Mentalization‐based Therapeutic Interventions for Families

This article attempts to bridge two seemingly different and yet related worlds, the intra‐psychic and the interpersonal, by viewing systemic practice(s) through a mentalization‐based lens. It is argued that in therapy there needs to be a deliberate, conscious and consistent focus on mentalizing. The emerging mentalization‐based therapy for families is an innovative approach and a distinctive model which is systemic in essence, deriving its ideas and practices from a variety of diverse systemic approaches, yet enriching family work by adding mentalizing ingredients.     

Elucidating the psychosocial context of ‘post‐concussion syndrome’ (PCS): a case study from post‐Milan systemic family therapy

The literature on post‐concussion syndrome (PCS) following mild head injury includes biopsychosocial formulations. However, it is contended that the complexities of the psychosocial remain conceptually underdeveloped. An engagement with this complexity is presented via a case study from post‐Milan systemic family therapy. The work described is with grandparents, a mother and daughter. The latter two both initially experienced PCS following a road traffic accident, yet demonstrated contrasting outcomes in the year post‐injury. Implications for family therapy services and the wider literature are discussed.     

Family systems psychiatry in an acute in‐patient setting: the implementation and sustainability 5 years after its introduction

From 2003 to 2008 a multicentre research project, systems therapy methods in acute psychiatry (SYMPA), attempted to establish structured in‐patient treatment based on systemic interventions in German non‐university psychiatric hospitals. Utilising multi‐professional family systems training for team members in six in‐patient wards, its main goal was to improve the involvement of familial and non‐familial important others. This follow‐up study explores the sustainability of family systems psychiatry by evaluating the frequency of the utilisation of four core systemic interventions; elements of a systemic organizational culture in psychiatry; and institutional barriers to this new approach. The degree of implementation was high to moderate, depending on the intervention. More intense communication developed among staff of different professions and the status of nursing staff improved. Organizational barriers to implementation included the ambiguous role of junior doctors in teams, continuously understaffed wards and frequent over‐occupancy.     

A randomized pilot study of mindfulness‐based cognitive therapy and group cognitive‐behavioral therapy for young adults with social phobia

Piet, J., Hougaard, E., Hecksher, M. S., & Rosenberg, N. K. (2010). A randomized pilot study of mindfulness‐based cognitive therapy and group cognitive‐behavioral therapy for young adults with social phobia. Scandinavian Journal of Psychology, 51, 403–410. Twenty‐six young participants, 18–25 years, with social phobia (SP) were randomly assigned to eight 2‐hour sessions of group mindfulness‐based cognitive therapy (MBCT) and twelve 2‐hour sessions of group cognitive‐behavioral therapy (CBT) in a crossover design with participants receiving treatments in reversed order. Outcome was assessed after treatments, and at 6‐ and 12‐month follow‐ups. MBCT achieved moderate‐high pre‐post effect sizes (d = 0.78 on a composite SP measure), not significantly different from, although numerical lower than those of CBT (d = 1.15). Participants in both groups further improved in the periods following their first and second treatment until 6‐months follow‐up (pre‐follow‐up ds = 1.42 and 1.62). Thus, MBCT might be a useful, low cost treatment for SP, although, probably, less efficacious than CBT.     

Understanding Pamina's recovery: An application of the hermeneutic single‐case efficacy design

This article reports an effectiveness case study of the individual systemic therapy of a 22‐year‐old Portuguese woman with a diagnosis of paranoid personality disorder, conducted in a university‐based clinic in Lisbon, Portugal. Data were analysed using the hermeneutic single‐case efficacy design, a non‐experimental interpretive approach that aims to determine whether change occurred, whether change was due to therapeutic strategies, and what in therapy caused the change. Results indicate that the treatment was effective and that de‐pathologising Pamina's condition and genogram‐based exploration techniques played a crucial role in her recovery.     

Individual and Group Child‐Centered Play Therapy: Impact on Social‐Emotional Competencies

The authors conducted a randomized controlled trial study with 56 elementary school children to test the effectiveness of 16 sessions of individual and group child‐centered play therapy (CCPT) in improving social‐emotional assets, including self‐regulation/responsibility, social competence, and empathy. Parent reports indicated that treatment in both CCPT conditions was correlated with substantial gains in overall social‐emotional assets and in the constructs of self‐regulation/responsibility and social competence.     

