Therapeutic Experiences of Lesbian Couples

Abstract

This study explores the therapeutic experience of lesbian couples who had received couples psychotherapy earlier in their relationship. It examines their feelings regarding their own levels of acceptance, disclosure of sexual orientation, and connectedness with the professional providing services using qualitative methodology. The perspectives of both members of the lesbian couple were taken into account and explored. Lesbian couples who had accepted their sexual orientation appeared to have higher levels of satisfaction in their therapeutic experience and reported having an improved sense of self. Couples who had a therapist that portrayed a positive acceptance of homosexuality, low levels of heterosexism, and knowledge of issues relevant to the lesbian community reported an experience that was conducive to growth and development thus leading to an enriched relationship.     

Clinical Application of the Couple Adaptation to Traumatic Stress (CATS) Model: A Pragmatic Framework for Working With Traumatized Couples

ABSTRACT

The authors attempt to apply knowledge of traumatization to clinical practice with couple dyads. Elaborating on the Couple Adaptation to Traumatic Stress (CATS) Model (Nelson Goff & Smith, 2005), the authors have worked to bridge the gap between a general understanding of trauma's impact on the couple relationship and couples' treatment. This article facilitates the application of the CATS Model to clinical work with couples impacted by trauma. Incorporating Herman's (1997) traumatic process with the original CATS Model, the authors created a more specific, clinically useful framework for clinicians. The goal of the current article is to provide clinicians with a pragmatic illustration articulating a clinical framework for understanding and treating posttraumaumitc symptoms and processes within the couple relationship. The main implication is that clinicians will be able to conduct effectively guided systemic therapy with distressed couples necessary to generate progress in the treatment of symptomatology and couple functioning of trauma survivors and their partners.     

Developmental and Adjustment Issues of Gay, Lesbian, and Bisexual Adolescents: A Review of the Empirical Literature

Various studies have reported adjustment problems experienced by gay, lesbian, and bisexual (GLB) adolescents. A primary purpose of this paper is to critically review this literature. Difficulties that have been studied include past suicide attempts, substance use and abuse, conduct problems, and academic concerns. For example, a considerable number of GLB youth report a history of suicide attempts, with prevalence rates ranging from 11 to 42%. However, among other methodological concerns, studies in this area have not used a comparison sample of heterosexual youths. Characteristics of development particular to GLB adolescents are described, the empirical research on adjustment issues is reviewed, and potential risk and protective factors for GLB youths are discussed.     

The Couple's Mutual Identity and Reflexivity: A Systemic-Constructivist Approach to the Integration of Persons and Systems

This paper presents a systemic-constructivist approach to working therapeutically with couples. Therapeutic change is optimal when both the intrapersonal processes of each individual and their unique interpersonal system are synthesized. This approach targets partners' ways of knowing and experiencing themselves in the context of their relationship. The therapist endeavors to engage the aspect of personal identity which each partner derives through his or her participation in the relationship. Emphasis is placed upon (1) The mutual identity that emerges as a result of the couple's intersubjective, dialectical interplay; (2) each partner's ability to engage as participant–observers within their own relationship; and (3) the ability for the couple to utilize their conjoint reflexive faculty in the service of their own change. Change which arises from this combination of personal motivation and collective agency exhibits a self-generated life of its own predicated upon the couple's own expertise rather than that of an external agent.     

Outside the Box: (Post) Secular Projects of Transcendence

Secular theology builds upon the growing recognition and critique of the limitations of the confining box of religion built in and through the modern secularist dispensation. A bipolar model of religion and the secular, and the classificatory web within which it is nestled, have limited theology's field of vision and engagement. This article explores several examples of projects of transcendence that resist easy identification with either the religious or the secular, illuminating the limitations of the religion‐secular classification and the diffuse cultural trends that are reconfiguring it, even leading beyond it.     

