Family therapy and systemic interventions for child‐focused problems: the current evidence base

This review updates previous similar papers published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews, narrative literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with common mental health problems and other difficulties. In this context, systemic interventions include both family therapy and other family‐based approaches such as parent training, or parent implemented behavioural programmes. The evidence supports the effectiveness of systemic interventions either alone or as part of multimodal programmes for sleep, feeding and attachment problems in infancy; recovery from child abuse and neglect; conduct problems, emotional problems, eating disorders, somatic problems, and first episode psychosis.     

El abuso de drogas y su prevención

RESUMEN

Probablemente el consumo de drogas por la humanidad es tan lejano como su misma historia. De hecho, casi todas las culturas disponen de una droga que acompaña sus rituales sociales, religiosos, o ambos. El ejemplo más cercano se nos presenta en la transformación del vino en la liturgia católica.

El consumo de drogas viene condicionado por la interación individuo/ambiente, con toda su complicidad cultural, educativa, consumista, etc. Su prevención es, por tanto, de enorme complejidad y supone una confluencia de esfuerzos entre las diferentes estructuras sociales, que van desde procedimientos legales hasta programas educativos, campañas de consumo, marketing, reestructuración de la economía, educación sanitaria y procedimientos individuales de tratamiento y rehabilitación.

Este trabajo hace especial hincapié en los procedimientos psicológicos que deberían formar parte o tomarse en consideración en los programas educativos y de rehabilitación dirigidos a la labor preventiva.     

Longitudinal Associations among Parental Acceptance,Familism Values,and Sibling Intimacy in Mexican‐Origin Families

Prospective associations among parent – adolescent acceptance and familism values in early and middle adolescence and sibling intimacy in late adolescence and young adulthood were assessed in 246 Mexican‐origin families. Older sibling gender and sibling gender constellation were investigated as moderators of these associations. Sibling intimacy was stable over time and younger siblings with older sisters reported higher levels of sibling intimacy than those with older brothers. As predicted, stronger familism values were associated with greater sibling intimacy, but this link was evident only for older sisters and for girl‐girl dyads. The links from mother‐ and father‐acceptance to sibling intimacy also depended on the gender constellation of the sibling dyad: Higher levels of maternal warmth were associated with greater sibling intimacy for older sisters and girl‐girl sibling pairs but higher levels of paternal warmth were linked to greater sibling intimacy only for older siblings in mixed‐gender sibling dyads. Findings are consistent with prior research on the role of gender in family relationships but extend this work to encompass the effects of both parents' and siblings' gender, as well as the role of sociocultural values in parents' socialization influences.     

Perceptions of Boundary Ambiguity in the Process of Leaving an Abusive Partner

The process of leaving an abusive partner has been theorized using the Stages of Change Model. Although useful, this model does not account for changes in relational boundaries unique to the process of leaving. Using family stress and feminist perspectives, this study sought to integrate boundary ambiguity into the Stages of Change Model. Boundary ambiguity is defined as a perception of uncertainty as to who is in or out of a family system (Boss & Greenberg, 1984). Twenty‐five mothers who had temporarily or permanently left their abusers were interviewed. Data were analyzed using constructivist grounded theory methods. Results identify types, indicators of, and mothers' responses to boundary ambiguity throughout the five stages of change. Most mothers and abusers fluctuated between physical and psychological presence and absence over multiple separations. The integration of boundary ambiguity into the Stages of Change Model highlights the process of leaving an abusive partner as systemic, fluid, and nonlinear.     

Scaling Up Family Therapy in Fragile,Conflict‐Affected States

This article discusses the design and delivery of two international family therapy‐focused mental health and psychosocial support training projects, one in a fragile state and one in a post‐conflict state. The training projects took place in Southeast Asia and the Middle East/North Africa. Each was funded, supported, and implemented by local, regional, and international stakeholders, and delivered as part of a broader humanitarian agenda to develop human resource capacity to work with families affected by atrocities. The two examples illustrate how task‐shifting/task‐sharing and transitional justice approaches were used to inform the scaling‐up of professionals involved in each project. They also exemplify how state‐citizen phenomena in each location affected the project design and delivery.     

