Unconscious fantasy (or phantasy) as clinical concept

A clinical phenomenology of the concept ‘unconscious fantasy’ attempts to describe it from a ‘bottom‐up’ perspective, that is, from the immediate experience of the analyst working in session. Articles of psychoanalytic authors from different persuasions are reviewed, which taken as a whole would shed some light on how the concept of unconscious fantasy takes shape in the analyst's mind during the session with the patient. A clinical phenomenology in three steps is described. Each step is illustrated by clinical material. Current controversies around the concept of unconscious fantasy (or phantasy) are still trapped in the discussion about if and how they are really unconscious. The strategy to describe from a ‘bottom‐up’ perspective the process of how the analyst's mind embraces the idea that an emerging phenomenon in the relationship with the patient can be defined as ‘unconscious fantasy’, allows us to elude the question as to whether or not we believe that unconscious fantasies exist at all, since we are neither required to assert or deny such a prior existence in order to describe the process of elaboration which, in the end, does formulate a fantasy as fantasy.     

Student Experiences of the Adolescent Diversion Project: A Community-Based Exemplar in the Pedagogy of Service-Learning

Service-learning partnerships between universities and surrounding communities striving to create systems-level change must consider an emphasis in critical community service; a community centered paradigm where students are taught to work with communities to better understand contexts surrounding a social problem, as opposed to merely volunteering to provide a service to a community. The Adolescent Diversion Project (ADP), which has been operating for over 30 years, demonstrates critical community service through the type of relationship built between students and the local community. This article describes: a qualitative study with ADP students, the historical context of ADP, what and how students learned through their involvement in ADP, and reframes the work of this project as a form of service-learning pedagogy. Inductive content analysis was employed to identify underlying themes across participants related to their personal experiences of ADP and its impact in their lives. Findings were compared with service-learning outcomes and other quantitative studies conducted with past ADP cohorts from the literature. Consistent with past studies, ADP students become more negative toward social systems involved with their youth. This finding may explain an increase in feelings of political commitment following involvement in ADP. Consistent with service-learning outcomes, results demonstrate that ADP should be further documented as not only an effective community-based program but also as an exemplar in the pedagogy of service-learning. This study highlights why service-learning opportunities for students are not just one way to teach students, they are opportunities to bridge relationships within communities, bring life to theoretical concepts, and build the foundations necessary for educated citizens that will one day take lead roles in our society.     

Emerging Practices of Counseling and Psychotherapy in China: Ethical Dilemmas in Dual Relationships

A qualitative study was conducted with 48 Chinese counselors and psychotherapists who were interviewed in 2006 and an independent sample of 50 participants who responded to a survey in 2014. This study aims to explore how the new emerging expansion of mental health practice is related to issues and challenges of dual role relationship and how the well-engrained values and social characteristics of Chinese culture influences perceptions and resolution of ethical dilemmas. The participants identified similar dual relationships in 2006 and 2014: (a) Incidental boundary crossings, a sexual or romantic relationship, a dual social relationship, and a professional dual relationship were the most frequently reported types of dual relationships encountered by Chinese practitioners, and (b) the socioeconomic and cultural context and the development trajectory of counseling and psychotherapy in China play a significant role in shaping practitioners’ behaviors. The comparison of the data in 2006 and 2014 indicated that practitioners in psychotherapy and counseling have an improved awareness and understanding of ethical issues, evidenced by the decreasing cases of romantic and sexual relationships and increasing cases of social dual relationships influenced by the interrelatedness of traditional Chinese culture.     

Protective effect of supportive family relationships and the influence of stressful life events on adolescent adjustment

The purpose of this study was to determine the association between the occurrence of stressful life events and internalizing and externalizing problems, and to analyze longitudinally buffering effects of supportive family relationships. To this end, 100 Spanish adolescents were studied twice, when they were in mid-adolescence (15-16 years) and two years later. They completed questionnaires regarding stressful life events, family relationships, and adolescent adjustment. Results showed that high quality parent-adolescent relationships protected boys and girls against the negative consequences of stressful life events on externalizing, but not internalizing, symptoms. The adolescents who enjoyed good relationships with their parents in mid-adolescence did not increase their externalizing problems in late adolescence as consequence of the occurrence of stressful events. However, these stressors did lead to an increase in the number of externalizing problems when the family relationships were of a middle or low quality. These results highlight the important role that supportive family relationships play in the behavioral adjustment of adolescents, protecting them against some negative consequences of stressful life events, and suggest the relevance of supporting parents through resources such as parent education in order to help them to improve their relationships with their adolescents.     

Ethnic differences in the effects of spiritual well-being on long-term psychological and behavioral outcomes within a sample of homeless women

The present study examines ethnicity as a moderator variable between spiritual well-being (SWB) and psychological and behavioral outcomes. Participants included in this analysis were 88 African American (46.6%) and 101 non-African American (total N = 189) homeless mothers. Through structured interviews conducted at 3-month intervals over a period of 15 months, data were collected on spiritual well-being, mental health, trauma symptoms, substance use, parenting, and child behavior. Hierarchical linear model and general estimating equation results indicated that ethnicity moderates the relationship between SWB and anxiety, trauma symptoms, child behavior, and parenting outcomes. On average, African Americans reported significantly higher SWB than non-African Americans, indicating the relative importance of spirituality in their lives. These findings support previous research indicating a difference in the role that SWB plays in the lives of African Americans compared to non-African Americans.     

SOCIOEMOTIONAL AND BEHAVIORAL PROBLEMS IN TODDLERS WITH LANGUAGE DELAY

Toddlers with language delay are at risk for persistent developmental and behavioral difficulties; however, the association between socioemotional/behavior problems and language in young children is not well understood. This study explored socioemotional/behavior problems in a unique sample of toddlers with language delays using a measure developed explicitly for this age group. Toddlers identified by 18 months with receptive and expressive language delay (LD; n = 30) or typical development (TD; n = 61) were evaluated at 18 and 24 months of age using the Infant‐Toddler Social and Emotional Assessment (ITSEA) and the Mullen Scales of Early Learning. Compared to toddlers who had TD, toddlers with LD had significantly more concerning scores at 18 and 24 months on all ITSEA domains. The rate of “clinical concern” on most domains was not high in either group, except that >60% of LD toddlers were in the clinical concern range on the Competence domain. Socioemotional/behavioral problems were dimensionally related to receptive and expressive language, with greater language delay associated with more concerning ITSEA scores. Socioemotional and behavioral problems are related to receptive and expressive language abilities in 18‐ and 24‐month‐olds, indicating the need for screening of both types of concerns in toddlers identified with potential language delays.     

Effects of iron deficiency in infancy on patterns of motor development over time

This longitudinal study of the effects of iron deficiency in infancy assessed motor development over time in 185 healthy Costa Rican children who varied in iron status at 12-23 months. Longitudinal analyses (hierarchical linear modeling) used the Bayley Psychomotor Index before and both 1 week and 3 months after iron treatment in infancy and the Bruninks-Oseretsky Test of Motor Proficiency - long form at 5 years and short form at 11-14 years. Children with chronic severe iron deficiency in infancy had lower motor scores at the beginning of the study and a lower but parallel trajectory for motor scores through early adolescence. Thus, there was no evidence of catch-up in motor development, despite iron therapy in infancy that corrected iron deficiency anemia in all cases.