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It was in the years immediately following World War II and through the 1950s that the psychoanalytic establishment officially defined psychoanalysis as a subspecialty of psychiatry, and it was in that context of the professionalization of American medicine that they codified the distinction between psychoanalysis and (psychoanalytic) psychotherapy. In this commentary on Steven Stern's “Session Frequency and the Definition of Psychoanalysis,” I deconstruct a series of binaries that was built into the analysis/therapy distinction and that has plagued our discipline. It is argued that psychoanalysis identified itself with the culturally “masculine” and heterosexual values of autonomous individuality (the intrapsychic), while it split off all that was relational and social (interpersonal), marked as “feminine,” homosexual, and “primitive,” onto psychotherapy, which it then devalued. The paper then examines the implications for practice and psychoanalytic education. [ABSTRACT FROM AUTHOR]

Purpose: We examined positive behavioral resources and characteristics that might distinguish resilient personality prototypes among persons with chronic spinal cord injury/disorder (SCID). Positive psychology variables with clear linkages to existing psychological interventions were examined as potential mediators of the resilience–well-being relationship. Research Method and Design: A cross-sectional, self-report study was conducted. Two hundred and ninety-eight consenting members of the Paralyzed Veterans of America (268 male; 236 self-identified as white) provided useable survey data for analysis (including 161 veterans with tetraplegia, 107 with paraplegia, 30 with cauda equina). Cluster analysis of Big Five personality traits identified resilient and nonresilient personality profiles. Tests of mean differences between resilient and nonresilient participants on behavioral resources and characteristics were performed. Path models predicting well-being and health-related quality of life (HRQL) were conducted. Results: One hundred and sixty-three respondents had resilient personality profiles and 135 had nonresilient profiles. Resilient individuals reported significantly more optimal scores on every positive psychology variable, and greater well-being and HRQL than nonresilient respondents. Path models found the relationship of resilience to well-being was explained through its beneficial associations with psychological flexibility, use of personal strengths, meaning in life (MIL), and gratitude. Psychological flexibility also mediated the resilience–HRQL relationship. Cauda equina was significantly associated with higher pain interference and lower HRQL. Conclusions: Higher gratitude, MIL, use of personal strengths, and psychological flexibility appear to characterize resilience and well-being among persons with chronic SCID. Further studies are needed to understand the impact of pain interference on HRQL among individuals with cauda equina. Impact and Implications: The present study documents several positive behavioral resources and characteristics that typify resilience among persons with chronic spinal cord injury/disorder. The results should prompt rehabilitation psychologists to consider further study of the positive psychology variables examined in this paper, and the potential use of the existing interventions associated with each one. [ABSTRACT FROM AUTHOR]

Introduction/Objective: As in the rest of the world, in Latin America there is a high prevalence of interpersonal violence (IV) in childhood and adolescence, which is associated with psychological consequences in the short, medium and long term. At the international level, progress has been made in the recognition of evidence-based psychotherapies, but the situation in Latin America is unknown. The objective of this systematic literature review is to identify which psychotherapy models or modalities have been shown to be effective in Latin America. Methods: A systematic search of five databases was carried out with search terms relating to psychosocial interventions of people exposed to IV during childhood, based in Latin America. Studies regarding Latino populations based in United States were excluded. Results: 14 papers describing 13 studies and one follow-up were identified. Individual and group interventions (mainly cognitive-behavioural and with psychodynamic influence) were included. Although all showed clinically or statistically significant changes in symptoms of post-traumatic stress, anxiety and depression, most were pilot studies with important methodological limitations and a high risk of bias. Conclusions: It is necessary to develop clinical practice in Latin America with more robust research (i.e., controlled and randomised clinical trials) that produce more reliable evidence regarding the effectiveness of psychosocial interventions for IV involving children and adolescents in the Latin American context. [ABSTRACT FROM AUTHOR]

