Collaborative helping maps: a tool to guide thinking and action in family-centered services

This article highlights "disciplined improvisation" as a metaphor for community-based work with multi-stressed families. It introduces Collaborative Helping maps as a tool that both helps workers think their way through complex situations with families and provides a structure to support constructive conversations between workers and families about challenging situations. The article illustrates this map through a clinical vignette and uses interviews with workers to highlight ways in which the map can both enhance worker thinking and support constructive conversations between workers and families about problems that could easily divide them and lead to polarization and escalating tension.     

Developing an outcome-based assessment for family therapy training: the Rochester Objective Structured Clinical Evaluation (ROSCE)

This paper addresses a growing need for cost-effective, outcome-based assessment in family therapy training. We describe the ROSCE, a structured, evidence-informed, learner-centered approach to the assessment of clinical skills developed at the University of Rochester Medical Center. The ROSCE emphasizes direct observation of trainees demonstrating clinical competencies. The format integrates both formative and summative assessment methods. It can readily be adapted to a wide variety of educational and training settings.     

African American cultural history and reflections on Jung in the African Diaspora

Racism is defined as a psychopathology and the ground in which the covenant of whiteness is rooted and mirrored in the system of apartheid structured by American Constitutional Jurisprudence between 1857 and 1954. This historical period overshadowed Carl Jung's visit to America between 1909 and 1937. The spirit of the times and practices of racism coloured Jung's views, attitudes, and theories about African Americans, just as colonialism coloured his attitudes toward Africa and Africans. Consequently Jung failed to see the African Diaspora and the extraordinary intellectual and artistic period of the Harlem Renaissance (1919‐1929). Its introduction here foregrounds the exceptionalism of African Americans and the cultural continuity of African ancestry. This exceptionalism was not seen by Jung and there have been no attempts to redress its omission from analytical psychology and other sub‐disciplines of Western psychology. Jung's theories of personality and psychoanalysis and his negative projections about primitivism among Africans and African American ‘Negroes’ would have been mediated by knowledge of a legislated American apartheid and the Harlem Renaissance which occurred within the barriers of apartheid. In this paper I posit that culture, kinship libido, and the African principle of Ubuntu are healing modalities that play a critical role in instinct and the relational ground of human psychology and biology, from which culture as an environmental expression constellates around common goals of the human species. Cultural equivalencies and expressions within the wisdom traditions and mythologies of the Africa Diaspora are considered. Specifically, the Bantu principle of Ubuntu or ‘humanity’ is identified as the relational ground in African cultures, while the Kemetic‐Egyptian deity Maat, as an archetypal anima figure and the religio‐mythology offer a transcendent position from which to critique the inequities and constitutional jurisprudence that structured American apartheid. Maat is the personification of truth, justice, balance and weighing of the heart in orderly judicial processes. In her we find the alignment of the spirit and matter in the law and judgement. The paper concludes with reflections on pathways toward healing the psychopathology of racism and recommendations to enhance clinical training and practice.     

Evaluation of a Family Systems Intervention for Managing Pediatric Chronic Illness: Mastering Each New Direction (MEND)

Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness.     

El lenguaje autista desde una perspectiva correlacional

Resumen

A pesar del interés reciente por las alteraciones del lenguaje en autismo infantil, es notable la carencia de investigaciones en que se analicen las correlaciones de las variables de lenguaje entre sí y con otra variables comportamentales. En este artículo se realiza tal análisis, correlacionando variables lingüísticas entre sí (L.M.E., complejidad estructural, comprensión, porcentaje de ecos y habla socializada, etc.) y con variables no lingüísticas (cociente global de desarrollo, niveles de imitación, percepción, motricidad, integración óculo-manual y cognitivo y cognitivo-verbal, P.P.O.D.). El análisis de los datos intragrupales permite identificar índices lingüísticos, de interés para guiar la evaluación clínica, porporciona una base para la valoración pronostica y permite situar las alteraciones de lenguaje en un contexto global de anomalías que afectan a la construcción de la conducta intencional, el desarrollo de los códigos simbólicos y las conductas de relación e interacción presimbólica.     

El lenguaje autista desde una perspectiva correlacional

Resumen

A pesar del interés reciente por las alteraciones del lenguaje en autismo infantil, es notable la carencia de investigaciones en que se analicen las correlaciones de las variables de lenguaje entre sí y con otras variables comportamentales. En este artículo se realiza tal análisis, correlacionando variables lingüísticas entre sí (L.M.E., complejidad estructural, comprensión, porcentaje de ecos y habla socializada, etc.) y con variables no lingüísticas (cociente global de desarrollo, niveles de imitación, percepción, motricidad, integración óculo-manual, cognitivo y cognitivo-verbal, P.A.O.D.). El análisis de los datos intragrupales permite identificar índices lingüísticos de interés para guiar la evaluación clínica, proporciona una base para la valoración pronóstica y permite situar las alteraciones de lenguaje en un contexto global de anomalías que afectan a la construcción de la conducta intencional, el desarrollo de los códigos simbólicos y las conductas de relación e interacción presimbólica.     

