1
|
Baradon T, Avdi E, Sleed M, Salomonsson B, Amiran K. Observing and interpreting clinical process: Methods and findings from 'Layered analysis' of parent-infant psychotherapy. Infant Ment Health J 2023; 44:691-704. [PMID: 37341063 DOI: 10.1002/imhj.22073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/22/2023]
Abstract
This paper describes a method for investigating clinical process, Layered Analysis, which combines therapist countertransference reports and multi-faceted microanalytic research approaches. Findings from the application of Layered Analysis to video-recorded micro-events of rupture and repair in four psychoanalytic parent-infant psychotherapy sessions are presented. Layered analysis showed that countertransference and observation are complementary perspectives, which enable concomitant study of interactive events, conscious internal experiences, as well as nonconscious and unconscious elements of therapeutic interaction. Interactional rupture and repair were found to constitute co-constructed micro-events that occurred fleetingly and often implicitly, and differed in the structure, coherence and flow of interactions and in the relationship between verbal and nonverbal communication. Furthermore, interactional ruptures were found to sometimes 'get into' the therapist and transiently disrupt their self-organization, such that the therapist became a locus of disruption for the patient(s), actively contributing to the rupture, which thus became embedded in the therapeutic system. Interactive repair was found to be most often initiated by the therapist and to be underpinned by the therapist re-establishing self-regulation, through metabolizing embodied and verbal aspects of the rupture. Studying such processes can enhance our understanding of clinical process, inform therapist training and clinical supervision, and contribute to clinical outcomes.
Collapse
Affiliation(s)
- Tessa Baradon
- Child Attachment and Psychological Therapies Research Unit, Anna Freud Centre, London, UK
| | - Evrinomy Avdi
- Child Attachment and Psychological Therapies Research Unit, Anna Freud Centre, London, UK
- School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michelle Sleed
- Child Attachment and Psychological Therapies Research Unit, Anna Freud Centre, London, UK
| | - Björn Salomonsson
- Child Attachment and Psychological Therapies Research Unit, Anna Freud Centre, London, UK
- Unit of Perinatal Health, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Keren Amiran
- Child Attachment and Psychological Therapies Research Unit, Anna Freud Centre, London, UK
| |
Collapse
|
2
|
García E, Arandia IR. Enactive and simondonian reflections on mental disorders. Front Psychol 2022; 13:938105. [PMID: 35992462 PMCID: PMC9382120 DOI: 10.3389/fpsyg.2022.938105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
As an alternative to linear and unidimensional perspectives focused mainly on either organic or psychological processes, the enactive approach to life and mind-a branch of 4-E (embodied, embedded, enactive, extended) cognitive theories-offers an integrative framework to study mental disorders that encompasses and articulates organic, sensorimotor, and intersubjective dimensions of embodiment. These three domains are deeply entangled in a non-trivial manner. A question remains on how this systemic and multi-dimensional approach may be applied to our understanding of mental disorders and symptomatic behavior. Drawing on Gilbert Simondon's philosophy of individuation (focusing particularly on the concepts of tension, metastability, and preindividual), we provide some enactive conceptual tools to better understand the dynamic, interactive, and multi-dimensional nature of human bodies in mental disorders and psychopathological symptoms. One of such tools cursiva is sense-making, a key notion that captures the relational process of generating meaning by interacting with the sociomaterial environment. The article analyzes five aspects related to sense-making: temporality, adaptivity, the multiplicity of normativities it involves, the fundamental role of tension, and its participatory character. On this basis, we draw certain implications for our understanding of mental disorders and diverse symptoms, and suggest their interpretation in terms of difficulties to transform tensions and perform individuation processes, which result in a reduction of the field of potentialities for self-individuation and sense-making.
