Aversive-Nonaversive Issue: Tip of the Iceberg

ABSTRACT

This article addresses the lack of communication between child behavior analysis (CBA) and what has been referred to as “mainstream clinical child psychology” (MCCP). It is suggested that the emotionality of the aversive-nonaversive debate is attributable in part to a lack of information exchange among these two sub-specialties. Distinct contributions of CBA and MCCP are examined in each of the following four areas: population, assessment, research, and treatment. Recommendations are made for enhancing child clinical psychology by (a) promoting constructive communication, and (b) integrating components of the two approaches.     

Mind the gap: the need for a generic bridge between psychoanalytic and systemic approaches

The context for this paper is the ongoing systemic/psychoanalytic debate. It offers an alternative perspective to the recent contribution by Brodie and Wright (2002), in which they are concerned to underscore difference between the two therapeutic approaches. Here it is argued that the relationship is a great deal more complex than Brodie and Wright's analysis might suggest. Attention is focused on significant areas of commonality, in particular the impact of social constructionist thinking across the two therapies as well as current developments in technique. A case is made for the consolidation of generic space where there is opportunity for cross-fertilization and for integrative and combined systemic/psychoanalytic approaches to be nurtured and developed where appropriate. Case vignettes are used to highlight different aspects of the generic component in child and family therapy and to underline the need for bridge-building between these key therapeutic approaches in the field.     

Psychological Research With Administrative Data Sets: An Underutilized Strategy for Mental Health Services Research

A key element in the identity of professional psychologists is their commitment to base practice on the best knowledge available about a problem being tackled. Although administrative data (e.g., records of provider billing and procedures) can often shed light on the dark areas of the complex U.S. health care system, psychologists make notably little use of them. Experience teaches that decisions must often be made despite the absence of "gold standard" knowledge from the well-designed, controlled studies learned in graduate school. Increased involvement of psychologists in work using administrative data can improve service provision but requires that psychologists adopt unaccustomed approaches to research. The authors discuss administrative data's strengths and limitations, recent progress made in using them, how psychologists can acquire and use low-cost information from administrative data, and examples of questions that can be answered.     

Cholinergic modulation of learning and memory in the human brain as detected with functional neuroimaging

The advent of neuroimaging methods such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) has provided investigators with a tool to study neuronal processes involved in cognitive functions in humans. Recent years have seen an increasing amount of studies which mapped higher cognitive functions to specific brain regions. These studies have had a great impact on our understanding of neuroanatomical correlates of learning and memory in the living human brain. Recently, advances were made to go beyond the use of fMRI as a pure cognitive brain mapping device. One of these advances includes the use of psychopharmacological approaches in conjunction with neuroimaging. The paper will introduce the combination of neuroimaging and psychopharmacology as a tool to study neurochemical modulation of human brain function. A review of imaging studies using cholinergic challenges in the context of explicit and implicit learning and memory paradigms is provided which show that cholinergic neurotransmission modulates task-related activity in sensory and frontal cortical brain areas.     

Improving the Transportability of CBT for Internalizing Disorders in Children

Research provides strong support for the efficacy and effectiveness of cognitive behavioral therapy (CBT) for the treatment of childhood internalizing disorders. Given evidence for limited dissemination and implementation of CBT outside of academic settings, efforts are underway to improve its transportability so that more children with mental health needs may benefit from treatment. Creative modifications to existing treatments aim to deliver CBT for anxiety disorders and depression in a more transportable format. Notable progress has been made within the areas of computerized CBT, camp-based CBT, school-based CBT, and CBT delivered through primary care settings. These approaches are discussed within the context of key elements of transportability that are particularly germane to the dissemination and implementation of child treatments.     

Topic-focused analysis in a case of integrative psychotherapy with a father fearing his own anger

Even though evidence-based knowledge is considered the foundation of clinical practice, many clinicians question the clinical relevance of published research. Clinicians increasingly define themselves as having an integrative stance, in contrast to the tendency for most research to be based on clearly defined psychotherapies. Qualitative single case studies make it possible to generate knowledge about what actually occurs in integrative therapy. Topic change process analysis (TCPA) is used in the analysis of brief integrative therapy conducted by a very experienced psychotherapist drawing on a complex variety of therapeutic approaches. The client was a man in his late thirties, worrying about his strong anger, particularly related to one of his children. Analysis of topic areas, topic shifts, response patterns within topics and changes in perspective made it possible to identify key processes and key patterns of the therapy which resulted in a very positive outcome for the client. Implications of these findings for practice, and future research, are discussed.     

