The Relationship Between Client Emotional Expressions, Therapist Interventions, and the Working Alliance: An Exploration of Eight Emotional Expression Events

The relationship between client emotional expression and therapist interventions was studied in two working alliance conditions. An events-focused methodology was used to examine a total of 8 events taken from a variety of therapeutic orientations. Results indicated that, in the presence of a good client–therapist relationship, therapists showed higher levels of empathy and effectively focused on the immediately expressed feelings; in turn, their clients were engaged in exploration of feelings. In poor-relationship dyads, clients expressed negative feelings toward the therapists. Interventions rated as effective by clinical judges were characterized by accurate therapist understanding of clients' emotional expressions and working with strains in the therapeutic relationship. Ineffective interventions were associated with inaccurate assessments of clients' emotional states. Intensive analysis of these sessions led to three distinct models of in-session emotional expression events. Theoretical and practical implications of these models will be discussed.     

Association of prenatal attachment and early childhood emotional,behavioral, and developmental characteristics: A longitudinal study

This study examines the associations between prenatal attachment and child development, socioemotional behavioral problems, and competence at early childhood. It also inquires whether maternal depression and anxiety at the prenatal period and at early childhood are associated with child outcomes. The study consisted of 83 mothers and their children. Data regarding the prenatal attachment, depression, and anxiety were collected during Weeks 28 to 40 of gestation. When the children were 21 to 31 months old, the Brief Infant and Toddler Social Emotional Assessment (BITSEA) and the Ankara Developmental Screening Inventory (ADSI) were applied to children along with Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) administered to mothers. Results showed that prenatal attachment scores significantly correlated with BITSEA-Competency subscale scores and ADSI total scores at early childhood, r(83) = 0.246, P = .025, and r(82) = 0.316, P = .004, respectively. Prenatal attachment levels were found to be the predictors of both behavioral and emotional competence and development at early childhood, b = 0.081, t(83) = 2.273, P = .014, and b = 0.281, t(83) = 3.225, P = .002, respectively. In addition, prenatal attachment was shown to be even a stronger predictor of development than was worsening maternal depression at early childhood, b = −0.319, t(83) = 2.140, P = .035. Our results indicate that fostering prenatal attachment may be beneficial for better infant outcomes at early childhood.     

Examining the initial usability,acceptability and feasibility of a digital mental health intervention for college students in India

Generalised anxiety disorder (GAD) is prevalent among college students in India; however, barriers like stigma, treatment accessibility and cost prevent engagement in treatment. Web- and mobile-based, or digital, mental health interventions have been proposed as a potential solution to increasing treatment access. With the ultimate goal of developing an engaging digital mental health intervention for university students in India, the current study sought to understand students' reactions to a culturally and digitally adapted evidence-based cognitive behavioural therapy (CBT) for GAD intervention. Specifically, through theatre testing and focus groups with a non-clinical sample of 15 college students in India, the present study examined initial usability, acceptability and feasibility of the “Mana Maali Digital Anxiety Program.” Secondary objectives comprised identifying students' perceived barriers to using the program and eliciting recommendations. Results indicated high usability, with the average usability rating ranking in the top 10% of general usability scores. Participants offered actionable changes to improve usability and perceived acceptability among peers struggling with mental health issues. Findings highlight the benefits of offering digital resources that circumvent barriers associated with accessing traditional services. Results build on existing evidence that digital interventions can be a viable means of delivering mental healthcare to large, defined populations.     

Moral imperatives,professional interventions and resilience,and educational action in chaotic situations: the souls of children amidst the horror of war

Drawing from the research on children of war in Bogota, Beirut and Bosnia, this paper serves as a framework for dialogue about the criminalization of children by armed conflict and other forms of violence. Furthermore, it addresses the aching question of how best to care for these children so that they have every chance to become illuminated and not carbonized (Restrepo, 1999 Restrepo, L. 1999. La novia oscura [The dark bride], New York: HarperCollins.  [Google Scholar], p. 209) by the tragic circumstances of their environments. The author posits that educators everywhere bear a moral imperative to provide opportunities for children to reclaim hope, reintegrate socially, learn well, reflect deeply, and act justly. Specifically, this essay reflects on varied approaches aimed at fostering resilience, as well as cognitive and moral growth and development in children who are witness and/or victims of social, political, and violent struggles.     

The Perceptions of Lutheran Pastors Toward Prenatal Genetic Counseling and Pastoral Care

The purpose of this study is to explore a theological perspective toward genetic counseling. A survey was sent to 207 ministers within the Evangelical Lutheran Church of America (ELCA), to determine their perspectives toward four different scenarios in a prenatal genetic counseling setting. The four different scenarios included situations involving Huntington disease, Down syndrome, trisomy 18, and anencephaly. Nearly all ELCA Lutheran pastors perceived genetic counseling as beneficial and useful and wanted to be involved in the decision-making process for whether or not to terminate the pregnancy. Their views toward termination of pregnancy varied depending on the severity of the genetic abnormality. Severity in this study was based upon life compatibility. As the severity of the genetic abnormality increased, the percentage of Lutheran pastors who viewed termination as an option increased from 23% (Down syndrome) to 62% (anencephaly). A better understanding of how spiritual leaders view genetic counseling would provide an insight into how genetics and religious beliefs together play a significant role in shaping the decisions of those faced with abnormal pregnancies.     

Antenatal Genetic Testing and the Right to Remain in Ignorance

As knowledge increases about the human genome,prenatal genetic testing will become cheaper,safer and more comprehensive. It is likelythat there will be a great deal of support formaking prenatal testing for a wide range ofgenetic disorders a routine part of antenatalcare. Such routine testing is necessarilycoercive in nature and does not involve thesame standard of consent as is required inother health care settings. This paper askswhether this level of coercion is ethicallyjustifiable in this case, or whether pregnantwomen have a right to remain in ignorance ofthe genetic make-up of the fetus they arecarrying. While information gained by genetictesting may be useful for pregnant women whenmaking decisions about their pregnancy, it doesnot prevent harm to future children. It isargued that as this kind of testing providesinformation in the interests of the pregnantwomen and not in the interests of any futurechild, the same standards of consent that arenormally required for genetic testing should berequired in this instance.     

产前超声检查的相关伦理学思考

超声检查是产前诊断的一项主要检查技术,应坚持将患者的利益放在首位的原则,并且在检查前充分告知孕妇超声检查的安全性及局限性。对知情同意、人工流产及性别鉴定等伦理问题进行了分析。医生应告知孕妇胎儿的异常情况。以便其做出决定。