ICD-11 guidelines for psychotic,mood, anxiety and stress-related disorders in Mexico: Clinical utility and reliability

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mood, anxiety- and stress-related disorders in Mexican patients. Method: Adult volunteers exhibiting the selected symptoms were referred from the pre-consultation unit of a public psychiatric hospital to an interview by a pair of clinicians, who subsequently assigned independent diagnoses and evaluated the clinical utility of the diagnostic guidelines as applied to each particular case, on the basis of a scale developed for this purpose. Results: 23 clinicians evaluated 153 patients. Kappa scores were strong for psychotic disorders (.83), moderate for stress-related (.77) and mood disorders (.60) and week for anxiety and fear-related disorders (.43). A high proportion of clinicians considered all diagnostic guidelines to be quite to extremely useful as applied to their patients. Conclusions: ICD-11 guidelines for psychotic, stress-related and mood disorders allow adequate inter-rater consistency among Mexican clinicians, who also considered them as clinical useful tools.     

Prospective Pilot Study of the Mastering Each New Direction Psychosocial Family Systems Program for Pediatric Chronic Illness

Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty‐five families participated in a 21‐session intensive outpatient family systems‐based program for pediatric CI. Within this single arm design, families were measured on five domains of Health‐Related Quality of Life (HRQL) self‐report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre‐, post‐, and 3‐month posteffects in all five domains. The program effects ranged from small to moderate (η² = .07–.64). The largest program effects were seen in the domains of cognitive functioning (η² = .64) and stress (η² = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention.     

Foreign‐Born Therapists: How Acculturation and Supervisors' Multicultural Competence Are Associated With Clinical Self‐Efficacy

The authors examined the associations between acculturation, supervisors' multicultural competence, and clinicians' self‐efficacy in a sample of 153 immigrant therapists currently practicing in the United States. Participants completed a demographic questionnaire and 3 additional questionnaires that examined their levels of acculturation, perceived supervisors' multicultural competence, and clinical self‐efficacy. Results suggested that perceived prejudice, not level of acculturation, was significantly associated with foreign‐born therapists' clinical self‐efficacy. Perceived supervisors' multicultural competence was significantly associated with therapists' clinical self‐efficacy. Recommendations for supervisors working with foreign‐born therapists are provided. Los autores examinaron las asociaciones entre aculturación, competencia multicultural de los supervisores y autoeficacia de los profesionales clínicos en una muestra de 153 terapeutas inmigrantes actualmente en activo en los Estados Unidos. Los participantes completaron un cuestionario demográfico y tres cuestionarios adicionales que examinaron sus niveles de aculturación, la competencia multicultural percibida de sus supervisores y la autoeficacia clínica. Los resultados sugieren que los prejuicios percibidos, no el nivel de aculturación, están asociados de forma significativa con la autoeficacia clínica de los terapeutas nacidos en el extranjero. La competencia multicultural percibida de sus supervisores está asociada significativamente con la autoeficacia clínica de los terapeutas. Se proporcionan recomendaciones para supervisores que trabajan con terapeutas nacidos en el extranjero.     

The Uses of Emotion Maps in Research and Clinical Practice with Families and Couples: Methodological Innovation and Critical Inquiry

We explore how “emotion maps” can be productively used in clinical assessment and clinical practice with families and couples. This graphic participatory method was developed in sociological studies to examine everyday family relationships. Emotion maps enable us to effectively “see” the dynamic experience and emotional repertoires of family life. Through the use of a case example, in this article we illustrate how emotion maps can add to the systemic clinicians’ repertoire of visual methods. For clinicians working with families, couples, and young people, the importance of gaining insight into how lives are lived, at home, cannot be understated. Producing emotion maps can encourage critical personal reflection and expedite change in family practice. Hot spots in the household become visualized, facilitating dialogue on prevailing issues and how these events may be perceived differently by different family members. As emotion maps are not reliant on literacy or language skills they can be equally completed by parents and children alike, enabling children's perspective to be heard. Emotion maps can be used as assessment tools, to demonstrate the process of change within families. Furthermore, emotion maps can be extended to use through technology and hence are well suited particularly to working with young people. We end the article with a wider discussion of the place of emotions and emotion maps within systemic psychotherapy.