Coming to terms: Client subjective experience of ending psychotherapy

How do clients consider their own contribution and that of their therapist in the last phase of therapy when they are moving toward the end? Thirty-seven clients who had received therapy from highly experienced clinicians were interviewed. Since the time for ending had not been decided at the onset, clients in both short- and long-term therapies were included. Thematic case-by-case analyses were carried out. Clients actively engaged in looking back and looking ahead, as means of reflecting on their capability to handle issues on their own. The majority of clients were satisfied with what they perceived as a reciprocal engagement that enabled them to come to terms with emotionally charged issues in life and in therapy. For some clients unresolved issues remained: wondering whether a therapist with another approach could have helped more; feeling pushed away by the therapist; having to take the lead in ending therapy; the fear of being an “unworthy” client; or wanting to end without the therapist’s approval. Coming to terms with the ending of therapy was highly personally meaningful and loaded with affective tensions, in ways that were not always shared with their therapist.     

Systemic Family Therapy Competences in Child and Adolescent Mental Health Care

This article is based on a doctoral research project aiming to identify a comprehensive and detailed outline of the systemic therapist competences in child and adolescent mental health care in Norway. Because of the growing demands to offer specialized services within child and adolescent mental health care, I intended the identified competences to target the psychosocial difficulties that are categorized as associated abnormal psychosocial situations (axis 5) in the multiaxial diagnostic system (WHO, Multiaxial classification of child and adolescent psychiatric disorders. The ICD-10 classification of mental and behavioural disorders in children and adolescents. Cambridge University Press, Cambridge, 1996). The project is based on twelve qualitative in-depth interviews with six experienced systemic family therapists, and fieldwork observations of the therapists (participants) in practice. The qualitative methodology is based on Grounded Theory and five overarching categories were identified through the analysis: (1): the importance of ethical and contextual awareness in systemic therapy; (2) the systemic therapist’s stance; (3) therapeutic processes; (4) therapeutic practices; and (5) session-specific features. Challenges, such as limiting the systemic approach to five overarching competences, are discussed alongside this strengths and limitations of the study. The detailed outline of systemic therapist competences is intended to offer a framework for delivering flexible, yet specialized systemic therapy in the context of child and adolescent mental health care. This research may therefore facilitate a “bridge-building process” between mental health’s biomedical focus and postmodern systemic ideas.     

Sleep deprivation and hallucinations. A qualitative study of military personnel

Much anecdotal evidence suggests that sleep deprivation not only impairs performance, but also brings about other extraordinary effects like hallucinations. However, knowledge about how sleep deprivation may trigger hallucinations is limited. To qualitatively describe hallucinatory experiences during sleep deprivation 12 male military officers from the Norwegian Armed Forces who all had experienced at least one sleep loss-induced hallucinatory experience were recruited. Data were collected and analyzed by semi-structured interviews and thematic analysis. This resulted in the identification of three distinct main themes: (1) Modalities, (2) circumstances/triggers and (3) reactions to hallucinations. Hallucinations were experienced in several modalities (visual, auditory and multi-modality), although visual hallucinations seemed to dominate. Typical reported circumstances/triggers were sleep loss, physical exhaustion, time-of-day, low calorie intake, mental exhaustion and lack of external stimuli (low sensory and social input, boring situations, and monotonous activity). Negative emotions were dominant during the hallucinatory episodes. Often some reasoning and checking on behalf of the officers were necessary to differentiate between real percepts and hallucinations. In some cases the hallucinations caused erroneous actions. Retrospectively, most officers viewed their hallucinatory experiences in light of positive emotions and several emphasized having learned something from them. The results are discussed in relation to the existing literature and suggestions for future studies are outlined.     

The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review

Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists’ competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists’ competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists’ competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.     

Disentangling the Concept of Well-Being in Very Old Age Using Rodgers’ Evolutionary Concept Analysis

Journal of Happiness Studies - Well-being has received increasing attention from researchers and policymakers, and its promotion could be considered pivotal to handle the challenges of aging...     

