Winnicott's children: The holding environment and therapeutic communication in brief and non-intensive work

This paper discusses brief and non-intensive work using a Winnicottian framework for understanding the processes involved. The importance of play, communication and interpretation are considered within the careful establishment of a unique holding environment for each patient. Parallels are drawn with ordinary development and care of the infant and young child. Two clinical examples are given to illustrate these concepts. The first describes the treatment of parents and children following the accidental death of the youngest child, and the second describes time-limited work with a sexually abused and abusing teenage boy. The value of providing a range of psychoanalytic treatments to meet the range of needs of patients is discussed. The importance of conceptualizing such treatments in ways that do not imply that they are ‘diluted’ psychoanalysis is also stressed, particularly with a view to the increasing pressure on therapists to offer help to as many children as possible within limited treatment time.     

Individual needs as correlates of satisfaction and involvement with a modified Scanlon Plan company

This investigation examined individual need strengths as they relate to job satisfaction and job involvement with a company using a modified Scanlon Plan. Participants in the study were 78 production workers. The company utilized a unique management system which stressed employee participation, semi-autonomous work teams, individual pay incentives, and a plant-wide bonus system based on yearly profits. The study focused on four of H. A. Murray's (Explorations in personality, New York: Oxford Univ. Press, 1938) original needs: n Ach, n Aff, n Aut, and n Dom. Satisfaction and involvement were positively related to n Ach and n Dom, but negatively related to n Aut. Results pertaining to the n Aff scale could not be interpreted due to a low degree of internal consistency. Issues related to the internal consistency of the Manifest Needs Questionnaire (R. M. Steers & D. N. Braunstein, Journal of Vocational Behavior, 1976, 9, 251–266) are discussed along with the potential role of individual differences in understanding employee reactions to the Scanlon Plan process.     

Individual,Community, and National Resilience in Peace Time and in the Face of Terror: A Longitudinal Study

The present paper is based on thrice-repeated measures. The sample constituted 561 Jewish Israeli adults who experienced these terror attacks. The study examined individual, community and national resilience and their associations with resilience-promoting factors (sense of coherence, social support, and self-efficacy); as well as resilience-suppressing factors (distress symptoms, sense of danger, and exposure). Results indicated that resilience scores were quite stable across the three repeated measures, whereas sense of coherence, distress symptoms, sense of danger, and exposure significantly changed across the three repeated measures. Sense of coherence was the best predictor for individual, community, and national resilience.     

Self-control progressive relaxation training as an alternative nonpharmacological treatment for essential hypertension: therapeutic effects in the natural environment.

Two clients with 3 and 5$\text{1}\text{2}$ yr history of essential hypertension were successfully treated using self-control progressive relaxation training (PRT). Blood pressure was self-recorded twice daily in the natural environment by each client. The natural environment blood pressures of both clients declined during treatment and stabilized within the normotensive range. Blood pressure reductions were maintained at six months follow-up for one client and two months for the other.     

Virtual reality in the treatment of spider phobia: a controlled study

This study explored whether virtual reality (VR) exposure therapy was effective in the treatment of spider phobia. We compared a treatment condition vs. a waiting list condition in a between group design with 23 participants. Participants in the VR treatment group received an average of four one-hour exposure therapy sessions. VR exposure was effective in treating spider phobia compared to a control condition as measured with a Fear of Spiders questionnaire, a Behavioural Avoidance Test (BAT), and severity ratings made by the clinician and an independent assessor. Eighty-three percent of patients in the VR treatment group showed clinically significant improvement compared with 0% in the waiting list group, and no patients dropped out. This study shows that VR exposure can be effective in the treatment of phobias.     

More than meets the eye: a consideration of the influence of a counsellor's visual impairment upon his therapeutic relationships

Other than through personal reflection and anecdotal evidence, I have had little opportunity to explore the influence of my visual impairment upon my therapeutic relationships. In order to address this, I conducted three research conversations with former clients (participants), each of whom had expressed an interest in participating in the research. Potential participants also had to meet the inclusion criteria for the research and provide informed consent prior to their participation. Research conversations were conducted between March and July 2009 and were analysed qualitatively, using a method informed by Moustakas's heuristic inquiry. Participants demonstrated idiosyncratic responses to my visual impairment; their perception of their responses to my visual impairment sometimes differed from mine. Feelings identified included uncertainty, disappointment and relief. My visual impairment appeared to influence the therapeutic relationship in a variety of ways, including resonance with the inner world significance of disability to the participant and interaction with my personal process. While not the therapeutic agent, my visual impairment had the potential to act as a catalyst in therapeutic change. The potential for me to either under-estimate or over-estimate the significance of my visual impairment highlights the need for continued self-awareness and the maintenance of an open and non-defensive attitude.     

