Fatal violence – from trauma to offence: A case study in forensic psychotherapy and trauma therapy with a migrant patient

Abstract

That persons who are objects of violence and traumatisation become offenders themselves is a typical feature of ill-fated cycles of violence in countries torn by fierce political, ethnic, and religious conflicts. Some refugees and migrants with this background present a challenge to forensic psychotherapy when they continue such patterns of physical force and criminal behaviour in a host country like Germany, and are found to be either not responsible or of diminished responsibility for their criminal acts by reason of mental disorders or addictions. Their offences create a critical legal situation for them, since they are threatened with deportation. At the same time, their clinical condition is critical, for they were possibly subjected to traumatic experiences by authorities in their past; their cooperation in the treatment can seriously affect their legal status. Finding a way out of these complications has to take these special factors into account. Our paper focuses on the case study of a refugee from North Africa, illustrating a model of cooperation in forensic inpatient treatment, special trauma therapy (narrative exposure therapy), and expert testimony.     

Counsellors’ and psychologists’ experience of working with male survivors of sexual trauma: a pilot study

A qualitative study was undertaken to enhance awareness of the therapeutic needs of the male survivor of sexual trauma through exploration of counsellors’ and psychologists’ experience of working with this client group. The participants were 32 counsellors and psychologists who work for an NHS Trust department. Interpretative Phenomenological Analysis was used to analyse the data which was gathered by means of a postal questionnaire. Six categories emerged from the analysis that highlighted prevalent experience. These were: (a) that the therapist's gender was important, (b) professional concerns, (c) the importance of the relationship, (d) transference/counter transference, (e) that male and female abusive experiences are the same and (f) attention to client's presenting problems. The main conclusions derived from these results and implications for practice are considered.     

Vivid memories of distant trauma: Examining the characteristics of trauma memories and the relationship with the centrality of event and posttraumatic stress 26 years after trauma

In the present study, we investigated the phenomenological characteristics of distant trauma memories and the relationship between the vividness of trauma memories, the centrality of event and symptoms of posttraumatic stress in two groups with different types of trauma exposure, namely survivors and bereaved, from the fire on the passenger ferry, Scandinavian Star, 26 years earlier. More than two decades after the fire, the traumatic event was represented as a vivid, emotional recollection for many of the victims. For both the survivors and the bereaved, a higher degree of vividness of trauma memories and centrality of the event were associated with higher levels of posttraumatic stress. The present findings show that even very distant trauma memories can be represented as vivid recollections. Furthermore, the findings suggest that both vividness of trauma memories and event centrality may contribute to explain how posttraumatic stress reactions can remain present over a very long time.     

Parent–child interaction therapy (PCIT) in young children with autism spectrum disorder

Abstract

Parent–child interaction therapy (PCIT) is an evidence-based treatment for typically developing children with disruptive behavior. We conducted a randomized-controlled trial of PCIT versus wait-list control (WLC) with 23 children with ASD (3–7?years) and disruptive behavior. Over 16 treatment sessions, PCIT significantly predicted reductions in disruptive behavior over WLC and explained a significant variation in scores on the ECBI Intensity subscale. Additionally, parent skills improved significantly compared to WLC. However, no statistically significant group differences were found on child compliance rates, autism severity, or parental stress. Results support PCIT as an evidence-based treatment for disruptive behavior in ASD.

• Highlights

• Parent skills were significantly improved for those receiving PCIT

• Intensity of disruptive behaviors decreased significantly for those receiving PCIT

• Parental stress and autism severity did not significantly decrease with PCIT

     

“Hunting with a knife and … fork”: Examining central coherence in autism,attention deficit/hyperactivity disorder,and typical development with a linguistic task

A local processing bias, referred to as “weak central coherence,” has been postulated to underlie key aspects of autism spectrum disorder (ASD). Little research has examined whether individual differences in this cognitive style can be found in typical development, independent of intelligence, and how local processing relates to executive control. We present a brief and easy-to-administer test of coherence requiring global sentence completions. We report results from three studies assessing (a) 176 typically developing (TD) 8- to 25-year-olds, (b) individuals with ASD and matched controls, and (c) matched groups with ASD or attention deficit/hyperactivity disorder (ADHD). The results suggest that the Sentence Completion Task can reveal individual differences in cognitive style unrelated to IQ in typical development, that most (but not all) people with ASD show weak coherence on this task, and that performance is not related to inhibitory control. The Sentence Completion Task was found to be a useful test instrument, capable of tapping local processing bias in a range of populations.     

