From the private I to the public ear: Effective learning groups for college-age students

This paper addresses the problem of organizing and conducting groups at a college counseling center. It focuses on the importance of a therapist learning from his/her errors, of appropriately matching a client with a particular group and of preparing clients and group leaders for work with a group. The concept of boundary management is used as a way to understand group events and to make sense of group leader errors. Throughout the paper, attention is given to how best to develop groups within the unique framework of a college community.This paper was presented at Brandeis University's Conference on Psychological Work with College Students, November 6, 1982. It was written in the memory of Eugenia Hanfmann, Ph.D., who as Director of the Brandeis University Counseling Center encouraged the author to appreciate the value of learning from his errors! In writing this paper the author is grateful for the support and for the suggestions offered by his colleagues, Bruce Weiss, Ph.D., and E. Martin Schotz, M.D.     

Support groups for medical caregivers of people with HIV diseases

As we enter the second decade of AIDS, medical caregivers are experiencing stress and burnout as a result of their work with people with HIV diseases. There are common themes to the stress, as well as differences in the experience of stress according to the characteristics of the healthcare setting. Caregiver support groups are a means of reducing this stress by helping medical caregivers cope better, manage difficult cases, normalize their feelings, put understanding and context to their experiences, decrease isolation, and instill meaning in their work. The use of support groups across various medical settings is presented.The author wishes to acknowledge the assistance of Nicholas Covino, Ph.D., Peter Kassel, Psy.D., Randall Paulsen, M.D., Veronica Rempusheski, Ph.D., Dan Silverman, M.D., and Susan Burns Tisdale, R.N., in ongoing research regarding caregiver support groups. The author also wishes to express gratitude to Genya Bernstein, Psy.D., for many editorial contributions.     

Using group therapy to foster the psychosexual development of patients with eating disorders

When eating-disordered patients participate in long-term eating-dis-order groups, they move through phases of group development that parallel phases of psychosexual development. In the trust (oral) phase, members have an opportunity to experience a positive symbiosis, a suitable holding environment, and optimal frustration. In the control (anal) phase, members learn to identify and express anger constructively. In the intimacy (oedipal) phase, members learn to compete and be intimate. Individual and group movement is facilitated by the group leader being able to identify stages of group development and being able to utilize phase-related techniques.Many thanks to Anne Alonso, Ph.D., Robert Dies, Ph.D., and Geraldine Alpert, Ph.D., for their critiques of the first draft of this paper.     

Sex role orientation and marital satisfaction in dual- and one-provider couples

Scores on the Baucom scales of Masculinity (MSC) and Femininity (FMN), and on three scales from the Snyder Marital Satisfaction Inventory, were obtained from samples of dual- and one-provider couples. Data on rewards and difficulties of the dual- and one-provider lifestyles were collected by means of open-ended questions. The two groups of couples did not differ in sex role orientation or marital satisfaction. The men's levels of MSC were positively related to their marital satisfaction in both groups, and the women's levels of FMN were especially important to couples' satisfaction in the dual-provider group. In both groups, cross-sex scores (women's MSC and men's FMN) were positively related to couples' satisfaction with marital companionship.Bernadette Gray-Little, Ph.D., W. Grant Dahlstrom, Ph.D., and Elizabeth Rossman, Ph.D. are gratefully acknowledged for the guidance and support they provided to the author during this research.     

Self psychology and group therapy

This paper illustrates how the theories of Heinz Kohut elucidate the curative aspects of group treatment. Group therapy is an ideal milieu in which mirroring, idealizing and alterego transferences can be experienced and worked through. Transmuting internalizations, or psychic structure building, occur when optimal frustration of these needs can be provided by available selfobjects. In group therapy a patient can use the group-as-a-whole, the individual members as well as the leader as potential selfobjects. With the help of individual sessions to reflect on group encounters, a patient can gain a more fully integrated therapeutic experience.The author wishes to acknowledge Susan Sands, Ph.D., Jane Jordan, M.S.W., and Ruth White, Ph.D., for their help.     

Introducing the living with illness group: A specialized treatment for patients with chronic schizophrenic conditions

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.The authors would like to thank Bruce Levine, Ph.D., and Terry Fujeoko, Ph.D., for their assistance with the initial formation of the group. Mr. Howe and Dr. Fujeoko originated the Living with Illness group and began the first group in 1985 at Waterbury Hospital Health Center, Waterbury, CT.     

