Transference-focused psychotherapy (TFP) was originally conceived as an extended, individual outpatient treatment. Our goal is to describe the development of group treatment interventions informed by TFP principles in two different settings: a program for adults in Munsterlingen, Switzerland, and a program for adolescents in Cologne, Germany. We outline the essential elements of TFP-informed group treatment and the role these group treatments play in the comprehensive programs offered to patients at these two sites. Group TFP theory for adults, as developed by (...) Kernberg, builds on a foundation of group dynamics and theory described by Bion and others. Offering any group treatment designed for patients with personality disorder diagnoses requires specific modifications; integrating TFP principles into group treatment can add an extra dimension to these offerings, adding insights derived from object relations theory. These two examples are reflective of the growing movement in sites in multiple countries adapting TFP principles for work in group settings. For example, the innovation of TFP group treatment for adolescents with borderline personality disorder (BPD), underscores the importance of the peer group in the treatment of this population in a group setting. This leads to a triadic situation and due to this, several challenges are in place that play an important role in the life of adolescent borderline patients. The special perspectives with this population are discussed based on group therapy experiences in a day hospital program and in this chapter explored in the context of a broader movement of TFP-informed group work. (shrink)

Transference-focused psychotherapy (TFP) emphasizes the need to inform patients with borderline personality disorder (BPD) about the nature and course of their personality pathology, as well as about available treatment options. As the scope of TFP has been extended to a broader group of patients with borderline personality organization (BPO), the same goal for pertinent instruction has been maintained. While the need for psychoeducation (PE) has been stressed in various TFP manuals, clinicians may benefit from a more detailed exploration of this (...) process. This chapter outlines a proposed structured group PE program for patients with personality disorder diagnoses. Using straightforward language, the program adopts an informal and collaborative stance to educate patients diagnosed with BPD, among other comparable personality disorder presentations, about the symptoms, etiology and course of their conditions, reviewing existing treatment options, and illustrating how TFP might help them to overcome their difficulties. Therefore, this PE program can be integrated into the pre-treatment phase of both a standard individual TFP treatment and of TFP-informed treatment programs in those settings where they are available, as those described in the following chapters of this volume. In perspective, this program could also be implemented as part of a process for treatment selection for the patient considering among multiple possible intervention and as a stand-alone PE intervention that can be scaled to meet the needs of those systems tasked with educating clinicians and patients about personality disorder pathology. (shrink)

Transference-focused psychotherapy (TFP) is an effective psychotherapy intervention for patients with borderline personality disorder (BPD), as well as other personality disorder presentations described as meeting the criteria for borderline personality organization (BPO). TFP has been used predominantly as an outpatient, individual modality. More recently, TFP principles have been integrated into the approach used in the day hospital (DH) setting; this use of TFP elements in a setting that involves interactions with multiple patients and clinicians has been described as “Institutional therapy,” (...) which distinguishes it from the standard, familiar individual patient-therapist dyad. We present material from two DH treatment programs, one for adult patients in Barcelona, Spain, and the other for adolescents in Cologne, Germany. The specific theoretical and practical elements of TFP that are used in these programs are reviewed. We describe the aspects of applied TFP that are useful in the DH setting for both patient populations, and the modifications that are required based on the patient’s age, development, and severity of illness. The elements of TFP applied in this context are outlined, with special attention to the facilitation of reflective capacity, the resolution of splitting, and the promotion of identity integration. Overall, these interventions informed by TFP principles allow patients to be successfully discharged from the DH to less intensive outpatient treatment settings. (shrink)

Transference-focused psychotherapy (TFP), from its inception, has focused on the centrality of unintegrated aggression and associated destructive impulses in severe borderline pathology. Clinicians treating forensic patients have identified the utility of TFP’s perspective in working with those patients who are chronically predisposed to acting out and showing antisocial behavior. This chapter examines: (1) the prototypes and psychopathological dimensions relevant to diagnostic assessment in the forensic population, (2) the TFP strategies requiring modification with this population, and (3) the evolution of forensic (...) psychotherapy and the use of TFP principles for understanding different institutional contexts. The foundations of TFFP (transference-focused forensic psychotherapy) are described with attention to future developments that would advance its implementation. (shrink)