Integrating Hip‐Hop Culture and Rap Music Into Social Justice Counseling With Black Males

In this article, the author suggests that Hip‐Hop culture and rap music, in particular, can be integrated into individual counseling interactions with Black male clients to discuss the social injustices (e.g., hypercriminalization) they face. Literature examining the history of Hip‐Hop culture and how rap music has been used therapeutically with Black males is presented. The article concludes with a vignette illustrating how Elligan's ( 2000 ) rap therapy framework can help explore experiences Black male clients encounter.     

Meta‐stereotypes,Social Image and Help Seeking: Dependency‐Related Meta‐stereotypes Reduce Help‐Seeking Behaviour

People who need help can be reluctant to seek it. This can be due to social image concerns. Here, we investigate if these concerns may be prompted by a salient negative meta‐stereotype: the belief that one's group is judged negatively by another group. Specifically, we researched group members' help‐seeking behaviour in the context of a dependency‐related meta‐stereotype. In a two‐condition study (N = 45), we manipulated participants' belief that their national group was judged dependent by a significant out‐group. We then examined their subsequent help‐seeking behaviour on a real‐world task. Participants whose social identity as a group member was salient showed greater reluctance to seek help when the meta‐stereotype was made prominent compared with when it was not. This suggests that, in a context where social image and social identity concerns are relevant, group members are willing to sacrifice the possibility of accessing needed help in order to avoid confirming a negative stereotype of their group. The implications of these results for helping transactions and community development are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

A review of Evidence‐Based Evaluation of Measures for Assessing Social and Emotional Well‐Being in Indigenous Australians

Addressing low levels of social and emotional well‐being (SEWB) in Indigenous communities has been a national strategic priority for over 10 years and yet progress in assessing the impact of interventions has been slow. One of the key factors limiting the development of evidence‐based practice has been the lack of well‐validated instruments to assess SEWB and how it changes over time as a result of intervention. This article systematically reviews available measures, classifying them in terms of the evidence base that exists to support their use. It is concluded that there is an ongoing need to develop psychometrically sound, comprehensive, culturally appropriate measures to operationalise Indigenous SEWB at a population health, programme evaluation, and clinical level. It is suggested that seven pathways be followed to achieve this goal, including the need to recognise that the gold standard status for Indigenous measurement tools cannot be ascribed based on evidence‐based assessment criteria alone.     

Ubiquity of Whiteness in majority group national imagination: Australian = White,but New Zealander does not

This research examined cross‐national differences in the extent to which majority ethnic group members (White Europeans) in Australia and New Zealand automatically privileged members of their ingroup, relative to Indigenous targets, in cognitive representations of nationhood. As predicted, European Australian undergraduates implicitly associated their own ethnic group with the concept of “Australian”, relative to Aboriginal Australian targets (N = 50), but the implicit preferencing of Whiteness in representations of nationhood (relative to Maori targets) was absent in a comparable sample of New Zealand European undergraduates (N = 50). These results indicate that the extent to which representations of minority groups are interwoven with non‐conscious cognitive representations of nationhood and national identity are not immutably fixed. Instead, it is argued that this cross‐national difference is due to underlying systemic differences in the extent to which symbolic markers of Indigenous culture, identity, and values are consensually represented in majority group (White) national culture.     

Nie Wieder: Group‐Based Emotions for In‐Group Wrongdoing Affect Attitudes toward Unrelated Minorities

This article focuses on the effects of group‐based emotions for in‐group wrongdoing on attitudes towards seemingly unrelated groups. Two forms of shame are distinguished from one another and from guilt and linked to positive and negative attitudes towards an unrelated minority. In Study 1 (N = 203), Germans' feelings of moral shame—arising from the belief that the in‐group's Nazi past violates an important moral value—are associated with increased support for Turks living in Germany. Image shame—arising from a threatened social image—is associated with increased social distance. In Study 2 (N = 301), Britons' emotions regarding atrocities committed by in‐group members during the war in Iraq have similar links with attitudes towards Pakistani immigrants. We extend the findings of Study 1 by demonstrating that the effects are mediated by a sense of moral obligation and observed more strongly when the unrelated group is perceived as similar to the harmed group. Guilt was unrelated to any outcome variable across both studies. Theoretical and practical implications about the nature of group‐based emotions and their potential for affecting wider intergroup relations are discussed.     

