Diagnoses,Relational Processes and Resourceful Dialogs: Tensions for Families and Family Therapy

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), given its psychiatric focus on mental disorders in individuals, presents families and family therapists with challenges. Despite considerable controversies over its adoption, the DSM‐5 extends a process of standardizing a language for human and relational concerns. No longer a diagnostic language of professionals alone, its use is medicalizing how mental health funders and administrators, as well as clients, respond to human concerns. For family therapists who practice systemically, particularly from poststructuralist and strengths‐based orientations, many tensions can follow when use of the DSM‐5 is expected by mental health administrators and funders, or by clients who present concerns about themselves or a diagnosed family member. In this paper, I explore how such DSM‐5 related tensions might be recognized, navigated, and negotiated in the practice of family therapy with clients, and with administrators and funders.     

Narrative Approaches to Organizational Development: A Case Study of Implementation of Collaborative Helping

Across North America, community agencies and state/provincial jurisdictions are embracing family‐centered approaches to service delivery that are grounded in strength‐based, culturally responsive, accountable partnerships with families. This article details a collaborative consultation process to initiate and sustain organizational change toward this effort. It draws on innovative ideas from narrative theory, organizational development, and implementation science to highlight a three component approach. This approach includes the use of appreciative inquiry focus groups to elicit existing best practices, the provision of clinical training, and ongoing coaching with practice leaders to build on those better moments and develop concrete practice frameworks, and leadership coaching and organizational consultation to develop organizational structures that institutionalize family‐centered practice. While the article uses a principle‐based practice framework, Collaborative Helping, to illustrate this process, the approach is applicable with a variety of clinical frameworks grounded in family‐centered values and principles.     

¿Puede un antropoide generar una oración?

Resumen

Se analizaron más de 19.000 locuciones de varios signos de un chimpancé de corta edad (Nim), en busca de regularidades sintácticas y de semánticas. Las regularidades léxicas se observaron en el caso de las combinaciones de dos signos: determinados signos (por ejemplo, más) tendían a aparecer en una posición concreta. Estas regularidades no podían atribuirse a la memorización o a los hábitos de poslción, lo que hace pensar en una restricción estructural. Esta conclusión, sin embargo, se rechazó al analizar la grabación video, que mostraba cómo la mayoría de las locuciones de Nim se apoyaban en la locución anterior de su maestro, y que Nim interrumpía a sus maestros mucho más que un niño el lenguaje del adulto. Las expresiones de signos de otros antropoides (como muestran las películas) revelaban pautas similares de diálogo no humano.     

La formación de la oración simple: las omisiones sintáctica (S-V-O) en la adquisición del español

Resumen

Presentamos un modelo hipotético sobre el proceso de formación de la oración simple en español. El modelo pretende aar cuenta del desarrollo de la categorización sintáctica y de cómo ésta sustituye paulatinamente a la previa categorización semántico-pragmática de la oración simple. Ello a partir del estudio de los errores ae Omisión cometidos por los niños. La evidencia presentada consiste en el uso productivo del lenguaje de 62 niños de 1,6 a 3,6 años. El registro de verbalizadones comprende el conjunto de las espontáneas más las respuestas de los niños a la Elicitación sistemática de las tres categorías sintácticas estudiadas (S.V.O).     

Collaborative helping maps: a tool to guide thinking and action in family-centered services

This article highlights "disciplined improvisation" as a metaphor for community-based work with multi-stressed families. It introduces Collaborative Helping maps as a tool that both helps workers think their way through complex situations with families and provides a structure to support constructive conversations between workers and families about challenging situations. The article illustrates this map through a clinical vignette and uses interviews with workers to highlight ways in which the map can both enhance worker thinking and support constructive conversations between workers and families about problems that could easily divide them and lead to polarization and escalating tension.     

The Effectiveness of Functional Family Therapy for Adolescent Behavioral and Substance Misuse Problems: A Meta‐Analysis

A systematic review of published and unpublished English language articles identified 14 studies containing 18 comparisons between functional family therapy (FFT) and another condition in the treatment of adolescent disruptive behavior and substance use disorders. In 11 of these comparisons, assignment to conditions was random, while nonrandom assignment occurred in seven studies. For both random and nonrandom comparisons, separate meta‐analyses were conducted for subgroups of studies depending on the type of comparison group used. Data from studies of untreated control groups (CTL), treatment as usual (TAU), and well‐defined alternative treatments (ALTs) were analyzed separately. Effect sizes from these six meta‐analyses were as follows: random assignment FFT versus CTL (k = 3, d = 0.48, p < .01); random assignment FFT versus TAU (k = 3, d = .20, ns); random assignment FFT versus ALT (k = 5, d = .35, p < .05); nonrandom assignment FFT versus CTL (k = 2, d = .90, ns); nonrandom assignment FFT versus TAU (k = 2, d = .08, ns); and nonrandom assignment FFT versus ALT (k = 3, d = .75, p < .001). These results provide support for the effectiveness of FFT compared with untreated controls and well‐defined ALTs, such as cognitive behavior therapy, other models of family therapy, and individual and group therapy for adolescents.     

