Contemporary issues with stuttering: The Fourth Croatia Stuttering Symposium

PurposeDuring the 2019 Fourth Croatia Clinical Symposium, speech-language pathologists (SLPs), scholars, and researchers from 29 countries discussed speech-language pathology and psychological practices for the management of early and persistent stuttering. This paper documents what those at the Symposium considered to be the key contemporary clinical issues for early and persistent stuttering.MethodsThe authors prepared a written record of the discussion of Symposium topics, taking care to ensure that the content of the Symposium was faithfully reproduced in written form.ResultsSeven contemporary issues for our field emerged from the Symposium.ConclusionEffective early intervention is fundamental to proper health care for the disorder. However, as yet, there is no consensus about the timing of early intervention and how it should be managed. Currently, clinical translation is a barrier to evidence-based practice with early stuttering, and proactive strategies were suggested for junior SLPs. Apprehension emerged among some discussants that treatment of early stuttering may cause anxiety. For persistent stuttering, assessment procedures were recommended, as were strategies for dealing with childhood bullying. There was agreement that SLPs are the ideal professionals to provide basic cognitive-behavior therapy for clients with persistent stuttering. Questions were raised about our discipline standards for basic professional preparation programs for stuttering management.     

Symposium Introduction: Reflexivity in Life Designing Interventions

This article introduces the Symposium on Reflexivity in Life Design Interventions. Eight articles report studies of counseling processes and client operations during life design interventions as well as client feedback during subsequent Interpersonal Process Recall interviews. The Symposium concludes with comments on and discussion of the studies.     

Rational consensual procedure: Argumentation or weighted averaging?

The following is a defense of Jurgen Habermas' argumentational consensual procedure against Keith Lehrer and Carl Wagner's weighted averaging consensual procedure (and, I tentatively claim, against any weighted averaging consensual procedure). The argument is twofold: if Lehrer and Wagner intend, implicity, to replace what is for Habermas the metatheoretical stage of a discussion with the aggregation of judgments of respect, then their procedure fails to make use of all available information and the participants are not committed to the weighted average position on these grounds; if, on the other hand, they do not intend to replace metatheoretical discussion by aggregation, then the conditions under which the discussion could conceivably have come to a halt are such as to provide no support for the claim that it is rational to aggregate, rather than to consider the discussion unresolved until more information is available.An earlier and abbreviated draft of this paper was read at the 10th Annual International Wittgenstein Symposium, August 1985, in Kirchberg, Austria.     

Normal crises: Stage theory and family therapy

Abstract

The theme of the Twenty-Third Georgetown University Symposium on Family Theory and Family Psychotherapy, held November 8 and 9,1986, in Washington, DC, was Toward a Science of Human Behavior. The program included famed sociobiologist Edward O. Wilson as the Distinguished Guest Lecturer; a special panel discussion about what is involved in moving toward a science of human behavior; a presentation by Murray Bowen, Director of the Georgetown University Family Center; a presentation by Walter Toman, who is well-known for his research on sibling position; and 10 other presentations related to various aspects of family systems theory and therapy.     

SYMPOSIUM: LOCKE AND THE VEIL OF PERCEPTION Preface

Abstract: This Symposium comprises five papers on Locke's theory of sense perception. The authors are John Rogers, Gideon Yaffe, Lex Newman, Tom Lennon, and Martha Bolton. There are also comments on the papers, both individually and as a group, by Vere Chappell. In addition to Locke's view of perception, the papers deal with the nature of Lockean ideas and with the question whether Locke is committed to skepticism regarding the external world. The authors (and the commentator) disagree in their readings of Locke on these issues, but most maintain – and some argue – that he holds a representative theory of perception, and that he is not an external‐world skeptic.     

Acts of betrayal. Reading the letters of Wilhelm Stekel to Sigmund Freud

Abstract

This paper presents a discussion of the previously unpublished correspondence between Stekel and Freud. The authors start with a brief overview of most important historic events and facts that constitute the context against which these letters should be read. The matters cover questions of publishing policy, personal priorities, and psychoanalytic principles. The authors suggest that the Stekel letters may have been preserved by Freud as evidence of the latter's estrangement from him, as tokens of betrayal. A minute discussion of the correspondence makes it possible to discuss day-to-day developments in this fateful relation, taking into account Stekel's side of the story for the first time as well, highlighting the backfiring of a strategic maneuver by Stekel to psychoanalyse the Freud family, which heralded his downfall, and also revealing the role that Victor Tausk played in this. The paper concludes with a discussion of the dialectics of estrangement.     

