A slow unfolding – at double speed: reflections on ways of working with parents and their young children within the Tavistock clinic's under fives service

This paper describes clinical work carried out as part of the Tavistock Clinic Under Fives Service, which offers brief focused psychoanalytically based interventions to families with young children, as well as longer-term work. It elaborates psychoanalyst Annette Watillon's idea that it is the dramatic way in which children enact their (and their family's) predicament in the consulting room which speeds up the process of change. The author clusters clinical cases into three categories, each cluster representing a different kind of ‘dramatic’ enactment and leading to a different kind of intervention relating to the therapist's role, the structure of the interventions and the ‘ports of entry’ for the work. The categories are defined as: ‘child-led drama’ with the therapist in the role of ‘therapeutic observer’; ‘internal parental drama’ with the therapist in the role of ‘therapeutic consultant’; and ‘external parental drama’ with the therapist in the role of ‘therapeutic modulator’. The author defines these categories, illustrating each category with clinical examples.     

Navigating Bereavement With Spirituality‐Based Interventions: Implications for Non‐Faith‐Based Counselors

The relationship between spirituality and bereavement has been studied in a multitude of disciplines, yet there is a significant gap in the counseling literature on this topic. The authors explore how spirituality is often avoided in secular counseling settings, discuss adverse effects of unresolved grief on clients' functioning, and propose the concept that spirituality can be used to help clients through the bereavement process. Finally, the authors offer research and clinically based interventions that counselors, particularly those who do not identify as faith‐based, can use to incorporate spirituality into their work with bereaved clients.     

Comparing the role of psychological flexibility and traditional pain management coping strategies in chronic pain treatment outcomes

Psychologically-based interventions for chronic pain traditionally include a mix of methods, including physical conditioning, training in relaxation or attention control, strategies to decrease irrational or dysfunctional thinking patterns, and activity management training. Recent developments suggest additional methods to promote acceptance, mindfulness, values-based action, and cognitive defusion (a cognitive process entailing change in the influences exerted by thoughts without necessarily changing their form or frequency). Collectively, these processes entail what is referred to as psychological flexibility. This study examined how changes in traditionally conceived methods of coping compare to changes in psychological flexibility in relation to improvements in functioning over the course of an interdisciplinary treatment program. Participants were 114 chronic pain sufferers. Results indicated that changes in the traditionally conceived methods were essentially unrelated to treatment improvements, while changes in psychological flexibility were consistently and significantly related to these improvements. We suggest that psychological flexibility appears highly relevant to the study of chronic pain and to future treatment developments. The utility of more traditionally conceived pain management strategies, on the other hand, may require a reappraisal.     

Understanding and Combating School‐Based Bullying From an Individual‐Level Perspective: A Review

Bullying is an ongoing problem in our schools with a significant psychological impact on young people. Despite evidence that school‐based bullying is related to a range of individual, social and environmental factors, the majority of interventions are focused on a “whole of school” approach. Whole‐school interventions have been shown to be successful in reducing rates of bullying, but it is argued that a focus on individual factors, specifically those that are amenable to change, will add to these “whole of school” effects. It is argued that interventions that target factors such as internalising symptoms, externalising behaviours, friendship quality and self‐esteem will help children to build resilience against the bullying behaviours of their peers, and further reduce the incidence of bullying, when applied both at a preventative and treatment intervention level.     

Understanding and Incorporating God Representations Within Counseling

The religious and spiritual identity of a client may be relevant to the counseling process, and thus counselors should be prepared to integrate these components within treatment. The authors consider the assessment and exploration of God representations (i.e., God images and concepts) to understand and integrate religious and spiritual meanings within the context of a client's presenting concerns. The authors provide examples, strategies, and considerations for how to apply God representations within counseling.     

Legal and Ethical Issues in the Court-Mandated Treatment of Batterers

Summary

In the following article, we will explore the nature of the therapeutic relationship as it relates to batterers' treatment programs. We will consider the impact of obligations created by forces outside the relationship, such as those imposed by legal proceedings. We will discuss the concepts of confidentiality, privilege, and agency and their impact on the therapeutic relationship and the extent to which the therapists' understanding of the role these concepts play may be altered by court orders that impose treatment on a client/patient. Finally, we examine the issues and choices a therapist must make when engaging in court-ordered treatment of batterers, and the implications of those choices for both therapist and client; we will also suggest guidelines to help therapists sort through the often conflicting goals of therapy and the legal process.     

Fostering Social Competence in Preschool Children Exposed to Intimate Partner Violence: Evaluating the Preschool Kids' Club Intervention

This study assessed whether participation in an intervention program enhanced social competence in 113 preschool-aged children who were exposed to intimate partner violence. Change in competence was evaluated from baseline to approximately five weeks postbaseline and compared preschool children who did and did not receive intervention services. Protective factors, such as exposure to less severe violence, were identified that predicted change in competence scores. Results indicated that children with the highest social competence pre-intervention exhibited a significant increase in their postintervention scores, if they participated in the program. The extent of this change was predicted by a higher preintervention score and exposure to less severe violence. This study indicates that even short-term intervention could result in meaningful change in key aspects of child functioning.     

Building Resilience

Abstract

The context for the National School Intervention Project-Israel has been the ongoing security situation that has exposed the entire civilian population to extremely high levels of trauma. This project places itself within the framework of the resilience literature, focusing on characteristics of resilience that can be brought into the classroom and empower school staff. This article highlights the Building Resilience project, a series of teacher workshops. An initial evaluation of teachers participating in the Building Resilience project found change in knowledge, skills, and willingness to use tools learned with their students in the classroom.