Personhood of the Therapist in Couples Therapy

SUMMARY

Integrity Therapy (Lander, 1986; Lander & Nahon, 1992a, 1995a; Mowrer, 1961b, 1964a) views the personhood of the therapist as the very essence of therapy. By meeting the deepest part of the therapist with the deepest self of individuals in therapy, a healing process unfolds which opens up the healing potential of both the individuals and the couple. This article offers couple therapists and other mental health professionals an Integrity Therapy perspective of the personhood of the therapist and its therapeutic potential for helping couples in distress to reclaim their personhood. Two aspects of the Integrity Therapy approach which play a critical role in enhancing therapists' use of their personhood in the therapeutic process are explored: (a) the use of therapist self-disclosure, and (b) therapists' awareness and therapeutic use of counter-transference issues.     

Telephone-Administered Cognitive Behavior Therapy for Obsessive-Compulsive Disorder

Exposure with response prevention and cognitive behavior therapy are widely recognized as effective treatments for obsessive-compulsive disorder. Unfortunately, many people with obsessive-compulsive disorder - particularly those living in rural areas - do not have access to therapists providing these treatments. Accordingly, we investigated the efficacy of telephone-administered cognitive behavior therapy for obsessive-compulsive disorder. Two open trials are reported, for a total of 33 people with obsessive-compulsive disorder (without major depression). The first trial consisted of 12 weeks on a waiting list followed by 12 weeks of treatment (delayed treatment). The second trial consisted of 12 weeks of immediate treatment. Obsessive-compulsive symptoms did not change during the waiting period. Symptoms declined from pre- to post-treatment, with gains maintained at 12-week follow-up. For the pooled sample our pre-to-post-treatment effect size was as large or larger than those obtained in other studies of reduced contact treatment, and similar to those of face-to-face exposure with response prevention. Our proportion of treatment dropouts tended to be lower than those of other reduced contact interventions. The results suggest that telephone-administered cognitive behavior therapy is effective and well-tolerated, at least for people with obsessive-compulsive disorder without major depression. It remains to be seen whether this treatment is safe and effective when comorbid major depression is present.     

Dietary Control of Rumination: Two Case Studies

Chronic rumination of 2 institutionalized men with profound mental retardation was treated using a dietary approach. In the first case, a peanut butter or honey supplement was given, whereby 2 spoonfuls of either food was added to every meal, with drinks moved to a later time. In the second case, food satiation together with a honey supplement was applied. In the first case, an ABABACA design was used. In the second case, the non-experimental AB design was applied. In both cases, rapid decrease in rumination was achieved. Anecdotal follow-up confirmed the permanency of the results.     

集体主义与贿赂

贿赂是指财物由行贿者向受贿者转移, 公共权力由受贿者向行贿者的暂时转移, 并涉及到为私利而滥用公共权力的过程。研究者认为集体主义是影响贿赂的文化心理根源, 而实证研究发现集体主义与贿赂的关系受到两个方面因素的影响。一方面贿赂的研究视角影响集体主义与贿赂的关系。研究一致证明集体主义促进贿赂行为意向。然而虽然大部分研究表明集体主义与贿赂感知和贿赂态度正相关, 但仍有少量不一致结果。另一方面集体主义类型也影响着集体主义和贿赂的关系。前人关于集体主义对贿赂的作用机制仍以理论探讨为主, 实证研究主要以道德卷入和计划行为理论为基础。未来可以从澄清不同贿赂研究视角的区别与联系、区分不同类型集体主义与贿赂的关系以及关注集体主义对贿赂的作用机制这三个角度进行深入探索。     

Socioeconomic status as a moderator between social cognitions and physical activity: Systematic review and meta-analysis based on the Theory of Planned Behavior

BackgroundHealth inequalities are to a substantial degree due to socioeconomic status (SES) related differences in health behaviors such as physical activity. However, little is known about the role SES plays in the self-regulation of physical activity.PurposeThis systematic review with meta-analysis examines whether a comprehensive set of indicators of SES (income, education, occupational status) impacts on the behavioral self-regulation by moderating the relationships between social cognitions in the Theory of Planned Behavior (TPB) and physical activity.MethodsA systematic literature search identified 99 studies from 88 articles that provided information on sample SES and correlations between TPB variables and physical activity. Random-effects meta-analyses were used to pool correlations corrected for sampling and measurement error. Random-effects meta-regression was used to examine moderating effects of study-level SES on these correlations.ResultsEducation moderated the relationship between intentions and physical activity, such that studies with better educated samples reported stronger intention-physical activity relationships.ConclusionsThese results suggest that education might play a major role in the self-regulation of physical activity, with better educated samples more likely to translate intentions into behavior. This can both help to explain heterogeneity in the relation between intentions and physical activity as well as support the development of more effective interventions targeting intentions and physical activity.     

