The multi-level approach: a road map for couples therapy

This paper presents a multi-level framework and road map to guide the therapeutic process. Starting with the couple's reactive pattern, the multi-level approach first orients the therapist on how to create a "holding environment." It then suggests how the therapist, in collaboration with the couple, can proceed to explore interactional, sociocultural/ organizational, intrapsychic, and intergenerational processes that might be fueling the couple's dynamics. Central to this approach is the construct of the vulnerability cycle, a nexus of integration that helps the therapist stay anchored while moving through the many layers of therapeutic work. The overall goal is to help the partners move from reactivity to responsibility for their own feelings and behavior; from impasse to a greater ability to reflect, express feelings, listen, negotiate, and make choices about how to be in the relationship. This paper describes a range of concepts and interventions from basic to complex; it is intended as an organizational tool for practice and clinical training.     

Lessons Learned from the Intensive Mental Health Program: A School-based,Community Oriented Program for Children with Serious Emotional Disturbances

The Intensive Mental Health Program meets the needs for services in school systems for children with serious emotional disturbances and for training graduate students in clinical applications with a difficult-to-serve population. We address the range of challenges and rewards experienced in the development of the comprehensive intervention program, the continued maintenance of program elements, and the program evaluation.     

Psychologists in Academic Health Centers: Traditions and Innovations in Education,Science, and Practice

Psychologists, interns, and postdoctoral fellows convened in Minneapolis May 3–5, 2007 for the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC): “Psychologists in Academic Health Centers: Traditions and Innovations in Education, Science, and Practice.” This paper reviews the development and organization of the conference, which built upon the two previous conferences of the Association of Medical School Psychologists. The articles in this special issue are based on a selected number of the 32 conference presentations, covering a range of timely topics that reflect the conference theme. Participants’ positive perceptions and satisfaction with the conference reveal the value of such conferences focused on the activities, interests, opportunities, and challenges of psychologists who work in academic health centers (AHCs) and teaching hospitals. Moreover, the content and success of the conference underscores the importance of APAHC as an organization serving the needs and promoting the interests of psychologists affiliated with AHCs.

Perfectionism and performance in a new basketball training task: Does striving for perfection enhance or undermine performance?

ObjectivesIn the psychology of sport and exercise, the question of how perfectionism affects performance is highly debated. While some researchers have identified perfectionism as a hallmark quality of elite athletes, others see perfectionism as a maladaptive characteristic that undermines, rather than helps, athletic performance. Against this background, the purpose of the present study was to investigate how different aspects of perfectionism predict performance and performance increments.MethodA study was conducted with 122 undergraduate athletes to investigate how perfectionism during training affects performance and performance increments in a series of trials with a new basketball training task. Two aspects of perfectionism were examined: striving for perfection and negative reactions to imperfection.DesignThe design was a correlational prospective design.ResultsResults showed that striving for perfection during training predicted higher performance in the new task. In contrast, negative reactions to imperfection predicted lower performance when athletes attempted the task for the first time, once the positive influence of striving for perfection on task performance was partialled out. However, negative reactions to imperfection did not undermine performance in the consecutive trials. On the contrary, athletes with both high levels of striving for perfection and high levels of negative reactions to imperfection showed the greatest performance increments over the series of trials.ConclusionThe findings suggest that perfectionism is not necessarily a maladaptive characteristic that generally undermines sport performance. Instead, when learning a new training task, perfectionism may enhance performance and lead to performance increments over repeated trials.     

The effect of training in verbal self-guidance on the self-efficacy and performance of Native North Americans in the selection interview

Native North Americans (n = 35) received training in verbal self-guidance (VSG) designed to increase self-efficacy in a selection interview. At the end of the training program, the trainees who acquired skills in VSG had higher self-efficacy than the participants in the control group (n = 31) regarding their interview performance. They also performed better in the selection interview as judged by managers who were blind to the experimental conditions.     

Which training method works best? A randomized controlled trial comparing three methods of training clinicians in dialectical behavior therapy skills

This study evaluated the efficacy of three methods of training community mental health providers (N = 150) in Dialectical Behavior Therapy skills, including a written treatment manual; an interactive, multimedia online training (OLT); and a two-day instructor-led training workshop (ILT). A hybrid design was utilized that incorporated aspects of efficacy and effectiveness trials. Assessments were completed at baseline, post-training, and 30- and 90-days following training. The results indicate that learner satisfaction with the training was highest in OLT and ILT, and both resulted in significantly higher satisfaction ratings than the manual. OLT outperformed ILT and the manual in increasing knowledge of the treatment, whereas ILT and the manual did not differ. All three training methods resulted in comparable increases in clinicians' ability to apply course content in clinical simulations. Overall, the results provide strong support for the efficacy of technology-based OLT methods in disseminating knowledge of empirically supported treatments to community mental health providers, suggesting that OLT may be a high-quality, easily accessible, and affordable addition to traditional training methods.     

The River Model: A Metaphor and Tool for Training New Psychotherapists

A conceptual frame of reference called The River is presented for training of beginning psychotherapists. Using metaphors, trainees are taught specific tools (Equipment) and to identify salient features of the therapy process (Topography) by means of a series of metaphors for the process elements of timing and of level of intervention. Student therapist feedback indicated that this model facilitated learning of how much or little to do at given points in the therapeutic process, and that these metaphors appeared to transcend specific theoretical orientations.     

Training analysis and training models

This article has the intention of giving impulses to a hopefully more creative and open-minded discussion of the function of training analysis and the kind of training model we seem to take for granted in the Scandinavian countries, the Eitingon model. I will consider some historical background data on this model as well as some historical data on the development in France which have created an alternative model of training. Especially in Sweden, there has been a stormy debate during the last years about the training analyst functions and some members have actually decided to leave our association because of this. I would like to try to shift focus from just a ‘yes-or-no-perspective’? to a broader question of our psychoanalytical society’s purpose and structure and how the training-model could sustain it.     

Comment on Björn Sahlberg’s paper

This paper is a comment on Björn Sahlberg’s paper on the function of training analysis in the Swedish psychoanalytic association and discusses some aspects of the candidates’ personal analysis and supervision. The paper further suggests some possible sources for inspiration and perspective on organizational and educational issues, for example taking an interest in the epistemology of professions, in what the concept of ‘reflection-in-action’ could mean in the training situation, or in empirical research about the educational models and the practice of psychoanalysis.