“A definite feel‐it moment”: Embodiment,externalisation and emotion during chair‐work in compassion‐focused therapy

Chair‐work is an experiential method used within compassion‐focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair‐work and is focused on clients' lived experiences of a chair‐work intervention for self‐criticism. Twelve participants with depression were interviewed following the chair‐work intervention and the resulting data were examined using interpretative phenomenological analysis. Three superordinate themes were identified: “embodiment and enactment,” “externalising the self in physical form” and “emotional intensity.” The findings suggest the importance of accessing and expressing various emotions connected with self‐criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair‐work. The findings are discussed in terms of clinical implications, emphasising how core CFT concepts and practices are facilitated by the chair‐work process.     

Systemic psychotherapy as an intervention for post‐traumatic stress responses: an introduction,theoretical rationale and overview of developments in an emerging field of interest

The purpose of this article is to critically examine the literature to provide a rationale for including systemic family therapy (SFT) in the psycho‐social treatment of people suffering the impact of post‐traumatic stress (PTS). Attention is drawn to the relatively underdeveloped academic literature on PTS and the family. The impact of PTS is conceptualized within a psycho‐social framework and the current evidence base for psycho‐social interventions for PTS responses is described, highlighting the opportunity and need to undergird this area of daily practice. The impact of PTS on the family at multiple levels is identified, emphasizing its recursive nature. The case for SFT is articulated and a range of models of family intervention for PTS briefly reviewed, concluding with an emphasis on Walsh's key processes in family resilience as a framework for practice.     

Enhancing Well‐being of Homeless Individuals by Building Group Memberships

There is growing recognition that social isolation and a lack of connectedness with social groups is one of the reasons why the subjective well‐being of homeless individuals is generally worse than the rest of the population. Past research amongst a range of populations suggests that the ability of an individual to take on new group memberships and/or their ability to maintain their memberships in meaningful groups is an important predictor of well‐being. In a mixed method study (N = 119), we examined the extent to which experiences at homeless accommodation form building blocks for the formation of multiple group memberships and to what extent this predicts positive well‐being. Qualitative analysis reveals the importance of feeling connected to the homeless service and supported by homeless accommodation staff. Linking these data to quantitative data from a second wave, we found that these experiences predicted well‐being. These findings provide further support for a strength‐based approach to homelessness, by providing insights into the ways that experiences at homeless accommodation can contribute to the development of multiple group memberships (i.e. social capital), and enhance the well‐being of those experiencing, and exiting, homelessness. Copyright © 2016 John Wiley & Sons, Ltd.     

Change process in systemic therapy: A qualitative investigation

This study addresses the process of therapeutic change in individuals who received systemic therapy. This study is an exploratory qualitative study based on the client's perceptions and therapeutic experiences. The sample included 10 clients who had completed their therapy with systemic therapists. The method used for the collection of the data was semi‐structured interviews (Change Interview; Elliott, Slatick, & Urman, 2001). The interviews were analysed using grounded theory analysis. The results showed that both specific and common factors in therapy function in a co‐occurring mode, hence suggesting a synergy effect between common factors and specific techniques or therapist factors in psychotherapy. The core category ‘experience of therapeutic change, within the secure frame of therapy, is a process of deconstructing and reconstructing the house you live in: Yourself’ emerged based on self‐exploration and self‐discovery and is then discussed in a theoretical constructivist framework. Implications for research on the issue of the process of therapeutic change are discussed.     

Changes in personality in pre‐ and post‐dialectical behaviour therapy borderline personality disorder groups: A question of self‐control

Dialectical behaviour therapy (DBT) is an evidence‐based therapy for people with borderline personality disorder (BPD). Past research has identified behavioural changes indicating improved functioning for people who undergo DBT. To date, however, there has been little research investigating the underlying mechanism of change. The present study utilised a between‐subjects design and self‐report questionnaires of Self‐Control and the five factor model of personality and drew participants from a metropolitan DBT program. We found that pre‐treatment participants were significantly lower on Self‐Control, Agreeableness and Conscientiousness when compared to both the post‐treatment assessment and the norms for each questionnaire. Neuroticism was significantly higher both before and after treatment when compared to the norms. These findings suggest that Self‐Control may play a role in both the presentation of this disorder and the effect of DBT. High levels of Neuroticism lend weight to the Linehan biosocial model of BPD development.     

Estimating Religious Populations with the Network Scale‐Up Method: A Practical Alternative to Self‐Report

Getting accurate information on religious demographics from survey‐based self‐reports presents a difficult task, suffering from the biases of social desirability, personal safety concerns, and the ambiguous definitions of religious identity. The network scale‐up method (NSUM) is an estimation strategy based on the enumeration of social network ties. NSUM has recently been employed to estimate the sizes of hidden populations in criminology and public health, but it has not been utilized in the study of religion. In this study, we argue for the advantages of NSUM in overcoming the biases associated with self‐reports and lay out a practical guide for the scholars of religion to the design and calculation of NSUM. We use a recent survey of Chinese international students to illustrate the use of NSUM and estimate the percentage of Buddhists (4.3 percent) and Christians (8.6 percent) in this population. We recommend interested scholars to adopt NSUM for its reliability, easy implementation, and the affinity between the sociological perspective on religion and the socially‐oriented assumption of NSUM.     

