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Psychodynamics, Training, and Outcome in Brief Psychotherapy - 1st Edition - ISBN: 9780750615457, 9781483193854

Psychodynamics, Training, and Outcome in Brief Psychotherapy

1st Edition

Authors: David Malan Ferruccio Osimo
eBook ISBN: 9781483193854
Imprint: Butterworth-Heinemann
Published Date: 18th March 1992
Page Count: 350
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Psychodynamics, Training, and Outcome in Brief Psychotherapy provides information pertinent to the fundamental aspects of dynamic psychotherapy. This book discusses the selection criteria, the principles of therapeutic methods, and the factors leading to therapeutic effects in psychotherapy. Organized into five parts encompassing 37 chapters, this book begins with an overview of the influence of research on clinical practice. This text then examines the evidences showing that most of the improvements were in fact due to therapy. Other chapters summarize the essential characteristics of the methods used with the patients in various case studies. This book discusses as well the concept of the triangle of conflict, which refers to one of the cornerstones of psychodynamic theory. The final chapter deals with the advantages of a psychotherapeutic clinic to certain kind of patients who can be greatly helped in a relatively short time. This book is a valuable resource for psychotherapists, psychiatrists, psychologists, and social workers.

Table of Contents

What this book is about


Part One Introduction to the Present Study

1 Beginning at the end

The Nurse Mourning her Fiancé

The Girl and the Mountain Tarn

The Miner"s Daughter

The Borderline Graduate Clerk

The Librarian who Sought Suffering


2 The present study: background, aims, methods

Balint"s Workshop

Malan"s Brief Psychotherapy Workshop

Previous follow-up studies at the Tavistock Clinic

Assessing outcome in previous follow-up studies

Method of working in the present study

Aims and characteristics of the present study

Previous work by other authors

The work of Davanloo

3 Measuring outcome


The Sculptress with Nightmares


The scoring of "false solutions"

Patients who are worse


4 Overview of the present study and its results


The return rate

Eligibility for the study

Over-all results

The ages of patients in the study

Therapeutic aims

Patients who had subsequent treatment

Another moderately good result in an ineligible patient

Definition and scientific status of the present study

5 The therapists


6 Therapeutic technique and the two therapeutic triangles

The focal technique and focal patients

The two therapeutic triangles

Part Two Clinical Material

7 The conservative and radical techniques: two patients with favourable outcome


Notes on the case histories

The Pacifist Conductor

The Sculptress with Nightmares


8 Two further patients with favourable outcome

The Nurse Mourning her Fiancé

The Librarian who Sought Suffering

9 Two male patients with oedipal problems


The Car Battery Man

The Betrayed Son


10 A woman patient with oedipal problems

The Girl and the Mountain Tarn

11 The seven "best" cases, discussion

Total resolution"

Total resolution and the rest of the sample

Similarities within the sample

Relations with the opposite sex

12 False solutions: I. general. II. two patients with relatively adaptive false solutions


False solutions: General

The Rebellious Script Writer

The Concert-goer in an Acute Panic

13 False solutions: III. three patients with less adaptive false solutions. IV. general discussion

The Hypomanic Advertising Executive

The Secretary in a State of Nirvana

The Self-driving Physicist

General discussion of false solutions

14 Two women who showed limited improvements

The Allergic Receptionist

Mother, or Teenage Daughter?

15 Patients who showed minimal improvements

The Acting-out Accounts Clerk

The Actress with Elocution Problems

The Miner"s Daughter

16 Patients who showed no improvement

The Anorexic Museum Assistant

The Psychiatric Nurse with Attacks of Rage

17 Discussion of the five patients who showed minimal or no improvement

18 Patients who were worse: I. three patients who were wrongly diagnosed at initial assessment

The Girl with Eye Problems

The Borderline Graduate Clerk

The Robot Man

19 Patients who were worse: IL a patient who ought to have given a favourable outcome

The Victimised Telephonist

20 A calculated risk ending in catastrophe

The Acutely Suicidal Receptionist

21 The five patients who were worse: discussion

Part Three Types of Changes Found at Follow-up

22 Types of change: general



Discussion of Table 22.1

23 Emotional freeing

24 Resolution of maladaptive behaviour patterns

25 The ability to "be oneself


26 Symptoms


27 Relations with the opposite sex: I. clinical material


Clinical material

28 Relations with the opposite sex: II. problems of commitment

29 Problems of aggression and self-assertion: I. general

Introduction: maladaptive and adaptive forms of aggression The Determined Mother

The concept of constructive self-assertion

Constructive self-assertion in the present series

30 Problems of aggression and self-assertion: II. clinical material

31 Problems of aggression and self-assertion: III. discussion

Comparison between problems of self-assertion and problems with the opposite sex

Classification of problems over aggression

The causes of problems over aggression

Comments on Table 31.1

Improvements that occurred during therapy

"Subjective" and "objective" evidence

Part Four Research Results

32 Therapeutic effects during therapy


33 Can the improvements be attributed to therapy?

Introduction: the nature of the evidence

Patients in whom the improvements persisted at follow-up

Additional evidence from improvements that did not persist at follow-up



34 Selection criteria


The evidence on the four criteria

The four criteria, conclusion

35 Further research results

Further disproof of the conservative view of brief psychotherapy

Types of patient treated and focus used


Therapeutic results

Two fresh observations from the present work

The possibility of "multi-focal" therapy

Brief therapy by trainees

Part Five The Value of the Work

36 The practical and theoretical value of the work: I. for trainees, supervisors, and psychotherapists in general


Trainees, supervisors, and other therapists

Initial assessment



Material and events of therapy


37 The practical value of the work: II. for psychotherapeutic clinics and III for patients

Psychotherapeutic clinics


The relevance to the position of brief psychotherapy in general

The present work in the context of the work of Davanloo




No. of pages:
© Butterworth-Heinemann 1992
18th March 1992
eBook ISBN:

About the Authors

David Malan

Ferruccio Osimo

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