Psychological Aspects of Genetic Counseling. X. Advanced Counseling Techniques

Four procedures commonly used by experienced counselors are described: simple interview formulations, helping clients think through their problems, reframing, and role playing. Each procedure is illustrated by examples. Among other things, the goal of these procedures is to promote the autonomy and self-directedness of clients and thus are particularly valuable in circumstances requiring a nondirective stance. The need is underscored for a more active counseling stance appropriate to the psychological and problem-solving needs of genetic counselees.     

Harry Potter and the Relational Child: Engaging Millennials in a New Generation of Counseling

Harry Potter and the Cursed Child: Parts One and Two (Rowling, Thorne, & Tiffany, 2016) is the latest installment in a franchise that has defined the millenial generation. The screenplay captures the essence of human behavior as it is molded by individual effort, human interactions, and cultural wellbeing. The authors present a way to conceptualize the millennial generation and their families through the lens of Relational-Cultural Theory (RCT). The authors begin with an overview of RCT, followed by a conceptualization of the screenplay using RCT as a theoretical lens. A conceptualization of how this story can be used to process themes of family, friendship, isolation, parenting, and adolescents with millennials and their families is provided. Furthermore, the researchers explore how this story can be used as supplemental material in the classroom to help the next generation of counselors conceptualize and process these themes with clients.     

Treatment of panic disorder: live therapy vs. self-help via the Internet

A randomized trial was conducted comparing 10 individual weekly sessions of cognitive behaviour therapy for panic disorder (PD) with or without agoraphobia with a 10-module self-help program on the Internet. After confirming the PD diagnosis with an in-person structured clinical interview (SCID) 49 participants were randomized. Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail can be equally effective as traditional individual cognitive behaviour therapy. Composite within-group effect sizes were high in both groups, while the between-group effect size was small (Cohen's d=16). One-year follow-up confirmed the results, with a within-group effect size of Cohen's d=0.80 for the Internet group and d=0.93 for the live group. The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.     

Gender differences and the Defense Mechanism Test: A comparative study of adolescents in psychiatric care and healthy controls

The aim of this paper was to study gender differences in the percept-genetic method Defense Mechanism Test (DMT) among a group of 60 adolescent subjects. Three subgroups were used: patients with psychotic disorders (Axis 1); borderline personality disorder (Axis 2) according to the DSM-IV classification system, and a non-patient group. The test protocols were scored with respect to 124 DMT variables and analyzed by means of the multivariate projection method Partial Least Squares (PLS) in latent structures. The overall results showed considerable gender differences in the whole group as well as in the subgroups. The most striking finding was that girls compared to boys were characterized by the perceptual defense identification with the opposite sex, which means that they perceived male gestalts instead of females in the stimulus picture. When both gender and diagnostic group membership were considered simultaneously, the influence of diagnostic group membership seemed to be stronger than gender even if there was an interaction between diagnoses and gender. It was concluded that gender must be considered when the DMT is used on adolescent populations.     

A durable recording and feedback system

A durable low-cost data-recording and feedback system is described. Data transcribed with a special pen onto a plastic sheet can be removed only with two solvents. These data can be displayed for feedback purposes without fear of destruction.     

A probability-based formula for calculating interobserver agreement

Estimates of observer agreement are necessary to assess the acceptability of interval data. A common method for assessing observer agreement, per cent agreement, includes several major weaknesses and varies as a function of the frequency of behavior recorded and the inclusion or exclusion of agreements on nonoccurrences. Also, agreements that might be expected to occur by chance are not taken into account. An alternative method for assessing observer agreement that determines the exact probability that the obtained number of agreements or better would have occurred by chance is presented and explained. Agreements on both occurrences and nonoccurrences of behavior are considered in the calculation of this probability.     

EM and beyond

The basic theme of the EM algorithm, to repeatedly use complete-data methods to solve incomplete data problems, is also a theme of several more recent statistical techniques. These techniques—multiple imputation, data augmentation, stochastic relaxation, and sampling importance resampling—combine simulation techniques with complete-data methods to attack problems that are difficult or impossible for EM.A preliminary version of this article was the Keynote Address at the 1987 European Meeting of the Psychometric Society June 24–26, 1987 in Enschede, The Netherlands. The author wishes to thank the editor and reviewers for helpful comments.     

Tainted therapy and mistaken memory: Avoiding malpractice and preserving evidence with possible adult victims of childhood sexual abuse

Recent malpractice cases reflect increased liability for psychotherapists working with possible adult victims of childhood sexual abuse. These cases have related to recovery of past memory of abuse and the fashion in which the therapist managed the recovery and treatment. Ways in which therapists may harm clients by omission and commission are explored. The emerging lack of clarity between investigative and therapeutic interviews is discussed. False memory is considered in relationship to malpractice liability, standards of care, and attempts to preserve potential evidence. The author proposes written informed consent and investigative interviewing procedures for working with potential memory recovery cases. Formats for general informed consent to psychotherapy for patient record keeping of newly emergent material are appended.