Perinatal maternal mental health and infant socio-emotional development: A growth curve analysis using the MPEWS cohort

Pregnancy and the early post partum period are widely understood as a critical period for the infant’s emotional development and the earliest influence shaping social interaction. The present study aims to understand the potential influence of both antenatal and postnatal maternal anxiety and depressive symptoms on socio-emotional outcomes in offspring aged 12 months. The study used longitudinal data from a prospective cohort study on Australian pregnant women and their children. Data were available for 282 mothers and their children. Maternal depressive and anxiety symptoms were measured in early pregnancy, trimester three of pregnancy, six and 12 months postpartum. Social and emotional development in children was measured using the Brief Infant and Toddler Social Emotional Assessment (BITSEA) at 12 months. Using growth curve analysis of 4 waves of repeated measurement to examine intercept and slope, we found that both initial maternal depression and anxiety symptom levels, and the growth of these symptoms over time, predicted more problems with children’s social and emotional development. In the final model anxiety accounted for 19% of the variance in child socio-emotional problems and depression 23% of variance. The results emphasise the importance of perinatal maternal mental health as a potential risk factor for child development. This carries important implications for policy development, such as the need to build early identification and early intervention models in to the current clinical practice for perinatal care, specifically, to develop targeted screening, assessment and interventions to address maternal mental health issues for at-risk parents during pregnancy, and continuing monitoring of young children whose mothers have experienced perinatal mental health difficulties.     

Researching psychotherapy integration: A heuristic approach

Moustakas argues that questions and methodology in heuristic research flow out of inner awareness, meaning and inspiration. The approach might arguably embrace a combination of qualitative research methods, and constitute a kind of bricolage. This paper describes a heuristic enquiry into psychotherapy integration that used such a combination of methods – an interpretative phenomenological approach, case studies, reflexive action, and writing. It demonstrates how each of these methods contributed to the six phases of heuristic enquiry, from the initial engagement with psychotherapy as a trainee to the creative synthesis of published works and a PhD thesis, together with some reflection on the enquiry's limitations and rigour. Published texts, training, clinical practice and reflexivity constituted the material from which a new organizing framework for understanding psychotherapy integration was formulated. The author reflects on how the research design allowed deep engagement with this material, and changed his perspective of psychotherapy integration. In conclusion, this paper suggests that both psychotherapy integration and heuristic enquiry can only be conducted on an individual and personal basis, and that it is the quality of the relationship, with the client, or the research material, that produces results.     

The Boulder Model in Academia: Struggling to Integrate the Science and Practice of Psychology

For many professionals, the Boulder model captures the ideals of clinical psychology. Unfortunately, it can be extremely difficult to integrate science and practice in many work settings. The present paper provides several recommendations for encouraging the scientist-practitioner model in academia. Faculty can strive to integrate teaching, research, and clinical services in weekly activities. First, it is important for the professional to retain a strong and clear focus on clinical psychology, without straying into allied fields. Second, it is essential for anyone who works in academia to learn to juggle many different activities that demand the professional’s time. Third, it is important to maintain a consistent focus on specific areas of interest in order to cultivate them into domains of expertise. Fourth, it is helpful to appreciate the synergism whereby work in one area can enhance the other domains. Fifth, it is helpful to integrate several activities into one multi-purpose task. Finally, it can be useful to view professional involvement in many different activities that could help to advance the field.     

Using the MMPI-2 to Predict Symptom Reduction During Psychotherapy in a Sample of Community Outpatients

In the present study, potential MMPI-2 predictors of psychotherapy outcome were examined in a community clinical sample of 51 patients seeking treatment at a university training clinic. Results indicated that particular MMPI-2 scales (L, F, Pd, Pa, Sc, Trt) were the most predictive of initial levels of patient distress, whereas three other clinical scales (Hs, D, Hy) were significantly associated with actual symptom reduction over time. The clinical implications of these data include the use of the MMPI-2 in clinical practice as a means to frame the provision of direct feedback to patients regarding the likelihood of treatment response, which in turn, might actually have therapeutic benefits. The limitations of the study are reviewed and suggestions for future research are offered, including the potential use of widely known and utilized instruments in helping to predict response to psychotherapy.     

