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Psychoterapia 3 (178) 2016
strony: 5-22
Z cyklu: „Sylwetki psychoterapeutów”: „Bo dla mnie najważniejszą sprawą jest zbudowanie takiej relacji, żeby otworzyć człowieka, aby mógł poczuć swoje mocne strony” Rozmowa z dr Krystyną Ostoją-Zawadzką


Psychoterapia 3 (178) 2016
strony: 23-29
Jacek Bomba, Kazimierz Bierzyński
Psychoterapia estetyczna. Czy to kierunek rozwoju psychoterapii?
FREE ENGLISH FULLTEXT: Esthetic psychotherapy. New direction of psychotherapy development?
Streszczenie
Autorzy prezentują obserwowane w środowisku psychoterapeutów polskich tendencje dotyczące stosowania psychoterapii. Temat powiązania leczenia zaburzeń zdrowia z psychoterapią jest dyskutowany od początku stosowania psychoterapii. Artykuł prezentuje rysujące się coraz wyraźniej tendencje zmierzające do stosowania metod postępowania opracowanych do leczenia, w celach innych niż leczenie, jak np. w tzw. medycynie estetycznej.
Summary
The debate concerning the relations between the treatment of health disorders and psychotherapy has been going on within The Polish Psychiatric Association (PPA) for more than two decades. Aleksandrowicz formulated a radical opinion on the psychotherapy, to wit, that it is a treatment of health disorders with a psycho-social genesis. One of the authors (JB) postulated that the psychotherapy be extended to cover situations of risk of disorder (prevention), and that it deal with unsatisfactory outcome of disorder (rehabilitation). The efforts of the PPA psychotherapists (Pawlik, Tronczyński) resulted in the area of psychotherapy (as well as that of the counseling by psychologists) being financially taken into account by the national health insurance agency. In the second stage of the debate, de Barbaro criticized the medicalisation of psychotherapy, thus claiming its being a legitimate way of dealing with problems other than health disturbance. This approach is understandable especially in the psychotherapy of families and in the therapies promoting the individual development. In view of the fact that a significant portion of psychotherapy is delivered outside of the health care system based on the health insurance resources, in individual services, information concerning the clients is scarce. Nevertheless, the information gathered from supervision and training of supervisors lead to the supposition that the psychotherapists undertake psychotherapy of persons who had not been diagnosed as suffering from health disorders. Moreover, psychotherapists (non-doctors) abstain from making a diagnosis for psychotherapy, formulating their contracts as proposals aiming at exploration. All over the world we can see a growing interest in the esthetic medicine which is using the methods developed for the treatment of people with health disorders, to achieve the desired change of appearance in the clients. We suppose that in the field of psychotherapy a new direction is being born – the aesthetic psychotherapy. It employs therapeutic methods to achieve a mental change desired by the client.
ethics
contract
diagnosis for psychotherapy


Psychoterapia 3 (178) 2016
strony: 31-36
Agata Madej, Damian Sendler, Marta Makara-Studzińska
Psychoterapia on-line: wyzwanie dla etyki
FREE ENGLISH FULLTEXT: Psychotherapy Online: a challenge for ethics
Streszczenie
Na bazie dostępnej literatury autorzy opisują poważne kwestie etyczne psychoterapii prowadzonej na odległość poprzez komunikatory. Podstawowa trudność, jaka wyłania się przy tym sposobie pracy wynika z niemożności ustalenia rzeczywistej tożsamości osób uczestniczących w prowadzonym dialogu. Może to prowadzić do istotnych nieporozumień, a nawet nadużyć po obydwu stronach sieci, jak również rozmycia granic odpowiedzialności w takim procesie.
Summary
The Internet is the natural environment for many people. Difficulties experienced (failures in personal life, crises, emotional discomfort) are entered first as a query in the search engine. The search for answers often leads to sites offering online psychotherapy. E-psychotherapy is not very labor-intensive and is a fast way to get therapeutic help. The main goal we set upon ourselves is to look at the ethical issues related to the above-mentioned form of providing psychotherapy services. In spite of its many advantages (such as comfort, ease of access to specialists, search speed), does this work allow for ethical behavior towards the patient and for taking the full advantage of the psychotherapy at the same time? Using several electronic databases such as Web of Science, PubMed, Medline Complete, Scopus, ProQuest Dissertations & Theses A&I, we have searched the Polish and foreign reference material from the years 2000-2016. The obtained result is a database consisting of 671 articles, whose abstracts were checked for relevance. The inclusion criteria comprised reviews, scientific articles, and clinical reviews with some content on the ethics in online therapy. Ultimately, we have selected 31 works. It is important to carry out mandatory training for e-therapists, introduce a certificate confirming professional qualifications, and create a public database containing the e-therapists’ personal data. Lack of security mechanisms of the e-therapy poses a threat to the personal data of the patients, which in turn can cause more problems than it would bring benefits.
psychotherapy on-line
ethics
the Internet


