Therapeutic Action in the Work of a Playful Clinician: A Reflection on Dr. Silber’s Reimagining of Humpty Dumpty

ABSTRACT

In my discussion of Dr. Silber’s paper, Reimagining Humpty Dumpty: The Therapeutic Action of Play, I mirror Dr. Silber’s playful posture in her use of the Humpty Dumpty fable to talk about children and their care by society. My reflections on Dr. Silber’s therapeutic work with her two young patients focus on her co-creating meaning with each child’s parents as well as with the child. I discuss that by holding in her mind both the subjectivities of the child and his parents, Dr. Silber is able to practice a fundamentally relational therapy. I would have liked to have heard more about her emotional reactions in her work with both cases as another important dimension of her work. Finally, I emphasize through my play with Humpty Dumpty several ways that society can support children and families that are essential for their development: parental leave, developmentally approptiate expectations for children in school, and the facilitation and protection children’s open ended time and ability to play.     

Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: Evaluation of Caller Risk Profiles and Interventions Implemented

Crisis lines are settings where identifying individuals at imminent risk of suicidal behavior and intervening to keep them safe are critical activities. We examined clinical characteristics of crisis callers assessed by telephone crisis helpers as being at imminent risk of suicide, and the interventions implemented with these callers. Data were derived from 491 call reports completed by 132 helpers at eight crisis centers in the National Suicide Prevention Lifeline network. Helpers actively engaged the callers in collaborating to keep themselves safe on 76.4% of calls and sent emergency services without the callers' collaboration on 24.6% of calls. Four different profiles of imminent risk calls emerged. Caller profiles and some helper characteristics were associated with intervention type. Our findings provide a first step toward an empirical formulation of imminent risk warning signs and recommended interventions.     

Rate and accuracy of vowel recognition as a function of spoken reinforcers and age

Developmental differences among the effectiveness of three spoken reinforcers were evaluated by measuring rate and accuracy of performance on a vowel recognition task. Eighty-seven males were selected from grades 1 to 3, 6 to 7, and 11 to 12 of a predominantly urban, Black, parochial school. The effectiveness of approval and affirmation of correctness was related to grade level for accuracy of performance, but not for rate. For accuracy of performance a decreasing linear trend was found when approval effectiveness was evaluated across grades. For correctness, an increasing linear trend was found. The results were discussed in terms of a developmental hierarchy of reinforcers and information processing.     

Some Results from an Automated Statewide Comparison among Attempted,Committed, and Nonsuicidal Patients

ABSTRACT: In the Missouri Division of Mental Health statewide automated Standard System of Psychiatry, 151 patients who had attempted suicide were compared with 424 who had not and with 97 who had committed suicide. Much of the data was provided from relatives using an automated history. Compared with nonattempters, attempters were younger and more often female, depressed, assaultive, and had a family history of suicide. Actual suicides were more often male, better educated, and in general more resembled the attempters than nonattempters.