A fertile matrix: the birth of the Forensic Psychotherapy Society

This paper traces some aspects of the fertile matrix within which, over many years, the application of a psychoanalytic perspective to clinical work with the most severely mentally ill, difficult and at times frightening patients in secure and community settings has evolved and now led to the recent inauguration of the Forensic Psychotherapy Society (FPS), a new Member Institution of the British Psychoanalytic Council. The Society provides both a framework for a national, multidisciplinary professional training in psychodynamic forensic psychotherapy and the potential launching pad for an active post-qualification organisation supporting CPD and all other forms of professional development. The particular contributions to the birth of the FPS of the Forensic Psychotherapy Department at West London Mental Health NHS Trust, partly because we know it best but also because it is part of the largest forensic psychiatric service in the United Kingdom, are described.     

Parents Produce Explicit Cues That Help Toddlers Distinguish Joking and Pretending

While separate pieces of research found parents offer toddlers cues to express that they are (1) joking and (2) pretending, and that toddlers and preschoolers understand intentions to (1) joke and (2) pretend, it is not yet clear whether parents and toddlers consider joking and pretending to be distinct concepts. This is important as distinguishing these two forms of non‐literal acts could open a gateway to understanding the complexities of the non‐literal world, as well as the complexities of intentions in general. Two studies found parents offer explicit cues to help 16‐ to 24‐month‐olds distinguish pretending and joking. Across an action play study (n = 25) and a verbal play study (n = 40) parents showed more disbelief and less belief through their actions and language when joking versus pretending. Similarly, toddlers showed less belief through their actions, and older toddlers showed less belief through their language. Toddlers' disbelief could be accounted for by their response to parents' language and actions. Thus, these studies reveal a mechanism by which toddlers learn to distinguish joking and pretending. Parents offer explicit cues to distinguish these intentions, and toddlers use these cues to guide their own behaviors, which in turn allows toddlers to distinguish these intentional contexts.     

Making Sense of Dynamic Systems: How Our Understanding of Stocks and Flows Depends on a Global Perspective

Stocks and flows (SF) are building blocks of dynamic systems: Stocks change through inflows and outflows, such as our bank balance changing with withdrawals and deposits, or atmospheric CO₂ with absorptions and emissions. However, people make systematic errors when trying to infer the behavior of dynamic systems, termed SF failure, whose cognitive explanations are yet unknown. We argue that SF failure appears when people focus on specific system elements (local processing), rather than on the system structure and gestalt (global processing). Using a standard SF task (n = 148), SF failure decreased by (a) a global as opposed to local task format; (b) individual global as opposed to local processing styles; and (c) global as opposed to local perceptual priming. These results converge toward local processing as an explanation for SF failure. We discuss theoretical and practical implications on the connections between the scope of attention and understanding of dynamic systems.     

A Computational Evaluation of Sentence Processing Deficits in Aphasia

Individuals with agrammatic Broca's aphasia experience difficulty when processing reversible non‐canonical sentences. Different accounts have been proposed to explain this phenomenon. The Trace Deletion account (Grodzinsky, 1995, 2000, 2006) attributes this deficit to an impairment in syntactic representations, whereas others (e.g., Caplan, Waters, Dede, Michaud, & Reddy, 2007; Haarmann, Just, & Carpenter, 1997) propose that the underlying structural representations are unimpaired, but sentence comprehension is affected by processing deficits, such as slow lexical activation, reduction in memory resources, slowed processing and/or intermittent deficiency, among others. We test the claims of two processing accounts, slowed processing and intermittent deficiency, and two versions of the Trace Deletion Hypothesis (TDH), in a computational framework for sentence processing (Lewis & Vasishth, 2005) implemented in ACT‐R (Anderson, Byrne, Douglass, Lebiere, & Qin, 2004). The assumption of slowed processing is operationalized as slow procedural memory, so that each processing action is performed slower than normal, and intermittent deficiency as extra noise in the procedural memory, so that the parsing steps are more noisy than normal. We operationalize the TDH as an absence of trace information in the parse tree. To test the predictions of the models implementing these theories, we use the data from a German sentence—picture matching study reported in Hanne, Sekerina, Vasishth, Burchert, and De Bleser (2011). The data consist of offline (sentence‐picture matching accuracies and response times) and online (eye fixation proportions) measures. From among the models considered, the model assuming that both slowed processing and intermittent deficiency are present emerges as the best model of sentence processing difficulty in aphasia. The modeling of individual differences suggests that, if we assume that patients have both slowed processing and intermittent deficiency, they have them in differing degrees.     

