Longitudinal Model Predicting Self‐Concept in Pediatric Chronic Illness

Although self‐concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent–child attachment have been linked to self‐concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3‐month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self‐concept, as predicted by depressive symptoms and parent–child attachment, in a sample of 50 youths (M_age = 14.56, SD_age = 1.82) participating in MEND. Both “time spent in the program” and decreases in depressive symptoms were associated with increases in self‐concept over time. Higher baseline levels of avoidant attachment to both mother and father were also associated with greater initial levels of self‐concept. Targeting depressive symptoms and supporting adaptive changes in attachment may be key to promoting a healthy self‐concept in pediatric CI populations. The association between avoidant attachment and higher baseline self‐concept scores may reflect differences in participants’ autonomy, self‐confidence, or depression. Limitations of the study include variability in the amount of time spent in the program, attrition in final time point measures, and the inability to fully examine and model all potential covariates due to a small sample size (e.g. power).     

Latina/o Children Living With an Immigrant Mother With Depression: Developmental and Cultural Nuances in Recognition and Coping

The psychological experience of maternal depression and its impact on immigrant Latina/o families often goes unrecognized and unaddressed. Children may feel especially helpless and confused about the changes they observe in their mothers’ mood and behavior, and about the deterioration of family relationships. Given the interdependence of family structures of immigrant Latina/o households, maternal depression can be detrimental to Latina/o youth attributions and coping strategies, and to their relationship with their mothers. The quantitative focus of most research on maternal depression in Latina/o samples limits our understanding of family processes in maternal depression. The current qualitative study explores the perceived impact of maternal depression on Latina/o youths’ attributions and coping strategies. This inquiry involved focus groups with 12 participants aged 9–16 years to explore their perspectives on maternal depression. All youth had participated in a 12‐week multifamily group intervention focused on building family and cultural strengths to address maternal depression on immigrant Latina/o families. Findings of the focus groups illuminated the essential experience of youth living with maternal depression, and indicated that there are developmental considerations for how youth recognize and make meaning of maternal depression, and cope with disrupted family life. Additionally, youth reported engaging in these culture‐specific ways of coping: using close sibling relationships and family structure as support, having fathers and extended family members engage in additional and restorative parenting practices, and participating in religious practices to seek refuge from family stress. We propose considerations for intervention and further areas of research.     

Children's and Parents’ Well‐Being in Joint Physical Custody: A Literature Review

Joint physical custody (JPC), a parental care arrangement in which a child lives with each parent for at least 25–50% of the time after separation or divorce, is increasingly common in many Western societies. This is a major shift from the standard of sole physical custody, with mostly mothers providing primary childcare after a parental separation or divorce. The increasing share of separated or divorced parents who practice JPC, which in some countries, US states, and regions reaches 30% and more, results from increasing gender equality due to mothers participating considerably in the labor force and fathers being actively involved in their children's daily lives. This review focuses on the effects of JPC on children's and parents’ well‐being, based on 40 studies from North America, Australia, and Europe published between 2007 and 2018. In sum, there is empirical evidence from different countries that suggests that JPC arrangements can have positive effects on the well‐being of children and of parents. However, the existing studies are conceptually, methodologically, and contextually very heterogeneous. In addition, self‐selected highly educated parents with a high socio‐economic status, a low conflict level, and children between the ages of 6–15 practicing JPC dominate the samples. Thus, the risks and benefits of JPC are not clear yet and are heavily debated by advocates and academics. The review concludes with suggestions for future research.     

