Strengthening Connectedness in Close Relationships: A Model for Applying Contextual Therapy

This article presents a model for conducting contextual therapy with the aim of contributing to the further development of contextual therapy. Its founder, Ivan Boszormenyi-Nagy, introduced the core of this approach, relational ethics, as a new paradigm for family therapy, which has been received well. The authors presume that the training of (upcoming) contextual therapists and conducting contextual therapy itself can benefit from more concrete guidelines and a phased structure. It can also enhance the further development, research, and accountability of this approach. Therefore, using a design-oriented method, the authors developed a model that helps to shape a contextual therapy process and the applicable contextual interventions. It is based on strengthening connectedness in close relationships, using relational ethics as its compass. The framework of the model consists of three phases: exploring connectedness in close relationships, modifying connectedness in close relationships, and reinforcing connectedness in close relationships, whereby the goals of each of these phases are defined as process elements and expanded into guidelines for 19 interventions. The ingredients for these interventions are derived from two recent studies on the practice of Nagy and on the practice of current contextual therapists. The model is explained and substantiated based on contextual theory and therapy. Final remarks are presented in the conclusion.     

Paternal Support and Involvement in Unmarried Fragile Families: Impacts on Long-Term Maternal Mental Health

Fragile families are defined as those that include unmarried or romantically unstable parents who have children and are socioeconomically disadvantaged. Mothers in fragile families may experience risk factors that lead to increased depressive symptoms that inhibit their ability to bounce back after stressful events. Risk factors for poorer maternal mental health may include declines in father involvement and a lack of coparenting support. This study examined the connected nature of coparenting and father involvement over time among continuously unmarried mothers from the Fragile Families and Child Wellbeing Study. A bidirectional latent growth curve analysis demonstrated that early father involvement was associated with a more gradual decline in coparenting support over the child's first 5 years, while early coparenting support also predicted a slower decline in father involvement over time. Steeper declines in coparenting support and father involvement over time were linked with more maternal depression and lower maternal life satisfaction when their child was nine. Results demonstrate a clear need for targeted intervention with both parents in fragile families to promote involved fathering behavior and enhance coparental relationships.     

A systematic review of interventions for adults who stutter

PurposeTo examine the effectiveness of (i) face to face interventions (ii) models of service delivery and (iii) psychological treatments combined with speech-focused interventions for adults who stutter.MethodsFive electronic databases and three clinical trial registries were searched. Systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with adults who stutter were included. Pharmaceutical interventions were excluded. Primary outcomes included a measure of stuttering severity. Risk of bias assessment was conducted on included studies and overall quality of the evidence was graded.ResultsFive RCTS, four registered trials and three systematic reviews met inclusion criteria. Intervention approaches included speech restructuring programs (e.g. Camperdown Program) and transcranial direct current stimulation (tDCS). One study investigated cognitive behaviour therapy (CBT) alongside speech restructuring. Overall, studies were classified low risk of bias and good quality. Speech restructuring was included in all but one study (tDCS study) and had the most evidence i.e. supported by the greatest number of RCTs. On average, stuttering frequency was reduced by 50–57 % using speech restructuring approaches. No study reduced stuttering to the same level as community controls who don’t stutter. The study on tDCS reduced stuttering frequency by 22–27 %. Speech restructuring delivered via telehealth was non-inferior to face-to-face intervention. One study reported CBT was an effective adjunct to speech restructuring interventions.ConclusionSpeech restructuring interventions were found to reduce stuttering in adults, however degree and maintenance of fluency varied. The body of evidence surrounding tDCS and psychological interventions is limited. Replication studies should be considered.     

Intensive Transactional Analysis Psychotherapy (ITAP): A case series study

Intensive Transactional Analysis Psychotherapy (ITAP) is a new therapeutic approach based on the integration of Transactional Analysis and brief psychodynamic approaches. ITAP is based on two key therapeutic tools—the intrapsychic triangle and the interpersonal triangle—which the therapist uses to focus patients’ attention on moment‐by‐moment therapy processes. The aim of the present study was to provide early empirical documentation of ITAP effectiveness. To this aim, six patients (four females, two males) were longitudinally evaluated using an A‐B‐A mixed quantitative and qualitative design, with evaluations at Baseline, Treatment and Follow‐up phases. Each patient received 16 50‐min weekly sessions of ITAP therapy over 4 months. For quantitative evaluations, patients filled out the Clinical Outcome in Routine Evaluation‐Outcome Measure (CORE‐OM) at each evaluation. Effects size values were estimated to evaluate quantitative changes comparing mean scores of Baseline, Treatment and Follow‐up phases. At the first follow‐up, the Change Interview was used to qualitatively evaluate patients’ perceived changes. In the quantitative data, four of the six patients reported a very good outcome, with large to very large effect sizes in Baseline versus Treatment and/or Baseline versus Follow‐up scores comparisons, whereas two patients reported variable fluctuations within the non‐clinical range of outcome scores. In the qualitative evaluations, all patients reported several moderately to extremely important perceived changes attributed to psychotherapy.     

