Preventive work in a toddler group and nursery

This paper is about the sort of preventive work which can be carried out in early child care settings where incipient disturbance can be picked up and worked with promptly and effectively. It shows how toddler groups and nurseries can offer relationships and experiences which encourage mutuality and progressive development, while at the same time addressing difficulties before they have become fully internalized. It gives a detailed account of work with a single mother and her son who attended first a toddler group run by a child psychotherapist and her trainee assistant, and then a nursery where staff were in regular consultation with the child psychotherapist who also worked individually with the mother. It argues that the effectiveness of such early interventions can be conceptualized in terms of supplying maternal and paternal functioning at a time when children and parents alike are particularly needful of and responsive to this sort of help.     

An analysis of pretraining work behavior as a composition variable in group psychotherapy

Pretraining work behavior was investigated as a composition variable for group psychotherapy. The work behavior of sixty-six outpatients in nine pretraining groups was measured. Six of the pretraining groups were recomposed into either high or low work therapy groups on the basis of the pretraining scores. The other three groups entered therapy intact. Audiotapes from the first six months were analyzed to assess therapy process. Outcome measures were administered before therapy and after six months of therapy. Hypotheses concerned the effects of composition on process and outcome and the relationship between pretraining work behavior and outcome. The results suggest that pretraining work behavior has merit as a composition variable and may have promise as a selection variable. Therapeutic uses of pretraining are discussed.     

Effects of resource-building group intervention on career management and mental health in work organizations: randomized controlled field trial

A resource-building group intervention was developed to enhance career management, mental health, and job retention in work organizations. The in-company training program provided employees with better preparedness to manage their own careers. The program activities were universally implemented using an organization-level, 2-trainer model with trainers from the human resources management and occupational health services. The study was a within-organizations, randomly assigned field experimental study; it investigated the impacts of the intervention on immediate career management preparedness and later mental health and intentions to retire early. A total of 718 eligible individuals returned a questionnaire in 17 organizations and became voluntary participants. The respondents were randomly assigned to either an intervention (N = 369) or a comparison group (N = 349). Those in the intervention group were invited to group intervention workshops, whereas those in the comparison group received printed information about career and health-related issues. The 7-month follow-up results showed that the program significantly decreased depressive symptoms and intentions to retire early and increased mental resources among the group participants compared to the others. The mediation analyses demonstrated that the increase in career management preparedness as a proximal impact of the intervention mediated the longer term mental health effects. Those who benefited most from the intervention as regards their mental health were employees with elevated levels of depression or exhaustion and younger employees, implying additional benefits of a more targeted use of the intervention. The results demonstrated the benefits of the enhancement of individual-level career management and resilience resources as career and health promotion practice in work organizations.     

Termination: the hidden face of analysis

Although the question of analytic endings has been the subject of many contributions and round tables, it always presents a theoretical and clinical dilemma that remains unresolved by the search for more explicit criteria. The problem of the final phase is a post‐Freudian development which coincides historically with the emergence of studies on the countertransference, and it presupposes prior questions concerning the goals and results of analytic treatment. The following question is posed: what is the specific psychoanalytic event of the final phase? The author begins by examining the theoretical issues linked to temporality and separation, clarifying certain clinical aspects linked to the precession of the countertransference in determining the ending, before going on to illustrate a number of indicators with a clinical vignette. He proposes that the movement which develops in analysis from the transitional relationship towards the patient’s capacity to ‘stand on his own two feet’ in the clinical setting constitutes a crucial factor in the decision to embark on the process of termination. The conclusion opens out onto ethical issues, in view of the prior necessity for a movement to occur in the countertransference.     

Organizational citizenship behavior in work groups: a group norms approach

Although the relationship between unit-level organizational citizenship behavior (OCB) and unit outcomes has been well established in recent years, the conceptual development of OCB at the unit level of analysis has not been adequately addressed. In an effort to fill this conceptual gap and to spur future research, the authors apply the literature on group norms to the concept of OCB. The resulting framework suggests a cyclical relationship between individual- and group-level processes and ultimately offers an explanation for how OCB norms are established and maintained in work groups. The authors demonstrate how this framework incorporates past research on the relationship between unit-level OCB and unit outcomes and how it extends previous research by suggesting multiple directions for future efforts related to unit-level OCB.     