Teaching Jung in a theological seminary and a graduate school of religion: a response to David Tacey

In this article, in response to Professor Tacey's, I discuss the teaching of depth psychology, and of Jung in particular, in a theological seminary which is also a graduate school of religion. What distinguishes our approach to the teaching of religion at Union is the conviction that no finite theory can capture the whole truth. Our teaching in the program of Psychiatry and Religion is always part of a continuing conversation with other theorists of the unconscious. Thus we avoid the extremes of repudiation and idolization of Jung which Professor Tacey describes. Ours is less a world of disjunction than of conjunction. Resistance in my context focuses on the objectivity of psychic reality, especially the unconscious dimension. Through all of this, happily, closeness of the living psyche to religious life and thought is understood, experienced, and accepted.     

Individual response patterns and the effects of different behavioral methods in the treatment of agoraphobia

The importance of individual response patterns in agoraphobic patients was examined in the present study. Forty psychiatric outpatients with agoraphobia were assessed in individually relevant natural phobic situations. During this behavioral test their heart rates were measured continuously, and self-ratings of experienced anxiety were made at fixed intervals. On the basis of their reactions in the test situation, the patients were divided into two groups showing different response patterns—behavioral and physiological reactors. Within each group the patients were randomly assigned to one behaviorally-focused method (exposure in vivo, E) and one physiologically-focused method (applied relaxation, AR). The patients were treated individually for 12 sessions. Both treatments yielded significant improvements on most measures; 60% of the E group and 70% of the AR group patients were clinically improved after treatment. The between-group comparisons showed that both treatments did equally well both for behavioral and physiological reactors. Thus, the differential effects for these methods obtained in previous studies were not seen.     

Influence of body-centered information on the transfer of spatial learning from a virtual to a real environment

This study investigated the effects of body-centred information on the transfer of spatial learning using a wayfinding task and tasks that specifically probe the route and survey strategies of navigation. The subject learned a route in either a real or a virtual environment (VE; 3D scale model of a Bordeaux neighbourhood) and then reproduced it in the real environment. The involvement of body-based information was manipulated across the spatial learning conditions in the VE: participants learned with full body-based information (treadmill with rotation), with the translational component only (treadmill without rotation) or without body-based information (joystick). In the wayfinding task, the results showed a significant effect of the learning environment with the best scores obtained in the real and treadmill with rotation conditions. There was no significant difference between these two conditions, but the real condition was significantly different from the treadmill without rotation and joystick conditions. Also, the visual flow was sufficient to successfully perform the two egocentric tasks used as well as a direction estimation task (a survey task), in so far as there is no significant difference between the joystick and the treadmill conditions. By contrast, the distance estimates were improved by the treadmill condition including the translational component (but not the rotational component). Finally, our results show that treadmill with rotation promotes the transfer of spatial learning from a virtual to a real environment (compared to joystick and treadmill without rotation). Moreover, body-centred informations are more involved in allocentric (distance estimates) than egocentric navigational strategies.     

Client self-image,therapist acting,and the establishment of the therapeutic alliance in a training context

This study examined how clients’ self-image and perception of therapist’s behavior are related to the therapeutic alliance, as well as how these variables change in the psychotherapy process in trainee-led psychotherapy. A total of 164 participants (M = 28.9 years) who attended two semesters of treatment at the Psychology Clinic of Umeå University completed the Working Alliance Inventory (WAI) to evaluate their perception of their alliance with the therapist. They also completed two questionnaires based on the Structural Analysis of Social Behavior (SASB) model to give insight into their self-image patterns and to analyze their perceptions of the therapist’s behavior. The results show that a positive self-image and positive perceptions of the therapist’s actions increased significantly over the course of the therapy, with a corresponding decrease in negative patterns. The alliance scores show that the therapeutic alliance gains significance over time and that it is influenced more by the perception of the therapist’s behavior than by the self-image. The self-image becomes relevant after the mid part of therapy, underlining the role of the therapist in co-creating the treatment relationship. The implications of these results are discussed, and so are directions for future research in other trainee-led settings and samples.     

Reducing disruptive behavior in an urban school cafeteria: An extension of the Good Behavior Game

Non-classroom settings are often the most violence-prone areas within a school. This study investigated the impact of an interdependent group contingency on the disruptive behaviors of students in grades K-6 in an urban school cafeteria. Nine female noontime aides and National School and Community Corps staff members implemented the Lunchroom Behavior Game (LBG), a modification of the Good Behavior Game (Barrish, Saunders, & Wolf, 1969), within a multiple-baseline design across three lunch periods. Results showed a decrease in the level of disruptive behaviors following the implementation of the LBG in each lunch period and a decreasing trend for two of the three lunch periods. Discussion focuses on the use of the LBG in preventing antisocial behavior and role expansion for school psychologists interested in promoting school-based prevention strategies.     

