Evaluating Genetic Counseling: Client Expectations,Psychological Adjustment and Satisfaction with Service

Periodic evaluations of genetic counseling services are useful for determining the effectiveness of counseling in meetings its psycho-educational aims, as well as identifying where improvements to the service may be made. This study aimed to evaluate the genetic counseling services provided by Genetic Services of Western Australia (GSWA) to determine the impact of counseling on client expectations, satisfaction with the service, and psychological adjustment, defined as wellbeing and perceived personal control (PPC). A total of 122 clients participated in a self-administered survey conducted pre- and post-counseling. Client expectations of the service as a means of providing information were met, and opportunities for counselors to meet client’s expectations of psychological support were identified. Furthermore, counseling was found to maintain and enhance psychological wellbeing of clients. The role of counseling in facilitating the development of PPC was a key contributor to a high sense of satisfaction in clients.     

Effectiveness Research: Transporting Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) From the Lab to School-Based Health Clinics

This paper describes the process of modifying and transporting an evidence-based treatment, Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), from a university setting to school-based health clinics. It addresses conceptual issues involved in the shift from efficacy to effectiveness research as well as operational issues specific to the transport of IPT-A into school-based health clinics. Consideration is given to the rationale for an IPT-A effectiveness study, methodological concerns, and the timing of the move from the lab to the community. The authors identify challenges and barriers to initiating effectiveness and transportability research and provide suggestions for overcoming these barriers. Recommendations for conducting research in school-based practice settings are provided.     

Issues of Power, Control, and Status in Group Interaction: From Ferenczi to Foucault

Examination of the issues of power, control, and status in human interaction is made from the works of Kafka, Ferenczi, and Foucault. Ferenczi's confusion of tongues theory as a model is used to describe the dynamics of charismatic group leadership in training group for analyst group candidates.     

意象活动与自尊水平关系的研究

在当今的许多团体心理辅导和训练中,关于苹果意象的活动常常被用于测量团训参与者的自尊水平。但其科学性一直没有得到实证研究验证。该研究采用了这种意象想象技术,同时用SES量表测量其自尊程度。并通过对测量结果的统计分析,揭示了苹果意象大小与自尊水平之间的关系。     

From I: A/M to “Who am I?”—Aggregation/Massification and Trauma-Based Affects and Object Relations in Groups: A Response to Earl Hopper

Hopper's portrayal of the fourth basic assumption of Incohesion: Aggregation/Massification has two components: (1) a revision of Turquet's theory of BA Oneness to incorporate the polarity of aggregation and massification stemming from annihilation anxiety; and (2) a conception of the difficult patient as having an encapsulated psychosis. Hopper's theory of the encapsulated psychosis offers an important but incomplete perspective in explaining borderline and narcissistic pathology, as well as psychological trauma. In this response to Hopper, I suggest that the fourth assumption is in fact a still more primitive state of boundary opening and closing. I also see a need to differentiate trauma as such from borderline pathology, and further hold that the relationship between Hopper's British Independent theory and trauma theories based on dissociation needs to be clarified.     

Self Psychology, Dreams and Group Psychotherapy: Working in the Playspace

This paper presents one leadership style within a self-psychological approach to working with dreams in group psychotherapy. It stresses an empathic attunement, the creation of safety, and an experience-near playful relationship. Playful is not used lightly here. It is used in the spirit of Winnicott's intermediate space where a mother suspends questions of what is real or not real and what is me and not me. Freud's analogy to a playspace forms a metaphor for the creation of a special atmosphere in a group, or for that matter in individual work as well, that encourages exploration, risk taking, and vulnerability. Working with dreams in this playspace deepens the curative process, not only for the dreamer, but for the entire group.     

The Deep Structure of Group Life: Unconscious Dimensions

There is a reconsideration and renaissance of interest in expanded conceptions of unconscious processes as they affect individuals and groups (Grotstein, 1999). Recent focus on social unconscious (Hopper, 1996) and cultural unconscious processes (Henderson, 1988) and the nature of intersubjectivity (Harwood and Pines, 1998) raise questions about the location of group analysis. This paper considers the deep structure of group life by examining four functions of the unconscious: repressive, conservative, creative, and mythopoetic (Ellenberger, 1970). On an individual level of analysis, these functions are equated respectively with formative ideas about the: personal–subjective, social–political, intersubjective–cultural and collective–objective unconscious. Group level analogs, as they develop and affect groups and their members, are explored as synthetic, shared, symbolicy and synchronous unconscious processes.     

Social Dominance and Social Identity in the United States and Israel: Ingroup Favoritism or Outgroup Derogation?

American and Israeli university students completed questionnaires in their native languages assessing ingroup identification, social dominance orientation (SDO), and ingroup and outgroup affect. The interrelationships among the variables were examined for high- and low-status groups in three intergroup contexts: whites and Latinos in the United States, Ashkenazim and Mizrachim in Israel, and Jews and Arabs in Israel. Theoretical predictions of social identity theory and social dominance theory were tested. Results indicated that for all high- and low-status groups, stronger ingroup identification was associated with more positive ingroup affect, and for nearly all groups, higher SDO was associated with more negative affect toward the low-status group. In addition, SDO was positively associated with ingroup identification for all high-status groups, and negatively associated with ingroup identification for almost all low-status groups. Explanations for cross-cultural differences in the factors driving group affect are suggested, and theoretical refinements are proposed that accommodate them.     

Course of Treatment During a Cohort-Based Inpatient Program for Posttraumatic Stress Disorder

This study examined one group of veterans with post-traumatic stress disorder (PTSD) over the course of a four month inpatient treatment program. The aim of the study was to examine treatment process factors that may contribute to the generally poor outcome reported in previous studies. Group members made weekly ratings in the domains of PTSD symptoms, morale, interpersonal relationships, and physical problems. Results contrasted with clinical assumptions usually made regarding the treatment process in these programs. Despite an appearance of cohesion among group members, variation of scores on functional domains was explained largely by individual differences. Progress through the program showed a strongly linear pattern, with no phase effects. Somatic complaints did not increase during the phase when traumatic material was explored. Degree of improvement or worsening was best predicted by level of PTSD symptoms at admission, indicating that more symptomatic veterans did worse in the program. Additional factors of race, combat exposure, childhood abuse, and application for disability had no effect on the process variables measured.     

Improving staff nutritional practices in community-based group homes: evaluation, training, and management.

We evaluated the effectiveness of a staff training and management package on nutritional practices in two community-based group homes serving adults with developmental disabilities. Food storage, menu development, and meal preparation were trained in a multiple baseline format, followed by supervisor feedback. All staff behaviors increased after training and were maintained for up to 1 year. Biological indices reflected collateral improvements in the health of consumers, and surveys of staff and parents established social validity.