Involving the family in the evaluation and treatment of the child patient: A psychodynamic approach

The purpose of this article is to provide psychotherapists with a tool for family evaluation using the basic principles of psychodynamic work; and to introduce a transitional format for therapists who have practiced family evaluations in their training institutions and now need to adapt this model to the private practitioner's office. A case example illustrates: (1) Use of the therapist's unconscious for diagnosis of the child and its family, (2) joining the family's intersubjective space, and (3) use of play and therapist's neutrality as ways that the psychodynamically oriented clinician involves the family in the evaluation and treatment of the child.     

Gender,psychological well-being and somatic cardiovascular risk factors

The purpose of this study is to determine associations between cardiovascular risk factors and subjective experience of psychological general well-being with special reference to gender-related differences. One hundred fifty white-collar workers in a car manufacturing plant in Sweden participated in a health care screening program. Subjective experience of psychological well-being was significantly correlated with cardiovascular risk factors among both men and women. There were, however, marked differences between the genders. For men, the following specific psychological variables were significantly correlated with cardiovascular risk factors: estimation of general health, anxiety, self-control and vitality. For women, more complex significant relationships between the two sets of variables were found. Moreover, the direction of the correlations differed between the genders. For example, men with cardiovascular risk factors, such as increased blood pressure, blood lipids and body mass index, reported significantly morepositive estimation of their general health. For women the relation was the opposite with a significantly positive correlation (p-0.004) between experience of good health and a low risk factor profile indicating the concordance between physiological and psychological parameters. Possible reasons for these sex differences are discussed.     

Characteristics of Calls to Israeli Hotlines During the Gulf War

The current study presents results of a survey of 3,215 calls received at seven centers of telephone emergency services (TES) in Israel during the Gulf War, when citizens of Israel experienced severe stress resulting from SCUD missile attacks. Whereas former surveys have shown that characteristics of calls to TES in Israel are generally not affected by external stressogenic events, a remarkable change was recorded in both the quantity and quality of calls received in TES centers in Israel during the Gulf War. The relative frequencies of problem categories presented by callers during the Gulf War revealed a significant increase in environmental pressures, a category that reflected the stressful situation of the war, as opposed to intra- or interpersonal problems typical of peacetime calls. A comparison between this group of war calls and a control group of nonwar calls, revealed that the two groups represented populations of callers differing in sociodemographic characteristics, expectations, and benefits from the calls. Results are discussed in reference to the unique role of TES as a source of psychological first-aid in a community crisis situation.     

Requiem for “schizophrenia”

In this article a brief overview of the treatment of chronic psychosis for the last two centuries is covered, with particular emphasis on many scientifically demonstrated causes of chronic organic psychosis and their medically successful treatment, including recent neurotransmitter manipulations. With respect for the important contributions of Bleuler, the term “schizophrenic” is considered as an unscientific and unprovable nosological construct, which has hampered the successful resolution of chronic psychosis and has outlived its usefulness in the lexicon of modern psychiatry.     

The effects of situational variations in role-play scenes on assertive behavior

The study was conducted to determine the extent to which variations in the situational parameters of role-play scenes affect subjects' levels of assertiveness. Thirty-six psychology undergraduate students were randomly assigned to one of three role-play conditions that differed in the situation-setting characteristics presented in the scenes: a Difficult condition, designed to inhibit assertive responding; an Easy condition, designed to facilitate assertive responding; and a Neutral condition. Subjects also completed a self-report assertion inventory. Videotapes of the role-played interactions were rated for a variety of component responses. Results indicate that subjects responded differently in the three conditions. Subjects in the Difficult and Neutral conditions were more compliant, and those in the Easy and Difficult conditions were more fluent. It is suggested that failure to specify the situational parameters of role-play scenes may affect the validity of this assessment procedure.This research was supported in part by NIMH Grant, MH28279 to the third author.     

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.