Treating a Chronically Depressed Adolescent Female Using the Cognitive Behavioral Analysis System of Psychotherapy: A Case Study

A case is presented of an adolescent female with double depression who was treated using the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). CBASP is designed to teach a social problem-solving procedure called Situational Analysis (SA). Generalized treatment effects were measured through monitoring of diagnostic status, two administrations of the Minnesota Multiphasic Personality Inventory-Adolescent, weekly administrations of the Child Depression Inventory, and acquisition performance ratings on the SA task. The results showed that CBASP appeared to be an effective treatment. The double depressive disorder remitted, and the patient learned to identify behavioral consequences as well as target and attain her interpersonal goals. CBASP can be effective for adolescents, although modifications of the adult form of the therapy may be necessary.     

The Late Life Reconstruction of Selfhood Analyzed in Peter Hall's Film She's Been Away

The film She's Been Away tells the story of an old woman who had been locked in a mental asylum while a teenager, for willfully violating repressive sexual codes. Sixty years later her ward is closed and she moves in with her nephew and his wife. Faced with what appears to be a hopeless situation, she manages to forge a sense of a meaningful closure to a misspent life. Through narrative, story structure, and characterization the film throws into focus coping mechanisms and ego strategies deployed by a triple disadvantaged person (woman, old, and mad) in her ascent to a reconstructed selfhood. As the protagonist ties both ends of her life, and faces the abyss in between she makes genuine adaptive use of so-called regressive, late-life development assets (available to a lesser degree to elderly people in normal life circumstances), primarily the abolition of linear time. Through this abolition she makes reminiscing an actual reality while still maintaining a functional separation between the real and the remembered. Her portrayal is a valuable document for gerontologists as it explores, through artistic imagination and intuition, the workings of an aging mind in search for a meaningful sense of closure.     

Nietzsche Contra “Self-Reformulation”

Not only do the writings of Nietzsche – early and late – fail to support the pedagogy of self-reformulation, this doctrine embodies what for him is worst in man and would destroy that which is higher. The pedagogy of self-reformulation is also incoherent. In contrast, Nietzsche offers a fruitful and comprehensive theory of education that, while non-democratic and contemptuous of egalitarian aspirations, emerges consistently from his metaphysics and philosophical anthropology. Whatever, then, we might think of his premises, Nietzsche’s philosophy of education represents an attractive model for those who would develop a meaningful, distinctive, and persuasive educational theory. It defines a domain of the possible and then straightforwardly states what is and is not to be done within it – and why.     

Psychopathy in Children and Adolescents: The Need for a Developmental Perspective

The current paper introduces the special issue on research attempting to extend the construct of psychopathy to child and adolescent samples. Past special sections and reviews have typically focused on the implications of this research for forensic research and practice. The current special issue focuses on topics relevant for integrating this research within the broader literature on childhood psychopathology. Papers included in this special issue focus on the structure of psychopathic traits in youth, the relation of these traits to other important psychopathological and personality constructs in children and adolescents, and the utility of these traits for identifying a distinct subgroup of antisocial youth who differ on important cognitive processes and on the severity and stability of their problem behavior. These empirical works are followed by commentary provided by two prominent scholars who outline the potential importance of the construct for advancing our understanding of childhood psychopathology. In addition, these scholars provide a discussion of important directions for future research.     

Mnemonics Strategy Development: Improving Alphabetic Understanding In Turkish Students,At Risk for Failure in EFL Settings

The purpose of this study is to investigate the effects of integrated mnemonics on consonant letter naming and consonant sound production for three 4th grade Turkish students, at-risk for failure in an English-as-a-Foreign-Language (EFL) classroom. Mnemonic picture cards, where the target consonant letter was embedded as an integral part of the picture, were developed (e.g., the letter C as the clock, the letter D as the drum). Results showed that (a) all three students reached mastery on consonant letter naming, and (b) all three students showed marked improvement for consonant sound production, with one student reaching mastery. Letter-sound correspondence performance remained near instructional levels one week post-intervention. Generalization data showed students could produce some words that began and ended with consonant sounds, once consonant letter-sound correspondence was mastered.     

Assessment of the Use and Feasibility of Video to Supplement the Genetic Counseling Process: A Cancer Genetic Counseling Perspective

Cancer genetic counselors use a variety of teaching modalities for patient education. This survey of cancer genetic counselors assessed their use of educational videos and their recommendations for content of future videos. Thirty percent of respondents use videos for patient education. Cited benefits included reinforcement of information for clients and increased counselor efficiency. Of the 70% who do not use videos, predominant barriers included the perceived lack of an appropriate video, lack of space and/or equipment, and concern that videos are impersonal. Most respondents desired a video that is representative of the genetic counseling session, but emphasized the importance of using broad information. Content considered critical included the pros and cons of genetic testing, associated psychosocial implications, and genetic discrimination. The results of this exploratory study provide data relevant for the development of a cancer genetics video for patient education, and suggestions are made based on aspects of information processing and communication theories.     

Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective

The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in situations in which clients have presented information from other sources that is potentially discrepant with information given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly complex case is also analyzed and reflected on.     

Care of the Self and Patient Participation in Genetic Discourse: A Foucauldian Reading of the Surgeon General's “My Family Health Portrait” Program

Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing the power of genetics discourse has implications for our collective understanding of the operations of the care of the self and the uses of genetic information that we propose.     

Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.