Symptom reduction and termination: client change and therapist identified reasons for saying goodbye

Empirical efforts have focused on predicting whether or not clients prematurely terminate therapy, with nonattendance of last session equated to premature termination. However, this fails to explore the relationship between clients’ distress reduction and reasons for termination. With this study, we aimed to understand how clients’ distress change relates to premature termination and examine clients’ distress change in conjunction with therapists’ perceptions of termination reasons. We collected data from 797 clients who prematurely terminated or attended termination but completed therapy a minimum of three individual sessions provided by 38 therapists. Clients completed an assessment of psychological symptoms before each session. At the end of treatment, therapists identified the reasons they believed termination occurred for all clients in the sample. Results demonstrate that total sessions attended and missed predict premature termination, whereas distress change does not. Additionally, clients who were believed to accomplish goals do show greater change. However, therapists’ indicated that over half of clients did not reach goals at termination and they did not perceive nonattendance at last session to equate to drop out in all cases. Implications are discussed with respect to understanding why clients’ terminate, therapeutic goal conceptualization, and review of goals during termination in time-limited psychotherapy.     

分析性认知风格对偏差反应与冲突探查的影响

采用2Wingdings 2MC@2Wingdings 2MC@2混合设计和相关分析法,考察个体的分析性认知风格对其在完成有、无冲突的推理判断任务时的逻辑反应倾向和冲突探查过程的影响。结果表明分析性认知风格不会直接影响被试完成推理任务的逻辑反应倾向性,高、低分析性认知风格倾向组被试在逻辑反应正确率上不存在显著差异; 但对个体的冲突探查过程会有影响,高、低认知风格倾向组被试在反应自信率上存在显著差异,且冲突探查大小与分析性认知风格显著负相关,这一结果表明那些高分析性认知风格倾向的个体在完成冲突任务时,更可能探查到刻板反应与遵从逻辑规则做出的反应之间的冲突。     

Suicidal Thinking and Perfectionism: The Role of Goal Adjustment and Behavioral Inhibition/Activation Systems (BIS/BAS)

The current study investigated the associations among perfectionism, goal adjustment, behavioral activation sensitivity (BAS), behavioral inhibition sensitivity (BIS), and suicidal thinking. Participants (n = 255) completed the Multidimensional Perfectionism Scale, the BIS/BAS scale, the Goal Adjustment scale, and a measure of suicidal thinking. The findings showed that socially prescribed perfectionism was the only perfectionism dimension associated with suicidal thinking. Goal reengagement (but not goal disengagement) is an important construct in the suicidal process. A series of hierarchical regression analyses showed that goal reengagement moderates and mediates the effect of socially prescribed perfectionism on suicidal thinking. BIS was also associated with suicidal behavior but its effect was mediated via socially prescribed perfectionism. The theoretical and treatment implications of the relationships between socially prescribed perfectionism, goal reengagement, and suicidal thinking and between BIS, socially prescribed perfectionism, and suicidal thinking are discussed. Future research is required to determine whether these relationships are predictive of suicidal thinking and behavior over time.     

Children's engagement and competence in personal recollection: effects of parents' reminiscing goals

Parents' goal orientations in parent-child reminiscing were examined in this study, where 28 preschoolers (mean age = 46 months) experienced a standardized event. Dyads discussed the event that evening, with parents randomly assigned to either an "outcome-oriented" or a "process-oriented" condition. Outcome-oriented parents, who were told that children subsequently would be tested on event-related recall, were more controlling in these conversations compared with process-oriented parents, who were told that children's personal perspective would be assessed. Parents did not differ in their provision of structure. Children were interviewed 2 weeks later. Autonomy support in the parent-child conversation predicted children's engagement in the interview. Parental structure predicted children's recall of details and the coherence of their memories. Effects of parental reminiscing styles for children's memory and motivation to reminisce are discussed.     

A Two-Dimensional Theory of Health

The starting point for the contemporary debate about theories of health should be the holistic theory of Lennart Nordenfelt, claims George Khushf, not the refuted theory of Christopher Boorse. The present paper is an attempt to challenge Nordenfelt and to present an alternative theory to his and other theories, including Boorse’s. The main problems with Nordenfelt’s theory are that it is relativistic, that it leads to counter-intuitive results as to what goals can count as healthy, that it focuses on the wrong kind of abilities, that it makes measuring health extra difficult, and that it does not give us a sufficient account of health, at most a necessary one. The alternative theory proposed is two-dimensional. First, health is to have developed the abilities and dispositions that members of one’s culture typically develop, and be able to use them, in acceptable circumstances; and second, health is to experience positive moods and sensations, the kinds that have internal causes. The theory solves the problems attached to Nordenfelt’s theory by not being individual relativistic, by eliminating the goals in the definition, by giving an alternative interpretation of “ability,” by making health easier to measure, and by adding the dimension of well-being that, together with health as ability, not only gives us a necessary, but also a sufficient, account of health.     

