Feedback Informed Treatment: Evidence‐Based Practice Meets Social Construction

This article explores the challenges presented by the mandate for evidence‐based practice for family therapists who identify with the philosophical stance of social construction. The history of psychotherapy outcome research is reviewed, as are current findings that provide empirical evidence for an engaged, dialogic practice. The authors suggest that the binary between empiricism and social construction may be unhinged by understanding empiricism as a particular discursive frame (i.e., a particular way of talking, acting, and being in the world), one of many available as a way of understanding and talking about our work. Through a case vignette, the authors introduce the evidence‐based practice of Feedback Informed Treatment as an elaboration of social construction, and as an example of bridging the gap between the discursive frames of empiricism and social construction.     

Psychometric Properties and Responsiveness to Change of 15‐ and 28‐Item Versions of the SCORE: A Family Assessment Questionnaire

The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40‐item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. This study aimed to investigate psychometric properties of two short versions of the SCORE and their responsiveness to therapeutic change. Data were collected at 19 centers from 701 families at baseline and from 433 of these 3–5 months later. Results confirmed the three‐factor structure (strengths, difficulties, and communication) of the 15‐ and 28‐item versions of the SCORE. Both instruments had good internal consistency and test–retest reliability. They also showed construct and criterion validity, correlating with measures of parent, child, and family adjustment, and discriminating between clinical and nonclinical cases. Total and factor scales of the SCORE‐15 and ‐28 were responsive to change over 3–5 months of therapy. The SCORE‐15 and SCORE‐28 are brief psychometrically robust family assessment instruments which may be used to evaluate systemic therapy.     

A Video Recall Study of In‐session Changes in Sentiment Override

This study examines in‐session changes in sentiment override over the first three sessions of couple therapy. Couples viewed a video recording of therapy sessions immediately after each of the first three sessions and continuously rated their level of sentiment override. Ninety‐eight changes were randomly chosen for analysis. Three talk turns prior to each change was coded using the Family Relational Communication Control Coding System. Results show that changes in sentiment override occur frequently. Repeated incidents of communication control were related to negative change in sentiment override for females. Repeated incidents of being left out of the conversation were related to negative changes in sentiment override for females and positive changes for males.     

Gender Role Attitudes across the Transition to Adolescent Motherhood in Mexican‐Origin Families

Using longitudinal data collected at four time points from 191 dyads of Mexican‐origin adolescent first‐time mothers and their mother figures, we examined changes in and socialization of traditional gender role attitudes across the transition to parenthood using latent growth curve modeling and actor – partner interdependence modeling. Longitudinal growth models indicated that, regardless of nativity status, adolescent mothers' and their foreign‐born mother figures' gender role attitudes became more egalitarian across adolescents' transition to parenthood, spanning from the 3rd trimester of pregnancy to 36 months postpartum. Furthermore, actor‐partner interdependence modeling suggested that adolescents' and their mother figures' gender role attitudes during adolescents' third trimester of pregnancy equally contributed to subsequent increases in one another's gender role attitudes at 10 months postpartum. Importantly, this reciprocal socialization process was not moderated by adolescent mothers' nor by their mother figures' nativity status. Findings suggest that it is important to understand the cultural and intergenerational family processes that contribute to the development of gender role attitudes during the transition to parenthood for adolescent mothers and their mother figures in Mexican‐origin families.     

THE MAGIC OF PLAY: LOW‐INCOME MOTHERS’ AND FATHERS’ PLAYFULNESS AND CHILDREN'S EMOTION REGULATION AND VOCABULARY SKILLS

Using data from a diverse sample of low‐income families who participated in the Early Head Start Research Evaluation Project (n = 73), we explored the association between mothers’ and fathers’ playfulness with toddlers, toddler's affect during play, and children's language and emotion regulation at prekindergarten. There were two main findings. First, fathers’ playfulness in toddlerhood was associated with children's vocabulary skills in prekindergarten whereas mothers’ playfulness was related to children's emotion regulation. Cross‐parental effects were found only for mothers. The association between mothers’ playfulness and children's vocabulary and emotion regulation was strengthened when fathers engaged in more pretend play and when children were affectively positive during the play. These findings show that playfulness is an important source of variation in the vocabulary and emotion regulation of children growing up in low‐income families. They also point to domain‐specific ways that mothers and fathers promote children's regulatory and vocabulary skills, and highlight the importance of children's positive engagement in play.     

