Psychological Distress in Australian Clients Seeking Family and Relationship Counselling and Mediation Services

There is little published data on the prevalence of psychological distress among individuals and couples seeking counselling and mediation services from non‐government organisations (NGOs). This national cross‐sectional study establishes the prevalence of psychological distress among clients seeking family and relationship counselling and mediation services from Relationships Australia. A national sample of 1,365 clients attending services in April to May 2012 completed the 10‐item Kessler Psychological Distress Scale (K10) after their first counselling or mediation session. Individual counselling (M = 23.01, SD = 8.97, 95% CI [22.05–23.97]) and couple counselling (M = 21.63, SD = 8.10, [20.86–22.41]) clients reported a mean K10 score comparable to those reported by clinical studies of clients with anxiety or affective disorders. One quarter to one fifth of these clients reported very high psychological distress. Clients accessing mediation services had a mean score of 18.13 (SD = 7.76; [17.51–18.75]), and one tenth of clients reported very high distress. These elevated rates of very high psychological distress suggest that mental health issues may be a significant problem for a large proportion of clients accessing counselling and mediation NGO services provided under Family Support Programs (FSP) funding. Implications for screening for mental health and appropriate treatment planning are discussed.     

Why Didn’t Freud Reject Pfister? A Response to Isabelle Noth and Christoph Morgenthaler

The Freud-Pfister correspondence is in some sense an Urtext for the most friendly debate imaginable between the self-identified “godless Jew” who founded psychoanalysis, and the liberal Swiss pastor who was drawn to psychoanalysis while retaining his belief in God. Why didn’t Freud reject Pfister? This article will probe this question using the tools of psychoanalysis itself. After reviewing Freud’s associations to childhood religion, the Bible, and his father (citing Rizzuto), I am proposing that Pfister functioned unconsciously for Freud not only as an admiring son and disciple, but also a father substitute—much like Freud’s beloved antiquities—who represented both a God and a father who would admire and love him, and carry Freud’s name forward in the Book of Life.     

A Comparison of Two-Stage Approaches for Fitting Nonlinear Ordinary Differential Equation Models with Mixed Effects

Several approaches exist for estimating the derivatives of observed data for model exploration purposes, including functional data analysis (FDA; Ramsay &; Silverman, 2005 Ramsay, J. O., &; Silverman, B. W. (2005). Functional data analysis (2nd ed.). New York, NY: Springer-Verlag. [Google Scholar]), generalized local linear approximation (GLLA; Boker, Deboeck, Edler, &; Peel, 2010 Boker, S. M., Deboeck, P. R., Edler, C., &; Peel, P. K. (2010). Generalized local linear approximation of derivatives from time series. In S. Chow, E. Ferrer, &; F. Hsieh (Eds.), Statistical methods for modeling human dynamics: An interdisciplinary dialogue (pp. 161–178). New York, NY: Taylor &; Francis. [Google Scholar]), and generalized orthogonal local derivative approximation (GOLD; Deboeck, 2010 Deboeck, P. R. (2010). Estimating dynamical systms: Derivative estimation hints from Sir Ronald A. Fisher. Multivariate Behavioral Research, 45, 725–745. doi:10.1080/00273171.2010.498294[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). These derivative estimation procedures can be used in a two-stage process to fit mixed effects ordinary differential equation (ODE) models. While the performance and utility of these routines for estimating linear ODEs have been established, they have not yet been evaluated in the context of nonlinear ODEs with mixed effects. We compared properties of the GLLA and GOLD to an FDA-based two-stage approach denoted herein as functional ordinary differential equation with mixed effects (FODEmixed) in a Monte Carlo (MC) study using a nonlinear coupled oscillators model with mixed effects. Simulation results showed that overall, the FODEmixed outperformed both the GLLA and GOLD across all the embedding dimensions considered, but a novel use of a fourth-order GLLA approach combined with very high embedding dimensions yielded estimation results that almost paralleled those from the FODEmixed. We discuss the strengths and limitations of each approach and demonstrate how output from each stage of FODEmixed may be used to inform empirical modeling of young children’s self-regulation.     

