Child and Caregiver Dropout in Child Psychotherapy for Trauma

This study focused on the identification of variables collected at baseline assessments that predict children and caregivers who are at risk for dropout from treatment. A sample of 115 children and their caregivers who received evidence-based treatment for traumatic stress was utilized for this study. Multinomial logistic regression analyses indicated that caregiver and child age, the child's externalizing behaviors, and the child and caregiver's acknowledgment of posttraumatic stress symptoms significantly predicted premature dropout from treatment. Clarification of child and caregiver characteristics that increase the risk of dropout allows for the identification of families in need of additional support to stay in treatment.     

The double-edged pen: Omnipotent fantasies in the creativity and addictions of Stephen King

The legendary debate over whether a connection between creativity and addictions exists is one that is shrouded in mystery and intrigue, but also one that continuously returns to the circuitous metaphor of the chicken and the egg. In an effort to better understand nuances in the relationship between creativity and addictions, this paper examines the life of Stephen King, and the omnipotent fantasies from which both his creative processes and addictive behaviours emerged. Since the early twentieth century, psychodynamic thinkers have highlighted omnipotent fantasies as a psychological force driving creative processes as efforts towards personal transformation. Similarly, numerous psychodynamic theories have highlighted omnipotent fantasies as playing a cardinal role in the psychological processes that propel substance abuse. And yet, the construct of omnipotence has yet to be examined as a theoretical bridge to bind such theories of creativity and substance abuse together. While fostering personal meaning and self-transformation when manifested in his creative writing processes, omnipotent fantasies have also lead Stephen King down a precarious path of addictive behaviours. Through a narrative analysis of the life of Stephen King, who has written in great depth about both his creativity and substance abuse, I will illustrate how omnipotent fantasies often shape and foster both healthy, creative processes towards growth and maladaptive, addictive impulses towards self-destruction.     

Child Group Psychotherapy in the School at the Threshold of a New Millennium

This article reviews existing studies in child group interventions, including educational, counseling, and psychotherapy groups. It highlights both outcome and process research, regarding the different types of groups, and offers implications for practitioners as well as for future research.     

Child and Adolescent Psychotherapy Research: Developmental Issues

Describes developmental issues that pose current challenges to the design of treatment outcome investigation with children and adolescents. Normal childhood development and the development of childhood disorders are discussed using the transactional model of development. Challenges in diagnostic decision making, the selection of the most appropriate treatment regimen, and the measurement methods are highlighted. Recognition of the need to study child treatments through long-term follow-up periods underscores the need for resolution of these developmental issues.     

Taking the Sting Out: Manifesting Aggression and Containing Difficult States in a Relational Group Psychotherapy

This paper describes ways of handling aggression and difficulty in containing intense emotional experiences in group psychotherapy. The clinical vignette illustrates how, in cases of overprotectiveness, an external trigger may sometime serve as a vehicle of liberation and ventilation. The therapist’s enactment in response to the sudden penetration of a wasp into the room is discussed by relating to the functions it serves in the process of encountering aggression, as well as the group and therapist’s capacity to move from “twoness” to a “co-created third.” Whereas aggression, in general, is difficult to deal with, in a group it might prove to be extremely threatening, posing dangers unique to groups. Moreover, openly discussing the group conductor’s aggressiveness is especially challenging in a group. The paper illustrates the fruitful intersection of group analytic thinking and relational psychoanalytic conceptualization.     

Group Psychotherapy in France

This article discusses group therapy as part of a multidisciplinary approach to the management of the various psychological and physical rehabilitation concerns posed by kidney and liver transplant candidates and recipients at Howard University Hospital in Washington, DC. The group's history, format, intervention foci, and roles of clinicians and patients attending the group are described and evaluated. Given the relative paucity of research literature in this area, the authors offer recommendations for empirical evaluation of the benefits of multidisciplinary group psychotherapy in ameliorating physical and emotional suffering and prolonging life among transplant patients.     