Psychoterapia 3 (178) 2016
strony: 37-52
Cezary Barański
Dialog motywujący w pracy z grupami osób podejmujących zachowania ryzykowne
FREE ENGLISH FULLTEXT: Motivational Interviewing in group work on risk behaviors
Streszczenie
W artykule przedstawione są podstawy i idee dialogu motywacyjnego — metody opartej na założeniach psychoterapii humanistycznej Carla Rogersa, z których za najważniejszy czynnik powodujący zmianę uważa się umiejętne wyrażanie empatii i akceptacji. Autor, na podstawie własnych doświadczeń w stosowaniu metody dialogu motywującego w pracy z osobami dorosłymi, nastolatkami, rodzinami i grupami, przedstawia jej wymierne korzyści w krótkoterminowej pracy z osobami przejawiającymi zachowania ryzykowne oraz w sesjach motywujących do podjęcia terapii. Opisuje założenia pracy grupowej, wykorzystującej metodę dialogu motywującego oraz fazy rozwoju grupy, wobec której zastosowano tę metodę.
Summary
Motivational Interviewing (MI) is a counseling and therapy method based on empirical research (EBP). MI has a well-documented efficacy in the individual work with clients showing risk behaviors (substance abuse, behavioral addictions, aggressive behaviors, sexual risk behaviors). Its effectiveness stems from the Carl Rogers’ humanistic psychotherapy approach combined with the specific tools identified during years of studies on motivation in psychotherapy focusing foremost on pro-health behavior. The article presents the motivational approach and the proposed guidelines for the group work in risk behaviors along with description of its philosophical background, tools, therapist’s role and work. The author quotes the methods congruent with the MI spirit and describes the correlation (analysed in the DM context) between the presence of specific phrases (change talk) in the client’s narrative and introducing actual change in one’s life. The article proposes certain frame of assumptions for the MI group work, including the characteristic phases of motivation progress in the group members, and the key elements in the preselection and group forming. It is an attempt to describe the capabilities and limitations of MI work in the context of the author’s own experience in working with groups as well as against the background of other theoretical approaches to group work.
group therapy
risk behaviors
Motivational Interviewing


Psychoterapia 3 (178) 2016
strony: 53-62
Przemysław Turkowski, Jan Jędrzejczyk, Mirosława Huflejt-Łukasik, Joanna Wieliczko
Neuro-Lingwistyczna Psychoterapia w leczeniu zaburzeń lękowych
FREE ENGLISH FULLTREXT: Neuro-Linguistic Psychotherapy in treatment of anxiety disorders
Streszczenie
Artykuł przedstawia genezę i historię rozwoju Neuro-Lingwistycznej Psychoterapii (NLPt), różnice pomiędzy neurolingwistycznym programowaniem (NLP) a NLPt, a także obecny stan badań w tym obszarze. Autorka skupia się również na wykazaniu skuteczności stosowania tego modelu w pracy z osobami cierpiącymi na takie zaburzenia, jak fobie, PTSD i inne.
Summary
Neuro-Linguistic Psychotherapy (NLPt) is a systemic imaginative method of psychotherapy with an integrative-cognitive approach, recognised by the European Association of Psychotherapy. However, few papers on this subject exist, especially in Polish, and for this reason we have written this one. We present the history and origins of the NLPt and the differences between the NLPt and the Neuro-Linguistic Programming (NLP), providing also an outline of the present state of the research. The theoretical background, the underlying mechanisms and the techniques used in NLPt are described in such fields as PTSD, phobias, OCD and traumas, e.g. the Reconsolidation of Traumatic Memories or the Visual/Kinesthetic dissociation protocol. The authors show also the existing research describing the successful ways of treating PTSD, trauma, phobias and other anxiety disorders. Even though the NLPt is a rather recent approach, there are promising reports showing its potential, efficiency and durability of effects in the psychotherapy of people suffering from PTSD (veterans), or of victims of assaults, rapes or traumas (e.g. violence or abuse during childhood). The authors of the paper also point to a strong need for a systemization of the findings of the psychological research corroborating the pertinence of the interventions applied in the NLPt, which would foster further development and that research and provide material for the evaluation of the efficiency of that approach.
neuro-linguistic psychotherapy
memory reconsolidation
anxiety disorders


