02/07/2012 12:09:00, 108645werbartreport2012.doc, Andrzej Werbart ANDRZEJ WERBART 15-03-2012 Research programme: Private theories of pathogenesis and cure IPA funding 1999, 2000: The interaction between the patient's and the therapist's private theories of pathogenesis and cure. IPA funding 2001: Patients in psychoanalysis and their analysts: The interaction between the parties’ private theories of pathogenesis and cure and its impact on the process of change. Included research projects, partially supported by funding from IPA: Andrzej Werbart, principal investigator, and Sonja Levander Private theories of pathogenesis and cure: patients in psychoanalysis and their analysts (PSA) Institute of Psychotherapy, Stockholm, and Department of Psychology, Stockholm University, Sweden 1997–2011 Background: Concerning official psychoanalytic theories of therapeutic action, the current situation is characterized by the abundance of pluralism and lack of integration. Both patients in different kinds of treatment and their clinicians develop implicit, private theories of pathogenesis and cure. Aim: To investigate vicissitudes of implicit ideas of how psychoanalysis might be of help with the analysands’ psychological problems, and how concordance and discordance between the participants interacts with the process of change. Method: This prospective longitudinal study includs the total of 7 analyses. The Private Theories Interviews (PTI) with analysands and their psychoanalysts are conducted at the start of psychoanalysis, and then 6 months, 1.5 years, 3years, and 4.5 years after the first interview, at termination of the analysis, and with the analysands 1.5 years post- termination. Transcripts are investigated by means of a systematic multicase study methodology and inductive thematic analysis. Results: Both utopian ideas and ideas of more attainable cure were found in both parties. The utopian ideas of wished-for cures persisted throughout the psychoanalytic process in both participants in more than half of the cases. Utopian ideas often created feelings of incompatibility between the analyst and the analysand. The abandonment of these ideas was related to more positive experienced outcome of psychoanalysis. Furthermore, we found personality differences in analysands’ response to specific dimensions of the analytic process. Conclusions: The study suggests that the psychoanalytic process might profit from the analyst’s observance of incongruities between the parties’ ideas and openness to work them through. Financial support: The Bertil Wennborg Foundation and the Research Advisory Board, International Psychoanalytical Association. 2 Andrzej Werbart, principal investigator, David Forsström, et al. Psychoanalysis in Public Service Setting (PPSS): Outcomes and individual patterns of change Institute of Psychotherapy, Stockholm, and Department of Psychology, Stockholm University 1998–2012 Background: There are only few studies of psychoanalysis in public service settings. Aim: The aim of this study is an in-depth exploration of quantitative and qualitative data from a series of psychoanalyses conducted in a Swedish public service setting. The hypothesis is that patients categorized as anaclitic (focus on relatedness) and those categorized as introjective (focus on self-definition) according to Blatt’s personality model display different patterns of changes and differ as to their experiences of helpful and hindering factors in their analyses. Method: 26 patients in psychoanalysis and their 10 analysts at the Institute of Psychotherapy were included. Outcome measures included Symptom Checklist –90, Self-Rated Health, SASB, Sense of Coherence and socio-demographic data. The patients were interviewd at termination and 2-year follow-up sing the Change After Psychotherapy Interview (CHAP) and classified as anaclitic or introjective. The case series method enables looking at the questionnaire and interview data from different perspectives and focusing on clinically relevant questions. Results: Outcome data from a series of psychoanalyses conducted in a specialized public service setting are explored in-depth. Outcome data collected by different self-rating and expert-rating instruments are compared. In serial case studies we track the individual patterns of change in order to better understand how the patients benefited from psychoanalysis. The study is expected to result in identification of prototypical cases, representing different outcome profiles and different pathways of change. Financial