Lessons from the Transition to Relational Teletherapy During COVID-19

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship-based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context’s constraints and exploiting its strengths is key to providing high-quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add-on to a face-to-face practice.     

Visual Narrative Structure

Narratives are an integral part of human expression. In the graphic form, they range from cave paintings to Egyptian hieroglyphics, from the Bayeux Tapestry to modern day comic books ( Kunzle, 1973 ; McCloud, 1993 ). Yet not much research has addressed the structure and comprehension of narrative images, for example, how do people create meaning out of sequential images? This piece helps fill the gap by presenting a theory of Narrative Grammar. We describe the basic narrative categories and their relationship to a canonical narrative arc, followed by a discussion of complex structures that extend beyond the canonical schema. This demands that the canonical arc be reconsidered as a generative schema whereby any narrative category can be expanded into a node in a tree structure. Narrative “pacing” is interpreted as a reflection of various patterns of this embedding: conjunction, left‐branching trees, center‐embedded constituencies, and others. Following this, diagnostic methods are proposed for testing narrative categories and constituency. Finally, we outline the applicability of this theory beyond sequential images, such as to film and verbal discourse, and compare this theory with previous approaches to narrative and discourse.     

Prediction,events, and the advantage of Agents: The processing of semantic roles in visual narrative

Agents consistently appear prior to Patients in sentences, manual signs, and drawings, and Agents are responded to faster when presented in visual depictions of events. We hypothesized that this “Agent advantage” reflects Agents’ role in event structure. We investigated this question by manipulating the depictions of Agents and Patients in preparatory actions in wordless visual narratives. We found that Agents elicited a greater degree of predictions regarding upcoming events than Patients, that Agents are viewed longer than Patients, independent of serial order, and that visual depictions of actions are processed more quickly following the presentation of an Agent vs. a Patient. Taken together these findings support the notion that Agents initiate the building of event representation. We suggest that Agent First orders facilitate the interpretation of events as they unfold and that the saliency of Agents within visual representations of events is driven by anticipation of upcoming events.     

Framing Social Dominance Orientation and Power in Organizational Context

The present research incorporates both intergroup and interpersonal approaches to power to examine influence tactics in organizations. Both approaches suggest that there should be coordination between supervisors and subordinates in the workplace for the smooth functioning of organizations. Study 1 tested how employees' social dominance orientation corresponds to what interpersonal influence tactics employees view as acceptable for supervisors. Study 2 tested how employees' SDO corresponds to interpersonal influence tactics they would use on subordinates. Complementarily, results showed that the higher participants were on SDO, the more they endorsed harsh tactics as legitimate. Implications for integrating power theories are discussed.     

Toward a Shortened Measure of Adaptive Selling

This study investigates the psychometric properties of the adaptive selling scale (ADAPTS) developed by Spiro and Weitz (1990). A multiple industry sample of 1042 salespeople is employed, which provides the ability to more fully explore the dimensions of adaptive selling within a diverse cross-section of sales situations. An assessment utilizing confirmatory factor analysis suggests a shortened version of the scale consisting of five items that represent four of the facets originally proposed by Spiro and Weitz (1990). Based on its psychometric properties and measurement efficiency for business applications, this scale (labeled ADAPTS-SV, for shortened version) is recommended for future applications where appropriate.     

Deriving Training Strategies for Spatial Knowledge Acquisition From Behavioral,Cognitive, and Neural Foundations

While much has been made of the potential uses for virtual environment (VE) technologies as training aids, there are few guidelines and strategies to inform system development from the user’s perspective. Assumptions are that a human factors-based evaluation will ensure optimal performance, transferring training from virtual to real worlds; however, there are complex, yet unexplored, issues surrounding system optimization and employment. A comprehensive investigation into the foundations of training, traversing levels of performance analysis, from overt behavioral responses to the less explicit neuronal patterns, is proposed from which optimal training strategies can be inferred and system development guidelines deduced.     

Adolescent Decisional Autonomy Regarding Participation in an Emergency Department Youth Violence Interview

Much attention has been given to determining whether an adolescent patient has the capacity to consent to research. This study explores the factors that influence adolescents' decisions to participate in a research study about youth violence and to determine positive or negative feelings elicited by being a research subject. The majority of subjects perceived their decision to participate to be free of coercion, and few felt badly about having participated. However, adolescents who were alone in the room during the assent process were more likely to report that they chose freely to be a research subject. This study may influence the ways physicians communicate with adolescent patients around research assent within a clinical care environment.     