Psychoterapia 3 (178) 2016
strony: 63-76
Marta Szymańska-Pytlińska, Maria Beisert
Diagnoza niedojrzałości psychoseksualnej sprawców przestępstw seksualnych wobec dzieci jako wyznacznik opracowania programu ich psychoterapii
FREE ENGLISH FULLTEXT: Diagnosis of psychosexual immaturity as an indicator of designing psychotherapy programme for child molesters
Streszczenie
Treścią artykułu jest analiza możliwości terapii sprawców przestępstw seksualnych, u których zdiagnozowano niedojrzałość psychoseksualną. Artykuł przedstawia autorską propozycję kryteriów diagnozowania niedojrzałości psychoseksualnej uwzględniającą wiek jednostki, perspektywę integrującą różne aspekty rozwoju seksualnego oraz biorącą pod uwagę wewnętrzny i zewnętrzny kontekst występowania ocenianego zachowania seksualnego. Zdaniem autorek tylko wnikliwa diagnoza niedojrzałości psychoseksualnej sprawcy przestępstwa seksualnego wobec dziecka może pomóc ukierunkować plan jego terapii, która wyposażając pacjenta w nowe kompetencje zwiększałaby atrakcyjność niedewiacyjnych zachowań seksualnych i tym samym zmniejszałaby ryzyko powrotu do czynu.
Summary
The aim of this article is to discuss the psychotherapy of psychosexually immature child molesters. The authors present their proposals of diagnostic criteria of psychosexual immaturity, which in the psychological-sexuological practice is most commonly classified within the unspecified ICD-10 F66.8 category - Other psychosexual development disorders.
The diagnostic indicators were selected by defining the concept of sexual maturity and by establishing a contrario the characteristics of the state in which they are not fulfilled and which therefore is classified as psycho-sexual immaturity of an adult. For this purpose, biological, psychological and social approaches to psychosexual maturity were described and analysed by reference to Bancroft’s [1] eclectic interactional model of sexual development.
The diagnostic criteria of psychosexual immaturity were defined on the basis of the three developmental strands proposed by Bancroft [1]: lack of a fully formed sexual identity, inability to formulate an adequate sexual response and inability to establish a dyadic relationship. Deficits in these areas characterize some child molesters.
Psychological work with sex offenders (with minors) should be preceded by a thorough functional diagnosis, which identifies the existing deficits and uses them to build a treatment plan. Developing a psychosexual maturity in the offenders could be used to create and strengthen new, more adaptive sexual behaviors and as a result may help to prevent relapse. The application of the proposed classification for the diagnosis of psychosexual immaturity requires: 1. adoption of a holistic perspective, integrating the various aspects of the sexual development, 2. reference to the individual’s age, 3. taking into account the internal and external context in which the analysed sexual behaviour occurs, 4. cooperation of a psychologist-sexuologist or a physician-sexuologist with medical professionals of other specialties.
ICD-10
psychosexual immaturity
treatment of child molesters


