Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

Parent–Child Attunement Moderates the Prospective Link between Parental Overcontrol and Adolescent Adjustment

Parental overcontrol (OC), behavior that intrusively or dominantly restricts child autonomy, has been identified as a transdiagnostic risk factor for youth. However, it is as yet unknown whether the association between parental OC and child maladjustment remains even when OC is exerted infrequently or by attuned parents. Rather, the selective use of OC might steer children away from danger. Taking a developmental psychopathology approach, this study focuses on the larger parent–child relationship context, testing whether either the dose at which parents demonstrate OC or the degree to which children perceive their parents as attuned determines whether OC is risky or protective for adolescents’ adjustment. Among a community sample of 114 families of children followed from the ages of 12–18, we examine whether OC, behaviorally coded from triadic mother–father–child discussions in middle childhood, is associated with later risky behavior and anxiety symptoms in adolescence. Overcontrol exerted by either mothers or fathers had a curvilinear effect on adolescent risky behaviors, and this effect was moderated by children's perceived attunement. Although OC generally was associated with increased risky behaviors, low doses of OC or OC exerted by highly attuned parents protected against engagement in risky behaviors. No main effect of OC was observed on adolescent anxiety; however, mothers’ OC interacted with perceived parental attunement, such that OC exerted by less attuned parents predicted greater anxiety. Results underscore that the effect of parenting behaviors depends on the larger parent–child relationship context.     

The Partners for Change Outcome Management System: A Both/And System for Collaborative Practice

Systematic client feedback (SCF) is increasingly employed in mental health services worldwide. While research supports its efficacy over treatment as usual, clinicians, especially those who highly value relational practices, may be concerned that routine data collection detracts from clinical process. This article describes one SCF system, the Partners for Change Outcome Management System (PCOMS), along a normative (standardized measurement) to communicative (conversational) continuum, highlighting PCOMS’ origins in everyday clinical practice. The authors contend that PCOMS represents “both/and,” providing a valid signal of client progress while facilitating communicative process particularly prized by family therapists steeped in relational traditions. The article discusses application of PCOMS in systemic practice and describes how it actualizes time‐honored family therapy approaches. The importance of giving voice to individualized client experience is emphasized.     

Attachment Versus Differentiation: The Contemporary Couple Therapy Debate

This paper reviews the current debate between differentiation and attachment in treating couples through exploring the tenets of crucible therapy (Schnarch, 1991) and emotionally focused couple therapy (Johnson, 2004). We provide a review of the two theories—as well as the two “pure form” example models—and explore the debate in light of the integrative movement in couple and family therapy (Lebow, 2014). We also examine points of convergence of the two theories and models, and provide clinicians and researchers with an enhanced understanding of their divergent positions. Both differentiation and attachment are developmental theories that highlight the human experience of balancing individuality and connection in adulthood. The two models converge in terms of metaconcepts that pervade their respective theories and approach. Both models capitalize on the depth and importance of the therapeutic relationship, and provide rich case conceptualization and processes of therapy. However, they substantially differ in terms of how they view the fundamental aspects of adult development, have vastly divergent approaches to how a therapist intervenes in the room, and different ideas of how a healthy couple should function. In light of the deep polarization of the two models, points of integration—particularly between the broader theories of attachment and differentiation—are offered for therapists to consider.     

Counselor Education Students’ Perceptions of Wellness and Mental Health in African American Men: The Effects of Colorism

Colorism is discrimination based on skin tone. Skin color influences clinicians’ diagnostic impressions. The degree to which colorism influences counseling students’ clinical decision making is unknown. This study examined colorism's effect on counselor education master's students’ (N = 154) clinical decisions. Analysis of covariance failed to produce statistically significant results when comparing students’ evaluations of a male African American's mental health and wellness, when controlling for presentation management, across 4 skin tones. Counselors should include colorism in diversity training. El colorismo es la discriminación basada en el tono de la piel. El tono de la piel influye en las impresiones diagnósticas de los profesionales clínicos. Se desconoce hasta qué punto el colorismo influye en las decisiones clínicas de los estudiantes de consejería. Este estudio examinó el efecto del colorismo en las decisiones clínicas de estudiantes de maestría en educación de consejeros (N = 154). El análisis de la covarianza no produjo resultados estadísticamente significativos al comparar las evaluaciones de los estudiantes sobre la salud mental y el bienestar de un cliente afroamericano varón, controlando la gestión de la presentación de 4 tonos de piel diferentes. Los consejeros deberían incluir el colorismo en la capacitación de diversidad.     