Integrating group psychotherapy and 12-step work: a collaborative approach

Group therapists can expect to treat an increasing number of patients who are active in a 12-step program or other addiction-related self-help groups. The value of simultaneous participation in these two modalities has been recognized; 12-step work supports abstinence necessary for the focus on emotional growth in psychotherapy. However, mere simultaneous participation in the two modalities fails to incorporate the benefits of a collaborative relationship where both modalities are used to support both abstinence and emotional growth. The conjoint approach to group and individual treatment is used to (a) argue for the possibility of a collaborative relationship between psychotherapy and a patient's 12-step work, (b) understand the benefits and challenges to collaboration, and (c) provide guidelines for how to work collaboratively with a 12-step program. Illustrations are provided of typical issues raised by this type of collaborative relationship.     

The influence of psychological flexibility on work redesign: mediated moderation of a work reorganization intervention

This quasi-experiment tested the extent to which an individual characteristic, psychological flexibility, moderated the effects of a control-enhancing work reorganization intervention in a call center. Results indicated that, compared with a control group, this intervention produced improvements in mental health and absence rates, particularly for individuals with higher levels of psychological flexibility. Findings also showed that these moderated intervention effects were mediated by job control. Specifically, the intervention enhanced perceptions of job control, and hence its outcomes, for the people who received it, especially for those who had greater psychological flexibility. Discussion highlights the benefits of understanding the processes (e.g., mediators, moderators, and mediated moderators) involved in work reorganization interventions.     

Changes in goal-related affects: Decrease burnout during a group psychotherapy intervention

The study examined the role played by changes in employees' goal-related affects in decreasing burnout during a group intervention. 62 white-collar employees, suffering from severe burnout, were randomized into 10-month group intervention programmes consisting of 16 intensive 1-day sessions every second week. The participants appraised their work and interpersonal goals according to their positive and negative affects weekly for 54 weeks. During the pre- and postintervention and follow-up (6 months later) measurements, the participants filled out a burnout measurement. The results, analysed by multilevel modelling, showed that a decrease in the negative affects and an increase in the positive affects of work and interpersonal goals during the later part of the intervention was related to a decrease in burnout symptoms. The decrease in goal-related negative affects was associated with a decrease in burnout in the postintervention measurement, whereas the increase in goal-related positive affects was related to a decrease in follow-up burnout.     

Termination of parental rights: A neglected side effect of infant intervention programs

A significant proportion of infants receiving treatment in programs designed to prevent abuse and psychosocial disorders may be removed from the custody of their parents by social service agencies. In an effort to help distinguish those cases at risk for termination of parental rights (TPR), seven such cases were analyzed and compared to seven similar cases where TPR did not occur. All 14 cases were referred because of abuse/neglect, and were at risk for continued abuse. Results showed that TPR was most likely in families where the parents were viewed as being unpleasant, as having a poor relationship with their child, were seen as retarded by the social service agency, and whose infants showed large gains in developmental level, especially during foster placement. These findings were interpreted as indicating a mixture of actual lack of progress in treatment and a negative attitudinal set about these clients.     

Professional issues in group work

This article first describes the explosion of interest in and practice of group work, with the resultant lag between the development both of standards for training and practice and of a code for ethical behavior/ practice. We used a questionnaire to fill in some gaps regarding the number of cases of unethical behavior/practice in group work and the respondents' recommendations for dealing with the problems raised both externally by the public media and internally by professional association members. The data from the questionnaire are summarized, analyzed, and made relevant to the problem of ethics for group practices. We drew conclusions from these data, from others who have addressed themselves to the problems, and from our own experiences in the group field. From these conclusions we list recommendations for alleviating the problem.     

