Pastoral work,metacommunication and myth

The writer discusses two phenomena the pastoral counselor encounters in work with families and individuals: family survival myths and individual survival myths or fatal statements. Family survival myths are inefficient defense mechanisms, directed at the support of the parental relationship and the maintenance of the family balance. Fatal statements are expressions inherited from the family of origin. They function as myths and are intended to help one survive. From his perspective the pastor can, through a process of metacommunication, open the possibility to discuss the myth and so help people to free themselves from an unhealthy and life inhibiting bondage.     

Pastoral care and the people of god

Various attempts in the last twenty years have sought to understand pastoral care as a function of the congregation, yet even ardent supporters have lost sight of their own vision. This article proposes that we define pastoral care as the work of the church, tie it more closely to the suffering associated with carrying out the church's mission, and develop a model of pastoral care that will differentiate everyday untrained lay pastoral care, care by clergy and trained laypersons, and pastoral psychotherapy. It offers theological rationales and draws implications for pastoral theory.Reverend Burck is Chaplain-Supervisor and Assistant Professor of Religion and Health, Rush-Presbyterian-St. Luke's Medical Center, 1753 West Congress Parkway, Chicago, Illinois 60612     

Issues in group work with older lesbians

This article outlines considerations in group interventions with older lesbians. It is intended for mental health professionals who work—as leaders, supervisors, and consultants—with various kinds of groups in their professional practice, including therapy, psychoeducational, support, growth, recreational, and self-help groups. First, unique issues in the life circumstances of older lesbians are addressed. Next, five case examples are presented that illustrate the usefulness of group interventions with this population. The article concludes with recommendations for effective practice.     

Pastoral counseling with youth

Conclusion Young people need their pastor, not only as the preacher, or as the youth group leader, or as the energetic dynamo of congregational life, but as the one to whom they can go with their personal problems. They need a representative of the adult world with whom they can share and find in such sharing an incentive for developing their own identity. The pastor is in a unique position to be such a representative since he represents also the world of the Spirit.     

Repetition increases false recollection in older people

Aging is accompanied by an increase in false alarms on recognition tasks, and these false alarms increase with repetition in older people (but not in young people). Traditionally, this increase was thought to be due to a greater use of familiarity in older people, but it was recently pointed out that false alarms also have a clear recollection component in these people. The main objective of our study is to analyze whether the expected increase in the rate of false alarms in older people due to stimulus repetition is produced by an inadequate use of familiarity, recollection, or both processes. To do so, we carried out an associative recognition experiment using pairs of words and pairs of images (faces associated with everyday contexts), in which we analyzed whether the repetition of some of the pairs increases the rate of false alarms in older people (compared to what was found in a sample of young people), and whether this increase is due to familiarity or recollection (using a remember‐know paradigm). Our results show that the increase in false alarms in older people due to repetition is produced by false recollection, calling into question both dual and single‐process models of recognition. Also, older people falsely recollect details of never studied stimuli, a clear case of perceptual illusions. These results are better explained in terms of source‐monitoring errors, mediated by people's retrieval expectations.     

Residential environment and self-directedness among older people

Research on the environmental psychology of later life has produced data and theoretical advances that have been incorporated into the design of nursing homes and housing, neighborhood planning, housing policy, and housing-related services for older people. The applications of knowledge have been particularly useful in compensating for behaviors impaired by the physical illnesses that become more prevalent with aging. Some research has also documented environmental transactions made with the intent of choosing, creating, or shaping environments that increase need fulfillment. These two directions of the transactions between the older person and the environment have been characterized as environmental docility and environmental proactivity. The need for more research on promoting opportunities for proactivity in an attempt to raise environmental quality is discussed.     

Nonbelieved memories in middle-aged and older people

Previous studies have reported that young participants typically date events that they remember, but no longer believe they experienced, to the period of childhood. The present study investigated whether participants aged between 40 and 79 years dated events related to relinquished memories to the period of childhood, as do younger people, or whether they dated such events to a period later in life. The study also compared believed and nonbelieved memories with respect to memory perspective (1st vs 3rd person perspective). Results indicated that the majority of middle-aged and older people dated nonbelieved memories to the period of childhood (median age = 8 years). No correlation was found between the participants’ current age and their age at the time the nonbelieved event occurred. In addition, results showed that believed memories were more likely to be retrieved from a 1st person perspective than were nonbelieved memories.     

Pastoral communication with the confused

Three basic kinds of strategies can aid the pastor in communicting with a confused person: (1) focusing the person's attention, (2) fostering orientation to time, place, and person, (3) finding meaning in the person's experience. Despite the logical incongruities in the communications of a confused person, on a feeling level there is a basis of reality. To persist in the effort to communicate is to care on the deepest level.     