Clinicians working in higher-acuity settings will routinely treat patients with serious personality disorder (PD) pathology. The goal of this chapter is twofold: to introduce the utility of imparting principles of Transference-Focused Psychotherapy (TFP) to clinicians working in these settings in the Spanish mental health system, and to outline a didactic approach to imparting this matter to clinicians who may have limited familiarity with psychodynamic theories in general, and TFP’s core principles, in particular. A review of the Spanish system will highlight (...) the familiar challenges observed in mental health systems worldwide, underscoring the specific gaps in the optimal treatment of those patients with primary or co-occurring PD diagnoses. The authors describe the ways that TFP principles derived from extended, individual outpatient psychotherapy can be learned and used by those who work in significantly different situations including the day program, emergency room (ER), and psychiatry inpatient services. Use of TFP principles in this context is proposed as an adjunctive set of skills. Application of TFP principles in the management of PD patients across the continuum of services in this particular government-supported system is offered as a template with a focus on avoiding iatrogenic complications and improving patient care. (shrink)

The outpatient treatment of patients with severe personality disorders (SPD) within the community-based Departments of Mental Health (DMH) of the Italian National Health System is often complicated by (1) the absence of a clear treatment structure and goals, (2) the lack of a shared understanding, among various members of the multi-professional mental health teams who work in the DMH, of PD pathology and its mechanisms of change, and (3) the difficult relationships between patients and providers. This chapter illustrates how Transference-focused (...) psychothearpy (TFP) principles can be taught to and then applied by a community-based Italian outpatient mental health team, comprising several professionals with different therapeutic backgrounds, roles, and orientations. A TFP-oriented approach may successfully improve the service’s standard of care for SPD, provide a coherent framework through which the unfolding of personality pathology can be observed and consistently addressed by various staff members, and ameliorate the staff’s attitudes toward patients with SPD. (shrink)

This chapter illustrates a model of family therapy intervention that applies the principles of transference-focused psychotherapy (TFP) for improving parental functions in the family (TFP-PF). This intervention is indicated for a group of adolescents with severe personality pathology who show a limited appreciation of their difficulties. They present marked identity diffusion and impairment in their family, academic, and social functioning. According to Kernberg’s diagnostic classification, this group of patients would be included within the medium or low level of borderline personality (...) organization (BPO). These adolescent patients are often referred to treatment by their adult relatives. However, adherence to individual treatment without a personal motivation to do so is often impossible in this population or leads to premature drop out early in treatment. This combination of personality pathology severity and adherence difficulties makes individual outpatient treatment unfeasible in most cases. The TFP-PF approach focuses on the resolution of certain active dysfunctional family ties that maintain or aggravate the pathological organization of the adolescents’ personalities. This family intervention initiates a process of differentiation and individuation that improves the global functioning of adolescent patients and of the relationships between them and their parents. Thus, TFP-PF promotes the adolescents’ awareness of their own difficulties, and increases adherence to individual treatment, thereby expediting its progress, and, ultimately, fostering recovery. (shrink)

In the context of China’s supply-side structural reform and the concept of green development, we introduce the energy and environmental factors into the analytical framework of the total factor productivity of the logistics industry and use the Global Malmquist–Luenberger index method to analyze the evolution trend and heterogeneity of green TFP in the logistics industry of 30 provinces in China from 2003 to 2017. The results show that, firstly, the green TFP and traditional TFP of China’s logistics industry are both (...) on the rise and the absence of energy and environmental factors will lead to the overestimation of TFP of the logistics industry. Whether it is green TFP or traditional TFP, the main source of its growth is technical progress. Secondly, there is obvious regional heterogeneity in green TFP of logistics industry. Under the three regional division standards, the average annual growth rate of green TFP is from high to low in the order of eastern, western, and central regions. Under the eight regional classification standards, the eastern coastal economic zone, the southern coastal zone, the northern coastal zone, the northeast region, the middle reaches of the Yellow River, the southwest region, the middle reaches of the Yangtze River, and the northwest region are in order from high to low. Thirdly, there is obvious interprovincial heterogeneity in green TFP of the logistics industry. The highest growth rate of green TFP is in Zhejiang, followed by Jiangsu and Guangdong, and the slowest growth rate is in Chongqing. The technical progress of logistics industry in most provinces contributes more to the growth of green TFP. Fourthly, the differences of green TFP in the three regions of the east, center, and west are shrinking, which may be σ convergence, but the differences among the three regions are expanding. Compared with the existing literature, this paper applies the measurement framework of green TFP to China’s logistics industry and investigates the regional and provincial heterogeneity of green TFP in logistics industry. The conclusions are significant to understand and grasp the heterogeneity of green TFP growth in China’s logistics industry under environmental constraints and how to promote the development of green logistics in China. (shrink)

