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Les théories de la pensée étudient la capacité de penser à la pensée des autres, soit de réfléchir aux pensées, désirs, croyances et intentions d’autrui. Une telle capacité pourrait à l’âge adulte contribuer au développement de la pensée post-formelle et l’utilisation de cette dernière par des clients en thérapie pourrait à son tour contribuer à l’efficacité du traitement. L’objectif spécifique de notre étude est de vérifier les effets de l’utilisation des différents niveaux de développement de la pensée post-formelle dialectique par des clients en psychothérapie sur l’efficacité de celle-ci. Pour ce faire, nous avons exploré ces mêmes impacts à travers six études de cas dans une thérapie centrée sur les émotions (TCE) dans des cas de dépression majeure (Watson, Goldman et Greenberg, 2007). Trois traitements …

Self-criticism is considered as a harsh or punitive evaluation of the self. It is omnipresent in culture, in daily life as well as in psychotherapy. Self-criticism can lead to question oneself but can also open new perspectives and guide us. However, it can become excessive, rigid, and might turn out to be deleterious. This present article focuses on the concept of self-criticism in clinical psychology and psychotherapy and aims to review current knowledge about this topic. First, its definition and the reasons for its development in individuals will be presented. Second, a description of the links between self-criticism and psychopathology will be made, in particular regarding depression. Finally, the third part of this article will be dedicated to the therapeutic interventions that can reduce self-criticism.

Keywords: auto-critique, psychopathologie, dépression, troubles de la personnalité, interventions thérapeutiques, self-criticism, psychopathology, depression, personality disorders, therapeutic interventions

Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Montreal, has conducted a research program over the past two decades that aims to inform improvements in the management of depression in primary care and general medical settings, among older adults. This paper reviews the findings from this research program, discusses the findings in the context of other research, and highlights the implications for practice and health policy.Methods Narrative review and synthesis of 25 published articles, that included: 4 systematic reviews, 10 observational studies, 9 intervention trials, and 2 consensus conference reports.Results The results pertain to 4 research areas: detection of depression in primary care and general medical settings; collaborative care of depression; depression self-care interventions; and the role of family and friends in supporting depression self-care interventions.Conclusions We propose six recommendations for improving the management of depression in the target population. 1) Depression detection and treatment can be improved through collaborative care models that involve primary care physicians, mental health specialists and non-physician mental health workers who are trained to assist with the detection of depression, with the delivery of brief, low-intensity psychological interventions and with self-care support. More research and evaluation are necessary to determine the factors that enhance the effectiveness, cost-efficiency, and consumer-centeredness of these interventions. 2) Supported depression self-care (and other low-intensity interventions such as short problem-solving therapy) offered by telephone or via internet, either as part of collaborative or usual care are feasible treatment options but more research is necessary to determine their effectiveness in different clinical populations. Some populations (e.g., those aged 75 and over, with visual and/or mild cognitive impairment) are likely to need greater or face-to-face support. 3) As most family physicians are unlikely to have the necessary time or interest to support depression self-care interventions, other sustainable programmatic contexts are needed for delivery of these interventions. Options include: nurses or other mental health workers in multidisciplinary family medicine groups; regional mental health programs; and voluntary organizations dedicated to assisting in the management of chronic illnesses. Research is needed on the feasibility and effectiveness of using peer support workers or volunteers to provide coaching of depression self-care interventions. 4) Involvement of family or friends in depression self-care may improve outcomes (e.g., dyadic interventions) but further research is necessary. 5) Further research should explore the potential of depression self-care interventions to prevent major depression and in depression relapse prevention in this population.

Keywords: dépression, soins primaires, soins collaboratifs, interventions d'autogestion de soins, rôle aidants naturels, depression, primary care, collaborative care, self-care interventions, role of caregivers

This paper is a contribution to a debate that is currently taking place in the well-defended field of psychotherapy in Quebec, but also wherever interventions of this nature are practiced. Some are claiming “evidence-based practice” as defined by scientific criteria, in accordance with a particular definition of the word science. Others emphasize the relational dimension of the psychotherapeutic act, but without sacrificing its rigour. The reflections that follow will attempt to get to the root of this opposition, or at least to one possible source. As a part of this task, I will resort to thinkers preoccupied with the nature of science and the effect of its practice on the two major object categories: nature and human phenomena.