support: The Research Advisory Board, International Psychoanalytical Association. Andrzej Werbart, principal investigator, Lena Johansson, Peter Lilliengren, Björn Philips (doctoral project), et al. Young Adult Psychotherapy Project (YAPP) Institute of Psychotherapy and Karolinska Institutet, Stockholm 1998–2009 Background: The evidence base in psychotherapy research can be enriched adopting a naturalistic stance and taking the patients’ view into account. Aim: To study psychoanalytic psychotherapy with young adults from the viewpoints of outcome and patients’ ideas of cure, and how these two aspects are related to each other. Method: 134 patients were included. Measures included Symptom Checklist –90, Self-Rated Health, GAF, IIP, SASB, Differentiation-Relatedness Scale and Helping Alliance. Ideas of cure were explored using the Private Theories Interview. Qualitative methods included idealtype analysis and grounded theory. 3 Results: The patients were considerably more troubled than Swedish norm groups at intake. The patients showed improvement on all outcome measures at termination. The largest positive changes were with respect to the patients’ overall health and functioning. A majority of the patients had ideas of cure that were in line with psychoanalytic psychotherapy. Patients who terminated therapy prematurely were significantly closer to the ‘distancing’ pole regarding ideas of cure, while completers closer the ‘approaching’ pole. Tentative theoretical models of therapeutic action were construted, starting from the patients’ and the therapists’ perspective. The patients and therapists both stress the importance of establishing a special kind of relationship enabling the patients to talk openly about their inner experiences. However, both parties had incompatible, implicit theories regarding what the problem in therapy was and what was needed to change it. Conclusions: The introductory sessions seem to be of vital importance in helping patients to engage in a potentially beneficial therapy. Financial support: Söderström-Königska Nursing Home Foundation, the Bank of Sweden, Tercentenary Foundation, and the Research Advisory Board of the International Psychoanalytical Association. Andrzej Werbart and Gunnel Jacobsson (doctoral project), principal investigators Young Adult’s Own Thinking, Understanding, and Managing of Everyday Life (YOUTH) Institute of Psychotherapy, Stockholm, and Department of Education, Stockholm University 2000–2006 YOUTH is a study of private explanatory systems and personal strategies, created by young adults (aged 18-25; non-clinical population) in confrontation with strains and challenges on the threshold of adulthood. Part 1: Using case study methodology, both successful and non-adaptive strategies are investigated, as well as differences between women’s and man’s private theories about their difficulties and ways of managing strains and challenges in life. The material includes PTIinterviews with 24 young adults, as well as interviews, questionnaires, and rating scales used in YAPP. Data is collected at 3 points of time: at the baseline, 1.5 and 3 years later. Part 2: A survey in a representative random sample of young adults in Stockholm (N=630). In this part of the research programme a Private Theories Questionnaire was constructed and tested. Part 3: A pilot study of private theories constructed by young adults in narratives collected online on the Net. Financial support: Stockholm County Council, Secretariate for Research and Development, and the Research Advisory Board of the International Psychoanalytical Association. Andrzej Werbart (principal investigator), students at the Department of Psychology, Stockholm University and at the Department of Clinical Neuroscience, Karolinska Institutet, Sweden 2003–2011 4 Changes in the representations of self, mother and father among young adults in psychoanalytic psychotherapy Background and aim: Studies of cognitive-affective schemas of self and significant others provide a method for investigating therapeutic change. The present study explores the changes in young adult patients’ representations of their parents from prior to psychotherapy through long-term follow-up Method: Twenty-five women and 16 men from the Young Adult Psychotherapy Project (YAPP) were interviewed according to Sidney Blatt’s unstructured Object Relations Inventory prior to psychoanalytic psychotherapy, at termination and at the 1.5-year follow-up, comprising 123 interviews in all. Typologies of the 246 parental