Pathways of Risk and Resilience: Impact of a Family Resilience Program on Active‐Duty Military Parents

Over the past decade, studies into the impact of wartime deployment and related adversities on service members and their families have offered empirical support for systemic models of family functioning and a more nuanced understanding of the mechanisms by which stress and trauma reverberate across family and partner relationships. They have also advanced our understanding of the ways in which families may contribute to the resilience of children and parents contending with the stressors of serial deployments and parental physical and psychological injuries. This study is the latest in a series designed to further clarify the systemic functioning of military families and to explicate the role of resilient family processes in reducing symptoms of distress and poor adaptation among family members. Drawing upon the implementation of the Families Overcoming Under Stress (FOCUS) Family Resilience Program at 14 active‐duty military installations across the United States, structural equation modeling was conducted with data from 434 marine and navy active‐duty families who participated in the FOCUS program. The goal was to better understand the ways in which parental distress reverberates across military family systems and, through longitudinal path analytic modeling, determine the pathways of program impact on parental distress. The findings indicated significant cross‐influence of distress between the military and civilian parents within families, families with more distressed military parents were more likely to sustain participation in the program, and reductions in distress among both military and civilian parents were significantly mediated by improvements in resilient family processes. These results are consistent with family systemic and resilient models that support preventive interventions designed to enhance family resilient processes as an important part of comprehensive services for distressed military families.     

Narrative Approaches to Organizational Development: A Case Study of Implementation of Collaborative Helping

Across North America, community agencies and state/provincial jurisdictions are embracing family‐centered approaches to service delivery that are grounded in strength‐based, culturally responsive, accountable partnerships with families. This article details a collaborative consultation process to initiate and sustain organizational change toward this effort. It draws on innovative ideas from narrative theory, organizational development, and implementation science to highlight a three component approach. This approach includes the use of appreciative inquiry focus groups to elicit existing best practices, the provision of clinical training, and ongoing coaching with practice leaders to build on those better moments and develop concrete practice frameworks, and leadership coaching and organizational consultation to develop organizational structures that institutionalize family‐centered practice. While the article uses a principle‐based practice framework, Collaborative Helping, to illustrate this process, the approach is applicable with a variety of clinical frameworks grounded in family‐centered values and principles.     

Experiences of Families Transmitting Values in a Rapidly Changing Society: Implications for Family Therapists

Intergenerational value transmission affects parent–child relationships and necessitates constant negotiation in families. Families with adolescents from rapidly changing societies face unique challenges in balancing the traditional collectivistic family values that promote harmony with emerging values that promote autonomy. Using modern Turkey as an example of such a culture, the authors examine the transmission process in families that hold more traditional and collectivistic values than their adolescent children. Special consideration is given to generational and cultural differences in the autonomy and relatedness dimensions.     

Comparison of four short forms of the French adaptation of the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV)

IntroductionThe Wechsler Intelligence Scale for Adults - 4^th Edition (WAIS-IV) is widely used in France and French-speaking countries for clinical assessment and research. This scale has excellent metric qualities; there is ample evidence of the validity and reliability of its scores. However, it takes 60 to 90 min to complete the full test. That can be problematic in research where time is limited and when examining very disturbed patients. In such cases, a short form of the WAIS-IV may be useful. Unfortunately, no short form of the French version of WAIS-IV has yet been validated using the standardization sample.ObjectiveThe aim of the present study was to identify an abbreviated form of WAIS-IV with sufficient validity and reliability to replace, in some cases, the full test.MethodFour short forms were developed taking into account the fidelity and the correlation with the FIQ of the subtests included in each of form. The metric qualities the four short forms were compared using the standardization data of the French WAIS-IV. The standardization was done using the results of a sample of 876 individuals representative of the French population from 16 to 79 years 11 months.ResultsThe analyzes showed that a short form including Information, Matrices, Arithmetic and Code provides a fairly good estimate of the FIQ. The fidelity of the estimated IQ was 0.94 and its correlation with the FIQ was 0.91. However, the average of the absolute differences between the IQ calculated with this short form and the IQ calculated with the full form was 4.24 points, with a standard deviation of 3.15 points. These differences could lead to misidentification of some individuals tested with the short form.ConclusionThe proposed short form provides a sufficient approximation of the FIQ to be used in research where the collective results are more important than those of individuals. This short form, however, does not provide an IQ measure as robust as the full form. It should therefore be used with caution only when using the full form is not possible.     

Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta‐analysis

Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent–infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta‐analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta‐analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta‐analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta‐analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: –0.46; 95% confidence interval [CI] [–0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent–infant interaction (SMD: –0.10; 95% CI [–0.46, 0.26]), parental depression (SMD: –1.55; 95% CI [–3.74, 0.64]) or parental global distress (SMD: –0.19, 95% CI [–3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation‐based treatment with non‐mentalization‐based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.     

