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Case studies in psychotherapy training using Austria as an example

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World Journal of Clinical Cases 2020年第13期8卷 2787-2801页

作者： Ela Neidhart henriette löffler-stastka Department of Psychoanalysis and Psychotherapy and Teaching Center–Postgraduate UnitMedical University of Vienna/General Hospital of ViennaVienna 1090Austria

BACKGROUND Case studies(CS)are relevant for the development of theoretical and practical competencies in *** rapid progress in the development of methods and principles for establishing CS in the last three decades,research into the aims of CS,especially in training,or how CS are to be conducted is *** To elucidate the form and methodology of CS,the objectives of CS used in training institutions(TI),and if/how TIs handle therapist ***,this preliminary investigation will suggest avenues for further research and attempt to establish certain *** In order to counteract researcher bias and enlarge the question-pool,a focus group was *** recorded and transcribed text was analyzed with Mayring’s method of qualitative content analysis,and the generated categories were formulated as *** resulting questionnaire with both qualitative and quantitative queries was sent out(after pre-testing)to all 39 Austrian TIs that provide professional psychotherapy *** answers and text passages received were then also categorized with qualitative content *** analysis was discussed by a peer group consisting of three psychotherapists trained in differing schools of psychotherapeutic *** 94%of Austrian institutes use CS as part of their psychotherapeutic *** of the term“case study”is inconsistent and has a wide variety of *** serve mainly:(1)For observation of training/progress in therapeutic practice and knowledge/acquisition of the theory specific to each psychotherapeutic school;(2)To improve(self-)reflection capabilities;and(3)To expand theoretical *** of the CS written are not accessible for students nor for the research *** than two thirds of the CS take only the position of the author into account(the client’s position is not described).15.5%of the TIs do not consider researcher or therapist allegiance at *** A more pre

关键词： Case study Psychotherapy training Case study research Therapist allegiance Researcher bias

Personalized treatment-which interaction ingredients should be focused to capture the unconscious

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World Journal of Clinical Cases 2022年第7期10卷 2053-2062页

作者： Dagmar Steinmair henriette löffler-stastka Department of Psychoanalysis and Psychotherapy Medical University ViennaWien 1090ÖsterreichAustria

A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic *** mental health care in physical care services is still ***,interdisciplinary communication across treatment providers is *** standardized language provided by the diagnostic statistical manual favors a clear ***,this approach might not focus on the individual,as thinking in categories might impede recognizing the continuum from healthy to *** theory is concerned with an individual’s unconscious conflictual wishes and motivations,manifested through enactments like psychic symptoms or(maladaptive)behavior with long-term consequences if not *** modifiable internal and external factors often are inadequately ***,together with the physical chronic condition constraints,these factors determine degrees of freedom for a self-determined *** effect of therapeutic interventions,and especially therapy adherence,relies on a solid therapeutic *** and process research still investigates the mechanism of change in psychotherapeutic treatments with psychanalysis’s focus on attachment *** article examines existing knowledge about the mechanism of change in psychoanalysis under the consideration of current trends emerging from psychotherapy research.A clinical example is ***,further directions for research are *** theoretical frame in psychoanalytic therapies is the affect-cognitive *** affect-perception is enabled via awareness of subjective meanings in oneself and the other;shaping this awareness is the main intervention *** interactional ingredients,the patient’s inherent bioenvironmental history meeting the clinician,are relevant *** intrinsic,subliminal parameters relevant for changing behavior are *** inter

关键词： Chronic disease Psychological impairment Psychoanalysis Facial microexpressions Memory reconsolidation Reflection Relationship Resilience

Cognitive dissonance and mindset perturbations during crisis:“ecosocio-psycho-somatic”perspectives

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World Journal of Psychiatry 2024年第2期14卷 215-224页

作者： Felix Tretter henriette löffler-stastka Department of Systems Medicine and Healthcare Systems Bertalanffy Center for the Study of Systems ScienceVienna 1040Austria Department of Psychoanalysis and Psychotherapy Medical University ViennaVienna 1090Austria

