The formation of the therapeutic alliance in couple therapy

This study examines the predictive validity of several clinical variables--including marital distress, individual symptomatology, and family-of-origin experiences--on the formation of the alliance in couple therapy. Eighty people who were treated with a naturalistic course of integrative conjoint psychotherapy at a large midwestern outpatient clinic were assessed on the clinical variables before session 1. They also completed ratings of the therapeutic alliance after sessions 1 and 8. Individual symptomatology did not predict alliance formation at either treatment stage. Higher levels of marital distress predicted poorer alliances to treatment between partners at session 1. Marital distress also predicted therapeutic alliance quality for men and women at session 8. Family-of-origin distress predicted alliance quality for men at session 1, and for women at session 8. Family-of-origin distress for men and women predicted split alliances early in treatment, and marital distress predicted split alliances for women at session 8. Clinical implications for the assessment and treatment of couples are discussed.     

Knowledge about the probability of change affects change detection performance

The visual system continually selects some information for processing while bypassing the processing of other information, and as a consequence, participants often fail to notice large changes to visual stimuli. In the present studies, the authors investigated whether knowledge about the probability of particular changes occurring over time increased the likelihood that changes that were likely to occur in the real world (probable changes) would be detected. The results of two experiments showed that participants were more likely to detect probable changes. This occurred whether or not they were processing the scene in a meaningful manner or actively searching the scene for changes. Furthermore, participants were unable to accurately predict change detection performance for probable and improbable changes.     

Immigrant Parents and Their Emigrant Adolescents: The Tension of Inner and Outer Worlds

This article examines different experiences of immigrant parents and their children in transit between the parents' ethnic world and American culture through three clinical cases: a 16-year-old male, whose mother is Persian and father East Indian and who presents with depression and lack of focus; an 18-year-old girl, whose mother is Nigerian and father African American and who was reporting depressive symptoms and confusion about sexual identity; and an 18-year-old depressed male from an Assyrian Iraqi background whose parents both are from Northern Iraq, but have lived in the United States for 20 years. Adolescents of immigrant families have much more complicated tasks during this phase of their development to establish a future sense of self-identity. A well-consolidated sense of self-identity is more complicated for these types of multiethnic immigrant families. The adolescents must rely on parental ego functions and their coherent sense of identity to weather this stage of their turbulent experience. In their strong fantasy framework, these adolescents strive to belong to their new peer groups, in which parents do not belong, particularly when the immigrant parents present a variety of different social and cultural values discordant to the contemporary culture. The cases suggest that both positive and negative aspects of ethnic identification become diluted during adolescence, when identification with parental mores occurs.     

Emotional security and cognitive appraisals mediate the relationship between parents' marital conflict and adjustment in older adolescents

In this study, the authors evaluated a model of the effects of parental conflict witnessed in childhood on psychosocial adjustment in 175 college students. Using this model, which integrated the cognitive-contextual framework (J. H. Grych & F. D. Fincham, 1990) and the emotional-security hypothesis (P. T. Davies & E. M. Cummings, 1994), the authors proposed that both cognitive appraisal of parents' conflict and emotional security mediate the conflict-adjustment link in late adolescence. Furthermore, the authors proposed that cognitive appraisals are associated with emotional security. The results suggested that appraisals and security were both important mediators in the model but that they were not related to each other. Instead, there appeared to be parallel, yet separate, cognitive and emotional channels through which exposure to parental conflict in childhood can have detrimental effects on later adjustment.     

The Ontological Status of God and Other Small Questions

Pastoral Psychology -     

Executive functioning and compliance in HIV patients

25 adult HIV patients were evaluated in a study of appointments, medication, and compliance with restrictions on sexual activity. The Executive Interview (EXIT) was useful in assessing these patients for cognitive difficulties; compliance with medication and countertransference issues were negatively correlated with EXIT scores.     

Are Genetic Counselors and GLBT Patients “on the Same Page”? an Investigation of Attitudes, Practices, and Genetic Counseling Experiences

Gay, lesbian, bisexual, and transgender (GLBT) individuals comprise a growing patient population in genetic counseling, yet literature on working with this population is scarce. This study sought to investigate GLBT patient experiences in genetic counseling and genetic counselor attitudes and practices when counseling GLBT patients. Twenty-nine GLB individuals who had previously participated in genetic counseling, and 213 genetic counselors completed online surveys. No individuals identifying as transgender participated. The patient survey assessed disclosure of orientation, discrimination in genetic counseling, and quality of services received. The counselor survey assessed comfort with and attitudes about counseling GLBT patients, disclosure of counselor orientation, and whether they counsel differently with this population. Every patient denied experiencing discrimination during their session, but 17% reported their genetic counselor assumed they were heterosexual, and 45% indicated intake forms were not GLBT-inclusive. A majority of counselors (91%) reported having counseled GLBT patients and indicated they were comfortable doing so (86%), and 72% indicated no differences in their counseling approaches with GLBT patients. Few counselors (17%) received training in GLBT issues, and most (61%) desired such education. Additional findings and practice and research recommendations are presented.