Quel cadre pour les groupes d'analyse de la pratique ?

The article recounts an uncommon experience in which analysis of clinical situations in a group setting is led and animated by a psychologist who is a member of the same institution as the group of personnel requesting the clinical analysis. Due to the fact that the psychologist is also a member of the institution, this setting seems to go against the psychoanalytical theory, which serves as the main reference for this type of analysis. However, the author hypothesizes that this type of setting may allow a genuine process of subjective elaboration, provided that certain conditions are established in order to respect the principles of "transitional analysis" as defined by D. Anzieu. In this way, it is possible to respond to certain situations, which are organized by experiences or impressions of the "basic default" as theorized by M. Balint, and presented as very little differentiated request.     

Public and private responsibility for mental health services. A report on the Tennessee Task Force

The "privatization" of mental health services during the last decade has literally reshaped the way state and county departments of mental health go about fulfilling their statutory responsibilities. In Tennessee, a conference and later a task force examined the implications of this trend for the future. Two issues came to the forefront: Is it appropriate or possible for the private sector to take over the delivery of all mental health services, and if so, who will ensure that the poor receive adequate care? The Tennessee task force concluded that the privatization trend is appropriate and should be encouraged by government. It further concluded that government is ultimately responsible for ensuring access to care for the poor and uninsured although private facilities should provide some free care. Government best serves the poor by providing them the financial means to purchase care from private providers.     

Seek first to understand

A recent study suggests that doctors often diminish effective time with patients by talking about themselves in a manner that does not improve the patient visit and is sometimes disruptive to it. Good care requires hearing what the patient has to say, as the doctor cannot set proper goals for a visit without knowing the patient's agenda. Listening to the patient is the key both to good patient care and to caring for the patient.     

The structure and prevalence of behavioral problems in Hong Kong preschool children

Nearly all 3-year-old Chinese children in Hong Kong attend preschool facilities, making it possible to study their behavior in a group learning situation based upon teachers' perception. The Preschool Behavior Checklist (PBCL), a teacher's questionnaire, was applied to a random sample of 851 Chinese children, ages 36 to 48 months. The factor structure of the PBCL was very similar to that obtained from its original British study, supporting its usage cross-culturally. Prevalence of behavior disorder was high as defined by the PBCL. This reflected specific cultural demands at school settings. Significant sex differences were also found in the overall rate of behavior disorder and symptom patterns. As in other studies, boys had more hyperactive, conduct, and speech problems. The results suggested a certain degree of universality of symptomatology for children at the preschool level.This project was funded by the Hong Kong Society for Child Health and Development. We are grateful to all the kindergartens and child care centers which participated in this project. Valuable assistance was provided by the Education Department and the Medical Health Department.     

The limits of objective assessment of medical practice

Medical work is increasingly being subjected to objective assessment as those who pay for it seek to grasp the quality of that work and how best to improve it. While objective measures have a role in the assessment of health care, I argue that this role is currently overestimated and that no human practice such as medicine can be fully comprehended by objective assessment. I suggest that the character of practices, in which formalizations are combined with judgment, requires that valid assessment involve the perspective of the skilled practitioner. Relying exclusively on objective measures in assessing health care will not only distort our assessments of it but lead to damage as the incentives of health care workers are directed away from the important aspects of their work that are not captured by objective measures.

Socio-emotional behavior at 18 months as a function of daycare experience,temperament, and gender

From a longitudinal study of women and their first-born children, four types of daycare experience were identified. For three of the groups, the woman returned to full-time employment, and a relative, baby-sitter, or nursery provided daycare. In the fourth group, the women did not return to employment. Data on the children's socio-emotional behavior at 18 months were collected from interview, questionnaire items, and direct observation during a home visit. Results indicated several associations among type of day care, difficulty of temperament, and child socio-emotional development.     

In sickness and in health: An exploration of some of the unconscious processes involved in the decision by family caregivers to place a family member with dementia in residential care

This paper explores the feelings, conscious and unconscious, evoked by the difficult decision to place a family member with dementia into residential care. In an exploratory study I interviewed five people who had made this decision with a view to exploring some of the unconscious processes involved in their decision-making. The interviews were interpreted paying attention to my understanding of the transference and my countertransference feelings and as triangulated by a psychodynamic supervision group.

Intimate contact with ageing and death evokes fears about mortality and activates primitive anxieties. The progress of dementia may amplify primitive or psychotic states of functioning, particularly those involving evacuatory projection, and family carers may resort to splitting off unbearable feelings of anxiety which such projections can evoke and may contribute to their decision to look for residential care.

