Some comments on the role of cotherapists in group psychotherapy with borderline patients

This paper points out examples of patients in a psychotherapy group who meet DSM-III criteria for the diagnosis of borderline personality disorder and who are treated by cotherapists utilizing object relations theory. Interpretations of phenomena shown by borderline patients—splitting, projective identification and denial—are illustrated. How cotherapy lends itself to the recognition and management of the problems these patients bring to group psychotherapy is illustrated.Hope Aspell assisted in the editing of this paper.     

The Headache Symptom Questionnaire: Discriminant classificatory ability and headache syndromes suggested by a factor analysis

A brief Headache Symptom Questionnaire was administered to 129 chronic headache Sufferers. The questionnaire accurately classified 68.42% of headache subjects in their proper diagnostic category, comparable to, but statistically less accurate than, the 86.4% agreement between expert headache diagnosticians using clinical interviews. Results of a factor analysis of the Headache Symptom Questionnaire lend support for their being two commonly accepted global headache categories—vascular/migraine and muscle contraction—and one headache dimension concerned with duration of headache pain. Combined migraine-muscle contraction headache was found to be related more to migraine than to muscle contraction headache, and cluster headaches emerged as a separate clinical entity, not loading positively on any factor and loading negatively on all three.This research was supported in part by Grant NS-15235 from the National Institute of Neurological and Communicative Disorders and Stroke.     

An Evaluation of the Jamaican Anticrime Program

A sweeping anticrime package was implemented in Jamaica in 1974. This program included severe penalties for possession of illegal guns, censorhsip of gun scenes from television and the movies, and greatly broadened police powers. The impact of this anticrime package on crime was assessed using quasiexperimental time-series designs with both months and years as the units of analysis. In a one year period there was a 14% reduction in homicides ( p <.05), a 32% reduction in rapes ( p <.01), a 25% reduction in robberies ( p <.05), and a 37% reduction in nonfatal shootings ( p <.01). Data from the second year following the implementation of the anticrime package were not available. The data from the fist year suggest that strict anticrime measures can reduce crime.     

EVALUATION OF BIOFEEDBACK IN THE TREATMENT OF BORDERLINE ESSENTIAL HYPERTENSION1

Direct biofeedback of blood pressure was compared with frontal EMG biofeedback and with self-instructed relaxation for the treatment of essential hypertension in a controlled group outcome study. Patients were followed up for four months after the end of treatment. Generalization of treatment effects was assessed through pre- and posttreatment measurements of blood pressure under clinical conditions in a physician's office. There were no significant reductions in diastolic blood pressure. The systolic blood pressure (SBP) of the patients receiving blood pressure biofeedback decreased 8.1 mm mercury (p = 0.07) and the SBP of the patients in the relaxation condition decreased 9.5 mm mercury (p = 0.05). In the generalization measures, there were significant reductions in SBP for the relaxation group. The results are discussed in terms of the general lack of replicability within the area of biofeedback treatment of hypertension.     

The effects of conditioning and novelty on the rat's analgesic and pyretic responses to morphine

Six experiments with rat subjects investigated the role of conditioning in morphine tolerance. Concurrent assessments of body temperature and pain sensitivity were conducted. Experience with morphine produced tolerance to its analgesic effects but enhancement of its hyperthermic effects. Environmental novelty enhanced analgesia but not body temperature (Experiments 1 and 4). Under conditions in which a discriminated hyperthermic CR provided clear evidence that morphine-environment learning had developed, discriminated analgesic tolerance was not obtained (Experiments 2 and 3). Similarly, whereas placebo administrations extinguished the hyperthermic CR (Experiments 4 and 6), analgesic tolerance remained unaffected (Experiments 4, 5, and 6). These experiments suggest that the pyretic and analgesic systems are differentially sensitive to conditioning and the effects of novelty.     

How do group meetings make a community Therapeutic?

Summary Following an abrupt shift from a therapeutic community with emphasis on group meetings to a hierarchical medical model on a mental hospital floor, disturbed patients required extensive individual nursing care. This increased work load for the nursing staff resulted in admissions having to be limited to the rare cases who needed little or no nursing care. As patients were discharged, the vacancy rate went up to approximately 20% for a week and remained high for another two weeks. Nursing staff-patient relations deteriorated.Subsequently, it was possible to resume the emphasis on the groups of a therapeutic community and to observe the contrast. The experience showed how groups can effect and support a therapeutic community. It clarified some of the mechanisms by which groups positively affected disturbed patients. Some mechanisms by which the staff, community, and group meetings favorably influenced the nursing staff-patient relationship and intrastaff communications became clear also.     

Generic Models of Counseling Supervision: Counseling/Instruction Dichotomy and Consultation Metamodel

Major conceptual models for counseling supervision are described and compared: supervision as a counseling analog, as an instruction or teaching analog, and as a role that includes counseling and teaching aspects. Although each of these approaches avails supervisors of familiar roles, none adequately provides the scope and utility required of a model for such a complex function. Thus, a higher order metamodal, supervision as consultation, is presented, and this consultation metamodel is related to the psychoeducational model for counseling psychology.