Lessons from the Transition to Relational Teletherapy During COVID-19

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship-based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context’s constraints and exploiting its strengths is key to providing high-quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add-on to a face-to-face practice.     

Le dégoût dans le trouble obsessionnel compulsif,mécanismes, évaluation,implications pour des pistes thérapeutiques

IntroductionAlthough considered a basic emotion, disgust has received little attention from research from the psychology of emotions compared to other emotions such as fear or sadness.Literature findingsMany empirical and experimental data suggest, however, that disgust plays a determining role not only in our ability to adapt to our environment but also in the maintenance and development of certain psychopathological states such as obsessive-compulsive disorders. The purpose of this article is to review the literature on the construct of disgust, including its two basic dimensions of disgust and disgust. A first part will be dedicated to the acquisition of disgust in the framework of evaluative and Pavlovian learning, we will then describe in detail the assessment tools available in the literature allowing to evaluate the different dimensions, then we will address the continuum. Experience of disgust, from normal disgust to pathological disgust, and will particularly target its role in dysfunctional obsessions of contamination and emotional distress.DiscussionIf, from a theoretical point of view, the understanding of the underlying mechanisms of pathological disgust reactions improves, the proposals for treatment to mitigate these reactions are rare. New approaches to care will be described to allow the development of empirically based psychological interventions.ConclusionThe recognition of emotional influences beyond anxiety in obsessive-compulsive disorder (OCD) stems from the fundamental importance of a dimensional approach to psychopathology and support. The accumulated data suggest that the inclusion of disgust in the theoretical models of OCD, in particular those with contamination concern, will thus improve our understanding and treatment of this disorder.     

Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

The Italian Version of SCORE-15: Validation and Potential Use

SCORE-15 (Systemic Clinical Outcome and Routine Evaluation) is a 15-item questionnaire for completion by family members aged 12 years and older to assess outcomes in systemic therapy. This study aimed to investigate (a) the psychometric properties and the internal consistency reliability of the Italian version of SCORE-15, (b) clinical responsiveness, and (c) normative (Italian) criteria. Furthermore, (d) the study sought to evaluate the participants’ representation of both their family and their problems, analyzing open-ended questions included in the SCORE-15. Data were collected from two clinical centers for 208 families (n = 507). Results confirmed the three-factor structure (i.e., strengths, difficulties, and communication), a good internal consistency reliability, and indicated a cutoff threshold for the Italian version. Furthermore, results showed that SCORE-15 is a good instrument for clinical responsiveness and that it can be used to explore the way in which family members describe their families and problems. Overall, SCORE-15 is a brief, psychometrically robust family assessment instrument that may be used for both researchers and practitioners in several domains of clinical and social psychology.     

Resilience Factors and Suicide Risk for a Sample of Transgender Clients

This study explored how individual- and community-based resilience factors operated together in order to reduce risk of suicide for a sample of transgender therapy clients. We collected cross-sectional survey data from 106 transgender therapy clients at a local community center, including demographic information, experiences of relational support, participants' emotional stability, and risk for suicide. Results from our mediation analysis indicated that high levels of perceived relational support are related to reduced risk for suicide and that this happens by way of a person's emotional stability. Clinical implications for family therapists are discussed based on the significant indirect effect found in this study.     

Applying a Family-Ecosystemic Model to Reunite a Family Separated Due to Child Abuse: A Case Study

Family reunification following the removal of a child due to child abuse is a challenging process. In this case study the authors demonstrate the success of a family-ecosystemic intervention for achieving the reintegration of an adolescent into her family following a court-imposed separation. The SET (Structural Ecosytems Therapy) model was used to: (1) repair family bonds, (2) build collaborations among the agencies involved in overseeing the child's welfare, and (3) build an alliance between the mother and agency personnel. This case study suggests that facilitating such collaborations can be helpful in the evaluation and follow-through of high risk cases.     

Elaborate reflections on a simple manifesto

In an earlier article (^{McFall, 1991}), I urged clinical psychologists to work toward the goal of integrating science and practice and proposed the adoption of a principle and two corollaries aimed at achieving this goal. In general, I argued that all aspects of clinical psychology must be guided by the highest scientific and ethical standards, that clinical practice be limited to empirically supported procedures, and that clinical training be devoted to producing clinical scientists. In the present article, I elaborate and defend these points by offering reflections on a number of submitted questions provoked by the earlier article. I address four major issues: the philosophical foundations for a scientific epistemology, the implications of this epistemology for clinical practice, the implications for clinical training, and the likely impact of adopting this epistemology on the field of clinical psychology.     

On the Ethics of Constructing Realities

The author describes the successful use of Solution-Focused Brief Therapy intervention with an 11-year-old female who had been hospitalized for two weeks because she could not walk. He raises some ethical questions about the use of diagnosis “if, or when, we know different and maybe faster and simpler ways to find out what can be helpful?”     

The History of Family Therapy in South Africa

The history of family therapy in South Africa is presented from 1960 up to the present. The early days leading to the establishment of the South African Association of Marital and Family Therapy, national conferences, publications, national and international links are discussed.