Behavioral family therapy symposium

Abstract

The Albert Einstein College of Medicine/Montefiore Medical Center (AECOM/MMC) Department of Psychiatry and the Gralnick Foundation/ High Point Hospital jointly sponsored the Second Annual Einstein Symposium on November 7, 1985 commemorating the centennial year of Yeshiva University. The symposium, focusing on Behavioral Family Therapy, opened with the presentation of the Einstein Award for Research in Psychiatry to B. F. Skinner by Herman van Praag, Chairman of the Department of Psychiatry. After Skinner's discussion of the role of emotions in behavior analysis, several nationally renowned clinical researchers in the field of behavioral family therapy presented findings of their recent work.     

Group therapy with the multiply oppressed: Treating Latino,HIV-infected injecting drug users

The Latino community in New York City and across the country is disproportionally represented in the AIDS epidemic. This article explores the impact of multiply oppressed group membership on the psychotherapeutic group treatment of Latino, HIV-infected injecting drug users. The interaction of traditional Latino values with injecting drug user and seropositive identities is described. Clinical examples drawn from a bilingual group held in a methadone maintenance clinic in the South Bronx highlight how oppressed group memberships affect Yalom's curative factors.This article was written with the support of a Ryan White CARE Act Title I grant to Montefiore Medical Center through the City of New York, contract OHF-4165.     

Predicting knowledge acquisition in two clinician groups: Rethinking the standard paradigm

The focus of this study was an innovative antibiotic preventive regimen recommended by experts and regularly updated. Data about knowledge of this regimen and potential predictors of knowledge levels were obtained from representative samples of New York State urban and rural general dental practitioners. Using multivariate analyses, four research objectives were achieved: measurement of clinicians' level, of knowledge in both groups; identification of personal and professional work and communication factors influencing clinicians' knowledge level; assessment of the effect of each of these factors on knowledge; and differentiation between sets of predictors for each group. Explanatory factors in this study appeared to be specific, situational, and/or ecologic. The role of distinct configurations of communication networks in the knowledge acquisition process is noted. Donald Sadowsky is professor, Department of Dentistry, Albert Einstein College of Medicine. Research interests include the latter stages of professional socialization, measurement of clinician knowledge and knowledge-related behavior, and planned interventions to change that behavior. Carol Kunzel is assistant professor of dentistry at Albert Einstein College of Medicine. Her academic degree is in sociology. She is currently studying clinician knowledge and its role in the prevention of bacterial endocarditis in a national sample of general practice dentists.     

Sequential cotherapy of groups for training and clinical care

Cotherapy has often been used as the leadership model in group therapy. The literature is full of contradictory data and impressions as to the efficacy of this model. In this article a new form of cotherapy is presented which may offer some of the assets attributed to the cotherapy leadership model while at the same time reducing some of the liabilities. Sequential cotherapy refers to cotherapy when each of the therapists leads sequentially rather than at the same time. The pros and cons of such an approach are discussed from both the perspectives of training new group therapists and of service to patients in groups.Dr. Rutan and Mrs. Alonso are members of the faculty of Harvard University Medical School and share responsibility for training psychiatric residents in group therapy at Massachusetts General Hospital, Boston, Massachusetts.     

Clinical Pragmatism in Bioethics: A Pastoral Approach

This paper addresses the integration of the philosophical school of American Pragmatism, as articulated by John Dewey and others, with the disciplines of bioethics and pastoral care. It suggests new avenues for theological reflection in the bioethical enterprise. It was first presented as the inaugural Anton. T. Boisen Lecture in Pastoral Care and Education in 2004 under the auspices of Continuum Hospice Care, New York.Curtis W. Hart, M.Div., is Director of Pastoral Care and Education, NewYork-Presbyterian Hospital, Weill Cornell Medical Center and Lecturer in Public Health, Medicine and Psychiatry, Division of Medical Ethics at Weill Medical College, Cornell University. Correspondence to Curtis W. Hart, Cuh9001@nyp.org.     

