Pragmatic Case Studies in Psychotherapy

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March 3, 2016 -- From the Editor 


Getting into the ACT with Psychoanalytic Therapy: The Case of "Daniel"

***  Robert Cohen, Madonna University and University of Michigan 


***  Jill Bresler, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis  

*** Stephen Holland, Capital Institute for Cognitive Therapy, Washington, DC  

Response to Commentaries 

*** Robert Cohen, Madonna University and University of Michigan

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Can psychoanalytic therapy be effectively integrated with cognitive-behavior therapy (CBT) for the same client? This is the question explored in Robert Cohen's case study of his client "Daniel." Cohen had been seeing Daniel for more than ten years in psychoanalytic therapy for problems involving anxiety, depression, and a tendency to obsessively ruminate about his self-worth, with Daniel at times experiencing paralyzing discomfort and shame in relationships with friends and colleagues.

While significant progress was made in the psychoanalytic therapy, with significant symptom improvement, Daniel continued to struggle with facing and working through his self-denigrating feelings. The case study describes how Cohen decided to integrate techniques from a "third wave" CBT treatment—Steven Hayes' Acceptance and Commitment Therapy (ACT)—to break what had become an impasse in the therapy, allowing Daniel to resolve outstanding difficulties and helping him to move towards a successful termination.  

In the first commentary, Jill Bresler observes how Cohen, in his demonstration of responsive therapeutic flexibility, was a valuable role model in promoting Daniel's psychological flexibility. (In the treatment, Cohn first moved from traditional to relational psychoanalytic therapy, and then to ACT.)   

Stephen Holland, in his commentary, explores the question of how the use other CBT treatments—drawn from "first wave" and "second wave" CBT approaches—could have offered additional benefit to Daniel, creating a more complete theoretical integration between CBT and psychoanalytic approaches. Finally, Cohen's critical reflections on the commentaries concludes the issue. 

With the case study of Daniel as a foundation, this issue brings to light many of the intricacies and potentials of integration across psychoanalytic and CBT approaches.   

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** Manuscripts. Two types of manuscripts are desired: those consisting of one or more case studies, and those consisting of case method articles.

** Suggested Author Guidelines. These can be found by clicking on the link Instructions for Authors, as described above. Note that we suggest 11 common headings for case study manuscripts:
1. Case Context and Method
2. The Client
3. Guiding Conception with Research and Clinical Experience Support
4. Assessment of the Client's Problems, Goals, Strengths, and History.
5. Formulation and Treatment Plan
6. Course of Therapy
7. Therapy Monitoring and Use of Feedback Information
8. Concluding Evaluation of the Therapy's Process and Outcome
9. References
10. Tables (optional)
11. Figures (optional)
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Vol 12, No 1 (2016)

Table of Contents

Case Study

Getting into the ACT with Psychoanalytic Therapy: The Case of "Daniel" Abstract PDF
Robert Cohen 1-30
Promoting Psychological Flexibility by Practicing Flexibly: The Therapist as Model Abstract PDF
Jill Bresler 31-38
A Cognitive-Behavioral Perspective on Robert Cohen’s Case of "Daniel" Abstract PDF
Stephen J.F. Holland 39-55
Expanding My Perspective on the Case of Daniel Abstract PDF
Robert Cohen 56-64