Therapist Role in Narrative Group Psychotherapy

With its assumptions about the interpersonal origins of individual learning, narrative theory suggests certain leadership functions for group therapists: providing a perspective on how multiple meanings may be constructed about experience; leading the process of deconstructing individual narratives through careful questioning to distinguish persons from problems; enlisting participants in active awareness and engagement with group dynamics and group process; and enabling the co-creation of a group narrative through the development of a new community of conversations.     

Group Psychotherapy in the Treatment of Some Neurodermatoses

The relation of patient verbal activity to pretherapy symptom status and outcome was examined for ninety patients in time-limited group psychotherapy. For each half-hour segment the most verbally active member, or main actor (MA), was identified. Verbal activity was measured by counting the number of times each patient was MA during the course of the group. Outcome was assessed by administering a battery of instruments pre- and posttherapy and by obtaining direct ratings of patient benefit from the patient, therapist, and an independent rater: the number of times MA was found to be significantly correlated with four pretherapy measures, indicating that the most disturbed patients were most active in these group; the number of times MA was also correlated with patient and therapist benefit ratings, indicating that therapists and patients themselves agreed that those who spoke the most benefited the most. However, partial correlations between number of times MA and other outcome measures did not produce any significant relationships. Thus, it does not appear that patient verbal activity is related to outcome, as measured by objective instruments.     

Group Psychotherapy in the Context of Cultural Diversity

The authors review the salient issues involved in therapy with culturally diverse populations. They present a framework where group therapy addresses those issues. Clinical vignettes from each of the authors serve to illustrate the power of group therapy with ethnocultural populations.     

Working with Racial Themes in Group Psychotherapy

Racial themes frequently emerge in group psychotherapy but are often unaddressed by therapists. Confusion about the relevance of race to the psychotherapeutic process, countertransferential responses, and a lack of training in how to address racial content contribute to therapists' reluctance. Approaches to addressing racial content in groups are examined. Case examples are used to demonstrate therapist characteristics and perspectives on the group process that create a climate where racial content can be explored. An exploration of the meaning of racial content provides an opportunity for deepened understanding of interpersonal relationships for patients and therapists.     

Group Psychotherapy in the Treatment of Acute Emotional Disorders

The authors have constructed a Dutch version of Yalom's “Questionnaire for Curative Factors.” This Dutch version has been administered to 134 participants of 22 psychotherapy groups in various psychiatric services in the Netherlands. Results concerning validity and reliability of the instrument are presented, as well as concerning the homogeneity of the hypothesized “factors.” Differences between types of groups and categories of group members were tested by means of techniques of analysis of variance (ANOVA). Multiple regression analysis was applied in order to detect variables of differential qualities on one or more factors. Only the factor identification, neglected in literature on curative factors, was highly predictable.     

Group Psychotherapy in the Psychiatric Training of Medical Students

Group-as-a-whole theory is a relational paradigm of some complexity. Despite the growing popularity of this perspective, there is abiding confusion about the essence of group-as-a-whole practice and whether the approach attends sufficiently to members and part processes. The threefold aims of this article are to (a) show how group-centered thinking differs essentially from traditional psychodynamic theory that relies heavily on familial dynamics, interpretation, and transference analysis; (b) present the mind-set and working principles for a generic treatment that specifically utilizes collective forces generated in the context of the group matrix; and (c) compare and contrast the thrust of recent dyadic relational therapies with group therapy generally and the group-as-a-whole approach more particularly. The relationship between the whole (group) and its parts (members and what they bring) is detailed and demonstrated as it appears in the context of fused, affiliated, fragmented, and differentiated groups.     

Nonrelativist Ethical Standards for Goal Setting in Psychotherapy

A number of authors have commented on the topic of mandated reporting in cases of suspected child maltreatment and the application of this requirement to researchers. Most of these commentaries focus on the interpretation of current legal standards and offer opinions for or against the imposition of mandated reporting laws on research activities. Authors on both sides of the issue offer ethical arguments, although a direct comparison and analysis of these opposing arguments is rare. This article critically examines the ethical arguments made by authors on both sides of the debate. The conclusion is reached that researchers should be mandated reporters of child maltreatment because the current arguments do not justify their exclusion from current ethical and legal standards. The author makes recommendations for the ethically responsible conduct of research in regard to this topic and legal implications are discussed.