The availability of treatment for patients with personality disorder (PD) diagnoses in the National Health Service (NHS) of the United Kingdom (UK) is uneven, ranging from services with relatively limited resources and a dearth of specialized approaches, to centers of excellence offering high quality, empirically validated treatments. The goal of this chapter is to outline the place of transference-focused psychotherapy (TFP) in the UK’s highly regarded system of comprehensive, government-supported care. We review the need for specialized treatment services for PD (...) patients within the NHS and the range of services offered that put into context the introduction of TFP in recent years. We describe the collective experience of NHS clinicians in offering a weekly, TFP-informed treatment that adapts the TFP format to the specifications of a nationalized healthcare structure. Finally, we examine different NHS pilot programs integrating TFP principles in their work and the related teaching initiatives on TFP principles. We conclude by providing details about a novel, innovative use of applied TFP in engagement with old-age PD patients. (shrink)

This chapter describes the borderline personality organization integrated care continuum treatment program (BPOTP) developed in multiple public health network services in Barcelona, Spain. These services include an outpatient service, two-day hospitals, a subacute service, and a specialized rehabilitation service. This innovative program offers continuity of care for patients with a range of personality disorder pathology, integrating principles and techniques of transference-focused psychotherapy (TFP) into comprehensive care. We review the profile of the patients involved, and the setting, components, and organization of (...) this ambitious program. We outline how and when TFP principles are employed across this continuum of services; our goal is to describe the value of a TFP-informed psychodynamic approach with this challenging patient population in varied situations. The public health implications of this program and associated research opportunities are reviewed. (shrink)

Patients with co-occurring medical and personality disorder (PD) symptomatology pose distinct challenges for treating clinicians. Providers of mental health services will routinely see patients with PD pathology who have co-occurring medical concerns, either directly or obliquely related to specific PD manifestations. Physicians, nurses, and other professionals will frequently see patients with PD pathology in most settings of medical care; these patients may carry PD diagnoses, or they are often described only as “difficult” patients. While these referenced clinical situations are predictably (...) vexing, there has been relatively limited investigation of these phenomena, and few overarching approaches to patient management proposed. Transference-focused psychotherapy (TFP) offers clinicians general principles for use with these sub-populations. This chapter focuses on two approaches informed by TFP precepts: (1) using TFP principles in consultation-liaison psychiatry, and (2) a pilot program using TFP principles in general medicine training. (shrink)

Originally developed by Otto Kernberg in the 1960s and 1970s in the United States, inpatient transference-focused psychotherapy (TFP) still exists today, notably in German-speaking countries and the Netherlands. Inpatient TFP is a disorder-specific, manualized, and modified psychodynamic psychotherapy for patients with a borderline personality organization (BPO). The treatment focuses on non-integrated self-object representations of the patients that are based on dysfunctional early relationships and are actualized in the transference relationships between the patients and staff. The distinguishing aspect of inpatient TFP (...) is the particular focus on the different interactions and related transference-countertransference processes between the patients and the various staff members, who have different therapeutic and nursing tasks. The transference-countertransference relationships are explored jointly with all staff members involved in the treatment of the patients. The basics of this approach including the indications, the therapy components, as well as the different phases of a TFP inpatient treatment model lasting several months, are described as it is carried out today in German-speaking countries. Finally, the applications of TFP principles in brief inpatient settings and acute psychiatric care are discussed. (shrink)