The River Model: A Metaphor and Tool for Training New Psychotherapists

A conceptual frame of reference called The River is presented for training of beginning psychotherapists. Using metaphors, trainees are taught specific tools (Equipment) and to identify salient features of the therapy process (Topography) by means of a series of metaphors for the process elements of timing and of level of intervention. Student therapist feedback indicated that this model facilitated learning of how much or little to do at given points in the therapeutic process, and that these metaphors appeared to transcend specific theoretical orientations.     

Positive Psychotherapy’s Theory of the <Emphasis Type="Italic">Capacity to Know</Emphasis> as Explication of Unconscious Contents

Positive Psychotherapy (PPT), founded by Dr. Nossrat Peseschkian, a Persian Bahá’í who has lived in Europe for many years, assumes the functional capacities of the unconscious to be ‘basic capacities.’ PPT makes a distinction between actual capacities and basic capacities. The basic capacities are the capacity to love and the capacity to know. These basic capacities are comprehensive categories underpinning primary and secondary capacities. Based upon Bahá’í teachings, this therapy accepts belief as an implicit aspect of healthy psychological functioning. Moreover, contents of the unconscious in PPT are the conflicts between capacities, and undifferentiated and undeveloped actual capacities.

Personality and the coherence of psychotherapy narratives

The stories people construct about themselves and their social worlds are key aspects of their identities [Bruner, J. S. (1990). Acts of meaning. Cambridge, MA: Harvard University Press; McAdams, D. P. (2001). The psychology of life stories. Review of General Psychology, 5, 100–122]. Whereas certain expected life experiences (e.g., leaving home, getting a job) may be relatively easy to narrate, more unexpected and difficult events, such as undergoing psychotherapy, may pose a challenge to successful narration. Yet it is especially important to successfully narrate one’s experience in psychotherapy in order to maintain the gains from treatment [Frank, J. D. (1961). Persuasion and healing: A comprehensive study of psychotherapy. Baltimore, MD: Johns Hopkins University Press; Spence, D. P. (1982). Narrative truth and historical truth: Meaning and interpretation in psychoanalysis. New York: W.W. Norton]. The present study collected psychotherapy narratives from 76 adult former clients and coded them for the fundamental story criterion of coherence [Baerger, D. R., & McAdams, D. P. (1999). Life story coherence and its relation to psychological well-being. Narrative Inquiry, 9, 69–96]. Former clients that were high in trait Openness to experience and those at higher stages of ego development told more coherent stories about therapy. The relationship between ego development and narrative coherence remained significant even when controlling for Openness. The findings suggest that high ego development may provide narrators with the kind of sophisticated frameworks for meaning-making that are especially well-suited for the important task of making good sense of psychotherapy.     

A developmental perspective on psychotherapy process, psychotherapists' expertise, and “Meaning-Making Conflict” within therapeutic relationships: A two-part series

Part I (in this issue)—A Dialectical-Constructivist View of Human Development, Psychotherapy, and the Dynamics of Meaning-Making Conflict Within Therapeutic Relationships— reviews a dialectical-constructivist model of human development and articulates, in the language of that model, how psychotherapy, in general, works. It describes and illustrates three generic processes, which contribute to the frequent successes of an extremely diverse range of psychotherapy theories and practices. This view of psychotherapy focuses on both the client's meaning-making processes and the therapist's meaning-making processes and how they contribute together to effective psychotherapy. Part I also offers a way of understanding what is going on when therapeutic progress is blocked by conflict between the client's and the therapist's meaning-making processes. Part II—Dialectical Thinking and Psychotherapeutic Expertise: Implications for Training Psychotherapists and Protecting Clients from Theoretical Abuse—explores those experiences in which the therapist's own exercise of his or her meaning-making structures, and maintenance of the integrity of his or her theories, has a limiting or destructive impact on the value of therapy to the client. It considers the concept of “theoretical abuse” by psychotherapists as a way of characterizing the most destructive of these experiences. This serves as a rhetorical device for introducing comparisons between these phenomena and the phenomena of sexual abuse by psychotherapists, in terms of dynamics, prevalence, and appropriate strategies for prevention. Part II uses work on the development of dialectical thinking in adulthood to conceptualize how different understandings of the nature of psychotherapists' expertise increase or decrease the likelihood and severity of “theoretical abuse”. Finally, it derives implications for training psychologists and other psychotherapy professionals.