Treating Adults With Complex Trauma: An Evidence‐Based Case Study

This article presents an overview of complex trauma and a case study describing the evidence‐informed treatment of a 25‐year‐old woman with chronic complex trauma symptoms resulting from childhood sexual, physical, and psychological abuse from a caregiver. Treatment followed a relationship‐based, cognitive behavior therapy model across 3 treatment phases. Significant reductions in trauma and general distress symptoms occurred from pre‐ to posttreatment, although firm conclusions about cause cannot be drawn from case studies. Verbatim vignettes illustrate specific interactions.     

Methodology to select solutions for multiobjective optimization problems: Weighted stress function method

The weighted stress function method is proposed here as a new way of identifying the best solution from a set of nondominated solutions according to the decision maker's preferences, expressed in terms of weights. The method was tested using several benchmark problems from the literature, and the results obtained were compared with those of other methods, namely, the reference point evolutionary multiobjective optimization (EMO), the weighted Tchebycheff metric, and a goal programming method. The weighted stress function method can be seen to exhibit a more direct correspondence between the weights set by the decision maker and the final solutions obtained than the other methods tested.     

Theological Education: A Theological Framework for Renewed Mission and Models

Abstract : This essay explores renewed ways to reimagine theological education. Incarnation is used as a theological lens that engages anew “the transmission of Christian memory, the education for God's peace and justice, and the formation of church and community leadership.” Attention is given to apprenticeship, project‐based learning, distributed learning, and global learning, and concludes with implications for governance and faculty.     

Developing an outcome-based assessment for family therapy training: the Rochester Objective Structured Clinical Evaluation (ROSCE)

This paper addresses a growing need for cost-effective, outcome-based assessment in family therapy training. We describe the ROSCE, a structured, evidence-informed, learner-centered approach to the assessment of clinical skills developed at the University of Rochester Medical Center. The ROSCE emphasizes direct observation of trainees demonstrating clinical competencies. The format integrates both formative and summative assessment methods. It can readily be adapted to a wide variety of educational and training settings.     

Developing the therapeutic relationship: from 'expert' professional to 'expert' person who stutters

This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the “expert professional” towards a more collaborative relationship that recognises the “expert patient”. It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a ‘cure’ he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted.Educational objectives: The reader will learn about (1) the early history and development of stuttering therapy, (2) the influence of a variety of psychotherapeutic approaches, (3) the relevance of designing therapy to meet the needs of the PWS, and (4) discuss the role of ‘common’ factors in EBP.     

Benchmark‐based strategies in whole number line estimation

In this study, we used verbal protocols to identify whether adults spontaneously apply quartile‐based strategies or whether they need additional external support to use these strategies when solving a 0–1,000 number line estimation (NLE) task. Participants were assigned to one of three conditions based on the number of external benchmarks provided on the number line. In the bounded condition only the origin and endpoint were indicated, the mid‐point condition included an additional external benchmark at 50%, and in the quartile condition three additional external benchmarks at 25%, 50%, and 75% were specified. Firstly, participants in the bounded condition reported to spontaneously apply quartile‐based strategies to calibrate their estimates. Moreover, participants frequently relied on the external benchmarks for creating internal benchmarks at the mid‐point, quartiles, and even octiles of the number line. Secondly, overall estimation accuracy improved as the number of external benchmarks increased, and target numbers close to external benchmarks were estimated more accurately and with less variability. Thirdly, the use of a larger variety in benchmark‐based strategies was positively related to NLE accuracy. In summary, this study provides evidence that the NLE task induces more sophisticated strategy use in participants than initially anticipated.     

