Large-group psychotherapy in a day treatment program

The potential for psychotherapy in a large-group format has been discussed since the 1960s. Day treatment programs provide optimal support for such groups. One program type, which has maintained large-group psychotherapy as a central feature for over twenty years, is described. Essential features include an integrated therapeutic team, with clearly defined leadership, that is open to examination of its own process. Such groups may not only provide effective therapy, but are also readily amenable for teaching and research in psychotherapy.     

The psychodynamic psychiatry service of the University of Alberta Hospital: a thirty year history

This paper describes the Psychodynamic Psychiatry Service (PPS) of the University of Alberta Hospital over its 30 years of development. This psychiatric organization consists of three clinical programs-an outpatient clinic and intensive day and evening programs-and an integral evaluation and research unit. The PPS is unique in its group therapy clinical orientation, its psychodynamic theoretical orientation, and its integration of an ongoing research program that establishes empirical validation of its clinical work. The productivity and longevity of this psychiatric organization appear to derive from several strengths, including cooperation between leaders of the clinical and research programs; the institution of staff relations groups in the three clinical programs; the operation of the fully integrated evaluation and research program that serves to provide empirical support for the treatments offered; and a unifying ideology characterized by the valuing of both psychodynamic and group oriented work. Other important factors to the success of the PPS include the strengths of the founder of the service and financial and other support of the academic department in which it is housed. This paper describes the historical development and present structure and functioning of the PPS, the challenges it has been confronted with, and the responses to those challenges. We conclude with factors contributing to its survival and productivity and with thoughts about the future.     

Patient personality and time-limited group psychotherapy for complicated grief

We used a randomized clinical trial to investigate the interaction of two patient personality characteristics (quality of object relations [QOR] and psychological mindedness [PM]) with two forms of time-limited, short-term group therapy (interpretive and supportive) for 139 psychiatric outpatients with complicated grief. Findings differed depending on the outcome variable (e.g., grief symptoms, general symptoms) and the statistical criterion (e.g., statistical significance, clinical significance, magnitude of effect). Patients in both therapies improved. For grief symptoms, a significant interaction effect was found for QOR. High-QOR patients improved more in interpretive therapy and low-QOR patients improved more in supportive therapy. A main effect was found for PM. High-PM patients improved more in both therapies. For general symptoms, clinical significance favored interpretive therapy over supportive therapy. Clinical implications concerning patient-treatment matching are discussed.     

Relationships,health, and stress: Validation of a relationship sense of coherence measure

Although all romantic relationships experience stress, some thrive when faced with adversity while others are unable to manage the inevitable relationship ups and downs. Rather than seeing stress as a risk factor, this study applied a Salutogenic framework, which posits that stress is a naturally occurring and potentially beneficial part of relationships, to develop a new measure of relationship health and well‐being. In Study 1, we created and tested a self‐report Relationship Sense of Coherence (RSOC) scale. Study 2 demonstrated evidence of convergent reliability for the RSOC. In Study 3, we tested the RSOC in a two‐wave sample of romantically‐involved individuals with a chronic health condition. Guidelines for use and implications for future research are discussed.     

A Longitudinal Investigation of Children’s Trauma Memory Characteristics and Their Relationship with Posttraumatic Stress Disorder Symptoms

Research on Child and Adolescent Psychopathology - While trauma memory characteristics are considered a core predictor of adult PTSD, the literature on child PTSD is limited and inconsistent. We...     

The acceptability and feasibility of an anxiety reduction intervention for emergency department patients with non-cardiac chest pain

Despite good physical prognosis, patients who receive a diagnosis of non-cardiac chest pain (NCCP) may experience persistent pain and distress. While cognitive-behavioural interventions have been found to be effective for this group, they are difficult to deliver in busy emergency department (ED) settings. Addressing the acceptability and relevance of self-help interventions is an important initial step in addressing this need. This study sought to examine the acceptability and relevance of an evidence-based self-help intervention for ED patients with persistent NCCP and anxiety. Patient (interviews: N = 11) and specialist chest pain nurse (focus group: N = 4) views on acceptability and feasibility were examined. Data were analysed using thematic analysis. Patients and nurses reported that there was a need for the intervention, as stress and anxiety are common among patients with NCCP, and provision of psychosocial support is currently lacking. Both patients and nurses reported that the intervention was relevant, acceptable, and potentially useful. Some changes to the intervention were suggested. Nurses reported that the intervention could be used within the existing staff resources available in an ED setting. This study represents an important first step towards developing a brief self-help intervention for ED patients with NCCP and anxiety. Further research should seek to determine the efficacy of the intervention in a pilot trial.     

Does Executive Function Matter for Preschoolers’ Problem Behaviors?

Early problem behaviors are associated with a variety of cognitive deficits: in verbal ability, executive function (EF) and theory of mind (ToM). Previous studies with different age-groups yield contrasting results: for 2-year-olds, ToM skills appear particularly salient (Hughes & Ensor, 2006), but for 4-year-olds EF appears more important (Hughes, White, Sharpen, & Dunn, 2000). To examine this apparent developmental change in the relative salience of cognitive deficits we followed 122 children from Hughes and Ensor’s (2006) sample at ages 3 and 4. Tests of ToM, EF and verbal ability were included at each time-point and multi-informant, multi-measure, multi-setting ratings provided aggregate measures of problem behaviors. ToM and verbal ability showed non-specific associations with problem behaviors, but associations between EF and problem behaviors were strong and specific. In addition, age-3 EF mediated relations between age-2 verbal ability and age-4 problem behaviors.     

Personality and cognitive processes: self-criticism and different types of rumination as predictors of suicidal ideation

Self-criticism and rumination have been related to suicidality. In the present study, we investigated the extent to which different types of rumination (brooding and reflection) mediate the relationship between self-criticism and suicidal ideation. Two hundred and thirty-two healthy adults completed a range of psychological inventories at Time 1 and were followed up approximately 3 months later (Time 2). Brooding was more strongly associated with suicidal ideation than reflection. Hierarchical regression analyses confirmed that among those who completed measures at both time points, brooding rumination fully mediated the self-criticism-Time 2 suicidal ideation relationship. Reflection did not mediate the self-criticism-suicidal ideation link. The findings support a growing corpus of research which highlights the utility of personality and cognitive factors in advancing our understanding of the suicidal process. The theoretical and clinical implications are discussed.     

Narcissism and Empathy in Young Offenders and Non‐offenders

Understanding the individual factors that predispose persons to criminal behaviour is vital to reducing offending and rehabilitating those who have been sentenced to prison. This study examined the roles of narcissism (at both clinical and subclinical trait levels) and empathy, by comparing levels in young adult males currently serving a prison sentence to those with no history of criminal convictions. Prison participants had significantly higher levels of narcissism—in particular entitlement—than control participants, and this link was sequentially mediated by lower perspective‐taking and subsequently lack of empathic concern. Trait narcissism showed stronger effects than narcissistic personality disorder symptoms. Narcissistic young men's feelings of entitlement and ensuing lack of empathy for others may account for their greater likelihood of criminal behaviour. Copyright © 2013 John Wiley & Sons, Ltd.