The emergence of the ecological mind in Hua‐Yen/Kegon Buddhism and Jungian psychology

The complexity associated with deep interconnectedness in nature is beginning to be articulated and elaborated in the field of ecological studies. While some parallels to the psyche have been made and the field of Eco‐psychology has been developing, Jung's explicit contribution by way of the image of rhizomes has not been considered in detail. Philosopher Gilles Deleuze acknowledges borrowing the term from Jung, though he disagreed with Jung's Empedoclean use of the term. The paper presents some fundamental properties of rhizomes along with contemporary scientific research on mycorrhizal (fungal) networks. Comparisons are made, first with classical symbolic forms, demonstrating some overlap but also some differences. Then comparison of rhizomal networks is made to those found both in mammalian brains and in recent images of the ‘cosmic web’. While no hard conclusions can be drawn from these images, their remarkable similarities are suggestive of a need to reconsider what is meant by ‘intelligence’. The cosmic web is one of the largest structures in the known universe (clusters of galaxies which form into filaments and walls) with empty spaces in between. Exploration of the structure of this web leads to a discussion of dark matter and dark energy, current hot topics in science, probing into the mysteries of our ‘Big‐Bang’ cosmology. An additional comparison of the emerging image of the universe as a whole with the ancient Chinese Buddhist cosmological vision from the Hua‐Yen School (Kegon in Japan) again reveals profound parallels. The potential convergence of aspects of subjective, or meditative, explorations with objective scientific constructions is striking and offers links between East and West, as well as potential confirmation of the objective aspects of empathy.     

Analytical practice: do the new technologies have an impact?

Through commentary on four clinical vignettes, this article focuses on the anthropological transformations taking place in contemporary society, underlining their differences from the anthropologies of reference of the founding fathers of psychoanalysis. Hybridization between man and machine and the speeding up and alteration of communications which the new technologies promote are now crucial issues facing psychoanalysis. Social media and a 24/7 internet connection have produced deep changes in the way people live and perceive relationships. Analytical practice is not exempt from such issues, which can be particularly insidious, often subtle and difficult to recognize, or even underestimated or ignored by psychoanalysts outright, in order to preserve the illusion of a complete understanding of what unfolds in the analytical space. The authors suggest that such transformations, by (partially) rendering inadequate the theoretical and technical corpus on which the various depth psychologies are founded, require personal engagement on the part of psychoanalysts in the search for new strategies to treat their patients, with the consequent abandonment of the ‘certainties’ offered by sclerotic models of clinical procedure.     

God of the hinge: treating LGBTQIA patients

This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non‐conforming, cross‐dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender‐variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender‐variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening.     

Mindful Mates: A Pilot Study of the Relational Effects of Mindfulness‐Based Stress Reduction on Participants and Their Partners

Very little is currently known about how increases in dispositional mindfulness through mindfulness training affect the quality of participants’ romantic relationships, and no previous studies have examined how increases in specific facets of mindfulness differentially contribute to relationship health. Additionally, even less is known about how an individual's development of mindfulness skills affects the relationship satisfaction of his or her romantic partner. Thus, the purpose of this pilot study was to examine associations between changes in facets of mindfulness and relationship satisfaction among participants enrolled in a Mindfulness‐Based Stress Reduction (MBSR) course and their nonenrolled romantic partners. Twenty MBSR participants and their nonenrolled partners (n = 40) completed measures of mindfulness and relationship satisfaction pre‐ and post‐enrolled partners’ completion of an MBSR course. Results indicated that enrolled participants significantly improved on all facets of mindfulness and relationship satisfaction, while nonenrolled partners did not significantly increase on any facet of mindfulness or relationship satisfaction. Moreover, enrolled participants’ increases in Acting with Awareness were positively associated with increases in their own and their nonenrolled partners’ relationship satisfaction, whereas increases in enrolled participants’ Nonreactivity were positively associated with increases in their nonenrolled partners’ (but not their own) relationship satisfaction. These results suggest that increasing levels of mindfulness (particularly specific aspects of mindfulness) may have positive effects on couples’ relationship satisfaction and highlight mindfulness training as a promising tool for education and intervention efforts aimed at promoting relational health.