When confidentiality mandates a secret be kept: a case report.

The success of group psychotherapy is impeded when group members maintain secrets and fail to self-disclose to other group members. However, revealing secrets sometimes conflicts with the legal and ethical constraints of confidentiality, thus placing a greater burden on the group. The case reported here illustrates how complex the dynamics of group therapy become when one group member maintains a secret. In this case, one member maintained a secret about another to preserve that individual's right to privacy and confidentiality. This case also details the group member's deliberations and confusion about the effect his secret had on the group's success, as well as the burden he experienced by choosing to preserve confidentiality at the expense of successful therapy for himself.     

The need for personal and social education in secondary schools and further education

The need for personal and social education in schools is outlined. Reference is made to the concept of psychological education that is being developed in the United States, and a model of personal growth and career development is described with particular emphasis on areas of personal growth that need to be developed within the school curriculum. Results of a survey of young people's personal and interpersonal problems are presented which give accounts of the range of difficulties 235 fourth year and fifth year boys and girls in secondary education and 36 young people in employment had in their interpersonal relationships with parents, teachers, employers, community authority figures, same- and opposite-sex friends, etc. Information was also obtained on what actually occupied young people's thoughts: the things they found it difficult to cope with and talk about, the things that they felt parents should tell their children, what they would like to talk to their teachers and parents about, and the attributes which they felt they could or could not change for themselves.     

Videoconference to supervise early intensive behavioral intervention: A preliminary evaluation of acceptability

At present, early intensive behavioral intervention (EIBI) for children with autism spectrum disorders is the intervention that has the strongest empirical support. EIBI requires frequent supervision by qualified professionals. Norway, like many other countries, has a shortage of qualified supervisors, particularly in rural regions. This study used a reversal design to investigate how supervisors and supervisees perceive the quality of EIBI supervision and the local team's preparedness when supervision was provided either on-site or via videoconference. Calculations were made on how much time could be saved on travel when part of the supervision was provided via videoconference. There were no significant differences in the supervisors' and supervisees' ratings of on-site and videoconference supervision. Moreover, the supervisors found the local EIBI teams to be better prepared when supervision was provided via videoconference, and the videoconference supervision meetings were shorter. The study discusses the implications of these findings for the accessibility of EIBI and case capacity and proposes some areas for further research.     

Dreams as portraits of self and group interaction

Dreams presented in group psychotherapy portray different aspects of the dialectic between the group and the individual. A self psychology perspective emphasizes the interplay between the current self-state of the group-as-a-whole and the selfobject needs of the individual. With this focus in mind, the therapist should help the group to deepen its awareness and capacity to reflect on emerging new abilities ("forward edge") which dream imagery conveys and the needed human responsiveness that can actualize these abilities and thus help the individual and the group to break and transform chains of repetition compulsion. We illustrate this approach with two clinical examples.     

Hypoglycemia-induced suppression of luteinizing hormone (LH) secretion in intact female rhesus macaques: role of vasopressin and endogenous opioids

The first objective of this study was to determine whether insulin-induced hypoglycemia (IIH) inhibits LH secretion in unrestrained female macaques during the follicular phase of the menstrual cycle. There was a consistent inhibitory effect of hypoglycemia on LH secretion within 3 h in these females. This inhibition was likely an indirect effect since low glucose levels did not inhibit GnRH secretion from GT1-1 neurones in vitro. We next investigated whether administration of a vasopressin antagonist (AVPa) either alone, or with naloxone could reverse the IIH-induced inhibition of LH release. Females were studied in the follicular phase during 10 h periods with blood samples collected every 10 min. Experimental groups were IIH (n=6), IIH+AVPa (n=5) and IIH+AVPa+naloxone (n=4). The first 5 h of each study served as a control and hypoglycemia was then induced with insulin. The AVPa was given as a bolus (180 microg) just before the insulin and was followed by a continuous infusion (180 microg/h) for 5 h. Naloxone (5 mg/kg) was given with the AVPa and followed by a continuous infusion (5 mg/kg/h) for 5 h. In the IIH group, LH reached its lowest value 3-4 h after insulin. Neither AVPa nor AVPa+naloxone infusion reversed the inhibitory action of hypoglycemia on LH release. These data suggest that if there are inhibitory actions of vasopressin and endogenous opioids on GnRH release induced by hypoglycemia, they are not sufficient to explain the suppression of GnRH/LH release in intact female primates.