Life hassles, experiential avoidance and distressing delusional experiences

Life hassles have been implicated in both the formation and maintenance of psychosis symptoms. However, little is understood about the mechanism through which these stressors impact on psychosis. The current study proposed experiential avoidance (EA), a psychological coping style that is a central focus for change in Acceptance and Commitment Therapy (ACT), as a potential mediator of the link between life hassles and both the emergence and maintenance of delusional ideation. Participants were recruited to a non-clinical sample (N = 133) and a clinical sample of psychosis patients (N = 100). All participants completed a self-report questionnaire including a measure of delusions and delusional distress (Peters Delusions Inventory), life hassles (Survey of Recent Life Experiences) and EA (Acceptance and Action Questionnaire-II). Mediation testing (bootstrapping) indicated a significant mediation effect of EA in the relationship between life hassles and both delusions and delusional distress, in both clinical and non-clinical samples. The findings suggest that individuals (irrespective of their diagnostic status) with a tendency to suppress or avoid unwanted thoughts are significantly more likely to experience distressing delusions in response to stressful life occurrences. The use of ACT and Cognitive Behavioural Therapy to reduce EA in those at risk of emerging delusions and in patients with an already established psychosis is discussed.     

Providing therapy to children and families in foster care: a systemic-relational approach

Foster care is a system created to protect children from an unsafe home environment yet multiple foster home placements, conflictual or nonexistent relationships between foster parents and birth parents, long, drawn out court battles, and living in an on-going state of not knowing when or if they will be going home are just some of the challenges many children in care are expected to manage. This paper presents a guide for therapists working with families involved in foster care. Utilizing ideas from the postmodern therapies and structural family therapy, suggestions will be provided about who needs to talk to whom about what, when to have these necessary conversations, and how to talk to people in a way that mobilizes adults to take action for the children, with the goal of minimizing postplacement trauma, strengthening and repairing relational bonds, and moving children out of foster care and into permanent homes as quickly as possible.     

Integrative problem-centered metaframeworks therapy II: planning, conversing, and reading feedback

This is the second of 2 articles presenting Integrative Problem Centered Metaframeworks (IPCM) Therapy, a multisystemic, integrative, empirically informed, and common factor perspective for family, couple, and individual psychotherapy. The first article presented IPCM's foundation concepts and Blueprint for therapy, focusing on the first Blueprint component—Hypothesizing or assessment. This article, focusing on intervention, presents the other 3 Blueprint components—Planning, Conversing, and Feedback. Articulated through the Blueprint, intervention is a clinical experimental process in which therapists formulate hypotheses about the set of constraints (the Web) within a client system that prevents problem resolution, develop a therapeutic Plan based on those hypotheses, implement the Plan through a coconstructed dialogue with the clients, and then evaluate the results. If the intervention is not successful, the results become feedback to modify the Web, revise the Plan, and intervene again. Guided by the therapeutic alliance, this process repeats until the presenting problems resolve. IPCM Planning sequentially integrates the major empirically and yet‐to‐be empirically validated therapies and organizes their key strategies and techniques as common factors. Conversing and Feedback employ empirical STIC^® (Systemic Therapy Inventory of Change) data collaboratively with clients to formulate hypotheses and evaluate interventions. This article emphasizes the art and science of IPCM practice.     

RATIONAL-EMOTIVE DISPUTING AND THE FIVE-FACTOR MODEL: PERSONALITY DIMENSIONS OF THE ELLIS EMOTIONAL EFFICIENCY INVENTORY

This study investigates the relationship between three types of disputes used in Rational Emotive Behavior Therapy (REBT), and the five personality domains of the Five Factor Model of Personality. A sample of 194 subjects was assessed for the use of three categories of REBT disputes using the Ellis Emotional Efficiency Inventory (EEEI), and for the Big Five personality dimensions using the NEO-Five Factor Inventory (NEO-FFI). Disputing against “awfulizing” was found to correlate inversely with Neuroticism. Disputing against “self-downing” was found to correlate positively with both Extraversion and Conscientiousness. Disputing against “low frustration tolerance” was found to correlate positively with Agreeableness and Openness. Implications for REBT practice and research are discussed.     