Mandatory and restrictive health regulations during the corona pandemic caused psychic disorders in many people,which even led to clinically relevant mental *** the same time,there was gradually a polarization of opinions among the *** order to improve future pandemic management,an integrative understanding of these psychosocial processes therefore seems *** we start theoretically with the mental effects of inconsistencies of the information environment by referring to concepts such as the theory of cognitive *** a next step,we use the psychodynamic theory to understand the affective-motivational defense mechanisms underlying these cognitive states and ***,a broader theoretical framework of psychoanalysis seems to make sense,because self-referential processing also influences the style of *** this reason,we use a more comprehensive psychological systems theoretical framework model to integrate these different *** integrative view refers in part to basic knowledge of health psychology regarding the resistance of unhealthy ways of thinking and behaviors and the possibilities for interventions for *** then extend this model to a broader picture that also covers the relationship between men and their *** results in the perspective of a multidimensional socioecological theoretical framework,which as a heuristic reference model and related to other ecological approaches could also be helpful for various theoretical questions for public health,and could provide a better public understanding of health *** line with this perspective,we hypothesize that with regard to the coronavirus disease 2019 pandemic,the acceptance of public health narratives could be increased if a more consistent picture of the scientific descriptions and explanations of the pandemic-similar to the model proposed-could be provided,which would enable the understanding of the origin,course and countermeasur

关键词： Infodemic Affective-cognitive dissonance Systems model of the mind Socioecological model

COVID-19 survivors:Multi-disciplinary efforts in psychiatry and medical humanities for long-term realignment

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World Journal of Psychiatry 2022年第7期12卷 995-998页

作者： henriette löffler-stastka Monika Pietrzak-Franger Department of Psychoanalysis and Psychotherapy Medical University ViennaVienna 1090Austria of English and American Studies University ViennaVienna 1090Austria

The coronavirus disease 2019 pandemic represents an enduring transformation in health care and education with the advancement of smart universities,telehealth,adaptive research protocols,personalized medicine,and self-controlled or artificial intelligence-controlled *** changes,of course,also cover mental health and long-term realignment of coronavirus disease 2019 *** or anxiety,as the most prominent psychiatric“long coronavirus disease 2019”symptoms,need a theory-based and empirically-sound procedure that would help us grasp the complexity of the condition in research and *** the systemic character of the condition,such strategies have to take the whole individual and their sociocultural context into ***,at the moment,attempts to build an integrative framework for providing meaning and understanding for the patients of how to cope with anxiety when they are confronted with empirically reduced parameters(e.g.,severe acute respiratory syndrome coronavirus type 2)or biomarkers(e.g.,the FK506 binding protein 5)are *** this context,multidisciplinary efforts are *** therefore join in a plea for an establishment of‘translational medical humanities’that would allow a more straightforward intervention of humanities(e.g.,the importance of the therapist variable,continuity,the social environment,etc)into the disciplinary,medial,political,and popular cultural debates around health,health-care provision,research(e.g.,computer scientists for simulation studies),and wellbeing.

关键词： long COVID Resilience Multi-disciplinarity Medical Humanities Psychiatric sequelae

Importance of communication in medical practice and medical education:An emphasis on empathy and attitudes and their possible influences

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World Journal of Psychiatry 2022年第2期12卷 323-337页

作者： Dagmar Steinmair Katharina Zervos Guoruey Wong henriette löffler-stastka Department of Psychoanalysis and Psychotherapy Medical University of ViennaVienna 1090Austria Karl landsteiner University of Health Sciences Krems 3500Austria Department of Ophtalmology University Hospital St.PöltenSt.Pölten 3100Austria Department of Internal Medicine I KRH Klinikum Robert-Koch-GehrdenGehrden 30989Germany Faculty of Medicine University of MontréalMontréal 2900QuébecCanada

BACKGROUND Healthcare professionals need to be prepared to promote healthy lifestyles and care for *** focusing on what students should be able to perform one day as clinicians,we can bridge the gap between mere theoretical knowledge and its practical *** aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning *** To determine sets of intellectual,personal,social,and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking,in order to identify training *** An analysis of training clinicians’conceptions with respect to optimal medical history taking was *** chosen study design also aimed to assess gender *** interviews with supervising clinicians were carried out in a descriptive study at the Medical University of *** were analyzed by conducting a qualitative computer-assisted content analysis of the *** category formation was *** main questions posed to the supervisors dealt with(1)Observed competencies of students in medical history taking;and(2)The supervisor’s own conceptions of"ideal medical history taking".RESUlTS A total of 33 training clinicians(n=33),engaged in supervising medical students according to the MedUni Vienna’s curriculum standards,agreed to be enrolled in the study and met inclusion *** qualitative content analysis revealed the following themes relevant to taking an anamnesis:(1)Knowledge;(2)Soft skills(relationship-building abilities,trust,and attitude);(3)Methodical skills(structuring,precision,and completeness of information gathering);and(4)Environmental/contextual factors(language barrier,time pressure,interruptions).Overall,health care professionals consider empathy and attitude as critical features concerning the quality of medical history *** looking at physicians’theoretical conceptions,more general practitioners and ps

