‘And when you were a child?’: how therapists working with parents alongside individual child psychotherapy bring the past into their work

When a child is offered psychotherapy, it is common that regular meetings will be offered to the parents. However, there are debates in the literature about the degree to which such parent work should include a focus on the parents’ own childhood experiences. This study aimed to examine the way that those offering parent work as part of a study evaluating the treatment of adolescent depression dealt with this issue in their work with parents, both in the study and in routine clinical practice. Design: five therapists were interviewed on the subject of working with parents’ childhood experiences within parent work parallel to child psychotherapy. Data were analysed qualitatively, using Interpretative Phenomenological Analysis. Findings: participants described the need to consider the different parameters of this work to individual adult therapy; in addition, participants felt that it was necessary to negotiate permission to work on the parents’ childhood experiences. They also spoke of making use of insight into the repetition of the parents’ history, the analysis of parental projections and offering containment within the relationship; this varies from the ‘transference work’ of individual therapy and a different style of interpretation was described. Conclusions: there is a need to give more attention to the neglected field of working with parents alongside individual child psychotherapy, especially at a time when such work is under threat within many public services. There are particular technical issues related to work with parents’ own childhood histories that are different to how one might work in individual therapy with a parent.     

Killing the dead: evolution of melancholic identifications underlying suicide attempts in adolescence

Psychic processes underlying suicidal behaviours during adolescence and their evolution are explored. A longitudinal study was conducted of thirty adolescent patients hospitalised following a suicide attempt. Clinical interviews were used combined with the Rorschach Test and the Thematic Apperception Test (TAT) a few days after the suicide attempt and one year later. Results initially showed common forms of psychic adjustment: melancholic identifications were linked to an excessive dependence on objects. One year later, these forms of psychic adjustment changed: for many adolescents, the melancholic identifications shifted and self-image improved. The emergence of representations of murder fantasies immediately after the suicidal behaviour allowed a possible transformation of violence into symbolisation. A case study illustrates these psychic changes.     

Some considerations on the capacity to be alone

This paper considers the lack of coherence of the psychoanalytic theories of the primary and secondary process. As a consequence, the interplay of primary and secondary process modes of thought cannot be conceptualised properly. Firstly, we summarize the results of an elsewhere-made metapsychological re-examination of both principles of mental functioning, and argue that Rapaport's distinction between a drive and a conceptual organization of memory, elaborated on by Siegfried Zepf is an extremely useful means of understanding primary and secondary process activity. As a central thesis, we state that primary process operates by affects, whilst secondary process utilizes concepts. The second part of the paper makes an attempt to show the dialectical relationship of affective and conceptual thought in the functioning of the living psyche. Temporarily dominating mental functioning, primary and secondary process thinking each utilize the other as a means, but never work purely within the psychic apparatus. It is shown that it is the specific interplay of primary and secondary process activity, which produces new adaptive substitutive formations. Some basic assumptions about the concepts of regression and progression are made to elucidate the shift from secondary to primary process dominance and vice versa.     

Eating Disorder Recovery

Abstract

Qualitative studies addressing the eating disorder recovery process from the client's point of view are notably absent in the literature. For this case study, we conducted a retrospective examination of the recovery process, as recounted by a 37-year-old female who was diagnosed with anorexia nervosa, binge eating/purging subtype at the age of 30. Two in-person interview sessions provided insight into coping skills, multidisciplinary intervention strategies, and long-term treatment challenges. In sum, the client's perspective can add new information to the understanding of eating disorder recovery from feminist and other theoretical frameworks.     

不同特质焦虑水平的选择性注意偏向

高特质焦虑个体常表现出对威胁性刺激的选择性注意偏向的特点。然而其潜在的神经机制目前仍不清楚。通过记录高、低特质焦虑者各17名进行情绪加工时的ERP,比较了两组个体在选择性注意偏向发生的时间进程和相关的神经反应的差异。结果发现,高特质焦虑者诱发出更大的N1,进一步发现恐惧图片比中性图片诱发更大的N1;而低特质焦虑者诱发了更大的N2,特质焦虑得分越低, N2波幅越大。结果初步说明高特质焦虑者加工早期对恐惧图片分配了较多的注意资源,并且其抑制执行功能可能受损;而低特质焦虑者较晚开始区分恐惧图片和中性图片。这些结果提供了支持认知-动机模型的新证据。     

The interplay of received social support and self-regulatory factors in smoking cessation

Objective: In smoking cessation, individual self-regulation and social support have both proven to be useful. However, the roles of self-regulatory processes and social support are mostly examined separately. The present study aims at examining the unique and joint interactive effects of self-regulation as specified in the health action process approach (HAPA) and social support on smoking cessation. The study tested whether social support can compensate for low levels of self-regulation or whether synergistic effects emerge.

Design & Measures: Around a self-set quit date, 99 smokers completed baseline questionnaires on HAPA-variables, smoking-specific received social support and smoking cessation (continuous abstinence and point prevalence), with a follow-up Cpproximately 29?days after the quitdate.

Results: Social support moderated the association between volitional self-efficacy and smoking, as well as coping planning and smoking but not between action planning and smoking. No compensatory effect of social support for lower levels of individual regulation emerged but the combination of high levels of the individual variables and social support was related to successful smoking cessation, indicating a synergistic effect.

Conclusions: The results confirm the importance of examining both self-regulation and social factors in smoking cessation. This should be considered when developing future interventions for smoking cessation.     

Development and Validation of the Xhosa Translations of the Beck Inventories: 1. Challenges of the Translation Process

This article describes the translation of the Beck Depression Inventory-II, the Beck Hopeless Scale, and the Beck Anxiety Inventory, into Xhosa the language spoken in the Eastern Cape of South Africa. The processes of translation, back-translation and committee discussion failed to yield trustworthy translations because of practical difficulties in working with translators. Critical words and phrases were identified which gave rise to lack of agreement. For each, a range of options was generated and the advantages and disadvantages evaluated in terms of criteria such as conceptual and idiomatic equivalence, and extensiveness of usage. Examples are given of the problems encountered and the way in which final decisions were made. A pilot clinical trial demonstrated the acceptability of the translated instruments. Two further articles report the psychometric evaluation of the translated scales.     

Extended problem solving treatment for depression

Introduction: Effective brief psychological approaches for depression that can be delivered by a variety of health professionals with minimal training increase access to treatment by patients. Problem Solving Treatment (PST) was developed for primary care and was modified for this study (EPST) to better meet the needs of mental health patients. Method: A total of 92 therapists from different professional backgrounds completed EPST workshops and treated 92 patients with major depression with interval clinical and treatment process assessments. Results: EPST achieved a significant reduction in depressive symptom scores, life problem scores, and there were few treatment non‐completers. Treatment outcome was predicted by process and therapist variables. Discussion: EPST is an effective and easy to teach treatment that can be delivered by a variety of practitioners and suitable for busy primary mental health care settings.