Culturally Informed and Flexible Family-Based Treatment for Adolescents: A Tailored and Integrative Treatment for Hispanic Youth

The increasing utilization of evidence-based treatments has highlighted the need for treatment development efforts that can craft interventions that are effective with Hispanic substance abusing youth and their families. The list of evidence-based treatments is extremely limited in its inclusion of interventions that are explicitly responsive to the unique characteristics and treatment needs of young Hispanics and that have been rigorously tested with this population. Some treatments that have been tested with Hispanics do not articulate the manner in which cultural characteristics and therapy processes interact. Other treatments have emphasized the important role of culture but have not been tested rigorously. The value of well designed interventions built upon an appreciation for unique patient characteristics was highlighted by Beutler et al. (1996) when they argued that "psychotherapy is comprised of a set of complex tasks, and practitioners need comprehensive knowledge of how different processes used in psychotherapy interact with patient characteristics in order to make treatment decisions that will maximize and optimize therapeutic power" (p. 30). A focus on how treatment processes interact with patient characteristics is particularly relevant in the Hispanic population because of the considerable heterogeneity beneath the Hispanic umbrella. Our new program of clinical research focuses on articulating how the varied profiles with regard to immigration stressors, acculturation processes, values clashes, sense of belonging to the community, discrimination, and knowledge about issues important to adolescent health can be more effectively addressed by a culturally informed treatment.     

The ‘Emerging Church’ in America: Notes on the interaction of Christianities

The ‘Emerging Church’ is an American-born movement that dates to the late 1990s. It is fundamentally a movement of cultural critique in which the primary interlocutor is the dominant tradition in the United States, conservative Evangelicalism. In this article I address the phenomenon of Emerging Christianity based on historical, literary, and ethnographic analyses of Emerging Church advocates and critics. In particular, I argue that four points of dialogue characterize the status of Emerging in the United States: ‘post-foundational’ theology, ‘ancient-future’ worship, ‘missional’ evangelism, and a general posture of ‘deconversion.’ Ultimately, I present the story of the Emerging Church for its significance to two broad theoretical questions. First, how do new forms of religious identity come into being? And, second, for those working in the ‘anthropology of Christianity’: what happens when Christianities interact? In response to these questions, I stress the Janus-faced quality of Emerging Christianity and its reliance on the categories, narratives, and vocabulary of conservative Evangelicalism in constructing its thoroughgoing cultural critique.     

Feminism,Therapy, and Changing the World

ABSTRACT

In this essay, Miriam Greenspan reviews her life’s work as an early pioneer of Feminist Therapy, the influence of her birth in a displaced person’s camp to parents who were Holocaust survivors, and her development as a feminist, social activist, and psychotherapist. She discusses her most influential works, including A New Approach to Women & Therapy (1983 Greenspan, M. (1983). A new approach to women & therapy. New York: McGraw Hill. [Google Scholar], 1993 Greenspan, M. (1993). A new approach to women & therapy (10th anniversary ed.). New York: McGraw Hill. [Google Scholar]) and Healing Through the Dark Emotions: The Wisdom of Grief, Fear, and Despair (2003 Greenspan, M. (2003). Healing through the dark emotions: The wisdom of grief, fear, and despair. Boston: Shambhala. [Google Scholar]). She concludes with a look back at her own spiritual evolution, her assessment of the ultimate contribution of Feminist Therapy to society, the need for a wide model of therapy that incorporates the political and spiritual dimensions of experience, and the challenges that psychology and psychotherapy face in an age of global threat.     

实践智慧在二十一世纪(下)

这是一篇文章的第二部分,这篇文章概述了一个词汇表,从而发展出一个建设性的prudence(实践智慧)概念,以用来应对政治行动者以及社会理论所面临的那些问题。明智(审慎)的行为要求规范的、计虑的和施行的(实践智慧)这些形态的相互协调。这一部分将考察,这些要求如何可能在行为者、观众和后现代思想之中形成一个有机的结合。实践智慧可以通过节状自我、公共商讨以及对prudence历史上的教育学和哲学诸阶段的详尽论述来得到理解。     

Solution-Focused Brief Therapy

A brief history on Solution-Focused Brief Therapy is given, followed by pragmatic assumptions, offering a new ‘lens’ for looking at clients. SFBT originated from social constructionism: reality is subjective and there are many realities, all equally correct. Outcome studies indicate that SFBT has a positive effect in less time and satisfies the client’s need for autonomy. Indications and differences between problem-focused psychotherapy and SFBT are outlined. SFBT can be seen as a form of cognitive behavior therapy. Instead of reducing problems, the solution-focused question is: ‘What would you rather have instead?’ A lot could change for the better for both clients and therapists.     

