Economic Disadvantage at the Intersections: Contemporary Stereotypes in the Headlines

Effective multiculturally competent treatment of economically disadvantaged clients requires an awareness of the stereotypes and biases that these clients and their families face in contemporary culture—stereotypes that are so pervasive that they can subtly influence counselors’ thinking about poor and working‐class individuals. In this article, the authors apply an intersectional perspective to profile current stereotypes and biases that exist regarding low‐income groups at the intersections of race, religion, and immigration status. Implications for educators and counselors are suggested. Un tratamiento efectivo y multiculturalmente competente de clientes e conómicamente desfavorecidos requiere una conciencia de los estereotipos y prejuicios que estos clientes y sus familias enfrentan en la cultura contemporánea; estereotipos tan arraigados que pueden influir sutilmente en la forma de pensar de los consejeros sobre las personas pobres y de clase trabajadora. En este artículo, los autores aplican una perspectiva interseccional para perfilar estereotipos y prejuicios actuales que existen acerca de grupos de bajo nivel económico en las intersecciones entre raza, religión y estatus migratorio. Se sugieren implicaciones para educadores y consejeros.     

The Discursive Performance of Change Process in Systemic and Constructionist Therapies: A Systematic Meta‐Synthesis Review of In‐Session Therapy Discourse

Despite the emphasis of systemic and constructionist approaches on discourse and interaction, to date there has been no comprehensive overview of how change process is performed within in‐session therapeutic dialogue. In this paper, we present a qualitative meta‐synthesis of 35 articles reporting systemic and constructionist therapy process data from naturally occurring therapeutic dialogue. The studies were selected following the screening against eligibility criteria of a total sample of 2,977 studies identified through a systematic search of PsycINFO and MEDLINE databases. Thematic analysis of the 35 studies’ findings identified four main themes depicting change process performance: (a) shifting to a relational perspective, (b) shifting to non‐pathologizing therapeutic dialogue, (c) moving‐forward dialogue, and (d) the dialogic interplay of power. Findings highlight the interactional and discursive matrix within which systemic and constructionist change process occurs. Findings illuminate the value of qualitative research studies sampling naturally occurring therapeutic discourse in bringing this matrix forth, particularly when utilizing discursive methodologies like conversation or discourse analysis.     

How is Systemic and Constructionist Therapy Change Process Narrated in Retrospective Accounts of Therapy? A Systematic Meta‐synthesis Review

Despite the considerable potential of qualitative approaches for studying the systemic and constructionist therapy process due to shared theoretical and epistemological premises, to date there is lack of a comprehensive qualitative synthesis of how change process is experienced and conceptualized by clients and therapists. To address this evidence gap, we performed a systematic meta‐synthesis review of 30 studies reporting clients’ and therapists’ retrospective narratives of change process across systemic and constructionist models and across a range of client configurations, including individuals, couples, families, and groups. The studies were identified following a systematic search in PsycINFO and MEDLINE resulting in 2,977 articles, which were screened against eligibility criteria. Thematic analysis led to the identification of four main themes: (1) navigating through differences, (2) toward nonpathologizing construction of problems, (3) navigating through power imbalances, and (4) toward new and trusting ways of relating. Findings illustrate the multifaceted aspects of systemic and constructionist change process, the importance for their reflexive appraisal, and the need for further research contributing to the understanding of the challenges inherent in the systemic and constructionist therapeutic context.     

The Milan Approach,History, and Evolution

The two authors intend to underline the continuities and discontinuities that organize the Milan Approach, after the splitting from Selvini Palazzoli and Prata; they intend to tell the teachings of Luigi Boscolo and Gianfranco Cecchin from the beginning of training in 1978 till nowadays. After having spoken of some important stages in the work till the death of the two masters, the article underlines two major new aspects. 1. We speak about the corporeal turn: embodied experience as preconceptual know‐how from which concepts are structured. We speak about the connections between bodies and social issues that enact forms of knowledge and understanding. 2. In this period of war, violence, and tyranny, we speak about epistemology and ontology as complementary stances: the need to let others disclose themselves, by allowing them to speak their own terms of engagement. The therapeutic effort is one of deactivating the dangers of one’s own presuppositions and prejudices that limit one’s capacity to describe and make hypothesis. There are social ontologies, communities with strong moral intensity, historical and social realities that need therapists to take position, since they need to take side and be aware of the categories they utilize. Historical and social ontology deals with the continuous change of symptoms in connection to the continuous change of the social panorama in the context we live in. We live by the bodies we are.     