Dancing on a razor's edge: systemic group work with batterers

This paper describes a systemic approach to working with domestic violence which does not focus upon couple therapy but rather adapts the Duluth 'co-ordinated community response' model. It proposes that this model may be understood from a systemic perspective by drawing upon the 'levels of context' ideas prevalent within systemic therapy. The paper then demonstrates the practice of group work with men who are violent to their partners from this systemic perspective. The group work undertaken with these men may be understood as 'systemic' from a number of viewpoints. These include constructing the work within a systemic context , retaining a systemic perspective in the work, and adapting various systemic methods in the group work itself. In describing this approach to work with men who have abused their women partners, the authors hope to contribute to the domestic violence literature, to the understanding of group work methods within systemic work, and to the knowledge of practitioners who need to engage and work with abusive men.     

Termination as a therapeutic intervention when treating children who have experienced multiple losses

Children who have endured traumatizing events often have a history of prior disruptions and losses which also have been experienced as traumatic. Termination of therapy with these children, therefore, provides a unique opportunity for the clinician to provide the traumatized child and his or her caregiver with a new experience of loss; one that is controlled, predictable, and paced. Through this experience, the child and caregiver can develop a new model for loss, one that permits for losses that are a natural part of healthy growth and change. This article outlines one approach to utilizing termination as an integral component of the therapeutic process with infants, toddlers, and preschoolers and their caregivers. Using a psychodynamic model and working dyadically with the child and the caregiver, termination is approached as a primary intervention, pivotal to the successful treatment of this vulnerable population.     

Understanding how groups work: a study of homogeneous peer group failures

The study examines thirty-six homogeneous peer support groups that failed to positively benefit most of the participants. Outcomes were assessed pre and one-year post using measures of mental health, marital relationships, and motherhood role indices. Four central group process characteristics previously found to be common in successful peer support groups were used as a framework for developing a series of post hoc hypotheses. The groups were found to be low on cohesiveness defined behaviorally, saliency, cognitive structures for reframing common dilemmas, and limited in the range of therapeutic experiences.     

Ladies in waiting: a group intervention for families coping with deployed soldiers

It is widely recognized that military service during wartime can take a toll on a soldier's psychological health. Recent work has revealed effects on the families left behind as well, as reflected, for example, in an increase in child abuse and neglect in these families. My interest in studying the transgenerational transmission of trauma led me to offer the National Guard a pro bono group therapy for women whose husbands had been deployed overseas. A slightly unorthodox approach paved the way not only to group treatment but, ultimately, individual treatment for these women and their children. My hope is that this work can serve as a model for other therapists who share my interest in treating the intergenerational transmission of trauma by implementing group and mother-child psychotherapy.     

Treating work inhibition in group psychotherapy

Work Inhibition, defined as an impaired ability to pursue one's career goals, may be treated by combined individual and group therapy. The author presents a method for assessing the degree of work difficulty, a psychodynamic understanding of the problem, and an approach to treatment. He proposes that helping the patient work more actively in group will generalize to the workplace and reduce inhibition. A clinical illustration is provided.     

Being transformed: Delivering a psychotherapeutic group intervention targeting repeat suicide attempts

Clients who make repeat suicide attempts have complex needs, are at high risk of completed suicide and pose a range of challenges for clinicians. Targeted interventions are required. Acceptability, the perceived appropriateness of an intervention, is associated with successful implementation, engagement and effectiveness of interventions. Despite the advantages of group interventions, there is limited research into the acceptability of groups with this population. Using Interpretative Phenomenological Analysis, this paper reports on facilitators’ experiences (n = 9) of the acceptability of a therapeutic group intervention (PISA – a Psychoeducational/psychosocial Intervention for persons who make recurrent Suicide Attempts). Analysis of focus group data revealed how involvement with the intervention profoundly influenced facilitators’ perceptions of and approach to their work with this client group. They embraced the model, developed a deeper appreciation of clients’ resources and became unburdened from sole responsibility for the clients, the therapeutic process and outcomes. PISA provided a model that helped facilitators to work in a focused, compassionate and creative manner as they addressed the central concern of these clients, their suicidal desire, with newly found confidence and eagerness. PISA was experienced as acceptable to facilitators as it was useful to them and deemed appropriate and beneficial to the target population.