Do Geographic Regions with Higher Suicide Rates also have Higher Rates of Nonfatal Intentional Self‐Harm?

Fatal and nonfatal intentional self‐harm events in eight U.S. states were compared using emergency department, hospital, and vital statistics data. Nonfatal event rates increased by an estimated 24.20% over 6 years. Case fatality ratios varied widely, but two northeastern states' total event rates (fatal plus nonfatal) were very high (New Hampshire 206.5/100,000 person years; Massachusetts 166.7/100,000). Geographic context did not uniformly impact the likelihood of self‐harm across event types. The state‐level public health burden posed by such acts cannot, therefore, be accurately estimated from either mortality or morbidity data alone.     

The Beliefs in the Inheritance of Risk Factors for Suicide Scale (BIRFSS): Cross‐Cultural Validation in Estonia,Malaysia, Romania,the United Kingdom,and the United States

The genetics of suicide is increasingly recognized and relevant for mental health literacy, but actual beliefs may lag behind current knowledge. We examined such beliefs in student samples (total N = 686) from Estonia, Malaysia, Romania, the United Kingdom, and the United States with the Beliefs in the Inheritance of Risk Factors for Suicide Scale. Cultural effects were small, those of key demographics nil. Several facets of construct validity were demonstrated. Marked differences in perceived plausibility of evidence about the genetics of suicide according to research design, observed in all samples, may be of general interest for investigating lay theories of abnormal behavior and communicating behavioral and psychiatric genetic research findings.     

Using psychodramatic techniques in structural family therapy

This article describes how psychodramatic techniques can be used in structural family therapy sessions. After a preliminary discussion of the therapist's spontaneity and role functions in both psychodrama and family therapy, specific action techniques are then discussed using case examples. Auxiliary Ego, Role Reversal, Double, Use of Space, Physicalization, Warm-up, Soliloquy, Surplus Reality, and Future Projection are illustrated.     

Sexual tensions in a remarried family

The remarried family is vulnerable to sexual tensions between adults and children because of the weakness of generational boundaries and because the emotional tasks confronting the new couple can result in the detouring of conflict through a child. The case presented here demonstrates the use of structural family therapy which included several therapeutic tools not usually associated with a structural approach. These included family and marital history, individual and subsystem work, education, and modeling. Unspoken sexual tensions between stepfather and stepdaughter were interwoven with the structural problems that the family was experiencing. Following three months of therapy, significant shifts were made in the family structure that resulted in clearer and more appropriate boundaries between parents and the identified patient.Appreciation is expressed by the author to David Abelson, MA, Karlotta Bartholomew, PhD, and Joellyn Ross, PhD, for their support.     

Spouse abuse: An ecosystemic approach

This paper provides a perspective on spouse abuse from an ecosystemic approach suggested by second order cybernetics. An attempt is made to demonstrate the interactional basis for an understanding of spouse abuse and to suggest that the failure to use an ecosystemic perspective may result in therapists and other helpers inadvertently exacerbating the problem. Borrowing from the work of Keeney and Bateson, an analysis of the relational aspects of the problem of spouse abuse is provided which illustrates the similar nature of typical intervention strategies to the problem.The ideas discussed in this paper were developed while the author was a therapist at the Family Therapy Clinic at Texas Tech University. Appreciation is expressed to Monte Bobele, Bradford Keeney, and Thomas Conran for the helpful comments and ideas provided during the preparation of this paper.     

A neglected triangle: Grandmother,mother, and daughter

This paper reports on exploratory research and therapeutic work with a neglected but highly important family triangle, the grandmother-mother-daughter triangle. Some characteristic relationships are described from a clinical sample of 18 daughters for whom such a triangle was important. The triangle may signal both problems and strengths for therapy and the daughters.     

The role of faith in the psychotherapeutic context

The focus of this article is the role of faith in psychotherapy. It is suggested that the psychotherapeutic endeavor may be fruitfully informed by insights from other disciplines. The theologian Paul Tillich's view of faith is discussed as it applies to the psychotherapeutic endeavor. The relation between faith and anxiety is explored in the context of the problem of resistance and change in psychotherapy. The work of theorists from various perspectives (existential, analytic) is discussed in the light of Tillich's view of faith.     

Distance and fusion in Robinson Jeffers' “the purse-seine” and other poems

Distance and fusion are fundamental ideas in Bowenian thinking, especially as expressed in the dynamic of distancing and pursuing. In this paper I have used these ideas as a means to briefly examine a short selection of Robinson Jeffers' poetry, which provides us with a literary example of these concepts in action.My thanks to M. K. Lane and the anonymous reviewers of an earlier draft of this article for their many suggestions, especially to the reviewer who helped me better distinguish between distance and fusion, and intimacy and autonomy.     

Raids upon the random in family therapy training: Discovering what becomes significant

How do you provide family therapy training in a primarily rural state with limited resources? A model for training therapists and supervisors that well may offer guidance to other states that face such a challenge is described here. A meta supervision approach over long distance was used in the three-year project that is described in this paper. Self-reports from the 31 participants who completed the program reveal some interesting positive reactions.