中国人的人格特点与中国人人格量表(QZPS与QZPS-SF)的常模

该研究的目的是确定中国人人格量表(QZm与QZPS-SF)的常模,明确每一个因素的含义,为QZPS的应用做好准备。5000余名年龄在16∽55岁之间的被试构成了常模群体。将被试分为青年组(16∽25岁)、青壮年组(26∽40岁)和中年组(41∽55岁)后,比较了不同年龄、性别被试的人格特点。     

Assessing Sexual Orientation Symptoms in Obsessive-Compulsive Disorder: Development and Validation of the Sexual Orientation Obsessions and Reactions Test (SORT)

Obsessive-compulsive disorder (OCD) includes many symptom presentations, which creates unique diagnostic challenges. Fears surrounding one’s sexual orientation are common within OCD (also called SO-OCD), but SO-OCD is consistently misdiagnosed by physicians and psychologists. To address this issue, we describe the development of a self-report measure for assessing SO-OCD to help distinguish OCD from distress caused by a sexual orientation identity crisis. The current paper details two studies that established the psychometric properties and clinical utility of this measure. In Study 1, the factor structure, validity, and reliability were examined for the measure’s 12 items in a sample of 1,673 university students. The results revealed a two-factor solution for the measure (Factor 1: Transformation Fears; Factor 2: Somatic Checking) and preliminary evidence of validity and reliability. In Study 2, the measure was tested with LGBTQ and heterosexual community samples and clinical samples of individuals with SO-OCD and other types of OCD. The two-factor solution and evidence of validity and reliability were supported in these samples. Cut-off points were established to distinguish between community members and SO-OCD sufferers, as well as between those experiencing SO-OCD and other types of OCD. Limitations and future directions are discussed.     

Landscapes of Erotophobia: The Sexual(ized) Child in the Postmodern Anglophone West

The issue of ‘child sexualization’ is widely addressed in the mass media of the Anglophone West. It is a topic on which many voices, both lay and professional, pronounce upon with conviction. Almost universally the judgment is that this is a damaging and unwanted consequence of the ‘modern world’ that cannot be avoided, so that protection of ‘the child’ is the only recourse. This introduction argues that this hegemonic discourse entails unchallenged and naturalized assumptions. We identify three: the normative distinction between ‘proper’ and improper sexualization––where the former involves the staged transmission of approved knowledge from adult to child; while the latter is the consequence of a ‘free market’ in exploitative imagery and inappropriate expectations of the unprotected child in the adult world. Second, the sexually agentic child is not only missing but logically excluded. Paradoxically the very capacity essential for growing to full citizenship is denied the citizens of the future. Finally, that though ‘the child’ is deemed at risk, it is girls who are the naturalized victims within traditionally gendered framings. We develop these themes in relation to the work of the other contributors, whose work strengthens and deepens the necessary critical challenge.

Psychometric Properties of the Grief Cognitions Questionnaire (GCQ)

Cognitive behavioral conceptualizations of complicated grief propose that negative cognitions play a core role in the development and persistence of emotional problems after bereavement, because they generate negative emotions and cause mourners to engage in counterproductive attempts to avoid the implications and the pain of the loss. To facilitate the assessment of potentially problematic cognitions after bereavement, the Grief Cognitions Questionnaire (GCQ) has been developed—a 38-item questionnaire representing 9 categories of cognitions. Building on a previous study that supported the reliability and validity of the GCQ, the current study further examined its psychometric properties, with data of 531 bereaved individuals who completed research questionnaires online through the Internet. Confirmatory factor analyses supported the nine-factor structure with 9 interrelated factors. The reliability and convergent and discriminative validity were found to be adequate. Altogether the GCQ seems to be a useful tool for the assessment of negative thinking after bereavement in research and clinical practice.     

