Insight-oriented group psychotherapy of latency-age children in an acute care setting

Traditional approaches to group therapy with latency-age children have stressed activity and nonverbal therapeutic interventions. These approaches originated in the 1940s with Slavson's activity aroup therapy. A review of the literature of the past 25 years reveals that many clinicians have increasingly employed verbal techniques with latencyage groups. Most such reports describe groups for latency-age out-patients. In this paper, a verbal, interpretive technique for group therapy with latency-age inpatients is described. Clinical vignettes are included to illustrate this technique. Our experience suggests that such a technique can become an integral part of the inpatient treatment program for the latency-age child.     

Power,family therapy,and the systemic-organismic paradigm

How is the concept of power integrated into the systemic organismic paradigm? Power concepts, especially Kantor and Lehr's six dimensions of distance regulation mechanisms, are related to several models of family therapy. Power is found to be a part of the Gestalt formation process of Perls, a process of dynamic selfregulation. Each family therapy model is regarded as part of an integrating process. A theory of conflict strategy and of integration strategy in therapy is developed. The article is intended to promote comparison and exploratory discussion around different models of family therapy.     

Prophetic visions in 1988: A critical reappraisal

This paper reviews the research into a specific aspect of neardeath experiences (NDEs): the prophetic vision (PV). PVs are subjectively compelling flashforwards of planetary-wide cataclysms and eventual regeneration that sometimes occur during or in the immediate aftermath of an NDE. Previous research has shown that the most frequently mentioned year for the culmination of the geophysical calamities foreseen in PVs was 1988. I argue that PVs should be understood as manifestations of a collective prophetic impulse that historically tends to arise during periods of cultural crisis. PVs are thus expressions of the felt need for cultural renewal and therefore should not be taken literally as prognostic of drastic physical changes on Earth.     

Leadership behavior,group climate and outcome in group psychotherapy: A study of outpatient psychotherapy groups

A recent clinical study of outpatient psychotherapy groups in a community mental health center explored the linkage between group leadership variables, group climate, and outcome. The study involved nine outpatient therapy groups, over 50 group clients, and several group therapists. A repeated measures design involving assessment of clients' outcome and level of functioning, group leadership style, and group climate was used to assess changes over a 6-month period. The findings suggest: 1) a reduction in symptoms and improved functioning for clients; 2) a similarity of perceptions by members and leaders of perceived leadership behaviors and group climate; 3) the presence of direct and indirect influences of group climate and leadership behavior on clients' outcome; and 4) a linkage between leadership behavior and group climate with the theoretical orientation of the group. The findings of the research are discussed in relation to the understanding of specific effects in group psychotherapy and the implications for construction of group psychotherapy theory.The authors would like to thank Robert Dies, Ph.D., for his helpful suggestions in the early phase of this study; Roy MacKenzie, M.D., for permission to use the Group Climate Questionnaire; Diane DePalma, Ph.D., for permission to use the Global Leadership Behavior Index; Chris Boltwood, B.A., for her untiring efforts in administering the instruments and coding and entering the data; and most importantly, the psychotherapy group members and the group therapists for their cooperation in this endeavor—without their help, this clinical study would not have been possible.A version of this paper was presented at the Annual Meeting of the American Group Psychotherapy Association, 1987, New Orleans, Louisiana. Lenore Phipps, R.N., M.S., C.S., was formerly Director, Group Psychotherapy Program at Park Ridge Mental Health Center, Rochester, now in private practice at Guild Medical Center, Norwood, MA 02062.     

Professional liability (malpractice) coverage of humanist scholars functioning as clinical medical ethicists

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists.     

Acoustic analysis in the differentiation of Parkinson's disease and major depression

In its early stages, Parkinson's disease (P.D.) may be difficult to distinguish from major depression (M.D.) leading to inappropriate management. Both illnesses are characterized by psychomotor retardation. The neurovegetative symptoms used to diagnose M.D. are not specific and in P.D. may be due to the physical illness itself. Currently, differentiation of the two disorders relies on subjective clinical observation. Improved diagnostic accuracy based on more objective data is needed. To this end, this study used computerized acoustic analysis to contrast speech patterns in P.D. and M.D. The sample consisted of 30 P.D. patients without depression or dementia, 30 patients with uncomplicated M.D., and 31 normal controls, each 60 years of age or over. Of the acoustic variables studied, M.D. patients had significantly reduced rates of speech compared with P.D. patients. The data suggest that this temporal measure of speech may be useful in the differentiation of P.D. and M.D.     

Context-dependent variation in social stereotyping 1: The effects of intergroup relations as mediated by social change and frame of reference

During the 1990-1991 Persian Gulf conflict an experiment was conducted with Australian university students (N = 200) to investigate whether the social stereotyping of Americans varied with social contextual manipulations related to the hostilities. The study, conducted in two phases at the start and end of the conflict, examined how the assignment of standard stereotypical traits to Americans was affected (a) by the large-scale social change constituted by the war and (b) by variation in the frame of reference provided by relevant comparison groups. The elicited stereotypes were sensitive to both of these contextual variables, demonstrating significant variation and fluidity. Overall, stereotypes of Americans were relatively negative. They were significantly more negative (a) at the end of the war than at the beginning in the restricted frame (when Australia and Britain were comparison groups) and (b) in the first phase of the conflict when the frame was extended to include Iraq as a comparison group. The findings were in line with expectations derived from self-categorization theory (Turner, 1985) that the social categorization of self and other into ingroup and outgroup is inherently variable, comparative and context-dependent. They question the long-held view of stereotypes as fixed, rigid and resistant to change.     

Context-dependent variation in social stereotyping 2: The relationship between frame of reference,self-categorization and accentuation

This paper examines the hypothesis that patterns of stereotypic accentuation reflect the degree to which judged stimuli share the same social category membership as the stereotyper, Following self-categorization theory, the degree of this shared identity is operationalized in terms of the meta-contrast ratio as a function of the positions of (a) stereotyper and (b) stereotyped target relative to (c) the stereotyper's frame of reference. Three experiments are reported which sought to manipulate shared category membership either by extension of subjects' frame of reference or by extremitization of target and subject with respect to that frame. As predicted, greater shared identity was associated with stronger assimilation of the target to subjects' own position and with change in stereotype content. Findings are discussed in relation to theories of personality, social judgement and social cognition. Like the accentuation processes which underpin them, it is proposed that stereotypes are sensitive to comparative context and that they reflect veridically the social self-categorical properties of stimuli.