Zur Dynamik der Interaktion in der Supervision

The manifold functions of a supervisor in following the course of complex processes together with the trainee, are: ? to keep the goals of the supervision in view, ? to establish a teaching alliance and to support the wish and ambitions of the candidate to learn, ? to build a platform for the complex interactions with the trainee with regard to the dynamics of the training situation and keeping in mind the institutional influences, ? to lay down the setting for the work, ? to explore and to reflect how transference and counter-transference influence the interaction between patient and analyst as well as between trainee and supervisor, ? to examine these interactions together focussing continuously on the interaction between candidate and patient, and to encourage the candidate to do the same on his own, ? to continuously formulate hypotheses about the core conflict, the transference phenomena and resistance of the patient, ? to explore and reflect on the cooperative work.     

The self-narrative and acute psychosis

The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals.     

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.     

Suicide Risk Assessment and Risk Formulation Part I: A Focus on Suicide Ideation in Assessing Suicide Risk

The main procedure used by clinicians to determine whether an individual may be at risk of suicidal behaviors is the suicide risk assessment (SRA). The purpose of the SRA is to identify risk and protective factors that then provide the data for the formulation of suicide risk. The suicide risk formulation (SRF) assigns a level of suicide risk that ideally leads to triage and treatment deemed appropriate for that level of risk. Some of the problems with the SRA are explored here, with an emphasis on addressing the over reliance on communicated suicide ideation, and recommendations are made for improvements. Part II of this article (Berman & Silverman, 2013, also appears in this issue of STLB) examines the process of an SRF and, similarly, makes recommendations to improve clinical practice toward the desired end of saving lives.     

Predicting Persistence of Nonsuicidal Self‐Injury in Suicidal Adolescents

Prospective predictors of persistent nonsuicidal self‐injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy‐one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow‐up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI were more likely to persist in NSSI. Depression over follow‐up, but not at baseline, also predicted persistence. These results suggest that helping high‐risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI should be a high priority treatment target.     

Chaplains' Engagement with Suicidality among Their Service Users: Findings from the VA/DoD Integrated Mental Health Strategy

Chaplains play an important role in supporting the mental health of current and former military personnel; in this study, the engagement of Department of Veterans Affairs (VA), Army, Navy, and Air Force chaplains with suicidality among their service users were examined. An online survey was used to collect data from 440 VA and 1,723 Department of Defense (DoD) chaplains as part of the VA/DoD Integrated Mental Health Strategy. Differences were noted for demographics, work setting characteristics, encountering suicidality, and self‐perceived preparation for dealing with suicidality. Compared to DoD chaplains, VA chaplains encounter more at‐risk service users, yet feel less prepared for dealing with suicidality.