Manual‐based cognitive behaviour therapy for chronic fatigue syndrome: therapists' adherence and perceptions

Several randomized controlled trials have indicated that cognitive behaviour therapy is an effective treatment for chronic fatigue syndrome. In 1 of these studies 13 therapists applied cognitive behaviour therapy for chronic fatigue syndrome in 83 chronic fatigue syndrome patients. In the present study therapists' adherence and perceptions of the manual are studied. Following completion of the study the therapists were asked to complete a questionnaire. Audiotaped sessions were conducted to verify the therapists' adherence. Analyses of the audiotapes showed that in 87% of the sessions this appeared to be the case. The questionnaire revealed that the therapists found it more difficult to treat patients with chronic fatigue syndrome than to treat patients with psychological or other physical problems. Treatment aspects posing the most problems were integrating individual problems into the standardized treatment, dealing with the patients' lack of confidence in the treatment and handling insufficient motivation.     

Narrative Therapy Using a Reflecting Team: An Ethnographic Study of Therapists' Experiences

Narrative therapy in the last 15 years has been utilized by many clinicians and yet there is a lack of research on therapists' experience of this approach. This ethnographic research explores the views and perceptions of eight narrative therapists who belonged to a narrative team in an outpatient clinic. These therapists were observed and interviewed. Five themes emerge from the data. The themes include a sense of success in reducing the clients' problems as well as some limitations of narrative therapy. Two recommendations for research and practice involve the use of narrative therapy without a team and the use of narrative therapy in addressing issues of family violence.     

Grandparents Dealing with the Divorce of Their Child: Tips for Grandparents and Therapists

Some grandparents are still in their forties. When these young people are faced with the divorce of one of their children they have two dilemmas: 1) How to be supportive of their child and 2) How to avoid losing contact with their grandchildren. This article gives tips to grandparents and therapists faced with this common problem.     

System-of-Care Practice Review Scores as Predictors of Behavioral Symptomatology and Functional Impairment

The longitudinal comparison study of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program assesses factors in service delivery systems that may shape the impact of systems of care. We evaluated the extent to which services embodying the principles of a system of care, as measured by the System-of-Care Practice Review (SOCPR), affect clinical outcomes for children being served in federally-funded systems of care and matched comparison communities. The participants included 75 children and families selected for participation in the SOCPR. Results indicated that experience of services embodying system-of-care principles at a high level was associated with lower symptom and impairment scores one year after entry into services. Children in systems of care were rated to have experienced high levels of system-of-care principles implemented within their services, and their symptom severity and functional impairment did not vary as a function of their experiences. Children in matched comparison communities had more variable rated experiences of system-of-care principles within their services, and their symptom severity and functional impairment decreased as their experiences of the principles increased.     

Retrospective spiritual narratives: exploring recalled childhood and adolescent spiritual experiences

This paper draws on a collection of retrospective narratives of childhood and adolescent spiritual experiences to explore the qualities and characteristics of the spirituality of the young. They recall a range of spiritual experiences that touch on death, mortality, visions, and perceptions and connections beyond the self. Their experiences include varying intensities of emotion and invoke a range of responses in them and others. The paper considers the social, emotional and familial context of these early life experiences and their impact on spiritual experience and the possibility/impossibility and freedom/lack of freedom to express, and integrate spirituality.     

Nurturing spirituality in secular classrooms

Since 1999 the New Zealand secular school curriculum has included a statement on fostering children's spirituality in classrooms. This statement defines spirituality in a broad fashion and includes reference to Maori (indigenous New Zealander) views on spirituality. The implications of this for classroom teachers have not been researched in this country and therefore this paper reports on a study that examined teachers' views on spirituality and the implications for the children they teach. The methodology focused on the experiences of nine teachers in two multicultural secular primary schools. The classroom experiences of a spiritual nature that the teachers recounted, while many and varied, revealed some common themes that related to the climate of the classrooms. Such classrooms were characterized as being non-judgemental and non-self-conscious and as places where a community of spiritual discourse was encouraged and where deeply meaningful activities and events occurred. The findings suggest that while teachers cannot plan and predict precisely what will foster spirituality in classrooms, teachers can cultivate a climate that enhances children's spirituality.     

Faces of Shame: Implications for Self-Esteem,Emotion Regulation,Aggression, and Well-Being

There is an increasing interest in psychological research on shame experiences and their associations with other aspects of psychological functioning and well-being, as well as with possible maladaptive outcomes. In an attempt to confirm and extend previous knowledge on this topic, we investigated the nomological network of shame experiences in a large community sample (N = 380; 66.1% females), adopting a multidimensional conceptualization of shame. Females reported higher levels of shame (in particular, bodily and behavioral shame), guilt, psychological distress, emotional reappraisal, and hostility. Males had higher levels of self-esteem, emotional suppression, and physical aggression. Shame feelings were associated with low self-esteem, hostility, and psychological distress in a consistent way across gender. Associations between characterological shame and emotional suppression, as well as between bodily shame and anger occurred only among females. Moreover, characterological and bodily shame added to the prediction of low self-esteem, hostility, and psychological distress above and beyond the influence of trait shame. Finally, among females, emotional suppression mediated the influence of characterological shame on hostility and psychological distress. These findings extend current knowledge on the nomological net surrounding shame experiences in everyday life, supporting the added value of a multidimensional conceptualization of shame feelings.     

Approach-avoidance responses to infant facial expressions in nulliparous women: Associations with early experience and mood induction

Infant expressions are important signals for eliciting caregiving behaviors in parents. The present study sought to test if infant expressions affect adults’ behavioral response, taking into account the role of a mood induction and childhood caregiving experiences. A modified version of the Approach Avoidance Task (AAT) was employed to study nulliparous female university students’ implicit responses to infant faces with different expressions. Study 1 showed that sad, neutral and sleepy expressions elicit a tendency for avoidance, while no tendency for approach or avoidance was found for happy faces. Notably, differences between approach and avoidance response latencies for sad faces and participants’ negative caregiving experiences were positively correlated (r = 0.30, p = 0.04, Bonferroni corrected), indicating that individuals who experienced insensitive parental care show more bias toward sad infant faces. In Study 2, we manipulated participants' current mood (inducing sad and happy mood by asking to recall a happy or sad event of their recent life) before the AAT. Results showed that sad mood enhanced the bias toward sad faces that is buffered by positive mood induction. In conclusion, these findings indicate that implicit approach avoidance behaviors in females depend on the emotional expression of infant faces and are associated with childhood caregiving experiences and current mood.