Therapiekonzeption für traumatisierte Patienten mit schweren Persönlichkeitsstörungen

Comorbidity between severe personality disorder and posttraumatic stress disorder is a frequent clinical problem. Severe personality disorders are characterized by an impaired regulation of emotions, a low mentalization capacity and deficits in personality integration. For severe personality disorders and posttraumatic stress disorder, a variety of evidence-based treatment approaches of psychodynamic and cognitive-behavioral origin are available. However, a closer inspection of these treatment concepts shows that they do not sufficiently take the respective comorbid condition into account. No single concept is able to cover all problem areas presented by patients with this comorbidity. Therefore, an attempt is made to present an integrative psychodynamically oriented therapy concept for traumatized patients with personality disorders which contains elements from psychodynamic, cognitive-behavioral and other concepts. The phase structure of the concept clarifies the sequence hierarchy of the therapeutic interventions. The content of the five phases are: (1) safety, holding and strengthening of coping capacities, (2) emotion regulation and self-care, (3) mentalization and development of stable representations, (4) gentle trauma processing and (5) conflict-oriented psychotherapy and treatment of maladaptive relationship patterns.     

Values and learning approaches of students at an international university

This study indicates that values are statistically significant precursors to approaches to learning in a cohort of predominantly Bulgarian, German and Romanian students studying at a German university where the language of instruction in all subject areas is English. Values have been measured with the Portrait Values Questionnaire (Schwartz et al. 2001), and approaches to learning have been assessed by the Study Process Questionnaire (Biggs, 1987). The relationships between values and approaches to learning have been estimated by canonical correlation analysis. Results of the analysis suggest that values can be linked to learning approaches in a situation where students have left their home countries to undertake tertiary studies in a new social, cultural and educational environment. Four distinct pairings between values and learning approaches emerge whereby: (a) self-aggrandisement is linked to the achievement learning variable, (b) conservatism relates to the surface learning variable, (c) self-directedness is linked to the deep learning variable and (d) benevolent change is related to the learning strategies variable. The analyses for this research were conducted while the second author was a visiting scholar at the Flinders University Institute of International Education in Adelaide, South Australia. The assistance of Professor John Keeves in the implementation and interpretation of additional statistical analyses is gratefully acknowledged.     

Functional Psychoeducational Assessment: Trends and Issues

Careful match of assessment process and procedure to the decision(s) to be made is seen as the most important step in improving psychoeducational assessment. Clarification of the decision(s) to be made is best achieved through referral assessment and pre-referral interventions. Trends in assessment, particularly greater use of behavioral approaches and natural settings are also emphasized.     

Research Integration for Psychologists: An Overview of Approaches1

This article encourages psychologists to learn about and apply nontraditional (quantitative) approaches to research integration. Various research integration approaches (literary, vote-counting, combining significance levels, and meta-analytic) are summarized. Also discussed are the advantages of meta-analytic approaches to research integration and some of the problems posed by the use of such quantitative procedures. Implications for psychology include more complete reporting of research results, integration of research in areas of interest to psychologists, and identification of research gaps.     

Effects of peer social initiations on the behavior of withdrawn preschool children

Social approach to peers was evaluated as an intervention for isolate preschoolers. During baseline, confederate peers made few social approaches to the target subjects. Confederates greatly increased their rate of social approaches during the first intervention, decreased social approaches during a second baseline, and increased social approaches again in a second intervention phase. Increases in confederate social initiations immediately increased the frequency of subjects' positive social behavior. Additionally, five of six subjects showed an increase in their own positive social initiations during intervention periods. The results suggest that: (a) peers may be programmed to increase the positive social behaviors of their isolate classmates, and (b) remediating social deficits requires assessment and intervention specifically tailored to the individual child.     

Some Thoughts on the Integration of Narrative and Humanistic/Existential Approaches to Psychotherapy

Although humanistic and narrative approaches to psychotherapy make some different assumptions about the nature of the human condition and emphasize different aspects of human functioning in their therapeutic endeavors, I argue here that the underlying assumptions of these two approaches reflect a common view of humanness, thus making these two approaches candidates for attempts at integration. Four areas of commonality are discussed in detail: (a) life as a process of continual development, (b) the nature of experience and the process of meaning creation, (c) the nature of psychological dysfunction, and (d) the nature and importance of human relationships. The implications of these commonalities for the practice of therapy from an integrated perspective are explored in an extended case example.     

Stimulus control and associative learning.

Interest in operant research on stimulus control has declined at the same time that much interest has burgeoned in nonoperant areas. Several examples of this shift toward traditional learning theory are considered, all of which have sponsored theoretical approaches that attempt to characterize the underlying associative units. These theoretical approaches are defended on the grounds that they have generated a deeper understanding of a variety of often puzzling phenomena. My projection is that future research will be determined even more strongly by theories about the structure of associations. Particular issues for which such discussion will have major impact include (1) whether conditional stimulus control is qualitatively different than simpler forms of stimulus control, (2) whether stimulus control is organized hierarchically, and (3) the origin of categories of stimulus equivalence.     