Serial and free recall in children can be improved by training: evidence for the importance of phonological and semantic representations in immediate memory tasks

Children were assigned to three groups given training on unfamiliar words--phoneme-awareness training, rhyme training, and vocabulary training--and an untrained control group. Before and after training, we assessed the children's performance on serial- and free-recall tasks with these words, as well as their ability to define the words, manipulate phonemes in them, and generate rhymes for them. We found that phoneme-awareness training improved serial recall substantially and improved free recall to a lesser extent. In contrast, vocabulary training produced a substantial increase in free recall and a lesser increase in serial recall. These effects on recall were specific and did not generalize to untrained words. Rhyme training produced increases in rhyming skills but no increase in either serial or free recall. We argue that serial and free recall depend on common memory mechanisms, but serial recall relies more on phonological codes and free recall relies more on semantic codes.     

The impact of methodological moderators on prevalence rates of workplace bullying. A meta‐analysis

The aim of this study was to investigate how different measurement methods and sampling techniques contribute to the observed variation in prevalence rates of workplace bullying. A total of 102 prevalence estimates of bullying from 86 independent samples (N=130,973) were accumulated and compared by means of meta‐analysis. At an average, the statistically independents samples provided an estimate of 14.6%. Yet, the findings show that methodological moderators influence the estimated rates. As for measurement method, a rate of 11.3% was found for studies investigating self‐labelled victimization from bullying based on a given definition of the concept, whereas a rate of 14.8% was found for behavioural measure studies, and 18.1% for self‐labelling studies without a given definition. A difference of 8.7% points was found between randomly sampled and non‐randomly sampled studies. When controlling for geographical differences, the findings show that geographical factors also influence findings on bullying. Hence, findings from different studies on workplace bullying cannot be compared without taking moderator variables into account.     

The Swedish version of the parent-rated Junior Temperament and Character Inventory (J-TCI)

To evaluate the psychometric characteristics of the Swedish version of the Junior Temperament and Character Inventory (J-TCI), it was sent to parents of 9- and 12-yr.-old twins in Sweden. The final number of responders was 196 parents who rated 92 female and 104 male twin pairs. The inventory of one twin, randomly chosen from each pair, was included in the analyses. Reward Dependence, Persistence, and Cooperativeness were scored higher in girls; Novelty Seeking was higher in the 9-yr.-olds and Persistence in the 12-yr.-olds. Pearson's correlations showed that some dimensions were not statistically independent from each other, even if the covariance was moderate. Internal consistency (Cronbach's alpha) was satisfactory for Harm Avoidance, Novelty Seeking, Self-Directedness, and Cooperativeness (.68-.81), while it was lower in those dimensions that had fewer items. The Swedish parent version of the J-TCI shared about the same psychometric characteristics as found in international samples.     

Happiness,morality, and politics

The idea that politics should promote the happiness of the population is rather common in the community of happiness researchers. This political view is sometimes based on the happiness principle, the fundamental ethical view that we have a strong moral reason to do what we can to maximize the happiness and minimize the suffering in the world. The first main purpose of this paper is to investigate (1) what role this principle play in ethics as a whole, how it should be weighed against other moral considerations, and (2) how exactly it should be understood, i.e. which possible version of the principle that is most plausible. This is the only way to arrive at well-founded theory of the fundamental moral (and political) significance of happiness and suffering (an “ethics of happiness and suffering”). The idea that politics should promote happiness is sometimes accompanied by the notion that we should introduce some kind of happiness index, and that it is a central goal of politics to maximize the value of this index. The second main purpose of this paper is to examine this suggestion. I will first ask (3) how such an index should be constructed, assuming that it might be a good idea to construct an index in the first place. I assume that an index of this kind cannot be plausible unless it incorporates a number of moral considerations, and that (3) is very closely related to (2). I will then ask (4) whether the suggestion is plausible, or whether there are better ways to put a politics of happiness into practice, e.g. to simply apply the knowledge we have about the determinants of happiness.