A personal commentary on J.W. Perry,M.D., and introduction to ‘Reconstitutive process in the psychopathology of the Self’

John Weir Perry’s influence on the understanding of the psychotic process through his research in San Francisco between 1950 and 1981 was groundbreaking, because it both verified and expanded upon C.G. Jung’s research at the Burghölzli Hospital in Switzerland in the early 1900’s. The author explores both the brilliance of Perry’s contribution as a psychiatrist and Jungian analyst and also shows the flawed human, who, with his rare sensitivity to the psychotic process, devoted his life work to the schizophrenic population and their often ill-fated search for meaning. She tells how his creative engagement with the analytic processes of Self discovery eventually led to analytic boundary violations, which ultimately resulted in his indefinite suspension from membership in his local Jungian community. Further, this paper describes her reflections on the innovative work that influenced both the treatment of this population, as well as educating candidates in analytical training to be receptive to and cognizant of psychotic affects and imagery. The archetypal field of the psychotic process, its influence on the development of analytical psychology relative to the psychotic process, and one man’s impact on the analytic community are considered.     

Psychosis,symbol, affectivity 2: another perspective on the treatment of psychotic disorder

This is the second of two papers concerning our study into an integrated approach to psychotic disorders conducted at the University Psychiatry Unit of Palermo’s Polyclinic over approximately 15 years; this paper concentrates on the clinical phenomena. The study aimed to find the best possible treatment and to improve the prognosis of this patient group. We have explored the efficacy of a range of psycho-therapeutic (cognitive-behavioural, systemic-relational, psychodynamic, group and others), psycho-pharmaceutical, psychiatric rehabilitative and psycho-educational treatments, with a hermeneutic approach instead of a systematic one. The study’s conclusions, described in the paper, are that all psychotic functions start with a nuclear psychic issue connected to emotional development. We describe how the most significant symptoms of acute psychotic manifestations (delusions and misperceptions) make use of an encrypted psychological meaning that can be decoded through the patient’s symbolic language. This language is a key element in diagnosis and in the choice of treatment. The paper describes how we revised our understanding of psychosis from being a brain disease to being a process aimed at the rearrangement of psychic functioning. Our significant results are described.     

Art in support of life: Caravaggio and the plague

In the struggle with COVID-19, art offered a way to face the solitude of the lockdown. The focus of this paper is primarily on Caravaggio’s painting The Seven Works of Mercy, with references to other paintings to amplify some aspects of the artist’s approach to life and his uniqueness in the artistic landscape of his time. Darkness was part of Caravaggio’s research for spiritual truth and by entering the stories of his life and exploring the tales told through imaginative expression in his paintings, it is possible to understand his process of exploration of ancestral darkness. The author uses her imagination to reflect on how art can help to contact the profound fears buried in the unconscious which are now being awakened by the pandemic. The contemplation of this painting facilitated the emergence of emotions related to the darkness of our time, with the discovery that empathy and mercy offer a way to come to terms with the pandemic. This approach demands a different understanding of reality with Caravaggio’s dark creative world becoming a companion that permits the exploration of what is not yet thinkable in daily life. Images accompany the author’s research that relies on her imagination and amplifications.     

The technologically-mediated self: reflections on the container and field of telecommunications

This paper contains reflections on the use of the imagination in technologically-mediated therapy and analysis. As part of the individuation process the psyche is seen as needing to adapt to new technological ways of communicating. The notion of a technologically-mediated self is posited describing a self which can only be apprehended through, and by, the use of telecommunications. This self is seen as identical to the in-person self, a subset, or superset of it. There is a revisioning of our notions of the container and the field in this work performed through technological-mediation. The need to engage the imagination in approaching this kind of work is emphasized in order to create an imaginal play-space in which the body will be deeply affected. Some thoughts on how the process of individuation might look through such analytic work is presented.     

George Floyd’s death and COVID-19: inflection points in the Anthropocene Era?

George Floyd’s death, the COVID-19 pandemic and climate change are on a continuum from the immediate shock of viewing a video-recorded murder, to millions dying worldwide from disease, to deaths related to climate change accumulating over a millennium. They participate in the powerful archetypes of death and inequality. ‘Increase’, Hexagram 42 in the I Ching, archetypically addresses inequalities at all levels – racial, economic, political and the profound imbalance between humans and the environment. Floyd’s death highlights the consequences of systemic racism and income inequalities. The pandemic as ‘nature’s revenge’ hits minority populations harder due to underlying health conditions resulting from poverty and greater exposure to the virus in the workplace. President Trump as Trickster showed Americans their shadow and his response to the pandemic amplified its severity. The pandemic has shocked our social, political and economic systems and paused our species rush into environmental disasters at many levels. The disruptions present opportunities for reflection, experimentation and developing new systems as old forms are challenged. The ecological dimensions of Jung’s concepts emphasize interconnectedness at all levels and the paradigm shift he called a ‘new age’ provides a framework for altering the course of the Anthropocene Era.