Collapse
Affiliation(s)
- Enara García
- IAS Research group, Department of Philosophy, University of the Basque Country, San Sebastián, Spain
| | | |
Collapse
|
3
|
Palmieri A, Fernandez KC, Cariolato Y, Kleinbub JR, Salvatore S, Gross JJ. Emotion Regulation in Psychodynamic and Cognitive-Behavioural Therapy: An Integrative Perspective. CLINICAL NEUROPSYCHIATRY 2022; 19:103-113. [PMID: 35601247 PMCID: PMC9112990 DOI: 10.36131/cnfioritieditore20220204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective Psychotherapy fragmentation constitutes a significant barrier to progress. In the present article, we argue that emotion regulation processes operate across psychotherapy approaches, serving as an overarching meta-factor of therapeutic change. Method Two major therapeutic approaches-psychodynamic and cognitive-behavioural-were examined through the lens of emotion regulation theory. In particular, key constructs within each approach were analyzed in terms of relevant emotion regulation processes. Results Emotion regulation processes are an overarching meta-factor relevant to a wide range of therapeutic constructs (e.g., defence mechanisms, internal working models, coping strategies, ruptures/reparations of alliance). Different clinical traditions emphasize different aspects of emotion regulation, mainly in terms of implicit vs explicit emotion regulation processes. Conclusions An integrative emotion regulation perspective contributes to our understanding of the core change mechanisms of psychotherapy, with significant implications both for research and clinical practice.
Collapse
Affiliation(s)
- Arianna Palmieri
- Department of Philosophy, Sociology, Education & Applied Psychology
- Padua Neuroscience Centre; University of Padova; Via Venezia, 14-35131 Padova; Italy
| | - Katya C. Fernandez
- Department of Psychology, Stanford University; Stanford, CA 94305-2130; USA
| | - Ylenia Cariolato
- Department of Philosophy, Sociology, Education & Applied Psychology
| | | | - Sergio Salvatore
- Department of Dynamic and Clinical Psychology; University La Sapienza, Roma; Via degli Apuli, 2-00185 Roma; Italy
| | - James J. Gross
- Department of Psychology, Stanford University; Stanford, CA 94305-2130; USA
| |
Collapse
|
4
|
Why people join pro-Ana online communities? A psychological textual analysis of eating disorder blog posts. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
5
|
Conversano C. The Psychodynamic Approach During COVID-19 Emotional Crisis. Front Psychol 2021; 12:670196. [PMID: 33897574 PMCID: PMC8062854 DOI: 10.3389/fpsyg.2021.670196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
6
|
Conversano C, Di Giuseppe M. Psychological Factors as Determinants of Chronic Conditions: Clinical and Psychodynamic Advances. Front Psychol 2021; 12:635708. [PMID: 33584488 PMCID: PMC7876054 DOI: 10.3389/fpsyg.2021.635708] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/08/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
7
|
Avdi E, Amiran K, Baradon T, Broughton C, Sleed M, Spencer R, Shai D. Studying the process of psychoanalytic parent-infant psychotherapy: Embodied and discursive aspects. Infant Ment Health J 2020; 41:589-602. [PMID: 32881006 DOI: 10.1002/imhj.21888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper presents findings from an intensive, mixed methods case study of one session of psychoanalytic parent-infant psychotherapy (PPIP) addressing early relational trauma, and aims to shed light on the multimodal interactive processes that take place in the moment-to-moment exchanges comprising the therapeutic encounter. Different research methods were used on video material from PPIP sessions, including microanalysis of adult-infant interactions, discourse analysis of talk, and coding systems developed to study parent-infant interaction. These different perspectives were brought together with the clinical narrative to illuminate the complex, dynamic processes of parent-infant-therapist interaction. More specifically, the detailed analysis of one interactive episode revealed brief behavioral manifestations of fearful and disoriented states of mind, reflecting dysregulated interaction between mother and infant, which also powerfully affected the therapist. The processes through which the therapist gradually resolves this rupture are also described in detail. Through this pilot study, we were able to show that it is possible to systematically study the process of PPIP. The study contributes to the growing psychotherapy research literature that takes into account both the verbal domain and implicit, interactional processes in therapeutic practice, and underscores the therapist's comprehensive engagement in the therapeutic process.