Accelerated resolution therapy (ART) is a psychotherapy for the treatment of prolonged grief disorder (PGD) defined as severe, enduring longing for the lost person. Currently, ART lacks examination of intrapersonal processes, like expectancy, as behavioural mechanisms for action. Therefore, the purpose of this paper was to present the findings on participants' treatment expectations of ART for PGD and then discuss potential hypotheses for future testing. This study was a primary qualitative descriptive analysis of prospectively collected interview data (collected 2017–2019) accrued as part of a randomised, wait‐list controlled clinical trial in bereaved hospice family caregivers in the United States. The sample included 29 former informal caregivers who were at least 1‐year post death of their care recipient. They were primarily female, older (67.4 ± 7.1 years), and a little over half (n = 18) had been married to their care recipient. Thematic analysis resulted in three distinct themes with six sub‐themes: The role of knowledge in expectations (sub‐themes uncertainty, prior knowledge); The role of personality in expectations (sub‐themes openness, positive affect); and Expecting a process (sub‐themes cognitive processes, affective processes) which described the interaction of person and process in shaping expectations of our intervention. An across theme analysis of the specificity of the participants' expectations uncovered that knowledge and personality inform expectations of ART and that individuals who verbalise a process for recovery tend to be very specific in their expectations. Three hypotheses for testing are put forward and implications for practice, research and policy discussed. [ABSTRACT FROM AUTHOR]

Biomarkers may serve as objective measures in complicated grief (CG) potentially capturing responses to stress reduction treatment. This paper reports challenges in obtaining and assessing salivary cortisol and α-amylase (sAA) for a recent randomized clinical trial. Within-session changes in salivary cortisol and sAA for 54 older adults with CG who received Accelerated Resolution Therapy were compared with perceived stress measured by Subjective Units of Distress Scale. Bivariate correlations and multiple regressions examined changes in biomarkers. Protocols, study logs, and audit reports identified challenges. Challenges included obtaining unstimulated passive drool salivary samples and their analyses. Our sample of older females on multiple medications may have resulted in a perfect storm of moderating and intervening variables which affected the stress response. This paper contributes to the discussion on designing clinical trials for older adults which must account for physiologic changes, multimorbidity, and polypharmacy common in this population and makes recommendations moving forward. [ABSTRACT FROM AUTHOR]

As we go to press in a COVID‐19 world, the topic of anxiety is foremost on our minds. While each situation has to be considered in its own context, how to manage different anxieties has common denominators. There is currently a sharp increase in forced migration around the globe so mental health professionals must develop effective skills, like the ability to adapt services to different contexts and cultures, to manage the needs of immigrant people. Problem‐Solving Brief Therapy, as developed at the Mental Research Institute in Palo Alto, is a systemic model of therapy, which aims at promoting change in the complaint the presenting client (the 'talker') cares about. The model's roots in Constructivism foster integrating the clients' beliefs and values into therapy to allow the therapists to adapt to the clients' particular needs. This paper is the analysis of a single case where the therapist worked with an immigrant family because their child suffered from severe anxiety related to the parents' threatened deportation. The paper focuses on premises and strategies that allowed minimising cultural barriers between therapists and family members, thus facilitating a strong therapeutic alliance conducive to improvement. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (EDs) were once conceptualized as primarily affecting affluent, White women, a misconception that informed research and practice for many years. Abundant evidence now discredits this stereotype, but it is unclear if prevailing "evidence‐based" treatments have been evaluated in samples representative of the diversity of individuals affected by EDs. Our goal was to evaluate the reporting, inclusion, and analysis of sociodemographic variables in ED psychotherapeutic treatment randomized controlled trials (RCTs) in the US through 2020. Methods: We conducted a systematic review of ED psychotherapeutic treatment RCTs in the US and examined the reporting and inclusion of gender identity, age, race/ethnicity, sexual orientation, and socioeconomic status (SES) of enrolled participants, as well as recruitment methods, power analyses, and discussion of limitations and generalizability. Results: Our search yielded 58 studies meeting inclusion criteria dating back to 1985. Reporting was at times incomplete, absent, or centered on the racial/gender majority group. No studies reported gender diverse participants, and men and people of color were underrepresented generally, with differences noted across diagnoses. A minority of papers considered sociodemographic variables in analyses or acknowledged limitations related to sample characteristics. Some progress was made across the decades, with studies increasingly providing full racial and ethnic data, and more men included over time. Although racial and ethnic diversity improved somewhat, progress appeared to stall in the last decade. Discussion: We summarize findings, consider context and challenges for RCT researchers, and offer suggestions for researchers, journal editors, and reviewers on improving representation, reporting, and analytic practices. Public Significance: Randomized controlled trials of eating disorder psychotherapeutic treatment in the US are increasingly reporting full race/ethnicity data, but information on SES is inconsistent and sexual orientation absent. White women still comprise the overwhelming majority of participants, with few men and people of color, and no gender‐diverse individuals. Findings underscore the need to improve reporting and increase representation to ensure evidence‐based treatments are effective across and within diverse groups. [ABSTRACT FROM AUTHOR]

