Trauma-Focused CBT in the Context of Parental Chronic Medical Conditions: A Case Report

Parental chronic medical conditions (CMCs) are relatively common and have been shown to impact children’s psychosocial functioning. Previous research suggests that, for some youth, parental CMCs may be conceptualized as a form of traumatic stress. Trauma-focused cognitive behavioral therapy (TF-CBT) is a multicomponent, evidence-based intervention that is designed to reduce symptoms of posttraumatic stress, depression, and anxiety, as well as behavioral problems, among children and adolescents. Despite its robust empirical support, however, no known studies have utilized this treatment approach to address the mental health needs of youth affected by parental CMCs. The purpose of this article is to describe the application of TF-CBT to treat an adolescent male whose mother was diagnosed with a CMC, which had resulted in continuous family stressors since his birth. Results suggest that TF-CBT offers a promising approach for treating symptoms of posttraumatic stress, anxiety, and depression among children of parents with CMCs, and clinical trials to investigate its effectiveness among this population may be warranted.     

Innovative moments and poor outcome in narrative therapy

Aims: To analyse a poor outcome case of narrative therapy with a woman victim of intimate violence. Method: The Innovative Moments Coding System: version 1 was applied to all sessions to track the innovative moments (i‐moments) in the therapeutic process. I–moments are the narrative details that occur in psychotherapeutic conversations that are outside the influence of the problematic narrative. This research aims to describe the processes involved in the stability of meanings in psychotherapy through a dialogical approach to meaning making. Findings: Contrarily to what usually occurs in good outcome cases, re‐conceptualization i‐moments are absent. Moreover, two specific types of i‐moments emerged with higher duration: reflection and protest. Qualitative analysis showed that the potential meanings of these i‐moments were surpassed by a return to the problematic narrative. Conclusion: The therapeutic stability seems to be maintained by a systematic return to the problematic narrative after the emergence of novelties. This process was referred from a dialogical perspective as a mutual in‐feeding of voices, one that emerges in the i‐moment and another one that supports the problematic narrative, which is maintained by an oscillation between these two types of voices during therapy.     

Ethics and Accreditation in Addictions Counselor Training: Possible Field Placement Issues for CACREP‐Accredited Addictions Counseling Programs

The Council for Accreditation of Counseling and Related Educational Programs now recognizes addictions counseling as a specialized field of practice. Two case studies illustrate possible unintended violations of ethical and training standards.     

Coming to an end: A case study of an ambiguous process of ending psychotherapy

Aim: When the duration of therapy is not preset and the outcome is a matter for negotiation, the decision to end psychotherapy will be an experiential concern for the two participants. This case study draws attention to how ambiguities may be settled in a process where ending is initiated by the therapist and resisted by the client. Method and analysis: The actual case was strategically selected as exceptional owing to a combination of circumstances. The client and the therapist had developed a ‘good enough’ alliance (WAI) and reached a ‘good enough’ outcome (OQ‐45), and still the client felt she was far from finished. A close inspection of interactional data in sessions together with both clients' and therapists' reflections in post‐therapy interviews elicited information about both substantial content and structural aspects of this complicated process of ending. Findings and discussion: The discrepancy between therapist and client was not addressed, but rather postponed and revisited again later. Structural elements like preparations for a break for vacations and reducing the frequency of sessions were used to test experiential qualities, such as how the client managed life without therapy. Carefully preserving a ‘good enough’ emotional bond through the negotiations seemed important to both parties. Significantly, the client's autonomy was interpreted as the final proof of improvement and the client came to a point where she could affirm that she had got better only by accepting that treatment was coming to an end.     

Religious freedom and cultural asymmetry: Some pitfalls of secularism

ABSTRACT

Disputes concerning state interference in the religious practices and traditions of citizens have created uproar in public debate in India and Europe during the past decades. The contributors to this colloquium on Europe, India, and the Limits of Secularism point to the importance of two domains in addressing these disputes: the comparative study of court decisions and the budding domain of comparative political theory. In this response, I discuss several issues that emerge from these domains and argue that the problem of cultural asymmetry continues to create major pitfalls in the debates on secularism and religious freedom.     

Mentalizing in Parents after Traumatic Loss. Analysis of Couple Counseling

Abstract

The aim of the study is to explore whether bereaved parents’ capacity to mentalize is related to their progression through grieving and how it changes during couple therapy. The clients’ RF levels were assessed using the Reflective Functioning Scale and Psychotherapy Reflective Functioning Scale Manual. The content of the sessions was analyzed using Thematic Analysis. At the beginning of the therapy, concrete images of the child’s death were more frequent and the parents’ RF was lower than their general RF level. As the therapy progressed these images were gradually supplanted by more mental references to the deceased child.     

基于模式分类的中医医案分析技术

中医药经历数千年的发展,已积累了大量数据,特别是从古到今的医案数据,但这些数据因没有用现代信息手段整理、分析,而不能为中医药的科学研究提供支持。本文将模式分类技术应用于医案数据的分析中,从已知的病症推断出所属的证型。该方法能够进行自动学习,不需要专家的辅助即可从医案中学习到病症和证型的联系。     

一例医学院校男生考研失败引发一般心理问题的报告

案例描述了一位大四护理学专业的男生，因为考研失利后出现注意力不集中、睡眠障碍等问题前来咨询，诊断为一般心理问题。咨询师采用合理情绪疗法，经过5次心理咨询，取得预期效果。