Why did she put nail polish in my drink? Applying the Therapeutic Assessment model with an African American foster child in a community mental health setting

Although the majority of research on Therapeutic Assessment (TA) discusses the application of TA in research or private practice settings, we found that the model could be applied in a community mental health setting. We argue that when implementing this model with racially diverse, low socioeconomic status children, it is essential to integrate issues of class, privilege, and race into the assessment process. A case is presented that illuminates the specific concerns and struggles of adapting this model to a community psychology population. This analysis includes the interface with systems, placement stability, and consideration of culturally responsible treatment. We also demonstrate how the support of a treatment team helps the individual clinician process and integrate the levels of trauma and pain with which these families present.     

Interaction of therapeutic process and alliance during psychological assessment

Utilizing a collaborative therapeutic assessment (TA) model proposed by Finn and Tonsager (1997), we examined the interaction between therapeutic alliance and in-session process during the assessment phase of treatment. This study compares the utility of the TA model (n = 38) versus a traditional information gathering model (n = 90) of assessment. The results of this study indicate that the use of a TA model may decrease the number of patients who terminate treatment against medical advice. The Session Evaluation Questionnaire (Stiles & Snow, 1984), Combined Alliance Short Form (Hatcher & Barends, 1996), and Penn Helping Alliance Questionnaire-Revised (Barber & Crits-Christoph, 1996) can reliably measure the patient's experience of the assessment. The psychological assessment process may impact the patient's experience of assessment feedback and aid in the development of a therapeutic alliance. The therapeutic alliance developed during the assessment was found to be related to alliance early in psychotherapy. We discuss the theoretical, clinical, and research implications of these findings.     

The Incubator Treatment Development Model: The SAFETY Treatment for Suicidal/Self-Harming Youth

Youths who make suicide attempts or engage in repetitive self-harm are at risk for future suicide attempts and death by suicide or self-harm. This treatment development report focuses on the Safe Alternatives for Teens and Youth (SAFETY) treatment. SAFETY is a 12-week outpatient child and family-centered cognitive-behavioral treatment, informed by dialectical-behavior therapy, and designed to promote safety following a suicide attempt or repeated episodes of self-harm. Previous reports have described results of small open and randomized treatment development trials. Here, we describe our “incubator” treatment development model. Combining scientific rigor with attention to the community context in which treatment is delivered, the incubator model emphasizes laboratory-based treatment development trials and quantitative and qualitative data generated through partnerships with community treatment sites and youth and parent consumers of care. Aims of this approach are to: (1) integrate information from our partners throughout the treatment development process; (2) create a more feasible and easily transportable “youth” and “family” centered treatment; and (3) accelerate the pace with which laboratory-based treatment advances can be incorporated into improvements in community care. We describe our incubator treatment development model and how data generated through our treatment development process and interactions between the laboratory and community teams contributed to the development of the SAFETY treatment.     

Applying a Process-Oriented Model of Cultural Competence to Behavioral Activation for Depression

Efforts to integrate cultural competence and evidence-based treatments (EBTs) typically take the form of cultural adaptations of EBTs, characterized by modifications to the existing treatment based on presumed cultural notions of a given race or ethnic group. Much less attention has been given to ways EBTs can integrate a process model of cultural competence, which focuses on what clinicians do in-session to identify and integrate key cultural factors for a given individual in the treatment. Our objective is to consider how a process model of cultural competence (Shifting Cultural Lenses) can be integrated with an EBT (Behavioral Activation). We present a theoretical rationale for integrating the SCL model with BA and illustrate this integration, which provides an additional approach to bringing culture to treatments and shows promise for identifying clinicians’ in-session behaviors that reflect cultural competence.     

A Short-Term,Family-Oriented,Child and Adolescent Psychiatric Inpatient Treatment Program

We describe a short-term inpatient treatment program whose purpose is to integrate the different interventions in the child, his or her family, and the outpatient professional network. The interaction between the family and the ward is the basic structural element of child psychiatric inpatient treatment. The child, the family, the professional outpatient network, and the ward community together form an extended therapeutic system. Inpatient treatment can be understood as a coevolving process between these systems. The essential feature in our working model is the continuous, daily nursing staff supervision and a focus on interactions in the extended therapeutic system.     

