Working briefly with reluctant clients: child protective services as an example

Therapists and counsellors often are faced with reluctant clients and constraining circumstances. Such difficulties are especially prevalent and severe in casework in child protective services - the parents of abused or neglected children are all involuntary clients, case loads are large, and time is limited.
Drawing on experience in applying and modifying prior work at the Brief Therapy Center of MRI to work in child protective services of a Northern California county, this article suggests general principles for effective intervention in such difficult circumstances and illustrates these with specific case examples.
Since consideration of extreme conditions is often helpful in dealing with parallel but less extreme ones, the authors' aim and hope is that readers will find this article helpful not solely in child protective work but also in the much wider territory where similar obstacles to effective counselling also occur.     

ON SYSTEMS ANALYSIS IN AUTISM INTERVENTION PROGRAMS

Although intervention technology has grown substantially during the past quarter century, the design of intervention systems has not grown apace. This paper examines organizational arrangements that enhance and diminish treatment effectiveness and argues that defining, measuring, and manipulating systemic antecedent and consequent variables are as important as assessment and intervention on an individual client's behalf.     

Auditory preference of children with autism spectrum disorders

Research on children with autism spectrum disorders suggests differences from neurotypical children in the preference for ‘social’ versus ‘nonsocial’ sounds. Conclusions have been based largely on the use of head-turn methodology which has various limitations as a means of establishing auditory preference. In the present study, preference was assessed by measuring the frequency with which children pressed a button to hear different sounds using an interactive toy. Contrary to prior results, both groups displayed a strong preference for the highly social sounds. These findings have implications for approaches to language intervention and for theoretical debates regarding social motivation.     

In-Session Stuck Points and Pitfalls of Community Clinicians Learning CBT: Qualitative Investigation

Given the preponderance of evidence supporting the efficacy of cognitive behavior therapy (CBT), there has been an increased emphasis on dissemination to community mental health systems (CMH). Trainers from two large-scale dissemination initiatives (n = 27) were surveyed regarding the common pitfalls and difficulties encountered by CMH clinicians learning CBT. Common pitfalls were organized according to the items of the Cognitive Therapy Rating Scale (CTRS; Young & Beck, 1980) and reviewed. Guided discovery was reported to be the most challenging CBT competency to learn. Qualitative methods were used to construct a grounded theory; trainer responses indicated they viewed the practice of CBT as not only a set of discrete skills, but also a way of thinking. Efforts may be needed to provide support, assistance, and resources to these CMH clinicians as they continue to build CBT competency.     

The Presence of Self-Stigma,Perceived Stress,and Suicidal Ideation among Selected LGBT Filipinos

Minority group members experience what is known as “minority stress,” by which individuals suffer stress because of their membership in stigmatized social categories. In turn, minority stress may lead to self-stigmatization. This occurs when minority group members experience a sense of shame created by the view of the majority culture and then incorporate the majority opinion into their self-image. Because it is cumulative with the stress an individual is already experiencing, self-stigmatization may become a significant stressor itself, possibly contributing to the development of suicidal ideation. A total of 609 self-identified LGBT individuals were asked to answer a battery of psychological tests to assess the interrelationships between self-stigma, perceived stress, and suicidal ideation. As expected, perceived stress predicted suicidal ideation, whereas self-stigmatization predicted both perceived stress and suicidal ideation. Structural equation modeling confirms the predictive value of self-stigma together with perceived stress in determining the suicidal ideation present among LGBT Filipinos. Self-stigma exerted a direct effect upon suicidal ideation not accounted for by perceived stress.