Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

An Ecological Approach to Enhancing Parenting Skills in Family Therapy

To increase the effectiveness of parent education interventions, family therapists can address those factors that shape the way in which parents interact with their children. This article presents ecological theory as a framework that can help clinicians expand the range of their parent training efforts. In order to assess the utility of ecological theory for clinical practice, the present study empirically explored the ways in which selected characteristics of parents, children, and the family context related to mothers' parenting behavior. Specific recommendations for family therapists who employ parent training techniques are offered.     

AUGMENTING SIMPLIFIED HABIT REVERSAL WITH AN AWARENESS ENHANCEMENT DEVICE: PRELIMINARY FINDINGS

The chronic hair pulling of a 36-year-old woman with moderate mental retardation was initially treated with a simplified habit-reversal (SHR) procedure that consisted of awareness training, competing response training, and social support. When SHR did not produce large and sustained reductions in hair pulling, an awareness enhancement device was added, and it reduced hair pulling to near-zero levels in two settings. The results are discussed, and directions for future research with this device are provided.     

Aggression Observation Scale for Group Psychotherapy

An observational scale to record aggressive behaviors, defenses, and interventions that occur during a psychotherapy group has been developed. Content and process items were included. The content items focus on the spoken material and are on a continuum of increasing group members' awareness of and responsibility for their anger. The process items are directed to underlying psychodynamic issues on a continuum from avoiding anger, to indirect and then expression of anger. Leader interventions (responses) are also included. The development of the scale, the Aggression Observation Scale for Group Psychotherapy (AOSGP), is described including pilot testing and reliability and validity findings.     

Developing the matrix representation grid (MRG): A method for observing group processes. Findings from time-limited group psychotherapy for alcohol-dependent patients

The MRG was published 1988 in order to support developments in group psychotherapy methods as one of the all too few process observation research methods for studying group-as-a-whole. After 9 years of what pilot studies have labeled successful clinical trials, this study aims at validating the MRG against the established SAVI: Structural Analysis of Verbal Interaction (Agazarian & Simon 1989). Videotaped group sessions from short-term groups for alcohol dependent patients conducted along two therapy methods, one behaviorally oriented and the other group analytic, are used as material. The MRG is validated in the study, confirmed to be clinically valuable, and some interesting comparisons between the two treatment modalities are also made.     

Structural models of psychotherapy groups and their effect on inpatients with borderline personality disorders: Patients' perceptions

This research compares the way in which various group structural models affect self-understanding, interpersonal relationships and catharsis in hospitalized patients with borderline personality disorders. Each of the models is characterized by a different combination of group focus and leadership style. Three psychotherapy groups were chosen as paradigms: the dynamic psychotherapy group; the therapeutic games group, and psychodrama group. Sixty three inpatients with borderline personality disorders participated in the study. The one-way ANOVA yielded significant differences between the group models. Results of the post-hoc t-test showed that the dynamic and the games groups were perceived by the patients as more beneficial than psychodrama.     

A plea for more intervision

The author presents an argument for tolerance, mutual understanding and reconciliation in psychotherapy, instead of a continued emphasis of schools. Psychotherapists' work with clients is proposed as a likely area for mutual understanding, rather than continued emphasis on their particular theories and academic matters. Psychotherapeutic intervision groups in which a small number of therapists voluntarily discuss their cases with peers from various backgrounds have become increasingly common again in recent years.Slightly revised version of a presentation made at the Georgetown Family Center Symposium in November 1995.     

Practice-based competencies for accreditation of and training in graduate programs in genetic counseling

In January 1996, the American Board of Genetic Counseling (ABGC) adopted 27 practice-based competencies as a standard for assessing the training of graduate students in genetic counseling. These competencies were identified and refined through a collective, narrative process that took place from January through November 1994, and included directors of graduate programs in genetic counseling, ABGC board members and expert consultants. These competencies now form the basis of the document Requirements for Graduate Programs in Genetic Counseling Seeking Accreditation by the American Board of Genetic Counseling (American Board of Genetic Counseling, 1996). The competencies are organized into four domains and are presented and discussed in this article.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January, 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

A case-based approach to the development of practice-based competencies for accreditation of and training in graduate programs in genetic counseling

The American Board of Genetic Counseling (ABGC) sponsored a consensus development conference with participation from directors of graduate programs in genetic counseling, board members, and expert consultants. Using a collective, narrative, and case-based approach, 27 competencies were identified as embedded in the practice of genetic counseling. These competencies were organized into four domains of skills: Communication; Critical Thinking; Interpersonal, Counseling, and Psychosocial Assessment; and Professional Ethics and Values. The adoption of a competency framework for accreditation has a variety of implications for curriculum design and implementation. We report here the process by which a set of practice-based genetic counseling competencies have been derived; and in an accompanying article, the competencies themselves are provided. We also discuss the application of the competencies to graduate program accreditation as well as some of the implications competency-based standards may have for education and the genetic counseling profession. These guidelines may also serve as a basis for the continuing education of practicing genetic counselors and a performance evaluation tool in the workplace.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

TEACHING FOSTER GRANDPARENTS TO TRAIN SEVERELY HANDICAPPED PERSONS

Five foster grandparents were taught training skills for use in their daily interactions with severely handicapped persons in an institution. Following baseline, specific teaching procedures consisting of teacher instructions, prompts, modelling, and praise were implemented. The grandparents' frequency of training three skill areas increased as the specific teaching was implemented in multiple-baseline format. The total amount of training continued as teacher instructions, prompts, and modelling were terminated and praise continued, although the grandparents spent their training time emphasizing only two of the three skill areas. Teacher presence was gradually reduced over an 11-week period, with no decrease in grandparents' frequency of training. Four of the foster grandchildren, all profoundly retarded and multiply handicapped, demonstrated progress throughout the study. Results were discussed in light of the available contributions of foster grandparents in institutional settings and maintenance of staff training.