Couple and Family Treatments: Study Quality and Level of Evidence

This paper examines the application of the guidelines for evidence‐based treatments in family therapy developed by Sexton and collaborators to a set of treatment models. These guidelines classify the models using criteria that take into account the distinctive features of couple and family treatments. A two‐step approach was taken: (1) The quality of each of the studies supporting the treatment models was assessed according to a list of ad hoc core criteria; (2) the level of evidence of each treatment model was determined using the guidelines. To reflect the stages of empirical validation present in the literature, nine models were selected: three models each with high, moderate, and low levels of empirical validation, determined by the number of randomized clinical trials (RCTs). The quality ratings highlighted the strengths and limitations of each of the studies that provided evidence backing the treatment models. The classification by level of evidence indicated that four of the models were level III, “evidence‐based” treatments; one was a level II, “evidence‐informed treatment with promising preliminary evidence‐based results”; and four were level I, “evidence‐informed” treatments. Using the guidelines helped identify treatments that are solid in terms of not only the number of RCTs but also the quality of the evidence supporting the efficacy of a given treatment. From a research perspective, this analysis highlighted areas to be addressed before some models can move up to a higher level of evidence. From a clinical perspective, the guidelines can help identify the models whose studies have produced clinically relevant results.     

Fieldwork Using the Professional Development Schools Model: Developing a Social Justice Orientation and Multicultural Competency

Practicum fieldwork was conducted in an urban high school setting using a Professional Development Schools (PDS) model, with a focus on multicultural and social justice counseling competencies (MSJCC). Interpretative phenomenological analysis was used to analyze the journal responses of 16 counseling students to ascertain MSJCC development during fieldwork. Themes emerged related to multicultural counseling skills, self‐awareness, understanding educational inequities, and serving as agents of change. Implications of using a PDS model in counselor training are explored. Se llevó a cabo un trabajo de campo en práctica clínica en una escuela secundaria usando un modelo de Escuelas de Desarrollo Profesional (PDS, por sus siglas en inglés), con un enfoque en las competencias en consejería multicultural y de justicia social (MSJCC, por sus siglas en inglés). Se empleó un análisis fenomenológico interpretativo para analizar las respuestas registradas de 16 estudiantes de consejería para determinar el desarrollo de las MSJCC durante el trabajo de campo. Surgieron temas relacionados con las habilidades en consejería multicultural, la autoconciencia, la comprensión de desigualdades educativas, y la actuación como agentes de cambio. Se exploran las implicaciones de usar un modelo PDS en la formación de consejeros.     

Factorial structure of the perceived stress scale and implications for scoring

IntroductionThe 10-item Perceived Stress Scale (PSS-10) is a brief, widely-used measure of perceived stressful experiences that evaluates the degree to which people perceive their lives as unpredictable, uncontrollable or overloaded.ObjectiveThe present study examined the factor structure of the Greek version of the PSS-10.MethodUsing a representative sample of 320 adults from Cyprus, alternative confirmatory factor analytic models were compared to specifically assess bidimensional versus unidimensional specifications for the scale.ResultsA bifactor model with a general factor which loads on all items and a specific one which loads on positively-worded items that capture the notion of self-efficacy to deal with stressful situations, was found to fit well to the data, while providing evidence of a robust latent factor of general distress. Reliability and construct validity evidence with multiple criterion variables were also examined.ConclusionsAlthough a simple unidimensional specification has not been empirically supported in previous research, bifactor modeling exemplifies the extent of multidimensionality and implies that a single score may be reliably used for practical purposes.     

Narrative Approaches to Organizational Development: A Case Study of Implementation of Collaborative Helping

Across North America, community agencies and state/provincial jurisdictions are embracing family‐centered approaches to service delivery that are grounded in strength‐based, culturally responsive, accountable partnerships with families. This article details a collaborative consultation process to initiate and sustain organizational change toward this effort. It draws on innovative ideas from narrative theory, organizational development, and implementation science to highlight a three component approach. This approach includes the use of appreciative inquiry focus groups to elicit existing best practices, the provision of clinical training, and ongoing coaching with practice leaders to build on those better moments and develop concrete practice frameworks, and leadership coaching and organizational consultation to develop organizational structures that institutionalize family‐centered practice. While the article uses a principle‐based practice framework, Collaborative Helping, to illustrate this process, the approach is applicable with a variety of clinical frameworks grounded in family‐centered values and principles.     

The use of antibiotics in veterinary medicine: Representations of antibiotics and biosecurity by pig farmers

The heavy reliance on antibiotics in livestock farming has contributed to the development of antimicrobial resistance. To tackle this phenomenon, it is important to know the determinants of their use. Thus, this study investigated the way in which French pig farmers perceive antibiotics and biosecurity depending on their farm's department and ALEA (Animal Level of Exposure to Antimicrobials). A qualitative study was carried out on 87 livestock farms of a French agricultural cooperative specialising in pig production. The results show a social representation of antibiotics organized around the notion of demedication (i.e. the elimination or reduction of reliance on antibiotics). Concerning biosecurity, “large consumers” of antibiotics associate it with the idea of constraints, regulatory standards and temporal distances separating them from this practice.     

Sitting through the emptiness

This article explores clinical encounters with experiences of the ‘empty ego’ which arise from early relational trauma. The ego’s emptiness is held in repetitious complexes and arises out of affectively charged experiences between self and other which remain split-off from awareness. This kind of consciousness is viewed as dualistic, separating non-dual subjectivity from its dualistic objects of consciousness. In contrast, what I am calling healing void states of non-dualistic consciousness, when admitted to awareness, allow the individual to dis-identify from the traumatizing representations of self and other through an experience of non-duality. In contrast to an objectified, dualistic emptiness of the ego, healing void states come about in moments of non-dual, unified consciousness. These states occur in the ego-Self relationship by linking the ego’s dualistic awareness in chronic subject/object splits to ones of non-dual pure consciousness. The healing void state is always incipiently present and potentially able to bridge the ego-Self connection in bogged-down treatment. The paper explores potential integrations with non-dual models of consciousness such as Vedantic and Kashmir Shaivism, among other mystical traditions. A combined Vedantic-Jungian understanding can provide a transcendent bridge that integrates Eastern concepts of non-duality in treating emptiness.     

The technologically-mediated self: reflections on the container and field of telecommunications

This paper contains reflections on the use of the imagination in technologically-mediated therapy and analysis. As part of the individuation process the psyche is seen as needing to adapt to new technological ways of communicating. The notion of a technologically-mediated self is posited describing a self which can only be apprehended through, and by, the use of telecommunications. This self is seen as identical to the in-person self, a subset, or superset of it. There is a revisioning of our notions of the container and the field in this work performed through technological-mediation. The need to engage the imagination in approaching this kind of work is emphasized in order to create an imaginal play-space in which the body will be deeply affected. Some thoughts on how the process of individuation might look through such analytic work is presented.