Recent research in academic psychology, particularly in areas pertaining to healthy illusion, has significant relevance to integrative psychotherapy, on both a technical and a conceptual level. The concept of healthy illusion can help us conceptually integrate-find common threads between-apparently disparate schools of psychotherapy. The cognitive-behavioral techniques of collaborative empiricism, manageable goal setting, and changes in self-talk; many of the dialectical-behavioral techniques used to balance acceptance and change, and to embrace paradox; the psychoanalytic concepts, and related techniques, of sublimation, self-object, internalization, transitional phenomena, and idealization have important links to the nourishing of positive illusion in therapy. The concept of healthy illusion also lends us some new integrative techniques, such as searching out, broadening, and even creating idealized figures and internalized objects, aside from the therapist. This research, in fact, challenges some of our most fixed and favorite beliefs about the process of therapy-particularly about the paramount importance of facing and accepting reality. Finally, the positive illusion research sheds some light on the difficulties of defining psychological health, hope, and resiliency.
Screening mammography is particularly effective in detecting breast cancer in elderly women. Yet, although half of all breast cancers are diagnosed in older women, statistics show that women aged 65 and over tend to underutilize screening mammography. Prior research has used the constructs of the Health Belief Model to explore attitudes and beliefs relative to breast cancer screening. Prior studies have also identified health beliefs and concerns relative to screening mammography and race/ethnicity as some of the patient-related predictors of screening mammography utilization among younger women. This study uses the theoretical framework of the Health Belief Model to explore the effects of these variables on utilization in a multiracial, multiethnic, random sample of 1011 women, aged 65 and over. Race/ethnicity, belief that mammograms detect cancer, ease the mind, and provide accurate results; concern over the radiation, pain, and cost associated with receiving a mammogram; and other independent variables were tested as predictors of screening mammography utilization. Regression analysis identified that the belief that having a mammogram eases recipients minds was the most significant predictor of screening mammography utilization. None of the other health beliefs or health concerns were significant predictors. Race/ethnicity had no direct effects on utilization nor was it a confounder in the relationship between health beliefs, concerns and utilization. These results indicate that, along with emphasizing the importance of mammograms in early detection of breast cancer, stressing the reassurance that mammography brings recipients may be an effective health education strategy for elderly women of different racial/ethnic backgrounds.
A transtheoretical approach (Prochaska & Norcross, 2010) is proposed for the precontemplative phase of treatment for anorexia. Prochaska and Norcross recommend motivational interviewing (originating in behavioral medicine) and psychodynamic techniques for this most problematic, unmotivated first stage of therapy. It is argued here that these two forms of treatment can be integrated as long as the treater remains alert to the transference implications of the motivational stance as well as his or her countertransference. This argument will be applied specifically to medical management issues early on in anorexia treatment. This is a time when medical management difficulties are prominent and of great concern. As a result, special technical questions and formidable transference-countertransference issues arise. It is intended that these clinical recommendations, which draw on both behavioral medicine and psychoanalytic thinking, will be of help to therapists and physicians who work with anorexia.
Integrating psychoanalytic and action models of development affords a rich, detailed depiction of developmental psychopathology. Psychoanalytic models depict mental representations of self and others as unconsciously organizing and regulating affect, cognition, and behavior, in response to both maturational imperatives and drive related conflicts. Action models emphasize the active, reciprocal, and goal oriented nature of person-context exchanges. In linking the two perspectives, we propose that representations serve as the mechanisms through which individuals shape their development, personality, and well-being. This integrative perspective is illustrated using a clinical case of an adolescent female treated for an eating disorder.
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