Training in child and adolescent group therapy: Two surveys and a model

Although group therapy is widely used in the treatment of children and adolescents, there has been little attention paid to establishing training standards and developing comprehensive programs for training psychiatry fellows in child and adolescent group psychotherapy. The authors conducted two surveys of child and adolescent training programs. After reviewing the literature, they present the data from their surveys, compare similarities and differences, and discuss trends. Finally, they propose a model for training in child and adolescent group therapy.     

BOOK REVIEWS

Books reviewed:
How Policies Make Citizens: Senior Political Activism and the American Welfare State. By Andrea Louise Campbell. Princeton, NJ: Princeton University Press. 2003. 229 pp. Reviewed by Kay Lehman Schlozman Boston College
Votes and Violence: Electoral Competition and Ethnic Riots in India. By Steven I Wilkinson. Cambridge: Cambridge University Press. 2004. 310 pp. Reviewed by Clark McCauley Bryn Mawr College     

Techniques for handling resistances in group psychotherapy with severely disturbed patients

There has been an increased interest in recent years in the treatment of those with severe psychopathology through application of object relations theory and modern ego psychology. Yet, for the past 20 years, such patients have been treated in day hospitals where rehabilitation and socialization concepts have been employed. This paper integrates some of the advances in psychoanalytic theory with more established methods of milieu therapy. In the patients studied, the therapists noted the presence of severe envy, dependency, passivity and with-holding, an intolerance for aggression along with an intransigent, paranoid-schizoid position. The techniques described here worked through the effects of these resistances so that the patients could use the psychotherapy group, and the entire milieu, more constructively than they did before.Ruthe Feilbert-Willis, C.S.W. was formerly Senior Social Worker in the Adolescent and Adult Day Hospital at The New York Hospital-Cornell Medical Center, in White Plains, New York.He was a psychiatric resident at The New York Hospital-Cornell Medical Center, in White Plains, New York, during the time the clinical work of this paper was undertaken.     

A Constructive Approach to Counseling and Psychotherapy Supervision

Clinical supervision is central to the successful training and ongoing professional development of counselors and psychotherapists. Although clinical supervision shares much in common with psychotherapy, it is a distinct activity from psychotherapy that requires its own distinct theories and techniques (Bernard & Goodyear, 2014). In this article, an approach to clinical supervision (which I refer to as constructive clinical supervision) that is grounded in constructivist principles of learning, growth, and development is presented. In addition to outlining the key constructivist principles that have influenced this approach, I also provide supervision strategies that can be used to facilitate critical self-reflection in supervisees, which includes establishing a solid relationship, asking reflective questions, and implementing reflective-based activities. Additionally, guidelines for conducting supervisee assessment and evaluation in ways consistent with constructivist thinking are described.     

The making of a group psychotherapist: Needs and goals for graduate and postgraduate training

Group therapy is a widely practiced, effective, but underrated specialty. Unfortunately, group therapy seems to be taught more haphazardly, with less attention to quality, than is individual therapy. Group therapy has a technique, history, and literature of its own and should be taught independently from individual psychotherapy. The training of psychiatric residents is particularly crucial for group therapy to prosper and be seen as more prestigious. A common core of experience is vital for training in group therapy, whether the trainee's background is psychiatry, psychology, social work, pastoral counseling, or nursing. This core consists of: 1) clinical experience doing group therapy; 2) supervision; 3) a professional training group experience; 4) observation of experienced group therapists; 5) exposure to current thinking in the field; 6) personal group therapy; and 7) a didactic course in theory and technique. Clinical experiences involving cotherapy and combined individual and group treatments are especially useful, both as training and as treatment modalities.He is on sabbatical leave from John Jay College of Criminal Justice where he is Professor of Psychology and was founding Chairman of the Psychology Department.The authors wish to thank Arnold Rachman, Ph.D., Michael Lapidus, M.D., Fayek Nakhla, M.D., Nyapati R. Rao, M.D., and Dorothy Gartner, Ph.D., for their helpful comments on earlier versions of this paper, and Ms. Deloris J. Johnson for her typing and editorial assistance.     