Sex differences in ADHD: Conference summary

Clinical samples of attention deficit hyperactivity disorder (ADHD) have been dominated by males. Consequently, female manifestations and sex differences have been relatively neglected in the extensive ADHD research. Because ADHD is so common (3% to 5% of school children) and chronic (lifelong in many cases), even a small proportion of females multiplied by such a large base means hundreds of thousands of girls and women with ADHD, a significant public health problem. An NIMH conference concluded that research is needed not only on sex differences related to ADHD, but also on manifestations of ADHD in females as such. Areas of focus should include differences in life course (sex-differential age effects); effects of hormones; effects of ADHD parenting (in utero and postnatal) on the next generation; response to and implications for design of psychosocial treatment; effects of differential comorbidity; normative background sex differences that influence the manifestation of ADHD; differences in development of verbal fluency and social behavior; possible interactions of sex and ethnicity; a prospective study of both sex offspring of ADHD adults; and such methodological issues as appropriate instruments and diagnostic thresholds, power to prevent false negatives, valid impairment measures, validity and reliability of child self-reports, and more inclusive samples (all three subtypes: inattentive, hyperactive-impulsive, and combined).The following participants in the November 16–17, 1994, NIMH Conference on Sex Differences in ADHD may be considered ghost co-authors of the contents in this summary. Special thanks are due to Euthymia Hibbs, Ph.D., co-organizer of the conference; Peter Jensen, M.D., who suggested the successful format; Delores Parron, Ph.D., who gave much helpful advice on the conference arrangements; Emily Areia, Ph.D., who thoroughly critiqued the summary; Joan Cole, who helped abstract the recorded proceedings; and Jose Bauermeister, Ph. D., F. Xavier Castellanos, M.D., Stephen Hinshaw, Ph.D., and Mark Stein, Ph.D., who helped with referencing. Other participants, in alphabetical order, included Russell Barkley, Ph.D.; Joseph Biederman, M.D.; Caryn Carlson, Ph.D.; C. Keith Conners, Ph.D.; Monique Ernst, M.D.; Miranda Gaub; Jay N. Giedd, M.D.; Michael Gordon, Ph.D.; Jeffrey Halperin, Ph. D.; Betsy Hoza, Ph.D.; Hans Huessy, M.D.; Jean King, Ph.D.; Kathleen Kiely; Rachel Klein, Ph.D.; Benjamin Lahey, Ph.D.; Jan Loney, Ph.D.; Elizabeth Lorch, Ph.D.; Spero Manson, Ph.D.; Keith McBurnett, Ph.D.; Richard Milich, Ph.D.; Douglas Novins, M.D.; Daisy Pascualvaca, Ph.D.; Linda Pfiffner, Ph.D.; Jane Steinberg, Ph.D.; James Swanson, Ph.D.; Marcus Thomeer, Ph.D.; Lillie Williams, M.D.; Alan Zametkin, M.D.The opinions expressed herein are the views of the author and conference participants and do not necessarily reflect the official position of the National Institute of Mental Health or any other part of the U.S. Department of Health and Human Services.     

Parental responses to competence and trauma in infants with reproductive casualty

This study of 31 infants in neonatal intensive care and their parents examined the relationship involving infant characteristics (medical and behavioral), parent characteristics (personality and situational variables), and the development of parental attachment. As expected, infants who were more visually competent had mothers who were more attentive. Contrary to expectation, greater prematurity was related to greater parental involvement. There were important differences in maternal and paternal responses, with mothers using more denial to cope with the medical crisis. Parents who relied heavily on denial were found to have impaired attachment.This study is based on a M. A. thesis submitted to Michigan State University by the first author under the direction of the second author. The authors are grateful for the support and assistance of Thomas Helmrath, M. D., Elizabeth Seagull, Ph.D., Dess Johnson, M.S. W., and the staff of the Regional Neonatal Intensive Care Unit at E. W. Sparrow Hospital.     

Self-help groups for the bereaved: Theory,theology, and practice

Self-help groups for the bereaved are a relatively unexplored area of wholistic ministry. The article grows out of the author's experience as an advisor to a local chapter of The Compassionate Friends, a group of parents whose children have died. The article explores the self-help concept, describes the experience of losing a child and the way the self-help process functions in that dynamic, and enumerates some roles the author has been able to fill as an aid to a local chapter. Within that framework, the article shows the affinities between self-help and ministry.Dennis Klass, Ph.D., is Chairman of the Department of Religion at Webster College in St. Louis. He is also co-author ofThey Need to Know: How to Teach Children about Death, published by Prentice-Hall in 1979.     

