Using system differences to orchestrate change: a systems-guides intervention model

Successful community-based interventions require that change agents give attention to the complexities of interwoven systems, described in the literature as complicated or complex, purposeful or purposive. The author further notes the separate standards, norms, principles and/or goals (here-named systems-guides) of systems. This paper describes the author's experience as a consultant to a multi-system collaboration where observed tensions among participants resulted in the author's implementation of a three-step systems-guides model, which can increase change agents' effectiveness with systems. The steps comprise: detection (of systems, systems-guides, and discrepancies between them; here through observation); documentation (of discrepancies; here through small group discussions); dissemination (to systems participants; here to the collaboration). Two small but fundamental systems changes emerged from systems participants, not from the change agent/author who facilitated systems members' recognition of discrepancies. A major limitation in the implementation of this systems-guides model centers on the critical necessity of the close relationship change agents must have with the involved systems.     

Links between behavioral regulation and preschoolers' literacy, vocabulary, and math skills

This study investigated predictive relations between preschoolers' (N=310) behavioral regulation and emergent literacy, vocabulary, and math skills. Behavioral regulation was assessed using a direct measure called the Head-to-Toes Task, which taps inhibitory control, attention, and working memory, and requires children to perform the opposite of what is instructed verbally. Hierarchical linear modeling (HLM) was utilized because children were nested in 54 classrooms at 2 geographical sites. Results revealed that behavioral regulation significantly and positively predicted fall and spring emergent literacy, vocabulary, and math skills on the Woodcock Johnson Tests of Achievement (all ps<.05). Moreover, growth in behavioral regulation predicted growth in emergent literacy, vocabulary, and math skills over the prekindergarten year (all ps<.05), after controlling for site, child gender, and other background variables. Discussion focuses on the role of behavioral regulation in early academic achievement and preparedness for kindergarten.     

A Comparison of Mood and Quality of Life Among People with Progressive Neurological Illnesses and Their Caregivers

The current study was designed to investigate differences in mood and a range of QOL domains among 423 patients and 335 caregivers of people with motor neurone disease (MND), Huntington’s disease (HD), Parkinson’s, and multiple sclerosis (MS). Patients and caregivers completed an anonymous questionnaire that evaluated their mood (anxiety, depression, fatigue, confusion) and QOL (physical, psychological, social, environment). The results demonstrated that caregivers of people with MND and HD experienced most problems with their mood and QOL compared to caregivers of people in the other illness groups. There were few differences in mood or QOL between patients and caregivers. Patients generally showed greater confusion, physical impairment, and psychological maladjustment. The findings suggest that educational and intervention programs need to be developed to help both patients and their caregivers to adjust and cope with these illnesses, particularly caregivers of people with MND and HD.     

Sex and Aggression: The Relationship Between Gender and Abuse Experience in Youngsters Referred to Residential Treatment

We examined the relationship of gender and different forms of abuse experience on internalizing symptoms, externalizing symptoms, and IQ in a sample of 397 youngsters who were admitted to a residential treatment program. Three types of abuse experience were examined in this study: sexual abuse only, physical abuse only, and both sexual and physical abuse. Results indicate that girls exhibited higher levels of internalizing and externalizing symptoms even though abuse experience was accounted for in the analyses. Moreover, youngsters who had experienced sexual abuse (but not physical abuse) exhibited higher levels of internalizing and externalizing symptoms than youngsters who had not been abused. Implications for developing individualized interventions based on gender and abuse experience in residential treatment programs is discussed.     

'Silent' priming of translation-dependent LTP by ß-adrenergic receptors involves phosphorylation and recruitment of AMPA receptors

The capacity for long-term changes in synaptic efficacy can be altered by prior synaptic activity, a process known as "metaplasticity." Activation of receptors for modulatory neurotransmitters can trigger downstream signaling cascades that persist beyond initial receptor activation and may thus have metaplastic effects. Because activation of β-adrenergic receptors (β-ARs) strongly enhances the induction of long-term potentiation (LTP) in the hippocampal CA1 region, we examined whether activation of these receptors also had metaplastic effects on LTP induction. Our results show that activation of β-ARs induces a protein synthesis-dependent form of metaplasticity that primes the future induction of late-phase LTP by a subthreshold stimulus. β-AR activation also induced a long-lasting increase in phosphorylation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) GluA1 subunits at a protein kinase A (PKA) site (S845) and transiently activated extracellular signal-regulated kinase (ERK). Consistent with this, inhibitors of PKA and ERK blocked the metaplastic effects of β-AR activation. β-AR activation also induced a prolonged, translation-dependent increase in cell surface levels of GluA1 subunit-containing AMPA receptors. Our results indicate that β-ARs can modulate hippocampal synaptic plasticity by priming synapses for the future induction of late-phase LTP through up-regulation of translational processes, one consequence of which is the trafficking of AMPARs to the cell surface.     