Do positive children become positive adults? Evidence from a longitudinal birth cohort study

BACKGROUND: Little is known about the long-term consequences of positive wellbeing in childhood in the general population. We used the MRC National Survey of Health and Development (the British 1946 birth cohort) to test associations between adolescent positive wellbeing and social functioning in midlife. METHOD: Temperament and behaviour at ages 13 and 15 years were rated by school teachers on a range of criteria. These mostly referred to absence or presence of conduct and emotional problems, but four items allowed positive ratings: 'very popular with other children', 'unusually happy and contented', 'makes friends extremely easily' and 'extremely energetic, never tired'. In addition, at age 16 years survey members self-completed the Maudsley Personality Inventory, from which a summary measure of extraversion was derived, as this was previously found to be associated with midlife positive wellbeing in this cohort. RESULTS: Being a happy child, defined as receiving at least two of the above teacher ratings, was positively associated with midlife functioning and wellbeing, specifically a low probability of lifetime emotional problems, a high frequency of contact with friends or relatives, engagement in social activities, and to a lesser extent feeling satisfied with accomplishments in working life. These associations were independent of father's social class, childhood cognition, educational attainment, and midlife occupational social class. There were no independent associations between being a happy child and educational or occupational attainment, being married, engagement in prosocial activities, taking leadership in community activities, and with life satisfaction in general or with family life. Extraversion was associated with a low probability of lifetime emotional problems, high engagement in social activities, being married, general midlife life satisfaction, and satisfaction with family life, but not with social contact, prosocial activity, leadership activity, or work satisfaction. While childhood conduct and emotional problems were associated with few of the social and life satisfaction outcomes, the former were negatively associated with educational and occupational attainment, and positively with divorce, whereas the latter were negatively associated with being married. CONCLUSIONS: Prospectively rated childhood wellbeing has long-term beneficial links to adult functioning; our results also support the view that positive wellbeing has a unique impact on these outcomes, and does not merely represent the absence of mental ill-health.     

Delineating potential mechanisms of implicit alcohol cognitions: drinking restraint, negative affect, and their relationship with approach alcohol associations

Problem drinkers may use alcohol to avoid negative mood states and may develop implicit cognitive associations between negative emotional states and reinforcing properties of drinking. It is paradoxical that attempts to control drinking, such as among those high in drinking restraint, may inadvertently increase desire to drink and subsequent alcohol consumption, and this may be exaggerated under times of emotional distress when urges to drink are high. We examined whether individuals who are high on drinking restraint would demonstrate stronger alcohol-related thoughts elicited by stimuli that represent the desire to use alcohol, in response to stronger versus weaker negative mood arousal. Seventy hazardous drinkers completed measurements of drinking restraint, alcohol consumption, and consequences of use. After being randomized to view negative or positive pictures sets, participants completed an Implicit Association Task (IAT) to test differences in the strength of the association between desire to approach or avoid alcohol or water cues, and then a measurement of subjective craving following the IAT. Regression analyses showed that trait restriction not temptation was positively related to IAT scores, after controlling for relevant covariates and explained 7% of the total variance. Trait temptation not IAT predicted subjective craving. Negative affect was unrelated to IAT scores, singly or in conjunction with measures of drinking restraint, contrary to predictions. In sum, implicit alcohol cognitions are related to attempts to restrict drinking not temptation to drink and are less strongly influenced by mood state.     

Alcohol and group formation: a multimodal investigation of the effects of alcohol on emotion and social bonding

We integrated research on emotion and on small groups to address a fundamental and enduring question facing alcohol researchers: What are the specific mechanisms that underlie the reinforcing effects of drinking? In one of the largest alcohol-administration studies yet conducted, we employed a novel group-formation paradigm to evaluate the socioemotional effects of alcohol. Seven hundred twenty social drinkers (360 male, 360 female) were assembled into groups of 3 unacquainted persons each and given a moderate dose of an alcoholic, placebo, or control beverage, which they consumed over 36 min. These groups' social interactions were video recorded, and the duration and sequence of interaction partners' facial and speech behaviors were systematically coded (e.g., using the Facial Action Coding System). Alcohol consumption enhanced individual- and group-level behaviors associated with positive affect, reduced individual-level behaviors associated with negative affect, and elevated self-reported bonding. Our results indicate that alcohol facilitates bonding during group formation. Assessing nonverbal responses in social contexts offers new directions for evaluating the effects of alcohol.