Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

Reducing the barriers to accessing psychological therapies for Bengali,Urdu, Tamil and Somali communities in the UK: some implications for training,policy and practice

The aim of this research was to investigate the feasibility of achieving Improving Access to Psychological Therapies (IAPT) for people from Black, Asian and Minority Ethnic (BAME) communities living in the UK, with specific reference to Bengali, Urdu, Tamil and Somali speaking communities. Focus groups were carried out with each of the communities to investigate how they conceptualise and experience ‘mental health issues’ and what they do when faced with what they regard as these issues. A thematic analysis of the data suggested that participants did not fully understand common conceptualisations about mental health issues, nor did they know how to seek mental health support. Implications of cultural barriers and recommendations for IAPT outcomes for the four communities are discussed.     

Your heart makes my heart move: Cues of social connectedness cause shared emotions and physiological states among strangers

Two experiments tested the hypothesis that cues of social connectedness could lead even new interaction partners to experience shared emotional and physiological states. In Experiment 1, a confederate prepared for a stress-inducing task. Participants who had been led to feel socially connected to the confederate reported feeling greater stress than participants who had not. In Experiment 2, a confederate ran vigorously in place. Socially-connected participants had greater cardiovascular reactivity (heart rate and blood pressure) than controls. Each study held constant exposure to the confederate. The results suggest that the sharing of psychological and physiological states does not occur only between long-standing relationship partners, but can also result from even subtle experiences of social connectedness. These findings illustrate the dynamic and fluid ways in which important aspects of self can change in response to cues of social relatedness.     

The Impact of Neighborhood Factors on the Well-Being of Survivors of Intimate Partner Violence Over Time

Intimate partner violence (IPV) is a pervasive social problem impacting the psychological well-being of millions of US women annually. The extant literature draws our attention to the devastating mental health effects of IPV, but largely overlooks how ecological factors may further explain survivors' well-being. This study examined how neighborhood disadvantage may contribute to survivors' compromised well-being, in addition to the abuse women experienced. Neighborhood disorder and fear of victimization significantly impacted survivors' well-being, over and above abuse. Although between-women effects of neighborhood disorder and fear were unrelated to change in women's depression or quality of life (QOL), significant within-woman effects were detected. Change in neighborhood disorder was negatively associated with change in QOL, and this relationship was fully mediated by fear. While no direct relationship between change in neighborhood disorder and depression was detected, an indirect effect through survivors' fear was revealed. Implications for future research and practice are discussed.     

Testing orofacial abilities of children who stutter: the Movement, Articulation, Mandibular and Sensory awareness (MAMS) assessment procedure

Objective

The purpose of this article is to introduce a new assessment designed to measure the orofacial abilities of children who stutter (CWS), the Movement, Articulation, Mandibular and Sensory Awareness (MAMS) Orofacial Assessment. The new instrument was developed and validated to measure orofacial abilities in a comprehensive manner.

Design

A group of 43 CWS (mean age 13.10 years, S.D. 2.10 years) and a control group of 32 fluent children (mean age 13.4 years, S.D. 2.6 years) were tested with the new tool. It was hypothesized, that (a) the MAMS is a reliable and valid instrument to measure orofacial abilities in CWS, (b) fluent children have better orofacial abilities than CWS and (c) that the therapy outcome of CWS depend on their orofacial abilities.

Results

The MAMS Orofacial Assessment proved to be a valid and reliable instrument to assess orofacial abilities. Compared with their fluent peers, CWS had significantly worse orofacial abilities. CWS with better orofacial abilities had a better prognosis for therapy outcome.

Conclusions

The new instrument is a reliable and valid tool to measure orofacial abilities and MAMS distinguishes CWS and controls. Orofacial abilities are one set of factors that influence therapy outcome for CWS.Educational objectives: The reader will get an overview over of the literature on orofacial abilities in people who stutter and will learn about and be able to (1) describe different characteristics of orofacial abilities, (2) use the MAMS Orofacial Assessment in the diagnostic process for CWS and for research purposes, and (3) interpret the results of the MAMS to use them for therapy planning.     

惠能心理化功思想的心理结构与成分分析

惠能的思想中蕴含丰富的心理化功思想,其心理化功思想以心为核心,强调心在化消极为积极中的本体性或核心作用。这种转化作用主要表现在化烦恼为菩提、化恶为善、化邪为正几个方面,其心理机制包括认知转化、心态转化、信念转化、归因和诠释转化等。这一化功思想对当今人们化解心理困扰,提升心境界,激发心理潜能,满足对美好生活向往的需要,具有十分重要的现实价值。     

A Life Domains Perspective on Acculturation and Psychological Adjustment: A Study of Refugees from the Former Soviet Union

The study articulates a contextual approach to research on acculturation of immigrants, suggesting that the relationship between acculturation and adjustment is dependent on the cultural demands of the life domains considered. Specifically, the study investigated the mediating effects of adjustment in occupational and social life domains on the relationship between acculturation and psychological adjustment for 391 refugees from the former Soviet Union. The study used bilinear measures of acculturation to the host (American) and heritage (Russian) cultures. Using Structural Equation Modeling, the study confirmed the hypothesized relationships, such that the positive effects of American acculturation on psychological adjustment were mediated by occupational adjustment, and the effects of Russian acculturation on psychological adjustment were mediated by satisfaction with co-ethnic social support. Psychological adjustment was measured in two ways, as psychological well-being, using a measure of life satisfaction, and as symptoms of depression and anxiety, using the Hopkins symptom checklist (HSCL). Life satisfaction served as a mediator between adjustment in occupational and social domains and HSCL, suggesting that it may be an intervening variable through which environmental stress associated with immigration contributes to the development of symptoms of mental disorder.     

Exercise as a coping strategy and its impact on the psychological well-being of Japanese community-dwelling older adults during the COVID-19 pandemic: A longitudinal study

This study aimed to examine the prevalence of exercise as a coping strategy among Japanese community-dwelling older adults and its impact on their psychological well-being during the COVID-19 pandemic. In October 2019 (baseline [BL]), 720 community-dwelling older adults living in an urban area in Japan participated in a comprehensive health survey. Of these, 618 responded to a mail survey (follow-up [FL]) in June 2020, after the first state of emergency was lifted. Their psychological well-being was assessed using the WHO-5 Well-Being Index (WHO-5). Exercise as a coping strategy during the stay-at-home period was determined at FL by asking respondents whether they had engaged in 1) walking and 2) at-home exercise and strength training to maintain their physical and mental health. Each type of exercise’s impact and the effective exercise combinations were examined. Time and group interaction effects on the WHO-5 scores were investigated using a two-way analysis of covariance. Of the final sample, 65.1% engaged in walking. The WHO-5 mean scores at BL and FL were 16.7 and 15.4 for the walking group and 16.7 and 14.5 for the non-walking group, respectively; interaction for time and group was significant. Additionally, 56.4% of the participants engaged home training. The WHO-5 mean score at BL and FL were 17.5 and 15.5 for the home training group and 15.7 and 14.5 for the no home training group, respectively; there was no significant interaction. Older adults who engaged in both walking and home training received higher score on the WHO-5 than those who engaged in only one activity at FL. The decline in psychological well-being was most attenuated in the walking only group compared to the at-home exercise and strength training groups. Exercise as a coping strategy during the stay-at-home period was associated with psychological well-being, with different impacts observed depending on the type of activity.