Initiation of Reflective Frames in Counseling for Huntingtons Disease Predictive Testing

Genetic professionals and clients are likely to assign different meanings to the extended format of the counseling protocols for predictive testing. In order to facilitate informed, client-centered decisions about the possibility of predictive testing, counselors routinely use the question format to initiate what we call "reflective frames" that invite clients to discuss their feelings and encourage them to adopt introspective and self-reflective stances toward their own experience--spanning the past, the present, and the hypothetical future. We suggest that such initiations of reflective frames constitute a key element of counselors' nondirective stance, although the exact nature of their formulations can be complex and varied. Examining 24 Huntington's Disease (HD) clinic sessions involving 12 families in South Wales with the tools of discourse analysis, our focus in this paper is twofold: (i) to propose a classification of six types of reflective questions (e.g. nonspecific invites, awareness and anxiety, decision about testing, impact of result, dissemination, and other) and to examine their distribution across the various clinic appointments, and (ii) to investigate the scope of these questions in terms of temporal and social axes. We link our analysis to the current debate within the genetic counseling profession about the merits of reflection- versus information-focused counseling styles and the need to abide by professionally warranted and institutionally embedded counseling protocols.     

Marking the anniversary: adolescents and the September 11 healing process

Clinical data are presented from a day spent at a New Jersey high school severely impacted by the World Trade Center disaster. Dissociation, a sense of numbness, anger, and guilt about feelings induced by the tragedy are all common dynamics in adolescents responding to trauma. The developmental issues that adolescents are confronting are described and discussed in terms of the challenges they present to the healing process. An argument is made that using groups to aid in the long recovery process with our young people should be a top public health priority.     

The Self as violent other: the problem of defining the self

This paper identifies the problem of arriving at a solid definition of C. G. Jung's notion of the Self, and seeks its resolution. The author first demonstrates how this problem is articulated by scholars of Jungian theory by showing that they have ultimately depended upon 'limited' definitions of the Self, where the Self is no more than a transcendental postulate, a simple derivative from the internal structure of Jungian argument. She then determines the reason for the problem by arguing that there can never be a complete definition of the Self for it encompasses that which is unconscious and is thus irreducible to ego-comprehension. By using a method of philosophical analysis (in the guise of Levinas) the author will show that through the Self's very need to evade comprehension the Self is essentially comprehended as an overpowering and violent entity. The author will argue that the Self as a force of violence is crucial to its definition, and scholars must not ignore the Self as numinous experience in favour of passive functionality. She will thus argue that through the adoption of a Levinasian critique, the Self can be defined and justified outside of the internally self-consistent system from which it is conventionally derived.     

An interview study exploring clients' experiences of receiving therapeutic support for family estrangement in the UK

Many people experience estrangement from a family member, which is broadly understood to refer to negative relationships that are characterised by little or no contact. However, little is known about how people cope with family estrangement. To address this gap, interviews were conducted with 46 participants who identified as being estranged from a parent/sibling and/or child and having sought therapeutic support for this experience. The participants were recruited from a UK-based charity that supports individuals experiencing family estrangement. The participants had a range of experiences of therapeutic support, with most (N = 31, 67%) having paid for private therapy. The data were analysed using thematic analysis, and three themes were generated: (1) finding the missing qualities in estranged family relationships: warmth, validation and safety; (2) speaking the unspoken: addressing the causes and consequences of estrangement; and (3) learning relational skills: improving the relationship with oneself and with others. When the causes of estrangement were addressed in the context of a safe therapeutic relationship, participants learned strategies to improve the relationships they had both with themselves and with others. When participants experienced a cold or unresponsive therapeutic relationship, and the causes and consequences of estrangement were not adequately addressed or understood, counselling was experienced as unhelpful. Individuals who seek therapeutic support for family estrangement have specific needs. Training around these needs and the causes and consequences of estrangement could be beneficial to helping professionals and the clients with whom they work.     