descriptions were constructed by means of ideal-type analysis for male and female patients separately, and for representations of mother and father separately. Results: The analysis resulted in 5 to 7 ideal types of mother and father representations. Prior to psychotherapy, women’s representations of their fathers and men’s representations of their mothers seemed most problematic. As to the content, the most common descriptions of the parent were the emotionally or physically absent parent, and the parent with his or her own problems. In most cases, the descriptions of the parent changed over time in terms of belonging to different ideal-type clusters. There were important improvements in the quality of the descriptions, and the changes continued after termination of psychotherapy. However, most of the parental representations were negative in all three interviews. Discussion: The possible explanations of these findings are discussed. Financial support: The Bank of Sweden, Tercentenary Foundation, the Secretariate for Research and Development, Stockholm County Council, and the Research Advisory Board of the International Psychoanalytical Association. Andrzej Werbart, principal investigator, Camilla von Below et al. Depression among young men and women in psychotherapy: patient perspective on own problems, medication and psychotherapy in relation to outcome Institute of Psychotherapy, Stockholm County Council, and the Psychotherapy Section, Department of Clinical Neuroscience, Karolinska Institutet. 2005–2009 Background: Growing incidence of mental ill-health and depression among young adults, and women in particular, is reported in Sweden. Aim: The first aim was a longitudinal follow-up of young adult psychotherapy patients with diagnoses within the depression spectrum. The the second aim was to explore patients’ experiences of overcoming depression. Method: The material consisted of data collected in YAPP. Of the 87 diagnosed cases in YAPP, 23 patients (26%) had pre-treatment Mood Disorder diagnosis. Both quantitaive and qualitative methods were used. Results: At termination, 45% 16 of patients still had a diagnosis of Mood Disorder, while 1.5 years later 20% had this diagnosis. The percentage of patients on medication remained unchanged. The patients significantly improved at termination and at 1.5 years follow-up in respect of self-reported symptoms, self-rated health, positive and negative aspects of selfconcept, and the differentiation-relatedness of self and object representations. 5 Grounded theory analysis resulted in 15 distinct categories, organized into five general domains: experiences of positive change, in-therapy contributions to positive change, extratherapeutic contributions to positive change, obstacles in therapy and negative experienced outcomes. Exploration of interplay between these domains resulted in a process model for the way out of depression. The positive changes experienced extended beyond symptom relief. The patients emphasised finding out how they wanted to live and how they started forming their lives in that direction. Obstacles in therapy interplayed with the experience of being stuck in depression. Discussion: These findings are related to age-specific challenges on the threshold of adulthood. Financial support: Bank of Sweden, Tercentenary Foundation, the Centre for Health Care Science, the Clas Groschinsky Memorial Fund, and the Research Advisory Board of the International Psychoanalytical Association. Andrzej Werbart, principal investigator, and students at the Department of Psychology, Stockholm University Patients’ view of helpful and hindering factors in psychoterapy in relation to longitudinal outcomes: Post-termination changes Institute of Psychotherapy, Stockholm, Child- and Adolescent Psychiatry, Stockholm County Council, Karlinska Institutet, and Department of Psychology, Stockholm University. 