Psychotherapy training in a changing world: A Swedish perspective

The City and Hackney Primary Care Psychotherapy Consultation Service is an innovative, public sector service designed to support GPs in meeting the needs of patients with complex psychological/physical health issues throughout the London Boroughs of Hackney and the City. This paper provides an account of how this new model for the National Health Service (NHS) developed in the context of psychotherapy provision within the NHS, within the national and local context in the UK and gives an overview of some the service's key features and how it differs from other services operating in primary and secondary care. A linked paper, in this journal, explores the reality within which the service functions and describes clinical outcomes, health economic data, the modifications to the original model and prospects for the future.     

Tools for Transforming Trauma,by Robert Schwarz,New York: Brunner-Routledge Publishers, 2002, 258 pages, $29.95.

The purpose of this study was to modify a study by Hansen, Harway, and Cervantes (1991) Hansen, M., Harway, M. and Cervantes, N. 1991. Therapists' perceptions of severity in cases of family violence. Violence &; Victims, 6: 225–235. [CSA][PubMed] , [Google Scholar] that investigated whether clinicians recognized and responded to indicators of intimate partner violence. In the current study participants included 112 mental health clinicians who read a clinical vignette, then responded to several open-ended questions, while still blind to the purpose of the study. Participants then answered several objective questions about how they respond when treating cases of intimate partner violence. Logistic regressions were conducted for recognition of and response to partner violence to determine significant predictors. While the overall models were significant, few significant individual predictors emerged. The significant predictors included: education, mental health discipline, and theoretical orientation.     

At the verge of unthinkable anxiety: On the relevance of a neurophysiologically informed relational perspective on meaning-making in psychosis

Abstract

This article examines the relevance of relationally oriented psychoanalytic phenomenology as a frame of reference for understanding psychotic states in schizophrenia. The etiology and structural characteristics of such states are examined from both a neurophysiological, and a relational and interpersonal point of view. Many findings indicate organic abnormalities in schizophrenia, acquired through an exposure to physical risk factors and genetic predisposition, but relational traumas also seem to have an impact on the form and content of psychotic states. This may happen through interruptions in the “use-dependent” maturation of the brain in a relational milieu. In addition, at the level of meaning-making, we find that the emotional and relational contexts—both past and present—give the substance or “raw material” for hallucinations and delusions. In a psychotic state, the person also tries to handle basic affects and relational needs, and to make meaning in states of overwhelming chaos and anxiety. Donald W. Winnicott's theory of “a holding environment”, Stephen Mitchell's theory of the relational matrix, and Stolorow, Atwood, and Orange's concepts of a “shattered world” and annihilation anxiety are used as a framework in the analysis of the phenomenology of psychosis. Two case illustrations, one from child psychotherapy and one from therapy with an adult patient, are used to illuminate the theoretical points of view.     

On the common stimulus condition and explanation of the Müller‐Lyer,Poggendorff and Zöllner illusions: The basis for a class of geometrical illusions

Although the Müller‐Lyer, Poggendorff and Zöllner figures and the illusions with which they are associated– those of length, misalignment and non‐parallelism, respectively – are quite different, all three are attributable to the same basic effect, that of the difference in the apparent length of equal lines forming acute and obtuse angles. The role of this basic affect, reported originally by Müller‐Lyer but overlooked by him and others as a possible cause of the three illusions, is identified and discussed. It is suggested that the demonstration of a basic stimulus condition (acute and obtuse angles) and its associated illusion (difference in apparent length) generating a class of “higher order” geometric illusions has implications not only for a closer understanding of the three illusions under consideration but for other classes of illusory phenomena that might also share a common basis.     

Investigating the mediating effects of emotional intelligence and coping on problem behaviours in adolescents

This study explored the mediating effect of emotional intelligence (EI) and coping strategies on problem behaviours in Australian adolescents. One hundred and forty‐five adolescents (60 boys and 85 girls with a mean age of 12.02 years) completed self‐report instruments of EI, stress coping strategies, and problem behaviours. The relationships between Emotional Management and Control and engagement in internalising and externalising behaviours were found to be mediated by the use of non‐productive coping strategies. Mediation models of the relationship between problem behaviours and the Understanding Emotions and Emotional Recognition and Expression dimensions were found to be only partially mediated by the engagement in problem‐focused and non‐productive coping strategies. The results are discussed in regards to how coping strategies utilised in adolescence may produce more or less adaptive patterns of coping during adulthood. The development of emotional abilities may be required to improve coping outcomes for adolescents, which in turn may produce better psychological outcomes for adolescents in the long term.     

Reactive aggression in psychopathy and the role of frustration: Susceptibility,experience, and control

This article is a commentary on ‘Psychopathy, frustration, and reactive aggression: The role of ventromedial prefrontal cortex’ ( Blair, 2010 ).     

Conjoint therapy and domestic violence: Treating the individuals and the relationship

Domestic violence is a common complaint encountered by counselling psychologists and other mental health professionals. Common psychological treatment practices separate perpetrators and victims into individual intervention modalities. However, there is some research that has been emerging that suggests in some cases a couples treatment approach may be a useful adjunct to existing treatments. The present paper examines research and considerations in making the decision to employ a conjoint approach to treating domestic violence issues.     

Counsellor facial expression and client-perceived rapport

The effects of counsellors’ facial expressions upon the degree of rapport experienced by a Standardized Client (STC) was assessed via examination of 59 counselling interviews conducted by graduate students in counselling. Izard's (1971 Izard, CE. 1971. The face of emotion, New York: Appleton-Century-Crofts.  [Google Scholar]) Affex system of classifying facial expressions was used to operationalize the independent variable of facial expression, with STC ratings of rapport on a five-point scale each minute of the interviews constituting the dependent variable. Data indicated that there was significant more (in seconds/minute) counsellor facial expression of the categories “Interest-excitement” and “Enjoyment-joy” during minutes rated as high in rapport than in minutes rated as low in rapport, but that there was significantly less of the counsellor facial expression “Hypothesized Interest” in high rapport minutes. Implications for the development of effective training procedures for counsellors, plus the need to emphasize the building of emotional engagement between counsellor and client are discussed.     

Heidegger’s resonance with engineering: The primacy of practice

This paper describes how some aspects of Martin Heidegger’s philosophy resonate strongly with an engineering outlook. He argued that practice was more “primordial” than theory, though preserving an important role for theoretical understanding as well, thus speaking to the gap between engineering education (highly theoretical) and engineering practice (mostly empirical). He also underlined the reality of “average” practices into which we are socialized, though affirming the potential for original work and action too, thus providing the grounds for self-actualization whether within the routine or in transcending it. His notion of “thrownness” emphasizes the importance of context, with which engineers are constantly engaged. While all this relates to the idea of our “being”, Heidegger also dealt with the influence of time on our practices. Future death could be seen as spurring innovation, cultural history as a source for critiquing current practice and the present “situation” as the immediate context for corrective action. His major book is appropriately called “Being and Time”.¹