Assessing risk: confrontation or avoidance—what is taught on counsellor training courses

Recent mental health policy development has focused on the assessment and management of risk in vulnerable clients. Counsellors have a significant role to play in delivering mental health care in a range of settings, with clients sometimes presenting with suicidal ideation, self-injury and a risk of violence. The aim of this research was to explore the profile of risk assessment teaching within BACP accredited courses. A total of 49 BACP accredited courses were contacted and 24 responded. This response rate is discussed with particular reference to those courses that did not respond to the questionnaire. Risk assessment was viewed as an important consideration for counsellor training whilst suicide and self-harm seemed to have a higher profile than violence to others. Supervision was cited by the majority of respondents to have an important role in developing trainees' skills in assessing risk. The implications of the findings of this study for how counsellors are prepared by their training experiences to work with clients at risk are discussed and some recommendations made for future training developments.     

In a search for meaning: challenging the accepted know-how of working with suicide risk

This opinion piece considers the current predominance of assessment tools and strategies in working with people at risk of suicide, and questions their efficacy and how they are privileged in day to day mental health practice. While such tools and an evidence-based ‘scientific’ approach to assessment clearly has its place, the author instead asserts that the modus operandi of therapy – a discursive based exploration – has much more to offer and should be the primary intervention in understanding suicide potential. Helping the client to gain insight into the meaning of their suicidality helps position the client – and practitioner – in the best possible place to reduce risk.     

Commentary on Federica Melandri’s “Milk and Tears”

ABSTRACT

Dr. Melandri’s use of the 2001 Revised Diagnostic Profile to assess 5-year-old Leo brought forth different emphases than Anna Freud’s original Diagnostic Profile (1965). Dr. Melandri’s explicit sharing of how she reacted to and felt in Leo’s presence is far more explicit. Another difference is how fluently Dr. Melandri integrates metapsychology with diverse clinical theories to describe Leo’s development. Had the original Diagnostic Profile been used, there would have been greater emphasis on libidinal phase development, such as orality, anality, phallic, and oedipal development, not to mention dynamic and structural achievements. This essay asks: “what’s at stake?” regarding these different emphases. The author concludes with a few remarks in general about the 2001 Revised Profile, including comments about the fate of Freud’s and Anna Freud’s radical vision.     

Parents think their sons are brighter than their daughters: sex differences in parental self-estimations and estimations of their children's multiple intelligences

In this study, 156 participants, predominantly White British adults (M age = 44.3 years) rated themselves on overall IQ and on H. Gardner's (1983) 7 intelligence subtypes. Parents (n = 120) also estimated the intelligence of their children. Men's self-estimates were significantly higher than women's (110.15 vs. 104.84). Participants thought their verbal, mathematical, and spatial intelligence scores were the best indicators of their own overall intelligence. Parents estimated that their sons had significantly higher IQs than their daughters (115.21 vs. 107.49). Self-estimates and estimates of children's multiple intelligences were higher for men and sons, significantly so for logical-mathematical and spatial intelligence. Parents rated 2nd-born daughters as having significantly higher verbal and musical intelligence than their male counterparts. Higher parental IQ self-estimates corresponded with higher IQ estimates for children. Results for 1st-born children were clearest and showed the most significant differences. The findings are interpreted in terms of sociocultural and familial influences and the possibility of actual sex differences in particular abilities.     

Thinking Developmentally in Child and Adult Psychoanalysis

Psychoanalysis in theory and clinical practice is a developmental domain. Psychoanalysts think about their patients from a developmental point of view. The analytic relationship promotes development in both analyst and patient. Two concepts central to this author’s developmental point of view are epigenetics—as used in biology and philosophy—and that of the analyst as “developmental object.” Optimally, the analyst as developmental object facilitates what Rita Tähkä terms the “developmental illusion,” which intersubjectively transforms psychic structures, enabling alternatives to the repetition compulsion. Two vignettes with adult patients illustrate how empathic intimacy in psychoanalysis with an emphasis on latency and toddler phases as reconstructed in adult analysis presaged psychic growth. Transference as a vehicle for a developmental history taking is also considered.     

METHODOLOGY IN SCIENCE AND RELIGION: A REPLY TO CRITICS

Debates about methodology have been central to the emergence of the “field of science of religion.” Two questions that have motivated scholars in that field over the past half century: “is it theoretically justifiable to bring scientific and religious beliefs into dialogue?” and “can theology be rational in the same way as science?” This article responds to commentary on Against Methodology: Recent Debates on Rationality and Theology, a book which critically examines three major methodologists of recent years: Nancey Murphy, Alister McGrath, and J. Wentzel van Huyssteen. Themes raised in the commentary include the status of realism and truth in science, the unity of science, the adequacy of the term “critical realism,” proper ways of seeking legitimacy for an academic discipline, and new directions for the field of science and religion.     

Are Religiosity and Spirituality Associated with Obesity Among African Americans in the Southeastern United States (the Jackson Heart Study)?

There are several lines of evidence that suggest religiosity and spirituality are protective factors for both physical and mental health, but the association with obesity is less clear. This study examined the associations between dimensions of religiosity and spirituality (religious attendance, daily spirituality, and private prayer), health behaviors and weight among African Americans in central Mississippi. Jackson Heart Study participants with complete data on religious attendance, private prayer, daily spirituality, caloric intake, physical activity, depression, and social support (n = 2,378) were included. Height, weight, and waist circumference were measured. We observed no significant association between religiosity, spirituality, and weight. The relationship between religiosity/spirituality and obesity was not moderated by demographic variables, psychosocial variables, or health behaviors. However, greater religiosity and spirituality were related to lower energy intake, less alcohol use, and less likelihood of lifetime smoking. Although religious participation and spirituality were not cross-sectionally related to weight among African Americans, religiosity and spirituality might promote certain health behaviors. The association between religion and spirituality and weight gain deserves further investigation in studies with a longitudinal study design.