African American cultural history and reflections on Jung in the African Diaspora

Racism is defined as a psychopathology and the ground in which the covenant of whiteness is rooted and mirrored in the system of apartheid structured by American Constitutional Jurisprudence between 1857 and 1954. This historical period overshadowed Carl Jung's visit to America between 1909 and 1937. The spirit of the times and practices of racism coloured Jung's views, attitudes, and theories about African Americans, just as colonialism coloured his attitudes toward Africa and Africans. Consequently Jung failed to see the African Diaspora and the extraordinary intellectual and artistic period of the Harlem Renaissance (1919‐1929). Its introduction here foregrounds the exceptionalism of African Americans and the cultural continuity of African ancestry. This exceptionalism was not seen by Jung and there have been no attempts to redress its omission from analytical psychology and other sub‐disciplines of Western psychology. Jung's theories of personality and psychoanalysis and his negative projections about primitivism among Africans and African American ‘Negroes’ would have been mediated by knowledge of a legislated American apartheid and the Harlem Renaissance which occurred within the barriers of apartheid. In this paper I posit that culture, kinship libido, and the African principle of Ubuntu are healing modalities that play a critical role in instinct and the relational ground of human psychology and biology, from which culture as an environmental expression constellates around common goals of the human species. Cultural equivalencies and expressions within the wisdom traditions and mythologies of the Africa Diaspora are considered. Specifically, the Bantu principle of Ubuntu or ‘humanity’ is identified as the relational ground in African cultures, while the Kemetic‐Egyptian deity Maat, as an archetypal anima figure and the religio‐mythology offer a transcendent position from which to critique the inequities and constitutional jurisprudence that structured American apartheid. Maat is the personification of truth, justice, balance and weighing of the heart in orderly judicial processes. In her we find the alignment of the spirit and matter in the law and judgement. The paper concludes with reflections on pathways toward healing the psychopathology of racism and recommendations to enhance clinical training and practice.     

Orbital and ventromedial prefrontal cortex functioning in Parkinson's disease: neuropsychological evidence

A recent paper (Zald & Andreotti, 2010) reviewed neuropsychological tasks that assess the function of the orbital and ventromedial portions of the prefrontal cortex (OMPFC). Neuropathological studies have shown that the function of the OMPFC should be preserved in the early stages of Parkinson's disease (PD) but becomes affected in the advanced stages of PD. This pattern has also been suggested by studies that have shown that dopaminergic drugs impair the performance of early PD patients in OMPFC tasks that involve reinforcement learning but enhance the performance of advanced PD patients. Based on these empirical findings, we reviewed the neuropsychological evidence of OMPFC functions in PD patients to test two hypotheses regarding the following: (1) OMPFC functions at different stages of PD; (2) different effects of dopaminergic drugs on OMPFC functions based on PD stage and task demand. We focused our review only on the neuropsychological tasks that were specific and sensitive to the functions of the OMPFC and that were adopted at different stages of PD, such as reversal learning tasks, the Iowa Gambling Task and the affective Theory of Mind task. We found robust empirical evidence that in early PD, OMPFC functions are preserved and dopaminergic drugs result in a detrimental effect when the task involves reinforcement learning. Further studies are needed to verify the status of OMPFC functions in non-demented, advanced PD and to describe the longitudinal course of OMPFC functions in this clinical population.     

El cierre gramatical: Una prueba para la medida de la habilidad morfosintáctica

Resumen

Este estudio fue diseñado para elaborar una prueba psicológica que midiera la habilidad gramatical del niño catalán expuesto a un ambiente castellano-catalán. La hipótesis de trabajo y procedimiento empleados se basaron en el «Grammatic Closure», una de las pruebas del Illinois Test of Psicolinguistic Abilities (ITPA). La muestra experimental constó de 400 niños tomados de la población escolar catalana de edades comprendidas entre 3 y 10 años. El coeficiente de fiabilidad global fue.95 y el coeficiente de fiabilidad para cada edad comprendió valores entre.97 y.48. La validez de la prueba quedó determinada para cada edad mediante la relación entre los resultados específicos y el coeficiente de inteligencia. Los resultados obntenidos indicaron que. el niño adquiría los automatismos básicos de su lengua materna alrededor de los 7 años. Entre los 7 y 10 años, la adquisición de nuevas estructuras gramaticales dependía, aparentemente, del aprendizaje. La lengua utilizada en la escuela resultó también un factor importante. La prueba presentada aquí puede servir de modelo para la elaboración de instrumentos semejantes aplicables a otras comunidades lingüísticas.     

Exploring the Relationship Between Gay Affirmative Practice and Empathy Among Mental Health Professionals

During the last several decades, psychologists have placed emphasis on multicultural competence as an essential aspect of training and practice. However, despite this emphasis, empirical data on the effects of multicultural training and practice are generally limited to variables such as race and ethnicity, with very little research on sexual minorities. However, a framework for understanding competent practice with sexual minorities does exist in the form of the concept of gay affirmative practice (GAP), which has been successfully operationalized by Crisp ( 2006b ). Using the GAP measure and scores of empathy, the authors examined students and practitioners in the helping profession to explore the relationship between empathy and level of gay affirmative work. Findings indicated that levels of empathy predicted overall levels of GAP. The authors discuss the clinical implications of these findings and explore how the findings fit within the literature surrounding empathic understanding. Durante las últimas décadas, los psicólogos han puesto un énfasis especial en la competencia multicultural como un aspecto esencial en la formación y la práctica. Sin embargo, a pesar de este énfasis, los datos empíricos sobre los efectos de la formación multicultural y su práctica están generalmente limitados a variables como raza y etnicidad, con escasas investigaciones realizadas sobre minorías sexuales. Aun así, existe un marco teórico para comprender la práctica competente con minorías sexuales denominado terapia afirmativa gay (GAP, por sus siglas en inglés), que fue operacionalizado con éxito por Crisp ( 2006b ). Usando las medidas GAP y puntuaciones de empatía, los autores examinaron a estudiantes y profesionales del campo de la consejería para explorar la relación entre empatía y el nivel de trabajo afirmativo con la comunidad gay. Los resultados indicaron que los niveles de empatía pronosticaron niveles totales de GAP. Los autores discuten las implicaciones clínicas de estos resultados y exploran cómo estos encajan con la literatura sobre comprensión empática.