Subject benchmarking,Orders in Council and European Directives

This paper describes a range of professional self-regulation and of higher education (HE) developments which form a backdrop to decisions the profession/s of psychotherapy (and counselling) may wish to take on issues around professional self-regulation. The developments described are: - the codification of ‘subjects’ and their qualifications in HE by the Quality Assurance Agency, especially ‘Subject Benchmarking’ led by ‘Subject Associations’, and the opportunities this offers, - European Directives of various sorts relating to regulated professions and the impact the relevant Directive would have if the profession was regulated, - the legislative history of professional self-regulation up to the present day and ‘Orders in Council’ made under the Health Act, 1999, and - criteria and safeguards for professions to enjoy statutory self-regulation and their implications. The paper concludes with how these developments interact and options for how the profession could respond to them including a separate Order or joining the Health Professions Council     

What Does It Mean to Be Relational? A Framework for Assessment and Practice

The authors begin with a question regarding how to better draw upon relational thinking in making case assessments and treatment plans. They first address issues regarding the cultural construction of self and relationships, integrating women's psychology, family systems, and collectivist culture literatures within a discussion of power. Then they present a heuristic framework for how individuals orient themselves within relationships that includes two dimensions--focus and power--and evolves out of the social context. From these two dimensions, a typology of four basic relational orientations is presented: position directed, rule directed, independence directed, and relationship directed. Case examples from couple's therapy and suggestions for practice are provided.     

The efficacy of systemic therapy with adult patients: a meta-content analysis of 38 randomized controlled trials

Systemic therapy is a widely used psychotherapy approach. Yet there exist few systematic reviews on its efficacy. A meta-content analysis was performed to analyze the efficacy of systemic therapy for the treatment of mental disorders in adulthood. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems oriented therapy in various settings (family, couple, individual, group, multifamily group therapy) with adult index patients suffering from mental disorders were identified by database searches and cross-references in other reviews. Inclusion criteria were: index patient diagnosed with a DSM or ICD listed mental disorder, trial published in any language up to the end of 2008. The RCTs were content analyzed according to their research methodology, interventions applied, and results. Thirty-eight trials published in English, German, Spanish, and Chinese were identified, 34 of them showing systemic therapy to be efficacious for the treatment of mood disorders, eating disorders, substance use disorders, mental and social factors related to medical conditions and physical disorders, and schizophrenia. Systemic therapy may also be efficacious for anxiety disorders. Results were stable across follow-up periods of up to 5 years. There is a sound evidence-base for the efficacy of systemic therapy for adult index patients with mental disorders in at least five diagnostic groups.     

The Effectiveness of Therapy with Couples Reporting a History of Childhood Sexual Abuse: An Exploratory Study

The purpose of this pilot study was to explore the impact of childhood sexual abuse (CSA) on couples therapy. Participants were couples seeking therapy who were screened for CSA prior to therapy. Groups were compared using self-report and therapist-rated measures of individual and relational distress. Results indicate that although therapists report significant differences between CSA couples and couples not reporting abuse at the onset of therapy, those differences do not translate into significant differences in the perceived effectiveness of therapy as measured by change scores on therapist rated levels of distress, questions regarding the effectiveness of therapy, dropout, and length of treatment.     

The multi-level approach: a road map for couples therapy

This paper presents a multi-level framework and road map to guide the therapeutic process. Starting with the couple's reactive pattern, the multi-level approach first orients the therapist on how to create a "holding environment." It then suggests how the therapist, in collaboration with the couple, can proceed to explore interactional, sociocultural/ organizational, intrapsychic, and intergenerational processes that might be fueling the couple's dynamics. Central to this approach is the construct of the vulnerability cycle, a nexus of integration that helps the therapist stay anchored while moving through the many layers of therapeutic work. The overall goal is to help the partners move from reactivity to responsibility for their own feelings and behavior; from impasse to a greater ability to reflect, express feelings, listen, negotiate, and make choices about how to be in the relationship. This paper describes a range of concepts and interventions from basic to complex; it is intended as an organizational tool for practice and clinical training.     

Disarming jealousy in couples relationships: a multidimensional approach

Jealousy is a powerful emotional force in couples' relationships. In just seconds it can turn love into rage and tenderness into acts of control, intimidation, and even suicide or murder. Yet it has been surprisingly neglected in the couples therapy field. In this paper we define jealousy broadly as a hub of contradictory feelings, thoughts, beliefs, actions, and reactions, and consider how it can range from a normative predicament to extreme obsessive manifestations. We ground jealousy in couples' basic relational tasks and utilize the construct of the vulnerability cycle to describe processes of derailment. We offer guidelines on how to contain the couple's escalation, disarm their ineffective strategies and power struggles, identify underlying vulnerabilities and yearnings, and distinguish meanings that belong to the present from those that belong to the past, or to other contexts. The goal is to facilitate relational and personal changes that can yield a better fit between the partners' expectations.     

“What do gay Asian men want?”: Desiring otherwise in the work of Richard Fung

A vast literature on queer of color critique, and increasingly on queer of color geographies, has shed greater light on how queer people of color negotiate racialized sexual economies. This paper considers how cultural geography, informed by psychoanalysis and queer of color critique, might contribute additional sophistication and critical insight to conversations about sexual racism – by not only decrying sexual racism, but by shedding light on racialized people's complex forms of psychical agency, as well as political agency, in relation to it. It turns to the work of gay Trinidadian-Canadian artist and scholar Richard Fung, whose films and essays both proffer underrepresented images of racialized queer sexual subjectivities and grapple with the ways in which queer people of color can themselves become enlisted in racial-sexual hierarchies. Providing geographical and historical context for Toronto's stratified racial and sexual politics as they play out in ordinary life, I point to moments in which Fung's films both decry such inequality and meditate on alternatives that detour from dramas of mis/recognition by whiteness.     