The effect of Multi Convergent Therapy on the psychopathology,mood and performance of Chronic Fatigue Syndrome patients: A preliminary study

Objectives: Multi Convergent Therapy combines approaches such as Cognitive Behaviour Therapy and Graded Exercise Therapy in an holistic treatment of Chronic Fatigue Syndrome. Initial follow‐up data showed that patients were benefiting from this individualised form of therapy. The objective of the present study was to evaluate this Multi Convergent approach, developed at a specialised Chronic Fatigue Syndrome Outpatient clinic in Cardiff, and compare it to Relaxation Therapy and control groups using multiple outcome measures. Design: Thirty‐five participants fitting the Centre for Disease Control criteria for Chronic Fatigue Syndrome were recruited from two outpatient clinics and members of our existing patient panel. Patients were assigned to Multi Convergent Therapy (N=12), Relaxation Therapy (N=14) or recruited as controls (N=9). Methods: Each patient completed a battery of mood and performance tasks along with comprehensive set of questionnaires at baseline, post‐treatment and at six‐month follow‐up. These measures had been validated in previous studies on untreated patients and matched healthy controls. Results: Patients attending the Multi Convergent Therapy clinic showed statistically significant improvements in many of our measures. Most importantly we have produced data indicating that Multi Convergent Therapy provides improvements in objective measures of psychomotor performance and cognition. Discussion: The outcomes of this small study are encouraging. Multi Convergent Therapy has not only produced results indicating significant improvements in standardised questionnaire based measures but also in objective cognitive performance tasks. The next step would be to assess Multi Convergent Therapy at the primary medical care level, with a greater number of patients to further evaluate its efficacy as a treatment for Chronic Fatigue Syndrome.     

An outcome evaluation of Functional Family Therapy for court‐involved youth

This article presents results of a study on the effectiveness of Functional Family Therapy (FFT), a family intervention designed to prevent delinquency. The sample includes 155 court‐involved youth. This study employs two complementary outcomes: court‐obtained data on recidivism and the clinical data on clients’ psychosocial functioning, the Strengths and Needs Assessment (SNA). Adolescents in the treatment and in the comparison groups experienced statistically significant improvements on the majority of the SNA domains. Although youths in the treatment group improved more, the differences between the groups were not statistically significant. Multivariate analysis showed that youths in FFT had significantly lower odds of recidivism as measured by reconvictions for drug offenses, property offenses and technical violations. The results suggest that FFT was effective in reducing recidivism, however, such reductions cannot be attributed to improvements in the SNA scores.     

Can the REBT theory explain loneliness? Theoretical and clinical applications

Loneliness is a common psychological experience affecting a significant minority of the general population. Loneliness may in part be related to the existence of dysfunctional cognitive evaluations. To date, however, loneliness has yet to be explicitly assessed within a cognitive-behavioural theoretical framework. The current study sought to determine the association between negative cognitions, within the context of Rational Emotive Behaviour Therapy (REBT), and the experience of loneliness. A multinational sample of university students (n = 397) completed self-report assessments of rational and irrational beliefs, and loneliness. Structural equation modelling results found that the REBT model of psychopathology, and the REBT model of psychological health, provided satisfactory representations of loneliness, explaining 36% and 23% of variance in loneliness, respectively. Several dysfunctional (“Demandingness”, “Catastrophising” and “Self-Downing” beliefs) and functional (“Preferences” and “Self-Acceptance” beliefs) cognitions were directly and indirectly associated with loneliness. These results highlight that cognitions and loneliness are meaningfully related, and indicate that cognitive-behavioural models may be useful in understanding loneliness. More specifically, current results suggest that REBT may offer a viable psychotherapeutic approach to treating loneliness.     

Current Issues in the Practice of Integrative Couple and Family Therapy

This paper provides an overview of current issues in integration in couple and family therapy. It summarizes the evolution of integration in couple and family therapy, the various traditions in integration, the strengths of integrative approach, and the possible pitfalls involved. It highlights the extent to which most couple and family therapy is now integrative practice. It concludes with a consideration of an emerging trend toward methods of practice centered on modules of intervention that have been identified as effective with certain presenting phenomena. The example of therapy for high conflict divorce is utilized to illustrate how various components can be brought together to create a maximally effective intervention.     

Third‐Order Thinking in Family Therapy: Addressing Social Justice Across Family Therapy Practice

We contend that the field of family therapy is undergoing a notable shift from second‐ to third‐order thinking. We offer theoretical support and examples to demonstrate how third‐order thinking provides a framework for integrating heightened sociocultural attunement into family therapy practice. We discuss the importance of third‐order thinking relative to being prepared to invite families into third‐order change. Finally, we offer a case example to show specific guidelines for third‐order practice.     

The Relationship of Rational Emotive Behavior Therapy (REBT) to Social Psychology

Rational Emotive Behavior Therapy (REBT) includes several main theories and practices, especially the hypotheses that people are both constructivists and destructivists. It holds that they have powerful innate and socially acquired tendencies to often be self-helping and rational but also self-defeating and irrational. REBT largely derives its method of therapy from many clients seen by the author, from hundreds of therapy studies, and from the social psychology literature. This article shows how REBT formulations overlap with some of the findings of social psychology, how these findings can appreciably be used to improve REBT practice, how some of the unique theories and methods of REBT may contribute to the field of social psychology, and how social psychologists can help to research some of the main REBT principles.