Coronavirus: does its activation of archetypes of evil cause added psychological suffering?

Fear and grief caused by the pandemic have produced a powerful unconscious narrative in the collective psyche that the coronavirus is driven by an innately evil, and possibly divine, force. The resulting archetypal dimension of fear causes an extra layer of psychological suffering in individuals. This paper discusses how and why this narrative was created and why it is so compelling by looking at 1) the myth-making nature of the human psyche, 2) the psychodynamics of fear that drive the narrative, 3) the properties of the coronavirus and the pandemic that activate negative poles of some archetypes, in particular, archetypes of evil, and 4) asking how analytical psychology can help ease psychological suffering caused by these negative narratives, where one possibility is to invoke the transcendent function. The author’s personal experiences as both biochemist and analytical psychologist elucidate how the transcendent function can promote healing.     

Comparing Cognitive Behavioral Therapy and Systemic Therapy for Social Anxiety Disorder: Randomized Controlled Pilot Trial (SOPHO-CBT/ST)

This randomized controlled trial (RCT) aimed to pilot the newly developed manualized and monitored systemic therapy (ST) for social anxiety disorder (SAD), as compared to manualized and monitored cognitive behavioral therapy (CBT). We conducted a prospective multicenter, assessor-blind pilot RCT on 38 outpatients (ICD F40.1; Structured Clinical Interview for DSM (SCID); Liebowitz Social Anxiety Scale, LSAS-SR >30). The primary outcome was level of social anxiety (LSAS-SR) at the end of treatment. A total of 252 persons were screened, and 38 patients were randomized and started therapy (CBT: 20 patients; ST: 18 patients; age: M = 36 years, SD = 14). Within-group, simple-effect intent-to-treat analyses (ITT) showed significant reduction in LSAS-SR (CBT:d = 1.04; ST:d = 1.67), while ITT mixed-design ANOVA demonstrated the advantage of ST (d = 0.81). Per-protocol analyses supported these results. Remission based on reliable change indices also demonstrated significant difference (LSAS-SR: 15% in CBT; 39% in ST;h: 0.550), supported by blind diagnosticians’ ratings of those who completed therapy (SCID; 45% in CBT, 78% in ST,p = .083). No adverse events were reported. CBT and ST both reduced social anxiety, supporting patient improvement with the newly developed ST for SAD; this has yet to be verified in a subsequent confirmatory RCT.     

Changing Me,Changing Us: Relationship Quality and Collective Efficacy as Major Outcomes in Systemic Couple Therapy

We examine the sensitivity to change in the Evaluation of Social Systems (EVOS) scale, which assesses relationship quality and collective efficacy. In Study 1 we conducted a waitlist‐control, short‐term couple therapy RCT study (N = 43 couples) with five systemic therapy sessions treating communication and partnership problems; our intent was to provide high external validity. Construct validity of EVOS was assessed by comparison with additionally applied scales (Family Scales; Outcome Questionnaire, OQ‐45.2). In Study 2, N = 332 individuals completed an experiment with high internal validity in order to verify sensitivity to change in three different social contexts. Results from Study 1 revealed a significant increase in relationship quality in the treatment group directly after treatment, as compared to the control group. Sensitivity to change was slightly better for EVOS than for other measures. While this positive change could not be fully sustained between posttreatment and a 4‐week follow‐up, EVOS score did not fall below baseline and pretreatment levels, supporting moderate‐to‐large sensitivity to change. Study 2 supported high sensitivity to change in EVOS for couple relations, family relations, and work‐team relationships. Therefore, EVOS can be used as an outcome measure to monitor the process of systemic interventions focusing on relationship quality and collective efficacy. Due to its sensitivity to change, EVOS can provide evidence for treatment success with regard to relationship aspects.