Reply by Edward S. Casey

Stigma and discrimination against mental illness represent chronic social stressors that can inflame psychiatric symptoms and limit functional adjustment. The implication is that the prevalence and severity of mental illness is determined, at least to a certain extent, by aversive socio-cultural factors. In a hostile social environment, these factors may seriously limit the effectiveness of professional interventions; whereas, removing social barriers to functioning often results in a favorable clinical outcome. For example, studies show that inclusive settings with supportive employment decrease psychiatric symptoms and the use of mental health services. By extrapolation, these results point to the possibility that a society-wide reduction in the prevalence and severity of mental illness may come from benevolent changes in the social climate, not just from innovative treatments. Public health policies rarely take this possibility into consideration in resource allocation decisions.     

Interpersonal Psychoanalysis: The Selected Papers of Clara M. Thompson Edited by Maurice Green

The aging process presents a challenge to the narcissism of the individual due to physical, social, and psychological changes and losses. There is a danger that mental health professionals may add to narcissistic trauma by underestimating the elderly patient's potential for change. An older adults group established on a short-term psychiatric unit is presented. Therapeutic principles and strategies are discussed which are aimed at helping the aged patients make restitution for losses and regain self-esteem through renewed engagement with their environment. The importance of cohesion and inclusion in the group is examined, with attention given to the particular needs and conflicts experienced by the older adult population. The use of techniques to promote the experience of mastery is also discussed.     

Environmental psychology in the U.S.S.R.

A preliminary version of this paper was presented at the 19th National Convention of the American Association for the Advancement of Slavic Studies, Boston, November, 5, 1987.     

School psychology in the U.S.S.R.

Soviet psychologists perform various tasks and provide useful psychological services for pupils and educators. This article describes the general characteristics of education and the preparation and research of psychologists in the U.S.S.R. Also discussed are current practices and emerging trends relating to the establishment of school-based psychological services as well as future developments that may lead to the enhancement of the profession of school psychology in the Soviet Union.     

The Teaching and Learning of Psychotherapy by Rudolf Ekstein and R. S. Wallerstein

The homogeneous group has been the most common form of group therapy for chronically physically ill children and adolescents. The goals of these groups have included the provision of peer support, adaptation to the realities of physical illness, and acceptance of and cooperation with the medical management of the disease. The refinement of the theory of developmental ego psychology suggests that the heterogeneous group has potential for aiding the emotional maturation of the chronically physically ill. This paper presents examples of groups of latency-age children, early adolescents, and middle adolescents that included chronically physically ill with physically healthy peers. The groups were planned under the assumption that despite external differences, children and adolescents of a similar age identify with peers in terms of normal age-specific developmental needs and conflicts.     

U.R.S.S. 1925: Politique et religion

The religious debates of the 1920's in the Soviet Union were marked by an agreement to disagree which no longer seems to exist.