Transformational education for psychotherapy and counselling: a relational dynamic approach

ABSTRACT

An evolving relational dynamic approach to psychotherapy and counselling education is described. Key themes integrated within the approach are the learning community and transformational relationships. Learning is a reciprocal change process involving students, teachers, supervisors and therapists in overlapping learning communities. Drawing on evidence that effective outcomes in therapy correlate with effective aspects of the therapeutic relationship, the relational dynamic approach emphasises the findings of attachment and intersubjectivity theorists. The intersubjective matrix of infant/caregiver and client/therapist is mirrored and embodied in the relational ethos of training and actively engaged in group supervision. An emphasis on embodied relating is discussed, drawing on infancy studies and recent neuroscientific findings     

Approaches to Research on Intersectionality: Perspectives on Gender, LGBT, and Racial/Ethnic Identities

Intersectionality theories, or the recognition of multiple interlocking identities, defined by relative sociocultural power and privilege, constitute a vital step forward in research across multiple domains of inquiry. This special issue, which extends Shields (2008) contribution in Sex Roles, provides an opportunity to reflect on past, present, and future promise in intersectionality scholarship. To provide a common ground for this work, each paper in this special issue addresses the intersections of gender; lesbian, gay, bisexual, and transgender (LGBT); and racial/ethnic identities and related experiences. In this introduction, we (1) provide an overview of definitions and conceptualizations of intersectionality, (2) discuss the various approaches utilized in this issue to conceptualize and assess gender, LGBT, and racial/ethnic identities, (3) describe how these conceptualizations and assessments were translated into analyses of intersectionality, and (4) close with a discussion of some additional approaches and considerations intended to advance intersectionality research.     

Cognitive and neuropsychological underpinnings of relational and conjunctive working memory binding across age

The ability to form associations (i.e., binding) is critical for memory formation. Recent studies suggest that aging specifically affects relational binding (associating separate features) but not conjunctive binding (integrating features within an object). Possibly, this dissociation may be driven by the spatial nature of the studies so far. Alternatively, relational binding may simply require more attentional resources. We assessed relational and conjunctive binding in three age groups and we included an interfering task (i.e., an articulatory suppression task). Binding was examined in a working memory (WM) task using non-spatial features: shape and colour. Thirty-one young adults (mean age = 22.35), 30 middle-aged adults (mean age = 54.80) and 30 older adults (mean age = 70.27) performed the task. Results show an effect of type of binding and an effect of age but no interaction between type of binding and age. The interaction between type of binding and interference was significant. These results indicate that aging affects relational binding and conjunctive binding similarly. However, relational binding is more susceptible to interference than conjunctive binding, which suggests that relational binding may require more attentional resources. We suggest that a general decline in WM resources associated with frontal dysfunction underlies age-related deficits in WM binding.     

Taking As: Experience & Judgment in the Life of Agents

Although appearances may deceive them, agents are capable of achieving their ends; this success is frequently explained by the fact that the agents may, for example, see a stick in water as bent without believing that it is actually bent. Although the notion of ‘seeing as’ is supposed to both bridge the gap between experience and action and explain our reaction to illusions, such accounts break down because of their exclusive focus on visual episodes and their tendency to interpret the metaphysics of agency in a psychologistic fashion. This paper shows that ‘seeing as’ needs to be understood as a species of the genus ‘taking as.’ The genus admits a wider array of expression, in terms of the kinds of attitudes, actions, and epistemological statuses involved. Such an analysis allows us to avoid the problems of ‘seeing as’ accounts and deepens our understanding of the relationship between practical and theoretical reason.     

International Exchange Training in Genetic Counseling: An Exploration of the Value in Exchange Experiences

International exchange training in genetic counseling is increasing, but research examining these experiences is lacking. In this study 309 genetic counseling students and genetic counselors completed an anonymous survey investigating six major research questions: (1) How prevalent are international genetic counseling experiences? (2) What types are pursued and why? (3) What supports and barriers exist? 3) What are the demographic characteristics of individuals accruing international experience? (5) Does international experience promote professional development? and (6) Do genetic counseling students and professionals perceive international experiences as beneficial? Most respondents were Caucasian females born in one of 25 countries. The most prevalent experiences involved either clinical observation or clinical training. Common motivations for pursuing international experience were personal growth, exposure to a different healthcare system, and travel opportunities. Outcomes included professionally-relevant experience and personal growth. Barriers included finances, limited availability of opportunities, and for those without international experience, family responsibilities. Additional findings, practice and training implications, and research recommendations are provided.     

The Strengths and Difficulties Questionnaire (SDQ): the Factor Structure and Scale Validation in U.S. Adolescents

The Strengths and Difficulties Questionnaire (SDQ) is one of the most commonly used instruments for screening psychopathology in children and adolescents. This study evaluated the hypothesized five-factor structure of the SDQ and examined its convergent validity against comprehensive clinical diagnostic assessments. Data were derived from the National Comorbidity Survey - Adolescent Supplement (NCS-A), a nationally representative sample of U.S. adolescents aged 13 to 18 years. Parents/parent surrogates (n=6,483) was asked to complete a self-administered questionnaire including the SDQ and DSM-IV comprehensive diagnostic information on the participating adolescents. Confirmatory factor analysis (CFA) was conducted to assess the factor structure of the SDQ. The five-factor solution of the SDQ (including emotional, conduct, hyperactivity-inattention, peer relationship, and prosocial) provided a satisfactory fit to the data, and was invariant across sex, age, race/ethnicity and income subgroups. SDQ scores predicted a significantly increased probability of meeting criteria for a DSM-IV disorder, with better prediction for behavior disorders than for mood disorders. Decreasing the SDQ cutoffs to the 80th percentile significantly increased the sensitivity from 39% to 63% for the SDQ Total Difficulties Score, with an expected decrease in specificity from 93% to 87%. This work confirms the five-factor structure of the SDQ in an ethnically and sociodemogrpahically diverse community sample of adolescents. Our findings strengthen empirical evidence for the use of the parent-reported SDQ as a screening tool for DSM-IV behavioral and emotional disorders in adolescents identified in the general population.     