Collapse
Affiliation(s)
- Evrinomy Avdi
- Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children & Families, London, UK
| | - Keren Amiran
- Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children & Families, London, UK
| | - Tessa Baradon
- Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children & Families, London, UK.,School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Carol Broughton
- Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children & Families, London, UK
| | - Michelle Sleed
- Child Attachment and Psychological Therapies Research Unit, Anna Freud National Centre for Children & Families, London, UK
| | - Rose Spencer
- Coombe Wood Mother and Baby Unit, Central and North West London, NHS, London, UK
| | - Dana Shai
- School of Behavioral Science, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| |
Collapse
|
8
|
Nair A, Rutledge RB, Mason L. Under the Hood: Using Computational Psychiatry to Make Psychological Therapies More Mechanism-Focused. Front Psychiatry 2020; 11:140. [PMID: 32256395 PMCID: PMC7093344 DOI: 10.3389/fpsyt.2020.00140] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 02/14/2020] [Indexed: 12/21/2022] Open
Abstract
Psychological therapies, such as CBT, are an important part of the treatment of a range of psychiatric disorders such as depression and anxiety. There is a growing desire to understand the mechanisms by which such therapies effect change so as to improve treatment outcomes. Here we argue that adopting a computational framework may be one such approach. Computational psychiatry aims to provide a theoretical framework for moving between higher-level psychological states (like emotions, decisions and beliefs) to neural circuits, by modeling these constructs mathematically. These models are explicit hypotheses that contain quantifiable variables and parameters derived from each individual's behavior. This approach has two advantages. Firstly, some of the variables described by these models appears to reflect the neural activity of specific brain regions. Secondly, the parameters estimated by these models may offer a unique description of a patient's symptoms which can be used to both tailor therapy and track its effect. In doing so this approach may offer some additional granularity in understanding how psychological therapies, such as CBT, are working. Although this field shows significant promise, we also highlight several of the key hurdles that must first be overcome before clinical translation of computational insights can be realized.
Collapse
Affiliation(s)
- Akshay Nair
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Robb B. Rutledge
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - Liam Mason
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| |
Collapse
|
9
|
Kerr DJ, Deane FP, Crowe TP. Pilot study of a serious board game intervention to facilitate narrative identity reconstruction in mental health recovery. Health Psychol Open 2020; 7:2055102920905628. [PMID: 32095256 PMCID: PMC7008560 DOI: 10.1177/2055102920905628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
This quasi-experimental study explores the effects of a narrative coaching board game intervention aimed at enhancing participants’ sense of self-mastery as part of facilitating narrative identity reconstruction. Three mixed analyses of variance compared differences between clinical (n = 31) and non-clinical (n = 31) groups over time on a measure of mastery. There were no significant group-by-time interaction effects, but both groups demonstrated a statistically significant improvement in mastery over time. From a complex adaptive system perspective, changes may indicate adaptive growth in recovery. A serious board game may be a useful way of facilitating narrative identity reconstruction in recovery.
Collapse
|
10
|
Kerr DJR, Deane FP, Crowe TP. Narrative Identity Reconstruction as Adaptive Growth During Mental Health Recovery: A Narrative Coaching Boardgame Approach. Front Psychol 2019; 10:994. [PMID: 31133932 PMCID: PMC6517514 DOI: 10.3389/fpsyg.2019.00994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
Objective The purpose of this paper is to construct a conceptual framework for investigating the reconstruction of narrative identity in mental health recovery from a complexity perspective. This conceptual framework provides the foundation for developing a health boardgame to facilitate narrative identity reconstruction. Methods A selective integrative review of the theoretical and empirical literature relevant to narrative identity reconstruction in recovery was conducted. Sources included books, dissertations, internet resources, and professional journals. Findings The reviewed material provides a conceptual framework that offers an enriched understanding of narrative identity reconstruction in recovery as a process of adaptive growth. It identifies the Hero's Journey, the life story model of identity (LSMI), and intentional change theory (ITC) as particularly relevant in informing strategies for narrative identity reconstruction. The conceptual framework can be operationalized in a narrative coaching treatment approach using a boardgame. Conclusion and Implications for Practice In practice, mental health professionals could use the narrative coaching boardgame to facilitate people's adaptive change with a focus on building skills to reconstruct their preferred narrative identity and foster hope. Future research should explore what aspects of narrative identity and non-linear dynamic processes of change are most important in people's recovery narratives and in particular these processes can be assessed in response to the use of the boardgame.
