast, the MBT participants emphasized a long-lasting process of exploring to create procedural learning with therapists who followed their lead. Discussion The participants' stories of change shed light on how a change narrative was developed, and therefore how the rationale, explanations and procedures were conveyed differently by MBT and DBT.
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Affiliation(s)
| | | | - Erik Stänicke
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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3
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Feinstein D. Uses of Energy Psychology Following Catastrophic Events. Front Psychol 2022; 13:856209. [PMID: 35548526 PMCID: PMC9084314 DOI: 10.3389/fpsyg.2022.856209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/14/2022] [Indexed: 12/15/2022] Open
Abstract
Energy psychology, as most widely practiced, integrates the manual stimulation of acupuncture points with imaginal exposure, cognitive restructuring, and other evidence-based psychotherapeutic procedures. Efficacy for energy psychology protocols has been established in more than 120 clinical trials, with meta-analyses showing strong effect sizes for PTSD, anxiety, and depression. The approach has been applied in the wake of natural and human-made disasters in more than 30 countries. Four tiers of energy psychology interventions following the establishment of safety, trust, and rapport are described, including (1) immediate relief/stabilization, (2) reducing limbic arousal to trauma-based triggers, (3) overcoming complex psychological difficulties, and (4) promoting optimal functioning. The first tier is most pertinent in psychological first aid immediately following a disaster, with the subsequent tiers progressively being introduced over time with complex stress reactions and chronic disorders. Advantages of adding the stimulation of acupuncture points to a conventional exposure approach are identified, and challenges around cultural sensitivities and unintended effects are discussed. After establishing a framework for introducing energy psychology in disaster relief efforts, reports from a sampling of settings are presented, based on interviews with this paper's author. These include accounts of relief work with survivors of mass shootings, genocide, ethnic warfare, earthquakes, hurricanes, tornadoes, floods, wildfires, and the COVID-19 pandemic. Hundreds of other reports from the field show a pattern of strong outcomes following the use of energy psychology in the days or weeks after a disaster and in the subsequent treatment of trauma-based psychological problems. Many of these accounts corroborate one another in terms of rapid relief and long-term benefits. Finally, examples of more efficient delivery methods utilizing large groups, lay counselors, digital technology, and cultivating community resilience are presented.
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Burke N, Michaels L, Muhr J. Psychotherapy Action Network: Seeing Beyond the Crossroads. PSYCHOANALYTIC INQUIRY 2021. [DOI: 10.1080/07351690.2021.1983392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Quinlan E, Deane FP, Schilder S, Read E. Confidence in case formulation and pluralism as predictors of psychologists’ tolerance of uncertainty. COUNSELLING PSYCHOLOGY QUARTERLY 2021. [DOI: 10.1080/09515070.2021.1997918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Elly Quinlan
- Discipline of Psychology, Australian College of Applied Psychology, Sydney, Australia
| | - Frank P. Deane
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Suzanne Schilder
- Discipline of Psychology, Australian College of Applied Psychology, Sydney, Australia
| | - Ellen Read
- Discipline of Psychology, Australian College of Applied Psychology, Sydney, Australia
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Smith K, McLeod J, Blunden N, Cooper M, Gabriel L, Kupfer C, McLeod J, Murphie MC, Oddli HW, Thurston M, Winter LA. A Pluralistic Perspective on Research in Psychotherapy: Harnessing Passion, Difference and Dialogue to Promote Justice and Relevance. Front Psychol 2021; 12:742676. [PMID: 34552542 PMCID: PMC8450328 DOI: 10.3389/fpsyg.2021.742676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/05/2021] [Indexed: 11/23/2022] Open
Abstract
The adoption of a pluralistic perspective on research design, processes of data collection and analysis and dissemination of findings, has the potential to enable psychotherapy research to make a more effective contribution to building a just society. A review of the key features of the concept of pluralism is followed by a historical analysis of the ways in which research in counselling, psychotherapy and related disciplines has moved in the direction of a pluralistic position around knowledge creation. Core principles of a pluralistic approach to research are identified and explored in the context of a critical case study of contemporary research into psychotherapy for depression, examples of pluralistically oriented research practices, and analysis of a pluralistic conceptualisation of the nature of evidence. Implications of a pluralistic perspective for research training and practice are discussed. Pluralistic inquiry that emphasises dialogue, collaboration, epistemic justice and the co-existence of multiple truths, creates opportunities for individuals, families and communities from a wide range of backgrounds to co-produce knowledge in ways that support their capacities for active citizenship and involvement in open democratic decision-making. To fulfil these possibilities, it is necessary for psychotherapy research to be oriented towards social goals that are sufficiently relevant to both researchers and co-participants to harness their passion and work together for a common good.
