Infantile defences in parent‐infant psychotherapy: The example of gaze avoidance

Findings from parent‐infant observational research have stimulated the development of intersubjective models of psychotherapeutic action. These models have brought out the infant as an interactive partner with the parent. Conversely, interest in describing the individual psyche of the baby has decreased, especially the unconscious levels of his/her experiences and representations. In parallel, clinicians and researchers have been less prone to apply classical psychoanalytic concepts when describing the internal world of the infant. The author argues that this is inconsistent with the fact that psychoanalytic theory, from its inception, was founded on speculations of the infant's mind. He investigates one such concept from classical theory; the defence. Specifically, he investigates if selective gaze avoidance in young babies may be described as a defence or even a defence mechanism. The investigation links with Selma Fraiberg's discussion of the phenomenon and also with Freud's conception of defence. The author also compares his views on the baby as a subject with those suggested by infant researchers, for example, Stern and Beebe. The discussion is illustrated by vignettes from a psychoanalytic therapy with a 3 month‐old girl and her mother.     

Ethical Considerations for Psychologists Providing Treatment to Arab Americans

Given the recent increase in hate crimes against Arab Americans, there are growing concerns over the mental health needs of Arab Americans and a pressing need for psychologists’ competence in treating this group. Although there are several clinical guidelines for other health care professions, there remains a paucity of information on the ethical issues that may arise for psychologists treating this Arab Americans. This article briefly provides background information on Arab Americans, highlights elements of Arab culture that might influence psychological treatment, discusses ethical issues that might arise when psychologists provide services to Arab Americans, and provides recommendations to address these issues.     

Ethical and Legal Issues Addressing the Use of Mobile Health (mHealth) as an Adjunct to Psychotherapy

mHealth refers to the rapidly evolving use of mobile devices for health care treatment purposes, particularly the use of apps and texting as adjuncts to psychotherapy. Although there is currently an extensive literature on issues related to telehealth, to date little guidance has been developed to help professionals function ethically in the rapidly emerging area of mHealth. This article identifies the major ethical considerations that need attention and proposes several recommendations to address mHealth use as an adjunct to psychotherapy, including the pressing need for relevant American Psychological Association practice guidelines to assist mental health providers in the ethical implementation of mHealth.     

Suggestion,persuasion and work: Psychotherapies in communist Europe

Abstract

This article traces what recent research and primary sources tell us about psychotherapy in Communist Europe, and how it survived both underground and above the surface. In particular, I will elaborate on the psychotherapeutic techniques that were popular across the different countries and language cultures of the Soviet sphere, with a particular focus upon the Cold War period. This article examines the literature on the mixed fortunes of psychoanalysis and group therapies in the region. More specifically, it focuses upon the therapeutic modalities such as work therapy, suggestion and rational therapy, which gained particular popularity in the Communist countries of Central and Eastern Europe. The latter two approaches had striking similarities with parallel developments in behavioural and cognitive therapies in the West. In part, this was because clinicians on both sides of the ‘iron curtain’ drew upon shared European traditions from the late nineteenth and early twentieth centuries. Nevertheless, this article argues that in the Soviet sphere, those promoting these approaches appropriated socialist thought as a source of inspiration and justification, or at the very least, as a convenient political shield.     

A transdiagnostic examination of decreased intolerance of uncertainty and treatment outcome

Intolerance of uncertainty (IU) is characterized by negative beliefs and reactions to uncertainty. IU is present in emotional disorders and may be a mechanism of change in treatment . There are two components of IU, prospective and inhibitory IU, that may be differentially associated with outcome. The current study tested associations between pre- and post-treatment changes in the components of IU, symptoms of anxiety and depression, and treatment outcome in a large diagnostically heterogeneous partial hospital sample. Results suggested that social anxiety disorder was associated with greater pre-treatment prospective and inhibitory IU scores than those without the diagnosis. Results also showed that inhibitory IU predicted change in anxiety and depression symptoms and prospective IU and depression reductions predicted improvements in overall psychological health and psychological inflexibility. Only change in depression predicted improvement in interpersonal relationships throughout treatment. Clinical and theoretical implications of the findings are discussed.     

The Couple's Mutual Identity and Reflexivity: A Systemic-Constructivist Approach to the Integration of Persons and Systems

This paper presents a systemic-constructivist approach to working therapeutically with couples. Therapeutic change is optimal when both the intrapersonal processes of each individual and their unique interpersonal system are synthesized. This approach targets partners' ways of knowing and experiencing themselves in the context of their relationship. The therapist endeavors to engage the aspect of personal identity which each partner derives through his or her participation in the relationship. Emphasis is placed upon (1) The mutual identity that emerges as a result of the couple's intersubjective, dialectical interplay; (2) each partner's ability to engage as participant–observers within their own relationship; and (3) the ability for the couple to utilize their conjoint reflexive faculty in the service of their own change. Change which arises from this combination of personal motivation and collective agency exhibits a self-generated life of its own predicated upon the couple's own expertise rather than that of an external agent.     

Teaching Family Therapy-Centered Integration: Assimilation and Beyond

This article addresses key themes in the teaching of family therapy-centered integration and describes the critical role of assimilative integration. The tenets of assimilative integration provide a framework for introducing students to multiple systemic theories and techniques while allowing them to maintain a secure base in one main theory. This form of integration is compared and contrasted to theoretical eclecticism, which guides students to become securely based in multiple theories through providing a framework for selecting which systemic approach to use when and with whom. Other issues that shape the form, content, and process of integrative training are discussed including the role of institutional culture and clinical needs, the importance of fully incorporating issues of diversity and social oppression, and the relational context within which teaching and learning take place.     

Introduction to the Special Issue on Assimilative Integration

This issue of Journal of Psychotherapy Integration includes a set of articles that explore and apply the concept of assimilative integration. They do so from different theoretical perspectives, including psychodynamic, cognitive–behavioral, family systems, and Yogic/Buddhist, as well as from broad conceptual standpoints. The articles are followed by 3 commentaries that offer an appreciation and critique of assimilative integration and recommendations for its further development.     

Integrating Individual and Family Systems Psychotherapy to Treat Borderline Personality Disorder

This paper focuses on two areas. The first is the framework for psychotherapy integration used by Unified Therapy, a psychotherapy approach that is an integration of psychodynamic, cognitive–behavioral, and family systems therapy. The second is the use of this treatment paradigm in the psychotherapy of adults with borderline personality disorder. The theory posits that continuing and recurrent interpersonal behavior patterns within the patient's family of origin serve as behavioral triggers to typical acting-out behaviors. Therapy is geared toward planning strategies to alter these destructive patterns. A case example is presented to demonstrate the use of the therapy's theories and techniques.