The influence of group discussion on performance judgments: rating accuracy, contrast effects, and halo

The authors investigated the effect of group discussion, such as may occur formally in panel interview scenarios, assessment centers, or 360-degree feedback situations, on judgments of performance. Research on group polarization suggests that the effect of group discussion combined with raters' preexisting impressions of ratees or interviewees should result in an extremitization of impressions. Thus, the authors hypothesized that group discussion would (a) make ratings less accurate, (b) polarize impressions that were already good or poor as reflected by greater contrast effects, and (c) increase positive halo. Results indicated that group discussion resulted in less accurate ratings and greater contrast effects. Additional analyses suggested that group discussion increased positive halo. The authors discuss implications for research on group or panel judgments.     

Spiritual Assessment in Counseling: Methods and Practice

Given the widely expanding professional and empirical support for integrating spirituality into counseling, the authors present a practical discussion for raising counselors' general awareness and skill in the critical area of spiritual assessment. A discussion of rationale, measurement, and clinical practice is provided along with case examples. D. R. Hodge's (2001) spiritual life map is highlighted as an assessment tool. The authors also discuss the influence of counselor–client values and beliefs in therapy and the need to incorporate developmental and cultural influences in spiritual assessment.     

Intrapsychic factors influencing career aspirations in college women

A 300-item questionnaire designed to assess the relationship and relative importance of several factors for women's career aspirations was answered by 169 female college juniors and seniors. Regression analyses showed that women with high career aspirations were satisfied with their lives; confident of their career plans; willing to postpone marriage; nontraditional in their values and behaviors; generally external in orientation, believing that discrimination is responsible for many of women's failures and that organized pressure rather than individual action is necessary to combat this discrimination; certain that women's demands for equality are justified and that most men agree with them; likely to have had a working mother who was perceived as being dissatisfied with her own life; and if planning to marry soon, endorsing dual role compatability. When all variables were considered simultaneously, attitudinal factors were found to best predict career aspirations, while socialization variables were relatively unimportant.This study was supported by funds from the University of California, Los Angeles, Personality and Social Psychology Training Grant, USPHS 1 T 1 MH 11, 696. The authors wish to express their thanks to the Women's Studies Program at UCLA for its continued cooperation. Also deserving of recognition for their help with early phases of this study are Cathy Connor, Jomary Hilliard, Paula Johnson, Karen Paige, Andrea Tyree, and Gail Zellman. Portions of this paper were presented at the University of California, Los Angeles, Symposium on Sex Roles and Sex Differences, Los Angeles, 1972.     

Section II Group Therapy for Children in Latency

A variety of intrinsic and extrinsic factors exert pressure on clinicians and researchers to forge a more effective alliance in their mutual efforts to understand treatment process and outcome. The authors provide a general framework and a specific group-therapy model to demonstrate how research measures can facilitate this integration and thereby improve the quality of service delivery. We divide treatment into four phases: negotiation, retention, enhancement, and evaluation, and illustrate how psychotherapists can use research instruments to overcome problems at each stage of intervention.     

Group Pacing: A Developmental Eclectic Approach to Group Work

The authors examine a new approach to conducting group work, which is referred to as “developmental eclecticism.” Using Loevinger's (1976) theory of ego development as a guiding force in their counseling practice, the authors present a discussion that reflects various strategies implemented in working with a group of adults in a community mental health center setting.     

The personal myth: A re‐evaluation

This paper presents a re‐evaluation of Kris's personal myth. The notion has been used rather sparingly despite the Delphi Symposium in 1984 on the question of its clinical usefulness. After framing the notion of myth, some difficulties related to the question are identified. A clinical vignette exemplifies some of the ambiguities in its definition but stresses its clinical relevance. A discussion expands on these situations so as to propose three various aspects of personal myths to account for the two variants identified by Kris. The actualization of the underlying fantasy in the character organization is a third form and the technical aspect associated with it is reviewed from a new perspective. The family romance is revisited to reassess its role as the basis of the personal myth in the face of studies favouring an earlier development of the myth.     

Behavioral family therapy symposium

Abstract

The Albert Einstein College of Medicine/Montefiore Medical Center (AECOM/MMC) Department of Psychiatry and the Gralnick Foundation/ High Point Hospital jointly sponsored the Second Annual Einstein Symposium on November 7, 1985 commemorating the centennial year of Yeshiva University. The symposium, focusing on Behavioral Family Therapy, opened with the presentation of the Einstein Award for Research in Psychiatry to B. F. Skinner by Herman van Praag, Chairman of the Department of Psychiatry. After Skinner's discussion of the role of emotions in behavior analysis, several nationally renowned clinical researchers in the field of behavioral family therapy presented findings of their recent work.     