Once placed in residential care different dynamics evolve and further difficult questions arise: how often to visit; whether and when to dispose of the person's possessions and ultimately how to grieve. The focus of this paper is, as far as it is possible, on the partner without dementia as an individual and the impact of their relative's dementia on their lives.     

Diversity in the person,diversity in the group: Challenges of identity complexity for social perception and social interaction

Social psychological research is increasingly coming to grips with the complexity of social identity within the individual, both from the perspective of perceivers trying to form impressions and make judgments about multiply categorizable targets, as well as from the perspective of actors using their different self‐aspects as a framework for guiding their interactions with the social world. I review several contributions to the effort to better understand these issues and then explore some of their possible implications for understanding the nature and consequences of diversity within the group. Copyright © 2009 John Wiley & Sons, Ltd.     

The relation of modelling and the perception of parental care with adolescent smoking: a cross-sectional study

The smoking of tobacco among adolescents is due to several influential factors, both individual and social. The present study aimed at comparing the effects of different variables on adolescent cigarette smoking, specifically, peer and parent modelling, self-regulatory efficacy, and parental degree of care as perceived by the adolescent. Data were collected by means of a self-report questionnaire administered to a sample of 229 secondary school students aged between 15 and 20 years (mean = 16.69, SD = 1.14). To test the influence of different variables, we performed a binary logistic regression analysis. Results indicated that the father is a key figure in that his care and affection can prevent adolescents from becoming a smoker and his modelling is a risk factor. The significant influence of friends was also confirmed and indicated that peer modelling is a strong predictor of adolescent cigarette smoking. Finally, the results revealed that self-regulatory efficacy is a relevant psychological variable capable of preventing smoking initiation during adolescence.     

Provider management of child stress behavior in family day care facilities: scaffolding for learning and development by developmentally appropriate practice

Six children (5 boys, 1 girl; aged 36-60 months) participated in this qualitative study. Each child was enrolled in a different family child care facility. The authors rated the child care providers in 3 of the facilities as using developmentally appropriate practices (DAP) most of the time and rated the providers in the 3 other facilities as rarely or never using DAP. They also examined provider management of children's stress behaviors. The authors observed less active and passive stress behaviors in the high-DAP facilities than in the low-DAP facilities. The authors discuss the results with regard to the distinctively different day care culture found in high-DAP facilities versus low-DAP facilities and the implications for practice.     

Visual causal impressions in the perception of several moving objects

Several kinds of visual causal impressions occur when people observe stimuli involving objects in motion. It is hypothesized that these impressions occur when the visual system avoids coincidences by matching the observable kinematic features of the stimulus to a template of a physical mechanism. This was tested by constructing a stimulus in which several spatially separated objects move in a coordinated manner. Variations on this stimulus were constructed such that some were inconsistent with a possible physical mechanism that could explain the motions of the objects and others were consistent with it. Mechanism‐inconsistent variations yielded significantly lower ratings of the causal impression and mechanism‐consistent variations did not, supporting the hypothesis. Misperceptions of features of the stimulus were also reported by a majority of participants, and the nature of these misperceptions is also consistent with the hypothesis that the stimulus is interpreted as a representation of a kind of physical mechanism.     

Excerpts from An Artist's Thought Book: Intriguing Thoughts about the Artistic Process

An Artist's Thought Book: Intriguing Thoughts About the Artistic Process is a series of aphorisms by Dr. Richard Bargdill, associate professor of psychology at St. Francis University. These original aphorisms are 1- or 2-sentence thoughts that are roughly categorized into 5 book chapters concerning: what it means to be an artist, a poet, a singer, and a painter, as well as thoughts on the nature of creativity. The purpose of an aphorism is to say enough to provoke thoughts in the reader without completely spelling out what the author specifically means. The beauty of writing in the aphoristic style is that different people can interpret the same sentence in many ways. Here, the author has picked a few of his favorite aphorisms from each of the chapters. Bargdill is an award-winning poet and artist who was most recently recognized for his first place sculpture at the prestigious 2009 Pennsylvania State art show: Art of the State. To learn more about the artist, please visit his Web site at www.poetryartandsong.com. The book is available at Amazon.com.     

Environmental factors in suicide in long-term care facilities.

One major purpose of this study was to identify environmental factors related to suicide in long-term care facilities. Questionnaires were mailed to a random sample of administrators at 1,080 facilities. Information was collected on facility characteristics, overt suicide, and intentional life-threatening behavior. Chi-square analyses revealed 4 environmental characteristics related to suicidal behavior and deaths from suicide: staff turnover, size, auspices, and per diem cost. More suicides occurred in larger facilities and facilities with higher staff turnover. Religious or "other" facilities experienced more suicidal deaths than public or private facilities; facilities charging less experienced more deaths.     