Understanding community re-entry of former prisoners with mental illness: a conceptual model to guide new research

Criminal justice, mental health, and social service professionals face a myriad of role expectations in working with prisoners with mental illness to facilitate community re-entry. These expectations include those related to law enforcement, social welfare, and administrative efficiency. The challenge for front line workers and the multiple systems that employ them is to integrate all these expectations effectively on behalf of the individual as well as the community. Current models of re-entry for individuals leaving prison with mental illness focus on the management and interaction of service systems. This paper presents a model of prisoner re-entry that incorporates a larger social context, illustrating dynamics related to both individuals with mental illness leaving prison and their interaction with the community setting. This model was generated through an interdisciplinary team effort. It was refined through a focus group process that included advocates, community members and other informants from mental health and criminal justice systems in five states. The model is designed to generate new questions for research that address both individual and community level issues.     

Appraisal of Emotions in Media Use: Toward a Process Model of Meta-Emotion and Emotion Regulation

Over the past 20 years, research on meta-emotion and related concepts such as meta-mood and need for affect has become fruitful and prominent across a variety of disciplines, including media psychology. This paper reviews the literature on meta-emotion and considers problems regarding the definition and operationalization of this construct. We propose a process model of meta-emotion and emotion regulation to integrate and extend existing work. Drawing on appraisal theories of emotion, we understand meta-emotion as a process that monitors and appraises emotions and recruits affective responses toward them, which results in a motivation to maintain and approach emotions, or to control and avoid them. This meta-emotion process plays an important role in media users' selection or rejection of specific media offerings and their invitation to experience emotion. We discuss how this framework may integrate previously unrelated findings on the role of emotions in guiding selective media use and conclude with directions for further research.     

Évaluation thérapeutique et obligation de soins

This article presents an application of therapeutic assessment in a mandatory treatment setting. Assessment has been traditionally considered as specially important in this setting. Following previous works (Chudzik & Aschieri, 2013) about the therapeutic relationship in this setting, we show that TA is useful to avoid some common pitfalls and make a real psychotherapeutic process possible. We consider the specificity of each step of TA in this setting and we illustrate it by a clinical case.     

Capturing Changes in Social Identities over Time and How They Become Part of the Self‐concept

How people come to develop a feeling of belongingness to a new social group and orchestrate this new group membership with pre‐existing identities within the self‐concept is a theoretically and socially relevant phenomenon that has received increased scientific attention in recent years. Models from different fields of psychology – including social, cultural, and organizational psychology – have proposed factors involved in this change and integration process along with consequences of this phenomenon. We present overview of this literature, including a recent model on the process of identity integration: the cognitive‐developmental model of social identity integration. Specifically, this model highlights the fundamental cognitive and developmental processes involved as people develop new social identifications and integrate their different identities into their overall self‐concept. We then present recent empirical evidence testing the model. Finally, we propose conceptual, methodological, and statistical avenues for future research on identity change and integration.     

Therapeutic assessment case study: treatment of a woman diagnosed with metastatic cancer and attachment trauma

This article presents a Therapeutic Assessment (TA) case study of a woman recovering from 4 years of intense medical treatment for stage IV cancer. The inclusion and utility of using the Adult Attachment Projective Picture System (AAP) in the TA is highlighted. The client's attachment classification as unresolved helped identify that her current experiences with dissociation and problems restructuring her life following cancer remission were related to severe childhood sexual abuse, which she had suppressed for decades. The AAP also provided information regarding the unconscious defensive processes the client employed to cope with attachment distress and her inability to find comfort and support from others. These findings were instrumental in guiding the subsequent psychotherapy. The TA process, particularly the assessor-client relationship, facilitated an experience of containing her previously unintegrated and dysregulated affect. A single-case experiment using daily measurements suggested that participation in TA coincided with symptomatic improvements in multiple domains. These improvements were maintained during 4 months of biweekly psychotherapy after the completion of the TA. This case illustrates the applicability of the TA model in health care settings, demonstrates the usefulness of the AAP in the context of TA, and provides empirical support for the effectiveness of the TA model in initiating symptom improvement.     