Collapse
Affiliation(s)
- Douglas J R Kerr
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Trevor P Crowe
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| |
Collapse
|
11
|
Avdi E, Seikkula J. Studying the Process of Psychoanalytic Psychotherapy: Discursive and Embodied Aspects. BRITISH JOURNAL OF PSYCHOTHERAPY 2019. [DOI: 10.1111/bjp.12444] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
The effect of patients' feedback on treatment outcome in a child and adolescent psychiatric sample: a randomized controlled trial. Eur Child Adolesc Psychiatry 2019; 28:819-834. [PMID: 30390148 PMCID: PMC6555773 DOI: 10.1007/s00787-018-1247-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 10/26/2018] [Indexed: 11/01/2022]
Abstract
The systematic use of feedback from patients on treatment progress and treatment satisfaction is a promising method to increase treatment effectiveness. The extent to which this also applies to the treatment of children with severe psychiatric problems is not clear. We conducted a Randomized Controlled Trial (RCT) to study the effect of adding Feedback Informed Treatment (FIT) to care as usual in a child psychiatric sample. Quality of Life (QoL) was used as the primary outcome measure and symptom severity as the second. Fifty-one therapists from eight Autism Care Teams in a multi-center facility for Child and Adolescent Psychiatry (Karakter) participated and were cluster randomized to the FIT condition (n = 4 teams) or the Care as Usual (CAU) condition (n = 4 teams). Children aged 6-18 years, mainly with an Autism Spectrum Disorder (ASD) and treated in one of the Autism Care Teams were allocated to the FIT condition (n = 86) or the CAU condition (n = 80). Results indicated that adding FIT leads to an increased QoL [F (2,165) = 3.16, p = 0.045]. No additional effects were observed for symptom severity decrease [F (2,158) = 0.19, p = 0.825]. No interaction with time was found for QoL nor symptom severity. Adding FIT in a child psychiatric setting may increase QoL, but does not appear to decrease symptom severity as compared with CAU. It is suggested that FIT positively changes parents' expectations. Results should be replicated in other child psychiatric samples and with an extended theoretical model.
Collapse
|
13
|
|
14
|
Abstract
In this paper I discuss two basic theses about the formalization of cultural psychology. First, I claim that formalization is a relevant, even necessary stage of development of this domain of science. This is so because formalization allows the scientific language to achieve a much needed autonomy from the commonsensical language of the phenomena that this science deals with. Second, I envisage the two main functions that formalization has to perform in the field of cultural psychology: on the one hand, it has to provide formal rules grounding and constraining the deductive construction of the general theory; on the other hand, it has to provide the devices for supporting the interpretation of local phenomena, in terms of the abductive reconstruction of the network of linkages among empirical occurrences comprising the local phenomena.
Collapse
|
15
|
Abstract
Zusammenfassung. Dieser Artikel bietet eine Übersicht zum Forschungsstand zu Tanztherapie bei Krebs. Der erste Teil widmet sich der theoretischen Fundierung der Tanztherapie im onkologischen Setting. Der zweite Teil fasst wissenschaftliche Erkenntnisse aus Tanztherapie Studien in der onkologischen Behandlung zusammen. Abschließend werden Einsatzmöglichkeiten während verschiedener Phasen der Behandlung mit entsprechenden tanztherapeutischen Behandlungszielen aus den Studienergebnissen abgeleitet. Die Literaturrecherche ergab, dass Tanztherapie in allen Phasen der Krebsbehandlung eingesetzt wird mit dem Ziel, den emotionalen, sozialen, physischen und spirituellen Zustand der Patientinnen und Patienten zu verbessern. Zukünftige randomisierte kontrollierte Trials könnten die Wirksamkeit spezifischer tanztherapeutischer Interventionen während unterschiedlicher Behandlungsphasen auf Symptome und bei Männern und Kindern untersuchen.
