Psychoanalytically Based Treatment for Traumatized Children and Families

A psychoanalytic orientation provides an important perspective for developing community-based prevention and intervention programs for traumatized children and their families. In New Orleans, the Violence Intervention Program for Children and Families is designed to reduce the risk of exposure to violence, mental health problems following exposure, interference with normal developmental progression, academic performance, family functioning, onset of behavioral and conduct disturbances, later psychopathology, and subsequent violence. The program includes an unusual focus on work with police officers as first responders to increase their sensitivity and responsiveness to traumatized children. A psychoanalytic perspective helps a therapist or interventionist understand a person's strengths and weaknesses, frustrations, and conflicts as well as those within a chaotic environment and social situation. The psychoanalytic approach allows for more effective therapeutic approaches as well as more flexible problem-solving strategies.     

Group process in short-term outpatient therapy groups for schizophrenics

The short form of the group climate questionnaire (GCQ-S) was used to evaluate process in three 12-session therapy groups for outpatient schizophrenics. Results showed no difference on the Engaged dimension between the short-term schizophrenic groups and either a normative sample of outpatient neurotic groups or the first 26 sessions of a long-term outpatient schizophrenic group. However, the short-term groups scored significantly lower (p<.001) on the Avoiding and Conflict dimensions as compared with either long-term sample. The session-to-session GCQ-S dimension pattern did not support the presence of sequential group stages, but there was a tendency for the Engaged scores to increase and the Avoiding and Conflict scores to decrease as time went on.The authors gratefully acknowledge K. Roy MacKenzie, M.D., and Don Brown, M.D., for their helpful comments regarding this paper. Parts of this paper were presented in a poster session at the American Group Psychotherapy Association Annual Meeting in New York, February 8–12, 1988.     

Applying the Concept of Gender: Unsettled Questions

In commenting on Susan Bordo's discussion of gender bias, 1 both support and build on her contention that women's exclusion from philosophical discourse has been epistemologically and politically significant. But I also explore difficulties associated with applying the concept of gender and I voice concern about how to characterize the perspectives we share as women. Finally, I consider some theoretical and political limitations of utilizing gender as an analytical category.     

Methodological issues in short-term motor memory research

Four methodological issues identified and studied by short-term motor memory researchers were examined in this paper: (a) the distributions of three commonly used measures of error (AE, CE, and VE); (b) statistical analysis of these scores as dependent measures in an experiment; (c) within-cell and experiment-wise estimates of the reliability of CE; and (d) the power of the statistical test with CE as the dependent measure. The first two sub-problems were explored theoretically, while the latter two were subjected to empirical examination using four data sets from previously published experiments. The distributions of AE and VE scores were described as non-normal under certain conditions, while the CE score distribution was shown to be normal. Therefore analyses of these three dependent measures may require different statistical procedures. In light of this information, the assumptions affecting estimates of reliability and power in an experimental framework were examined. Based on an analysis of the four data sets, a strategy was proposed in which a relatively small number of subjects could be utilized in an experiment without sacrificing desired experimental controls.     

Some ethical issues in feminist-oriented therapeutic groups for women

Review of the origins of group psychotherapy reveals concerns with social as well as with personal "psychopathology." Thus, group processes have been mobilized for curative or change purposes for ideological as well as individual therapeutic goals. Psychopolitical as well as personal change are the goals for some groups. The ethical problem stems from a persistent assumption that the group's processes are inherently benign and curative and beneficial to individual participants. A more sophisticated understanding takes into account their essential neutrality and their potential use (or abuse) for purposes of ideological persuasion that may or may not be personally therapeutic. As in other ethically implicated issues in the psychotherapies, the question becomes one of treatment versus exploitation, or therapy for the individual versus recruitment on behalf of a cause.     

Cohesion and outcome in short-term psychodynamic groups for complicated grief

This study used two measures of cohesion for the process analysis of 12 short-term, time-limited groups for complicated grief. The measures had similar theoretical definitions but differed in terms of rater source (member vs. observer), measurement score (mean of items vs. global rating), and rating unit (individual vs. group). We examined the relationship between the measures, assessed the development of cohesion over the life of the group, and evaluated each measure's relationship to outcome. A principal components analysis with each measure yielded one cohesion component, which supported a unidimensional model; however, the two cohesion components were independent of each other, which supported a multidimensional model. Repeated measures analyses indicated that observer-rated cohesion developed in a quadratic manner (v pattern) across sessions, while member-rated cohesion developed in a linear manner. The object focus (the group, other members, the therapist) of the members' ratings determined whether cohesion increased or decreased across sessions. No significant relationships between cohesion and outcome were identified. Implications of the findings for the understanding of group cohesion are considered.     