如何建立聊天机器人与用户间的数字治疗联盟：关系线索的作用

近年来,研究者们将“治疗联盟”(Therapeutic Alliance,TA)的概念与在线自助干预(Internet-based Self-help Interventions,ISIs)相结合,以解决ISIs中用户参与度较低的问题。这种在数字环境中形成的TA,被称之为“数字治疗联盟”(Digital Therapeutic Alliance, DTA)。随着人工智能的迅速发展,聊天机器人可模拟人类指导,相对于传统ISIs程序更易于与用户建立关系,可通过友好、尊重、倾听、鼓励、真诚、理解、信任这几个关系线索来促进DTA的发展,为解决用户低参与度的问题提供了一种新思路。未来的研究可从影响因素、ISIs技术迭代、测量规范、实验操纵等方面对DTA作进一步的探索。     

A History of Women and Feminist Perspectives in Community Psychology

Using an historical framework, we document and assess efforts to include women, women's issues, and feminism in community psychology and in the Society for Community Research and Action (SCRA). Initiatives of the SCRA Task Force/Committee on Women are traced from its inception to present. We also chronicle the dilemmas and difficulties of moving toward a feminist community psychology. The history is divided into five phases. Each phase is described in terms of women's involvement in the field and efforts to integrate feminist content into research and practice of the field. Reflections on the qualities of contexts that have both supported and inhibited inclusion are identified. We look to this history to try to understand the observation that while women have been increasingly visible in leadership roles and women's professional development has been encouraged, less progress has been made toward building a feminist community psychology.     

Therapeutic Assessment With Children: Intervening With Parents “Behind the Mirror”

All the steps in the model of therapeutic assessment used with children (TA–C) are designed to involve and impact the child's parents. However, a distinctive process that parallels and accompanies the testing sessions with the child might be the most significant in helping parents shift their story of their child and family. In this process, parents are invited to observe their child's testing sessions (in an adjacent room through a live video feed, through a 1-way mirror, or in the corner of the testing room) and process the experience with the assessor (either simultaneously in the case of the 2-assessor model or after the fact in the 1-assessor model). We discuss the development and evolution of what we have come to call the “behind the mirror” method. We describe the therapeutic intent of the method and delineate 13 techniques utilized to enlist parents as active collaborators. We illustrate each technique using the case study of a 10-year-old boy where the 2-assessor model and live video feed method were used. We also provide research findings from the case study that address the parents’ experience of the assessment and their changed view of their child.     

Community treatment for the seriously mentally ill: Is this community psychology?

Community treatment for seriously mentally ill individuals fits well into the philosophy of community psychology. Community psychologists have skills and experiences with other populations that represent assets in improving the ACT service model and producing richer and more useful research results for the future. Maybe we should ask ourselves why community psychologists have obviously avoided this intervention area and the population of seriously mentally ill individuals. Does this represent an adolescent reaction to the parent discipline — clinical psychology? Is the label “mentally ill” as stigmatizing to community psychologists as it is to the general population? Are these individuals written off as not worthy of or capable of benefiting from preventive interventions? Advocates for the seriously mentally ill are mounting a backlash against prevention services. We would be well advised at this time to become involved in community treatment and demonstrate that community psychology is forall vulnerable and at-risk population groups. If the truth of the matter is that “community psychology is not doing much of a job of empowering people” (Berkowitz, 1990), maybe the truth of the matter is also that we need to reach out to more disenfranchised populations with research to show that community psychologycan do the job of empowering some.     