“Subordination” and sensitivity to nonverbal cues: A study of married working women

Sex Roles - Women's superiority in decoding nonverbal cues of emotion has often been discussed as an adaptation to low status. To examine the relation of status to nonverbal sensitivity,...     

“That was so mean :D” – Playful virtual violence and the pleasure of transgressing intersecting emotional spaces

This paper explores how virtual violence in computer games is used to enact the pleasure of transgression. It draws on theories of violence, virtuality, play, and space, combining them with an ethnographic perspective on pleasure as enacted emotional experience. I will analyze communicative emotional practices, observed in gaming videos on YouTube as well as during participant observation in online multiplayer games and in qualitative interviews, to come to a better understanding of the emotional experiences enacted when players transgress feeling rules within intersecting emotional spaces between games and everyday life.     

Binding “what” and “where” in auditory working memory: An asymmetrical association between sound identity and sound location

Contrasting results in visual and auditory working memory studies suggest that the mechanisms of association between location and identity of stimuli depend on the sensory modality of the input. In this auditory study, we tested whether the association of two features both encoded in the “what” stream is different from the association between a “what” and a “where” feature. In an old–new recognition task, blindfolded participants were presented with sequences of sounds varying in timbre, pitch and location. They were required to judge if either the timbre, pitch or location of a single-probe stimulus was identical or different to the timbre, pitch or location of one of the sounds of the previous sequence. Only variations in one of the three features were relevant for the task, whereas the other two features could vary, with task-irrelevant changes. Results showed that task-irrelevant variations in the “what” features (either timbre or pitch) caused an impaired recognition of sound location and in the other task-relevant “what” feature, whereas changes in sound location did not affect the recognition of either one of the “what” features. We conclude that the identity of sounds is incidentally processed even when not required by the task, whereas sound location is not maintained when task irrelevant.     

Family therapy and a “good” society: Fit or misfit?

Contextual therapy is compared with a good society based on socialist principles of equality, planning and sociality. The two models are analyzed across dimensions of justice, connectedness, change, and basic human resource for similarities and differences.     

Are families supported to come to terms with an autism diagnosis? A service evaluation of referrals to family therapy for young people with autism in one NHS trust

Young people with autism are increasingly being referred for family therapy (FT) owing to impaired family functioning, but few studies have investigated the support families receive following a diagnosis through specific NHS Trusts. This study examined (1) the proportion of autism cases referred for FT in one Trust and (2) the post-diagnostic support families received. Participants (n = 144; 9.5–19.3 years) were FT referrals between 2019–2020. Autism diagnostic status and the support families received from FT, from the neurodevelopmental (ND) service which specialises in autism, and for co-occurring conditions [e.g., cognitive behavioural therapy (CBT)] was extracted retrospectively from routine data. Forty FT referrals met autism criteria: several families did not receive FT; few were provided with support from the ND service; and if CBT was offered, no adaptations for autism were noted. Families received insufficient support following a diagnosis through this Trust. Implications include improving post-diagnostic support for families in practice.     