The impact of contextual family risks on prisoners' children's behavioural outcomes and the potential protective role of family functioning moderators

Abstract

Research suggests that children of prisoners have an increased risk for behavioural and emotional problems. However, in a resilience approach, one should expect heterogeneous outcomes and thus apply a contextualized perspective. As this is rarely acknowledged in empirical research, the present study sought to fill this gap using data from the Fragile Families and Child Wellbeing study on 801 children of imprisoned fathers. We explored the extent to which cumulative family risks measured during the first year of life (e.g., poverty and mental health problems) predicted behavioural outcomes at age 9 and whether potentially protective aspects of family functioning moderated the impact of these risk factors. Cumulative risk significantly predicted behavioural outcomes, but the associations were weak. No strong evidence of moderation was found. At low risk, mother–child closeness moderated behavioural outcomes. There was also some evidence of moderation by accumulated protective factors. Potential implications for policy and practice and challenges for further research are discussed.     

Congruency effects in dot comparison tasks: convex hull is more important than dot area

The dot comparison task, in which participants select the more numerous of two dot arrays, has become the predominant method of assessing Approximate Number System (ANS) acuity. Creation of the dot arrays requires the manipulation of visual characteristics, such as dot size and convex hull. For the task to provide a valid measure of ANS acuity, participants must ignore these characteristics and respond on the basis of number. Here, we report two experiments that explore the influence of dot area and convex hull on participants’ accuracy on dot comparison tasks. We found that individuals’ ability to ignore dot area information increases with age and display time. However, the influence of convex hull information remains stable across development and with additional time. This suggests that convex hull information is more difficult to inhibit when making judgements about numerosity and therefore it is crucial to control this when creating dot comparison tasks.     

Properties of bootstrap tests for N‐of‐1 studies

N‐of‐1 study designs involve the collection and analysis of repeated measures data from an individual not using an intervention and using an intervention. This study explores the use of semi‐parametric and parametric bootstrap tests in the analysis of N‐of‐1 studies under a single time series framework in the presence of autocorrelation. When the Type I error rates of bootstrap tests are compared to Wald tests, our results show that the bootstrap tests have more desirable properties. We compare the results for normally distributed errors with those for contaminated normally distributed errors and find that, except when there is relatively large autocorrelation, there is little difference between the power of the parametric and semi‐parametric bootstrap tests. We also experiment with two intervention designs: ABAB and AB, and show the ABAB design has more power. The results provide guidelines for designing N‐of‐1 studies, in the sense of how many observations and how many intervention changes are needed to achieve a certain level of power and which test should be performed.     

Stress and coping among student teachers at a South African university: An exploratory study

This article reports findings from an exploratory qualitative study on the lived experience of stress among a convenience sample of 14 South African university student teachers (female = 8, black = 7; age range = 22 to 31). The students were participating in training in mindfulness meditation, and completed three interviews over a six-week period on stressors impacting on their personal and professional lives and on how they experienced them and responded. There were additional data from recordings of the mindfulness training sessions and a self-report scale, the Depression, Anxiety and Stress Scale (DASS). Thematic analysis revealed a wide range of stressors experienced by the students and provided insight into sources of resilience in dealing with them. In conclusion, the authors consider whether the extreme experiences of stress foreshadow the discontent among South African students that would fuel the serious unrest and disruption that has been negatively affecting South African universities since.     

The Effect of Maltreatment Type on Adolescent Executive Functioning and Inner Speech

There are indications that different types of maltreatment can lead to different cognitive and behavioural outcomes. This study investigated whether maltreatment type was related to executive functioning (EF) abilities and the use of inner speech. Forty maltreated adolescents and a comparison group of 40 non‐maltreated typically developing adolescents completed a battery of tasks designed to assess both their EF abilities and their vulnerability to disruptions to inner speech. They also completed an IQ test. Multivariate analysis of covariance (MANCOVA) and ANCOVA analyses were carried out to examine potential effects of maltreatment type (abuse alone; neglect alone; abuse/neglect combined and no maltreatment) on EF and use of inner speech. Maltreatment type was related to EF abilities. In particular, abuse only and abuse/neglect combined had a greater negative impact on EF than neglect only. However, the neglect alone group was more vulnerable to disruptions to inner speech than the other two maltreatment groups, suggesting that they may be more reliant on the use of inner speech. These findings provide new insights into the differential impact of maltreatment type on EF and the use of inner speech in adolescence and could be used to improve the educational outcomes of these vulnerable young people. Copyright © 2015 John Wiley & Sons, Ltd.