2007–2010 Background and aim: There is a need of long-term follow-up of the effects of psychotherapy, as well as appplying the patient perspective on process and outcome. Mathods: The material consists of quantitative and qualitative data collected in YAPP. Results: All outcome measures changed significantly from intake to follow-up. Lower therapist-rated alliance predicted greater change in psychiatric suffering for patients reporting more psychiatric symptoms at intake. A qualitative study of changes in parental representations showed that most common descriptions of the parent were the emotionally or physically absent parent, and the parent with his or her own problems. Dissatisfied patients lacked confidence in their relationship to the therapist, felt unable to express their own feelings, lacked direction in therapy and wanted more response from the therapist. They felt abandoned by an insufficiently flexible therapist, a therapy lacking intensity, and links missing between therapy and everyday life. In the most successful therapies, helpful factors in therapy and in life reinforced each other in a positive feedback loop. In a growth-promoting and secure relationship the patients and the therapists could overcome obstacles to their collaboration. The patients obtained support in close relationships, could cope with strains in life and continued to apply therapeutic experiences after termination. The therapists experienced the therapeutic work in a strikingly similar way. Conclusions: The long-term effectiveness of psychoanalytic psychotherapy for young adults was supported. Hypotheses were generated about the benefits of a therapist listening to the patient’s ideas and making interpretative interventions focusing on obstacles to the therapeutic work. Financial support: Secretariate for Research and Development, Stockholm County Council, and the Research Advisory Board of the International Psychoanalytical Association. 6 Andrzej Werbart, principal investigator, and Peter Lilliengren (doctoral project) Therapists’ view of helpful and hindering factors in psychoterapy with young adults Institute of Psychotherapy, Stockholm, and Department of Psychology, Stockholm University. 2007–2010 Background: Studying experienced therapists’ implicit theorizing may contribute to our understanding of what is helpful and what hinders treatment with particular patient populations. Aim and method: In this study, 16 therapists’ views of curative factors, hindering factors and outcome were explored in 22 interviews conducted at termination of individual psychoanalytic psychotherapy with young adults. The material consists of data collected in YAPP. Grounded theory methodology was used to construct a tentative model of therapeutic action based on the therapists’ implicit knowledge. Results: The results indicated that Developing a Close, Safe and Trusting Relationship was viewed as the core curative factor in interaction with the Patient Making Positive Experiences Outside the Therapy Setting and the therapist Challenging and Developing the Patient’s Thinking about the Self. The therapeutic process was experienced as a joint activity resulting in the patient Becoming a Subject and acquiring an Increasing Capacity to Think and Process Problems. The Patient’s Fear about Close Relationships was seen as hindering treatment and leading to Core Problems Remaining. Discussion: The model is discussed in relation to major theories of therapeutic action in the psychoanalytic discourse and previous research focusing on young adults’ view of curative and hindering factors in psychotherapy. Implications for practice and further research are suggested. Financial support: Clas Groschinsky Memorial Fund, the Centre for Health Care Science, Karolinska Institutet, and the Research Advisory Board of the International Psychoanalytical Association. Andrzej Werbart (principal investigator), Sverker Sikström and David Arvidsson Changes in self- and object representations following psychotherapy measured by a theory-free, computational, semantic space method Institute of Psychotherapy, Stockholm, and Departments of Psychology, Stockholm University, Lund University and Gothenburg University 2008–2011 Background: Theory-driven measures of object representations may be useful for evaluating the particular theory they were designed for. However, they may be at risk of ignoring other potentially important characteristics. Aim: To propose a theory-neutral, computational and data-driven method for assessing changes in semantic content of object representations following long-term psychodynamic psychotherapy. Method: Young adults in psychodynamic psychotherapy were compared with an age-matched, non-clinical sample at three time points. Verbatim transcripts of descriptions of the self and parents were quantified in a semantic space constructed by Latent Semantic Analysis. 