Cluttering upgraded

The articles in this special edition have been scrutinized for new information on the problem of cluttering. The etiology of the disorder is still a riddle, but we now seem to know more about its relationship to learning disorders. Cluttering is not only a fluency and language disorder, but pragmatic rules are also violated by clutterers.

The most encouraging advances presented in this special edition are within assessment and therapy. New diagnostic instruments have been developed. The widely accepted view of a poor prognosis for clutterers has been partly refuted, even if we still only have a couple of case studies showing long-time effects of therapy. Recommendations for further research and development are suggested.     

Efficacy of delayed auditory feedback for treating cluttering: Two case studies

Two clutterers were treated with similar preplanned delayed auditory feedback (DAF) procedures, using probe samples in which the DAF was not present to measure treatment efficacy. Whereas both clients met established fluency criteria during treatment, both clutterers had difficulty transferring gains to probe sessions—one more than the other. Differences in results of DAF treatment are discussed from the perspectives of differences in cluttering severity, coexisting disorders, and supplementary clinical techniques.     

Pause time and phonation time in stuttering and cluttering

This study examined the potential usefulness of automated analysis of on-off speech patterns in the differentiation of stuttering from cluttering. Two groups of fifteen persons who had been previously classified as stutterers and clutterers served as subjects for this investigation. The data indicate that stutterers tend to have greater mean pause times and lower mean phonation times than clutterers. This result corresponds to the clinically observable characteristics of these groups. It is concluded that automated analysis of on-off speech patterns provides some basis for the differential diagnosis of stuttering from cluttering.Supported, in part, by a general research support grant from NIMH to the Research Foundation for Mental Hygiene, Inc.     

An examination of various aspects of auditory processing in clutterers

This study examined auditory processing ability in three school-aged male clutterers who presented concomitant diagnoses of attention deficit disorder (ADD) and three age- and sex-matched normal-speaking control subjects. Subjects underwent a brief central auditory processing (CAP) and auditory event-related potential (AEP) battery. All three clutterers performed below normal test-established performance criteria on at least two of the four CAP measures and exhibited abnormal AEP waveform morphology. All control subjects performed within normal test-established performance criteria on all measures.     

A study of pragmatic skills of clutterers and normal speakers

In communication dyads, three junior high clutterers interacted verbally with three matched control subjects in a task that required one member of the dyad to explain a complicated route (from a marked map of a town center) to the other (who had an unmarked map.) Members played both roles in the dyads. These six subjects were compared with one group of normally speaking control subjects carrying out the same task. Both quantitative and qualitative analyses indicate that, compared with normal speaking pupils, clutterers frequently manifested pragmatic errors and communication failures.     

Differential diagnosis of cluttering and stuttering in Bulgaria

Fifteen stutterers, primarily children, who visited the Medical Pedagogical Department at the University of Blagoevgrad were evaluated for a variety of criteria used in Bulgaria to differentiate cluttering, stuttering, and mixed cluttering and stuttering. The same battery of tests was administered to all subjects. Based on these criteria, five subjects were diagnosed as clutterers, six as stutterers, and four as mixed. Daly's (1992–1993) Checklist for Possible Cluttering, Experimental Edition was also utilized to classify the subjects. Differences between the differential diagnostic criteria used by Bulgarian logopedists and other authors are discussed.     

Family therapy research: What are the most important variables?

This report summarizes the results of a nearly day-long session of a group of experienced and distinguished family therapy practitioners and researchers. The task the group set for itself was to begin delineating the most important variables to attend to in understanding family therapy and evaluating its effectiveness. With full recognition that such a task could be only partially and tentatively accomplished in the time allotted, a great many such variables were outlined.     

Restorying family therapy

This article describes a multi-systemic model of therapy developed by the author over the past decade and summarizes the main products of this project: Explication of key family systems notions, strategic family play therapy, multi-systemic therapy, and culturally-competent family therapy. The model incorporates beyond the family system, culture, wider ecosystems, psychodynamics, and the individual's neuropsychological, cognitive, and socio-emotional development. The model enables the therapist to design flexible multimodal interventions.     

The psychotherapist's own psychotherapy: educating and developing psychologists

In this article, the author synthesizes 25 years of his research on the personal therapy of mental health professionals. The author summarizes the high prevalence of personal treatment, its use by seasoned practitioners, its personal and professional goals, its typically positive outcomes, and its lasting lessons concerning the practice of psychotherapy. Particular attention is devoted to the therapist's selection of a personal therapist and the conduct of treatment with patients who are themselves psychotherapists in comparison with patients who are laypersons. The cumulative results indicate that personal therapy is an emotionally vital, interpersonally dense, and professionally formative experience that should be central to the development of health care psychologists.     