Collapse
|
16
|
Active Factors in Dance/Movement Therapy: Health Effects of Non-Goal-Orientation in Movement. AMERICAN JOURNAL OF DANCE THERAPY 2016. [DOI: 10.1007/s10465-016-9240-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
17
|
Koch SC, Mergheim K, Raeke J, Machado CB, Riegner E, Nolden J, Diermayr G, von Moreau D, Hillecke TK. The Embodied Self in Parkinson's Disease: Feasibility of a Single Tango Intervention for Assessing Changes in Psychological Health Outcomes and Aesthetic Experience. Front Neurosci 2016; 10:287. [PMID: 27458332 PMCID: PMC4935674 DOI: 10.3389/fnins.2016.00287] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 06/08/2016] [Indexed: 12/19/2022] Open
Abstract
Background: Dance is an embodied activity with benefits for mobility, balance, and quality of life (QoL) of persons affected by Parkinson's Disease (PD). It is enjoyable and likely to support adherence to movement prescriptions. The objective of this study was to assess the feasibility of measuring changes in psychological outcomes, specifically well-being, body self-efficacy, outcome expectations, and experienced beauty after a single Argentine Tango intervention in a workshop format. To anchor experienced beauty in a theory, the article introduces a model of embodied aesthetics featuring active art-making as a central aspect of healing in arts-based interventions. Methods: In a single-group pre–post design, we tested the feasibility of measuring psychological changes of 34 PD patients from Southern Germany after an introductory workshop in Argentine Tango. They participated in a 90 min Tango for PD intervention and completed the Heidelberg State Inventory (HSI-24; (Koch et al., 2007)), the Body Self-Efficacy Scale (BSE; (Fuchs and Koch, 2014)) with a sub-dimension on aesthetic experience, and the Credibility-Expectancy Questionnaire (CEQ; (Devilly and Borkovec, 2000)) before and after the intervention. A subgroup completed the therapeutic factors of arts therapies-scale, a new measure to elaborate on the aesthetic experience. We analyzed pre–post-differences with a t-test for paired samples. Results and Discussion: The study supports the feasibility of measuring health-related psychological changes from a single Argentine Tango intervention for PD patients, as well as acceptance and appropriateness of the intervention for the patient group. After the tango intervention, well-being, body self-efficacy, and outcome expectancies increased. Participants also experienced an increase in beauty of their movements and other aesthetic aspects. We suspect that, in addition to the functional and psychological factors identified so far, the aesthetic experience in dance may be an important therapeutic factor mediating several outcomes of dance and other arts-based interventions. A controlled study for evidence-based testing of targeted variables can now follow to examine the new hypotheses.
Collapse
Affiliation(s)
- Sabine C Koch
- Faculty of Therapeutic Sciences, SRH University HeidelbergHeidelberg, Germany; Department for Creative Arts Therapies and Therapy Sciences, Alanus UniversityAlfter, Germany
| | - Katja Mergheim
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| | - Judith Raeke
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| | - Clarissa B Machado
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| | - Eliane Riegner
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| | - Joachim Nolden
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| | - Gudrun Diermayr
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| | - Dorothee von Moreau
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| | - Thomas K Hillecke
- Faculty of Therapeutic Sciences, SRH University Heidelberg Heidelberg, Germany
| |
Collapse
|
18
|
Gennaro A, Salvatore S, Rocco D, Auletta A. Deconstructive and Constructive Dynamics in the Clinical Process: A Step Further in the Validation of the Two-Stage Semiotic Model. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2016. [DOI: 10.1080/10720537.2016.1183536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|