7 Results: In the psychotherapy group, all representations changed from baseline to follow-up, whereas no comparable changes could be observed in the comparison group. Discussion: The semantic space method supports the hypothesis that long-term psychodynamic psychotherapy contributes to sustained change of affective-cognitive schemas of self and others. Financial support: The Research Advisory Board of the International Psychoanalytical Association. Publications from IPA supported projects Referee reviewed international publications 1. Arvidsson, D., Sikström, S., & Werbart, A. (2011). Changes in self- and object Arvidsson, D., Sikström, S., & Werbart, A. (2011). Changes in self- and object representations following psychotherapy measured by a theory-free, computational, semantic space method. Psychotherapy Research, 21, 430–446. DOI: 10.1080/10503307.2011.577824 2. von Below, C., Werbart, A., & Rehnberg, S. (2010). Experiences of overcoming depression in young adults in psychoanalytic psychotherapy. European Journal of Psychotherapy and Counselling, 12, 129–147. DOI: 10.1080/13642537.2010.482745 3. Jacobsson, G., Tysklind, F., & Werbart, A. (2011). Young adults talk about their problems. Scandinavian Journal of Psychology, 52, 282–289. DOI: 10.1111/j.14679450.2011.00874.x 4. Johansson, L., & Werbart, A. (2009). Patients’ view of therapeutic action in psychoanalytic group psychotherapy. Group Analysis, 42, 120–142. DOI: 10.1177/0533316409104361 5. Levander, S., & Werbart, A. (2003). Different views of a psychotic breakdown: Complementary perspectives of a bewildering experience. Psychoanalytic Psychotherapy, 17, 163–174. DOI: 10.1080/1474973031000105311 6. Levander, S., & Werbart, A. (2012). Personality related responses to the psychoanalytic process: A systematic multicase study. Psychoanalytic Psychology, 29, 1–16. DOI: 10.1037/a0024713 7. Lilliengren, P., & Werbart, A. (2005). A model of therapeutic action grounded in the Lilliengren, P., & Werbart, A. (2005). A model of therapeutic action grounded in the patients’ view of curative and hindering factors in psychoanalytic psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 42, 324–339. DOI: 10.1037/00333204.42.3.324 8. Lilliengren, P., & Werbart, A. (2010). Therapists’ view of therapeutic action in psychoanalytic psychotherapy with young adults. Psychotherapy: Theory, Research, Practice, Training, 47, 570–585. DOI: 10.1037/a0021179 9. Lindgren, A., Werbart, A., & Philips, B. (2010). Long-term outcome and post-treatment effects of psychoanalytic psychotherapy with young adults. Psychology and Psychotherapy: Theory Research and Practice, 83, 27–43. DOI:10.1348/147608309X464422 8 10. Philips, B., Wennberg, P. & Werbart, A. (2007). Ideas of cure as a predictor of premature termination, early alliance, and outcome in psychoanalytic psychotherapy. Psychology and Psychotherapy: Theory Research and Practice, 80, 229–245. DOI: 10.1348/147608306X128266 11. Philips, B., Wennberg, P., Werbart, A., & Schubert, J. (2006). Young adults in psychoanalytic psychotherapy: Patient characteristics and therapy outcome. Psychology and Psychotherapy: Theory Research and Practice, 79, 89–106. DOI:10.1348/147608305X52649 12. Philips, B., Werbart, A., & Schubert, J. (2005). Private theories and psychotherapeutic technique. Psychoanalytic Psychotherapy, 19, 48–70. DOI: 10.1080/02668730512331341573 13. Philips, B., Werbart, A., Wennberg, P., & Schubert, J. (2007). Young adults’ ideas of cure prior to psychoanalytic psychotherapy. Journal of Clinical Psychology, 63, 213–232. DOI: 10.1002/jclp.20342 14. Werbart, A. (2005). Between private construction of meaning and canons of science: Freud’s case studies noch einmal. International Journal of Psychoanalysis, 86, 1441– 1461. DOI: 10.1516/EJ86-V8CP-345T-QFQN 15. Werbart, A. (2007). Utopic ideas of cure and joint exploration in psychoanalytic supervision. International Journal of Psychoanalysis, 88, 1391–1408. DOI: 10.1516/ijpa.2007.1391 16. Werbart, A., in collaboration with Grünbaum, C., Jonasson, B., Kempe, H., Kusz, M., Linde, S., Lundén O’Nils, K., Sjövall, P., Svenson, M., Theve, C., Ulin, L., & Öhlin, A. (2011). Changes in the representations of mother and father among young adults in psychoanalytic psychotherapy. Psychoanalytic Psychology, 28, 95–116. DOI: 10.1037/a0022344 17. Werbart, A., & Levander, S. (1998). La construcción de significado y las teorias privadas de la patogénesis y la cura. Revista de Psicoanalisis, 55, 767–768. 18. Werbart, A., & Levander, S. (2005). Understanding the incomprehensible: Private theories of first-episode psychotic patients and their therapists. Bulletin of the Menninger Clinic, 69, 103–136. 