Jacques Derrida and Gianni Vattimo (eds.), Religion. Trans. by David Webb and others

International Journal for Philosophy of Religion -     

Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Full statistical mediation of the relationship between trauma and depressive symptoms

Owing to the potentially devastating effects of trauma‐induced depression, explaining the relationship between trauma and depressive symptoms is important. In this study, we measured lifelong exposure to potentially traumatic events and depressive symptoms in 370‐female undergraduates. We also measured anxiety, past negative time perspective and dissociation as potential mediators. Trauma exposure and depressive symptoms were related with a small but significant effect size (r = .16). Trauma was not associated with dissociation. We found that past negative time perspective and anxiety were full statistical mediators of this trauma‐depressive symptoms relationship. These two mediators combined accounted for all of the variance in that association. Anxiety accounted for more of the variance than past negative time perspective. A proposed explanation is that trauma both affectively elevates anxiety and cognitively creates an enduring focus on the events. Chronic anxiety and a past negative time perspective may lead to depression over time. The clinical implications are possible explanations as to why some treatments work.     

Temperament,Repetitive Negative Thinking,and Depressive Symptoms in Early Adolescence: a Prospective Study

Repetitive negative thinking (RNT) is a transdiagnostic vulnerability factor, involved in the maintenance of a variety of emotional problems. Recently, the Perseverative Thinking Questionnaire – Child version (PTQ-C) was developed as a content-independent measure of RNT in children and adolescents. The current study investigated the reliability and predictive validity of the PTQ-C and examined temperament as a developmental predictor of RNT. For this end, 701 early adolescents completed measures of RNT, depressive symptoms, stressors, and temperament, both at baseline and after three months. First, the factor structure of the PTQ-C was investigated by comparing a one-factor model and a three-factor higher-order model using confirmatory factor analyses. Both models showed good fit to the data, but the more parsimonious one-factor model was retained. Internal consistency, as measured by cronbach’s alpha and (hierarchical) omega, was found to be excellent for the total scale. Second, associations with depressive symptom levels were examined. RNT predicted both concurrent and prospective symptom levels, even when taking into account baseline depressive symptoms. RNT was further shown to act as a moderator strengthening the link between stress and levels of depressive symptoms, both concurrently and prospectively. Finally, associations with temperament were explored by investigating the mediating role of RNT in the association between temperament dimensions and depressive symptoms. One indirect effect was found, with low effortful control predicting increases in depressive symptoms through heightened levels of RNT. The current study supports the PTQ-C as a useful and psychometrically sound measure of dysfunctional RNT that may facilitate research on emotional problems in child and adolescent samples.     

Temperament and Problematic Alcohol Use in Adolescence: an Examination of Drinking Motives as Mediators

The present study investigated the associations between temperamental reactivity, drinking motives, alcohol consumption and alcohol-related consequences. Furthermore, it investigated whether drinking motives mediate the relations between temperamental reactivity and the alcohol use variables. The sample consisted of 188 adolescents (64.9% boys) between the ages of 13–20 years (M _age  = 16.9, SD = 1.32). Results revealed that the temperament factors of high BAS fun seeking and high negative affectivity were related to alcohol consumption and alcohol-related consequences respectively. Furthermore, high social and enhancement motives and low conformity motives were associated with alcohol consumption, whereas high coping-depression motives were associated with alcohol-related consequences. Finally, the relation between BAS fun seeking and alcohol consumption was mediated by enhancement and social motives and the association between negative affectivity and alcohol-related consequences was mediated by coping-depression motives. These results highlight the importance of focusing on temperament profiles and their associated drinking motives in the prevention and intervention of alcohol use problems among adolescents.     

Assessment and Diagnosis of Eating Disorders: A Guide for Professional Counselors

Despite the prevalence of and risk associated with disordered eating, there are few guidelines for counselors on how to conduct an eating disorder assessment. Given the importance of the clinical interview, the purpose of this article is to provide recommendations for the assessment and diagnosis of eating disorders that (a) specifically focus on assessment in the context of a clinical interview and (b) can be used by counselors whether or not they specialize in eating disorder treatment.     

Are Genetic Counselors and GLBT Patients “on the Same Page”? an Investigation of Attitudes, Practices, and Genetic Counseling Experiences

Gay, lesbian, bisexual, and transgender (GLBT) individuals comprise a growing patient population in genetic counseling, yet literature on working with this population is scarce. This study sought to investigate GLBT patient experiences in genetic counseling and genetic counselor attitudes and practices when counseling GLBT patients. Twenty-nine GLB individuals who had previously participated in genetic counseling, and 213 genetic counselors completed online surveys. No individuals identifying as transgender participated. The patient survey assessed disclosure of orientation, discrimination in genetic counseling, and quality of services received. The counselor survey assessed comfort with and attitudes about counseling GLBT patients, disclosure of counselor orientation, and whether they counsel differently with this population. Every patient denied experiencing discrimination during their session, but 17% reported their genetic counselor assumed they were heterosexual, and 45% indicated intake forms were not GLBT-inclusive. A majority of counselors (91%) reported having counseled GLBT patients and indicated they were comfortable doing so (86%), and 72% indicated no differences in their counseling approaches with GLBT patients. Few counselors (17%) received training in GLBT issues, and most (61%) desired such education. Additional findings and practice and research recommendations are presented.