Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

The Partners for Change Outcome Management System: A Both/And System for Collaborative Practice

Systematic client feedback (SCF) is increasingly employed in mental health services worldwide. While research supports its efficacy over treatment as usual, clinicians, especially those who highly value relational practices, may be concerned that routine data collection detracts from clinical process. This article describes one SCF system, the Partners for Change Outcome Management System (PCOMS), along a normative (standardized measurement) to communicative (conversational) continuum, highlighting PCOMS’ origins in everyday clinical practice. The authors contend that PCOMS represents “both/and,” providing a valid signal of client progress while facilitating communicative process particularly prized by family therapists steeped in relational traditions. The article discusses application of PCOMS in systemic practice and describes how it actualizes time‐honored family therapy approaches. The importance of giving voice to individualized client experience is emphasized.     

Attachment Versus Differentiation: The Contemporary Couple Therapy Debate

This paper reviews the current debate between differentiation and attachment in treating couples through exploring the tenets of crucible therapy (Schnarch, 1991) and emotionally focused couple therapy (Johnson, 2004). We provide a review of the two theories—as well as the two “pure form” example models—and explore the debate in light of the integrative movement in couple and family therapy (Lebow, 2014). We also examine points of convergence of the two theories and models, and provide clinicians and researchers with an enhanced understanding of their divergent positions. Both differentiation and attachment are developmental theories that highlight the human experience of balancing individuality and connection in adulthood. The two models converge in terms of metaconcepts that pervade their respective theories and approach. Both models capitalize on the depth and importance of the therapeutic relationship, and provide rich case conceptualization and processes of therapy. However, they substantially differ in terms of how they view the fundamental aspects of adult development, have vastly divergent approaches to how a therapist intervenes in the room, and different ideas of how a healthy couple should function. In light of the deep polarization of the two models, points of integration—particularly between the broader theories of attachment and differentiation—are offered for therapists to consider.     

Attachment Style Differences and Depression in African American and European American College Women: Normative Adaptations?

This study examined ethnic differences in attachment styles and depression among African American and European American college women. African American women reported less favorable views of others, which suggests that attachment styles emphasizing caution in relationships may be normative and adaptive for these women. There were no differences between groups in views of self or reports of depressive symptoms. Implications for long‐term relationships and counseling are discussed. Este estudio examinó las diferencias étnicas en estilos de apego y depresión entre estudiantes universitarias Afroamericanas y Euroamericanas. Las mujeres Afroamericanas expresaron una visión menos favorable sobre los demás, lo que sugiere que los estilos de apego que enfatizan la precaución en las relaciones pueden ser normativos para estas mujeres, y el resultado de su adaptación. No hubo diferencias entre los grupos en cuanto a la visión de sí mismas o expresión de síntomas depresivos. Se discuten las implicaciones para las relaciones a largo plazo y la consejería.     

Somali Women's Reflections on the Adjustment of Their Children in the United States

Somali women were interviewed regarding their children's adjustment. Qualitative analysis revealed 5 themes: cultural comparisons, concerns about children, parents' loss of disciplinary authority, available support, and the future. The women discussed changes in their children, such as loss of respect and threats to use law enforcement against parents. They also discussed their loss of parental authority and the lack of support from U.S. institutions. Implications for schools and mental health professionals are presented. Se entrevistó a mujeres Somalíes con respecto a la adaptación de sus hijos. Los análisis cualitativos revelaron 5 temas: comparaciones culturales, preocupaciones sobre los niños, la pérdida de autoridad disciplinaria de los padres, apoyo disponible y el futuro. Las mujeres hablaron sobre los cambios en sus hijos, como la pérdida de respeto y las amenazas de usar las fuerzas del orden contra sus padres. También hablaron de la pérdida de su autoridad paterna y la falta de apoyo por parte de las instituciones de los Estados Unidos. Se presentan las implicaciones para escuelas y profesionales de la salud mental.     

Those Easily Forgotten: The Impact of Emigration on Those Left Behind

Much has been written about the experiences and stresses of those who emigrate. By contrast, little attention has been paid to the experiences of those who stay behind—family members and friends who for various reasons do not to join their loved ones in the destination country. In this article, I describe the experiences of some South Africans whose families and friends have emigrated. This study forms part of a larger research project focusing on the impact of emigration on South African family life. Twenty‐one participants were interviewed by means of a semistructured interview at least 6 months after one or more family member(s) and/or friend(s) left South Africa, to explore participants’ experiences around their loved ones’ emigration. A thematic analysis of the data reveals that those left behind experience various emotions, ranging from emotional ambivalence to anger and distress. Emigration is mostly experienced as a vast loss, almost akin to a “death,” bringing about significant changes in social networks and relationships. The therapeutic significance of the findings for those working with emigrant families is also explored.     

Confort des élèves et performance du bâtiment scolaire

Schools today are designed above all as educational tools and do not always take sufficient account of the physical parameters that are nevertheless environmental factors that have an impact on the capacity to read and concentrate. The aim of our study is to compare the comfort perceived by children in two schools, one with traditional design, the other with a modern design. Two types of tool were used: (a) an analytical study of the plans of the two schools, and (b) a survey using questionnaires completed by 232 elementary school children (8-10 years old). We discuss the results showing that the children in the school with a modern design had higher scores on the “Disturbance” dimension, and on “Privacy”.     

Apprendre à résoudre des problèmes en favorisant la construction d’une représentation alternative chez des élèves scolarisés en éducation prioritaire

In arithmetic problems solving, the representation of the problem spontaneously induced by the content of the statement is not always compatible with the solving strategy. This study evaluates a learning approach designed to lead pupils to build an alternative representation to the one spontaneously induced. In this paper, we evaluate the efficiency of this learning approach with children with learning difficulties enrolled in a priority education network. This learning by semantic recoding is a process based on an analogy between the problems and a comparison of strategies. The results show that after learning, the pupils built alternative representations.     

Problematic,absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys

This study examined English- and Spanish-speaking psychologists’ and psychiatrists’ opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed.