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.     

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.     

Duality and nonduality in meditation research

The great variety of meditation techniques found in different contemplative traditions presents a challenge when attempting to create taxonomies based on the constructs of contemporary cognitive sciences. In the current issue of Consciousness and Cognition, Travis and Shear add ‘automatic self-transcending’ to the previously proposed categories of ‘focused attention’ and ‘open monitoring’, and suggest characteristic EEG bands as the defining criteria for each of the three categories. Accuracy of current taxonomies and potential limitations of EEG measurements as classifying criteria are discussed.     

The Quarter-life Time Period: An Age of Indulgence,Crisis or Both?

A new developmental stage called the quarter-life is proposed, extending from approximately 18–29 years of age and sometimes later. The emergence of this period is believed to be the result of several social, historic and economic factors that occurred post WWII. This article explores these changes in terms of the experiences of affluent young people in today’s Western society. A typology of adaptational responses are presented and explored as the quarter-lifers attempt to navigate their way to adulthood within the context of this ‘new’ affluent society. Implications for family therapists are considered.     

Styles of pulling in youths with trichotillomania: exploring differences in symptom severity, phenomenology, and comorbid psychiatric symptoms

To date, no studies have examined possible phenomenological differences between the automatic and focused styles of pulling in youths with TTM. The aims of the current study were to examine differences in TTM severity, phenomenology, comorbid psychiatric symptoms, and functional impact across youths with varying degrees of these pulling styles. Youths between the ages of 10 and 17 years (and their parent) were recruited via an Internet-based survey. A total of 186 youths with chronic hair pulling was classified as “high-focused” or “low-focused” and either “high-automatic” or “low-automatic” based upon scores obtained on the Milwaukee Inventory for Styles of Trichotillomania-Child Version (MIST-C) using a median-split procedure. Results demonstrated significant differences between pulling styles. More specifically, “high-focused” pullers reported more severe TTM and greater symptoms of anxiety and depression than “low-focused” pullers, and “high-automatic” pullers reported greater symptoms of depression than “low-automatic” pullers. Subsequent analyses suggest that, in comparison to youths with low levels of both automatic and focused pulling, those experiencing high levels of focused pulling but low levels of automatic pulling reported phenomenological differences and were more likely to engage in additional repetitive behaviors (i.e., skin picking, lip/cheek biting). Clinical and research implications, study limitations, and future areas of research are discussed.     

强迫思维女大学生的箱庭疗法个案研究

探讨箱庭疗法对强迫思维患者的有效性和治疗过程.采用个案研究法,对一名强迫思维女大学生进行12次箱庭治疗,结果发现:来访者的箱庭治疗经历了问题呈现-斗争对抗-转化成长-治愈整合四个阶段;来访者的箱庭作品主题呈现出由"受伤主题"向"治愈主题"的转化.经过箱庭治疗,来访者的强迫症状得以缓解,来访者的内心世界从创伤走向治愈.