The Efficacy of Systemic Therapy for Childhood and Adolescent Externalizing Disorders: A Systematic Review of 47 RCT

Systemic (family) therapy is a widely used psychotherapy approach. However, most systematic efficacy reviews have focused solely on “family‐based treatment” rather than on the theoretic orientation “systemic therapy.” We systematically review trials on the efficacy of systemic therapy for the treatment of childhood and adolescent externalizing disorders. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems‐oriented therapy in various forms (family, individual, group, multi‐family group therapy) with child or adolescent index patients (0–17 years) suffering from mental disorders were identified by data base searches and cross‐references. Inclusion criteria were as follows: index patient diagnosed with a DSM‐ or ICD‐listed mental disorder, and trial published in any language up to the end of 2011. The RCTs were analyzed for their research methodology, interventions applied, and results (postintervention; follow‐up). A total of 47 trials from the United States, Europe, and China, published in English, German, and Mandarin, were identified. A total of 42 of them showed systemic therapy to be efficacious for the treatment of attention deficit hyperactivity disorders, conduct disorders, and substance use disorders. Results were stable across follow‐up periods of up to 14 years. There is a sound evidence base for the efficacy of systemic therapy for children and adolescents (and their families) diagnosed with externalizing disorders.     

Psychosocial response to COVID‐19 pandemic in India: Helpline counsellors’ experiences and perspectives

The COVID‐19 pandemic presents a threat to physical and psychosocial health of individuals. In lieu of the subsequent lockdown and containment measures, helpline counselling becomes a viable method of accessing psychosocial services during the pandemic. The present paper describes experiences of counsellors working with a special COVID‐19 counselling helpline initiated by iCALL, a national‐level technology‐assisted counselling service of the Tata Institute of Social Sciences, India, which aims to address the psychosocial impact of the pandemic and the lockdown. The paper is based on two focus group interviews held with 11 counsellors during the initial two months of the helpline's functioning. Findings of the study highlight the diverse profile of the callers, with individuals belonging to different strata of society and to marginalised communities. The nature of concerns presented by the callers were often a mix of psychological, relational and practical issues. The resultant distress emanated from an interplay of these factors with the relational contexts, their social locations and social structures the individuals were embedded in. This highlighted the need for conceptualising and responding from a psychosocial lens, whereby interventions involved traditional counselling approaches and strategies for addressing determinants of distress by connecting callers to required ground‐level resources. Counsellors’ engagement with this process impacted their professional and personal selves, necessitating the need for structured and continuous training, supervision and support. At a larger level, the counsellors’ narratives asserted the need for adopting a psychosocial paradigm for conceptualising and addressing mental health concerns in India.     

The role of epistemic and social characteristics in children’s selective trust: Three meta‐analyses

Over the last 15 years, researchers have been increasingly interested in understanding the nature and development of children’s selective trust. Three meta‐analyses were conducted on a total of 51 unique studies (88 experiments) to provide a quantitative overview of 3‐ to 6‐year‐old children’s selective trust in an informant based on the informant’s epistemic or social characteristics, and to examine the relation between age and children’s selective trust decisions. The first and second meta‐analyses found that children displayed medium‐to‐large pooled effects in favor of trusting the informant who was knowledgeable or the informant with positive social characteristics. Moderator analyses revealed that 4‐year‐olds were more likely to endorse knowledgeable informants than 3‐year‐olds. The third meta‐analysis examined cases where two informants simultaneously differed in their epistemic and social characteristics. The results revealed that 3‐year‐old children did not selectively endorse informants who were more knowledgeable but had negative social characteristics over informants who were less knowledgeable but had positive social characteristics. However, 4‐ to 6‐year‐olds consistently prioritized epistemic cues over social characteristics when deciding who to trust. Together, these meta‐analyses suggest that epistemic and social characteristics are both valuable to children when they evaluate the reliability of informants. Moreover, with age, children place greater value on epistemic characteristics when deciding whether to endorse an informant’s testimony. Implications for the development of epistemic trust and the design of studies of children’s selective trust are discussed.