Negotiated nonmonogamy and male couples

One issue that has the potential to confound family or couples therapists working with male couples is the issue of nonmonogamy. For many therapists, sexual nonexclusivity challenges fundamental clinical assumptions that "affairs," or extra-relationship sex or romantic involvements, are symptoms of troubled relationships and are always a form of "sexual acting out." This article explores the issue of sexual exclusivity and nonexclusivity within male couples. In order to achieve both clinical and cultural competency in work with male couples, therapists need to challenge their cultural biases regarding monogamy.     

Facilitating relational empowerment in couple therapy

Couples in distressed relationships often get caught up in power struggles, "Power Over" interactions that are informed by both neurobiology (e.g., the fight-flight reaction) and by cultural assumptions (e.g., competition, individualism, and patriarchy). This article seeks to widen the discourse about power by highlighting "Power To" and "Power With." Power To includes the ability to self-regulate, to read and manage one's own emotions, and to have voice while respecting the other's voice. Power With reflects the couple's commitment to conurture the relationship through empathy, respect, and generosity. Power To and Power With are proposed to constitute relational empowerment, the ability to navigate one's inner world and the interpersonal realm. The neurobiology of both couples' reactivity and relational empowerment are considered. Techniques are offered to facilitate Power To and Power With, interventions that interrupt couples' cycles of reactivity and allow them to make more thoughtful choices. Emotion regulation and empathy are particularly important skills of relational empowerment, and examples are offered to increase these capacities in couple therapy. The therapeutic perspective offered in this article challenges cultural practices and assumptions that keep intimate partners polarized in power struggles, and explores how relational empowerment can foster an egalitarian, mutually respectful relationship.     

Vulvar pain: a phenomenological study of couples in search of effective diagnosis and treatment

Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of ... the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships.     

L’accueil en santé mentale,si on en parlait ! Une revue de littérature

ObjectiveThis narrative literature review aims to present the studies on the concept of welcome in the field of health. The concept of reception remains difficult to define by healthcare professionals and their beneficiaries. This is a fruitful concept but whose outlines are still poorly defined. This paper aims to identify the intrinsic dimensions of reception?MethodA narrative synthesizes systematic reviews was conducted using 4 search engines: PubMed, PsychINFO, Cairn and Science Direct. A total of 17 publications was selected.ResultsSeven dimensions of the welcome have emerged: (1) relational approach; (2) singular and iterative process; (3) conditions of the reception; (4) risks of the encounter; (5) personal qualities of healthcare professionals; (6) gestures at the reception; (7) needs of people welcomed. These results highlight the importance of integrating these dimensions within an integrative model.ConclusionIt appears that reception must be perceived as a complex iterative process enroll in a relational approach. The major issues to the establishment of a sufficiently good welcome are to be perceive in a reflexive attitude for all the protagonists.     

A confusion of tongues between psychoanalysis and philosophy: Is the controversy over drive versus relational theory a philosophical one?

In recent years the controversy over Drive versus Relational models of the psyche has become entangled in a philosophical controversy over epistemology. Some have argued that the Drive model was a relic of an age of positivistic science, while Relational models are a product of a postmodern condition. This paper argues that the controversy need not be a philosophical one, and that Relational views are not, in fact, a product of postmodernism, nor are they necessarily dependent on a postmodern epistemology. Separating the epistemological from the psychological more carefully may help return the debate to its proper, psychoanalytic domain, and perhaps contribute to a more fruitful dialogue across what, at times, seems like an abyss between Relational views and Drive theory.     

CBT and Behavioural Medicine: On Definitions,Applications and Practical Considerations

Abstract

In the late seventies, behavioural medicine was conceptualized as a promising area for the application of cognitive-behaviour therapy (CBT) to medical problems. Although many studies have been published in which CBT has been applied to somatic conditions, they do not always call it behavioural medicine. It is uncertain if the term “behavioural medicine” is the most appropriate to use in the future; its impact on medicine and psychology can be questioned. However, in this paper it is concluded that CBT has great potential in the treatment of somatic conditions. In addition, practical considerations when applying CBT in multidisciplinary somatic team situations are discussed. A combined “scientist-practitioner” role is seen as especially promising for the introduction of CBT in a context wider than isolated research studies.     

Parental Marital Quality and Well-Being,Parent-Child Relational Quality,and Chinese Adolescent Adjustment

The linkages between parents’ report of marital quality and parental well-being and children’s report ofparent-child relational quality and adolescent psychological well-being in 378 Chinese families over 2 years were examined. Results revealed that (a) marital quality predicted parental well-being; (b) fathers’ marital quality and well-being predicted parent-child relational quality but mothers’ did not; (c) paternal influence appeared to be stronger than maternal influence on adolescent adjustment; and (d) both direct and indirect paths were found for the linkages between parental marital quality and well-being and adolescent psychological well-being.     

内隐关系评估程序(IRAP)：测量原理及应用

内隐关系评估程序(Implicit Relational Assessment Procedure, 简称IRAP)是基于关系结构理论直接测量社会认知、信念或态度的新内隐测量方法, 具备一定的可靠性和有效性, 并与其它相关测量方法的适用性存在一定差异。不同的理论模型为IRAP的不同效应提供了解释。IRAP最初应用于临床诊断性研究, 新近已扩展到自我、社会认知、群体和态度等研究领域。进一步验证不同形式IRAP的信效度、探究IRAP的心理机制及产生的心理效应、在不同领域发挥IRAP的方法优势等将是未来研究的重要方向。