Relative effects of reduced weight and increased physical activity on hemoglobin A1c: Suggestions for behavioral treatments

Behavioral treatments for diabetes have often been unsuccessful and may benefit from a better understanding of the relative effects of two common treatment foci – decreased weight and increased volume of physical activity – on blood glucose. Overweight and obese adults (N = 59; M_age = 60 years) with hemoglobin A1c (HbA1c) values consistent with diabetes participated in a 6-month community-based behavioral treatment based on tenets of self-efficacy theory and social cognitive theory. The treatment was associated with significantly increased physical activity, reduced body mass index (BMI), and reduced HbA1c levels (ps < .001). Changes in BMI and physical activity accounted for a significant portion of the variance in change in HbA1c, R² = .13, p = .023. Change in volume of physical activity, β = ?.36, p = .007, but not change in BMI, β = ?.03, p = .792, significantly contributed to the variance in HbA1c change that was accounted for. There was no effect based on the sex of participants. Discussion focused on how findings might impact the efficacy, efficiency, and application of behavioral treatments for diabetes management.     

Gentzen Calculi for the Existence Predicate

We introduce Gentzen calculi for intuitionistic logic extended with an existence predicate. Such a logic was first introduced by Dana Scott, who provided a proof system for it in Hilbert style. We prove that the Gentzen calculus has cut elimination in so far that all cuts can be restricted to very simple ones. Applications of this logic to Skolemization, truth value logics and linear frames are also discussed.     

The Garden of the Heart and Soul: the image,the way,and the meaning

This paper begins with an explanation of the four Chinese characters that represent the project of the Garden of the Heart and Soul. This project was founded to help the psychological development of orphans, as well as to provide psychological relief for the victims of ecological disasters such as earthquakes through the use of Jungian psychology, sandplay therapy, and the psychology of the Heart. Eleven years after its founding, there are 83 work‐stations on mainland China. The authors discuss how the Chinese characters influenced the way they set up their project and the values that guide them. In addition to helping the individuation of the people they work with, their work provides a container for the collective psyche and a connection with the cultural archetypal roots.     

Binding legacies: ancestor,archetype and Other

This article discusses the multicultural interconnection between Jungian analysts’ training and Africanist training candidates. The importance of ancestral lineage and archetypal influences in the clinical setting are explored for better understanding of issues related to the transference and therapeutic interventions. A discussion of racial relations and racism is addressed as a frequently missing element in the psychoanalytical training of future Jungian analysts.     

Psychodynamic Psychotherapy Process Research: A quick ride through what you should know about process (research)

This paper gives an overview of psychoanalytic process research, which brings to light the complexity of psychotherapy sessions. This complexity is so rich that many instruments intended to make the process measurable failed in the past because they initially used a strategy of complexity reduction. This method however did not help to further our understanding of the complexity involved. Three former presidents of the Society for Psychotherapy Research (Stiles, Hill, Elliot 2015) decided to solve the following equivalence paradox: many therapies work successfully though they all follow different theories, produce a heterogeneity of processes and often enough a misfit between what theories maintain to be a good process and their realization in the treatment room. As theories are often compared to maps, a driver would wonder which route to take. But therapists‐as‐drivers go undaunted ‐ and nevertheless achieve their goals together with their patients. Norcross and Wampold (2018) found that good therapists invent new therapies with every new patient. They hypothesize that it is because of conversation. This is in accord with the 3 former presidents’ proposal to return to detailed single case analyses including the micro‐analytic power of conversation analysis of which a few insights are outlined in this article.     

Fidelity Failures in Brief Strategic Family Therapy for Adolescent Drug Abuse: A Clinical Analysis

As evidence‐based family treatments for adolescent substance use and conduct problems gain traction, cutting edge research moves beyond randomized efficacy trials to address questions such as how these treatments work and how best to disseminate them to community settings. A key factor in effective dissemination is treatment fidelity, which refers to implementing an intervention in a manner consistent with an established manual. While most fidelity research is quantitative, this study offers a qualitative clinical analysis of fidelity failures in a large, multisite effectiveness trial of Brief Strategic Family Therapy (BSFT) for adolescent drug abuse, where BSFT developers trained community therapists to administer this intervention in their own agencies. Using case notes and video recordings of therapy sessions, an independent expert panel first rated 103 cases on quantitative fidelity scales grounded in the BSFT manual and the broader structural‐strategic framework that informs BSFT intervention. Because fidelity was generally low, the panel reviewed all cases qualitatively to identify emergent types or categories of fidelity failure. Ten categories of failures emerged, characterized by therapist omissions (e.g., failure to engage key family members, failure to think in threes) and commissions (e.g., off‐model, nonsystemic formulations/interventions). Of these, “failure to think in threes” appeared basic and particularly problematic, reflecting the central place of this idea in structural theory and therapy. Although subject to possible bias, our observations highlight likely stumbling blocks in exporting a complex family treatment like BSFT to community settings. These findings also underscore the importance of treatment fidelity in family therapy research.     

Treatment‐as‐Usual for Couples: Trajectories Before and After Beginning Couple Therapy

Couple therapy has been shown to be a meaningful way to improve couples’ relationships. However, less information is known about couples’ functioning prior to entering treatment in community settings, as well as how their relationship functioning changes from initiating therapy onward. This study examined 87 couples who began community‐based couple therapy during a longitudinal study of couples in the military. The couples were assessed six times over the course of 3 years, including time points before and after starting couple therapy. Using an interrupted‐time series design, we examined trajectories across the start of couple therapy in relationship satisfaction, divorce proneness, and negative communication. The results demonstrated that couples’ relationship satisfaction was declining and both divorce proneness and negative communication were increasing prior to entering couple therapy. After starting couple therapy, couples’ functioning on all three variables leveled off but did not show further change, but previous experience in relationship education moderated these effects. Specifically, those who were assigned to the relationship education program (vs. control) demonstrated greater reductions in divorce proneness and greater increases marital satisfaction after starting therapy; however, they also started more distressed.