Genetic Counseling—Stress, Coping, and the Empowerment Perspective

Historically one of the basic foundations of the genetic counseling process has been nondirectiveness; however, its definition and utility continues to be in question. There remains a need to develop genetic counseling interventions in order to qualify, quantify, measure, and enhance the genetic counseling process as well as to delineate the complex interactions of education and counseling that occur. We propose a framework for genetic counseling interventions utilizing an empowerment perspective and Lazarus and Folkman's adaptation of the theory of stress and coping. This model frames the genetic counseling process as one that promotes the autonomy of the individual by providing the individual with the tools required to make their own decisions and enhances coping and adjustment to the outcome of those decisions through control and mastery.     

Some Practical Implications of Integrating Narrative and Humanistic/Existential Approaches to Psychotherapy

Although the humanistic/existential and the narrative approaches to psychotherapy are clearly distinct perspectives with some marked differences at the level of metatheory, they also show very important similarities in their conceptualization of the human condition and the processes involved in living adaptively (Richert, 1999). These similarities make these two approaches reasonable candidates for integration. The present paper examines five specific points of integration at the level of strategy and techniques (Neimeyer, 1993b): Interplay of experiential meanings and narrative structure in developing client meaning, use of existential themes in client narratives, deconstruction as a means of dealing with existential guilt, contextualization of wishes as a means of mobilizing will, and reflexivity as a way of developing the I–Thou relationship. A brief theoretical rationale is offered for each of these points of integration, and each is illustrated with clinical examples.     

Effective Treatment for Mental Disorders in Children and Adolescents

As pressure increases for the demonstration of effective treatment for children with mental disorders, it is essential that the field has an understanding of the evidence base. To address this aim, the authors searched the published literature for effective interventions for children and adolescents and organized this review as follows: (1) prevention; (2) traditional forms of treatment, namely outpatient therapy, partial hospitalization, inpatient treatment, and psychopharmacology; (3) intensive comprehensive community-based interventions including case management, home-based treatment, therapeutic foster care, and therapeutic group homes; (4) crisis and support services; and (5) treatment for two prevalent disorders, major depressive disorder and attention-deficit hyperactivity disorder. Strong evidence was found for the treatment of attention-deficit hyperactivity disorder, depression, anxiety, and disruptive behavior disorders. Guidance from the field relevant to moving the evidence-based interventions into real-world clinical practice and further strengthening the research base will also need to address change in policy and clinical training.     

Therapeutic Interventions

This article has two aims. One is addressed to practitioners, to say to them that too big a distinction is being drawn between interpretations and other interventions, and in particular that the term directive is being wrongly used. This militates against important moves toward the integration of different therapies. The other is addressed to researchers, to say to them that their research will be inadequate to the extent that they ignore many of the interventions used in therapy. Both of these aims are eventually served by the provision of a list of interventions running the whole continuum from non-directive to more directive. By looking at this list, we can become more aware of the range of what is possible in psychotherapy, and also of where the standard types of interpretations come in the scheme of things. It seems as though the wide range of interventions available in psychotherapy represents one of the ways in which it differs from counseling.     

Manipulating parameters of reinforcement to reduce problem behavior without extinction

Differential reinforcement of alternative behavior (DRA) most often includes extinction as a treatment component. However, extinction is not always feasible and it can be counter‐therapeutic if implemented without optimal treatment integrity. Researchers have successfully implemented DRA without extinction by manipulating various parameters of reinforcement such that alternative behavior is favored. We extended previous research by assessing three participants' sensitivities to quality, magnitude, and immediacy using arbitrary responses and reinforcers that maintain problem behavior. The results were used to implement an intervention for problem behavior using DRA without extinction. Our findings indicate that arbitrary responses can be used to identify individual and relative sensitivity to parameters of reinforcement for reinforcers that maintain problem behavior. Treatment was effective for all participants when we manipulated parameters of reinforcement to which they were most sensitive, and, for two participants, the treatment was less effective when we manipulated parameters to which they were least sensitive.     

Evaluating Three Models of Intimate Relationships

The purpose of this study was to evaluate three models of intimate relationships: attachment, elementary pragmatic, and selfhood. These models were evaluated with three instruments respectively constructed to evaluate the validity of each model. One convenience group of functioning individuals and three experimental groups of inpatients and outpatients were administered the three instruments. All three instruments showed relatively high internal consistency and discriminated among the four groups. Significant correlations were found among the measure of attachment with measures of the pragmatic elementary and selfhood models. These correlations indicate that all three instruments were measuring similar aspects of intimate relationships. Clinical and preventive implications and applications of these models are briefly discussed.     

Helping to overcome intervention inertia in bystander’s dilemmas: Behavioral disinhibition can improve the greater good

Conventional wisdom holds that behavioral disinhibition has negative effects on what humans do. Behavioral disinhibition may indeed frequently have negative effects, but in the present paper we reveal some positive consequences as well: the disinhibition hypothesis proposed here states that people may feel inhibited to intervene in situations in which non-intervening bystanders are present and that, therefore, behavioral disinhibition may help to overcome the bystander effect. Findings presented here provide evidence supporting this prediction both inside and outside the psychology laboratory: in both real-life and controlled bystander situations, people were more likely and faster to provide help when (unrelated to the bystander situations) they had (vs. had not) been reminded about having acted with no inhibitions. These findings suggest that, in contrast with what various theories and worldviews dictate, behavioral disinhibition may have positive effects on helping behavior and hence can be conducive for the greater good.     

The Role of Lay Health Advisors in Cardiovascular Risk Reduction: A Review

Interventions are needed to reduce the negative impact of cardiovascular disease. The combination of health risks for disease, disability, and mortality, particularly among underserved populations, might be best addressed with programs designed to enhance awareness and development of resources within a context of community support. The objectives of this review were to: (1) provide a comprehensive review and evaluation of the roles, evaluation, and effectiveness of LHA in community-based programs with an emphasis on cardiovascular risk reduction; and (2) provide recommendations for future research involving LHA in such programs. Computer and manual searches were conducted of articles in the English-language literature from 1980 to 2007. Twenty articles were evaluated, which emphasized the role of the LHA in cardiovascular risk reduction. A review of research literature provides a starting point for determining salient approaches for intervention and evaluation, issues related to program implementation and sustainability, and strengths and limitations of existing approaches.     

Still a rite of passage? A perspective on current therapeutic attitudes and interventions in relation to cyberbullying

This paper examines cyberbullying concerning therapeutic interventions. A section on bullying and how bullying impacts the therapeutic environment is included. The author provides his definition of bullying to incorporate cyberbullying and how it is no longer a “new issue” but an evolving one. The current status of therapeutic interventions used to support victims of cyberbullying has been explored, emphasising their effectiveness in assisting those experiencing bullying. A segment has been implemented to comprehend whether practitioners fully understand the potential implications of cyberbullying on clients, whether bullying is still seen as a “rite of passage” and what the possible consequences of this could be. Peer interventions and support groups concerning cyberbullying have been referenced, including The KiVa Programme, the Shared Concern Method and The Circle of Friends Method. These have highlighted specific examples of therapeutic and nontherapeutic approaches to intervene with cyberbullying. A section on potential further training is presented for practitioners working within educational environments. Moreover, physical, psychological, sexual and relational bullying are discussed in the article when applicable, with the umbrella term “bullying” used to discuss all forms of bullying at once. The paper has uncovered two key messages: (1) cyberbullying requires more awareness in counselling and is no longer a new issue and (2) more extensive training is required to assist therapists to work with cyberbullying victims.