The complexity of the African American community in the United States continues to evolve. The growing number of professional African Americans who grew up in the postcivil rights era combined with the persistent reminders of inequity paints a complex backdrop for understanding African American relationships. The majority of our knowledge about African American couples disproportionately comes from nonclinical social science fields such as sociology and demography. Unfortunately, the scholarly literature on how to work with African American couples is relatively scant. This paper seeks to add to this limited literature by providing clinicians and scholars with a proposed set of issues to consider when conceptualizing and treating African American couples. In particular, the complexity and nuance needed to work with African American couples are best done by using an integrative model. Thus, this paper will discuss how the Integrative Systemic Therapy (IST) model is particularly well suited for working with African American couples. This paper will summarize the science on African American marriages with a focus on salient factors such as gender, SES, and trust, which will then be translated into clinical practice by utilizing a case example. The case example will be of a middle‐class couple in order to delineate the challenges and the growing heterogeneity of African Americans. The article will conclude with a commentary on the evolving heterogeneity of African Americans, which sheds light on how an integrative perspective is important for disentangling and embracing the growing complexity of African American couples. [ABSTRACT FROM AUTHOR]

Coronavirus outbreak created diverse challenges for mental health services in general and to psychotherapy in particular. One of the most prominent of these is the move from delivering psychotherapy in face to face sessions to telephone or internet-based platforms. While this is a challenge to all psychotherapies, this paper examines specific considerations that should be taken into account when doing recovery-oriented integrative psychotherapy with persons with schizophrenia. Based on our clinical experiences conducting trials of psychotherapy with people with schizophrenia in Israel and in the United States, we describe several changes that took place as we were providing psychotherapy at the outbreak of the pandemic. These include general changes in the platform of psychotherapy and in the focus of sessions at both process and content levels. These changes represent both barriers and opportunities for the recovery process. Following a description of these changes we discuss and outline adaptations that are needed for sustaining patient's sense of their own agency and of the intersubjective nature of the session. [ABSTRACT FROM AUTHOR]

Details an experience which led to the writing of the scientific paper," An Examination of Wilhelm Reich's Demonstration of Orgone Energy" in 1953. Reason for attending a psychotherapy session with a substitute English teacher, Robert Kronemeyer; Assertion by the originator of orgasm therapy and vegetotherapy, Wilhelm Reich regarding orgone energy; Complaint filed by the U.S. Food and Drug Administration against Reich and his associated in February 1954.

This paper summarizes the place of psychotherapy and psychoanalysis in the US health care system. It addresses trends in the field, tensions between biomedical and biopsychosocial models of mental and substance use disorders, and summarizes top-down legislative and bottom-up judicial actions that impact access to psychosocial treatments for mental and substance use disorders. [ABSTRACT FROM AUTHOR]

