Rethinking a Familiar Model: Psychotherapy and the Mental Health of Refugees

This paper examines with a somewhat critical eye the primary role that psychotherapy and other clinic-based services currently play in addressing the mental health needs of political refugees in the industrialized countries. Two factors are considered which suggest that refugee mental health needs might be better served by complementing clinic-based treatments with a variety of community-based interventions. The first factor concerns the pervasiveness of psychological distress within refugee communities, coupled with the reluctance of many refugees to utilize formal psychological and psychiatric services. This calls into question both the adequacy and appropriateness of clinical-based services as cornerstones of our response to the mental health needs of refugees. More precisely, it suggests the need to complement such services with a variety of culturally grounded, community-based strategies that do not require attendance in formal mental health settings. Second, recent findings have shown consistently that a considerable amount of the distress reported by refugees is related not to prior exposure to violent events, but to a constellation of exile-related stressors such as the loss of one's community and social network, the loss of important life projects, changes in socioeconomic status and related concerns about economic survival, the loss of meaningful structure and activity in daily life, and the loss of meaningful social roles. It is suggested that while psychotherapy can play an important adjunctive role in helping people confront these exile-related stressors, they may most effectively be addressed through targeted community-based interventions. Examples of such community-based approaches are briefly described, and suggestions are offered for community-level strategies that might be explored. The paper concludes by emphasizing the complementary nature of clinical and community-based programs, and by suggesting that psychotherapy might best be conceptualized as one component of a more comprehensive approach to addressing the mental health needs of refugee communities.     

Is analytical psychology a religion? In statu nascendi

This paper elucidates and discusses Jung's conceptions of the relation between psychology, psychotherapy and religion.     

Infants’ coding of location in continuous space

The ability to code location in continuous space is fundamental to spatial behavior. Existing evidence indicates a robust ability for such coding by 12 months, but systematic evidence on earlier origins is lacking. A series of studies investigated 5-month-olds’ ability to code the location of an object hidden in a sandbox, using a looking-time paradigm. In Experiment 1, after familiarization with a hiding-and-finding sequence at one location, infants looked longer at an object being disclosed from a location 12 inches (30 cm) away than at an object emerging from the hiding location, showing they were able to code location in continuous space. In Experiment 2, infants reacted with greater looking when objects emerged from locations 8 inches (20 cm) away from the hiding location, showing that location coding was more finely grained than could be inferred based on the first study. In Experiment 3, infants were familiarized with an object shown in hiding-and-finding sequences at two different locations. Infants looked longer at objects emerging 12 inches (30 cm) away from the most recent hiding location than to emergence from the other location, showing that infants could code location even when events had previously occurred at each location. In Experiment 4, after familiarization with two objects with different shapes, colors, and sounding characteristics, shown in hiding-and-finding sequences in two locations, infants reacted to location violations as they had in Experiment 3. However, they did not react to object violations, that is, events in which the wrong object emerged from a hiding location. Experiment 5 also found no effect of object violation, even when the infants initially saw the two objects side by side. Spatiotemporal characteristics may play a more central role in early object individuation than they do later, although further study is required.     

Infant responses to adult happy and sad vocal and facial expressions during face-to-face interactions

We examined 5-month-olds’ responses to adult facial versus vocal displays of happy and sad expressions during face-to-face social interactions in three experiments. Infants interacted with adults in either happy-sad-happy or happy-happy-happy sequences. Across experiments, either facial expressions were present while presence/absence of vocal expressions was manipulated or visual access to facial expressions was blocked but vocal expressions were present throughout. Both visual attention and infant affect were recorded. Although infants looked more when vocal expressions were present, they smiled significantly more to happy than to sad facial expressions regardless of presence or absence of the voice. In contrast, infants showed no evidence of differential responding to voices when faces were obscured; their smiling and visual attention simply declined over time. These results extend findings from non-social contexts to social interactions and also indicate that infants may require facial expressions to be present to discriminate among adult vocal expressions of affect.     

Energy psychology and psychotherapy: A study of the use of energy psychology in psychotherapy practice

Aim: The aim of the study was to increase understanding of how energy psychology informs and affects counselling/psychotherapy practice. By undertaking phenomenological interviews with experienced clinicians, the aim was to enrich and expand on the scientific approaches to energy psychology research. Method: This research is based on in‐depth semi‐structured interviews using interpretative phenomenological analysis (IPA). Five experienced psychotherapists who are also practitioners of energy psychology were interviewed. Findings: Four main themes emerged from the analysis: energy psychology as a potent intervention that facilitates shifts in emotions, cognitions, behaviours and physiology; the safety of energy psychology techniques; the role of the therapeutic relationship when using energy psychology techniques; and the challenges of integrating energy psychology into the work context, highlighting the need for more complex, systemic models to understand how people experience distress and how change is facilitated. Conclusion: Overall, participants in this study found energy psychology to be a valuable supplement to counselling and psychotherapy. The implications for current practice are discussed.     

