The Hard-to-Engage Patient: A Treatment Failure

I discuss the relatedness with certain hard-to-engage patients as a kind of dissociative enactment, and I present a case illustration of a man whom I liked but could not help.     

Relational Spirituality and Dealing With Transgressions: Development of the Relational Engagement of the Sacred for a Transgression (REST) Scale

In the study of spirituality and forgiveness, researchers have begun to look at how dynamic spiritual experiences influence forgiveness. In three studies, we develop the Relational Engagement of the Sacred for a Transgression (REST) Scale, which assesses the extent to which victims actively engage a relationship with the Sacred to deal with a specific transgression. In Study 1, exploratory factor analysis was used to determine the factor structure of the REST. In Study 2, the factor structure was replicated using confirmatory factory analysis. The REST was correlated with religious commitment and negatively related to avoidant attachment to God. In Study 3, evidence supporting the scale's construct validity was adduced. REST scores were correlated with other appraisals of relational spirituality. Structural equation modeling was used to compare theoretical models. REST scores were related to dedication to the Sacred and viewing the transgression as a desecration. In addition, REST scores were positively related to empathy, which was positively related to forgiveness. Furthermore, REST scores predicted forgiveness above and beyond other appraisals of relational spirituality.     

Building a Bridge of Trust: Collaborative Assessment With a Person With Serious Mental Illness

Collaborative assessment utilizes psychological testing to help people make positive changes in their lives. Limited research has evaluated the utility of collaborative assessment for persons with serious mental illness. This case example uses the Personality Assessment Inventory to illustrate the usefulness of collaborative assessment with a person with serious mental illness. This approach informed not only diagnostic considerations but also revealed the client's current level of distress, contributed to enhanced therapeutic alliance, and directly pointed to psychiatric rehabilitation strategies.     

Safety Engineering for Artificial General Intelligence

Machine ethics and robot rights are quickly becoming hot topics in artificial intelligence and robotics communities. We will argue that attempts to attribute moral agency and assign rights to all intelligent machines are misguided, whether applied to infrahuman or superhuman AIs, as are proposals to limit the negative effects of AIs by constraining their behavior. As an alternative, we propose a new science of safety engineering for intelligent artificial agents based on maximizing for what humans value. In particular, we challenge the scientific community to develop intelligent systems that have human-friendly values that they provably retain, even under recursive self-improvement.     

Christian Couple Counseling by Professional,Pastoral, and Lay Counselors from a Protestant Perspective: A Nationwide Survey

Couple counseling is widely practiced by Christian counselors, but there are almost no empirical data investigating it. The present study presents data from a national web-based survey of counselors from the American Association of Christian Counselors (AACC). We describe the nature of Christian couple counseling, as well as counselors' religiousness and their attitudes toward integrating religion and spirituality into couple counseling. Christian couple counselors were highly religious and their personal religiosity affected their attitude toward incorporating religion in counseling. There were differences between professional, pastoral, and lay counselors suggesting that each be treated separately rather than be lumped generically as Christian couple counseling.     

Summer Reading: Predicting Adolescent Word Learning from Aptitude,Time Spent Reading,and Text Type

Mostly low-income African American and Hispanic teens (N = 192) were tested in (a) passage comprehension, (b) vocabulary ability, (c) cloze task performance, and (d) listening comprehension in the spring and vocabulary in the fall. Students were surveyed about reading (a) narrative, (b) expository, (c) teen culture, and (d) online texts. Interaction terms created by the product of cloze task scores with the time and frequency of student narrative and expository reading were both significant predictors of fall vocabulary. Online reading was popular but did not predict vocabulary gains. Teen culture reading predicted vocabulary loss. Text type and student profiles both play a role in predicting fall vocabulary scores from summer reading.     

Transference Focused Psychotherapy for Patients with Comorbid Narcissistic and Borderline Personality Disorder

Clinical experience involving the treatment of patients with comorbid borderline and narcissistic personality disorders suggests that this patient population is among the more difficult to treat within the personality disorder spectrum. In this article, we present refinements of Transference Focused Psychotherapy (TFP) based on our clinical experience with and research data on patients with comorbid narcissistic personality disorder/borderline personality disorder (NPD/BPD). We briefly review object relations formulations of severe narcissistic pathology, as well as recent research in attachment and the allied concept of mentalization, which have provided a new lens through which to view narcissistic disorders. The research findings from two randomized clinical trials demonstrating the efficacy and effectiveness of TFP are presented. The data from the two Randomized Clinical Trials (RCT) allowed for the study of the characteristics of the subgroup of borderline personality disorder patients who have comorbid NPD/BPD. Findings on comorbidity, attachment status, capacity for mentalization, and level of personality organization of borderline patients with comorbid NPD/BPD, compared with borderline patients without comorbid narcissistic pathology (BPD), are presented. Clinical implications of the observed group differences are discussed, with a focus on refinements in the technique of TFP. Clinical case material is presented to illustrate the specific challenges posed by narcissistic patients to carrying out TFP in each phase of treatment.