Comparing Cognitive Behavioral Therapy and Systemic Therapy for Social Anxiety Disorder: Randomized Controlled Pilot Trial (SOPHO-CBT/ST)

This randomized controlled trial (RCT) aimed to pilot the newly developed manualized and monitored systemic therapy (ST) for social anxiety disorder (SAD), as compared to manualized and monitored cognitive behavioral therapy (CBT). We conducted a prospective multicenter, assessor-blind pilot RCT on 38 outpatients (ICD F40.1; Structured Clinical Interview for DSM (SCID); Liebowitz Social Anxiety Scale, LSAS-SR >30). The primary outcome was level of social anxiety (LSAS-SR) at the end of treatment. A total of 252 persons were screened, and 38 patients were randomized and started therapy (CBT: 20 patients; ST: 18 patients; age: M = 36 years, SD = 14). Within-group, simple-effect intent-to-treat analyses (ITT) showed significant reduction in LSAS-SR (CBT:d = 1.04; ST:d = 1.67), while ITT mixed-design ANOVA demonstrated the advantage of ST (d = 0.81). Per-protocol analyses supported these results. Remission based on reliable change indices also demonstrated significant difference (LSAS-SR: 15% in CBT; 39% in ST;h: 0.550), supported by blind diagnosticians’ ratings of those who completed therapy (SCID; 45% in CBT, 78% in ST,p = .083). No adverse events were reported. CBT and ST both reduced social anxiety, supporting patient improvement with the newly developed ST for SAD; this has yet to be verified in a subsequent confirmatory RCT.     

A Randomized Comparison of Two Psychosocial Interventions on Family Functioning in Adolescents with Bipolar Disorder

Impairments in family functioning are associated with more severe depressive and manic symptoms, earlier recurrences, and more suicidal behaviors in early-onset bipolar disorder. This study examined whether family-focused treatment for adolescents (FFT-A) with BD I or II disorder led to greater increases in family cohesion and adaptability and decreases in conflict over 2 years compared to a briefer psychoeducational treatment (enhanced care, EC). Participants were 144 adolescents (mean age: 15.6 ± 1.4 years) with BD I or II with a mood episode in the previous 3 months. Adolescents and parents were randomized to either FFT-A (21 sessions) or EC (three sessions). Patients received guideline-based pharmacotherapy throughout the 2-year study. Trajectories of adolescent- and parent-rated family cohesion, adaptability, and conflict were analyzed over 2 years. FFT-A had greater effects on adolescent-rated family cohesion compared to EC over 2 years. Participants in FFT-A and EC reported similar improvements in family conflict across the 2 years. In the FFT-A group, low-conflict families had greater adolescent-rated family cohesion throughout the study compared to high-conflict families. High-conflict families in both treatment groups tended to show larger reductions in conflict over 2 years than low-conflict families. Family psychoeducation and skills training may improve family cohesion in the early stages of BD. Measuring levels of family conflict at the start of treatment may inform treatment responsiveness among those receiving FFT-A.     

Moving from “I” to “We”: A Grounded Theory Analysis of Couple Therapy with Liver Patients and Their Partners

Prior research indicates that couples who cope with chronic illness from a relational “we” orientation experience more positive outcomes than couples that cope individually; however, little prior research identifies clinical processes that promote reciprocity or how societal gender processes are involved. This grounded theory analysis of 25 videotaped therapy sessions with six heterosexual couples coping with chronic liver disease (LD) used a feminist-informed relational lens to focus on the clinical processes involved in shifting from an individual to a relational orientation. Findings identified three contextual barriers to attaining a “we orientation”: (a) autonomy discourse, (b) illness-related power, and (c) gendered power. Analysis detailed therapist actions that decreased the impact of barriers to reciprocity and fostered relational coping. Clinical implications attend to complex intersections among gender, caregiving, and contextual barriers to reciprocity.     

Helping Couples in the Shadow of COVID-19

The pandemic caused by the SARS-CoV-2 virus (coronavirus) and the associated illness, COVID-19, has caused a level of worldwide upheaval unlike any most people now living have seen in their lifetimes. This crisis affects people in their most important, committed, and intimate relationships. Although this crisis has damaged the health and well-being of individuals, crushed economies, and led to an extensive period of uncertainty about the future, there may also be positive outcomes in the motivation people have to protect their relationships. In this paper, we focus on strategies that therapists and relationship educators can use to help couples preserve and protect their relationships during such a time. We describe four foundations of safety that allow relationships to thrive: physical, emotional, commitment, and community. We then highlight three keys from our body of work that can help guide individuals and couples in protecting their relationships on a day-to-day and moment-to-moment basis: (1) decide, don’t slide; (2) make it safe to connect; (3) do your part.