Religion,moral thought–action fusion,and obsessive–compulsive features in Israeli Muslims and Jews

Previous studies suggest that the link between obsessive–compulsive (OC) symptoms and moral thought–action fusion (TAF) depends on religion; however, no study has compared Muslim and Jewish samples. We examined the relationships between OC symptoms, scrupulosity, religiosity, and moral TAF in Israeli Muslims and Jews. Religiosity was not associated with elevations in OC symptoms, although religiosity correlated with scrupulosity across the entire sample after controlling for depression and anxiety. Moral TAF was related to scrupulosity across the entire sample. The Muslim group had higher levels of OC symptoms, scrupulosity, and depressive symptoms than did the Jewish group, but the groups were equally religious. In addition, Muslims scored higher than did Jews on moral TAF even after controlling for symptoms; however, moral TAF was not related to scrupulosity within the Muslim group. In combination, these results imply that moral TAF depends on cultural and religious factors and does not necessarily indicate pathology.     

Girls’ Spatial Skills and Arithmetic Strategies in First Grade as Predictors of Fifth-Grade Analytical Math Reasoning

This study investigated longitudinal pathways leading from early spatial skills in first-grade girls to their fifth-grade analytical math reasoning abilities (N = 138). First-grade assessments included spatial skills, verbal skills, addition/subtraction skills, and frequency of choice of a decomposition or retrieval strategy on the addition/subtraction problems. In fifth grade, girls were given an arithmetic fluency test, a mental rotation spatial task, and a numeric and algebra math reasoning test. Using structural equation modeling, the estimated path model accounted for 87% of the variance in math reasoning. First-grade spatial skills had a direct pathway to fifth-grade math reasoning as well as an indirect pathway through first-grade decomposition strategy use. The total effect of first-grade spatial skills was significantly higher in predicting fifth-grade math reasoning than all other predictors. First-grade decomposition strategy use had the second strongest total effect, while retrieval strategy use did not predict fifth-grade math reasoning. It was first-grade spatial skills (not fifth-grade) that directly predicted fifth-grade math reasoning. Consequently, the results support the importance of early spatial skills in predicting later math. As expected, decomposition strategy use in first grade was linked to fifth-grade math reasoning indirectly through first-grade arithmetic accuracy and fifth-grade arithmetic fluency. However, frequency of first-grade decomposition use also showed a direct pathway to fifth-grade arithmetic reasoning, again stressing the importance of these early cognitive processes on later math reasoning.     

Characterizing Clinical Genetic Counselors’ Countertransference Experiences: an Exploratory Study

Countertransference (CT) refers to conscious and unconscious emotions, fantasies, behaviors, perceptions, and psychological defenses genetic counselors experience in response to any aspect of genetic counseling situations (Weil 2010). Some authors theorize about the importance of recognizing and managing CT, but no studies solely aim to explore genetic counselors’ experiences of the phenomenon. This study examined the extent to which clinical genetic counselors’ perceive themselves as inclined to experience CT, gathered examples of CT encountered in clinical situations, and assessed their CT management strategies. An anonymous online survey, sent to NSGC members, yielded 127 usable responses. Participants completed Likert-type items rating their CT propensities; 57 of these individuals also provided examples of CT they experienced in their practice. Factor analysis of CT propensities tentatively suggested four factors: Control, Conflict Avoidance, Directiveness, and Self-Regulation, accounting for 38.5% of response variance. Thematic analysis of CT examples yielded five common triggers: general similarity to patient, medical/genetic similarity, angry patients, patient behaves differently from counselor expectations, and disclosing bad news; six common manifestations: being self-focused, projecting feelings onto the patient, intense emotional reaction to patient, being overly invested, disengagement, and physical reaction; five CT effects: disruption in rapport building, repaired empathy, over-identification, conversation does not reach fullest potential, and counselor is drained emotionally; and three management strategies: recognizing CT as it occurs, self-reflection, and consultation. Results suggest CT is a common experience, occurring in both “routine” and emotionally complex cases. Training programs, continuing education, and peer supervision might include discussion of CT, informed by examples from the present study, to increase genetic counselor awareness and skills for managing the phenomenon.     

Social power facilitates the effect of prosocial orientation on empathic accuracy

Power increases the tendency to behave in a goal-congruent fashion. Guided by this theoretical notion, we hypothesized that elevated power would strengthen the positive association between prosocial orientation and empathic accuracy. In 3 studies with university and adult samples, prosocial orientation was more strongly associated with empathic accuracy when distinct forms of power were high than when power was low. In Study 1, a physiological indicator of prosocial orientation, respiratory sinus arrhythmia, exhibited a stronger positive association with empathic accuracy in a face-to-face interaction among dispositionally high-power individuals. In Study 2, experimentally induced prosocial orientation increased the ability to accurately judge the emotions of a stranger but only for individuals induced to feel powerful. In Study 3, a trait measure of prosocial orientation was more strongly related to scores on a standard test of empathic accuracy among employees who occupied high-power positions within an organization. Study 3 further showed a mediated relationship between prosocial orientation and career satisfaction through empathic accuracy among employees in high-power positions but not among employees in lower power positions. Discussion concentrates upon the implications of these findings for studies of prosociality, power, and social behavior.