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AbstractPatients suffering from borderline personality disorder have by definition a poorly functional personality which is readily reacting to changes and psychosocial stressors with recurrent crises. A personality disorder is necessarily fraught with interpersonal difficulties, and it is often within the individual psychotherapeutic encounter that such clashes develop. This article discusses basic principles offering clinicians ways to prevent or structure crisis intervention adapted to borderline personality disorder within the individual psychotherapy context. It thus reviews various clinical issues such as suicidal or homicidal threats, conflicts related to requests expressed by the patient, the absence of the therapist or attempts at breaking the therapeutic framework in order to offer intervention modalities for the resolution of these crises.

The Assimilation Model is a qualitative and integrative approach that enables to study change processes that occur in psychotherapy. According to Stiles, this model conceives the individual's personality as constituent of different voices ; the concept of voice is used to describe traces left by past experiences. During the psychotherapy, we can observe the progressive integration of the problematic voices into the patient's personality. We applied the Assimilation Model to a 34-session-long case of an effective Short-term Dynamic Psychotherapy. We've chosen eight sessions we transcribed and analyzed by establishing points of contact between the case and the theory. The results are presented and discussed in terms of the evolution of the main voices in the patient.

AbstractThe author refers here to the saying : prevention is better than cure. In this context, he describes some pitfalls that are inherent in the process of psychodynamic psychotherapy. In trying to avoid these pitfalls, they are presented following the chronological unfolding of the psychotherapy. In so doing, the author brings out a new paradigm of the analytic method, the paradigm of transitionnality. These considerations tend to emphasize the heuristic value of the notion of paradox.

L'espoir est un concept de la psychologie positive de plus en plus étudié, particulièrement depuis qu'il est reconnu comme l'un des facteurs communs d'efficacité de la psychothérapie. Considérant l'importance de ce concept dans le succès thérapeutique, l'auteure de cette thèse s'est intéressée à sa façon de susciter l'espoir chez ses clients. Suivant un devis qualitatif, descriptif et exploratoire, ainsi qu'une méthode de type praxéologique, la présente étude a permis de mettre en lumière un modèle personnel visant à susciter l'espoir en psychologie positive. Ce modèle comprend deux volets. Le premier décrit comment la chercheure-acteure instaure un espace relationnel favorisant le développement de l'espoir. Le second décrit comment son style d'intervention suscite l'espoir chez ses clients.

L’anxiété est une problématique de santé mentale très répandue chez les enfants. Elle peut altérer leur fonctionnement psychologique et scolaire en plus de générer des coûts sociétaux importants. Différents traitements sont disponibles pour aider les enfants présentant de l’anxiété. Celui faisant l’objet de la présente étude est la psychothérapie par le jeu d’approche psychodynamique, celle-ci se révélant ajustée aux besoins et aux capacités de l’enfant. Cette recherche se penche sur le vécu du parent et de sa perception du vécu de son enfant impliqués dans ce type d’intervention. Six parents ont participé à un entretien semi-structuré. L’analyse thématique a mis en lumière l’expérience de ce traitement pour le parent et son enfant. Les résultats de la recherche ont permis de rendre compte des attentes initiales …

AbstractSanté mentale au Québec is pleased to offer its readership a special issue on Transference-focused psychotherapy (TFP). Published in two parts (the first in the current issue; the second, this Fall), this dossier examines the model of psychotherapy for the treatment of personality disorders as elaborated by Dr Otto F. Kernberg and his collaborators at the Personality Disorders Institute at the New York Presbyterian Hospital and Weill School of Medicine of Cornell University, Westchester Division. This publication has been made possible thanks to the collaboration of the Personality Disorders Institute, the Transference-focused psychotherapy group of the École de psychologie of Université Laval in Québec City, and Santé mentale au Québec.

The Pavillon Albert-Prévost (PAP) has played a leading role in the development of modern psychiatry in the province of Québec. It has also been, in the francophone milieu, the teaching hospital that was the most deeply influenced by psychoanalytic theories. The arrival of somatic approaches, particularly biofeedback and relaxation, in the Psychosomatic medicine and consultation-liaison service, as introduced by Dr. Jacques Monday in the 1970s, was initially greeted with great scepticism by the majority of his colleagues at PAP. In the 1980s and 1990s, Dr. Camille Laurin, then head of the department, invited Dr. Louis Chaloult to offer a clinical supervision seminar to mental health professionals. Drs. Chaloult and Monday trained generations of clinicians in cognitive behavior therapy and relaxation therapy as, over time, these approaches both practical, efficient and effective became more widely practiced and recommended by practice guidelines in psychiatry. Dr. Chaloult with the help of Dr. Jean Goulet developed a CBT teaching curriculum for residents in psychiatry and other health care professionals, wrote an influential textbook on CBT, co-developped a widely consulted website www.tccmontreal.com providing CBT practice guides for clinicians and patients alike, became one of the first psychiatrists acting as a psychiatre répondant in CLSCs (teaching CBT to other members of the team in order to provide CBT in primary care), co-developed the Centre de Psychothérapie at the PAP to promote cross theoretical training in psychotherapy for residents in psychiatry and interns of other mental healthcare disciplines. In this spirit, Dre. Thanh-Lan Ngô contributed to these endeavors and co-created with Dr. Jean Leblanc and Dre. Magalie Lussier-Valade another website www.psychopap.com dedicated to the transfer of knowledge in CBT as well as other forms of psychotherapy in order to celebrate 100 years of teaching in psychiatry at the PAP. Following the creation of specialised outpatient clinics in 1994, CBT was more widely offered and developed as a standard of care. These influential programs include those of three psychologists Dr Michel Dugas' Generalised anxiety disorder model, Pascale Brillon's teaching of trauma focussed CBT (with three books on the subject, Dr Richard Fleet's research on emergency room presentation of panic disorder. This collaborative teaching and research program included Dre. Julie Turcotte and Dr. Pierre Savard, both specialised in CBT and instrumental in training generations of psychiatrists in evidence-based treatments for severe refractory disorders. At the Early psychosis clinic, an innovative program of CBT modules adapted to the functional and symptomatic impairment level of the heterogeneous clientele was developed by Pierre Fortier and Dr. Jean-Pierre Mottard. At the Readaptation for Psychosis program, France Bérubé and Jocelyne St-Onge, offered auditory hallucinations group, metacognitive therapy, the integrated psychotherapy programme. At the Personality disorder clinic, dialectical behavior therapy groups were offered by Julie Jomphe who trained many cohorts of residents, offered adaptations to families (Family connections), adolescents, and children (in schools). At the Psychosomatic service Donald Bouthillier treated somatisation disorders with affective-cognitive behavioral therapy for somatization disorder. And finally, at the Mood disorder clinic, Drs. Ngô, Bernard Gauthier, Léon Maurice Larouche, Anne-Sophie Boulanger along with Manon Quesnel, Renée Leblanc and colleagues offered a sequential program of CBT approaches to treat severe and refractory mood disorders.

Keywords: thérapie cognitivo-comportementale, pleine conscience, MBCT, relaxation, psychose, anxiété généralisée, état de stress posttraumatique, thérapie comportementale dialectique, Pavillon Albert-Prévost, Hôpital Sacré-Coeur de Montréal, Québec, cognitive-behavior therapy, Pavillon Albert-Prévost, Michel Dugas, Pascale Brillon, Pierre Fortier, Jacques Monday, Louis Chaloult