Psychological Aspects of Aging Edited by John E. Anderson

Supervision and training groups have advantages over dyadic supervision and training that include factors to promote group learning and interaction within a sociocultural context. This article focuses on the gender aspects of group supervision and training. It provides a review of feminist theoretical developments and presents their application to group supervision and training in the form of eight guidelines that are illustrated by clinical examples.     

The Section of Psychology: Psychology in an Academic Health Sciences Center's Department of Behavioral Medicine and Psychiatry

This paper describes the organization of the Section of Psychology, Department of Behavioral Medicine and Psychiatry, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown. The organization of psychology is described in terms of the 10 organizational variables for psychology outlined by the Working Group on Governance and Administration from the 1995 Association of Medical School Psychologists, Georgetown Conference. Several aspects of the Department are highlighted that may account for the success of psychology section model including collegial relationship between the disciplines of psychology and psychiatry. The paper describes in detail how the section works, key successes, major obstacles encountered, and future challenges.     

Candidate Vulnerability and Exposure to Counterattitudinal Information: Evidence From Two U.S. Presidential Elections

Politically motivated selective exposure has traditionally been understood through the lens of long‐standing attitudes and beliefs, but the role of environment in shaping information exposure practices merits further consideration. Citizens might respond to the political environment in their information‐seeking behavior for numerous reasons. Citizens who believe their position is politically vulnerable have specific cognitive and affective needs that may make them uniquely attuned to counterattitudinal information. In the context of a presidential election, this means that as the defeat of a supported candidate appears more likely, attention to counterattitudinal content will increase. Data collected in the 2008 and 2012 U.S. Presidential elections support this prediction, although this relationship was observed primarily among supporters of the Republican candidate in both elections.     

Thoughts and feelings and things: A new psychiatric epistemology

Epistemology — the study of knowledge — is a philosophical discipline with close ties to psychiatry. When epistemologists address specific questions about how knowledge is actually realized by human beings, their philosophy must be informed by empirical studies of the sort psychiatrists now take up in a variety of forms. As this paper describes, psychiatrists can likewise improve their understanding of human psychology through a deeper appreciation of philosophical analysis in epistemology.The aim of this article is to introduce a unifying framework within which the experience from different approaches to psychiatry — (1) the conceptual schemas of cognitive psychiatry, (2) the mental structures of psychoanalytic psychiatry, (3) the categorical forms of existential psychiatry, and (4) the neural pathways of biological psychiatry — can all be applied productively to the central question of epistemology. By establishing a broad understanding of the problem of knowledge, this new view of epistemology is developed within the idiom of each psychiatric approach. In addressing themselves to a unitary problem, these diverse psychiatric approaches are themselves revealed, not as competing points of view, but as complementary views of a single subject. The result is a new epistemology that can not only bring the insights of psychiatry to philosophy, but can also contribute to the care of patients when psychiatrists bring this broader view to their clinical work.     

Teaching beginning group therapists to incorporate a patient's empathic capacity in treatment planning

The author suggests that a focus on a patient's empathic capacity helps the supervision and teaching of beginning group therapists. The paper describes a promising working model to present in class or in supervision for assessing the level of empathic ability manifested by a prospective or current group member. In addition, ways of using this data for treatment planning are described and illustrated by a case example.     

A Case of Child and Family Therapy: Is Anger Permissible in This Home?

This article illustrates the impact of a peer supervision group on the treatment of an Orthodox Jewish child and her family system. Examples of treatment difficulties encountered when Orthodox therapists treat Orthodox patients are also presented. It highlights the use of a peer supervision group as a means to manage some of these treatment difficulties.     

