Contemporary Psychotherapy: Looking Backward, Looking Forward

This editorial summarizes the founding of the Journal of Contemporary Psychotherapy, and its evolution into its current form. Also, the editor provides several recommendations for authors hoping to publish their ideas regarding psychotherapy. Finally, the current editor acknowledges the numerous people who have worked to develop, improve, and strengthen the journal.     

Some Historical Conditions of Narrative Work

Written to honor the immense contribution of Michael White as a leader in the development of narrative therapy, this historical essay contrasts the origins of psychoanalysis, family therapy and narrative therapy. Changes in the understanding of therapeutic strategies, methods of training and supervision, styles of leadership, the involvement of audiences in the therapeutic and training processes, and conceptions of the nature of the mind are described. A style of direct demonstration of methods, especially of the formulation of questions, is important in narrative work. The central master-role of the therapist in analysis and family therapy is replaced in narrative work by eliciting local knowledge, and the recruitment of audiences to the work. This is consistent with narrative therapy's "de-centered" image of the therapist.     

Contemporary Perspectives on Stress Management: Medication,Meditation or Mitigation

Stressful life events can increase the risk for developing a variety of physical disorders and emotional problems. A biopsychosocial approach can help mental health professions to better understand and more effectively treat disorders that are related to severe negative life events. Biological approaches focus on suppressing emotional reactions, usually through a reliance on psychopharmacological interventions. Psychological approaches usually focus on the cognitive processes that translate stress into distress. Psychological interventions focus on changing the negative attitudes and maladaptive behaviors that aggravate most stressful situations. Social interventions focus on improving social support and involvement with agencies to confront limited finances, unemployment, and housing problems. In these times of economic crisis and severe financial hardship, psychological and social intervention strategies appear more useful than biological treatments.     

Friendship,Depression, and Suicide Attempts in Adults: Exploratory Analysis of a Longitudinal Follow‐Up Study

Social support is thought to protect against the risk of suicidal behavior in young people and late life, but less is known about the role of friendship in adults. We explored the effect of friendship on suicide attempt risk during 1‐year follow‐up of 132 adults presenting with major depressive episode (MDE). Items from the Social Adjustment Scale–Self‐Report were used as an index of frequency and quality of recent friendship contacts. Survival methods tested associations of friendship with risk of suicide attempt, recurrent MDE, and related outcomes during follow‐up. Impaired friendship predicted greater risk of suicide attempt in an unadjusted Cox model. This association was stronger for quality (p = .009) than frequency (p = .081) of friendship contacts. In the adjusted model, the effect of friendship on suicide attempts was largely explained by self‐reported depression severity. Friendship has a potentially bidirectional relationship with depression, and its effect on suicidal behavior appears to occur through its relationship with depression. Future research should examine the effect of antidepressant treatment on friendship and be designed to test mediation models of relationships between friendship, depression, and suicidal behavior.     

Risk Factors of a Suicide Reattempt by Seasonality and the Method of a Previous Suicide Attempt: A Cohort Study in a Japanese Primary Care Hospital

Suicide has a great impact on the individual whose life is lost and the bereaved family members. The risk of a suicide reattempt is particularly high during the first 12 months after a suicide attempt. In this cohort study, risk factors for a suicide reattempt were explored among 291 patients at suicide risk. Clinical and demographic data were collected from a Japanese primary care hospital. Past psychiatric history and multiple diagnoses were associated with suicide reattempts in both genders. Drug overdose, past psychiatric history, and the summer season were linked to suicide reattempts among males. Past psychiatric history and multiple diagnoses were linked to suicide reattempts among females. Appropriate assessment of past psychiatric history, season and method of suicide attempt, gender, and diagnosis may play a role in preventing suicide.     

Postdeployment Suicide Risk Increases Over a 6‐month Period: Predictors of Increased Risk among Midwestern Army National Guard Soldiers

National Guard (NG) soldiers returning from deployments in Iraq and Afghanistan were surveyed at 6 and 12 months following their return (N = 970). The overall prevalence of suicide risk at 6 and 12 months following their return was assessed, as were changes in suicide risk among soldiers initially at high or low risk. Factors associated with changes in risk were assessed. The percentage of NG soldiers with high suicide risk increased from 6.8% at 6 months to 9.2% at 12 months (odds ratio = 1.7, p = .02). In the 882 soldiers initially at low risk, 5.9% (52/882) became high risk at 12 months; in the 64 soldiers initially at high risk, 46.9% (30/64) became low risk at 12 months. Initial levels of depressive symptoms were predictive of changing to high risk; this association appeared to be partially explained by soldier reports of increased search in the meaning in life and higher levels of perceived stress. Because suicide risk increases over the first 12 months, continued risk assessments during this time period should be considered. Supporting soldiers to find meaning in their life after deployment and enhancing their capacity to cope with perceived stress may help prevent increases in suicide risk over time.     

The personality disorders: A review and critique of contemporary assessment strategies

Despite the prevalence of personality disorders, only recently have they become the topic of extensive clinical research. Unfortunately, much of this research suffers from various assessment problems including poor interrater agreement, an overreliance on cross-sectional assessment, and inconsistencies across measures. The present review examines the strategies used to assess personality disorders. Three comprehensive tables are used to provide a quantitative review of existing studies. Although specific measures are examined, the focus remains on general strategies for assessment. Personality disorder assessment may be enhanced through the use of aggregation methods. Aggregating over raters can reduce the subjective biases inherent in any one person's perception. Aggregating data over time reduces the instability of personality assessment, while aggregating data across measures reduces the reliance on any one measure to assess personality disorders accurately. Thus, future research should be able to refine the strategies used to study personality disorders.     

The application of prospective strategies to family therapy

Among the most frequently used theoretical orientations for administering family therapy are the systems, interactional, structuralist, problem-centered, and attachment approaches. Each of these methods proposes a theory concerning the etiology and resolution of conflict, a protocol of assessment, and a view on the therapist's role in advocating intervention techniques. Despite the success of these methods, however, families often leave treatment lacking the interpersonal skills for predicting potential conflict and for overcoming episodes of transition. This paper explores how the prospective approach may rectify this problem by enhancing the family members' use of intuition for experiencing transition and predicting upcoming change. As such, the application of the prospective technique may be beneficial for strengthening family relationships.