Medication dynamics in group psychotherapy

The use of medications in insight-oriented groups has not been adequately investigated. We report a group in which the anxiolytic buspirone appeared to be associated with attractiveness to the group in the face of impending therapists' termination. We feel that in this group, medications became a variable associated with group cohesiveness, served as a vehicle for the expression of group dynamics, and as an indicator of regression within the group. These observations suggest that, under certain circumstances, medications may become an important variable in the process and expression of group dynamics.They would like to thank Myron Pisetsky, M.D., for reading the original draft of this paper, and are also indebted to Daniel O'Neil, Ph.D., for his input.     

My Enfant Terrible is Twenty: A Discussion of Slavin's and Gentile's Retrospective Reconsideration of “Love in the Afternoon”

The following is a response to papers by Jonathan H. Slavin, Ph.D., ABPP, and Jill Gentile, Ph.D., which both discuss my 1994 paper “Love in the Afternoon: A Relational Reconsideration of Desire and Dread in the Countertransference,” almost twenty years after its original publication in Psychoanalytic Dialogues. I begin with some retrospective thoughts of my own about this controversial paper, and then respond to interpretations of the paper offered by Slavin and Gentile. I conclude with my own thoughts about their original ideas and elaborations on the subject of erotic countertransference.     

The ecological validity of laboratory and analogue assessment methods of ADHD symptoms

An important question in the attempt to generalize laboratory findings on attention deficit-hyperactivity disorder (ADHD) children to clinical issues concerning their assessment, diagnosis, outcome, and treatment response is the ecological validity of the commonly used tasks and analogue behavioral observation procedures. This paper examines the concept of ecological validity and issues inherent in its evaluation. The evidence from a variety of sources is then reviewed on the relationship between laboratory methods of assessing inattention, impulsivity, and overactivity and measures of these same constructs in natural settings. Additional findings pertaining to this issue from a recent study of 140 ADHD and normal children and 159 ADHD and normal adolescents using a multimethod battery of tests are also reported. In general, the ecological validity of most methods is of a low to moderate degree, with some traditional laboratory tasks proving unsatisfactory. A few tasks demonstrated acceptable degrees of ecological validity but even these require improvement. It is concluded that future advances in ecological validity are likely to come from: (a) a greater reliance on assessments of the target behaviors in natural settings and (b) combining several of the more promising tasks and analogue methods into a battery that is taken over longer time intervals than has been customary and averaged across repeated administrations.An earlier version of this paper was presented at the International Symposium on Attention Deficit Hyperactivity Disorder, Amsterdam, The Netherlands, April 6 and 7, 1989. The author wishes to thank Charles E. Cunningham, Ph.D., Susan Campbell, Ph.D., Mark Rapport, Ph.D., Eric Mash, Ph.D., and Herbert Quay, Ph.D., for their comments on an earlier version of this paper, and to Marcel Kinsbourne, M.D., for his comments on the presentation itself. The author was supported by funds from NIMH grants 41464, 41583, and 42181 during the preparation of this review.     

The Forgotten Faculty: Challenges for Ph.D.s in Clinical Medical School Departments

The data and discussion contained in this invited paper are based on the opening plenary by the first author whose paper titled “The Status of Ph.D.s in US Medical Schools” was presented at the 3rd national conference of the Association of Psychologists in Academic Health Centers, Minneapolis, MN, May 2007. The significant growth of the number of Ph.D.s in clinical departments is described, as is their distribution. The roles they play; the barriers they face in terms of leadership opportunities, promotion and tenure; and the concerns they voice that are specific to this population are also discussed. Salary differentials between Ph.D.s on main and medical school campuses are provided. Recommendations for future investigation of disparate treatment and for faculty development opportunities specifically aimed at this group are found at the conclusion of the paper.     

Evaluation of self-administered rational emotive therapy programs for interpersonal anxiety

Self-administered rational emotive therapy (RET), withA New Guide to Rational Living (Ellis & Harper, 1975), as the treatment manual, was evaluated by comparing three groups which varied in terms of therapist contact (therapist administered, minimal contact, self-administered). University students who volunteered for the research program involving the treatment of interpersonal anxiety were randomly assigned to one of these treatments or to a wait-list control group. The results for 72 subjects who completed the 5-week program indicated the three treatment groups made significant gains over untreated controls on some of the self-report measures. No between-group differences appeared on ratings by significant others. A four- to five-month follow-up, which obtained data from 41 (58%) of the subjects, provided some support for the maintenance of treatment effects for the therapist administered and minimal contact groups. Correlations of assessed irrational beliefs with outcome measures provided some support for the RET model.Norris D. Vestre, Ph.D., is a Professor in the Department of Psychology, Arizona State University. Terrence J. Judge, M.C., R.N.C., is a nurse therapist at Camelback Vista Treatment Center, Scottsdale, Arizona.     

