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.     

The rhetorical foundation of philosophical argumentation

The rejection of rhetoric has been a constant theme in Western thought since Plato. The presupposition of such a debasement lies at the foundation of a certain view of Reason that I have called propositionalism, and which is analyzed in this article. The basic tenets of propositionalism are that truth is exclusive, i.e. it does not allow for any alternative, and that there is always only one proposition which must be true, the opposite one being false. Necessity and uniqueness are the ideals of propositionalism. But the question of the necessity of such a necessity is bound to arise. Foundationalism and propositionalism are intrinsically related. Since necessity excludes alternatives, rhetoric, which is based on the possibility of opposite standpoints, is unavoidably devalued as the crippled child of Reason, identical to sophistry or eristic. But propositionalism cannot justify itself and provide a justification for its own foundation without circle or contraditction. Since it responds to the problem of eradicating problems and alternatives through propositional entities, propositionalism is ultimately based on questioning to which it replies in the mode of denial. The unavowed foundation of Reason is therefore the question of questioning, even though this very question is suppressed as propositionalism. The trace of such a question is not only historical, but can also be seen, for instance, in the role played by the principle of contradiction in the constitution of propositional Reason (Artitotle): opposite propositions are not the expression of a problematic situation, they are either possible or successively unique propositions.We want to replace propositionalism by problematology which allows for the conceptualization of alternatives, thereby rendering a true rhetoric possible. Argumentation cannot then be equated with eristic any more, as propositionalism maintained.Rationality must be seen as having questioning as its true starting-point. Reason must be rhetorical if it is to survive the death of propositionalism which took place after the radical criticisms of Marx, Nietzsche and Freud. Even if it is still hard ffor philosophers and rhetoricians to think within another framework and even though they prefer endlessly to deconstauct the old one instead of changing it, problematology is bound to impose itself as the new voice for rationality, because Reason has always endeavored to solve problems. Propositionalism has been only one way of conceiving problems, based on the view that solutions could be but the suppression of questioning.     

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.     

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.     

On the Relation Between Time Perception and the Timing of Motor Action: Evidence for a Temporal Oscillator Controlling the Timing of Movement

Studies of time estimation have provided evidence that human time perception is determined by an internal clock containing a temporal oscillator and have also provided estimates of the frequency of this oscillator (Treisman, Faulkner, Naish, & Brogan, 1992; Treisman & Brogan, 1992). These estimates were based on the observation that when the intervals to be estimated are accompanied by auditory clicks that recur at certain critical rates, perturbations in time estimation occur. To test the hypothesis that the mechanisms that underlie the perception of time and those that control the timing of motor performance are similar, analogous experiments were performed on motor timing, with the object of seeing whether evidence for a clock would be obtained and if so whether its properties resemble those of the time perception clock. The prediction was made that perturbations in motor timing would be seen at the same or similar critical auditory click rates. The experiments examined choice reaction time and typing. The results support the hypothesis that a temporal oscillator paces motor performance and that this oscillator is similar to the oscillator underlying time perception. They also provide an estimate of the characteristic frequency of the oscillator.