Degrees of entrapment: living and dying in the claustrum

This paper explores Donald Meltzer’s concept of the claustrum, an unconscious phantasy of a space inside the body of the internal mother that has been forcibly entered and occupied. The author proposes that claustrophobic phenomena might be viewed on a continuum from the relatively ordinary to the severely pathological. Following a brief review of the characteristics of Meltzer’s claustral ‘compartments’, this continuum is explored through and illustrated by a psychoanalytic understanding of two films, Coraline, directed by Henry Selick and based on the novella by Neil Gaiman, and The Talented Mr. Ripley, based on the novel by Patricia Highsmith and directed by Anthony Minghella. The degree of entrapment in a claustrophobic world and the possibility of emerging from it into a world of authentic intimate relationships is shown to be influenced by the internal relationship to a parental couple.     

Is Fifty Really the New Thirty? The Stigma of Age as a Form of Strain and its Role in Drug and Alcohol Abuse and Dependence by Women

Aging bodies stigmatize women. The effects of stigma, health issues, goal disappointment, and a combination of age and minority group status, overwhelm older women’s coping strategies, leading to maladaptive behaviors. General strain theory posits a relationship between negative stimuli and deviant behavior. Advancing age and age-related stigma reflect this strain. This study explores the relationship between strain and substance abuse or dependence, comparing subsamples of middle age (35- to 49-year-old women) and older middle age (50- to 64-year-old) women. Data suggest that minority age status coupled with acute or mental health issues increase substance abuse or dependence by older women.     

Creating mother and baby therapy groups in prison: emotional valuation

Mothers in prison are at high risk of depression and other mental health issues and yet access to therapeutic services is limited. This paper describes the development by the author of two prison therapy groups: one for pregnant women, the other for mothers and their babies. Called the ‘Born Inside’ project, both groups are currently held in Bronzefield Prison, Surrey. The theory and principles behind the project are discussed, as well as the processes and practicalities involved in providing the therapy and specialised support to the women and their vulnerable infants. In addition, principles of forensic psychotherapy in relation to this specific prison population are described, and the situational and emotional challenges faced are illustrated through narratives of group members.     

The Viability of Structural Family Therapy in the Twenty-first Century: An Analysis of Key Indicators

This paper examines the degree to which structural family therapy has adapted effectively to client families and professional demands of the twenty-first century. A review of the current professional literature was conducted to assess the structural model’s continued clinical relevance, how the model has changed in adapting to contemporary social and professional contexts, and whether or not the integrity of the model’s core proposition has been eroded or confounded as a result of adaptive changes.     

Concurrent Validation of the Treatment Outcome Package (TOP) for Children and Adolescents

The Treatment Outcome Package for children and adolescents (TOP) is a behavioral health and well-being assessment used widely in clinical and child welfare populations. The primary purpose of this study was to examine the concurrent validity of the Child and Adolescent versions of the TOP with the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ) with a community sample. Children and adolescents (N = 203) 3–18 years of age from a community sample completed the CBCL, the SDQ, and the TOP. Significant correlations emerged between the TOP and theoretically similar scales on the SDQ and the CBCL. Analyses demonstrated that the TOP has excellent concurrent validity on most subscales with both the CBCL and the SDQ. These results provide additional evidence for the TOP’s utility and validity as a measure of psychological well-being and functioning.     

A Brief,Hospital-Initiated Motivational Interviewing and Acceptance and Commitment Therapy Intervention to Link Postpartum Mothers Who Use Illicit Drugs With Treatment and Reproductive Care: A Case Report

Maternal substance use during the prenatal period often results in infants with compromised health outcomes. The American College of Obstetrics and Gynecology recommends screening, brief motivational interviewing, and referral to existing treatment for women who use illicit substances prenatally. However, many of these women do not present for prenatal care and are not identified as using substances until delivery of their infants, many of whom are admitted to the neonatal intensive care unit (ICU). We describe a case from a novel, hospital-initiated intervention study, Moms in ACTion (MIACT) that combines motivational interviewing (MI) and acceptance and commitment therapy (ACT) to target new mothers with an infant in the neonatal ICU who screen positive for illicit substance use prenatally or at delivery. The MIACT program consists of an adaptive intervention that includes up to three sessions. Initiation of substance use treatment and reproductive care via a gynecological visit are the primary targets of the intervention. Urine samples were collected at 2- and 6-month follow-up visits. The participant successfully completed the program, achieved both treatment outcomes, and had negative urine drug screens at follow-up visits. Improvements in readiness to change and psychological flexibility were also observed. The present case report of a new mother who used substances demonstrated feasibility for combining MI and ACT treatments and the potential for MIACT to increase treatment and contraception initiation, ultimately preventing future substance-exposed pregnancies.