Psychoterapia 3 (178) 2016
strony: 77-88
Marta Wiśniewska, Dorota Mącik
Perfekcjonizm i wczesne nieadaptacyjne schematy Younga a przewlekłe zmęczenie w grupie młodych kobiet
FREE ENGLISH FULLTEXT: Perfectionism, Young’s early maladaptive schemas and chronic fatigue among young women
Streszczenie
Autorki, poszukując źródeł zespołu przewlekłego zmęczenia, analizują znaczenie perfekcjonizmu oraz schematów związanych z negatywnym obrazem siebie. Wyniki badań przeprowadzonych w grupie 156 kobiet wskazują, że zarówno patologiczny perfekcjonizm, jak i schematy związane z odrzuceniem oraz brakiem autonomii mogą skutkować występowaniem przewlekłego zmęczenia.
Summary
The aim of the study was to assess whether the unexplained chronic fatigue, observed among young women, is associated with perfectionism and Young’s early maladaptive schemas. This would allow to propose a hypothesis for the therapeutic practice, to wit, whether the therapy focused on schemas and non-adaptive perfectionism might indeed bring a reduction of such fatigue.
Methods: 156 women (19-24 years) were examined. None of them had a family of her own, they were somatically healthy and without mental disorders. For the measurement the following questionnaires were used: 1) schema questionnaire YSQ-S3, 2) fatigue questionnaire (KBPZ) , and 3) perfectionism questionnaire (PAD).
Results: The women were characterized by a relatively high level of fatigue. Strong correlations were perceived between the fatigue and the non-adaptive perfectionism, and between fatigue and schemas, especially related to the area of rejection / disconnection and insufficient autonomy. It was also noted that women of the non-adaptive perfectionist type were characterized by a a significantly higher intensity of all schemas and dimensions of fatigue. Adaptive perfectionism appears not to have any strong correlation with any of the above variables.
Conclusions: These studies provide a first basis for the conclusion that the chronic fatigue may be the result of repeated attempts to cope with the negative beliefs about oneself and of the perception of the lack of effectiveness of those attempts. This may constitute a therapeutic indication for the work with the patients reporting fatigue problems.
perfectionism
chronic fatigue
early maladaptive schemas


Psychoterapia 3 (178) 2016
strony: 89-102
Magdalena Adamczyk
Style przywiązania a psychospołeczne funkcjonowanie młodzieży w oparciu o studia przypadków
FREE ENGLISH FULLTEXT: Attachment styles and adolescents psychosocial functioning – case studies
Streszczenie
Artykuł prezentuje wyniki badań dotyczących ustalenia związków między wyróżnionymi stylami przywiązania (lękowo-ambiwalentny, lękowo-unikający, zdezorientowany) a sposobem funkcjonowania młodzieży w sferze psychospołecznej. Wyniki tych badań eksponują znaczenie teorii przywiązania, która nie tylko tłumaczy etiologię zaburzeń okresu adolescencji, ale też wyjaśnia sens pojawiających się symptomów oraz podaje użyteczne propozycje terapeutyczne.
Summary
The main aim of the research was to establish the relations between the specific attachment styles and the disorders in adolescent psychosocial functioning. In order to understand how the early childhood experiences, parental attitudes and family system can lead to emotional and behavioural disorders in adolescence, a case study analysis was conducted.
Three qualitative methods were applied in this study: content analysis, regular participating observation, in-depth interview with adolescents, their tutors and members of families.
In the treatment group, three styles of attachment were distinguished: anxious-ambivalent, anxious-avoidant, and disorganized. Each attachment type is described in terms of its cognitive, emotional, behavioral and social characteristics. Moreover, each attachment style is related to specific child/adolescent mental problems, and to disorders observed in whole family functioning.
It seems that early negative attachment experiences constitute a risk factor for developing serious behavioral, emotional or social problems during the adolescence. Rejecting or overly permissive parental attitudes and disorders in family functioning and structure play a crucial role in this process. The attachment theory provides not only a useful explanation of the etiology of such disorders, but also gives us an exhaustive explanation of the symptoms observed and provides useful proposals of treatment methods.
attachment styles
adolescence
case study



Omówienia książek i czasopism:

Dominika Sznajder
Celestyna Grzywniak: DOJRZAŁOŚĆ NEUROPSYCHOLOGICZNA DO SZKOLNEGO UCZENIA SIĘ DZIECI SZEŚCIO-
I SIEDMIOLETNICH. Kraków: Wydawnictwo Scriptum; 2013, stron 188


Jacek Kopeć
Richard F. Summers, Jacques P. Barber (red.): TERAPIA PSYCHODYNAMICZNA W PRAKTYCE. STUDIA PRZYPADKÓW
Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego, 2016, wydanie I, stron 342. Tłumaczenie Joanna Gilewicz