A Controlled Study of Eye Movement Desensitization and Reprocessing (EMDR) for Boys with Conduct Problem

Summary

We suggest that trauma contributes to the development and persistence of conduct problems, and should be addressed. Eye movement desensitization and reprocessing (EMDR) was selected as a promising trauma treatment. Twenty-nine boys with conduct problems in residential or day treatment were randomized into standard care or standard care plus 3 trauma-focused EMDR sessions. The EMDR group showed large and significant reduction of memory-related distress, as well as trends towards reduction of post-traumatic symptoms. The EMDR group also showed large and significant reduction ofproblem behaviors by 2-month follow-up, whereas the control group showed only slight improvement. These findings provide support for EMDR's use as a trauma treatment for boys ages 10-16, as well as support for the hypothesis that effective trauma treatment can lead to reduced conduct problems in this population.     

Comparison of Prolonged Exposure (PE) Coach to Treatment as Usual: A Case Series With Two Active Duty Soldiers

PE Coach is a mobile application (app) designed as a treatment companion to support patient and provider work during prolonged exposure (PE), a first-line treatment for posttraumatic stress disorder. Little research exists about patients’ and providers’ reactions to mobile apps in the context of psychotherapy. The present study examined PE Coach with 2 soldiers to assess usability and satisfaction with the app. Soldiers completed 8 sessions of PE and used PE Coach during 4 of those sessions. Soldiers rated the PE Coach positively and reported higher levels of satisfaction during PE with PE Coach as compared with PE alone. Authors discuss their clinical observations from using PE Coach. The soldier and provider experiences demonstrate the potential value of PE Coach in enhancing treatment engagement and support the value of future research exploring mobile computing platforms to support evidence-based treatments, in general.     

A New CBT Model of Panic Attack Treatment in Comorbid Heart Diseases (PATCHD): How to Calm an Anxious Heart and Mind

Treating anxiety comorbid with heart disease is challenging due to (a) diagnostic overlap between anxiety and heart disease, (b) the high risk associated with ignoring chest pain symptoms and delaying seeking medical attention, (c) that cognitive-behavioral therapy based on catastrophic misinterpretation of bodily symptoms requires adaption to incorporate the element of risk, and (d) that certain interoceptive symptom induction experiments may be harmful and are therefore fraught with liability. We describe Panic Attack Treatment in Comorbid Heart Diseases (PATCHD) that is based on enhancing coping skills, performing safe interoceptive exposures and supervised exercise, and countering avoidance to reduce panic attack frequency. Pre- and posttreatment data from 18 patients shows a significant reduction in cardiovascular hospital admissions and length of stay, panic attacks, general anxiety, and depression (all p < .05). Because of the complex nature of panic disorder comorbid with heart disease, health professionals should familiarize themselves with several necessary CBT adaptions.     

Measuring Experiential Avoidance: Reliability and Validity of the Dutch 9-item Acceptance and Action Questionnaire (AAQ)

Three studies evaluated psychometric properties of the Dutch version of the 9-item Acceptance and Action Questionnaire (AAQ)—a self-report measure designed to assess experiential avoidance as conceptualized in Acceptance and Commitment Therapy (ACT). Study 1, among bereaved adults, showed that a one-factor model, with AAQ-items constituting a single dimension of experiential avoidance, fitted the data well. The internal consistency and temporal stability of the AAQ were satisfactory. In Study 2, among undergraduate students, and Study 3, among 60 outpatients, higher AAQ scores were found to be significantly associated with psychopathology, maladaptive coping strategies, and neuroticism, attesting to the validity of the measure. In support of its incremental validity, Study 3 showed that the AAQ remained significantly associated with depression and anxiety after controlling for neuroticism and thought suppression. The current studies complement prior research supporting the psychometric properties of the AAQ and the ACT conceptualization of experiential avoidance.