Using a Training-of-Trainers Approach and Proactive Technical Assistance to Bring Evidence Based Programs to Scale: An Operationalization of the Interactive Systems Framework’s Support System

Bringing evidence based programs to scale was a major initial impetus for the development of the Interactive Systems Framework for Dissemination and Implementation (ISF). The ISF demonstrates the importance of the Support System in facilitating the uptake of innovations in the community (the Delivery System). Two strategies that members of the Support System commonly use are training‐of‐trainers (TOT) models and technical assistance (TA). In this article, we focus on the role of the Support System in bringing evidence‐based programs (EBPs) to scale in the Delivery System using a case example, with special attention on two strategies employed by Support Systems—training‐of‐trainers (TOT) and proactive technical assistance. We then report on findings from a case example from the Promoting Science Based Approaches to Teen Pregnancy Prevention project that furthers our conceptualization of these strategies and the evidence base for them. We also report on the limitations in the literature regarding research on TOTs and proactive TA and provide suggestions for future research on TOTs and proactive TA that will enhance the science and practice of support in the ISF. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Impact Challenges in Community Science-with-Practice: Lessons from PROSPER on Transformative Practitioner-Scientist Partnerships and Prevention Infrastructure Development

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.     

Ecclesiological Research and Natural and Human Sciences: Some Observations of an Unconventional Phenomenon

This article is motivated by the absence of published material dealing with the rapprochement between ecclesiology and the sciences. It presupposes that there is a need to broaden the scope of ecclesiological research in order to integrate into it theories and methods from the social and natural sciences. Ecclesiological research in this wider sense has as its object, church, as a broad concept. The article suggests a threefold aspect for ecclesiology, conceiving it as the ecclesiology of the researcher, and the ecclesiology of both the object and of the result of the research. Furthermore, its purpose is to identify transparent ecclesiological theories which are able to engage with and integrate scientific theories and methods. An inventory of examples of modes of collaboration used between ecclesiology and different sciences is then offered as an illustration of the context in which ecclesiology may integrate or relate to science in different ways. Finally, the article concludes that there is a need for further clarificatory research into the possibilities which exist for ecclesiology to be made more fully the science of being Christian in community or church.     

Recruitment and Retention of Low‐SES Ethnic Minority Couples in Intervention Research at the Transition to Parenthood

Low‐SES couples have limited resources to manage the chronic and acute stressors with which they are disproportionately faced. Although these couples are at greater risk for negative individual and relationship outcomes, evaluations of the impact of couple relationship education (CRE) in low‐SES couples have been plagued by methodological problems, most notably challenges associated with recruitment and retention. We review the literature on challenges couples face associated with low‐SES, as well as on recruitment, retention, and CRE in low‐SES, ethnic minority populations. We illustrate some of these challenges in a case study of CRE for low‐SES couples transitioning to parenthood. In this pilot study, 21 couples were recruited from a community health clinic and randomized to either an experimental treatment condition (EXP; N = 11) or a treatment‐as‐usual control condition (TAU; N = 10). This study sought to mitigate documented challenges with recruitment and retention: We leveraged community partnerships, attempted to build and maintain strong relationships with study participants, provided incentives for assessments as well as intervention meetings, and attempted to reduce potential barriers to enrollment and retention. Nonetheless, we had low rates of recruitment and retention. We integrate these findings and experiences with our review of previous work in this area. We make recommendations for future CRE research and practice that have potential implications for public policy in this area.     

Feminist Approaches to Social Science: Epistemological and Methodological Tenets

This paper is a primer for community psychologists on feminist research. Much like the field of community psychology, feminist scholarship is defined by its values and process. Informed by the political ideologies of the 1970s women's movement (liberal, radical, socialist feminism, and womanism), feminist scholars reinterpreted classic concepts in philosophy of science to create feminist epistemologies and methodologies. Feminist epistemologies, such as feminist empiricism, standpoint theory, and postmodernism, recognize women's lived experiences as legitimate sources of knowledge. Feminist methodologies attempt to eradicate sexist bias in research and find ways to capture women's voices that are consistent with feminist ideals. Practically, the process of feminist research is characterized by four primary features: (1) expanding methodologies to include both quantitative and qualitative methods, (2) connecting women for group-level data collection, (3) reducing the hierarchical relationship between researchers and their participants to facilitate trust and disclosure, and (4) recognizing and reflecting upon the emotionality of women's lives. Recommendations for how community psychologists can integrate feminist scholarship into their practice are discussed.