The Use of a Child-Based Acceptance and Commitment Therapy Curriculum to Increase Attention

Acceptance and Commitment Therapy (ACT) is a treatment that integrates mindfulness and acceptance training with behavior change processes. One of the core processes in ACT is contact with the present moment which involves shifting attention to what is happening here and now, contacting both internal and external stimuli. An experimental and control group were used to determine the impact ACT had on attention. ACT participants (M?=?5.4, SD?=?9.8) showed fewer inaccuracies on the CPT-X task compared to the control group (M?=?19.75, SD?=?16.1) at posttest F(1, 38)?=?11.49, p?=?.02, ηp²?=?.232. Results of the current study demonstrate participation in the use of an ACT curriculum for children to help increase attention outcomes.     

Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial

Objective

Feasibility, acceptability, and efficacy of a Dialectical Behavioral Therapy (DBT) -based method developed in Germany were evaluated in a Swedish outpatient psychiatric context.

Method

Fifty-one adults with ADHD on stable medical treatment or on no medication were randomized to the DBT-based skills training (n = 26) or a parallel loosely structured discussion group (n = 25). Self-rating scales were administered before randomization and after the treatment.

Results

Feasibility and participant satisfaction were good in both groups while skills training was perceived as more logical and effective for ADHD-related problems. The analyses of the individuals who completed the treatment and remained stable with regard to medication (n = 19 in skills training; n = 18 in control group) showed a significant reduction in ADHD symptoms in the skills training group, but not in the control group. No reduction of comorbidity was observed in any of the groups.

Conclusions

The treatment was feasible in an outpatient psychiatric context, well tolerated, and significantly reduced ADHD symptoms in on-treatment individuals who remained stable regarding medication status.     

Guidelines for classifying evidence-based treatments in couple and family therapy

Guidelines for Evidence-Based Treatments in Family Therapy are intended to help guide clinicians, researchers, and policy makers in identifying specific clinical interventions and treatment programs for couples and families that have scientifically based evidence to support their efficacy. In contrast to criteria, which simply identify treatments that "work" and have been employed in the evaluation of other psychotherapies, these guidelines propose a three-tiered levels-of-evidence-based model that moves from "evidence-informed," to "evidence-based," to "evidence-based and ready for dissemination and transportation within diverse community settings." Each level reflects an interaction between the specificity of the intervention, the strength and readth of the outcomes, and the quality of the studies that form the evidence. These guidelines uniquely promote a clinically based "matrix" approach in which the empirical support is evaluated according to various dimensions including strength of the outcomes, the applicability across cultural contexts, and demonstration of specific change mechanisms. The guidelines are offered not only as a basis for understanding the evidence for diverse clinical approaches in couple and family therapy within the systemic tradition of the field, but also as an alternative aspirational model for evaluating all psychotherapies.     

Facilitating relational empowerment in couple therapy

Couples in distressed relationships often get caught up in power struggles, "Power Over" interactions that are informed by both neurobiology (e.g., the fight-flight reaction) and by cultural assumptions (e.g., competition, individualism, and patriarchy). This article seeks to widen the discourse about power by highlighting "Power To" and "Power With." Power To includes the ability to self-regulate, to read and manage one's own emotions, and to have voice while respecting the other's voice. Power With reflects the couple's commitment to conurture the relationship through empathy, respect, and generosity. Power To and Power With are proposed to constitute relational empowerment, the ability to navigate one's inner world and the interpersonal realm. The neurobiology of both couples' reactivity and relational empowerment are considered. Techniques are offered to facilitate Power To and Power With, interventions that interrupt couples' cycles of reactivity and allow them to make more thoughtful choices. Emotion regulation and empathy are particularly important skills of relational empowerment, and examples are offered to increase these capacities in couple therapy. The therapeutic perspective offered in this article challenges cultural practices and assumptions that keep intimate partners polarized in power struggles, and explores how relational empowerment can foster an egalitarian, mutually respectful relationship.     

Developing the therapeutic relationship: from 'expert' professional to 'expert' person who stutters

This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the “expert professional” towards a more collaborative relationship that recognises the “expert patient”. It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a ‘cure’ he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted.Educational objectives: The reader will learn about (1) the early history and development of stuttering therapy, (2) the influence of a variety of psychotherapeutic approaches, (3) the relevance of designing therapy to meet the needs of the PWS, and (4) discuss the role of ‘common’ factors in EBP.