19. Werbart, A., & Levander, S. (2006). Two sets of private theories in analysands and their analysts: Utopian versus attainable cures. Psychoanalytic Psychology, 23, 108–127. DOI: 10.1037/0736-9735.23.1.108 20. Werbart, A., & Levander, S. (2011). Vicissitudes of ideas of cure in analysands and their analysts: A longitudinal interview study. International Journal of Psychoanalysis, 92, 1455–1481. DOI: 10.1111/j.1745-8315.2011.00485.x Book chapters 21. Werbart, A. (1998). Where the horsetails grow as high as palms: The case of the Wolf Man. In I. Szecsödy & I. Matthis (Eds.), On Freud’s couch: Seven new interpretations of Freud’s case histories (pp. 185–246). New York: Jason Aronson. 22. Werbart, A. (2011). Intersubjektivität und therapeutische Technik: Was ist neu und was alt? In P. Diederichs, J. Frommer, & P. Wellendorf (Hrsg.), Äußere und innere Realität: 9 Theorie und Behandlungstechnik der Psychoanalyse im Wandel (pp. 171–181). Stuttgart, Germany: Klett-Cotta. ISBN: 978-3-608-94667-3 23. Werbart, A., & Levander, S. (2000). Pain in the body – pain in the soul: The need of private explanations when not feeling well. In P. Nilsson & K. Orth-Gomér (Eds.) Selfrated health in European perspective (pp. 136–151). Stockholm: Swedish Council for Planning and Coordination of Research (FRN). 24. Werbart, A., Levander, S., Sahlberg, B., Ginner, H., Philips, B., Jacobsson, G., & Claesson, M. (2002). The research programme on private theories of pathogenesis and cure. In P. Fonagy (Ed.), An open door review of outcome studies in psychoanalysis, 2nd rev. ed. (pp. 211–214). London: International Psychoanalytical Association. Other publications (articles in other languages, reports) 25. Bengtsson, A. (2004). Unga vuxnas förväntningar på psykoterapi [Young adults’ expectations in psychotherapy]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 26. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 26. Claesson, M. & Werbart, A. (2002). Unga vuxna i psykoterapi I: Vilka är de? [Young adults in psychotherapy I: Who are they?]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 22. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 27. Diamond, D., Blatt, S. J., Stayner, D. & Kaslow, N. (2001). Bedömning av differentiering–relaterande i själv- och objektrepresentationer II: Manualen [Differentiation-relatedness of self and object representations II: The Swedish translation of the manual]. Swedish translation by G. Blomquist, A. Werbart, S. Levander, & Y. Hjälmdahl. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 21. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 28. Edenius, A., Jacobsson, G., & Werbart, A. (2003). Att jaga en flyende grupp [Searching for a fugitive group]. Psykologtidningen, 2003(18), 8–9. 29. Ginner, H., Werbart, A., Levander, S., & Sahlberg, B. (2001). Tillförlitlighet i studier av subjektiva förklaringssystem: Ett kodningssystem för privata teorier om patogenes och kur [Reliability in studies of subjective explanatory systems: A coding system for private theories of pathogenesis and cure]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 19. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 30. Halvarson, C. & Lilliengren, P. (2003). Private explanatory systems and informed consent online: An ethical and methodological discussion. In M. Thorseth (Ed.), Applied ethics in internet research (pp. 125–139). Trondheim: Norwegian University of Science and Technology (Programme for Applied Ethics, Publication Series No 1). 31. Hjälmdahl, Y., Claesson, M., Werbart, A. & Levander, S. (2001). Bedömning av differentiering–relaterande i själv- och objektrepresentationer I: En validitetsstudie. [Differentiation-relatedness of self and object representations I: Validity of the Swedish version]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 20. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 10 32. Jacobsson, G. (2001). Om manliga och kvinnliga element hos unga vuxna [Male and female elements in young adults]. Insikten, 10(4),:35–39. 33. Jacobsson, G. (2003). På tröskeln till vuxenvärlden: Unga vuxna berättar om påfrestningar och svårigheter i livet [On the threshold of adulthood: Young adults tell about strains and difficulties in life]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 25. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 34. Jacobsson, G., Lindgren, A., Werbart, A., & Boalt Boëthius, S. (2004). Unga vuxnas förhållningssätt vid påfrestningar i livet: En enkätundersökning [Young adults’ atttudes in confrontation with strains in life: A survey study]. [Psychotherapy: Research and Development], Report 27. