Gastelum Emily, Douglas Carolyn J, Cabaniss Deborah L
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City, New York, USA.
Psychodyn Psychiatry. 2013 Mar;41(1):127-40. doi: 10.1521/pdps.2013.41.1.127.
There is enduring controversy in our field regarding the place for supportive interventions in psychodynamic psychotherapy. This controversy is reflected in the differing ways in which psychodynamic psychotherapy has been conceptualized and taught in psychiatric residency training programs. The authors propose an "integrated" approach for teaching psychodynamic psychotherapy to trainees. In the integrated model, psychodynamic psychotherapy is conceptualized as a form of therapy designed to (a) uncover unconscious elements that influence thoughts, feelings, and behavior, and (b) support weakened psychological function. Using this model, residents learning psychodynamic psychotherapy are taught both uncovering and supporting techniques side by side in one course with specific guidelines for assessing when to use one set of interventions or the other. Teaching psychodynamic psychotherapy to residents in this integrated way prepares them to become skilled clinicians who are able to move fluidly from supporting to uncovering in a pragmatic and flexible manner, matched to the particular moment-to-moment needs of the individual patient.
在我们这个领域，关于支持性干预措施在心理动力心理治疗中的地位一直存在争议。这种争议体现在精神科住院医师培训项目中对心理动力心理治疗的不同概念化方式和教学方式上。作者们提出了一种“综合”方法来向学员教授心理动力心理治疗。在综合模型中，心理动力心理治疗被概念化为一种旨在：（a）揭示影响思维、情感和行为的无意识因素，以及（b）支持弱化的心理功能的治疗形式。使用这种模型，学习心理动力心理治疗的住院医师在一门课程中同时学习揭示性和支持性技术，并配有何时使用一组干预措施或另一组干预措施的具体评估指南。以这种综合方式向住院医师教授心理动力心理治疗，能使他们成为有技能的临床医生，能够根据个体患者特定的即时需求，以务实且灵活的方式从支持性干预流畅地转向揭示性干预。