Taking Access to the Community: An Ecological Systems Framework for In‐Home Counseling With Older Adults

Bronfenbrenner's (1977) ecological systems theory is a holistic framework placing an individual in a system's context to address their concerns. This article offers a case study demonstrating use of the theory with older adults and the in‐home setting. Implications for the counseling field and future research needs are discussed.     

体像障碍的认知机制及治疗

体像障碍是一种对想象的或轻微外表缺陷的先占观念, 这种先占观念给个体带来极大的痛苦。其负性的自我认知框架, 影响个体对信息的选择、组织及评估。因此结合心理实验范式和神经生理综合分析体像障碍的认知过程, 对深化体像障碍认知机制和优化其认知行为治疗具有重要意义。     

Relapse of anxiety-related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy

Excessive fear and avoidance in relatively safe situations can lead to a narrowing of one's behavioral repertoire and less engagement with valued aspects of living. Ultimately, these processes can reach clinical levels, as seen in anxiety, trauma, and obsessive–compulsive disorders. Research on the basic behavioral processes underlying successful treatment with exposure therapy is growing, yet little is known about the mechanisms contributing to clinical relapse. Until recently, these mechanisms have largely been conceptualized in terms of Pavlovian return of fear, with relatively little research into operant processes. In the current paper, we briefly review translational research in anxiety disorders and the connections between fear and avoidance, focusing on recent work in the acquisition, extinction, and relapse of avoidance behavior and the generalization of this learning through arbitrary symbolic relations. We then introduce one possible treatment approach to mitigating clinical relapse, acceptance and commitment therapy (ACT), and provide a conceptual analysis for why ACT may be especially well-situated to address this issue. Finally, we end with potential directions for future research on treatment and relapse of anxiety disorders.     

Understanding Personality through Patterns of Daily Socializing: Applying Recurrence Quantification Analysis to Naturalistically Observed Intensive Longitudinal Social Interaction Data

Ambulatory assessment methods provide a rich approach for studying daily behaviour. Too often, however, these data are analysed in terms of averages, neglecting patterning of this behaviour over time. This paper describes recurrence quantification analysis (RQA), a non-linear time series technique for analysing dynamic systems, as a method for analysing patterns of categorical, intensive longitudinal ambulatory assessment data. We apply RQA to objectively assessed social behaviour (e.g. talking to another person) coded from the Electronically Activated Recorder. Conceptual interpretations of RQA parameters, and an analysis of Electronically Activated Recorder data in adults going through a marital separation, are provided. Using machine learning techniques to avoid model overfitting, we find that adding RQA parameters to models that include just average amount of time spent talking (a static measure) improves prediction of four Big Five personality traits: extraversion, neuroticism, conscientiousness, and openness. Our strongest results suggest that a combination of average amount of time spent talking and four RQA parameters yield an R² = .09 for neuroticism. Neuroticism is shown to be associated with shorter periods of extended conversation (periods of at least 12 minutes), demonstrating the utility of RQA to identify new relationships between personality and patterns of daily behaviour. Materials: https://osf.io/5nkr9/ . © 2020 European Association of Personality Psychology     

Behavioral and pharmacological treatments for tourette syndrome: A review

This article reviews the published treatment outcome research on pharmacological and behavioral treatments for Gilles de la Tourette syndrome (TS). Controlled group outcome studies of pharmacological treatments show about a 50–60% reduction in tics with haloperidol and pimozide and about a 20% reduction with clonidine. A controlled group outcome study and several within-subject design studies of behavioral treatments show about a 90% reduction in tics with habit reversal training. A large number of case studies generally confirm these results and also show benefits from other behavioral treatments such as relaxation training, self-monitoring, and contingency management. Clinical limitations of TS drugs are that they produce side effects in 50–85% of the patients and require continuous use, and long-term compliance with the medications is limited. The primary limitation of behavioral treatments is that they require a large initial time commitment. The methodological strengths of the controlled drug studies are the use of double-blind and group designs. For the behavioral studies, the strengths are rigorous recording and controlled within-subject designs.