Models of health and wholeness

A church-clinic model of the neighborhood health center, developed initially in a low-income area, has now been established over the past three years in middle- and upper-income areas. The church-clinics, called Wholistic Health Centers, are primary care medical clinics located in church buildings that utilize an interdisciplinary team in the planning for patient treatment and health education. The project integrates primary medical care with pastoral counseling services. Evaluation of the two clinics in middle-to-upper-income areas indicates that the patients are middle to upper class, well educated, and are not medically disenfranchised; their presenting problems are only slightly more often medical (58%) than psychosocial (42%).This work was conducted in part when Dr. Holinger was at the Institute for Psychosomatic and Psychiatric Research and Training, Michael Reese Hospital and Medical Center, Chicago, Illinois.He is also the author ofWholistic Health.The authors gratefully acknowledge the assistance of the Rev. Granger E. Westberg, D.D., Clinical Professor, and Edward A. Lichter, Professor and Chairman, Department of Preventive Medicine and Community Health, University of Illinois at the Medical Center, Abraham Lincoln School of Medicine, Chicago, Illinois, in the preparation of this report.     

Reflections on using group therapy as a treatment modality—Why,how, for whom,and when: A guide to clinicians,supervisors, and instructors

This paper emphasizes the potential of group forces for benefit or harm in group therapy as well as human development. Clinical, experimental-historical, and experiential evidence is cited in order to assess methods for harnessing group forces effectively. Ways in which group therapy is particularly valuable for enabling individuals to develop interpersonal skills, resist group pressure, improve communicative skills, deal with problems of inferiority and pessimism, be responsive to feedback, deal with resistance and transference, and manage problems in the working through phase of therapy are focused on. Another emphasis is on how group therapy technique differs from, supplements, and improves on the effectiveness of individual therapy alone. Crucial problems of patient selection and placement are explored, as is the idea that doing group therapy helps the therapist deal with countertransference problems and increases overall effectiveness and personal growth.Dr. Fenster is Professor of Psychology and was founding Chairman of the Psychology Department at John Jay College of Criminal Justice. This paper was written while he was on sabbatical leave and serving as Coordinator of Group Therapy in the Psychiatry Department at Brookdale Hospital Medical Center.     

Helping at the edges of life: Perspectives of a psychedelic therapist

A case history is presented of a 70 year old man treated with psychedelic psychotherapy for depression, anxiety, and pain associated with terminal cancer. Interpersonal and intrapersonal aspects of treatment following a single 90 mg dose of dipropyltryptamine (DPT) are described. Comparisons are made between transpersonal, mystical, and religious elements in psychedelic drug experiences and near-death experiences.This paper is based on a study in which the author participated as a research psychotherapist at the Maryland Psychiatric Research Center. The author gives special thanks to the late Dr. T. Glyne Williams for his supervision, and to Dr. Albert A. Kurland for his administrative support of this work, and also thanks Friends of Medical Science Research, the Maryland Psychiatric Research Center, the Maryland Department of Health and Mental Hygiene, and the Mary Reynolds Babcock Foundation for the opportunity to carry out this work.     

Later-life depression: Influences of irrational thinking and cognitive impairment

The relationship of personality styles to depression at later-lifeand the influence of irrational thinking and cognitive impairment on this relationshp are addressed. Sixty older (>55) male psychiatric patients at a large medical center were given a battery of psychological tests, including the MCMI, BDI, the Idea Inventory, and the Hooper VOT. A record review for background/treatment factors was also conducted. Results showed that personality styles at later-life are distinctly related to depression, with four styles having an inverse relationship. The personality styles also have the same relationship to irrational thinking. When the influence of irrational thinking and cognitive impairment were removed from the relationship of each personality style to depression, there were only minimal changes in correlation coefficients. These components, therefore, are largely independent of the personality style and depression relationship with later-life inpatients.Leon Hyer, a clinical psychologist at the Veterans Administration Medical Center, Augusta, Georgia and assistant professor at the Medical College of Georgia, is Co-Director of the Psychogeriatric Unit at the Augusta VA Medical Center.William R. Harrison is the coordinator of the Augusta VA Medical Center's Psychodiagnostic Laboratory.Rebecca H. Jacobsen is currently a staff psychologist at the Veterans Administration Medical Center in Augusta, Georgia, where she works with psychiatric inpatients on the Psychosocial Unit. Dr. Jacobsen also is an assistant professor at the Medical College of Georgia.     

