Promoting Attachment and Mentalization for Parents and Young Children in the Foster Care System: Implementing a New Training and Treatment Approach in an Agency

The Building Blocks Program is an innovative psychodynamic treatment approach that was designed to fit within a social service agency structure. It is based on concepts of attachment, attunement, and mentalization and builds on the research of Beatrice Beebe (2003), Peter Fonagy and colleagues (2002), Arietta Slade (2005), Howard and Miriam Steele (2008), and Dan Stern (1985). The Building Blocks Program targets birth mothers and their young children under age 5 who have been or are in danger of being removed from their families. In the beginning of the program, the Building Blocks therapists faced many challenges. As noted (Remez, this issue), many of the therapists were unfamiliar with a Reflective Supervision model of learning. They were accustomed to a more traditional pedagogical approach that emphasized critiquing their work, with a focus on their clients’ pathology. The Building Blocks model focuses on therapist and client safety and support, prompting a paradigm shift in the therapists’ thinking about supervision and how to conduct therapy.     

A sorting‐to‐matching method to teach compound matching to sample

Individuals with developmental disabilities may fail to attend to multiple features in compound stimuli (e.g., arrays of pictures, letters within words) with detrimental effects on learning. Participants were 5 children with autism spectrum disorder who had low to intermediate accuracy scores (35% to 84%) on a computer‐presented compound matching task. Sample stimuli were pairs of icons (e.g., chair–tree), the correct comparison was identical to the sample, and each incorrect comparison had one icon in common with the sample (e.g., chair–sun, airplane–tree). A 5‐step tabletop sorting‐to‐matching training procedure was used to teach compound matching. The first step was sorting 3 single pictures; subsequent steps gradually changed the task to compound matching. If progress stalled, tasks were modified temporarily to prompt observing behavior. After tabletop training, participants were retested on the compound matching task; accuracy improved to at least 95% for all children. This procedure illustrates one way to improve attending to multiple features of compound stimuli.     

Character Development within Youth Development Programs: Exploring Multiple Dimensions of Activity Involvement

We examined links among three dimensions of youth involvement (intensity, duration, and engagement) in Boy Scouts of America (BSA), an international out‐of‐school time (OST) youth development program designed to promote moral and performance character in boys. Using data from 737 youth and their parents who participated in one of 40 BSA program sites (commonly referred to as “packs”), we first considered how individual‐ and pack‐level measures of program involvement were differentially linked with character development. Next, we examined whether pack‐level involvement characteristics moderate individual‐level involvement characteristics, hypothesizing that highly involved packs would serve to further enhance the positive effects of high levels of individual involvement. Results indicated engagement was the strongest, most frequent predictor of increases in both moral and performance character. Although there were no direct effects of pack‐level intensity, duration, or engagement, the effects of individual‐level engagement were moderated by pack‐level engagement, suggesting that the largest increases in moral and performance character occurred among highly engaged youth who were enrolled in highly engaged packs. These results highlight the need to examine multiple dimensions of OST program involvement simultaneously, and suggest that strengthening youth engagement in programming may provide a means for enhancing the positive effects of high‐quality youth programming.     

‘It’s about having exposure to this’: investigating the training needs of therapists in relation to the issue of anomalous experiences

Two focus groups, consisting of six participants each, were conducted to explore the training needs of therapists when working with clients reporting anomalous experiences (AEs). AEs are those that ‘depart from our own familiar personal experiences or from the more usual, ordinary, and expected experiences of a given culture and time’ [Braud, W. (2012). Health and well-being benefits of exceptional human experiences. In C. Murray (Ed.), Mental health and anomalous experience (pp. 107–124). Hauppauge, NY: Nova Science Publishers.]. A thematic analysis revealed four themes: ‘Quite often we get taken by surprise because it’s a subject we don’t talk about’, ‘It’s just having this in our vocabulary’, ‘Demystifying and valuing AEs as normal human experiences’ and ‘To ask or not to ask?’. Most of the participants felt that they were unequipped to work with clients reporting AEs and suggestions were made for overcoming this.     

