Treating Multidimensional Presenting Problems with a Mutually Integrative Approach Using the Genogram

The present article introduces a case study and describes a mutually integrative approach to treating a complex presenting problem. This article examines the specific issues surrounding integration when a supervisor and supervisee hold different theoretical perspectives. On occasion, such a relationship demands that the supervisee adhere to the model being taught by the supervisor. Examining integration in this format presents many advantages for both treatment and training. The key to the mutual integration is that two schools of psychotherapy can be combined in a way that creates a synergy; in that, together they are more powerful than either may be in isolation. A genogram with symbols from each model is incorporated to focus the treatment and create a format for the mutual integration.     

Examining the effects of group‐based instruction on emergent second‐language skills in young children

The present study evaluated the emergence of second‐language intraverbals in typically developing young children following a small‐group teaching intervention. Choral responding was employed with a group of 6 primary school children (5‐6 years old) to teach first‐language tacts (e.g., “What is this in English?” [“Hospital”]) and related second‐language tacts (e.g., “What is this in Welsh?” [“Ysbyty”]). A multiple‐probe design across stimulus sets was used to evaluate subsequent emergence of untrained first‐to‐second‐language derived intraverbals (e.g., “What is hospital in Welsh?” [“Ysbyty”]) and untrained second‐to‐first‐language intraverbals (e.g.,”What is ysbyty in English?” [“Hospital”]). Data indicated that the choral responding intervention produced robust increases in derived intraverbal relations for 3 of the 6 participants.     

Bread and Roses: Empathy and Recognition

Empathy and Recognition represent two closely intertwined, crucial elements of human relatedness, and thus of the analytic relationship. Each ushers in a different quality of relatedness in the dyad: Empathy is a response to a basic human need, crucial to psychic safety and coherence, and may be imagined ahead of time as the need for someone to understand one’s experience, to get one’s pain. By contrast, recognition as a longing may be only partially formulated before it is emergent, because it is in the moments when it is realized that the desire for its inherent mutuality may be most keenly felt. It is in such moments, often arising through collision and unpacking between two distinct and suddenly more fully knowable subjectivities, that the experience of desire may be both held and renewed. Recent relational writing has made clear how deeply intersubjective empathy may be, in its fullest realization; however, with recognition, the desire for the other as other, who may now be known as such, arises anew out of the experience of being met in intersubjective encounter. Like bread and roses, both are vital as felt experience, and in potentiating transformation.     

Effects of a handwashing intervention package on handwashing in preschool children

Young children who attend out‐of‐home care (e.g., preschool) are more susceptible to infections than children who do not attend out‐of‐home care. Previous research suggests handwashing is effective in reducing risk of infection and illness. However, research suggests that individuals do not routinely wash their hands using methods that healthcare agencies, such as the Centers for Disease Control and Prevention, have determined best practice. We evaluated the effects of a multicomponent handwashing intervention package on correct handwashing across groups of preschool children. Furthermore, we measured the degree to which their hands were clean using premeasures and postmeasures. Results suggest the intervention package was effective at increasing both correct handwashing and cleanliness of participants' hands.     

Using Multiple Contexts and Retrieval Cues in Exposure-Based Therapy to Prevent Relapse in Anxiety Disorders

The benefits of exposure-based interventions for anxiety disorders are substantial but not stable for everyone, given that these interventions are often followed by relapse of symptoms. A body of research provides a background on how to add certain strategies in exposure-based therapy to prevent relapse in anxiety disorders. This review summarizes some of these strategies and provides clear-cut clinical implications. Studies that provide support for two types of strategies to prevent relapse have been reviewed—the use of multiple contexts and the use of retrieval cues. The use of multiple contexts reduces context and stimulus specificity of extinction learning during exposure, while the use of retrieval cues enhances memory (re)consolidation and retrieval after exposure. The described strategies to enhance the accessibility and therefore the retrievability of exposure-based learning to prevent relapse in anxiety disorders can be summarized as advice to conduct exposure under variable conditions. This way, the generalizability of what is learned during exposure to the patients’ daily life after treatment improves. Therefore, adding these strategies in the course of exposure-based treatment of anxiety disorders seems beneficial. However, future replications and translational studies are needed to verify ecological validity.     

Do Marital Conflict Behaviors in Response to a Novel Stressor Uniquely Predict Adolescent Outcomes?

The goal of this study was to examine whether mothers’ and fathers’ marital conflict behaviors in response to a novel stressor are uniquely predictive of adolescent outcomes. Previous research establishing the detrimental consequences of marital conflict for child outcomes has relied exclusively on assessments of conflict that measure reoccurring or past conflict. From 153 adolescents and/or both of their parents, reports were gathered on marital conflict, adolescent conflict appraisals, parent-adolescent relationship quality, and adolescent adjustment. Couples engaged in two marital problem-solving interaction tasks—one that elicited conflict behaviors by requiring discussion of salient, reoccurring topics of disagreement and one that prompted conflict behaviors by requiring that couples worked together to solve an unfamiliar problem. Results indicated that compared to behaviors during the marital conflict discussion as well as parent-reports of the frequency, intensity, and resolution of typical conflict, conflict behaviors in response to a novel stressor, particularly those displayed by mothers, were uniquely associated with adolescents’ conflict appraisals and dimensions of the parent-adolescent relationship but not adolescent adjustment. Specifically more-negative (relative to positive) conflict behaviors in response to the novel stressor was associated with more-negative adolescent conflict appraisals; mothers’ more-negative conflict behaviors in response to a novel stressor were also linked to adolescents reporting less parental monitoring. In contrast, parent reports of typical marital conflict uniquely predicted conflict property appraisals, the affective quality of mother-adolescent relationships, and adolescent adjustment. Implications for future research elucidating associations between conflict behaviors in response to a novel stressor on children and families are discussed.     

Promoting Mental Health Equity: The Role of Integrated Care

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.     

Psychological Factors that Link Socioeconomic Status to Depression/Anxiety in Patients with Systemic Lupus Erythematosus

Our analyses examined whether reserve capacity factors would explain the relationship between socioeconomic status (SES) and symptoms of depression/anxiety in patients with systemic lupus erythematosus (SLE). We assessed disease activity, depression/anxiety symptoms, and intrapersonal and interpersonal reserve capacity measures in 128 patients with SLE. Multiple meditational analyses revealed that intrapersonal and interpersonal psychosocial aspects of reserve capacity fully mediated the relationship between SES and depression/anxiety. Lower SES was indirectly associated with higher symptoms of depression and anxiety through the effects of psychosocial resilience. Interventions aimed at improving modifiable reserve capacity variables, such as self-esteem and optimism, may improve anxious/depressive symptomatology in patients with SLE.