Which reality in the psychoanalytic session?

The author discusses how the analyst's theory influences what happens in the psychoanalytic session, and, in particular, how it determines which of several possible realities become the focus of attention. An overview of Bionian thought and how it informs the author's way of working is provided. In elaborating his use of the narrative level in the session and other key concepts, the author presents three brief clinical vignettes.     

Shadowboxing with Integrity

In 1979, Pastoral Psychology published the author’s first autobiographical case study: the story of a near-fatal automobile accident, collateral damage of a high-speed police chase in downtown Chicago. Five other articles have relied on this type of narrative history, focusing directly on the threatened author as a subject for analysis. Such non-risk-free projects could be a fitting requirement for a DMin thesis in pastoral counseling. The author provides practical writing suggestions as a modus operandi. Theologically, the hub of these accounts often reveal evidence of Providence. The clustering of coincidences is an initial clue of high probability. For 40 years, the author has effectively used this type of research or detection to better understand events such as a homicide, a burglary, a flatline, the Ku Klux Klan, and the death of my best friend. The current piece collectively draws on several years of pastoral care for a homeless veteran, a personal injury lawsuit, and an encounter with the Devil.     

Facial and self‐report questionnaire measures capture different aspects of romantic partner preferences

Romantic relationship researchers often use self‐report measures of partner preferences based on verbal questionnaires. These questionnaires show that partner preferences involve an evaluation in terms of underlying factors of vitality–attractiveness, status‐resources, and warmth–trustworthiness. However, when people first encounter a potential partner, they can usually derive a wealth of impressions from their face, and little is known about the relationship between verbal self‐reports and impressions derived from faces. We conducted four studies investigating potential parallels and differences between facial impressions and verbal self‐reports. Study 1 showed that when evaluating highly variable everyday face images in a context that does not require considering them as potential partners, participants can reliably perceive the traits and factors that are related to partner preferences. However, despite being capable of these nuanced evaluations, Study 2 found that when asked to evaluate images of faces as potential romantic partners, participants’ preferences become dominated by attractiveness‐related concerns. Study 3 confirmed this dominance of facial attractiveness using morphed face‐like images. Study 4 showed that attractiveness dominates partner preferences for faces even when task instructions imply that warmth–trustworthiness or status–resources should be of primary importance. In contrast to verbal questionnaire measures of partner preferences, evaluations of faces focus heavily on attractiveness, whereas questionnaire self‐reports tend on average to prioritize warmth–trustworthiness over attractiveness. Evaluations of faces and verbal self‐report measures therefore capture different aspects of partner preferences.     

Discussion of Helmut Hinz's case

The author comments on this case report from a relational and intersubjective perspective. He emphasizes the here-and-now, interactive attunement and the emergence and development of the patient's nascent healthy core, more than the interpretation of defense. A case report of clinical material selected and condensed by someone else necessarily lacks many of the subtle, non-verbal clues and shared treatment memory that the author would rely on for his perspective. Thus he approaches this report as a written narrative of manifest interaction and gives his impressions of how he might have understood the material and responded somewhat differently. He concludes that, although he and the treating analyst would have different conceptions of how the pivotal moment emerged, the outcome might not have been very different. Finally, he challenges the common usage of 'homosexual' to denote a certain dynamic position in a context that has nothing to do with sexual desire.     

Prospective assessment of late-luteal phase dysphoric disorder

This investigation evaluated a method for the prospective assessment of the symptoms of premenstrual syndrome (PMS). The American Psychiatric Association has proposed a diagnostic category for PMS in the DSM-III-R entitled late-luteal phase dysphoric disorder (LLDD). The criteria for this disorder include prospective documentation of at least two symptomatic cycles. Two groups of women were studied, one group that met the DSM-III-R diagnostic criteria for LLDD and a comparison group that did not. Subjects recorded symptoms related to PMS for two menstrual cycles. A clinically significant worsening of symptoms was defined as a symptom increase during the premenstruum of greater than one standard deviation above normal. These effect sizes were then used to determine if the subject met the DSM-III-R criteria for prospective confirmation. Data analysis showed that although the LLDD group showed evidence for PMS in several symptom groups, only a minority (31%) met the requirement of prospective confirmation of significant PMS symptoms for the two cycles recorded. These results were discussed in terms of the need for prospective behavioral assessment of LLDD and the implications of these findings for past and future research.Portions of this paper were derived from the master's thesis of the first author.