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 35. Levander, S. (2001). Jag var rädd att jag hade dödat Deng Xiao Ping: En ung, vietnamesisk kvinnas berättelse om hur hon tänker kring sin psykos och dess bakgrund [I was afraid that I killed Deng Xiao Ping: A young, Vietnamese woman’s narrative about how she thought of her psychosis and its background]. Insikten, 10(2), 30–31. 36. Levander, S. (2002). Problemformuleringsarbete: Ett identitets- och jagstärkande arbetssätt med förstagångspsykotiska patienter [Working with problem formulations: An identity and ego strengthening method of working with first-episode psychotic patients]. Report 2002:3. Unit for Mental Health, Social Medicine, Stockholm County Council. 37. Lindén, H. (2000). Mellan terapeut och forskare: Utprovning av en konsultfunktion [Between the therapist and researcher: Testing out of a consultant function]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 15. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 38. Lundén-O’Nils, K. & Werbart, A. (2006). Inför starten av psykoterapi: Unga mäns bilder av sina fäder [At the start of psychotherapy: Young men’s representations of their fathers]. Insikten, 15(1), 29–34. 39. Nilsson, G. (2001). Det subjektiva perspektivet i psykoterapi: En underskattad ansats i arbetet med ungdomar och unga vuxna [The subjective perspective in psychotherapy: An underestimated approach in work with adolescents and young adults]. Insikten, 10(1), 14– 19. 40. Nilsson, G. (2003). Två tonåringars syn på sina psykiska problem jämförda med deras föräldrars och behandlares [Two adolescents’ view of their psychic problems compared with their parents and therapists]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 24. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet. 41. Philips, B. (2004). När patientens och terapeutens teorier möts – vad händer? [When patient’s and therapist’s theories meet – what happens?] Insikten, 13(1), 38–43. 42. Philips, B. (2004). Psykoterapi med unga vuxna som vuxit upp med en förälder med psykisk störning [Psychotherapy with patients who have grown up with a parent with psychosis]. Psykisk Hälsa, 45, 30-42. 43. Philips, B., Wennberg, P. & Werbart, A. (2004). Unga vuxna i psykoanalytisk psykoterapi [Young adults in psychoanalytic psychotherapy]. Matrix, 21(4), 280–289. 11 44. Werbart, A. (2001). Freuds fallstudier: Inifrånperspektiv och den vetenskapliga metoden [Freud case studies: The “insider’s” perspective and the scientific method]. Divan, 34/2001, 63–75. 45. Werbart, A. (2004). Vilken psykoterapeut passar mig? Hur unga vuxna patienter ser på sina terapeuter [Which therapist suits me? Young adults’ view of their therapists]. Matrix, 21(4), 290–304. 46. Werbart, A. (2009). Patienten som gemensam faktor [The patient as common factor]. Glimtar från forskningsfronten, nr 25, 4–6. Child and Adolescent Psychiatry, Stockholm Country Council. 47. Werbart, A. (2009). Unga vuxnas perspektiv på hjälpsamma och hindrande faktorer i individualterapi och gruppterapi [Young adults’ view of helpful and hindering factors in individual and group therapy]. Glimtar från forskningsfronten, nr 25, offprint. Child and Adolescent Psychiatry, Stockholm Country Council. 48. Werbart, A. (2011). Psykoterapin har mycket att lära av patienten [Psychotherapy has a lot to learn from the patient]. Psykologtidningen, 2001(10), 29–31. 49. Werbart, A., & Levander, S. (1998). Ont i kroppen – ont i själen: Behovet av privata förklaringssystem vid upplevd ohälsa [Pain in the body – pain in the soul: The need of private explanations when not feeling well]. Psykisk Hälsa, 39:112-129. 50. Werbart, A., & Levander, S. (2000). Varför blev jag sjuk och vad kan göra mig frisk? Patienters och terapeuters privata teorier om patogenes och kur [Why do I get ill and what can make me healthy? The patients’ and the therapists’ private theories of pathogenesis and cure]. Insikten, 9(4), 39–45. 51. Werbart, A., & Levander, S. (2006). Capire l’incomprensible: teorie private tra pazienti psicotici e loro terapeuti, a proposito del primo episode psicotico. Laboro presentato al Convegno Trauma e Psicosi, Milano, Italia, 10 giugno 2006. http://www.spiweb.it/IT/images/stories/PDF/psicosi_trauma/Lavoro_Werbart.pdf 52. Wiman, M. & Werbart, A. (2002). Unga vuxna i psykoterapi II: Hur uppfattar de själva sina problem? [Young adults in psychotherapy II: How do they perceive their problems?]. Psykoterapi: Forskning och utveckling [Psychotherapy: Research and Development], Report 23. Stockholm: Institute of Psychotherapy and Psychotherapy Section at Karolinska Institutet.