Insight-oriented group psychotherapy of latency-age children in an acute care setting

Traditional approaches to group therapy with latency-age children have stressed activity and nonverbal therapeutic interventions. These approaches originated in the 1940s with Slavson's activity aroup therapy. A review of the literature of the past 25 years reveals that many clinicians have increasingly employed verbal techniques with latencyage groups. Most such reports describe groups for latency-age out-patients. In this paper, a verbal, interpretive technique for group therapy with latency-age inpatients is described. Clinical vignettes are included to illustrate this technique. Our experience suggests that such a technique can become an integral part of the inpatient treatment program for the latency-age child.     

Power,family therapy,and the systemic-organismic paradigm

How is the concept of power integrated into the systemic organismic paradigm? Power concepts, especially Kantor and Lehr's six dimensions of distance regulation mechanisms, are related to several models of family therapy. Power is found to be a part of the Gestalt formation process of Perls, a process of dynamic selfregulation. Each family therapy model is regarded as part of an integrating process. A theory of conflict strategy and of integration strategy in therapy is developed. The article is intended to promote comparison and exploratory discussion around different models of family therapy.     

Prophetic visions in 1988: A critical reappraisal

This paper reviews the research into a specific aspect of neardeath experiences (NDEs): the prophetic vision (PV). PVs are subjectively compelling flashforwards of planetary-wide cataclysms and eventual regeneration that sometimes occur during or in the immediate aftermath of an NDE. Previous research has shown that the most frequently mentioned year for the culmination of the geophysical calamities foreseen in PVs was 1988. I argue that PVs should be understood as manifestations of a collective prophetic impulse that historically tends to arise during periods of cultural crisis. PVs are thus expressions of the felt need for cultural renewal and therefore should not be taken literally as prognostic of drastic physical changes on Earth.     

Leadership behavior,group climate and outcome in group psychotherapy: A study of outpatient psychotherapy groups

A recent clinical study of outpatient psychotherapy groups in a community mental health center explored the linkage between group leadership variables, group climate, and outcome. The study involved nine outpatient therapy groups, over 50 group clients, and several group therapists. A repeated measures design involving assessment of clients' outcome and level of functioning, group leadership style, and group climate was used to assess changes over a 6-month period. The findings suggest: 1) a reduction in symptoms and improved functioning for clients; 2) a similarity of perceptions by members and leaders of perceived leadership behaviors and group climate; 3) the presence of direct and indirect influences of group climate and leadership behavior on clients' outcome; and 4) a linkage between leadership behavior and group climate with the theoretical orientation of the group. The findings of the research are discussed in relation to the understanding of specific effects in group psychotherapy and the implications for construction of group psychotherapy theory.The authors would like to thank Robert Dies, Ph.D., for his helpful suggestions in the early phase of this study; Roy MacKenzie, M.D., for permission to use the Group Climate Questionnaire; Diane DePalma, Ph.D., for permission to use the Global Leadership Behavior Index; Chris Boltwood, B.A., for her untiring efforts in administering the instruments and coding and entering the data; and most importantly, the psychotherapy group members and the group therapists for their cooperation in this endeavor—without their help, this clinical study would not have been possible.A version of this paper was presented at the Annual Meeting of the American Group Psychotherapy Association, 1987, New Orleans, Louisiana. Lenore Phipps, R.N., M.S., C.S., was formerly Director, Group Psychotherapy Program at Park Ridge Mental Health Center, Rochester, now in private practice at Guild Medical Center, Norwood, MA 02062.     

Professional liability (malpractice) coverage of humanist scholars functioning as clinical medical ethicists

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists.     

The influence of retrieval on retention

Four experiments tested the hypothesis that successful retrieval of an item from memory affects retention only because the retrieval provides an additional presentation of the target item. Two methods of learning paired associates were compared. In the pure study trial (pure ST condition) method, both items of a pair were presented simultaneously for study. In the test trial/study trial (TTST condition) method, subjects attempted to retrieve the response term during a period in which only the stimulus term was present (and the response term of the pair was presented after a 5-sec delay). Final retention of target items was tested with cued-recall tests. In Experiment 1, there was a reliable advantage in final testing for nonsense-syllable/number pairs in the TTST condition over pairs in the pure ST condition. In Experiment 2, the same result was obtained with Eskimo/English word pairs. This benefit of the TTST condition was not apparently different for final retrieval after 5 min or after 24 h. Experiments 3 and 4 ruled out two artifactual explanations of the TTST advantage observed in the first two experiments. Because performing a memory retrieval (TTST condition) led to better performance than pure study (pure ST condition), the results reject the hypothesis that a successful retrieval is beneficial only to the extent that it provides another study experience.     

Acoustic analysis in the differentiation of Parkinson's disease and major depression

In its early stages, Parkinson's disease (P.D.) may be difficult to distinguish from major depression (M.D.) leading to inappropriate management. Both illnesses are characterized by psychomotor retardation. The neurovegetative symptoms used to diagnose M.D. are not specific and in P.D. may be due to the physical illness itself. Currently, differentiation of the two disorders relies on subjective clinical observation. Improved diagnostic accuracy based on more objective data is needed. To this end, this study used computerized acoustic analysis to contrast speech patterns in P.D. and M.D. The sample consisted of 30 P.D. patients without depression or dementia, 30 patients with uncomplicated M.D., and 31 normal controls, each 60 years of age or over. Of the acoustic variables studied, M.D. patients had significantly reduced rates of speech compared with P.D. patients. The data suggest that this temporal measure of speech may be useful in the differentiation of P.D. and M.D.     

An exploratory study of videotapes of long-term group psychotherapy of outpatients with major and chronic mental illness

This study explored patterns emerging in videotaped sessions of group psychotherapy with seven outpatients of a large mental health facility. The 22 sessions spanned the 12th to 27th months of the group's existence. Group members had long histories (25–50 years) of symptoms characteristic of schizophrenia. Each session was rated on the Group Environment Scale. One session from a group in its earlier stages was also rated on the same instrument to give some indication of baseline patterns. Analyses of changes across the 15 months were not statistically significant. However, some GES subscales, including Cohesion, Independence, and Self-Discovery, showed relatively high mean levels across the 15-month period. These elevations are discussed as suggesting the codevelopment of orientations that have sometimes been viewed as incompatible and unattainable for schizophrenics. Interpreted clinically, the GES patterns help to elaborate recent findings about the relatively good success of long-term group therapy with such populations. The study, although merely suggestive, illustrates the potential for gleaning solid and clinically useful data from group psychotherapy research.The authors would like to thank Drs. Jill Rierdan, Nina Fieldsteel, Joseph Christy, and an anonymous reviewer for their suggestions, Kendra Bryant for serving as the reliability rater, and Janet Eltinge for her skilled videotaping.