Description of Relational Processes: Recent Changes in DSM‐5 and Proposals for ICD‐11

Epidemiologic, prospective, and retrospective research confirms that family relational variables are significant risk factors for the development of mental and physical health problems in children as well as adults. In addition, relationships also play a moderating role in the maintenance, exacerbation, or amelioration of chronic health problems. Although acknowledgment of the importance of these variables in the pathophysiology of a number of health conditions is reaching more prominence, the integration of assessments of family factors as part of standard health care has made little progress. With the arrival of the Affordable Care Act in the United States, there is a desire for earlier identification of these risk factors, and the ability to implement prevention programs that reduce risk, and enhance protective factors. On a global level, there is increased awareness of the health impact of relational problems, for example, many countries have attempted to implement programs to decrease domestic violence. More reliable and standardized assessments of key relational processes will enhance both of these missions, and allow comparison of a variety of prevention and intervention programs. This article discusses progress over the last decade in constructing more reliable definitions of relationship processes, how these have been integrated into the Diagnostic and Statistical Manual 5th edition (DSM‐5), and progress toward implementation into the World Health Organization's International Classification of Diseases (ICD‐11).     

The Cult Phenomenon: A Turn of the Century Update

A variety of groups that function on the fringes of both religion and psychotherapy have been evident in the U.S. since the 1960s, with perhaps their greatest presence noted in the 1970s. There were as many as 3000 cult-type organizations identified in that period. Many of these groups created havoc with their followers' lives and the lives of the followers' families. The authors examined the cults in the late 1970s and early 1980s, comparing their activities and requirements to those of "standard" religions and sects. The present article looks at the changes in the two decades since then, noting modifications in the cults' target populations as well as the increases in many kinds of violence in some of the groups.     

Utilization of Individual versus Family Therapy Among Adolescents with Severe Emotional Disturbance

Service utilization patterns among children with severe emotional and/or behavioral disturbances are described for 89 children and families, interviewed at two time points across a 6-month period. Children received a greater number of individual therapy sessions than family therapy sessions, and children significantly decreased their levels of internalizing and externalizing behaviors. Family therapy was associated with decreases in internalizing behaviors when children reported outcomes. Individual therapy was not associated with changes in either internalizing or externalizing behaviors regardless of reporter. Symptom severity did not dictate whether children were provided individual or family therapy. Recommendations for individualized treatment plans are offered.     

Consultation in family therapy

Abstract

This paper addresses the issue of the use of consultants by experienced family therapists. The authors discuss the need for consultation under different circumstances and review a number of models currently being utilized. Emphasis is placed on preparing the clients for the consultation, providing background information to and preparing with the consultant for the session(s), and transferring “power” to the consultant and back again to the primary therapist.     

Some Legal Issues Patients May Face While in Therapy

This article on forensic family therapy touches upon a few of the major germane ethical and legal dicta which regulate and circumscribe psychotherapy practice. Differences between ethical and legal rulings are delineated. Some of the problems which may confront and even engulf individuals, couples, and families during their life cycle and which bring them into the orbit of the legal and/or judicial systems before, during, or after the period of assessment and treatment are explored. Some issues that have received the least coverage in the family forensic literature are highlighted; and some of the areas that have been accorded a great deal of attention elsewhere are mentioned only briefly. A short commentary on the forensic family professionals’ potential role in each arena of practice is provided.     

Mentoring Interns and Postdoctoral Residents in Academic Health Sciences Center

This article was co-authored by a senior mentor and one of her students who worked with her as both an intern and a postdoctoral fellow. It is an expanded version of a presentation given by the first author after receiving the Association of Psychologists in Academic Health Centers (APAHC) Distinguished Achievement in Teaching Award. The article offers a historical view on mentoring, defines and describes the term, and delineates the characteristics of good mentors and mentees. The significant impact of mentoring on the professional and personal development of psychology interns and postdoctoral residents and their mentors in academic health centers is explored. Techniques for developing, maintaining, and promoting effective mentoring relationships are provided and the ethical considerations related to mentoring are examined. This article is based upon an invited address, “Mentoring of Predoctoral Interns and Postdoctoral Fellows in an Academic Health Sciences Center” given by the first author in recognition of the author’s receipt of the Association of Psychologists in Academic Health Centers 2005 Award for Distinguished Achievement in Teaching. The address was presented at the Annual meeting of the American Psychological Association, New Orleans, LA, August, 2006.     

Social problem solving: A moderator of the relation between negative life stress and depression symptoms in children

The social problem-solving skill of generating effective alternative solutions was tested as a moderator of the relation between negative life stress and depressed mood in children. Boys ( n= 25) and girls ( n= 25), ages 8 to 12 years, from inner-city, lower socioeconomic group families, completed measures of depression symptoms, negative impact of life events, and quantity and effectiveness of alternative solutions to social problems. Results indicated that the effectiveness of alternative solutions children generate in response to peer social problems moderates the relation between stress and depression. Children who experienced a high impact of negative life events, with less effective social problem-solving skills, reported higher levels of depression compared to children who experienced a high impact of negative life events but exhibited more effective social problem-solving skills. Results are discussed in terms of alternative theoretical models for the mechanisms whereby effective social problem-solving skills moderate stress-related depression.