EARLY MODERN PROTESTANT VIRTUOSOS AND SCIENTISTS: SOME COMMENTS

The following essay is divided in three parts. First, while sharing in principle Harrison's hypothesis of an affinity between the sixteenth‐century Reformation and early modern science, it questions the connection between the latter and the Weberian “disenchantment of the world.” Second, it suggests a broader group of possible actors than that envisaged by Harrison in referring to virtuoso collectors and their cabinets of curiosities who are rather marginalized in Harrison's narrative. And third, it highlights (in agreement with Harrison) the physico‐theology of the second half of the seventeenth and the first half of the eighteenth century and beyond as an important temporary fusion of religion/theology and science at a time when the new science was still striving for social and religious respectability.     

Meta‐Analysis of Counseling Outcomes for the Treatment of Posttraumatic Stress Disorder

This meta‐analysis of 152 published posttraumatic stress disorder (PTSD) clinical trials from 1990 to 2012 concluded that counseling generally produced a small to large effect of treatment across all comparison conditions at termination (d+ = 0.30 to 0.89). These gains were maintained at longest follow‐up (d+ = 0.58 to 0.86) for the wait‐list, treatment‐as‐usual, and single‐group comparisons, but not for the follow‐up placebo comparison (d+ = 0.15), probably because of the low power (j = 3 placebo studies). Clinical trial findings were synthesized using a random‐effects model. No effects of publication bias or moderating variables were evident. No difference was found between trauma‐focused and non‐trauma‐focused approaches. Implications for counseling practice and future PTSD outcome research are addressed.     

A Phenomenological Inquiry of Clients’ Meaningful Experiences in Counseling With Counselors‐in‐Training

This study is a follow‐up to Sackett, Lawson, and Burge's ( 2012 ) study that explored the meaningful experiences of clients and counselors‐in‐training (CITs). Using the previous study's themes of clients’ experiences in counseling with CITs as a launching pad, the authors examined in greater depth the meaningful experiences of clients who are in counseling with CITs through qualitative phenomenological interviews. Findings, as well as implications for counselor education, supervision, and counseling, are discussed.     

Mind the Gaps: Are Conclusions About Mindfulness Entirely Conclusive?

Mindfulness has emerged as an important construct in the mental health field. Although evidence suggests benefits, it also appears that excitement over the clinical applications of mindfulness has largely suspended concentrated efforts to clarify fundamental elements of the construct. This article explores conceptual confusion and contrasts primary mindfulness‐based techniques before investigating attrition factors, adverse effects of mindfulness practices, and populations contraindicated for mindfulness‐based techniques. Implications for practice are provided.     

A Qualitative Analysis of Home‐Based Counselors' Experiences in a Rural Setting

This qualitative study sought to understand the experiences of home‐based counselors working in a rural setting. In‐depth interviews were conducted with 12 counselors who were asked to describe their experiences in the areas of preparedness, professional development, challenges, and gender‐specific experiences. Fourteen coding categories emerged from the interviews, which led to the findings of 3 overarching themes: shared isolation, ethical ambiguity, and the high‐intensity nature of the job. Recommendations for home‐based counselors, agencies, and professional counseling associations are discussed.     

The Munroe-Meyer Approach: Continuous Integration of Didactic Instruction,Research, and Clinical Practice

Increased demand for applied behavior analysis (ABA) services has increased the need for additional masters-level practitioners and doctoral-level academicians and clinical directors. Based on these needs, the University of Nebraska Medical Center’s (UNMC) Munroe-Meyer Institute has developed a PhD program. The academic structure at UNMC allowed us to create our PhD program in a relatively quick and efficient manner. Our PhD program has many unique features, including (a) close integration of didactic instruction with clinical and research training provided by leading experts in ABA in which students immediately apply concepts introduced in the classroom during coordinated clinical and research practica; (b) structured grant writing training in which students learn to write and submit an NIH-level grant; (c) financial support in the form of a stipend of $23,400 per year, free health benefits, and a full-tuition waiver for up to 12 credits per semester for UNMC courses (a benefits package worth approximately $50,000 per year for an out-of-state student); and (d) encouragement and financial support to present papers at local, regional, and national behavior analysis conferences.