Effects of the School-to-Work Group Method among young people

This study examines effects of the School-to-Work Group Method among 17-25-year-old young people facing the transition from vocational college to work. After baseline measurement (N = 416) participants were randomized into experimental and control groups. The results of ten month follow-up (N = 334) showed notable beneficial impacts of the group method on both employment itself and on how well it matched participants’ education and personal career plans. The group method also had a significant preventive effect on psychological distress and depression symptoms among those initially at risk of suffering from mental disorder. Moreover, it considerably increased participants’ personal work life, finances and property goals.     

Evaluating progress in training: character or competence?

Jung was mercurial in his attitudes to method and technique, leaving us a problematic legacy when it comes to evaluating the progress of trainees. Some would say that those of us involved with the assessment of candidates during their training continue to rely too heavily on intuition and subjective assessments. However good our admissions' procedures and the structures in place to review progress, the emotional and financial demands for trainees of embarking on an analytic training, the tendency for analytic institutes to remain opaque and slow to link up with the external world and the cliques within our profession make more objective assessments of progress and readiness to qualify at best haphazard and at worst inadequate. Some trainees have an immediate talent for analytic work; others develop their gifts more slowly; some never find this capacity. Working from a definition of analytic talent, the paper begins to map out a Jungian framework for assessing progress, emphasizing the significance of both character and competence and the developing relationship between them.     

Performance as annihilation or integration?1

What happens when the analyst has the impression of being annihilated by the patient? Analysts have a tendency to use more general, i.e. simplifying, constructions such as destructiveness, psychosis or death instinct as explanatory models. In the authors' view, these constructions in the end evade rather than mirror clinical reality. More recent research points to promising possibilities of differentiation, e.g. psychotic mechanisms which are‐as yet undiscussed‐based on Freud's notion of the partial ‘rent in the relation between ego and external world’. These findings emphasize the restitutive function of a symptom or disturbance, i.e. destruction of a relationship which hinders the therapeutic process and which is not understood initially, instead of solely stressing the destructive meaning in a tabooing gesture. The concept of performance attempts to replace simplifying models with a discriminant process, and will be preliminarily defined and explained in delineation to terms already in use such as acting out, enactment, and role responsiveness. The authors explore the question of how the perception of unthought certainty in the performance can either be recognized as a blueprint, i.e. organizing activity, or as the destruction of the relationship so that a new one can emerge. The evidence from a detailed clinical example shows that many treatments can fail at this point and demonstrates how an understanding of performance in this sense offers a chance for integrating processes that otherwise impede treatment.     

The goals of psychoanalytic treatment: Conceptual considerations and follow‐up interview evaluation with a former analysand1

There has been a long, ongoing discussion of goals in psychoanalytic treatment. Some analysts are even of the opinion that psychoanalysis ought to be goalless (‘just analysing’). The growing number of outcome studies, however, is in need of a generally accepted set of criteria by which treatment results can be judged. The author proposes a definition of the goals of psychoanalysis that covers four areas: the alleviation of symptoms and complaints, changes in life adjustment, changes in personality structure, and procedural goals such as the resolution of the transference neurosis. She illustrates the relevance of this conceptualization by an empirical study that considers the assessments of 19 psychoanalysts discussing statements made by a former patient about her analytic treatment. On the basis of this case, which comes from the follow‐up study of the DPV (German Psychoanalytical Society), reported by Leuzinger‐Bohleber et al. in 2002, the author demonstrates that psychoanalysts use the criteria defined above implicitly in forming their opinions. Moreover, they arrived at similar judgements regarding the treatment's outcome.     

Semantics for Analytic Containment

In 1977, R. B. Angell presented a logic for analytic containment, a notion of relevant implication stronger than Anderson and Belnap's entailment. In this paper I provide for the first time the logic of first degree analytic containment, as presented in [2] and [3], with a semantical characterization—leaving higher degree systems for future investigations. The semantical framework I introduce for this purpose involves a special sort of truth-predicates, which apply to pairs of collections of formulas instead of individual formulas, and which behave in some respects like Gentzen's sequents. This semantics captures very general properties of the truth-functional connectives, and for that reason it may be used to model a vast range of logics. I briefly illustrate the point with classical consequence and Anderson and Belnap's tautological entailments.