Constructing We‐ness: A Communal Coping Intervention for Couples Facing Chronic Illness

Communal coping occurs when relationship partners view a stressful health problem as “ours,” rather than yours or mine, and take collaborative action to deal with it. Although research employing linguistic (we‐talk) and other measures of communal coping demonstrates relevance to a variety of chronic illnesses, the literature offers little about how clinicians can actively promote we‐ness and teamwork to help patients and their partners achieve the health benefits this appears to confer. This paper highlights clinical and supporting scientific features of a narrative intervention designed to foster communal coping by couples in which one partner has a chronic illness. The illustrative illness is diabetes, but with modification the protocol is suitable for other chronic conditions as well. Grounded in systemic and narrative models of problem maintenance and change, the communal coping intervention represents a distillation of research and clinical experience with family consultation over several decades. In contrast to more directive and educational approaches, the intervention consists entirely of questions, with no direct suggestions or instruction about how patients, partners, or couples should change. These questions comprise 8 sequential modules (Coping Challenges, Trajectory and Focus, Illness as External Invader, You as a Couple, Past Teamwork in Overcoming Adversity, Present and Future Teamwork, Obstacles to Teamwork, and Wrap‐Up), described here in manual‐like detail.     

Imaginal action: towards a Jungian conception of enactment,and an extraverted counterpart to active imagination

This theoretical paper considers the fashion in which Jung's psychology radically challenges modern assumptions concerning the nature of subjectivity. With an eye for the clinical implications of Jung's late work, the author introduces the idea of imaginal action. In order to explain what is meant by this, the paper begins by exploring how Jung's thinking demonstrates an underlying bias towards introversion. It is argued that while Jung's interest in synchronicity ultimately resulted in his developing a worldview that might address the introverted biases of his psychology, the clinical implications of this shift have not been sufficiently clarified. With reference to some short examples from experience, the author outlines a conception of relational synchronicity wherein the intrapsychic emerges non‐projectively within the interpersonal field itself. Comparing and contrasting these occurrences to the more introverted practice of active imagination, it is claimed that such a notion is implicit in Jung's work and is needed as a corrective to his emphasis on interiority. The author suggests that imaginal action might be conceived as a distinctly Jungian approach to the psychoanalytic notion of enactment. It is also shown how the idea outlined might find further support from recent developments in the field of transpersonal psychology.     

The ethical dimension of analytical psychology

The centrality of the ethical dimension in Carl Gustav Jung's analytical psychology is demonstrated through careful reference to fundamental moments in the Jungian text. Tracking Jung's statements about the primacy of the ‘moral function’ (or ‘moral factor’) in the cure of neurosis as well as in the process of individuation, the ethical nature of the psychotherapeutic praxis proposed by Jung is highlighted. This allows us to see the ethical aspect of psychological conflicts, and thus to understand better why individuation can be seen as a ‘moral achievement’. Finally, the intelligible ethical structure of Jungian psychotherapeutic praxis is exposed.     

PARENTAL CHILDHOOD ADVERSITY,DEPRESSIVE SYMPTOMS,AND PARENTING QUALITY: EFFECTS ON TODDLER SELF‐REGULATION IN CHILD WELFARE SERVICES INVOLVED FAMILIES

Parents who are involved with child welfare services (CWSI) often have a history of childhood adversity and depressive symptoms. Both affect parenting quality, which in turn influences child adaptive functioning. We tested a model of the relations between parental depression and child regulatory outcomes first proposed by K. Lyons‐Ruth, R. Wolfe, A. Lyubchik, and R. Steingard (2002). We hypothesized that both parental depression and parenting quality mediate the effects of parental early adversity on offspring regulatory outcomes. Participants were 123 CWSI parents and their toddlers assessed three times over a period of 6 months. At Time 1, parents reported on their childhood adversity and current depressive symptoms. At Time 2, parents’ sensitivity to their child's distress and nondistress cues was rated from a videotaped teaching task. At Time 3, observers rated children's emotional regulation, orientation/engagement, and secure base behavior. The results of a path model partly supported the hypotheses. Parent childhood adversity was associated with current depressive symptoms, which in turn related to parent sensitivity to child distress, but not nondistress. Sensitivity to distress also predicted secure base behavior. Depression directly predicted orientation/engagement, also predicted by sensitivity to nondistress. Sensitivity to distress predicted emotion regulation and orientation/engagement. Results are discussed in terms of intervention approaches for CWSI families.     