Not too late: Fortnightly short term dynamic therapy with older people

I describe a short-term dynamic therapy of 12–14 fortnightly sessions developed whilst working in a specialist mental health service for older people. Vignettes are given of this therapy with two women suffering from long histories of depression who experienced considerable benefit. They both showed an impressive capacity to reflect on and hold the therapy in mind during the fortnightly intervals and the longer breaks. To their surprise and relief, they did not become depressed during the period of therapy. They were especially pleased to discover an unexpected resilience. Less intensive frequency of sessions with fortnightly intervals offers the advantage of not encouraging a regression in the transference and, whilst recognising the importance of difficulties in early life, can galvanise adult capacities and resources developed over a long life. Particular influences in this work are discussed in the use of play from Winnicott, as described by Smith, and the importance of reaching hopeful and positive aspects of the personality described by Music.     

Brief-time-series analysis of depressive symptomatology in older people

This research shows the utility of systematic data-gathering from older people and of a statistical analysis procedure for interpreting the data. Four cases of institutionalized older people are presented, and their scores of depressive symptomatology over a period of one to two years is analyzed. Time-series analysis showed a significant positive trend of depression symptomatology in two of the cases, perhaps too subtle for detection in routine clinical check-up, but statistically verifiable. In one of these cases, none of the factors of the scale stands out, despite the fact that the general index shows a statistically significant change over the 36 observations made, so that the results obtained are related to the syndrome of depletion or exhaustion. In the second of the cases, we detect a significant change in the depressive mood factor, which may indicate a subclinical depressive form in its initial stages. Continuous registers can reveal valuable information about situations and progress in the evolution of an older person's mood, with regard to natural development, the prelude to a mood disorder, or follow-up in clinical cases.     

The effectiveness of counselling with older people: Results of a systematic review

In 2003 the British Association for Counselling and Psychotherapy (BACP) commissioned a systematic review of the research evidence relating to counselling older people. This paper reports on some of the findings of this review, particularly those which address the effectiveness of counselling with this population. Electronic searches of the research literature spanned six databases and were supplemented by hand‐searches of reference lists and key journals, along with an extensive search of the “grey” literature. The location of papers testing interventions which fall within a definition of counselling set out by the BACP, with samples aged 50 years of age or above resulted in the inclusion of 47 relevant studies. Studies investigated a variety of mental health problems in older people, particularly depression, anxiety, dementia and the psychological impact of physical conditions such as chronic obstructive pulmonary disease. Of the 47 studies, eight tested counselling as a generic treatment, 15 tested cognitive behavioural therapy, 13 tested reminiscence therapy, and 11 tested various other specific approaches. The review concluded that counselling is efficacious with older people, particularly in the treatment of anxiety and depression and outcomes are consistent with those found in younger populations. Evidence as to the efficacy of counselling interventions in the treatment of dementia is weak.     

Spirituality,quality of life,and depression in older people with dementia

ABSTRACT

This study aimed to observe dementia’s role in the relationship between spirituality, quality of life, and depression in aging. The sample included 61 participants between 65 and 98 years old, separated into two groups: participants diagnosed with dementia (N = 31) and control participants (N = 30). There was no significant difference in spirituality between demented and control participants; however, different patterns of correlation were observed between spirituality, depression, and quality of life in these groups. Although the level of spirituality did not differ despite dementia, this pathology would appear to play a role in the relationship between spirituality, quality of life, and depression.     

Suicide among older people: projections for the future

Guided by recent demographic analyses of birth cohort effects, the authors demonstrate the relationship between cohort size and longitudinal suicide rates, with reference to four particular cohorts which have entered adulthood at various periods throughout the present century. Combining this perspective with a look at projected population increases among older age groups, estimates are made of the scope of the problem of suicide among older people which is likely to be encountered during the early decades of the next century.     

Tenure, satisfaction, and work environment flexibility of people with mental retardation

In the Theory of Work Adjustment (TWA), Dawis and Lofquist (1984) hypothesize that Employee satisfaction (ES) and flexibility of the work environment moderate the functional relationship between satisfaction in the work environment (WS) and the correspondence between job requirements and employees’ abilities. In addition, they hypothesize that tenure in a job is a joint function of ES and WS. This Person-Environment Fit framework has not been tested to support job placements of candidates with mental retardation (CMR), except for Melchiori and Church (1997), whose results partially support other aspects of the TWA. Fifty-two CMR were placed in 53 natural work settings. In total, 61 matches based on commensurate measures were made and data were collected for 16 weeks after job placement. Results show that ES is a mediator while flexibility of the work environment is not. ES and WS together contribute to predict tenure.