Internal state of emergency – working with an international student suffering from trauma in a student counselling service

In this paper I look at the suicidal state of mind of an international student who comes from a country at war and has been traumatized by a violent event. The student is tortured by an internal dilemma surrounding unbearable feelings of guilt and shame that arise when she leaves her home country to study abroad. Her dilemma or survivor guilt triggers an internal contract with herself, whereby she is internally persecuted when she makes an attachment to the university and her course. I suggest that an individual in this state of mind, suffering from post-traumatic stress, has regressed to a primary state of unintegration where the self is at the mercy of psychotic anxieties and the student is at risk of suicide. It is suggested that a safety net made up of the student services and the wider health service can provide a symbolic or mental space and containment for the student's state of mind until she can function as a student.     

Family therapy and systemic practice with older people: where are we now?

Older people are becoming an increasingly significant group as demographic and cultural change impacts on their roles within the family and society. In this article we consider how family therapy and systemic practice with older people has developed over the past ten years from the early foundations identified by Richardson et al . in 1994. Although older people face particular challenges, themes such as social constructionism, attachment and narrative, familiar to therapists working with people earlier in the life cycle, have also been influential in work in this field. These developments have resulted in increasing recognition of the relevance of systemic practice in older people's services, but significant challenges remain.     

A review of: “interacting stories: Narratives,family beliefs,and therapy”

Rudi Dallos (1997) Interacting Stories: Narratives, Family Beliefs, and Therapy, London: Karnac Books, $18.95     

“Working with Couples: Satir and the Tao,”

SUMMARY

One of Virginia Satir's greatest gifts to the world was the use of herself as an instrument of healing. By daring to use all of her-self-body, mind and spirit-the connections Virginia made with others were warm and real. Besides being authentically caring, Satir worked out of a pluralistic and comprehensive theoretical base to individualize each intervention. By co-creating strong, trusting relationships she inspirited others with her own life-force energy, and enabled them to become more fully human. Able to put her own ego needs aside, Virginia modeled how to join common sense with a sense of high purpose.     

‘Un-certainty’: working therapeutically with a transgender young person and learning to bear the unknown

Abstract

The rate of referrals to mental health services for children and young people for whom gender dysphoria is the identified clinical issue has increased significantly over the last ten years. Debates around the classifications of gender identity disorder, gender dysphoria or gender incongruence, as well as the involvement of child and adolescent mental health services with this group of children and young people seem to be re-enacting the societal gender binary world view where we see acceptance versus rejection, open-mindedness versus conservative, trans-phobic thinking. In this paper the author will attempt to shed some light on the work with these young people in a clinical setting by reflecting on a year of therapeutic work with a female to male young person. Through the therapist’s reflections upon these binary preconceptions, along with the use of developmental and object relations theory, an in-depth account of the work is given. It is suggested that in some cases the therapist’s capacity to bear the unknown, while gradually observing and mirroring the un-integrated inner self of the patient, can gradually bring the fragments together, even if not in a perfect fit, and that this in turn provides a sense of relief.     

Australian speech-language pathologists’ experiences and perceptions of working with children who stutter: A qualitative study

PurposeEffective early intervention is recommended to ameliorate the potential long term negative effects of stuttering. Efficacious treatments are available, but speech-language pathologists (SLPs) report finding implementation to be challenging due to a range of clinician, client and clinical context factors. Previous survey-based research has found that SLPs lack self-efficacy working with CWS, however the reasons contributing to this are not well understood. This study presents the first in-depth analysis of the current practices and perceptions of SLPs working with children who stutter (CWS).MethodsIn this qualitative study 18 Australian SLPs who provide services to CWS were interviewed using a semi-structured interview approach. Data were analysed using reflexive thematic analysis.ResultsThe thematic analysis identified four themes: (1) A stronger sense of self-efficacy is needed in stuttering management compared to other areas of clinical practice; 2) SLPs’ sense of self-efficacy in stuttering management is influenced by early career experiences, client factors and the practice context; 3) Professional development and collaboration strengthen self-efficacy; and 4) Parental involvement and engagement are crucial to treatment success.ConclusionSLP self-efficacy for working with CWS appears a critical factor in the provision of effective management for this population. This study provides an in-depth analysis of the role of SLP self-efficacy and the factors that influence it.