关键词： Medical history taking Attitude Empathy Training Physicians’view

Affect regulation in psychoanalytic treatments of patients with a borderline personality disorder–psychoanalysis and psychodynamic psychotherapy–a comparison

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World Journal of Psychiatry 2021年第12期11卷 1328-1345页

作者： Dagmar Steinmair Guoruey Wong Sophie Frantal Christine Rohm henriette löffler-stastka Department of Psychoanalysis and Psychotherapy Medical University of ViennaWien 1090Austria Karl landsteiner University of Health Sciences Dr.Karl-Dorrek-Straße 30Krems 3500Austria Department of Ophtalmology University Hospital St.PöltenSt.Pölten 3100Austria Facultéde Médecine Universitéde MontréalMontréal H3C 3J7QuébecCanada

BACKGROUND A recent meta-analysis has confirmed that the effects of psychotherapy on patients with borderline personality disorders(BPD)are still insufficiently *** of differences between different types of therapies has been *** To study repetitive interaction patterns in patients with BPD undergoing either psychoanalysis or psychodynamic *** Psychoanalysis(PSA)or psychodynamic psychotherapy(PDT)was administered to 10 patients each,the two groups were *** regimens were applied according to care as usual/manualized including quality control and supervision as *** to one of the groups was done after baseline *** classical PSA(n=10)and PDT(n=10),semiannually,recordings(audio or video)of five consecutive therapy sessions were taken over three years for an ex-post *** patients'characteristics,such as affect parameters[Affect regulation and experience Q-sort(AREQ)],quality of object relations(quality of object relations scale)and personality traits[Shedler-Westen Assessment Procedure(SWAP-200)]were analyzed retrospectively by independent *** action(psychotherapy process Q-sort)and affective(re)actions of the patients(AREQ)were then analyzed in relation to changes found in the patients'*** During the first year of therapy(PSA:n=10;PDT:n=9),the therapeutic method PSA was associated with significant improvements in the variable"SWAP Borderline",while in PDT change was not significantly different to baseline(PSA:P=0.04;PDT:P=0.33).long-term results and follow up was available for seven participants in PSA and for five in PDT after three years;change in SWAP borderline for the whole sample was not significant at this time point when confronting to baseline(P=0.545).However,differences between PSA and PDT were significant when analyzing the“mean change”in the SWAP Borderline variable after one year of therapy(P=0.024):PSA led to slightly increased BPD sy

关键词： Psychoanalysis Psychodynamic psychotherapy Borderline personality disorder Affect regulation Affect regulation and experience Q-sort Transference

learning and competence development via clinical cases-what elements should be investigated to best train good medical doctors?

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World Journal of Meta-Analysis 2020年第3期8卷 178-189页

作者： henriette löffler-stastka Guoruey Wong Department of Psychoanalysis and Psychotherapy and Postgraduate UnitTeaching CenterMedical University of ViennaVienna 1090Austria Facultéde Médecine Universitéde MontréalMontréal H3T 1J4QuebecCanada

In European higher education,application of information technology,concentration on the learning-processes,consistent implementation,transfer learning,case-based learning,autonomous learning has been extensively studied in the last *** sciences based on neuroscientific findings use brain-based learning and teaching,including integrated thematic instructions and *** essential to this strategy,such as theory and methods for learning,competencies,attitudes,social reality,and a metadiscourse are described *** on learning tends to focus on declarative knowledge,associative learning with conditional stimuli,and procedural knowledge with polythematic/crosslinking *** on competencies:In research on competencies(e.g.,for clinical reasoning,decision-making),intuitive and analytical components are *** repeated presentation and exercising of clinical cases is crucial for an efficient learning process,the implementation of interactive scenarios including affectively involving didactics is *** competence-development observational methods,questionnaires/item sets or factors have to be targeted and empirically *** and social reality:Clinical decision-making,identification processes and attitudes(“Hidden curriculum”),as well as secondary socialization processes(integration of social norms,values,preparation of role-acquisition,occupational role)are studied via process research,conceptual research,and observational *** respect to social reality research,conscious and unconscious bargaining processes have to be taken into ***:Neuroscience-memory,neuronal,molecular biology,and computer science(Neurocircuits)are integrated into observational process research(e.g.,affective-cognitive interface,identification processes)and conceptual research is added and studied on the meta-level,including discussion of research *** discussion provides ongoing feedback to pro

