Using Cognitive Behavior Therapy in Clinical Work With African American Children and Adolescents: A Review of the Literature

A comprehensive review of the literature on clinical work with African American youth with cognitive behavior therapy (CBT) is presented. The strengths and limitations of CBT in relation to this population are outlined. Although CBT shows promise in helping, research on the efficacy and effectiveness of CBT in this group is lacking. Se presenta una reseña exhaustiva de la literatura sobre trabajo clínico con jóvenes Afroamericanos usando terapia cognitiva conductual (TCC). Se perfilan los puntos fuertes y las limitaciones de la TCC en relación a esta población. A pesar de que la TCC muestra signos prometedores para servir de ayuda, no hay suficiente investigación sobre la eficacia y efectividad de la TCC en este grupo.     

‘WITH PSYCHOSIS IN MIND’ – the reverberations of the psychotic encounter

Psychoanalytic theory offers a varied conceptual system for considering psychosis by providing a coherent representation of the anxieties and processes at work in adult patients. But at the practical clinical level, it is not enough simply to ‘think about psychosis’ and have a theoretical system in place. The therapist must also ‘have psychosis in mind’, that is, get to grips with its forms of logic, gain familiarity with its workings, and learn to understand and accept the effects it has on the therapeutic relationship and on their own expectations. Clinicians engaged in this type of work must be able to tolerate getting back in touch with processes deemed archaic at the core of their own psychological functioning, which will impact their ability to listen and think. These chaotic processes demand a change of approach since they cause a ‘desymbolisation’ that perturbs the internal mental structure of the therapist. This ‘desymbolisation’ is therefore the locus of the therapeutic work, which must attempt to render it comprehensible and represent it. A case study illustrates these processes.     

In Defense of Radical Social Constructivism

This article is a response to Alex North's ( 2016 ) critique of radical social constructivism (RSC). North claimed that RSC was a movement in counseling that would be monumentally problematic in its future application to counseling theory. In this article, the author defends RSC and posits that RSC is closely aligned with the values of counseling. RSC encourages counselors to look at the social understanding of clients' experiences as paramount to the behaviors they exhibit.     

Making the Smart Choice: a systemic response to school‐based violence

This paper reports on a school‐based intervention in which a family therapist, serving as a consultant to a high school, worked with that school to reduce the level of school‐based violence. The primary intervention reported in this paper is a conflict skills training programme called ‘Making the Smart Choice’. While designed for the families of students suspended for physical violence, this intervention also impacts upon the school's disciplinary system and the climate of the school itself. The context or responses to school‐based violence, the strategy to gain access to the school, the politics of developing such a programme, the programme itself and the infrastructure needed to maintain it are described. For four years, suspensions for school‐based violence were halved compared to the four years prior to the start of the programme.     

The impact of trauma on the psyche of the individual using the film Belleville Rendez-vous as an illustrative vehicle

Using the film Belleville Rendez-vous as a vehicle for discussion, this paper argues that whilst a traumatic complex may bring about dissociation of the psyche, this is not the only possibility, nor is dissociation necessarily to be seen solely as a difficulty to be overcome. If trauma is experienced within the context of support and validation, the experience of trauma may generate integration not only of the trauma but also of the growth potential that the trauma has previously inhibited.     

New Mandates and Imperatives in the Revised ACA Code of Ethics

The first major revision of the ACA Code of Ethics in a decade occurred in late 2005, with the updated edition containing important new mandates and imperatives. This article provides interviews with members of the Ethics Revision Task Force that flesh out seminal changes in the revised ACA Code of Ethics in the areas of confidentiality, romantic and sexual interactions, dual relationships, end‐of‐life care for terminally ill clients, cultural sensitivity, diagnosis, interventions, practice termination, technology, and deceased clients.     

Family-based obesity treatment, then and now: twenty-five years of pediatric obesity treatment.

OBJECTIVE: Family-based treatments for pediatric obesity were developed over 25 years ago. Over that time, youth have become more obese and the environment more obesiogenic, which may influence efficacy of pediatric weight control. Mixed-effects regression models were used to compare the efficacy of programs initiated 20 to 25 years ago to current programs through 24-month follow-up, as well as to reanalyze 10-year outcomes of previous research using contemporary measures and analytic strategies. MAIN OUTCOME MEASURES: z-BMI and percent overweight. RESULTS: Results showed significant reductions over time, with no differences in z-BMI change for older versus contemporary studies. Age was a predictor of z-BMI up to 24 months, with younger children showing larger change. Mixed-effects regression models replicated previous long-term effects of family-based interventions. Gender was a predictor of long-term z-BMI change, with girls benefiting more over time than did boys. CONCLUSION: The efficacy of the family-based behavioral approach to treating pediatric obesity replicates over a 25-year period. Challenges in evaluating treatment effects over time are discussed. Ideas for studying choice of treatments that vary in effect size and for strengthening family-based behavioral treatments are noted.     

A method for the delivery of reinforcement during exercise

The purpose of this study was to develop an automated system for positively or negatively reinforcing subjects while they exercised on an electronically braked bicycle ergometer. The circuitry used to interface the subject’s pedal speed responses with the delivery of auditory reinforcement is presented, as well as a study designed to test the utility of the system. Twenty 18- to 25-year-old male subjects exercised on an electronically braked ergometer at a constant workload of 50 W for three 5-min blocks. During the first 5 min, subjects pedaled at their preferred rate, and during the next two 5-min blocks, they pedaled faster or slower than their baseline pedal speed to turn on a comedy tape for positive reinforcement, or turn off 90 dB of white noise for negative reinforcement. Circuits that interfaced the subject’s pedal response with the delivery of reinforcement are discussed in detail. Both positive and negative reinforcement increased the targeted pedaling rates, with no differences as a function of targeting increased or decreased pedal speed. This system could be used with various reinforcers, such as video and other audio equipment to increase exercise behavior.     

The perceived vulnerability to disease scale: Cross-cultural measurement invariance and associations with fear of COVID-19 across 16 countries

Using cross-sectional data from N = 4274 young adults across 16 countries during the COVID-19 pandemic, we examined the cross-cultural measurement invariance of the perceived vulnerability to disease (PVD) scale and tested the hypothesis that the association between PVD and fear of COVID-19 is stronger under high disease threat [that is, absence of COVID-19 vaccination, living in a country with lower Human Development Index (HDI) or higher COVID-19 mortality]. Results supported a bi-factor Exploratory Structural Equation Modeling model where items loaded on a global PVD factor, and on the sub-factors of Perceived Infectability and Germ Aversion. However, cross-national invariance could only be obtained on the configural level with a reduced version of the PVD scale (PVD-r), suggesting that the concept of PVD may vary across nations. Moreover, higher PVD-r was consistently associated with greater fear of COVID-19 across all levels of disease threat, but this association was especially pronounced among individuals with a COVID-19 vaccine, and in contexts where COVID-19 mortality was high. The present research brought clarity into the dimensionality of the PVD measure, discussed its suitability and limitations for cross-cultural research, and highlighted the pandemic-related conditions under which higher PVD is most likely to go along with psychologically maladaptive outcomes, such as fear of COVID-19.