The Value of Integration: Psychoanalytic Psychotherapy Meets Ego Psychology in a Psychotherapy Group for Children

ABSTRACT

Psychotherapy integration requires us to look beyond the confines of a particular theoretical or technical approach towards other perspectives. Integrative work with children, in particular, meets the socio-emotional needs of the child while simultaneously modeling behaviors and skills. This paper presents an explicitly integrative approach to child group psychotherapy: Relationships. Individuals. Skills. Engagement (RISE) Group. We begin with an in-depth discussion of the RISE group structure illustrated by clinical examples (the “what”) followed by a review of the theory and treatment modalities that inform the approach (the “why” and “how”). The RISE group is grounded in two theoretical perspectives (psychoanalytic principles and ego psychology) and draws upon clinical techniques from multiple treatment modalities (including cognitive behavior therapy, psychodynamic play therapy and dialectical behavior therapy). Combined, the merger of these perspectives results in a multilevel intervention that forges pathways to mastery and competence within the child. Finally, we discuss the value and limitations of integration as applied to group psychotherapy for children.     

When objects lose their meaning: what happens to their use?

The 8 patients involved in this study were impaired on tests assessing knowledge of objects and on the demonstration of their use. The patients' success in object use was significantly correlated with their knowledge about the objects, providing further evidence that conceptual knowledge plays a key role in object use. Having a recipient present improved performance in the moderately impaired patients, suggesting that a certain level of conceptual knowledge must remain for the additional information to be beneficial. Although overall accuracy in using the target objects was not related to our measures of affordance, the specific aspects of use afforded by the objects' structures were relatively impervious to semantic impairment, suggesting a role for affordance information when object-specific knowledge is disrupted. The patients' familiarity with the objects was an important predictor of performance. Finally, despite good performance on tests of mechanical problem solving, the patients showed very little evidence of employing these skills in their interactions with real objects.     

Interplay between action and movement intentions during social interaction

Observing the movements of another person influences the observer's intention to execute similar movements. However, little is known about how action intentions formed prior to movement planning influence this effect. In the experiment reported here, we manipulated the congruency of movement intentions and action intentions in a pair of jointly acting individuals (i.e., a participant paired with a confederate coactor) and investigated how congruency influenced performance. Overall, participants initiated actions faster when they had the same action intention as the coactor (i.e., when participants and the coactor were pursuing the same conceptual goal). Participants' responses were also faster when their and the coactor's movement intentions were directed to the same spatial location, but only when participants had the same action intention as the coactor. These findings suggest that observers use the same representation to implement their own action intentions that they use to infer other people's action intentions and also that a dynamic, multitiered intentional mechanism is involved in the processing of other people's actions.     

When more is not merrier: shared stressful experiences amplify

ABSTRACT

Sharing experiences with others, even without communication, can amplify those experiences. We investigated whether shared stressful experiences amplify. Participants completed the Cold Pressor Task at the same time as a confederate, or while the confederate completed another task. Importantly, participants in the shared (vs. unshared) condition experienced more sensory pain characteristics and reported more stress over time in relation to the task. Importantly, they reported thinking more about the confederate’s thoughts and feelings. This mentalizing sometimes mediated effects, suggesting the task amplified when participants constructed mental representations of others’ CPT experience (e.g. that it hurts) and incorporated it into their own responses.     

Connecting Eating Pathology with Risk for Engaging in Suicidal Behavior: The Mediating Role of Experiential Avoidance

Individuals with eating pathology, particularly those with diagnosed eating disorders, are at high risk for suicide. It is less clear whether undiagnosed eating pathology and subsyndromal eating disorders carry the same risk and, if so, what mechanisms may explain why higher levels of eating pathology yield greater risk for engaging in suicidal behaviors. The indirect relationship between disordered eating and risk for suicidal behaviors via facets of experiential avoidance was tested using a multiple‐mediator model. The model was tested using bootstrapping estimates of indirect effects in a sample of 218 noncollege student adults (Mage = 32.33, 66.1% women) with a history of suicidal attempt and/or history of nonsuicidal self‐injury (NSSI). Results revealed that disordered eating indirectly predicted risk for suicidal behaviors, distress aversion (i.e., negative attitudes or dislike of distress), and procrastination (i.e., delaying engagement with distressing activities). Results suggest that targeting experiential avoidance and helping those who have a history of engaging in suicidal behaviors and/or NSSI develop regulation strategies to use during times of distress may be of utmost importance for treatment and prevention of eating pathology.     

DOES "FEMINIST" PLUS "THERAPIST" EQUAL "FEMINIST THERAPIST"?

This research examined the therapy behaviors self-identified feminist therapists engaged in. Practicing therapists (N = 101) were asked to endorse various feminist self-labels and to indicate how often they engaged in a variety of feminist (as assessed by the Feminist Therapy Behaviors-Revised [FTB-R] scale; and other therapy behaviors with both women and men clients. The following results were found. First, incrementally specific feminist self-labeling by therapists improved the prediction of therapy behaviors reflecting the notion that the personal is political. Second, the most strongly identified feminist therapists were distinguished from other therapists by their attention to issues of oppression (e.g., sexism, racism, heterosexism) and socialization. Third, therapists reported engaging in FTB-R behaviors with men clients almost as much as with women clients. And finally, FTB-R and other therapy behaviors emerged as distinct, both in terms of the underlying structure of therapists' responses and in terms of the links to feminist self-labeling.     

Suicide Among Health Care Practitioners and Technicians in Colorado: An Epidemiological Study

Suicide is a public health concern with risks that vary between occupation groups. Many suicide victims with a health care occupation die by poisoning, but few studies have epidemiologically studied this association. The objective of this study was to quantify the increased risk of suicide death by poisoning among health care professionals in Colorado. Eleven years (2004–2014, N = 8,753) of suicide deaths in Colorado were compiled from the Colorado Violent Death Reporting System. A retrospective cohort study using multivariate logistic regression was conducted to examine the risk associated with having a health care occupation and eventual suicide death by poisoning, compared independently to firearm and hanging methods. Suicide victims with a health care occupation were more likely to die by poisoning rather than by hanging (RR 1.54, 95% CI: 1.41–1.68) or firearm (RR 1.79, 95% CI: 1.60–2.01), when compared to suicide victims without a health care occupation. The association between health care occupation and suicide method was significantly (p = .032) modified by gender. The results show that health care workers who die by suicide have an increased risk of eventual suicide death by poisoning rather than by firearm or hanging. These results can be used to inform tailored suicide prevention efforts in health care professionals.