Sailing through social LA GRRAACCEESS: tool for deconstructing and facilitating reflective and reflexive practice

Reflective and reflexive practice has become an integral component of practitioner professional training, particularly within professions associated with psychology and nursing. One way of facilitating reflective and reflexive practice is to integrate sensitivity of social interrelated constructs and social differences in relation to Gender, Race, Religion, Age, Abilities, Class, Culture, Ethnicity, Education, Sexual orientation and Spirituality as outlined in the GRRAACCEESS acronym. Inspired from the eighteen-century sailing vessel replica ‘La Grace’, this paper extends Burnham’s original GRRAACCEESS acronym by adding ‘Language’ and ‘Anatomy’ to form the ‘LA GRRAACCEESS’ model. This paper explores the merits and implications of the LA GRRAACCEESS model in order to assist practitioners with unravelling or deconstructing reflective practice and encourage ongoing mindful reflective practice.     

Where’s the GPS? navigating treatment with co-existing problems. A reflective journey amongst graduate practitioners

This paper examines reflective portfolios of graduate students studying co-existing problems (CEP) within an alcohol and drug studies programme in New Zealand. The methodology employs Todd’s principles of treating co-existing disorders (culture, management, engagement, assessment, integrated care, well-being and management). The metaphor, a GPS, is employed in the title to describe how Todd’s principles are used as a GPS to help navigate the murky waters of working with this specialised client population. The principles, allocated as themes within the portfolios, highlight how these principles are reflected upon within their workplace. Culture and engagement principles were the most endorsed themes within the portfolios. The reflective portfolios also allowed us to reflect upon the ongoing process of curriculum development for this specialised client population.     

Some technical implications of Klein's concept of 'premature ego development'

In this paper, the author revisits the problem of 'premature ego development' first introduced by Melanie Klein in 1930. She also highlights several developments in post-Kleinian thinking since the publication of that paper, which can be seen as offshoots of or complements to Klein's work. The author proposes a link between this category of precocious development and the absence of the experience of what Bion termed the 'containing object.' She puts forward several technical considerations relevant to analytic work with patients who suffer as a result of early developmental failures and presents various clinical vignettes in order to demonstrate the ways in which these considerations take shape in the analytic setting.     

情境模型的实质：命题符号与知觉符号之争

阅读理解中情境模型的建构是当今阅读研究的热点。传统命题符号理论认为情境模型是组相关命题,是非模式符号系统;随着知识表征理论的发展,知觉符号理论认为情境模型的建构包括模式符号系统,即含有知觉符号。文章对比了两种理论对情境模型的不同解释,并介绍了相关的实证研究,最后对未来验证两种理论的研究方向进行了展望。     

双系统模型视角下的罪犯自我控制

自我控制是个体为了达成具有长远利益的目标而有意识控制自身冲动行为的能力。双系统模型提出自我控制系统包含冲动系统与控制系统, 该理论适用于分析罪犯低自我控制的内部结构。罪犯冲动系统中充满极易激活的犯罪相关行为图式, 而控制系统却不足以生成抑制冲动行为的策略。未来可基于双系统模型, 整合已有研究深入考察罪犯自我控制系统的内部运作机制, 以及该模型在罪犯心理矫治中的实际应用, 而犯罪易感青少年群体则需要特别关注。     

道德概念的空间形象性：语言因素和具身因素的共同作用

采用事件相关电位(ERP)技术探讨抽象道德概念的空间形象性效应, 以及语言因素和具身因素对该效应的影响机制及其加工进程。实验1检验词对空间位置对道德词对语义判断(反义程度)所产生的影响, 结果表明不符合空间形象性呈现条件(即道德-下, 不道德-上)诱发了较大的N400, 并且词对语义判断的反应时较长; 实验2检验词对语义的反义程度对道德词对空间形象性判断所产生的影响, 结果表明语义无关词对诱发了较大的N200和N700, 并且词对空间形象性判断的反应时较长。研究结果表明, 抽象道德概念的加工能够表现出空间形象性效应, 该效应由语言因素和具身因素共同塑造, 前者在概念加工过程中优先被激活并发挥持久影响, 后者仅在概念加工的中期发挥作用。     

Attachment & Child Health (ATTACH) pilot trials: Effect of parental reflective function intervention for families affected by toxic stress

Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function—parents’ capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child—may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at-risk mothers and children <36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low-income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi-experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress.     

Thinking with,and about,patients too scared to think: Can non‐interpretive maneuvers stimulate refl ective thought?

Patients incapable of higher-order (symbolic) thinking can often not tolerate evidence of the analyst's separate existence, particularly when that 'otherness' becomes evident in the process of the analyst's refl ecting upon and interpreting how the patient experiences or represents the analyst. The patient's intolerance of the analyst's efforts to think (refl ect upon and interpret) renders the usual psychoanalytic maneuvers employed to stimulate refl ective thought ineffective with such patients. Such patients have to learn to tolerate multiple perspectives before they can allow the analyst, or themselves, to think in the other's presence. The author presents two clinical vignettes that illustrate how the analyst's efforts to think about the patient were experienced by the patient as both intolerably distancing and as rejecting of an aspect of the patient's subjective reality. Working psychoanalytically with such patients requires the analyst to forgo the use of narrow interpretations that elucidate unconscious meanings and motives in favor of alternate technical maneuvers capable of facilitating the development of symbolic thinking and refl ective thought (insightfulness). These maneuvers include a demonstration of the analyst's willingness and ability to withstand (rather than 'interpret away') how he is being psychically represented by the patient, without becoming destroyed by, or lost within, the patient's characterization of him. Beside modeling a tolerance of alternate perspectives of one's self, other non-interpretive maneuvers that help facilitate the development of self-refl ective thought include: stimulating the patient's curiosity about the workings of his own mind by identifying incompletely understood behaviors or reactions worthy of greater psychological understanding, and insinuating doubt about the adequacy of the patient's explanations of such phenomena.     

The fear of love: the denial of self in relationship

This paper explores the fear of love and relationship which develops when a child has experienced parents who cannot tolerate emotional separation and so attempt to retain perfect contingency with their infant, long after the infant needs to begin to separate and individuate. The child is a 'self-object' for the parents, who depend on the responses of others, including their own child, to maintain a sense of their own identity. The impact of this demand for 'reverse parenting' on the child's development is explored and clinical work with an adult patient whose history reflects this process is described.