Open live supervision in family therapy

This article reviews changes in models of supervision, resulting from technological developments and reflecting a variety of theoretical approaches. The focus is on open live supervision, conducted in the presence of the family. The supervisor and a therapeutic team join the therapist and the family, creating a complex supra-system that opens up several options for therapeutic intervention. Sessions are videotaped, and therapists use recordings for additional supervision and independent study. Therapists may also show recordings to the family as part of the therapeutic process. The advantages and disadvantages of the model are considered, and examples of some of the therapeutic options are described.This model was developed in the course of the author's work teaching and supervising students at the Counseling Department of the School of Education at the Hebrew University of Jerusalem, and supervising a multi-disciplinary team including physicians, psychologists, and social workers engaged in family therapy at the Municipal Psychological Services for Schools in Jerusalem. A shorter version of this article appeared in Hebrew inSihot 5 1991. Appreciation is expressed to Batya Stein for translating the final version of this article from Hebrew. Reprint requests should be addressed to Katrit Ron, Neve Granot 3-B, Jerusalem 93706, Israel.     

新生儿重症监护室中放弃治疗的伦理问题

对于新生儿重症监护室中的一部分危重新生儿,虽然可以借助高新尖的医疗技术挽留他们的性命,但却不能避免其出现影响远期生存质量的后遗症。因此患儿家属和医务人员陷入了是否对这些危重新生儿实施放弃治疗的两难困境。对NICU中放弃治疗的对象、伦理学依据、伦理学意义以及如何实施放弃治疗的问题加以讨论,为NICU医务人员提供有益参考。     

我国恶性肿瘤的治疗现状与对策

尽管我国现在对恶性肿瘤的治疗已取得巨大成绩,但依然存在诸多问题及误区,一是医患双方对肿瘤治疗认识上存在误区;二是应调整肿瘤防治的思路,要努力做到“三早”,由过去的任其发展转变为有效检控;三是充分利用医疗资源避免晚期恶性肿瘤的过度治疗与必要时终止治疗;四是要不断更新观念,坚持个体化治疗,提高患者的生存质量。     

The quantity and quality of marital interaction related to marital satisfaction: A behavioral analysis

An assessment instrument is presented for the evaluation of the quantity and quality of dyadic interaction, as well as for the daily recording of behaviors presented and omitted which influence marital satisfaction. Comparison of data from ten happy couples and from ten couples entering therapy indicated two distinct dysfunctional patterns among distressed couples, with significantly different patterns of time-together and positive/negative ratios differentiating the happy versus therapy groups. Independent behavioral recording for 14 consecutive days significantly increased husband-wife agreement on a traditional adjustment questionnaire without significantly increasing or decreasing the level of satisfaction being assessed. There was no difference between groups as to interspousal agreement on amount of time together. However, the happy couples agreed on daily quality ratings of the 72 15-minute segments significantly more often than did the distressed couples. Couples at the extremes of the happy-distressed continuum reported rewarding and punishing, respectively, in response to the partners presence, regardless of behaviors emitted. Midrange happy couples defined "pleasant" as positive behaviors presented; midrange distressed couples defined "pleasant" as negative behaviors omitted. Theoretical and clinical implications of behavioral analysis of sequential patterns are discussed.     

Spirituality, Gender, and Supervisory Style in Supervision

This study used the following guiding question: Is gender associated with variations in perceptions of supervisory style and the frequency with which spiritual issues are addressed in supervision? Results suggest that spirituality is perceived relevant to numerous aspects of supervision. For example, findings indicate that a relationship exists between two characteristics of supervisory style and the frequency with which spirituality is addressed in supervision. Results also intimate that male therapists viewed male supervisors as addressing spirituality more frequently than female supervisors, and female therapists viewed female supervisors as addressing spirituality more frequently than male supervisors. Overall, these findings highlight the significance of spirituality within the context of supervision and underscore the critical need for attention to gender in the study of spirituality within clinical settings.     

Emotional Processing Theory (EPT) and Exposure Therapy for PTSD

Emotional processing theory developed by E. B. Foa and M. J. Kozak (1986) has informed the conceptualization of anxiety disorders and the development of effective treatments for these disorders, including posttraumatic stress disorder (PTSD). This article presents a summary and update of emotional processing theory as it applies to the treatment of PTSD, data in support of this theory, and clinical examples of how the theory can be used to assist in the treatment of clients with PTSD. Common difficulties confronted during exposure therapy for PTSD, including underengagement and overengagement, are discussed in the context of emotional processing theory and suggestions for how to manage these difficulties are presented.     

Internet-Delivered Exposure-Based Cognitive-Behavioral Therapy for Adolescents With Functional Abdominal Pain or Functional Dyspepsia: A Feasibility Study

Functional abdominal pain (FAP) and functional dyspepsia (FD) are common in adolescents and associated with low quality of life. Exposure-based cognitive-behavioral therapy (CBT) is efficient for adult and adolescent irritable bowel syndrome (IBS), but has never been evaluated for adolescent FAP/FD. The aim of this study was to evaluate the feasibility and potential efficacy of a novel disorder-specific Internet-delivered CBT (Internet-CBT) for adolescents with FAP or FD, using an uncontrolled open pilot including 31 adolescents. The Internet-CBT consisted of 10 weekly online modules, which focused mainly on exposure to abdominal symptoms. Parents received modules to help them reduce unhelpful parental behaviors. Participants reported the treatment to be credible, and an overall satisfaction with the treatment. Data attrition rate was low (7%) and adherence to treatment was acceptable. We saw a significant and large effect on the primary outcome, pain intensity, at posttreatment (d = 1.20, p < .001) that was further improved after 6 months (d = 1.69, p < .001). Participants also made significant and large improvements on gastrointestinal symptoms (d = 0.84, p < .001) and quality of life (d = 0.84, p < .001) that were sustained or further improved at follow-up 6 months after treatment. This study demonstrated that exposure-based Internet-CBT, tailored for adolescents with FAP or FD, is a feasible treatment that potentially improves pain intensity, gastrointestinal symptoms, and quality of life.     

Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety,Depression, or Traumatic Stress:A Meta-Analysis on Long-Term Follow-Ups

Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2 + years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23–1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.     

电信员工职业承诺因素结构的研究

本文在访谈、问卷调查的基础上,采用因素分析、回归分析等方法对电信业员工职业承诺的因素结构及其相关变量、人口统计学变量进行了深入研究。结果表明,电信业员工的职业承诺包括情感承诺、继承承诺、规范承诺、理想承诺四个维度。修订后的量表具有良好的信效度,职业承诺与相关变量间相关显著。     

中国传统的音乐治疗研究

音乐是人心理活动的产物,同时音乐还具有一定的治疗作用。音乐疗法是集心理学、医学、生理学、哲学、音乐、艺术于一体的综合性的新兴学科,作为一门应用科学,逐渐被社会所接受,并日趋成熟。中国有丰富的音乐治疗的思想。特别是五音疗法,反映了传统的“天人合一”思想。五音疗法整合了人与自然、社会的相互作用和影响;体现了对音乐与情绪及脏腑之间的互动关系;突现了音声与人格情志、脏气等的关系。五音疗法匹配了人体的不同脏腑,把五音、五行、五脏、人格配属用于音乐治疗实践。