Couples' Perceptions of Each Other's Daily Affect: Empathic Accuracy,Assumed Similarity,and Indirect Accuracy

This study examined couples' perceptions of each other's daily affect, using a daily diary methodology. Specifically, we tested the extent to which couples accurately inferred how their partner was feeling (empathic accuracy) and the extent to which spouses used their own feelings as a gauge for how their partner was feeling (assumed similarity). We also tested for indirect accuracy in couples' perceptions; that is, that assumed similarity in the context of actual similarity leads to empathic accuracy. Participants were 51 couples who completed daily diaries for seven consecutive nights. Results based on the Actor‐Partner Interdependence Model indicated that couples showed both empathic accuracy and assumed similarity in their perception of their partner's positive affect; however, they used assumed similarity in rating their partner's hard negative (anger, hostility) and soft negative (sadness, fear) affect. Furthermore, tests of indirect accuracy found that wives were indirectly accurate in perceiving their husbands' positive affect and both husbands and wives were indirectly accurate in perceiving each other's hard negative affect because they were biased. Complementing laboratory studies, the present study highlights that examining couples' perceptions of each other's feelings in contexts of daily life, and differentiating positive and negative emotions, can further our understanding of the role of emotions for healthy relationship functioning.     

Evaluating Supervision Models in Functional Family Therapy: Does Adding Observation Enhance Outcomes?

This study examined the effects of observation‐based supervision Building Outcomes with Observation‐Based Supervision of Therapy (BOOST therapists = 26, families = 105), versus supervision as usual (SAU therapists = 21, families = 59) on (a) youth externalizing behavior problems and (b) the moderating effects of changes in family functioning on youth externalizing behaviors for adolescents receiving Functional Family Therapy (FFT). Exploratory analyses examined the impact of supervision conditions on youth internalizing problems. In 8 community agencies, experienced FFT therapists (M = 1.4 years) received either BOOST or SAU supervision in a quasi‐experimental design. Male (59%) or female (41%) adolescents were referred for the treatment of behavior problems (e.g., delinquency, substance use). Clients were Hispanic (62%), African American (19%), Non‐Hispanic White (12%), or Other (7%) ethnic/racial origins. Therapists (female, 77%) were Hispanic 45%, African American (19%), White Non‐Hispanic (30%), or other (4%) ethnic/racial backgrounds. Analyses controlled for the presence or absence of clinically elevated symptoms on outcome variables. Clinical outcomes were measured at baseline, 5 months, and 12 months after treatment initiation. Clients with externalizing behavior above clinical thresholds had significantly greater reductions in problem behaviors in the BOOST versus the SAU conditions. Clients below thresholds did not respond differentially to conditions. Supervisors in BOOST had more experience with the FFT model; as such, the observed results may be a result of supervisor experience. The BOOST supervision was associated with improved outcomes on problem behaviors that were above clinical thresholds. The findings demonstrate the importance of addressing client case mix in implementation studies in natural environments.     

The Dynamic Interplay Between Satisfaction With Intimate Relationship Functioning and Daily Mood in Low‐Income Outpatients

Substantial research supports bidirectional links between intimate relationship discord and individual psychopathology, including depressive symptoms. However, few studies have utilized daily diary methods to capture the micro‐level processes underlying the association between couple discord and depression, particularly among populations that are at elevated risk for both interpersonal and individual dysfunction. To address this gap, we examined whether daily changes in satisfaction with relationship functioning were associated with daily changes in negative affect and positive affect over the span of 2 weeks among mental health outpatients of low socioeconomic status. Participants were 53 low‐income outpatients from community mental health clinics who completed a semi‐structured interview about the quality of their intimate relationships followed by 14 daily reports of positive and negative mood and satisfaction with relationship functioning across several domains. Growth curve analytic techniques revealed the hypothesized bidirectional relations. Decline in satisfaction with relationship functioning predicted escalation in negative affect and deterioration in positive affect over 2 weeks, and deterioration of mood predicted declining satisfaction with relationship functioning. This study extends existing knowledge about couple dysfunction and individual psychopathology by highlighting the immediate nature of this dynamic process as it unfolds over time.     