Tele‐analysis: the use of media technology in psychotherapy and its impact on the therapeutic relationship

A growing number of approaches in psychotherapy make use of internet‐ and other media‐based interactions. This paper discusses the impact on the therapist‐client relationship of using media technology and gives an overview of the current state of the debate. It is suggested that the technical conditions of internet‐based interactions produce new forms of social relationships that differ significantly from face‐to‐face‐interactions and that unconscious, nonverbal cues get lost. Research on the therapeutic interaction making use of ‘discourse linguistic’ methods is presented. The loss of nonverbal cues has implications for psychotherapy in general and especially for the treatment of patients who have difficulties relying on a secure therapeutic relationship. Emotional security in interactional relationships is transmitted to a much greater extent by nonverbal cues than by verbal content; psychoanalytic methods are specialized to refer to this level of interaction. Two alternative scenarios are discussed based on the psychoanalytic theories of Winnicott and Lacan: the risk of an illusionary, idealized image of the other and the possibility that cyberspace can be used for psychological development as a transitional space.     

Predicting the Emergence of Community Psychology and Community Development in 91 Countries with Brief Case Studies of Chile and Ghana

Using a mixed‐method analysis, we propose and test a framework for predicting the international development of community psychology (CP) and community development (CD) as two examples of applied community‐based research (CBR) disciplines aiming to link local knowledge generation with social change. Multiple regressions on an international sample of 91 countries were used to determine the relative influences of preexisting grassroots activism, population size, social and economic development, and civil liberties on estimates of the current strength of CP and CD based on Internet search and review of training courses and programs, published articles and journals, and professional organizations and conferences in these countries. Our results provide support for the proposed model and suggest that grassroots activism positively accounts for the development of CP and CD, above and beyond the influences of the other predictors. Brief qualitative case‐study analyses of Chile (high CP, low CD) and Ghana (high CD, low CP) explore the limitations of our quantitative model and the importance of considering other historical, sociopolitical, cultural, and geographic factors for explaining the development of CP, CD, and other applied community studies.     

Transforming Social Regularities in a Multicomponent Community‐Based Intervention: A Case Study of Professionals’ Adaptability to Better Support Parents to Meet Their Children's Needs

This paper presents an in‐depth case study of the dynamic processes of mutual adjustment that occurred between two professional teams participating in a multicomponent community‐based intervention (CBI). Drawing on the concept of social regularities, we focus on patterns of social interaction within and across the two microsystems involved in delivering the intervention. Two research strategies, narrative analysis and structural network analysis, were used to reveal the social regularities linking the two microsystems. Results document strategies and actions undertaken by the professionals responsible for the intervention to modify intersetting social regularities to deal with a problem situation that arose during the course of one intervention cycle. The results illustrate how key social regularities were modified in order to resolve the problem situation and allow the intervention to continue to function smoothly. We propose that these changes represent a transition to a new state of the ecological intervention system. This transformation appeared to be the result of certain key intervening mechanisms: changing key role relationships, boundary spanning, and synergy. The transformation also appeared to be linked to positive setting‐level and individual‐level outcomes: confidence of key team members, joint planning, decision‐making and intervention activities, and the achievement of desired intervention objectives.     

Ensuring Community Participation During Program Planning: Lessons Learned During the Development of a HIV/STI Program for Young Sexual and Gender Minorities

HIV/STI incidence has shifted to a younger demographic, comprised disproportionately of gay and bisexual men, transgender women, and people of color. Recognizing the importance of community organizing and participatory engagement during the intervention planning process, we describe the steps taken to engage diverse constituents (e.g., youth and practitioners) during the development of a structural‐level HIV/STI prevention and care initiative for young sexual and gender minorities in Southeast Michigan. Our multi‐sector coalition (MFierce; Michigan Forward in Enhancing Research and Community Equity) utilized a series of community dialogues to identify, refine, and select programmatic strategies with the greatest potential. Evaluation data (N = 173) from the community dialogues highlighted constituents’ overall satisfaction with our elicitation process. Using a case study format, we describe our community dialogue approach, illustrate how these dialogues strengthened our program development, and provide recommendations that may be used in future community‐based program planning efforts.