Este artigo explora a relação entre a Sociedade Brasileira de Defesa da Tradição, Família e Propriedade (TFP) e a ditadura militar brasileira de 1964. A análise revela como o anticomunismo serviu de elo unificador entre a TFP e a ditadura, destacando o papel da organização na criação de um clima favorável ao golpe civil-militar e suas subsequentes atividades de suporte ao regime. O trabalho também discute a dinâmica ambivalente entre a TFP e o governo militar, caracterizada por momentos de colaboração (...) e vigilância mútua, e a mudança do posicionamento da TFP após o fim do regime. As fontes incluem documentos da própria Sociedade, arquivos do Serviço Nacional de Informações (SNI) e publicações contemporâneas. (shrink)

Transference-focused psychotherapy (TFP) is an empirically validated treatment for a patient with borderline personality disorder (BPD) derived from psychoanalytic object relations theory. TFP was developed by clinicians steeped in traditional psychoanalytic theory and practice, but TFP deviates significantly from orthodox psychoanalytic practice. TFP is a highly structured treatment that rests on the foundation of Kernberg’s structural interview as an assessment tool, and the development and maintenance of a detailed treatment contract that anchors the extended exploratory process. While TFP is an (...) exploratory treatment, the identification and pursuit of concrete goals beyond symptom reduction are central to the approach. TFP’s strategies, tactics, and techniques were influenced by specific aspects of BPD psychopathology, including the predictable emergence of powerful negative or paranoid transferences, which historically had adversely impacted the effectiveness of psychoanalytic interventions with this patient population. Despite its deviations from the traditional psychoanalytic treatment approach, TFP nevertheless includes the pillars of technical neutrality, utilization of countertransference, transference analysis, and interpretation of unconscious processes. Since its development, the TFP model has been used for individual treatment with patients with narcissistic disorders and with other higher level personality disorder presentations. The goal of this chapter is to provide foundational information about the theory and practice of TFP; the expanded applications that are the subject to this volume are informed by this original treatment template. (shrink)

Transference-focused psychotherapy (TFP) is an empirically validated treatment for patients with borderline personality disorder (BPD) informed by psychoanalytic object relations theory. TFP was influenced by traditional psychoanalytic theory and practice, but its developers made several key adjustments in the design and implementation of the treatment to address the specific aspects of psychopathology identified in patients with personality disorder diagnoses. Since its introduction for use in adult patients with borderline pathology, TFP has been used more widely in other patient populations, including (...) adolescents with BPD, adult patients with narcissistic disorders, and patients with higher level personality pathology presentations. As clinicians in a variety of clinical settings have been introduced to TFP principles, the use of these principles in situations other than an extended, individual psychotherapy has proliferated. This movement of applied TFP principles has yielded a number of pilot programs in multiple locations with ambitious public health goals. This chapter puts into context these initiatives and outlines the subtypes of applied TFP projects, which include the development of clinical services informed by TFP principles, the integration of TFP principles with elements of other evidence-based treatments, and the introduction of TFP theory and practice in education and training systems. (shrink)

Inspirational lessons to live by, organized to follow the academic school year.

L’intervention que reprend cet article porte sur un cadre-dispositif singulier de thérapie familiale basé sur l’épistémologie psychanalytique groupale. Ce cadre est singulier dans la mesure où il a été tenté d’articuler un travail entre groupe de thérapeutes et néo-groupe. La réflexion développée ici s’origine dans la clinique des auteurs : lorsqu’ils parlent en groupe d’une famille, la règle d’association libre les amène fréquemment à évoquer une autre famille rencontrée précédemment en séance. Quelle est la nature et la fonction de cette (...) résonance? L’article pose l’hypothèse d’un nouveau contre-transfert : le contre-transfert transfamilial. Une vignette clinique permet d’illustrer le cheminement qui a conduit les auteurs à y aboutir. (shrink)

The technological progress makes great contribution to the rapid economic growth of China during its past three decades of reform and opening up. An empirical analysis conducted over China’s total factor productivity certifies this conclusion but it also reveals that China’s TFP growth rate is not very high. We further explore the various stages of change of China’s total factor productivity and the causes of these changes and finally take an analytical calculation over the present flaws of China’s innovation system (...) and offer some advices. (shrink)