Testing a new cognitive behavioural treatment for obesity: A randomized controlled trial with three-year follow-up

It is remarkably difficult for people with obesity to maintain a new lower weight following weight loss. The aim of the present study was to examine the immediate and longer-term effects of a new cognitive behavioural treatment that was explicitly designed to minimise this post-treatment weight regain. One hundred and fifty female participants with obesity were randomized to the new treatment, behaviour therapy (the leading alternative psychological treatment) or guided self-help (a minimal intervention). Both of the main treatments resulted in an average weight loss of about ten percent of initial weight whereas weight loss was more modest with guided self-help. The participants were subsequently followed-up for three years post-treatment. The great majority regained almost all the weight that they had lost with the new treatment being no better than the behavioural treatment in preventing weight regain. These findings lend further support to the notion that obesity is resistant to psychological methods of treatment, if anything other than a short-term perspective is taken. It is suggested that it is ethically questionable to claim that psychological treatments for obesity “work” in the absence of data on their longer-term effects.     

The Nutrition Attitude Survey: associations with dietary habits, psychological and physical well-being, and coronary risk factors

Attitudes play an important role in the adoption and maintenance of a variety of health habits. In the present study, the Nutrition Attitude Survey (NAS) was developed to measure attitudes pertaining to the adoption of a low-fat, low-cholesterol diet. Factor analysis identified four primary attitudinal factors: Helpless and Unhealthy, Food Exploration, Meat Preference, and Health Consciousness. For a community sample of 415 healthy men and women, relationships were examined among these attitudinal factors and dietary habits, family food patterns, medical and psychological symptoms, and traditional coronary risk factors. For both men and women, the Helpless and Unhealthy factor was associated with increased meat consumption, weight, emotional distress, reported medical and psychological symptoms, total cholesterol, and low-density lipoprotein cholesterol. The Food Exploration factor was more characteristic of younger men and women and positively associated with men's reported involvement in family food preparation activities. For both sexes, Meat Preference scores were positively associated with meat consumption and inversely associated with consumption of meatless meals, beans, and fruit. Health Consciousness factor scores were associated with less meat consumption, more meatless meals, and better overall dietary adherence scores for both men and women. Overall, the findings provide initial support for the reliability and predictive validity of the NAS and underscore the importance of assessing and addressing the attitudes and preferences of participants in dietary intervention programs.     

Exchange,Balance, and Formal Organization in Psychotherapeutic Interactions*

ABSTRACT: Psychotherapeutic interactions in crisis situations are analyzed in terms of the “sociodynamic” concepts of exchange, balance, and formal organization. It is argued that psychodynamic interpretations of crisis intervention therapy tend to be incomplete and nonsystematic and, thus, fail to produce adequate predictions, explanations, and control of psychotherapeutic outcomes. Small-group principles and methods are applied to selected crisis cases to illustrate gains in prediction and control over psychiatric approaches.     

Falling outside of the ‘nice little binary box’: a psychoanalytic exploration of the non-binary gender identity

The non-binary gender identity has recently emerged on the landscape of gender variance. It captures individuals who may experience a gender identity that is neither exclusively male nor female, is a combination of male and female or is between or beyond genders. The availability of literature exploring the non-binary gender experience is somewhat limited. Consequently, our understanding of the development of ‘self’ amongst such individuals seems to lag behind that of other gender variant identity, in particular the binary transgender identity. A psychoanalytically informed qualitative research design was used to explore the psychological realities of 6 individuals, aged between 19 and 29 years, who identified as gender fluid, genderqueer, polygender, non-binary Trans person, non-binary trans guy and non-binary gender. Analysis focused upon the integration of conscious and unconscious material in order to provide some insight into the participants’ internal world and object-relating. Three core themes emerged from the data: ‘A developing gender identity’, ‘Correct and incorrect language’ and ‘Being seen and unseen’. These themes, as well as the heterogeneity and complexity of non-binary gender identity, are explored within the discussion, with some implications around our clinical and wider cultural response to people who identify themselves in this way.     

Couples Work in Cultural Context: Te Ao Māori and Poststucturalist Practices Informing Counselor Training in Aotearoa New Zealand

This article outlines key themes that appear in the teaching of poststructuralist ideas and practices for couples counseling within the Postgraduate Diploma in Counseling Program at Unitec Institute of Technology in Auckland, New Zealand, and it explores the congruence of this pedagogical approach with Māori (indigenous) understandings of relationality, collaboration, and partnership. The diploma program's curriculum includes narrative therapy and relational language‐making. Themes explored in this article include: understanding (heterosexual) couple relationships as contextualized entities, deconstructing dominant discourses of coupledom, and the positioning of counselors/teachers as nonexpert. Taking each theme in turn, the authors, one of them Māori and two Pākehā (European), articulate points of alignment with Māori cultural concepts and practices.