The Facilitation and Maintenance of the Therapeutic Alliance in Family Therapy

The formation and maintenance of the therapeutic alliance in family therapy involves complexities pertaining to the stabilizing tendency of family systems, and the necessity for negotiation of the goals and tasks of therapy with and among multiple individuals (i.e., the family members) in a context of systemic reciprocity and mutual influence. This article explores the complexities associated with the establishment and maintenance of the therapeutic alliance in family therapy. Alliance stances are presented as clinical applications designed to assist therapists in working with split alliances, establishing within family collaboration, and in negotiating homeostatic processes.     

An evaluation of strengthening precursors to increase preschooler compliance

We evaluated the strategy of increasing precursors to compliance on the compliance of 2 preschool boys. Modeling and differential reinforcement were used to increase specific responses to his name being called prior to the opportunity to comply with an instruction. The precursors were stopping the ongoing activity and orienting to, making eye contact with, and saying "yes" to the instructor. High levels of precursors occurred during treatment, and increases in compliance also were observed, even though the consequences for compliance and noncompliance did not change.     

On the perpetuation of ignorance: system dependence, system justification, and the motivated avoidance of sociopolitical information

How do people cope when they feel uninformed or unable to understand important social issues, such as the environment, energy concerns, or the economy? Do they seek out information, or do they simply ignore the threatening issue at hand? One would intuitively expect that a lack of knowledge would motivate an increased, unbiased search for information, thereby facilitating participation and engagement in these issues-especially when they are consequential, pressing, and self-relevant. However, there appears to be a discrepancy between the importance/self-relevance of social issues and people's willingness to engage with and learn about them. Leveraging the literature on system justification theory (Jost & Banaji, 1994), the authors hypothesized that, rather than motivating an increased search for information, a lack of knowledge about a specific sociopolitical issue will (a) foster feelings of dependence on the government, which will (b) increase system justification and government trust, which will (c) increase desires to avoid learning about the relevant issue when information is negative or when information valence is unknown. In other words, the authors suggest that ignorance-as a function of the system justifying tendencies it may activate-may, ironically, breed more ignorance. In the contexts of energy, environmental, and economic issues, the authors present 5 studies that (a) provide evidence for this specific psychological chain (i.e., ignorance about an issue → dependence → government trust → avoidance of information about that issue); (b) shed light on the role of threat and motivation in driving the second and third links in this chain; and (c) illustrate the unfortunate consequences of this process for individual action in those contexts that may need it most.     

Divergent effects of activating thoughts of God on self-regulation

Despite the cultural ubiquity of ideas and images related to God, relatively little is known about the effects of exposure to God representations on behavior. Specific depictions of God differ across religions, but common to most is that God is (a) an omnipotent, controlling force and (b) an omniscient, all-knowing being. Given these 2 characteristic features, how might exposure to the concept of God influence behavior? Leveraging classic and recent theorizing on self-regulation and social cognition, we predict and test for 2 divergent effects of exposure to notions of God on self-regulatory processes. Specifically, we show that participants reminded of God (vs. neutral or positive concepts) demonstrate both decreased active goal pursuit (Studies 1, 2, and 5) and increased temptation resistance (Studies 3, 4, and 5). These findings provide the first experimental evidence that exposure to God influences goal pursuit and suggest that the ever-present cultural reminders of God can be both burden and benefit for self-regulation.     

Motor timing deficits in children with Attention-Deficit/Hyperactivity disorder

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are thought to have fundamental deficits in the allocation of attention for information processing. Furthermore, it is believed that these children possess a fundamental difficulty in motoric timing, an assertion that has been explored recently in adults and children. In the present study we extend this recent work by fully exploring the classic Wing and Kristofferson (1973) analysis of timing with typically developing children (n=24) and children with ADHD (n=27). We provide clear evidence that not only do children with ADHD have an overall timing deficit, they also time less consistently when using a similar strategy to typically developing children. The use of the Wing and Kristofferson approach to timing, we argue, will result in the discovery of robust ADHD-related timing differences across a variety of situations.     

The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM ?C whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined.