A Patient's Perspective on Genetic Counseling and Predictive Testing for Alzheimer's Disease

The availability of genetic testing for Alzheimer's disease is anticipated to be widespread in the future. As an individual at risk with a family history of Alzheimer's disease, I discuss why I sought predictive tests and how I would use the information from such tests. I relay what I learned in my genetic counseling session, my response to the counseling process, and steps I have since taken. I discuss life planning, psychological and fear of discrimination issues from a patient's perspective.     

儿童社会观点采择的发展及其子类型间的差异的研究

对幼儿园大班至小学阶段的４２５名儿童施以认知和情感两类观点采择测验,考察儿童社会观点采择发展的一般趋势以及两类观点采择的发展趋势及水平上的差异。结果发现：６岁左右儿童在准确推断他人观点方面还存在较大困难。６—１０岁左右是儿童社会观点采择能力快速发展的时期。１０岁左右儿童已能根据环境信息较准确推断他人的观点：儿童认知观点采择与情感观点采择能力的发展趋势基本一致,但后者的发展水平极显著地落后于前者。     

Parenting typologies in Georgian and Belgian adolescents: Associations with self-esteem

The parenting context is of fundamental importance for the optimal development of adolescents. Making use of a person-centered approach, we derived parenting typologies from the perspective of Georgian and Belgian adolescents based on four dimensions of perceived parenting (responsiveness, structure, psychological control, and autonomy support). Further, we examined how perceived parenting typologies were associated with adolescents' self-esteem. The study sample included 511 Georgian and 830 Belgian adolescents (N = 1341; 48% female). A cluster-analytic procedure on the full sample was conducted separately for mothers and fathers. The analysis yielded five parenting typologies: Supportive—Highly structuring (high responsiveness and structure), Highly structuring—Moderately controlling (high structure and psychological control, moderate—responsiveness), Supportive—Low structuring/controlling (high responsiveness and autonomy support, low structure and psychological control), Highly controlling (very high psychological control, low responsiveness and autonomy support) and Uninvolved (low on all dimensions). Results indicated that the Highly structuring—Moderately controlling paternal cluster was more prevalent in the Belgian sample. A country-moderating effect was found with the paternal Uninvolved profile associated with low levels of self-esteem in Belgian adolescents, but with moderate levels of self-esteem in Georgian adolescents.     

“In my own comfort zone”: Clients' experiences of relational aspects of online therapy for alcohol problems

Background

Therapists and counsellors increasingly use online video applications to offer treatment in place of face-to-face delivery. In the alcohol treatment sector, this offers a range of potential benefits for treatment providers. However, the impact of working remotely via video on the therapeutic relationship remains unclear and under-researched.

Aims

This study aimed to explore how alcohol treatment clients make sense of the relational aspects of therapy delivered remotely, and to examine how the use of remote therapy might disrupt existing ideas around the therapeutic relationship.

Methodology

This study utilised a qualitative design using thematic analysis, with 15 participant interviews with adult service users from a single treatment provider. All participants had previously undertaken at least four 1-h online therapy sessions.

Findings

The themes that were identified highlighted the significance of the participants' own homes as the site of therapy, with emphasis on the comfort of the home, and the presence of family members and pets. Participants stressed the importance of viewing the face of the therapist, the establishment of a therapeutic bond and specific therapist qualities. Participants also reflected on issues around denial and avoidance associated with self-image and identity.

Discussion

There are nuanced and potentially unforeseen consequences of undertaking therapy for alcohol problems via video, relating to the significance of the therapy environment and relationship between client and therapist. This may include issues of shame, denial and avoidance, which are of particular significance for clients experiencing difficulties associated with alcohol.     

时间透视的自我整合:I.心理结构方式的投射测验

用画圆测验和完成句子测验,配合时间标定作业,对２０１名大学生被试的时间透视特点作了探讨,结果发现,在时间透视的广度、方向及关联性等方面,高自我认同组被试有着更大的现有广度,更积极而远景开放的未来取向,以及更强的时间整合;低自我认同组则是过去广度更大,其时间分裂及未来中断的现象理易发生。这些结果初步揭示了建立在时间体验与自我概念的整合基础上的时间透视的心理结构方式。     

时间透视的自我整合:Ⅱ.心理功能机制的实验研究

以２４个人格形容词为材料,对１１１名大学生被试进行了“过去的我”、“现在的我”和“将来的我”三择一式的迫选反应实验,再配合时间标定作业。结果不仅验证了前文的研究结论,即不同同一性状态的被试在时间透视的广度、方向及关联性等心理结构特征上存在差异,而已表明了整合自我信息的不同的功能机制。不过,这种差异主要体现在积极词上,在消极词上差异不显著。     

Finding focus in a difficult landscape: Therapists’ experiences with challenging video guidance processes for parent–infant dyads

Marte Meo video guidance uses filmed interaction of the actual parent–infant dyad in the guidance of caregivers. Exploring the challenges that therapists meet in the guidance of parent–infant dyads may illuminate important aspects of the method itself as well as the therapists’ role and requirements. This could lead to method development and improved practice, but is hitherto little addressed. In this paper, we explore how skilled therapists experience and handle challenging or failing guidance processes with parent–infant dyads. We analyzed interviews with 13 Marte Meo therapists/supervisors using team-based reflexive thematic analysis. Four main themes were identified: promoting relational growth in a coercive context, building an alliance that feels safe for the parents, looking at positive moments in difficult lives, and handling intense feelings as a therapist. Our findings show that therapists experience specific therapeutic and ethical challenges with a vulnerable subgroup of parent–infant dyads where child protective issues arise, where caregivers’ insecurities impede the therapeutic relationship, and where caregivers have unsolved relational or mental health problems. The therapists’ role becomes pivotal and demanding with regard to the therapeutic alliance, the therapeutic interventions in the guidance process, and their own need for regulation, supervision, and structure. Identification of these vulnerable dyads early in the process could facilitate a better adaptation and practice of video guidance. Our findings suggest a need for supporting structures, clinical supervision, and training that address these challenges.