Dependency and perfectionism: Short-term dynamic group psychotherapy for university students

Abstract

This paper is based on the authors' experiences of conducting short-term psychodynamic group therapy with university students. The therapy groups focus on common problems among the members, i.e. perfectionism, procrastination, and fear of graduation. Working on their dependency and on their inadequate separation from parental figures typically helps the students cope more creatively with their academic problems. The paper explores technical questions and possible advantages in working within a short time frame using a group analytic approach.     

Accidental Communities: Race,Emergency Medicine,and the Problem of PolyHeme®

This article focuses on emergency medical care in black urban populations, suggesting that the classification of a “community” within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between “autonomy” and “community.” The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines a clinical trial for the blood substitute PolyHeme^® (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of “community.” The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment.     

Rethinking Research Ethics

Contemporary research ethics policies started with reflection on the atrocities perpetrated upoconcentration camp inmates by Nazi doctors. Apparently, as a consequence of that experience, the policies that now guide human subject research focus on the protection of human subjects by making informed consent the centerpiece of regulatory attention. I take the choice of context for policy design, the initial prioritization of informed consent, and several associated conceptual missteps, to have set research ethics off in the wrong direction. The aim of this paper is to sort out these confusions and their implications and to offer instead a straightforward framework for considering the ethical conduct of human subject research. In the course of this discussion I clarify different senses of autonomy that have been confounded and present more intelligible justifications for informed consent. I also take issue with several of the now accepted dogmas that govern research ethics. These include: the primacy of informed consent, the protection of the vulnerable, the substitution of beneficence for research's social purpose, and the introduction of an untenable distinction between innovation and research.     

BOOK REVIEWS

No abstract available for this article.     

An Evaluation of the Effects of Diagnostic Composition on Individual Treatment Outcome Within Transdiagnostic Cognitive–Behavioral Group Therapy for Anxiety

Recently, studies have supported the efficacy of treating anxiety disorders utilizing a transdiagnostic, or non-diagnosis-specific, framework (Erickson, D. H. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179–186; Garcia, M. S. (2004). Effectiveness of cognitive-behavioural group therapy in patients with anxiety disorders. Psychology in Spain, 8, 89–97; Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79–97). Transdiagnostic group treatment packages focus on the common aspects inherent across the anxiety disorders such as behavioral and cognitive avoidance, and faulty cognitive appraisals of threat potential or meaning (Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230). Although research supports the overall efficacy of transdiagnostic cognitive behavior therapy (CBT) for anxiety disorders (Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice and Training, 45, 214–226), the effect of diagnostically mixed group composition on individual outcomes is less clear. This study investigated the relationship between group composition and treatment outcome within diagnostically heterogeneous groups with the purpose of determining if diagnostic heterogeneity differentially impacted treatment outcome for 84 individuals during a 12-week transdiagnostic cognitive–behavioral group anxiety treatment program (Norton, P. J. (2012a). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York: Guilford). The diagnostic makeup of the treatment group was examined at the beginning of treatment and at the end of treatment, and the results indicated that the diagnostic makeup of the treatment group had no significant impact on individual treatment outcome. These findings have direct implications for the delivery of transdiagnostic treatments, and are discussed in terms of their global implications for the transdiagnostic approach to the treatment of anxiety disorders.     

具有类属知识性的思维:群体区别判断过程中的复杂性、有效性、有用性和实质性

类属性思维(stereotypes)在一定的程度上是对群体区别正确反映的类属信仰.类属性思维比我们一般假想的更为复杂.首先,我们在本论文中探讨了在立体性的类属性思维EPA理论框架之下的多维度,即类属性思维的三维度:评估、激活和准确度.同时还特别讨论了类属性思维与具体集体共识的表征特点的图腾信仰之间的密切关系.其次,对于作为人类信仰一部分的类属性思维准确性莫衷一是的研究,我们进行了全面综述,并且本文还仔细考查文化类属性思维,个体类属性思维,个体与群体的判断,准确性评判的标准,和原分析的数据等等,同时进一步表明类属性思维和客观现实性有密不可分的关系.最后,我们指出类属性思维对解释群体和民族的区别非常重要,特别是人的感知的实质性寓于实在的客观群体本身(“感知的同一性”).我们认为,类属性思维的过程,对于高度的实体性和感知的实质性的群体来说,具有深刻影响,况且群体或部落(民族)的图腾也是其群体或民族的实体性的外在表现.尽管我们不可能解决同类属性思维的过程有关的所有争论,但我们所强调的观点是:类属性思维是人类相互影响和生存的有效类属性识别.     

Traditional group therapy and computer-administered treatment for test anxiety

Abstract

Traditional group therapy for test anxiety, modelled after Weissberg (1976), was compared with the computer-administered treatment of Thoresen, Insel, Roth, Ross, and Seyler (1986). Both treatments contained cognitive and behavioral elements including systematic desensitization and Jacobsonian relaxation techniques. The participants were 36 test-anxious students seeking treatment within a university counseling center. Effectiveness of each treatment was assessed by studying changes in test anxiety (total, worry, emotionality), as measured by the Test Anxiety Inventory (Spielberger, 1980). and changes in grade point average (GPA). There was a statistically significant reduction in the three test anxiety measures for both treatments. No significant differences in GPA, as a result of the treatment, were found. There was no significant difference in reduction of test anxiety between the treatments. These findings support the efficacy of the computerized treatment which may be a suitable alternative to group therapy and, in some situations, may be the treatment of choice.     

Women Experiencing Psychological Abuse: Are They a Homogenous Group?

Dichotomizing women as “abused” versus “not abused” assumes that any psychological maltreatment results in similar outcomes. A national sample of women in conflictual relationships completed an online survey. Women with no incidence (N = 33), the lowest quartile (N = 86), and the top quartile (N = 81) of psychological maltreatment demonstrated significant differences in reactions to the maltreatment, mental health indicators, personality variables, perceived harm, problematic relationship schemas, and response styles. Women with no psychological abuse and women in the lowest quartile produced similar scores that were typically distinct from the top-quartile women. Effective treatment of women with lower amounts of psychological abuse might not require a unique intervention likely necessary for women experiencing much psychological abuse.     

Consider the Children

Summary

In this article, we consider interventions for children exposed to family violence in light of the research on children's problems associated with witnessing family violence. Next, we review risk and protective factors related to these children's adjustment with the view that all children are not similarly affected by exposure to family violence. Against this background, we then move to consider directions for interventions from a systemic perspective. We take into account not only the exposure to interactions between their mother and father, but also children's relationships with their mother, father, and siblings, as well as within broader systems such as the peer group, the school, and the community. We consider the critical challenges within each of these important systems for children exposed to family violence, and we propose some potential interventions to address the problems. Finally, we summarize an evaluation of an intervention that incorporates some of the elements identified by a systemic perspective. The evaluation revealed a significant improvement in children's self-reports of depression and anxiety over the course of the program. Mothers rated their children as significantly improved in emotional and hyperactive behaviour problems. There was no relation between mothers' involvement in counselling and children's improvement. Overall, the results suggest that the Peer Group Counselling Program effectively provided support to children exposed to family violence. Finally, we discuss the steps necessary to support children and families in moving toward violence-free lives.