The Type A Structured Interview: A behavioral assessment in the rough

The Type A behavior pattern is the focus of considerable research in behavioral medicine because of its causal relevance to coronary heart disease. The primary assessment of Type A behavior is a global rating made from a structured interview. From the perspective of behavioral assessment, this Structured Interview (SI) is important for two reasons. First, it provides an example of the superiority of an observed behavioral measure compared to self-report questionnaires for the assessment of an overt behavior pattern. Second, it provides a unique opportunity for the application of behavioral assessment technology. However, while the SI has demonstrated its clinical and research utility as a diagnostic procedure, its usefulness could be further enhanced in the areas of treatment selection and evaluation. The historical relationship between behavior and coronary heart disease is described. The development of the SI and the strengths of this assessment relative to other measurement approaches are reviewed. The standard questions and administration procedures for the interview are presented, along with several variations and modifications. Following this overview, the SI is discussed from the perspective of behavioral assessment.     

From Spontaneous to Planned Urban Development and Quality of Life: the Case of Ho Chi Minh City

This paper studies the quality of life (QOL) that residents perceive in typical urban patterns in Ho Chi Minh City. Its major focus is to examine the improvement in the QOL through public intervention into the urban development process. There are four findings. First, moderate government intervention to correct market failures in areas where spontaneous urban development has occurred generates similar levels of satisfaction to areas with planned development. Second, urban planning is important as housing values and subjective satisfactions in planned areas are higher than those in spontaneous development areas. Third, redevelopment negatively affects the QOL in areas undergoing redevelopment. Finally, the contrast between the housing value and the subjective life satisfaction in spontaneous development areas undergoing redevelopment shows the problem of relying on the revealed preference assumption in traditional economics and the need for having alternative approaches.     

Personality and Culture: Demarcating Between the Common and the Unique

Four traditions in research on personality and culture are distinguished: (i) the culture-and-personality school and recent relativistic perspectives, (ii) the trait approach, (iii) interactionistic orientations, and (iv) situationist approaches. Next, the first two of these traditions are evaluated to ascertain how much variance is explained by culture. Thereafter, it is argued that the (questionable) focus on explanations with a high level of inclusiveness or generality is a major reason for the near absence of situationist interpretation of cross-cultural differences. Finally, three possible strategies are discussed to bridge the gap between relativism (emphasizing differences) and universalism (assuming basic similarities). A suggestion is made as to how both approaches can be valuable when unexplainable, as well as explainable variances, in cross-cultural personality research are taken seriously.     

The psychotherapy of parenthood: towards a formulation and valuation of concurrent work with parents

This paper explores the process and value of concurrent work with parents when their child is being treated in individual psychotherapy. The position taken is that psychoanalytic understanding generally and the specific formulations presented in this paper have a broader applicability in other aspects and approaches in child and adolescent mental health practice. The central issues are the interweaving of knowledge of family processes, child development and psychopathology, and the uses that can be made of an understanding of transference and countertransference. A particular formulation is presented in relation to aspects of the work that constitute ‘child guidance’ and those that may be considered as ‘psychotherapeutic’ in relation to parental psychopathology. We have coined the term ‘the psychotherapy of parenthood’ to give this work the status it deserves and to define a boundary within which to explore the areas and levels of this complex work. Some practice and training implications are considered.     

The Occipital Cortex in the Blind

ABSTRACT— Studying the brains of blind individuals provides a unique opportunity to investigate how the brain changes and adapts in response to afferent (input) and efferent (output) demands. We discuss evidence suggesting that regions of the brain normally associated with the processing of visual information undergo remarkable dynamic change in response to blindness. These neuroplastic changes implicate not only processing carried out by the remaining senses but also higher cognitive functions such as language and memory. A strong emphasis is placed on evidence obtained from advanced neuroimaging techniques that allow researchers to identify areas of human brain activity, as well as from lesion approaches (both reversible and irreversible) to address the functional relevance and role of these activated areas. A possible mechanism and conceptual framework for these physiological and behavioral changes is proposed.     

A program for assessing body image disturbance using adjustable partial image distortion

Body image disturbance has been one of the most widely studied areas in the literature on eating disorders. Some of the tasks designed to assess it have been used to estimate the sizes of specific parts of the body, whereas others have served to make estimations of overall body size. In recent years, the introduction of innovative computing procedures has allowed the two approaches to be combined and has made their application more straightforward. The program we describe here (Body Image Assessment Software, or BIAS) evaluates body image distortions and body dissatisfaction via the on-screen presentation of a scale image, the different components of which can be modified by the patient. The program was developed using Microsoft Access 2000 and Visual Basic for applications. It can be run on any computer with Windows and Microsoft Access 2000 or Microsoft Access 2000 RunTime, which makes it particularly easy to use and enables direct analysis of the recorded data through the use of applications such as SPSS.     

Assessing Threats of School Violence: Implications for Counselors

The author describes important considerations when assessing students' threats made at schools. In a recent article, M. Reddy et al. (2001) presented 4 approaches to assessing the risk of school violence. They submitted important issues and problems with 3 commonly used approaches and suggested a 4th approach as an alternative. Implications for school counselors are explored.