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Affiliation(s)
- Kate Smith
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - John McLeod
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | | | - Mick Cooper
- Department of Psychology, Roehampton University, London, United Kingdom
| | - Lynne Gabriel
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Christine Kupfer
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Julia McLeod
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | | | - Hanne Weie Oddli
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Mhairi Thurston
- School of Applied Sciences, Abertay University, Dundee, United Kingdom
| | - Laura Anne Winter
- Manchester Institute of Education, Schools of Environment, Education, and Development, University of Manchester, Manchester, United Kingdom
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Rabeyron T. L’évaluation et l’efficacité des psychothérapies psychanalytiques et de la psychanalyse. EVOLUTION PSYCHIATRIQUE 2021. [DOI: 10.1016/j.evopsy.2020.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Domhardt M, Cuijpers P, Ebert DD, Baumeister H. More Light? Opportunities and Pitfalls in Digitalized Psychotherapy Process Research. Front Psychol 2021; 12:544129. [PMID: 33815184 PMCID: PMC8017120 DOI: 10.3389/fpsyg.2021.544129] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 02/27/2021] [Indexed: 12/23/2022] Open
Abstract
While the evidence on the effectiveness of different psychotherapies is often strong, it is not settled whereby and how these therapies work. Knowledge on the causal factors and change mechanisms is of high clinical and public relevance, as it contributes to the empirically informed advancement of psychotherapeutic interventions. Here, digitalized research approaches might possess the potential to generate new insights into human behavior change, contributing to augmented interventions and mental healthcare practices with better treatment outcomes. In this perspective article, we describe recent findings of research into change mechanisms that were only feasible with digital tools and outline important future directions for this rather novel branch of research. Furthermore, we indicate several challenges and pitfalls that are to be solved, in order to advance digitalized psychotherapy process research, both methodologically and technologically.
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Affiliation(s)
- Matthias Domhardt
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - David Daniel Ebert
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
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Abbass AA, Tasca GA, Vasiliadis HM, Spagnolo J, Kealy D, Hewitt PL, Hébert C, Drapeau M, Doidge N. Psychodynamic therapy in Canada in the era of evidence-based practice. PSYCHOANALYTIC PSYCHOTHERAPY 2020. [DOI: 10.1080/02668734.2020.1803390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Allan A. Abbass
- Centre for Emotions and Health, Dalhousie University, Halifax, Canada
| | | | - Helen-Maria Vasiliadis
- Professeure, Département Des Sciences De La Santé Communautaire, Université De Sherbrooke, Sherbrooke, Canada
| | - Jessica Spagnolo
- FRQS, Département Des Sciences De La Santé Communautaire, Université De Sherbrooke, Sherbrooke, Canada
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Paul L. Hewitt
- Department of Psychology and Associate Member, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Catherine Hébert
- Department of Counselling Psychology, McGill University, Montreal, Canada
| | - Martin Drapeau
- Department of Counselling Psychology and of Psychiatry, McGill University, Montreal, Canada
| | - Norman Doidge
- Psychiatrist, and Training and Supervising Psychoanalyst, Canadian Institute of Psychoanalysis, Toronto Institute of Psychoanalysis Branch, Canada