Psychiatry and religion circa 1978: Analysis of a decade,part I

Prior tensions between science and religion have dissolved and coalesced into new alliances based on ideology and philosophy. This general cultural pattern is reflected in the realignment of interests and interactions between psychiatry and religion. There are increasing numbers of mental health professionals with devout religious commitments and involvement in religiously oriented mental health activities; while clergy have developed new organizational structures to reflect many diverse mental health interests, including pastoral counseling, community mental health chaplains, hospital chaplains, and expanded parish ministries. Clinical and research literature has continued to rapidly proliferate, while a unique genre of pastoral care and counseling literature has emerged. A decade ago there was hope for an amicable alliance between specialists in psychiatry and in religion. That irenic quest has shifted into overlapping goals and roles, with tensions between those engaged in universalistic norms and those seeking to develop particularistic norms.Dr. Pattison is Professor of Psychiatry and Human Behavior, Social Science, Social Ecology; Acting Chairman, Department of Psychiatry and Human Behavior, University of California, Irvine; Deputy Director, Training, Consultation, Education Division, Orange County Department of Mental Health. His address is UCI Medical Center, 101 So. The City Dr., Orange, Ca. 92668. Part II of this article will be published inPastoral Psychology, Volume 27, No. 2.     

Psychiatry and transcendence

In the relationship which over the years has developed between psychiatry and religion, a common philosophical view of the human person has not always been in evidence. From a Catholic perspective this paper proposes a view which underscores the attribute oftranscendence in the person and accounts for that reality too often shunned by psychiatry, namely, a person'sspiritual life.     

Rorschach Comprehensive System data for a sample of 150 adult nonpatients from Israel

This study is composed of 150 adult nonpatients, all from Israel, who were administered the Rorschach. Inclusion/exclusion criteria are described. Senior graduate students from the clinical psychology program at Bar-Ilan University administered the Rorschach and were provided with extensive supervision and ongoing quality control. Interrater reliability statistics at the response level are presented along with scores for the Rorschach Comprehensive System (CS; Exner, 2005).     

Keeping a group psychotherapy program alive and well within a psychiatric residency

A mandatory year of outpatient group therapy training is an accepted part of residency training in psychiatry. Residents need stable groups to lead in order to have a satisfactory training experience. A solid group program is integrated and cohesive. A group therapy coordinator has to consider the following factors in developing and maintaining the optimum program: sanction from the department of psychiatry; integration of the program into the system; transfer of groups from one class to another; personal screening and followup of all referrals; availability to professionals in the community; coordinator participation in relevant group therapy classes; a vehicle for supervisors to collaborate with each other and administrator; and a format for all members of the group program community to interact.This paper is an elaboration of a symposium presentation, Training in Group Psychotherapy: The Quest for a Viable Model, AGPA Annual meeting, 1990.     

The Influence of General Predispositions on Specific Attitudes

Abstract

(Saenger, G. Today's Refugees, Tomorrow's Citizens: A Story of Americanization. New York: Harper, 1941. Pp. 286.) Reviewed by Gardner Murphy.     

Issues in the supervision of group psychotherapy: Countertransference and the group supervisor's agenda

Countertransference issues are of particular importance to the beginning group therapist. This paper describes the role of supervision in helping the beginning group therapist deal with counter-transference issues as they effect the formation of a group and the role that the group leader plays in facilitating therapeutic activity within the group. Particular problem areas and the countertransference they evoke and the role of supervision in working through are described.The author wishes to acknowledge the suggestions and support of Aaron Stein, M.D., and other members of the Division of Group Psychotherapy of the Department of Psychiatry of the Mt. Sinai School of Medicine.     

Differences between right versus left lateral body tilt in its effect on the visual and tactual perception of verticality

Summary Ninety six Ss were subjected to lateral body tilt, ranging from 10° to 90° to the right and to the left, and indicated the visual vertical (by means of a luminescent rod) and the tactual vertical (by means of a metal bar) in a darkroom. There were significant differences for deviations of apparent from true vertical in both series between body tilt to the right versus to the left. With tilts to the right, apparent vertical deviated more opposite the direction of tilt, the E-phenomenon, or less in the direction of tilt, the A-phenomenon, as compared with tilts to the left.This study was supported, in part, by a Public Health Service Research Grant, MH 00348, from the National Institute of Mental Health, while the author was a NATO research fellow at Clark University, Worcester, MA; and in part by a Federal Grant, MR HD 06276, to the Children's Hospital Medical Center, while the author was a research fellow in child psychiatry at Harvard University, School of Medicine, Boston, MA.