The flexible application of a manualized treatment for PTSD symptoms and functional impairment related to the 9/11 World Trade Center attack

The purpose of this treatment effectiveness study was to evaluate the flexible application of a manualized cognitive behavioral treatment (CBT) for PTSD and related symptoms in survivors of the 9/11 terrorist attack on the World Trade Center. Treatment delivery ranged from 12 to 25 sessions; therapist experience ranged from no prior training to extensive training in CBT; and training and supervision of clinicians in the treatment manual was considerably less than that required in a randomized clinical trial (RCT). Paired t-tests demonstrated significant pre-post reductions in symptoms of PTSD and depression for the flexible application of the treatment. A benchmarking analysis revealed that the moderate-to-large effect sizes found for these variables were similar to those obtained in an RCT of the same treatment. Furthermore, effect sizes on measures of outcomes particularly relevant to this population of mass violence survivors such as functional impairment, use of alcohol and drugs to cope, and use of social support to cope, were also medium to large.     

From Rogers to Clinebell: Exploring the History of Pastoral Psychology

This essay explores the recent history of pastoral psychology by examining the transition from Carl Rogers’s client-centered therapy as a dominating force to the emergence of Howard Clinebell’s growth counseling. The theory and application of each approach is explored, including an analysis of how the cultural milieu of World War II and the shift to neofreudian thought influenced both Rogers and Clinebell. Finally, this essay demonstrates how Clinebell modified Rogers’s client-centered therapy by combining confrontation with unconditional positive regard.     

Wrestling with matter: origins of intersubjectivity

Recent theories of intersubjectivity attach primacy to the creation of meaning between subjects, obscuring the role of the material world to which both Freud and Winnicott attached significance. Yet, as this article argues, intersubjectivity itself is predicated upon a transitional space between subjective creation and material life. After considering Winnicott's conceptions of psychesoma and transitionality, the author examines the developmental literature for precursors in the encounter with matter that set the stage for the emergence both of symbolic life and of an embodied "transitional subject" to come into being. Clinical illustrations are provided.     

is affirmative action still necessary?

The influences of socio‐race, racial identity development, gender, educational level, and age on promotion and compensation decisions by midlevel supervisors in industry were examined in this analogue study of 74 midlevel business and industry supervisors. The participants varied in socio‐racial classifications, gender, educational levels, and age. Results of this study indicated statistically significant differences in promotion rates of female analogue employees, rates of promotion between White male and Black male supervisors, and the rate of promotion when comparing older versus younger supervisors.     

Pattern separation, pattern completion, and new neuronal codes within a continuous CA3 map

The hippocampal CA3 subregion is critical for rapidly encoding new memories, which suggests that neuronal computations are implemented in its circuitry that cannot be performed elsewhere in the hippocampus or in the neocortex. Recording studies show that CA3 cells are bound to a large degree to a spatial coordinate system, while CA1 cells can become more independent of a map-based mechanism and allow for a larger degree of arbitrary associations, also in the temporal domain. The mapping of CA3 onto a spatial coordinate system intuitively points to its role in spatial navigation but does not directly suggest how such a mechanism may support memory processing. Although bound to spatial coordinates, the CA3 network can rapidly alter its firing rate in response to novel sensory inputs and is thus not as strictly tied to spatial mapping as grid cells in the medial entorhinal cortex. Such rate coding within an otherwise stable spatial map can immediately incorporate new sensory inputs into the two-dimensional matrix of CA3, where they can be integrated with already stored information about each place. CA3 cell ensembles may thus support the fast acquisition of detailed memories by providing a locally continuous, but globally orthogonal representation, which can rapidly provide a new neuronal index when information is encountered for the first time. This information can be interpreted in CA1 and other downstream cortical areas in the context of less spatially restricted information.     

Trafficking women: Gendered impacts of Canadian immigration policies

Women and men are subject to different forms of human trafficking; sexual exploitation is more common for women than for men, and the purposes of trafficking follow gender roles. This article argues that Canadian immigration policies have differential and discriminatory impacts according to gender. We define human trafficking before critiquing two Canadian immigration programs that leave women vulnerable to exploitation. Interviews, questionnaires, and a review of official documents were employed in exploring the government's response to this phenomenon. Our findings suggest that given the nature of the international trafficking and exploitation of women in Canada, the government's focus on border control is ineffective in protecting trafficked women's human rights and the rights of migrants generally.     

Reviews: Books Photography

RELATIONAL PSYCHOANALYSIS: THE EMERGENCE OF A TRADITION. Edited by Stephen A. Mitchell and Lewis Aron. 514 pp. Hillsdale, NJ: The Analytic Press, 1999. $39.95. D.H. LAWRENCE AND THE PARADOXES OF PSYCHIC LIFE. By Barbara Ann Schapiro. 155 pp. Albany: State University of New York Press, 1999. $17.95. TECHNOLOGY AS MAGIC: THE TRIUMPH OF THE IRRATIONAL. By Richard Stivers. 240 pp. New York: Continuum Press. 1999. $24. REFLECTIONS ON A RAVAGED CENTURY. By Robert Conquest. 317 pp. New York: W. W. Norton & Company, 2000, $27.95. THE MYSTERIES WITHIN A SURGEON REFLECTS ON MEDICAL MYTHS. By Sherwin B. Nuland. 274 pp. New York: Simon & Schuster, 2000, $24.00. DISEASE, PAIN, AND SUICIDAL BEHAVIOR. By Elisabeth Stenager and Egon Stenager. 127 pp. New York: The Haworth Medical Press, 1998. $17.95. TRAUMA ASSESSMENTS: A CLINICIAN'S GUIDE. By E. B. Carlson. 307 pp. New York: The Guilford Press, 1997. $30. ON INFANCY AND TODDLERHOOD: AN ELEMENTARY TEXTBOOK. By David A. Freedman, M.D. 247 pp. Madison: International Universities Press, Inc., 1999. $27.95. TUESDAYS WITH MORRIE. By Mitch Albom. 192 pp. New York: Doubleday, 1997. $21. THE SORROWS OF THE QUAKER JESUS; JAMES NAYLER AND THE PURITAN CRACKDOWN ON THE FREE SPIRIT. By Leo Damrosch. 322 pp. Cambridge, MA: Harvard University Press, 1996, $39.95. THE PASTORAL CARE OF DEPRESSION: A GUIDEBOOK. By Binford W. Gilbert. 127 pp. New York: The Haworth Pastoral Press, 1998. $19.95. LEARNING DISABILITIES AND PSYCHIC CONFLICT: A PSYCHOANALYTIC CASEBOOK. By Arden Aibel Rothstein, Ph.D., and Jules Glenn, M.D. 504 pp. Madison: International Universities Press, Inc., 1999. $78. HAUNTED CHILDREN: RETHINKING MEDICATION OF COMMON PSYCHOLOGICAL DISORDERS. By Arthur F. Roemmelt, MD. 196 pp. New York: State University of New York Press, 1998. $17.95. NAVIGATING THE DEEP RIVER: SPIRITUALITY IN AFRICAN-AMERICAN FAMILIES. By Archie Smith, Jr. 181 pp. Cleveland, Ohio: United Church Press, 1997. $15.95. AL-JUNUN: MENTAL ILLNESS IN THE ISLAMIC WORLD. Edited by Ihsan Al-Issa. 382 pp. Madison: International Universities Press, 2000. $48. Witnessing the Lack of Sanctuary