Development of behavioural problems in children adopted from Romania to the Netherlands,after a period of deprivation

A longitudinal study was conducted among 72 Romanian adoptive children (41 boys, 31 girls) in the Netherlands, who, according to the parents and medical records, had all experienced a period of some degree of deprivation before their adoption. The children were on average 2 years and 9 months old at adoption. Parents filled out the Child Behavioural Checklist twice. On average there was little change in scores between the two measurements, and correlations were high. Some children displayed a marked improvement, or worsening of problems. The change in CBCL scores was not related to age or health on arrival into the adoptive family. Children who received special education at the first measurement (31%) improved significantly more on Total Problems than children who didn't. The same applied to professional help, the 46 children (64%) for whom professional help was engaged improved significantly more than the other 26 children. It appears to be effective to engage educational and psychological help for these (severely) deprived children at an early stage.     

The relationship of participation in school activities to abilities and interests in a high school student sample

Participation in school activities is hypothesized to be related to the multiple abilities and interests of high school students. The Ball Aptitude Battery (yielding 14 ability scores), Holland's Vocational Preference Inventory, and a biographical information blank (to obtain information about participation in 53 extracurricular activities) were administered to over 900 high school seniors of both sexes. Correlational and multiple regression analyses showed different patterns of activity participation to be related to different abilities and interests. The degree of relationship was generally low, generally higher for the males than for the females, and higher for interests than for abilities. Activity correlates of abilities differed for the sexes, but activity correlates of interests tended to be similar. This suggests that the same ability can result from differential participation in activities, but the same interest develops from similar activities.     

Participation in school environment of children and youth with disabilities: a person-oriented approach

This study investigated patterns of interrelated positive subject and environmental factors related to participation in school activities of pupils with different kinds of disabilities. Questionnaires concerning participation were collected from 472 pupils with disabilities and their teachers, parents and special education consultants. A person-oriented approach with the aim to identify patterns of variables related to a high degree of participation of pupils with disabilities was used. Cluster-groups were formed based on scores for individual subjects on factors identified as important for participation. Groups with a high degree of participation were characterized by high scores in autonomy and perceived interaction with peers and teachers and an internal locus of control. Type and degree of disability did not predict cluster group membership. A conclusion is that the outcome participation is better predicted by patterns of interrelated positive subject and environmental factors than by type of disability or any other single factor.     

Between the street and the consulting room: The role of therapeutic frame in working with homeless clients

This paper explores the context of psychotherapy with people who are homeless and the kinds of dynamics and challenges that typically arise in this work. The paper specifically considers the process of therapy as it takes place with clients who have been recurrently homeless and who have difficulties with sustaining shelter that has its roots in deficits in early containment. Clinical case material from psychotherapy conducted with two homeless men is presented and the implications of the approach adopted are explored both in relation to policies around the provision of services for homeless people and the more specific issue of psychotherapy intervention.

It is argued that a clear, well-articulated set of expectations has to be developed around this work in order to protect it and to provide it with the greatest opportunity for providing the kind of safety that is required for the development of this work. It is argued that the most important issue here relates to the provision of a consistent therapeutic framework and a care around the development of the specific psychotherapeutic frame within, and in relation to, the other frames present in the person's life.     

The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: a review of the literature

This article reviews research into the use of virtual reality in the study, assessment, and treatment of body image disturbances in eating disorders and nonclinical samples. During the last decade, virtual reality has emerged as a technology that is especially suitable not only for the assessment of body image disturbances but also for its treatment. Indeed, several virtual environment-based software systems have been developed for this purpose. Furthermore, virtual reality seems to be a good alternative to guided imagery and in vivo exposure, and is therefore very useful for studies that require exposure to life-like situations but which are difficult to conduct in the real world. Nevertheless, review highlights the lack of published controlled studies and the presence of methodological drawbacks that should be considered in future studies. This article also discusses the implications of the results obtained and proposes directions for future research.     

Congruence between personality type and environment type as a predictor of stay in an environment

Following Holland's (Making Vocational Choices: A Theory of Careers. Englewood Cliffs, N.J.: Prentice-Hall, 1973) congruence hypothesis, the independent variable in this study is the level of congruence between the personality type of the subjects and the modal personality type in their environment. This variable is hypothesized to predict the two criteria of the study—the inclination to stay and the social acceptance of 71 couples from three settlements. Results show that (a) in each settlement the modal personality type of males is not similar to the modal personality type of females; (b) the correlation between congruence level and inclination to stay in the settlement is .44 (n = 142, p < .01); and (c) the correlations between congruence level and social acceptance are low and not significant. Theoretical and practical implications of the findings are discussed.