The Inclusion of Fathers In Family Therapy: A Research Based Perspective

This paper summarizes the results of research on the role of fathers in families and family therapy with particular reference to preparation for fatherhood, father involvement in family life as a protective factor, fathers' deviant behaviour as a risk factor, fathers' communication and coping styles, fatherhood and different types of marriages, and the effects of the workplace on fathers' behaviour within the family. Available research suggests that, with respect to problem formation, the behaviour of fathers may serve as either a risk factor or as a protective factor. With respect to problem resolution, fathers may be a powerful therapeutic resource or seriously compromise effectiveness of family therapy. The implications of research for clinical practice are discussed.     

The Experiential Liberation Strategy of the Existential-Integrative Model of Therapy

This article summarizes the experiential liberation strategy of the existential-integrative (EI) model of therapy. The existential-integrative model of therapy provides one way to understand and coordinate a variety of intervention modes within an overarching ontological or experiential context. I will (1) define the experiential liberation strategy—such as its emphasis on the capacities to constrict, expand, and center psychophysiological capacities; (2) describe its salient features—such as the four stances that promote experiential liberation: presence, invoking the actual, vivifying and confronting resistance, and the cultivation of meaning and awe; and (3) illustrate the relevance of the strategy to case vignettes drawn from actual practice.

创伤后应激障碍与物质使用障碍共病的病因学及其启示

创伤后应激障碍与物质使用障碍共病率高,现有的治疗方法疗效差,总结20年来创伤后应激障碍与物质使用障碍共病研究中病因学方面的新认识,通过对病因的哲学思考可以为今后的治疗方向提供一条思路:两病同治;应提倡药物治疗、认知干预和社会支持综合的治疗手段.     

伊斯兰教临终关怀与癌性疼痛心理治疗的探讨

如何利用伊斯兰教的信仰关怀、情感关怀和死亡关怀“三关怀”,提高癌症患者临终关怀质量和癌性疼痛心理治疗效果,作者根据在宁夏回族地区癌症患者中开展临终关怀的五年实践体会,从临终关怀的宗旨和目的出发,探讨了伊斯兰教的临终关怀之信仰关怀、情感关怀和死亡关怀三种形式和内容,解释了癌性疼痛的原因、疼痛的主观和客观影响因素及心理治疗的常用方法和原则,总结了在宁夏回族地区开展临终关怀应用伊斯兰教的信仰关怀、情感关怀和死亡关怀”三关怀”与癌性疼痛心理治疗之间的关系。     

Family treatment approaches to drug abuse problems: a review.

This review covers the literature that has emerged specifically on the family treatment of drug abuse problems. Following a brief discussion of patterns and structures prevalent in drug-abusing families, 68 different studies or programs (discussed in 74 papers) are compared as to their techniques and results. These are categorized within the following modalities: marital treatment, group treatment for parents, concurrent parent and identified patient treatment, treatment with individual families (both inpatient and outpatient), sibling-oriented treatment, multiple family therapy, and social network therapy. A table presents the various studies, along with the types of results they provide. Outcomes are contrasted for the 14 studies that quantified their results. The final section presents implications for the following areas: treatment activities (clarification of technique, family recruitment, direction and effectiveness of treatment, confidentiality, and treatment delivery systems), training, prevention, and future research (outcome, technique and responsibility). It is concluded that family treatment for drug abuse is gaining widespread acceptance and shows considerable promise for dealing effectively with problems of this type.     

Current Issues in the Practice of Integrative Couple and Family Therapy

This paper provides an overview of current issues in integration in couple and family therapy. It summarizes the evolution of integration in couple and family therapy, the various traditions in integration, the strengths of integrative approach, and the possible pitfalls involved. It highlights the extent to which most couple and family therapy is now integrative practice. It concludes with a consideration of an emerging trend toward methods of practice centered on modules of intervention that have been identified as effective with certain presenting phenomena. The example of therapy for high conflict divorce is utilized to illustrate how various components can be brought together to create a maximally effective intervention.     

Combat-related post-traumatic stress disorder: a case report using virtual reality exposure therapy with physiological monitoring.

The current report summarizes a case study from an Office of Naval Research (ONR) funded project to compare the effects of virtual reality graded exposure therapy (VRGET) with cognitive behavioral group therapy in active-duty corpsmen. Details of the collaborative program between the Virtual Reality Medical Center (VRMC) and Naval Medical Center San Diego (NMCSD) will be discussed.     

Change: How do we recognize it?

The paper seeks to examine the working assumptions that guide us as therapists engaged in the attempt to facilitate change in families. It summarizes a piece of preliminary research based on the responses of a group of therapists working in different agencies. A questionnaire on change was developed and given to the therapists followed by a group discussion.
The results suggest that therapy teams, and families, have common sense ideas about:

• the beginning, and end of a period of change;

• types of change—those falling into four categories; of behavioural, structural, communication and experiential.

Our results suggest that difficulties in therapy may be associated with a failure amongst the therapists in a team to negotiate their mutual assumptions about change. In addition the process of therapeutic change is seen as involving a negotiation between the family and the therapists about what will count as change.
The data were gathered from a group of therapists attending a local meeting of the Association for Family Therapy in Plymouth.