Attitudes about psychotherapy: A qualitative study of introductory psychology students who have never been in psychotherapy and the influence of attachment style

Design: Interviews about attitudes about psychotherapy with 12 undergraduate students who had never been in psychotherapy were analysed using consensual qualitative research. Results: Participants believed that the client role is to disclose, be receptive, and be motivated; that the therapist role is to listen, support, and give advice; and that the therapeutic relationship should be close and personal. Participants had ideas about the benefits (a healing therapeutic relationship, personal and interpersonal changes) and the barriers (self‐stigma and public stigma, difficulty revealing, need to solve problems on own, cost) associated with seeking therapy, and they disliked the idea of being diagnosed. In contrast with participants who were securely attached, those who were insecurely attached more often wanted a professional therapeutic relationship, wanted the therapist to ask questions, mentioned fewer benefits to therapy, and thought that they would have difficulty disclosing to a therapist. Discussion: Implications for changing attitudes about psychotherapy and improving training programs for practitioners are discussed.     

Effects of Dohsa‐hou relaxation on body awareness and psychological distress1

Relaxation is one of the most frequently used methods for treating psychological and physical problems. Many relaxation methods are effective treatments for various psychological problems. Body awareness could be an important component of body‐oriented psychological treatment. In this study, a self‐report measure for the assessment of body awareness was developed, and its psychometric characteristics and relationships with other psychological constructs were examined. The effect of Dohsa‐hou relaxation was investigated using the developed Body Awareness Scale (BAS). The results showed that the BAS had good internal consistency and test‐retest reliability, and that it was associated with related psychological constructs. Dohsa‐hou relaxation led to increased body awareness and decreased psychological distress. The BAS can be a useful instrument in the field of body‐oriented psychotherapy research and related treatment methods, and increased body awareness has an important role in Dohsa‐hou relaxation therapy.     

Acquisition of social referencing via discrimination training in infants

This experiment investigated social referencing as a form of discriminative learning in which maternal facial expressions signaled the consequences of the infant's behavior in an ambiguous context. Eleven 4- and 5-month-old infants and their mothers participated in a discrimination-training procedure using an ABAB design. Different consequences followed infants' reaching toward an unfamiliar object depending on the particular maternal facial expression. During the training phases, a joyful facial expression signaled positive reinforcement for the infant reaching for an ambiguous object, whereas a fearful expression signaled aversive stimulation for the same response. Baseline and extinction conditions were implemented as controls. Mothers' expressions acquired control over infants' approach behavior for all participants. All participants ceased to show discriminated responding during the extinction phase. The results suggest that 4- and 5-month-old infants can learn social referencing via discrimination training.     

Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy. The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.     

Psychologists' and counsellors' perspectives on prolonged grief disorder and its inclusion in diagnostic manuals

Introduction: In this research, proposed criteria for what has been termed ‘Prolonged Grief Disorder’ (PGD) (more recently termed, ‘Persistent Complex Bereavement‐Related Disorder’ (PCB‐RD) in the proposed DSM‐V), were presented to psychologists and counsellors. Method: Participants were asked about their views on the ‘disorder’ and whether they considered its inclusion in diagnostic manuals was justified. A total of 185 participants, (147 psychologists, specialist and general, and 38 counsellors) responded to an online survey (part of a larger research project), concerning their attitudes, choices and activities regarding bereavement therapy. In this part of the research, therapists’ perspectives about pathological grief, the recognition of PGD and its inclusion in diagnostic manuals were explored. Fifty‐nine participants took the option of adding written remarks to the survey to expand on their opinions regarding PGD. Results/Conclusions: Tentative support for the inclusion of PGD in diagnostic manuals was given; however many therapists indicated considerable reservations about potential negative repercussions of using such a diagnosis. One‐way between‐groups analysis of variance was undertaken to determine whether participants' opinions varied according to main occupation or specialism; however, no significant difference was found. This research was conducted prior to the latest update to the proposed revision and diagnostic category concerning bereavement in the DSM‐5 of April 2012, but many observations and recommendations concerning PGD made by the therapists participating in this research can be seen to be applicable to PCB‐RD. Implications: The implications of this research for assessing and diagnosing grief, and ways of working with bereaved clients, are discussed.