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Kovács G, van Dijke A, Enders-Slegers MJ. Psychodynamic Based Equine-Assisted Psychotherapy in Adults with Intertwined Personality Problems and Traumatization: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165661. [PMID: 32764468 PMCID: PMC7460234 DOI: 10.3390/ijerph17165661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/01/2020] [Accepted: 07/31/2020] [Indexed: 06/01/2023]
Abstract
The growing field of equine-assisted psychotherapy (EAP), a subfield of animal-assisted psychotherapy (AAP), needs theoretically-based clinical studies. This systematic review examines the existing clinical studies in adult populations on psychodynamic psychotherapy combined with equine-assisted psychotherapy. An electronic database search was divided in two studies to identify publications on 1) EAP combined with psychodynamic psychotherapy and 2) EAP combined to personality problems and traumatization in order to compile studies by population, intervention, outcome and therapeutic assets. Study 1 revealed no relevant clinical studies on EAP with a psychodynamic background with an adult population. Study 2 revealed 12 publications to review predominantly addressing veterans with PTSD. The methodological limitations of most of the studies restrain the overall findings on outcome. However, overall positive effects for EAP, specifically on its experiential features and on finding interpersonal trust for patients, can be discerned. There is an apparent need for clinical studies meeting methodological standards on psychodynamic underpinned EAP methodologies in adults with intertwined personality problems and traumatization.
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Affiliation(s)
- Géza Kovács
- Faculty of Psychology, Open University, Valkenburgerweg 177, 6419 AT Heerlen, The Netherlands;
- SPEL Psychologen Putten, Garderenseweg 158, 3881 NE Putten, The Netherlands
| | - Annemiek van Dijke
- Online poli’s I-psy psyQ Brijder, Parnassia Group, Schipholpoort 20, 2034 MA Haarlem, The Netherlands;
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11
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de Felice G, Giuliani A, Halfon S, Andreassi S, Paoloni G, Orsucci FF. The misleading Dodo Bird verdict. How much of the outcome variance is explained by common and specific factors? NEW IDEAS IN PSYCHOLOGY 2019. [DOI: 10.1016/j.newideapsych.2019.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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12
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Řiháček T, Čevelíček M. Common therapeutic strategies in psychological treatments for medically unexplained somatic symptoms. Psychother Res 2019; 30:532-545. [PMID: 31345126 DOI: 10.1080/10503307.2019.1645370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: Medically unexplained somatic symptoms (MUSS) represent a frequent complaint in health care services. While psychological treatments have demonstrated some effect in patients with MUSS, further progress may be achieved by a synthesis of clinical strategies used in diverse treatment models. The aim of this study was to identify clinical strategies shared across multiple psychological treatments intended for the treatment of adult patients with MUSS. Method: Descriptions of psychological treatments for patients with MUSS were searched in the PsycINFO, PsycARTICLES, and Medline databases and manually. N = 135 resources met inclusion criteria and were subjected to qualitative analysis. Results: Similarities across treatments were captured in 8 broad categories and 18 subcategories that covered aspects of the therapeutic relationship, specific skills (bodily, emotional, and relational) for patients to develop, search for the meaning of symptoms, and the orientation on life beyond symptoms. Conclusions: Despite the differences in technique, it was possible to identify common therapeutic strategies in psychological treatments for patients with MUSS. These overarching treatment strategies, many of which have already obtained empirical support, may inspire further research and the development of comprehensive treatments with enhanced efficacy. Limitations of the present study include the lack of focus on specific syndromes.
