Depression, hopelessness, and self-esteem: accounting for suicidality in adolescent psychiatric inpatients

The present study was designed to examine depression, hopelessness, and self-esteem as related to suicidal behavior in three groups of depressed adolescent psychiatric inpatients. Depressed adolescents who had never attempted suicide were compared to depressed adolescents who had attempted suicide once and to depressed adolescents who had attempted suicide on several different occasions. Results showed that suicidal adolescents experienced significantly greater depression and hopelessness than did the nonsuicidal adolescents. However, all three groups of depressed adolescents reported similar low levels of self-esteem. Measures of depression and hopelessness were useful in classifying the adolescents based on their suicidal behavior. Results suggest that the treatment of suicidal adolescents could benefit from strategies that focus on reducing feelings of depression and hopelessness.     

Projective identification: Pros and cons. An essay review of Samuel Slipp,the technique and practice of Object Relations Family Therapy

This paper is a critical appraisal of Samuel Slipp's book on Object Relations Family Therapy (ORFT), which uses the concept of projective identification as a central thesis in explaining interpersonal influence. Slipp's book is praised for its excellent review of the literature of object relations theory and the major schools of family therapy, classification of families according to complementary projections, and revealing case material. Interpersonal-Systemic (I-S) theory and methodology with its use of the concepts of empathy, interpersonal influences, search for intimacy, maintenance of self-esteem, selective inattention, and reflected appraisals is offered as an alternative view to projective identification.     

Looking for reconciliations between anecdotes and causalities: The stoical model

Our bias in establishing causality ties which attribute to one consequence a unique cause make circular causality difficult as a way of thinking. Philosophy shows many theories about causality which all are ways to reduce anxiety. Our experiences sometimes require us to go farther than the instrumental (causal) level and to discover a place where disorder may be reestablished in the movement and contradiction. The Stoical model of expressive causality gives a different meaning to our work. In practice the anecdote becomes the essential element in a chair of expressive causalities. A clinical example shows how the anecdote can be the intersection between the family and therapist, offering a new dimension to circular causality and helps the therapist to understand and create another way of thinking about disorder and confusion.     

Observing groups as seen from both sides of the looking glass

Conclusion This paper attempts to make a contribution to an area of the literature on group therapy about which very little has been published—the effects of the therapy group upon the observing group and the dynamics of the observing group as an entity in itself. Although work on which this paper is based took place in training institutions where education is the primary function, it is important to emphasize that education and personal change are interrelated. Psychotherapeutic activity takes place spontaneously with the observers and needs to be constructively utilized. This wealth of process and reaction is an untapped training opportunity for the observing group. The challenge of method, personal reactions, and group process responses are all opportunities for its members to both learn more as therapists and mature as individuals. At this juncture, we are trying to establish ways of     

Does family therapy produce change? an overview of outcome studies

Summary Families were randomly assigned to one of two forms of conjoint marital therapy: an insight-oriented treatment (n=10) or a problem-solving intervention (n=10.). The results on self-report measures of family functioning indicate that the problem-solving intervention produced more favorable changes after three months. However on long-term follow-up after a year, this more positive effect did not apparently persist, since the insight treatment group reported better results. Experienced therapists did better than inexperienced therapists in the insight treatment condition, but level of experience did not make a difference in the problem-solving intervention. A group of eight families who dropped out of the insight treatment group provided data on correlates of premature termination. Several of the practical obstacles to implementing an experimental design in a clinic setting are illustrated by the research.As we develop more sophisticated methodology, we hope that is the near future family therapy researchers will be better able to state which type of approach is more effective for whom and under what circumstances. A review of current studies of family therapy outcome research indicates that family therapy seems to be as effective as individual psychological treatment.     

Protection of animal research subjects

The use of experimental animals, mostly rodents, in biomedical research and especially in oncology and immunology should be acknowledged with respect, recognizing the contribution of animal experimentation in the fascinating scientific progress in these disciplines of research. It is an obligation of the investigator to justify the scientific and ethical aspects of each study requiring the use of animals. The international guiding principles for using animals in biomedical research are well defined and have been distributed worldwide by the International Council for Laboratory Animal Science (ICLAS) since 1956, when this Organization was founded. In Poland the ICLAS philosophy and principles are highly respected and were implemented firstly by the members of the Commission on Biology of Experimental Animals appointed in 1962 by the Department of Medical Science of the Polish Academy of Science in Warsaw. Animal Protection Acts, first proclaimed in 1928 were gradually modified and improved. Actual legislation (enacted in 1997, 2003 and 2005) is consistent with EU Directives (86/609/EEC) and follows the internationally recommended principles that include ICLAS guidelines concerning animal welfare and care condition in biomedical research. The problem of “alternative methods” is briefly discussed. Dr. Donald Boisvert, CCAC — Canadian Council on Animal Care A lecture on the subject of this paper was presented at the 6th International Bioethics Conference entitled ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005. The author is the National Representative of Polish Academy of Science to the International Council for Laboratory Animal Science (ICLAS) and a Member of the ICLAS Governing Board.     

Cognitive-Behavioral Treatment of Depression, Part X: Reducing the Risk of Relapse

Cognitive-behavioral therapy has been found effective for the treatment of depression. Nonetheless, many clients who respond to treatment are still vulnerable to relapse during the months following remission. It is important for therapists to be aware of the temporal patterns often seen in patients following recovery from depression so they can use strategies designed to reduce the risk of relapse or recurrence. Relapse prevention strategies focus on helping clients: 1) identify high risk situations, 2) develop specific coping strategies to deal with emotional distress, 3) deliberately seek and confront difficult situations, 4) cope with feeling overwhelmed, 5) expand and refine their coping skills, 6) enhance their feelings of self-confidence, and 7) anticipate and prepare for a lapse. These strategies provide much help in maintaining the gains that had been obtained through the earlier treatment efforts.     

Relational diagnosis: An essay review

A review ofHandbook of relational diagnosis and dysfunctional family patterns. Florence W. Kaslow, Ed. 566 pages. $55. Cloth. ISBN # 0471-08078-0. New York: John Wiley & Sons, 1996.     

Brief therapy in the Israeli kibbutz

Analysis of results of therapy in an unselected sample of 211 kibbutz patients seen over a three year period by the author in his capacity as kibbutz member and psychiatrist indicated that over 70% of the identified patients responded very satisfactorily to brief therapy. About one-third of the clients did not need more than a single comprehensive therapy session to achieve continuous improvement. In a minority of the cases more than 10 sessions were required. The results were significantly better in cases treated by brief therapy than in the sample treated by long-term therapy, where the pre-treatment severity was determined to be greater. The paper describes the unique aspects of brief therapy in the kibbutz setting, giving an outline of the author's model of intervention, using all components of the individual, family, and community ecosystem.