A dynamic systems approach to the feeling toned complex

A review of Jung’s writing on the ‘feeling‐toned complex’ shows that he considered it to comprise independent, split‐off, psychic elements. Modern advances in scientific thinking and technology, namely Dynamic Systems Theory and neuro‐imaging, allow us to better define and explore this psychic phenomenon. Considering the constellation of the complex as a hierarchy of dynamic systems allows for a prediction of the timing of brain activity. This has been confirmed by two independent studies using fMRI and QEEG while administering the Word Association Experiment, the tool Jung used to investigate brain/psychic functioning over a century ago. Using as a framework the stages of the constellation of a complex viewed as a hierarchy of dynamic systems, I review the neuro‐imaging studies reported by Petchkovsky et al. (2013, 2017) and Escamilla et al. (2018), concluding that quantitative theoretical predictions and experimental results are in agreement within an order of magnitude. The change in attention caused by the constellation of the complex can also be conceived as the switching from a default neuro‐network, a startle response activating executive functioning in the frontal cortex of either the ego‐complex or an autonomous complex.     

Disquiet in the consulting room: everything/nothing that is said here is confidential

Writing from experiences in the consulting room in private practice in Australia, the author refers to the layered complexity of a conflict of ethical duty which has legal and social implications. The paper explores how the ethics that are congruent with creating a safe vas bene claustrum can be diametrically opposed to the social and legal structures and processes on which we all rely. It is suggested that within the vas, analysts and analysands engage in a shared process of emotionally connected, layered, symbolic thinking. Subpoenas directed at analysts are seeking concrete evidence that will stand up in court. The paper argues that this is a category error based on ignorance and misconceptions of what analytic work entails. The intrusion of a subpoena into the vas has the potential to cause havoc in the mental health and the lives of already vulnerable, possibly traumatized and isolated individuals. It can undermine a fundamental human right and undermine the profession of psychotherapy as a whole. The paper proposes that analysts have an ethical obligation to protect the work contained within the vas from these category errors and to educate other professionals as to why we cannot provide the kind of evidence that the courts require.     

The analyst and analysand as citizens in the world

Beginning with Jung's reflections on individuation as a starting point, this article examines the analytic relationship in the context of our current reality. The latter exerts pressures of all sorts that do not favour individuation. Indeed, geopolitical commentators see present‐day society as marked globally by excessive self‐love that seeks to dominate, at the expense of the other. Given that such forms of dominance are now also very prevalent in the workplace, this article examines how to help the increasing number of individuals with highly successful professional careers who suffer from this pressure and who then seek analysis. ‘Progressive movement’, an indicator of and incentive to change, is examined by studying the narrative processes emerging from dream activity ‐ including dreaming with the hands in the sand tray ‐ in the co‐transference. The article highlights how ‘progressive movement’, founded on narrative Competence and on the reflective function, may generate experiences of ‘realistic hope’. The latter signals the start of an individuation process in the analytic couple and, simultaneously, the transformation of both the analyst and the analysand into good enough ‘citizens in the world’.     

From active imagination to active life: at the roots of Jungian social activism

Our traditional Western worldview is often unconsciously based on a polarized, dichotomous perspective. However, many of Jung's ideas hint at a deep interrelation between opposites, such as inside and outside, which are, as the principle of synchronicity shows, rooted in a conceptualization of psyche and matter conceived as intertwined. Another pair of philosophical concepts, traditionally considered as opposites, needs further investigation: that between imagination and reality. If we are lucky in our daily practice as analysts, we can use imagination as a powerful tool to help people discover themselves as individuals and to get in deeper, more lively and responsible touch with reality. This paper explores the difference that Jung outlined between ‘active imagination’ and ‘passive fantasies’, and the transformative power of taking an active part in what imaginatively happens – he called it ‘active participation’ – rather than being passively overwhelmed by invasive fantasies. It is argued that it makes a great difference whether we become the actors and not just the spectators of our lives, and this is linked with the core of the individuation process in which, if individuals discover their particular place and meaning in the universe, they can live an ‘active life’, playing a heartfelt and responsible role in the collective world to which they belong. These ideas are at the heart of Jung's work, and they represent one of the roots of Jungian social activism.