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Affiliation(s)
- Tomáš Řiháček
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Michal Čevelíček
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
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Vom Sinn des Verfahrenskonzepts und der Verfahrensvielfalt – und warum das Baukasten-System in der Psychotherapie nicht funktioniert. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2019; 65:321-340. [PMID: 31328676 DOI: 10.13109/zptm.2019.65.4.oa1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Why the concept of distinct psychotherapeutic approaches is indispensable - and why the tool box concept of psychotherapy cannot work Background: In Germany, the official psychotherapy guidelines are oriented towards the model of distinct psychotherapeutic approaches. Within the German health care system this also applies to the training in psychotherapy. Some critics, however, are presently pleading in favour of abolishing the model of distinct psychotherapeutic approaches, which also implies to abolish the concept of the so called "Richtlinienverfahren" in Germany - approaches of psychotherapy which proved to be efficacious and whose costs are reimbursed by the insurance companies. Objective: The arguments put forward such as the heterogeneity of the approaches as well as the proposed alternatives, for example, an "integrative" model of both mental disorders and psychotherapeutic treatment are critically discussed. Results: Both the arguments and proposed alternatives are found to be not convincing, neither from a scientific nor from a psychotherapeutic perspective. From a scientific perspective, there is no evidence for efficacy of a "general" or "integrative" model of psychotherapy - which is in contrast to the Richtlinienverfahren for which evidence for efficacy exists. From a psychotherapeutic perspective psychotherapy cannot be taught, learnt and applied by use of tools or modules without a theoretical orientation. Conclusions: The concept of distinct psychotherapeutic approaches proves to be an in dispensable principal for orientation in psychotherapy, for both therapists and patients.
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Abstract
OBJECTIVES This paper explores the ways empirically supported treatments (ESTs) help patients, therapists, and institutional administrators contain anxiety regarding complex human problems. METHOD The authors synthesized relevant literature with their experience as clinicians and psychotherapy researchers. RESULTS ESTs may manage patient anxieties by framing their symptoms in clearly stated mechanisms and relying on a therapist who is an "expert" capable of healing them quickly. ESTs allow therapists to streamline treatment decisions and minimize intersubjective aspects of treatment which reduces the complexity of therapy. ESTs assist institutional administrators in the top-down dissemination of treatments and limit concerns about malpractice and insurance reimbursement by providing assurance that interventions have been vetted. CONCLUSIONS While recognizing the benefits of ESTs, relying on ESTs to manage anxieties may diminish the importance of patient factors and clinical judgment, the other critical aspects of evidence-based practice, and thus limit the potential of clinical practice to reduce human distress.
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Affiliation(s)
- Nicole Nehrig
- VA New York Harbor Healthcare System, Manhattan Campus, New York, New York.,Department of Psychiatry, New York University, New York, New York
| | - Tracy A Prout
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, New York
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Leichsenring F, Abbass A, Hilsenroth M, Luyten P, Rabung S, Steinert C. Equivalence testing: reversed hypotheses, margins, and the need for controlling researcher allegiance. Psychol Med 2019; 49:876-878. [PMID: 30460890 DOI: 10.1017/s0033291718003380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Falk Leichsenring
- Department of Psychosomatics and Psychotherapy,Justus-Liebig-University Giessen,Ludwigstr. 76, 35392 Giessen,Germany
| | - Allan Abbass
- Department of Psychiatry,Dalhousie University, Centre for Emotions and Health,Halifax, 8203 5909 Veterans Memorial Lane, Halifax, NS, Canada, B3H 2E2,Canada
| | - Mark Hilsenroth
- Derner School of Psychology, Adelphi University, Hy Weinberg Center,1 South Avenue, Garden City, NY 11530-0701,USA
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences,University of Leuven, Klinische Psychologie (OE),Tiensestraat 102 - bus 3722, 3000 Leuven,Belgium
| | - Sven Rabung
- Department of Psychology,Alpen-Adria-Universität Klagenfurt,Universitätsstr. 65-67, A-9020 Klagenfurt,Austria
| | - Christiane Steinert
- Department of Psychosomatics and Psychotherapy,Justus-Liebig-University Giessen,Ludwigstr. 76, 35392 Giessen,Germany
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Zipfel S. 200 Years of Psychosomatic Medicine-And Still More Timely Than Ever. Front Psychiatry 2018; 9:674. [PMID: 30662410 PMCID: PMC6329012 DOI: 10.3389/fpsyt.2018.00674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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