ABSTRACT Addressing the productivity challenge of climate technology (ClimTECH) firms and avoiding the “green trap” is crucial for decoupling economic growth from carbon emissions and achieving sustainable development. This study uses the establishment of green finance reform and innovation pilot zones as a quasi‐natural experiment and employs a difference‐in‐differences model to explore the impact of green finance policies on the total factor productivity (TFP) of ClimTECH firms and its spillover effects. The results show that (1) Green finance policies significantly increase (...) TFP, especially in state‐owned firms, firms that actively disclose environmental information, firms led by long‐tenure CEOs, and those in regions with strong intellectual property protection. (2) The channel analysis shows that green finance policies enhance firms' TFP by easing financing constraints, encouraging green technology improvements, and improving capital allocation efficiency. (3) The spillover effect analysis shows that the TFP increase driven by green finance policies not only enhances firm value but also stimulates local green innovation and reduces regional carbon emissions. This research offers theoretical insights and policy implications for strengthening green finance frameworks and enhancing the environmental responsibility of ClimTECH firms. (shrink)

How much should the present generations sacrifice to reduce emissions today, in order to reduce the future harms of climate change? Within climate economics, debate on this question has been focused on so-called “ethical parameters” of social time preference and inequality aversion. We show that optimal climate policy similarly importantly depends on the future of the developing world. In particular, although global poverty is falling and the economic lives of the poor are improving worldwide, leading models of climate economics may (...) be too optimistic about two central predictions: future population growth in poor countries, and future convergence in total factor productivity (TFP). We report results of small modifications to a standard model: under plausible scenarios for high future population growth (especially in sub-Saharan Africa) and for low future TFP convergence, we find that optimal near-term carbon taxes could be substantially larger. (shrink)

Access to fruits and vegetables by low-income residents living in selected urban and rural Minnesotan communities was investigated. Communities were selected based on higher than state average poverty rates, limited access to grocery stores, and urban influence codes (USDA ERS codes). Four communities, two urban and two rural, were selected. Data were gathered from focus group discussions (n = 41), responses to a consumer survey (n = 396 in urban neighborhoods and n = 400 in rural communities), and an inventory (...) of foodstuffs available at stores located in all the communities and at large grocery stores in neighborhoods adjacent to the urban communities. In the two urban neighborhoods, a significant number of foods (26% and 52%) were significantly more expensive than the Thrifty Food Plan’s (TFP) market basket price (MBP). Additionally, a significant number of foods in the two rural communities were more expensive (11% and 26%). In focus groups, participants identified major barriers to shopping in their community to be cost, quality of food, and food choice limitations. Results of the food inventory show that foods within the communities were costly, of fair or poor quality, and limited in number and type available, supporting complaints verbalized by focus group participants. Through focus groups and surveys, participants expressed concern that healthy food choices were not affordable within their communities and believed that people in their community suffered from food insecurity. The absence of quality, affordable food for low-income residents in these four Minnesota communities prevents or diminishes their ability to choose foods that help maintain a healthy lifestyle. (shrink)

The following is a short introduction to this special issue, which builds on and significantly extends and updates the research published recently in the Iwanami Series on Japanese economic history. First, we offer a modern interpretation of four institutional elements that are particularly important for understanding the growth path of the Japanese economy. These are (a) ownership; (b) regulation of factor markets; (c) labor mobility and (d) the judiciary. These four elements properly clarify the incentive structure behind economic institutions. We (...) then briefly explain how the four articles in this special issue—two at the macro level providing updated estimates of long-run rates of growth in gross domestic product (GDP) and total factor productivity (TFP), and two at the micro level examining institutional changes in specific markets—build on this unified framework, and deepen our understanding of Japanese economic history. (shrink)