The rationing of health care: A doctor's dilemma

Physicians are currently presented with very difficult ethical issues regarding who receives what level of medical care and for how long. A meaningful response to these perplexing issues necessitates a collaboration of doctors with others steeped in religious and ethical traditions. This paper addresses the complicated issue of the rationing of health care, and this issue is then addressed by responses from representatives of the religious community. This symposium took place at the New York Hospital—Cornell Medical Center in March 1991.The Rev. Curtis W. Hart, M.Div. is Director of Pastoral Care and Education at the New York Hospital—Cornell Medical Center.The Rev. Paul Conner, O.P., is Associate Professor and Director of the Master's Program in Public Health Care Ethics at New York Medical College. Larry Rasmussen, Th.D., is Reinhold Niebuhr Professor of Social Ethics at Union Theological Seminary in New York. Dr. Harlan J. Wechsler is Rabbi of Congregation Or Zarua and Visiting Professor of Philosophy at Jewish Theological Seminary in New York.     

The New York Psychoanalytic Civil War.

The goal of this contribution is to give an overall survey of the analytic schisms in the New York area from 1934 on. The general background, laying the groundwork for potential schisms, is described. There were several major schisms in the New York area. The first related to Horney's departure from the New York Psychoanalytic Society and Institute. There were multiple splits in this group which eventuated in a psychoanalytic facility at the New York Medical College, as well as the establishment of the William Alanson White Institute. Then there was the establishment of a psychoanalytic training facility at Columbia University, one at the Downstate Medical Center, and another at the New York University School of Medicine. The various factors that played a role in the splits are discussed. Finally, there is a discussion of why psychoanalytic schisms take place.     

Some psychological correlates of generalized and focal epilepsy in children

School-aged children with two types of epilepsy, generalized and focal, were compared with normal children of the same age, sex, and IQ on measures of cognitive style, attention, motor control, and behavioral pathology. Epileptic children were found to employ less efficient cognitive strategies and to have longer reaction times and poorer control of fine motor movements than have normal children. Children with generalized epilepsy were more impaired than were normal children when sustained motor performance was required. Mothers of children with generalized epilepsy reported more behavior problems than did control mothers on an objective checklist. These results suggest special educational methods for the treatment and education of epileptic children.The research reported in this paper was supported by Grant No. MA-45O5 from the Medical Research Council of Canada. Grateful thanks are extended to Dr. Katherine Metrakos, Director of the Convulsive Disorder Clinic, Montreal Children's Hospital, who screened epileptic subjects and gave us her enthusiastic support. The Diagnostic Test Center was most helpful in providing blood serum levels on the clinical sample. We wish to thank the Notre Dame de Grace and Westmount branches of the Y.M.C.A. for access to control subjects.     

Introducing the living with illness group: A specialized treatment for patients with chronic schizophrenic conditions

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.The authors would like to thank Bruce Levine, Ph.D., and Terry Fujeoko, Ph.D., for their assistance with the initial formation of the group. Mr. Howe and Dr. Fujeoko originated the Living with Illness group and began the first group in 1985 at Waterbury Hospital Health Center, Waterbury, CT.     

Good moments in Rational-Emotive Therapy: Some unique features of this approach

Two independent teams of judges used a general category system of good moments and an RET category system of good moments, respectively, in assessing all client statements in two audiotaped sessions conducted by Dr. Albert Ellis. A comparison of the findings from using the two category systems identified four unique features of RET. The features involved (a) unique RET good moments given by the RET literature; (b) additional general categories of good moments that are also obtained by RET; (c) unique RET methods of obtaining insight-understanding; and (d) unique RET methods of promoting behavior change.Wayne P. Nadler, Irit Sterner, and Eran A. Talitman are members of the psychotherapy research team, School of Psychology, University of Ottawa. Patricia A. Gervaize, Ph.D., is clinical research psychologist, Ottawa Civic Hospital and School of Medicine, University of Ottawa, as well as a member of the psychotherapy research team, University of Ottawa.     