Acoustic resonance at the dawn of life: musical fundamentals of the psychoanalytic relationship

This paper uses a case vignette to show how musical elements of speech are a crucial source of information regarding the patient's emotional states and associated memory systems that are activated at a given moment in the analytic field. There are specific psychoacoustic markers associated with different memory systems which indicate whether a patient is immersed in a state of creative intersubjective relatedness related to autobiographical memory, or has been triggered into a traumatic memory system. When a patient feels immersed in an atmosphere of intersubjective mutuality, dialogue features a rhythmical and tuneful form of speech featuring improvized reciprocal imitation, theme and variation. When the patient is catapulted into a traumatic memory system, speech becomes monotone and disjointed. Awareness of such acoustic features of the traumatic memory system helps to alert the analyst that such a shift has taken place informing appropriate responses and interventions. Communicative musicality (Malloch & Trevarthen 2009) originates in the earliest non‐verbal vocal communication between infant and care‐giver, states of primary intersubjectivity. Such musicality continues to be the primary vehicle for transmitting emotional meaning and for integrating right and left hemispheres. This enables communication that expresses emotional significance, personal value as well as conceptual reasoning.     

Two Jungs. Apropos a paper by Mark Saban

Jung's idea of the ‘personal equation’ amounts to the reflection that theoretical differences between the psychologies that people teach are rooted in their personalities, in other words, that they are due to the psychology each one ‘has’. This concept also applies to different interpretations of Jung's work. The serious difficulties that Mark Saban has with my psychology are a case in point. Recourse to the concept of the personal equation reveals that Saban has his Jung and I have mine. With his insistence on his Talmudic methodological principle of dream interpretation, that ‘the dream is its own interpretation’, according to Saban Jung means nothing but a rejection of Freudian free association. My Jung goes far beyond that. Jung understands this methodological principle above all in terms of what he calls ‘circumambulation’. The main part of this paper is devoted to an elucidation of what circumambulation involves as a mode of dream interpretation. The paper concludes with the distinction Jung himself introduced between two types of reading of his work, either as ‘paper’ and ‘dead nostrums’ or as ‘fire and wind’, and pleads for a reconstruction of Jung's psychology as a whole in terms of his most advanced, deepest insights, instead of a dogmatic reading mainly based on the early Jung, a reading for which his later revolutionary insights are at best negligible embellishments.     

Bounded in a nutshell and a king of infinite space: the embodied self and its intentional world

This paper explores the implications of developments in phenomenological biology for a reconsideration of synchronicity and the self. The enactive approach of Maturana and Varela aims to reformulate the relation between biological organisms and the world in a non‐Cartesian way, breaking down the conceptual division between mind and world so that meaning can be seen as a function of the species‐specific way in which an organism engages with its environment. This leads to a view of the self as inherently embodied and engaged with the particularities of its material, cultural and social worlds, while being infinitely extended through the power of imagination; this enables humans to adapt to many different social and material environments. In order to understand these differences, we need to ‘enter into the world of the other’. Where understanding of other animals requires immersion in their environmental milieux, understanding other humans requires us also to recognize that differences in socio‐cultural milieux create significantly different worlds of meaning and experience.     

Conspiracies of immanence: Paul Tillich,Pierre Teilhard de Chardin and C.G. Jung

Jung's psychology proffers a sustained reflection on the traditional religious question of the relation of divine transcendence to immanence. On this issue his psychology affirms a position of radical immanence in its contention that the experience of divinity is initially wholly from within. Though this position remains on the periphery of religious and theological orthodoxy Jung is not alone in holding it among moderns. Paul Tillich adopts a similar stance with his controlling symbols of the divine as ‘Ground of Being’ and ‘Depth of Reason’. Pierre Teilhard de Chardin understands divinity as the experiential energy of evolution itself working within nature and humanity toward greater configurations of universal communion as the basis of community. All of Jung's master symbols of individuation assume such an understanding of immanence uniting individual and totality. His psychology strongly suggests and contributes to the current emergence of a new religious sensitivity based on the awareness of the intra‐psychic origin of all religions. In his later writings he held out such a position as a significant alternative to genocide.