We examine the role of experienced CEO in the CEO succession and their contributions to the performance of focal firms. We utilize the propensity score matching with difference in differences model to evaluate to what extent experienced CEO succession affects the total factor productivity growth. Based on the analysis of 1,675 listed manufacturing companies in China, results show that experienced CEO in succession significantly improves firms’ TFP. Our analysis demonstrates that, on average, the event of hiring an experienced CEO succession (...) yields a 3.1% increase in TFP improvement compared with nonsuccession firms. This positive effect can be continued for three years. Furthermore, the heterogeneous effect of experienced CEO succession on TFP is shown between different categories of focal firms. (shrink)

This book focuses on the practical utility of key precepts of Transference-Focused Psychotherapy (TFP) in contemporary psychiatry. This volume actively addresses the pressing public health crisis related to high numbers of patients with personality disorder pathology, often with significantly compromised functioning associated with marked social burdens related to health costs and lost productivity. TFP is one of the empirically validated treatments for patients with borderline personality disorder (BPD). Building on this evidence base, the contributors to this volume describe their work (...) in multiple clinical situations utilizing these principles with varying patient populations in different treatment settings. These settings include: the adult and adolescent day hospital, short term and extended inpatient hospitalizations, group therapy, and a range of outpatient services. Each chapter follows a consistent format to cover patient population, nature of treatment setting, overview of financial support, training of clinicians, treatment targets, elements of TFP employed, measurement of effectiveness, case study examples, and future research goals. Contributors from different backgrounds describe active use of TFP principles in their work, with adjustments from standard TFP protocol made accordingly. Implementing Transference-Focused Psychotherapy Principles builds on the growing literature about TFP by expanding the focus beyond the extended individual psychotherapy format. The text will resonate with psychiatrists, psychologists, social workers, and mental health counselors, among others. Clinicians involved in public health systems will find the material outlined of particular value in our evolving world of mental health services. (shrink)

According to neoclassical growth theory, there are two main patterns of economic growth, namely, intensive growth, which depends on total factor productivity, and extensive growth, which relies on factor input. This study explores the impacts of property taxes on growth patterns by considering the property tax pilots in Shanghai and Chongqing as a quasi-natural experiment. For evaluation, we applied multiple causal inference methods, including DID, PSM-DID, and a panel data approach for program evaluation. We found that the pilot of Shanghai (...) contributed to intensive growth, while the pilot of Chongqing reinforced the prevailing extensive growth. Specifically, Shanghai's property taxes restricted the buying of multiple homes and oversized homes, thereby reducing house prices and increasing TFP. Chongqing's property taxes are mainly for high-end houses, causing the substitution effect between high-end homes and ordinary houses; thus, the pilot increased the prices of ordinary houses and the average house price, which stimulated factor input and economic growth but decreased TFP. This study provides empirical evidence of the causal relationships between property taxes and growth patterns, indicating that transitional economies should avoid narrow tax bases during property tax reform for intensive growth. (shrink)

Following a brief overview of O. F. Kernberg’s biography, his theoretical construct of object relations theory is explained, incorporating neurobiological findings. Kernberg’s critique of the persistent anti-scientific attitudes within the psychoanalytic community and his proposed changes in this regard are discussed. He considers it both possible and desirable to identify foundational principles shared by the various psychoanalytic schools. His expectations include a willingness to modify the classical psychoanalytic method within psychoanalytic training. As a result of his life’s work, the fundamentals (...) of transference-focused psychotherapy (TFP), which he developed over many decades together with his research group, are described. This approach broadens the indications for psychoanalytic therapy to include severe personality disorders. Finally, Kernberg’s perspectives on how future psychoanalytic psychotherapy research should be conceptualized are presented. (shrink)

We use Penn World Table 10.0 data, which combine new infor mation on labor shares, physical capital, human capital, and total factor productivity (TFP), to analyze the contribution of factor accumulation and TFP to Egypt’s growth from 1955 to 2019. The objective of this chapter is to develop an understanding of Egypt’s growth experience, whether it was factor-based or productivity-based. We analyze the evolution of TFP in Egypt. Our findings show that Egypt’s growth experience has been capital-based rather than productivity-based. (...) TFP has indeed deteriorated over the entire period of analysis. Despite some fluctuation, there has been negative average TFP growth rate over the past 70 years at –0.1% per annum. Egypt needs to focus more on TFP growth to sustain future economic growth. (shrink)