Development of the Anxiety Change Expectancy Scale (ACES) and validation in college, community, and clinical samples

This study investigated the psychometric properties of a newly developed 20-item instrument that assesses one's anticipation of being able to change anxiety: the Anxiety Change Expectancy Scale (ACES). Study 1 evaluated the ACES in undergraduate university students, self-identified as experiencing difficulties with anxiety. Study 2 examined the ACES in a community sample of persons with anxiety difficulties. Study 3 tested the utility of the ACES in predicting treatment change in a group of individuals with generalized anxiety disorder participating in group cognitive behavioral therapy for anxiety. Across these samples, the ACES demonstrated excellent internal reliability (coefficient alphas=.89–.92) as well as good convergent, divergent, and factorial validity. The ACES was also significantly predictive of treatment-related changes in somatic anxiety symptoms and worry. The results of these studies provide strong support for the ACES as a reliable and valid measure of expectancies for changing anxiety.     

In defence of the criticism of the Defence Mechanism Test (DMT): A reply to Kragh (1998)

Kragh ( Scandinavian Journal of Psychology , 1998, 39, 123–124) criticises a recent empirical study of the Defence Mechanism Test (DMT) conducted by the present authors (Zuber & Ekehammar, 1997) concerning methodological and other shortcomings. The present paper reviews and responds to Kragh's critical points. As to the most serious criticism, the methodological, the main conclusion is that Kragh's own published empirical studies of the DMT, and also those of other researchers, can be criticised along similar lines. Furthermore, and surprisingly, in contrast to our study, Kragh's main DMT studies do not employ the DMT picture(s) at all.     

A developmental study of the Prelinguistic Auditory Store (PAS)

Lists of digits 5 and 7 items in length were presented to second graders, sixth graders, and low-IQ sixth graders in either the visual or auditory modality. Half the auditory lists were followed by the redundant nonrecalled, auditorily presented word “recall” which served as a list suffix. The second graders had the most errors in the ordered recall task followed by the low-IQ sixth- and normal sixth-graders in that order. The size of the modality and suffix effects for the various groups seemed to indicate that, for the younger subjects, a larger proportion of the recall after auditory presentation comes from the Prelinguistic Auditory Store than for the older subjects.     

"河图""洛书"与洛邑之营建及神道设教——关于"河图""洛书"的新揣测

"河图"、"洛书"最早很可能是周公决定营建洛邑的地图及占卜卜辞.而其后来不断被神化则是统治阶级为了神道设教、愚民以治的需要.     

Type indeterminacy: A model of the KT(Kahneman-Tversky)-man

In this paper, we propose to use elements of the mathematical formalism of Quantum Mechanics to capture the idea that agents’ preferences, in addition to being typically uncertain, can also be indeterminate. They are determined (i.e., realized, and not merely revealed) only when the action takes place. An agent is described by a state that is a superposition of potential types (or preferences or behaviors). This superposed state is projected (or “collapses”) onto one of the possible behaviors at the time of the interaction. In addition to the main goal of modeling uncertainty of preferences that is not due to lack of information, this formalism seems to be adequate to describe widely observed phenomena of non-commutativity in patterns of behavior. We explore some implications of our approach in a comparison between classical and type indeterminate rational choice behavior. The potential of the approach is illustrated in two examples.     

A note on the sampling properties of the Vincentizing (quantile averaging) procedure

To assess the effect of a manipulation on a response time distribution, psychologists often use Vincentizing or quantile averaging to construct group or “average” distributions. We provide a theorem characterizing the large sample properties of the averaged quantiles when the individual RT distributions all belong to the same location-scale family. We then apply the theorem to estimating parameters for the quantile-averaged distributions. From the theorem, it is shown that parameters of the group distribution can be estimated by generalized least squares. This method provides accurate estimates of standard errors of parameters and can therefore be used in formal inference. The method is benchmarked in a small simulation study against both a maximum likelihood method and an ordinary least-squares method. Generalized least squares essentially is the only method based on the averaged quantiles that is both unbiased and provides accurate estimates of parameter standard errors. It is also proved that for location-scale families, performing generalized least squares on quantile averages is formally equivalent to averaging parameter estimates from generalized least squares performed on individuals. A limitation on the method is that individual RT distributions must be members of the same location-scale family.