The Social Psychology of Black–White Interracial Interactions: Implications for Culturally Competent Clinical Practice

Social psychological research suggests that because of concerns about being perceived in stereotypical ways, people may experience negative affect and diminished attention and cognitive capacity during interracial interactions. The authors discuss this research in relation to therapy and assessment and also offer practical suggestions for ensuring culturally competent professional practice. La investigación en el campo de la psicología social sugiere que, debido a la preocupación por ser percibida de forma estereotipada, la gente puede experimentar sentimientos negativos y un nivel reducido de atención y capacidad cognitiva durante interacciones interraciales. Los autores discuten esta investigación en relación a la terapia y evaluación, y también ofrecen sugerencias prácticas para asegurar una práctica profesional culturalmente competente.     

The Shift from Monologue to Dialogue in a Couple Therapy Session: Dialogical Investigation of Change from the Therapists’ Point of View

As part of a larger research project on couple therapy for depression, this qualitative case study examines the nature of dialogue. Drawing on Bakhtinian concepts, the investigation shows how the conversation shifts from a monologue to dialogue. Among the findings are: first, the process of listening is integral to the transforming experience. That is, the careful listening of the therapist can evoke new voices, just as the experience of one of the partners’ “listening in” to the conversation between the other partner and the therapist can create movement and new trajectories. The latter is a qualitative difference between dialogic therapy with a couple and that with an individual. Second, the therapist not only acts as creative listener, but as the dialogue unfolds, actively contributes to meaning‐making. Third, the study upholds having a team of researchers as a polyphonic forum and the usefulness of Bakhtinian concepts in clinical research on dialogue in multi‐actor sessions.     

Belief in a just world and wellbeing in Indian schools

This study investigates the meaning of belief in just world (BJW) for students' subjective justice experiences with their parents and teachers and for students' subjective well-being. The hypotheses tested were that the more strongly students endorse BJW, the less the distress at school and depressive symptoms they experience. Two dimensions of BJW were assessed: personal BJW, reflecting the belief that events in one's own life are generally just, and general BJW, reflecting the belief that the world is basically a just place. The participants were 278 Indian students attending ten 10th grade classes at two private English-medium schools. The results showed that only the personal BJW, not the general BJW, was important in explaining justice experiences and wellbeing. The more the students endorsed the belief in personal just world, the more they felt treated justly by their teachers and their parents alike, and the less distress at school and depressive symptoms they experienced. In addition, teacher justice, but not parent justice, explained distress at school. Finally, the effect of personal BJW on depressive symptoms was partly mediated by both teacher and parent justice. This pattern of results persisted when class effects were controlled. Overall, this pattern of results emphasizes the importance of the individual and subjective experience of justice of the teacher behavior for adolescent wellbeing. Implications for further studies on BJW and wellbeing at school are discussed.     

Perceptions of personal sex discrimination: the role of belief in a just world and situational ambiguity

The roles of belief in a just world (BJW) and discrimination against ones' group in perceptions of personal discrimination were examined. Female participants (n = 63) were personally discriminated against in a laboratory setting. We manipulated whether the experimenter appeared to discriminate against other participants, which presumably made the presence of personal discrimination less ambiguous, or did not appear to discriminate against others, which presumably made personal discrimination more ambiguous. In the no group discrimination condition, but not in the group discrimination condition, participants' perceptions of being personally discriminated against depended on individual differences in BJW: Women with a strong BJW perceived less personal discrimination than those with a weak BJW. Also, strong BJW women in the group discrimination condition perceived less personal discrimination than strong BJW women in the no group discrimination condition.     

On Categories and A Posteriori Necessity: A Phenomenological Echo

This article argues for two related theses. First, it defends a general thesis: any kind of necessity, including metaphysical necessity, can only be known a priori. Second, however, it also argues that the sort of a priori involved in modal metaphysical knowledge is not related to imagination or any sort of so‐called epistemic possibility. Imagination is neither a proof of possibility nor a limit to necessity. Rather, modal metaphysical knowledge is built on intuition of philosophical categories and the structures they form.