Inpatient cognitive therapy: Detours,potholes, and roadblocks along the routes of progress

Developing innovative treatment approaches for psychiatric inpatient settings is an emerging area of interest. This paper delineates the detours and circuitous paths treatment with difficult patients often takes. Differences between typical outpatient and inpatient care are described and the obstacles to cognitive therapy that inpatients present are discussed. The role of case conceptualization is emphasized as a way to promote increased effectiveness. Finally, methods for maximizing therapeutic opportunities with inpatients are suggested.Robert D. Friedberg, Ph.D. is a staff psychologist on the Cognitive Therapy Unit at Mesa Vista Hospital and is an adjunct faculty member at the California School of Professional Psychology.Raymond A. Fidaleo, M.D. is the Clinical Director of the Cognitive Therapy Unit at Mesa Vista Hospital. He is also the Medical Director of the Cognitive Therapy Institute as well as an Associate Professor of Psychiatry at the University of California-San Diego School of Medicine. Dr. Fidaleo engages in private practice in San Diego, CA.Michele M. Mikules, M.A. is a predoctoral psychology intern with the United States Navy at Balboa Hospital, San Diego, CA.     

Preferred Prayer Styles and Anxiety Control

To date, the literature on prayer and anxiety has yielded mixed results. Recent development of a new instrument has improved our ability to measure individuals’ prayer activities, which may be a promising means of clarifying this literature. This correlational study examined preferred prayer styles and associated scores on measures of anxiety control and trait anxiety in a sample of 85 college students. Results suggested that individuals whose prayer styles were characterized by active rather than avoidant coping were likely to evidence greater perceived control of anxiety and lower levels of trait anxiety. Dr. Harris is a rehabilitation psychologist at the VA Medical Center in Minneapolis, MN. Dr. Schoneman is a clinical psychologist at Casa Pacifica and in private practice. Dr. Carrera is a counseling psychologist at the Psychological Services Center at the University of Cincinatti. Correspondence to J. Irene Harris, Staff Psychologist, VA Medical Center, One Veterans Drive, Minneapolis, MN 55417; e-mail: jeanette.harris2@med.va.gov.     

The dynamics of individual resistance and techniques for handling these manifestations in group psychotherapy

The dynamics of individual resistance in group psychotherapy are described under two classifications: 1) extragroup-session resistance, and 2) intragroup-session resistance. The different kinds of resistances in each classification are explained and examples from group sessions are given to demonstrate each.The author acknowledges with thanks the editorial assistance and suggestions made by Aaron Stein, M.D., F.A.G.P.A., Clinical Professor, The Mount Sinai School of Medicine, C.U.N.Y., and Attending in Charge, Group Psychotherapy Division, Department of Psychiatry, The Mount Sinai Hospital, New York.     

BOOK REVIEWS

Book reviewed in this article: Guidance Services in the Modern School by Merle M. Ohlsen. Girls at Vocational High by H. J. Meyer, E. F. Borgatta, and C. J. Wyatt. Organization and Conduct of Guidance Services by Lester D. Crow and Alice Crow. The Genius of the Apostolate By Paul F. D'Arcy and Eugene C. Kennedy. Youth and the Social Order by F. Musgrove. College Entrance Guide (Revised 1966) by Bernice W. Einstein. Decisions for Tomorrow by Ralph F. Berdie and Albert D. Hood. Employment and Unemployment in the United States by Seymour L. Wolfbein.     

Hiroshima and the King of Tyre

This paper—originally a sermon––addresses issues involved with nuclear idolatry from a biblical perspective. It utilizes psychological understanding and historical narrative as a context for theological reflection. It thus places depth psychological insight in service of social ethics. It was delivered at the Church of the Epiphany, Manhattan, New York, on August 14, 2005. The Rev. Curtis Hart, M.Div, is Director of Pastoral Care and Education, and Lecturer in Public Health, Medicine,and Psychiatry, Division of Medical Ethics, at the Weill Cornell Center of New York Presbyterian Hospital in New York City.