Identifying and Treating Race‐Based Trauma in Counseling

This study investigated 106 counseling professionals’ experiences with identifying and treating race‐based trauma and the relationship between training and treatment. Competency was assessed with the Race‐Based Trauma Survey for Counselors. Although most participants reported working with clients who had symptoms associated with race‐based trauma, many had not received training in identifying and treating race‐based trauma among individuals of color. This finding highlights the disparities between health care and the provision of related services. Recommendations for counseling professionals and researchers are included. Este estudio investigó las experiencias de 106 profesionales en consejería con la identificación y el tratamiento de traumas basados en la raza, así como la relación entre la capacitación y el tratamiento. La competencia se evaluó usando la Encuesta para Consejeros sobre Traumas Basados en la Raza. A pesar de que la mayoría de participantes informó que había trabajado con clientes que tenían síntomas asociados con traumas basados en la raza, muchos no habían recibido capacitación para identificar y tratar traumas basados en la raza en personas de color. Este hallazgo resalta las disparidades entre la atención sanitaria y la provisión de servicios relacionados. Se incluyen recomendaciones para profesionales en consejería e investigadores.     

Communication of Information about Genetic Risks: Putting Families at the Center

Genetic information is a family affair. With the expansion of genomic technologies, many new causal genes and variants have been established and the potential for molecular diagnoses increased, with implications not only for patients but also their relatives. The need for genetic counseling and intrafamilial circulation of information on genetic risks grew accordingly. Also, the amount and, particularly, the complexity of the information to convey multiplied. Sharing information about genetic risks with family members, however, has never been an easy matter and often becomes a source of personal and familial conflicts and distress. Ethical requisites generally prevent healthcare professionals from directly contacting their consultands' relatives (affected or still at risk), who often feel unsupported throughout that process. We discuss here the communication of genetic risks to family members. We first consider genomic testing as a basis for family‐centered health care, as opposed to a predominant focus on the individual. We reviewed the literature on sharing genetic risk information with family members, and the associated ethical issues for professionals. Some clinical cases are presented and discussed, and key issues for meeting the needs of individuals and families are addressed. We argue that genetic information is inextricably linked to the family and that communicating about genetic risks is a process grounded within the broader milieu of family relationships and functioning. We conclude for the need for a more family‐centered approach and interventions that can promote sensitive attitudes to the provision of genetic information to and within the family, as well as its inclusion in educational and training programmes for genetic healthcare professionals.     

Empirically distinguishing interpersonal styles within romantic relationships: What is helpful or harmful when having a goal for your romantic partner?

IntroductionRelationship research rooted in self-determination theory often focuses on autonomy support. However, rarely is this interpersonal style considered alongside other facets of relational behaviours such as directive support and control.ObjectiveThe present study aimed to distinguish the three styles by providing a tool that can simultaneously assess them.MethodA total sample of 710 French Canadians involved in a romantic relationship was used for factor extraction and test of dimensionality as well as reliability. Predictive validity was tested using multiple linear regressions with six outcomes: well-being, relationship quality, closeness, goal progress, cooperation and conflicts.ResultsResults suggested three distinct interpersonal styles, each of which showing a different pattern of prediction with the outcomes. Overall, autonomy support was associated with positive outcomes, whereas control was associated with negative outcomes. As for directive support, the global pattern was between the two others.ConclusionThe present research offers a scale which simultaneously assesses and distinguishes the autonomy-supportive, directive-supportive and controlling styles in a romantic relationship context using three items each. By examining the associations between these three interpersonal styles and various outcomes four months later, this study sheds light on helpful and harmful behaviours in relation to the goals people have for their romantic partner.     

Coparenting and Children's School Readiness: A Mediational Model

We examined the long‐term direct and indirect links between coparenting (conflict, communication, and shared decision‐making) and preschoolers' school readiness (math, literacy, and social skills). The study sample consisted of 5,650 children and their biological mothers and fathers who participated in the Early Childhood Longitudinal Study‐Birth Cohort. Using structural equation modeling and controlling for background characteristics, we found that our conceptual model of the pathways from coparenting to child outcomes is structurally the same for cohabiting and married families. Controlling for a host of background characteristics, we found that coparenting conflict and shared decision‐making were negatively and positively, respectively, linked to children's academic and social skills and co‐parental communication was indirectly linked to academic and social skills through maternal supportiveness. Coparenting conflict was also indirectly linked to children's social skills through maternal depressive symptoms. The overall findings suggest that for both cohabiting and married families, the context of conflicted coparenting may interfere with the development of children's social competencies and academic skills, whereas collaborative coparenting promotes children's school readiness because mothers are more responsive to their children's needs. These findings have implications for programs aimed at promoting positive family processes in cohabiting and married families.     

Understanding autism: how family therapists can support parents of children with autism spectrum disorders

The number of children diagnosed with an Autism Spectrum Disorder has increased dramatically in the last 20 years. Parents of children with autism experience a variety of chronic and acute stressors that can erode marital satisfaction and family functioning. Family therapists are well-suited to help parents stay connected to each other as they create a "new normal." However, family therapists need updated information about autism, and they need to understand how family therapy can help parents of children with autism. Because having a child with autism affects multiple domains of family life, this paper explores how family therapists can utilize an integrative approach with parents, enabling them to flexibly work with the domains of action, meaning, and emotion.