Self-efficacy and depressive affect in college students

In an attempt to extend Bandura's theory of self-efficacy, we investigated the hypothesis that increases in self-efficacy, based on mastery experiences, would lead to improvements in mood and problem solving among dysphoric subjects.College students (N=79), classified as dysphoric or nondysphoric by the Beck Depression Inventory, were randomly assigned to anagram training groups that received bogus bar graphs suggesting either task ease or difficulty. Before and after training, subjects rated themselves on depressive affect (DACL) and self-efficacy. A difficult anagram task and a final DACL rating completed the procedure.Anagram training conditions did not lead to differential self-efficacy. However, multiple regression analyses showed that self-efficacy was related to depressive symptoms. Greater DACL decreases after training were seen in dysphoric subjects who reported higher posttraining self-efficacy. This improved mood is consistent with Bandura's theory. An unexpected finding among dysphoric subjects was that the higher their self-efficacy was, the lower was their final anagram performance. It appears that dysphoric/high self-efficacy subjects may have become more demoralized than dysphoric/low self-efficacy subjects when they encountered a need for much greater effort expenditure on the difficult anagram task.The findings suggest that skills training interventions which raise self-efficacy may be most effective in reducing depressive symptoms. The relevance of effort expenditure to the development of competine in depressed undiriduals appears to merit further investigation.where he served previously as Director of Clinical Psychology and as Chairperson of the Department of Psychology.Jeffrey Schwartz, Ph.D., a clinical psychologist, has been a staff member at the Cliffwood Mental Health Center in Englewood, New Jersey for the past five years. He is also engaged in private practice in New York City.Jefferson M. Fish, Ph.D., is Professor of Psychology at St. John's University in New York City, where he served previously as Director of Clinical Psychology and as Chairperson of the Department of Psychology.This paper is based on the first author's Ph.D. dissertation in Clinical Psychology at St. John's University under the direction of the second author. Both authors wish to thank Jeffrey Nevid and John Hogan for their support and contributions as committee members, and Marc Garcia for his invaluable assistance with data analysis. Requests for reprints should be addressed to the second author, Department of Psychology, St. John's University, Jamaica, New York 11439. All other correspondence should be directed to the first author at the same address.     

Revolt in the garden of eden: An alternative group model

The most common model used to highlight the significant features of a group revolt has been Freud's primal horde myth. In this essay the utility of this model will be briefly reviewed, then its most apparent limitation will be addressed. To wit, in this model the women play no active part in the revolution. On the other hand, as a model for group behavior the myth of the Garden of Eden preserves much of what is valuable in the primal horde myth, including the oedipal paradigm inherent in the revolution and, at the same time, offers a critical psychological understanding of the very active involvement women do have in groups before, during, and after the revolt. This is the main focus of this essay and will be explored in depth. Concomitant with this exploration, certain commonly observed behaviors of male group members during this critical phase of group life can also be better understood. Furthermore, the Garden of Eden myth highlights other important facets of the group revolt, and these will be noted. Finally a clinical example will be explored that vividly underscores the value of this alternative model.The author is grateful to Thomas Kohut, Ph.D., W. Donald Ross, M.D., and Walter Stone, M.D., for their valuable comments on an earlier version of this paper.     

Women who lead

Summary This essay reviews aspects of historical and cultural changes that now permit women increasing opportunities to lead both women and men. Women assuming leadership responsibilities undergo psychic reorganization, reworking their personal histories and their modes of interaction. The author challenges women who inhibit their leadership potential to scrutinize their attitudes and to consider the implications for the next generation of women. Presented at the American Academy of Psychoanalysis Seminar Series: Clinical Advances in Dynamic Psychotherapy, October 30, 1994, New York University Medical Center Chestnut Lodge Hospital in Rockville, MD. She teaches at the Washington Psychoanalytic Institute, Walter Reed Army Hospital, the Uniformed Services University of the Health Sciences and the Washington School of Psychiatry. She coordinates a Washington School of Psychiatry study group with Maurine Kelly, Ph.D., and Tybe Diamond, LCSW, “Women’s Contributions to Psychoanalysis,” where many of the ideas in this paper were discussed.