FLEXING THE FRAME: CONTEMPLATING THE USE OF MULTIPLE PORTS OF ENTRY IN PARENT–INFANT PSYCHOTHERAPY

Multirelational interventions are well described in the psychoanalytic parent–infant literature. Daniel Stern (1995) originally suggested and described five “ports of entry” that may be employed to access the multiperson parent–infant clinical system. Other authors have elaborated and extended Stern's original list of ports of entry. The impact of using multiple ports of entry on the psychoanalytic frame, however, is largely neglected in the parent–infant psychotherapy literature. Danielle Quinodoz's (1992) four facets of the psychoanalytic setting are used to structure a discussion of how the multiplicities associated with parent–infant psychotherapy may impact the frame. The article argues strongly for a necessary flexing of the psychoanalytic frame to establish therapeutic alliances. A fifth facet, that of psychoanalytic mindfulness, is offered as a counterbalance to the risks associated with excessive flexing of the frame, particularly in relation to Quinodoz's fourth facet of “refraining from ‘doing.’” This article relies on case material to illustrate the issues under discussion. Further engagement and debate are invited.     

Love Troubles: Human Attachment and Biomedical Enhancements

In fascinating recent work, Julian Savulescu and his various co‐authors argue that human love is one of the things we can improve upon using biomedical enhancements. Is that so? This article first notes that Savulescu and his co‐authors mainly treat love as a means to various other goods. Love, however, is widely regarded as an intrinsic good. To investigate whether enhancements can produce the distinctive intrinsic good of love, this article does three things. Drawing on Philip Pettit's recent discussion of ‘robustly demanding goods’, it asks what exactly we intrinsically desire in seeking love; it considers four possible outcomes involving attachment‐enhancements and attachments; and it considers two different pieces of news we might receive about our lovers' attachment to us (that it is, or that it is not, sustained with the help of enhancement‐technologies). Enhancement‐sustained attachment, it is concluded, is less desirable than the intrinsic good of love.     

Case study: Analysis of a traumatized hemophiliac boy

The author presents a case study of a hemophiliac boy in four‐times‐a‐week analysis from the age of four to six and a half years. An extensive narrative of various phases of the analysis including the termination provides the reader access to the material for discussion of therapeutic action. Her analytic technique is based on a developmental point of view and illustrates the use of limits, play, and interpretation based on countertransference. She understands the boy's symptoms of preferring to be a girl, asking to cut his penis off, and wishing to die as defenses against the fear of castration, which in his case is aggravated by the actual threat of repeated medical interventions, and by the underlying fear of a lack of body composition. An unusual feature of the case is the illustration of the symptom, the analysis, and the recovery of the male self, captured in a complex collage that was made over the course of the relatively short analysis.     

Long-term effects of educational and peer discussion group interventions on adjustment to breast cancer.

The authors report a 3-year follow-up of the effects of 8-week support group interventions on the quality of life of women with early stage breast cancer. Shortly after diagnosis, women were randomly assigned to 1 of 4 conditions: control, education, peer discussion, and education plus peer discussion. The education group intervention focused on providing information to enhance control over the illness experience, whereas the peer discussion group intervention focused on providing emotional support through the expression of feelings. Consistent with the results that emerged 6 months after the interventions (V. S. Helgeson, S. Cohen, R. Schulz, & J. Yasko, 1999), the authors found that the benefits of the education intervention were maintained over a 3-year period (N=252), although effects dissipated with time. The authors continued to find no benefits of the peer discussion intervention, either alone or in combination with education.     

The Norton Dome and the Nineteenth Century Foundations of Determinism

The recent discovery of an indeterministic system in classical mechanics, the Norton dome, has shown that answering the question whether classical mechanics is deterministic can be a complicated matter. In this paper I show that indeterministic systems similar to the Norton dome were already known in the nineteenth century: I discuss four nineteenth century authors who wrote about such systems, namely Poisson, Duhamel, Boussinesq and Bertrand. However, I argue that their discussion of such systems was very different from the contemporary discussion about the Norton dome, because physicists in the nineteenth century conceived of determinism in essentially different ways: whereas in the contemporary literature on determinism in classical physics, determinism is usually taken to be a property of the equations of physics, in the nineteenth century determinism was primarily taken to be a presupposition of theories in physics, and as such it was not necessarily affected by the possible existence of systems such as the Norton dome.