Effectiveness of Seeking Safety for Co‐Occurring Posttraumatic Stress Disorder and Substance Use

The authors evaluated the Seeking Safety program's effectiveness for treating posttraumatic stress disorder (PTSD) and substance use symptoms across 12 between‐groups studies (N = 1,997 participants). Separate meta‐analytic procedures for studies implementing wait list/no treatment (n = 1,042) or alternative treatments (n = 1,801) yielded medium effect sizes for Seeking Safety for decreasing symptoms of PTSD and modest effects for decreasing symptoms of substance use. Limitations of the findings and implications for counselors are discussed.     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.     

Shared Traumatic Reality and Boundary Theory: How Mental Health Professionals Cope With the Home/Work Conflict During Continuous Security Threats

ABSTRACT

In a shared traumatic reality, mental health professionals and their clients are exposed to the same communal disaster. Both living and working in the same high-stress community can create a conflict between the professional's work and his or her private life. The author analyzed three focus groups consisting of 30 mental health professionals who worked with traumatized populations in a missile-stricken area in southern Israel. The professionals’ experience was explored through the lens of boundary theory by examining the ways in which they created and maintained boundaries between the different domains of their lives. Findings demonstrated that these professionals presented a continuum of segmentation and integration of the domains as suggested by boundary theory, when both living and working in a highly stressed environment. The discussion deals with possible costs and benefits of the boundary theory continuum.     

How positive processes function in negative relationships: Dispositional gratitude moderates the association between affective need and frequency of dating violence victimization

Evidence indicates that dispositional gratitude may improve romantic relationships by reinforcing positive emotions between partners and by increasing awareness of affective needs, such as receiving emotional support, nurturance, and reassurance. However, little research has investigated the influence of gratitude on relationships characterized by violence. In the present study, participants (N = 421) completed a cross-sectional survey of experiences with dating violence, dispositional gratitude, and affective need. Data were analyzed using structural equation modeling. Among individuals with lower rates of dispositional gratitude, higher levels of affective need were associated with lower frequency of dating violence victimization. However, among individuals with higher rates of dispositional gratitude, there was no evidence to suggest an association between affective need and frequency of victimization. These preliminary findings compel further investigation of how positive processes impact the perceived qualities of negative romantic relationships.     

Speed of Processing Time Slowing in Eating Disorders

We applied Brinley (1965 Brinley, J. F. (1965). Cognitive sets, speed and accuracy of performance in the elderly. In A. T. Welford, &; J. E. Birren (Eds.), Behavior, aging and the nervous system (pp. 114–129). Springfield, IL: Charles C. Thomas. [Google Scholar]) plot analysis to the eating disorders field. Across 23 studies and 165 experimental conditions [experienced by a total of 773 eating disorder (ED) participants, including anorexia nervosa (AN), binge eating (BE), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS) and 995 controls], the best-fit regression equation was Y (ED) = 1.08 X (CONTROL) – 31. This equation accounted for 98.2% of the variance. Thus, the ED subjects were only 1.08 times slower than the control subjects, suggesting little processing speed slowing in ED. We also examined simple reaction time [SRT; Y (ED) = .91 X (CONTROL) + 63; variance accounted for = 93.6%] and choice reaction time (CRT; Y (ED) = 1.12X (CONTROL) – 43, variance accounted for = 99.7%). These slopes are significantly different. ED subjects are more impacted when the task involves a decision component (CRT) than when it does not (SRT).     

Achieving socially significant reductions in problem behavior following the interview‐informed synthesized contingency analysis: A summary of 25 outpatient applications

Jessel, Hanley, and Ghaemmaghami (2016) reported the results of 30 interview‐informed, synthesized contingency analyses (IISCAs) and found the IISCAs to be an effective tool for identifying the functions of problem behavior across a variety of topographies, participants, and settings. Jessel et al. did not, however, include data on the effectiveness of the corresponding treatments. In the current study, we collected and summarized 25 additional applications, from analysis to treatment, in which the IISCA was applied in an outpatient clinic. The IISCA identified various social functions of problem behavior, which informed personalized treatments of functional communication training with contingency‐based reinforcement thinning. A 90% or greater reduction in problem behavior was obtained for every participant by the end of the treatment evaluation. The assessment and treatment process was socially validated by caregivers who rated the procedures highly acceptable and helpful, and the improvement in their child's behavior highly satisfactory.