Suicide Signs on the Rorschach

This paper reviews the literature concerning the assessment of suicide using the Rorschach and updates the important developments since Goldfried, Stricker, and Weiner's comprehensive review of the literature in 1971. Special attention is given to those indicators which show the most support in the literature and are most efficient to use. The presence or absence of any of these signs in a patient's record should not be taken to signify the presence or absence of suicidal ideation. However, the presence of even one of these indicators does provide a warning to the clinician, indicating that further exploration in this area may be warranted. Knowledge of the many suicidal indicators on projective tests places the clinician in a better position to predict such destructive behavior and intervene appropriately.     

The Economic Benefits of Increased Treatment Duration and Intensity in Residential and Outpatient Substance Abuse Treatment Settings

This study presents estimates of the economic benefits to society from community-based substance abuse treatment. The analysis focused on the impact of length of stay and frequency of counseling on clients' crime-related and health care costs, welfare receipts, and income taxes. The results indicate that the benefits from an additional day of treatment were on average $21 for short-term residential treatment (or 29% the cost of a day of care), $13 for outpatient drug-free treatment (or 94% the cost of a day of care), and $5 for long-term residential treatment (or 9% the cost of a day of care). No benefits were found from additional counseling provided by a client's primary therapist. Withthe exception of short-term residential care, estimated increases in client earnings from longer lengths of stayexceeded the benefits to society. Our estimates do not include benefits realized during treatment or beyond the year after treatment.     

Context-dependent memory for meaningful material: information for students

Context-dependency effects on memory for lists of unrelated words have been shown more often with recall than with recognition. Context dependency for meaningful text material was examined using two standard academic testing techniques: short answer (recall) and multiple choice (recognition). Forty participants read an article in either silent or noisy conditions; their reading comprehension was assessed with both types of test under silent or noisy conditions. Both tests showed context-dependency effects in which performance was better in the matching conditions (silent study/silent test and noisy study/noisy test) than in the mismatching conditions (silent study/noisy test and noisy study/silent test). Context cues appear to be important in the retrieval of newly learned meaningful information. An academic application is that students may perform better on exams by studying in silence. Copyright © 1998 John Wiley & Sons, Ltd.     

Color-Conscious Multicultural Mindfulness Training in the Counseling Field

The Color-Conscious Multicultural Mindfulness (CCMM) training focuses on addressing intercultural relationship ruptures, individual inequity, and systemic disparities. In this randomized control study, the authors examined the CCMM training effectiveness with 39 prelicensed counselors and counseling students using repeated measures analyses of covariance. Participants reported statistically significant changes in multicultural competence; mindfulness; and color-blind racial attitudes related to privilege, institutional discrimination, and blatant racism. Implications for counselor training practices and future research are provided.     

Laboratory and questionnaire measures of aggression among female parolees with violent or nonviolent histories

Female parolees were recruited into a laboratory study to determine the relationship between their previous aggression history, questionnaire measures of aggression, and behavioral measures of aggressive responding using a laboratory methodology: the Point Subtraction Aggression Paradigm (PSAP). Subjects were assigned to a violent or nonviolent group based on their criminal history. Subjects participated in sessions in which they were given three response options: (1) nonaggressive responding that earned money, (2) aggressive responding that ostensibly subtracted money from another fictitious person and was defined as aggressive since it resulted in the ostensible delivery of an aversive stimulus (subtraction of money) to another person, and (3) escape responding that protected the subject's earnings from periodic subtractions initiated by the fictitious other person. Results indicated that the violent female parolees emitted significantly more aggressive responses than subjects in the nonviolent group. This study provides additional external validity as well as evidence for convergent and discriminant validity for PSAP laboratory measurement of human aggressive responding and extends these findings to female parolees. Comparisons to previously published data with male parolees showed that gender differences were found among violent but not nonviolent parolees. Aggr. Behav. 26:291–307, 2000. © 2000 Wiley‐Liss, Inc.     

The construction of emotional experience: State‐related emotional awareness and its application to psychotherapy research and practice

The cognitive–developmental theory of ‘levels of emotional awareness’ (LEA) addresses an individual's capacity to experience and express emotion, a capacity highly relevant to psychotherapy. Previous papers on LEA and psychotherapy addressed the aspect of LEA theory pertaining to the ‘trait’ (i.e. enduring) aspects of an individual's emotional functioning over time. LEA theory also applies to the construction of emotional experience at any given moment, in which levels emerge or disappear in a process of microgenetic construction as a function of arousal and other variables. This state‐related perspective is supported by recent research showing that people vary in their LEA from moment to moment. Momentary changes in LEA correspond to the variations in lived experience that occur in relationships, including the therapy relationship, and provide the context for corrective emotional experiences that promote change. In this paper, the construction of emotional experience at different levels of organisation is discussed separately in relation to clients and therapists. Key phenomena relevant to psychotherapy include the transition from bodily sensations to specific differentiated emotional feelings, the ability to be aware of multiple feelings that may be contradictory or counter‐intuitive, and the appreciation of how complex combinations of feelings may differ in self and other. This perspective adds to the literature on how the integration of emotion and cognition contributes to change in psychotherapy. The clinical and research implications of this perspective are discussed.     

The Effect of PTSD Symptom Change on Suicidal Ideation in a Combined Military and Civilian Sample Engaged in Cognitive Processing Therapy

In light of the well-established relationship between posttraumatic stress disorder (PTSD) and suicidal ideation (SI), there has been a push for treatments that simultaneously improve symptoms of PTSD and decrease SI. Using data from a randomized controlled hybrid implementation-effectiveness trial, the current study investigated the effectiveness of Cognitive Processing Therapy (CPT; Resick, Monson, & Chard, 2016) on PTSD and SI. The patient sample (N = 188) was diverse in military and veteran status, gender, and comorbidity, and 73% of the sample endorsed SI at one or more points during CPT. Participants demonstrated significant improvement in SI over the course of CPT. Multilevel growth curve modeling revealed a significant association between PTSD symptom change and change in SI. Results from cross-lagged multilevel regressions indicated that PTSD symptoms predicted SI in the next session, yet SI in a given session did not predict PTSD symptoms in the next session. Potentially relevant clinical factors (i.e., military status, gender, depression diagnosis, baseline SI, study consultation condition) were not associated with the relationship between PTSD symptoms and SI. These results add to the burgeoning literature suggesting that evidence-based treatments for PTSD, like CPT, reduce suicidality in a range of individuals with PTSD, and that this reduction is predicted by improvements in PTSD symptoms.