关键词： Social neuroscience Case-based learning Mixed-method design Hidden curriculum Socialization Research

Simulating the mind and applications-a theory-based chance for understanding psychic transformations in somatic symptom disorders

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World Journal of Meta-Analysis 2021年第6期9卷 474-487页

作者： henriette löffler-stastka Dietmar Dietrich Thilo Sauter Martin Fittner Dagmar Steinmair Department of Psychoanalysis and Psychotherapy Medical University ViennaVienna 1090Austria Institute of Computer Technology TU WienVienna 1040Austria Center for Integrated Sensor Systems Danube University KremsWiener Neustadt 2700Austria University Hospital St.Pölten Karl Landsteiner University of Health SciencesSt.Pölten 3100Austria

With the new category of somatic symptom disorder/bodily distress disorder in ICD-11,research into pathogenetic and therapeutic pathways is *** turning away from the definition of somatoform disorders as“the lack of something physical explaining everything”,this new classification might offer a way to put the focus on the individual patient’s psychodynamic balance and conflicts and their condensation in the *** and simulation have a long history in science to gain insight also into complex *** the evolution of precision medicine many different parameters are meanwhile operationalised and ready for consequent process *** models have to fit to the complexity of this disorder *** an interdisciplinary discourse between computer and medical/psychoanalytic scientists a multilayer,fine grained calculation model is *** from a clinical case history,within iterative discussion,by acknowledging the demand for interdisciplinary synergy and cooperation in science,psychoanalytic theory served as the basis for computer-scientific information technique.A parallelisation with the Mealy model helped to establish a meaningful calculation possibility for further process *** psychic transformations can be understood properly in order to provide meaningful treatments,the respective training,and to conduct appropriate process-and outcome-research is established in simulating the mind and applications.

关键词： Psychic transformation Computer-technology Simulation Somatic symptom disorder Bodily distress disorder Mealy model

How does the‘environment’come to the person?The‘ecology of the person’and addiction

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World Journal of Psychiatry 2021年第11期11卷 915-936页

作者： Felix Tretter henriette loeffler-stastka Bertalanffy Center for the Study of Systems Science Vienna 1040Austria Department of Psychoanalysis and Psychotherapy Medical University ViennaVienna 1090Austria

Currently,psychiatry lacks a field that can be called“theoretical psychiatry”,which uses theoretical concepts and explanatory models:The main stream of research is to collect data of all kinds in the hope that the computational Big Data approach will shed a bright light on the black box of mental ***,the biology-based Research Domain Criteria of the National Institute of Mental Health have been ***,as philosophical analyses of concepts and methods have shown,several epistemological gaps stand in the way of a consistent multilevel understanding of mental ***,the implicit ontological problems in the biological reduction of the psychosocial level and in the integration of so-called hard and soft disciplines are mostly left *** a consequence,a non-reductive psychological theory of mental disorders is sought that also integrates correlating biological and sociological *** this context,one example of promising nonreductive psychiatric research is the option of systems/network *** possibilities for integrating different psychological perspectives are highlighted for the field of addiction research and treatment,where pragmatic behaviorist approaches dominate over the theorybased practice of *** comparing the theoretical constructs of these two approaches,the relevance of the concept of“(social)environment”as the wealth of influential sociocultural factors is discussed at levels superior to the interpersonal micro-level,namely the organizational meso-and societal macro level,which is not sufficiently considered in current *** this basis of argumentation,the usefulness of grounding and framing psychiatry through the field of ecological sciences,especially human ecology,is ***,to this end,an outline of an ecological model of mental health and illness is presented.

关键词： Systems/network psychopathology Theoretical psychiatry Ecology of the person Psychoanalytic object relations theory Addiction Mind Resilience