Some Thoughts on Language Use in Therapy

Drawing on the work of Ludwig Wittgenstein and his own experience as a therapist and educator/trainer, the author describes some of the issues involved in helping therapists to find their way out of various muddles and mazes that are deeply embedded in language.     

Clients Helping Therapists Find Solutions to their Therapy

This paper is offered as a beginning toward including client perspectives on treatment and client participation in supervision. Rather than see therapists as technical experts who do things to people, many of us now see therapists as nonexperts who create conversations with people (Goolishian & Anderson, 1992). This new shift challenges the traditional training positions of supervisor and supervisee, respectively. Including clients' voices the supervisor participate from a nonexpert position.     

Special Considerations in the Adaptation of Cognitive Behavioral Therapy for Insomnia With Active-Duty U.S. Army Personnel

Insomnia is highly prevalent among active-duty military service members. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-established and effective treatment; however, research and treatment recommendations have primarily focused on civilian or veteran populations. A multitude of military-specific factors directly impact service members’ sleep and the subsequent treatment recommendations. This article provides treatment considerations for the use of CBT-I with active-duty U.S. Army personnel. First, an overview of the theoretical model of insomnia, including military-specific predisposing, precipitating, and perpetuating factors, is presented, followed by a review of common comorbid conditions among service members with insomnia. Finally, discussion focuses on considerations and strategies for implementing components of CBT-I with service members, managing sleep during deployments, and adjusting sleep to accommodate overnight duties. Additional training resources and supplemental video examples (with actors) are provided.     

The Caregivers' Attachment and Relationship Education Class: A New and Promising Group Therapy for Caregivers of Individuals with Parkinson's Disease

The authors examined whether a newly developed group therapy, based on principles of attachment theory and emotionally focused couples therapy, can potentially address the unique mental health and relationship difficulties in caregivers of individuals with Parkinson's disease. A comprehensive outreach effort, involving a review of 251 military veterans' medical records, yielded enrollment of seven spousal caregivers in the group therapy. At 1-month follow-up, caregivers who initially reported mild or greater levels of caregiver burden demonstrated statistically reliable declines in psychological distress, relationship distress, or both. Posttreatment surveys indicated positive perceptions in overall helpfulness of treatment goals, as well as positive changes in insight (e.g., greater understanding of the patient's attachment needs) and behaviors (e.g., greater social contact and self-care of the caregiver). Results are considered in the context of inadequate access to treatment for caregivers of spouses with Parkinson's disease or other major medical issues.     

Distractor interference in focused attention tasks is not mediated by attention capture

Distractor stimuli possessing information that is relevant for a task (henceforth, task-relevant distractors) often interfere with task performance. The interference by task-relevant distractors is observed even when distractors are positioned outside the main attentional focus. We investigated whether such interference is due to an attention capture by the distractors. Participants responded to a target colour while ignoring word distractors positioned within (Experiment 1) or outside (Experiments 2 and 3) the attentional focus. The words carried task-relevant information in their colour and personally significant information in their content. Because personally significant information affects performance only when positioned in an attended region, it was used as a marker for the locus of the attentional focus. As expected, when distractors were attended, both task-relevant and personally significant information affected performance. However, when distractors were unattended, only task-relevant information caused interference, suggesting that attention did not shift to the distractors’ location. We discuss possible accounts for interference effects in focused-attention tasks.     

Characteristics and effectiveness of stand-alone body image treatments: a review of the empirical literature

This literature review examined the characteristics and effectiveness of treatments dedicated exclusively to body image. A total of 18 studies met selection criteria. All but one involved at least one cognitive-behavioural therapy (CBT) condition and only three compared CBT to another treatment approach. Twelve studies were conducted with non-clinical, body dissatisfied, participants and only one focussed on eating disordered women. Overall, the interventions were highly effective in improving body image and psychological variables and, to a lesser extent, eating attitude and behaviour. Changes were generally maintained at follow-up. Given their efficacy, more controlled trials of stand-alone body image treatments in clinical populations are needed. Investigating approaches other than CBT may open fruitful avenues of body image treatment.     

A within-subject analysis of stimulus control therapy with severe sleep-onset insomnia.

Stimulus control, a behavioral technique designed to reduce sleep difficulties, has been demonstrated to be effective when compared with control procedures. These comparisons, mainly involving between-subjects analyses, have neglected the contribution of the stimulus control procedure to the production of clinically significant amelioration of sleep dysfunction. In contrast, the present within-subjects experiment was conducted to assess the capability of stimulus control to produce clinically relevant reductions in multiple measures of sleep disturbance. A comparison with the credible placebo procedure indicated that the stimulus control techniques reduced subjects' sleep onset latency to a mean latency below 30 min per week. Additionally, sedative-hypnotic usage was greatly reduced.     

Adolescent Gender and Age Differences in Responsiveness to Functional Family Therapy

The current study contributes to a sparse literature on moderators of Functional Family Therapy (FFT) by examining whether responsiveness to FFT, measured by a broad range of outcomes, varies by adolescent gender, age, and their interaction. This study was informed by 687 families (n, adolescents = 581; n, caregivers = 933) and utilized a pre–post comparison design. Fixed-effects regressions with gender, age, and their interaction included as explanatory variables were conducted to calculate the average change in youth mental health, callous–unemotional traits, academic outcomes, substance use, and family functioning. Moderation analyses revealed that according to parent report, girls had significantly greater improvements in peer problems and family functioning, and boys benefited more in increased liking of school. There were differential effects by age, such that older youth had less beneficial mental health outcomes and a smaller decrease in frequency of hash use. The gender by age interaction was significant for adolescents’ report of mental health and family functioning outcomes, which suggests that girls benefit from FFT less than boys during early adolescence, but benefit more than boys in late adolescence. This finding adds to literature which has evidenced that family functioning is particularly important for girls by suggesting that FFT is important for improving older girls’ mental health and family functioning in particular. The study’s results expand the examination of outcomes of FFT to include academic outcomes, and provide insight into key factors that should be considered in addressing adolescent behavioral problems and family functioning.     

Introducing SYPRENE: An International Practice Research Network for Strategic and Systemic Therapists and Researchers

SYPRENE, a new international Systemic Practice Research Network (PRN), has been established to fill the gap in practice-based research on the effectiveness and efficiency of strategic therapies. This article presents the rationale for the creation of SYPRENE and describes data collection methods, and the encoding system implemented within this PRN. More developments are expected in the recruitment of practitioners, the types of data collected, findings, and the implementation of SYPRENE in supervision, trainings, and professional schools.