Keywords: données probantes, épistémologie, psychothérapie, Wilhelm Dilthey, sciences humaines, evidence-based practice, epistemology, psychotherapy, Wilhelm Dilthey, social science

Le portrait des différents contextes de pratique clinique en psychologie s'est transformé récemment avec l'apparition d'une nouvelle modalité de rencontre : la télépsychothérapie en vidéoconférence interactive. Lorsqu'il est question de modifier le contexte traditionnel de rencontre pour mener une psychothérapie, il est pertinent de se questionner sur l'incidence que cette modification peut avoir sur le processus psychothérapeutique et plus spécifiquement sur les variables associées au changement. Quoique la faisabilité et l'acceptabilité générale de la télépsychothérapie soient raisonnablement bien établies selon la documentation scientifique, les données sur les variables associées au processus et au changement psychothérapeutique demeurent limitées. Les études sur la télépsychothérapie par vidéoconférence ont porté pour la plupart sur l'efficacité psychothérapeutique en validant une approche de traitement psychologique spécifique. Peu de variables relationnelles ont …

La présente thèse consiste en une théorisation des aspects métapsychologiques de l'utilisation de la médiation picturale dans un cadre de psychothérapie psychanalytique avec des patients états limites. Cette démarche théorique vise à favoriser une compréhension plus approfondie du travail de la symbolisation avec des patients présentant des pathologies narcissiques. Avec une articulation de la théorie des pulsions et de celle de l'intersubjectivité, elle s'inscrit à l'intérieur d'une troisième topique qui délimite l'espace de la subjectivité qui serait préalable aux deux autres topiques freudiennes. Cette recherche couvre l'étude du concept de narcissisme, les aspects cliniques du narcissisme des états limites et les positions théoriques de Winnicott sur le self, sur la transionnalité, sur le cadre. L'analyse du cadre de la cure type et du dispositif du …

Identification with a newborn baby can revive primitive traumas in the parent. Due to their un-symbolized form, the transmission of these silent traumatic zones of experience can have deadening effects. This paper examines how the birth of a child can reveal the existence of breaks in the historical narrative, as the baby reawakens split-off distress and mobilizes help to deal with unconscious pressures. A clinical vignette illustrates how the awakening of primitive trauma results not in the classical projection of fantasies, but in unconscious repetition within the therapist him- or herself of aspects of the primitive distress. The author calls upon the work of Benedetti and the theory of psychosis to explore these unusual transferential configurations. Whether the therapist has the capacity to tolerate such death-infused zones in the experience of the baby and his/her parent is key to advancing the process. Experiences with the baby can help pick up the chronological thread and build a narrative where unprocessed traces of experience awaiting meaning can find their place. The author extends her thinking to the current world situation, questioning the impact of unconscious transmissions on birth and death experiences during these pandemic times and appealing for thoughtful consideration of families' difficulties during this historical sanitary crisis.

Keywords: transfert, traumatisme, transmissions inconscientes, clinique psychanalytique avec le bébé, pandémie, temps périnatal, transgénérationnel, transference, trauma, unconscious transmission, psychoanalytic practice with babies, pandemic, perinatal experience, trans-generational

Objective Common mental disorders, such as anxiety and depression, have many individual and societal consequences. Various treatments are available for people with these diagnoses, including medication and cognitive behavioral therapy. When these disorders are mild or moderate, psychotherapy is the recommended first-line treatment, given its greater long-term efficacy than pharmacotherapy. However, this is not what is observed in practice: medication is much more widely used than psychotherapy, the latter's accessibility being greatly reduced by long waiting lists. An alternative to these accessibility difficulties is the stepped-care model, which includes guided self-help. These are low-intensity interventions that enable more people to be treated with fewer resources (e.g., fewer meetings with a professional). The Programme québécois pour les troubles mentaux (PQPTM; Quebec Program for Mental Disorders) is a stepped-care model recently implemented in some settings in Quebec. The aim of this study is to gather the perceptions of social workers (SWs) in a Centre intégré (universitaire) de santé et de services sociaux (CI[U]SSS; Community mental health center) on the implementation of the PQPTM guided self-help.

Keywords: anxiété, dépression, modèle de soins par étapes, autosoins dirigés, implantation, anxiety, depression, guided self-help, stepped-care programs, implementation