Treatment contracts in long-term groups with alcoholic outpatients: A group case study

This paper describes the process of treatment contracting in a long-term group with alcoholic outpatients — relating the contracting process to the dynamics of the group and to the total treatment context. The material presented highlights the ways in which the contracting process (in particular, grappling with the issue of who should set the terms of the contract) may serve as a model for helping group members better understand and cope with problems in assertiueness and limit setting.     

Brief mother–infant treatment: Psychoanalytically informed video feedback

Specific patterns of interactive regulation documented by microanalytic methods of infant research can be applied to clinical interventions with mothers and infants. A brief treatment model is described that includes face‐to‐face split‐screen videotaping (one camera on each partner) and therapeutic observation of the videotape with the parent. The intervention uses “video feedback” informed by a psychoanalytic approach, including positive reinforcement, modeling, and information giving, as well as interpretation, while watching the videotape. Specific interactions in the areas of attention, arousal, affect, and timing regulation are evaluated. The psychoanalytic intervention links the “story” of the presenting complaints, the “story” seen in the videotape, and the “story” of the parent's own upbringing. An attempt is made to identify specific representations of the baby that may interfere with the parents's ability to observe and process the nonverbal interaction. The mother's powerful experience of watching herself and her baby interact, and our joint attempts to translate the action‐sequences into words, facilitates the mother's ability to “see” and to “remember,” stimulating a rapid integration of the mother's procedural and declarative modes of information‐processing. One treatment case, involving six contacts, is presented to illustrate the approach. By applying the specificity of interactive regulation identified by microanalysis of videotape into the psychodynamic treatment of mother–infant pairs, basic research can be translated into clinical practice. ©2003 Michigan Association for Infant Mental Health.     

Emergent themes and roles in short-term loss groups

Clinical observations regarding themes and roles that are characteristic of short-term, psychoanalytically oriented therapy groups for loss patients are presented. They reflect aspects of both the therapy and the patients. Themes refer to the content of a recurrent conflict in the group. They include trust, survivor guilt, mortality, and termination. Roles refer to a set of patient behaviors that represent a shared conflict. They include the apparition, monk, professor, professional nurturer, emotional conductor, and cruise director. Challenges that the themes and roles present to the therapist and clinical guidelines for addressing them are offered. Awareness of characteristic themes and roles and possible therapist responses are regarded as important parts of the preparation and training of therapists who plan to conduct short-term loss groups.     

Control groups in psychosocial intervention research: ethical and methodological issues

This article summarizes a National Institute of Mental Health (NIMH) workshop that was convened to address the ethical and methodological issues that arise when conducting controlled psychosocial interventions research and introduces 6 thoughtful and inspiring papers presented by workshop participants. These papers, on topics ranging from informed consent to ethnic minority issues, reflect the depth and breadth of expertise represented by the multidisciplinary group of scientists and ethicists present at the meeting. More extensive follow-up, particularly from federal research applications and publications, of how investigators balance the need for strong research design with ethical considerations may help advance the science of psychosocial intervention research.     

The cotherapy relationship: Special issues and problems in aids therapy groups

This paper examines the special issues and problems in the co-leadership relationship which arise in ongoing AIDS therapy and support groups. A brief review is given outlining some of the advantages and disadvantages of the coleader model. Specific attention is then paid to the issues/themes of physical deterioration of members, disfigurement, frequent absences, and members dying. Four particular patterns of interaction that develop between cotherapists are identified, illustrated, and discussed.The author thanks the Group Services staff and volunteer therapists for their contributions to this article.     

Psychologists' ethical responsibilities in Internet-based groups: issues, strategies, and a call for dialogue

How can psychologists participate ethically as facilitators, advisers, and peer members in Internet-based groups? The astonishing growth of Internet technology and on-line groups has outpaced the development of formal ethical guidelines for psychologists involved in on-line groups. This article provides an initial appraisal of psychologists' ethical responsibilities in discussion, support, and self-help groups that operate on the Internet and offers practical strategies for avoiding ethical problems. By presenting initial strategies and guidelines for ethical behavior in Internet-based groups, the authors hope to stimulate the field to further discuss and analyze these issues.