Objectives: We provide a review of the literature on posttraumatic stress disorder (PTSD) in older adults, focusing largely on older U.S. military veterans in two primary areas: 1) assessment and diagnosis and 2) non-pharmacological treatment of PTSD in late life. Methods: We performed a search using PubMed and Academic Search Premier (EBSCO) databases and reviewed reference sections of selected papers. We also drew on our own clinical perspectives and reflections of seven expert mental health practitioners. Results: Rates of PTSD are lower in older compared with younger adults. The presence of sub-syndromal/partial PTSD is important and may impact patient functioning. Assessment requires awareness and adaptation for potential differences in PTSD experience and expression in older adults. Psychotherapies for late-life PTSD appear safe, acceptable and efficacious with cognitively intact older adults, although there are relatively few controlled studies. Treatment adaptations are likely warranted for older adults with PTSD and co-morbidities (e.g., chronic illness, pain, sensory, or cognitive changes). Conclusions: PTSD is an important clinical consideration in older adults, although the empirical database, particularly regarding psychotherapy, is limited. Clinical Implications: Assessment for trauma history and PTSD symptoms in older adults is essential, and may lead to increased recognition and treatment. [ABSTRACT FROM AUTHOR]

The opioid epidemic is a national emergency in the United States. To meet the needs of individuals diagnosed with Opioid Use Disorder (OUD) office-based opioid treatment programs (OBOT) are quickly expanding. However, social workers roles in OBOT programs are not clearly described. This paper will emphasize three roles social workers may fulfill in OBOT programs to combat the opioid crisis. [ABSTRACT FROM AUTHOR]

This paper reviews the use of psychotherapeutic approaches to treat individuals who have committed sex crimes and/or have problematic sexual interests (PSI); including types of psychotherapy used, descriptions of preventive and reintegration programmes, and highlighting specific theoretical controversies. In the second part, experts from Canada, the Czech Republic, Russia, the United Kingdom, and the United States, who participated in an International Consensus Meeting held in Prague (2017), summarize treatment programmes in their countries. The comparison revealed some general findings: each country has variability between its own programmes; most countries have different programmes for people who are in custody and who are in the community; the state-directed treatment programmes are primarily focused on criminal individuals, while non-criminal individuals are treated in preventive programmes and/or in special clinics or are untreated; the presence of PSI in patients is acknowledged in most programmes, although specific programmes exclusively for individuals with PSI rarely exist. Studies on effectiveness are difficult to compare due to methodologic, political, and cultural differences. Further communication between more countries to share knowledge about successful treatments and preventive approaches is needed, especially enhanced international collaboration between researchers and clinicians to verify the effectiveness of current clinical and experimental program, rs. [ABSTRACT FROM AUTHOR]

Over the past two decades, research on pediatric bipolar disorder has grown geometrically. The diagnosis of pediatric bipolar disorder was met with enthusiasm, which in healthy doses catalyzed change, and skepticism, which in good measure pushes for rigor. Skepticism led to productive questions about the phenomenology of pediatric bipolar disorder and how best to diagnose and treat it. With regard to prevalence, key questions included whether it was increasing over time, and whether it was limited to the United States. In 2011, we published a meta‐analysis addressing the prevalence questions; results indicated that bipolar disorder manifested at statistically indistinguishable rates in youth community samples across the world. In their recent paper, Parry et al. examine the studies included in the 2011 meta‐analysis using a qualitative approach. Their opinion piece represents a step backwards; every study has shortcomings, but in focusing on a dozen individual studies, Parry et al. fail to take into account the preponderance of evidence – literally thousands of articles across countries, cohorts and methodologies – that support the existence of bipolar disorder in both prepubescent youth and adolescents. This commentary addresses misperceptions regarding the diagnosis of bipolar disorder in youth, particularly with regard to cross‐informant agreement, to present converging data from international sources regarding the onset of bipolar disorder in childhood, and to correct the false claim that pediatric bipolar disorder is controversial. As clinicians and researchers, we have an obligation to do what we can to improve the lives of youth affected by mental illness. Denying the existence of a serious mood disorder will not serve the best interests of young people and will perpetuate the long delays many experience before getting an accurate diagnosis, appropriate treatment, and a fair chance at a good quality of life. Read the Editors' introduction at: doi: 10.1111/camh.12315 Read the core debate at: doi: 10.1111/camh.12231; doi: 10.1111/camh.12243; doi: 10.1111/camh.12306 Read more perspectives in this debate at: doi: 10.1111/camh.12318 doi: 10.1111/camh.12317; doi: 10.1111/camh.12316; doi: 10.1111/camh.12313; doi: 10.1111/camh.12310; doi: 10.1111/camh.12314 [ABSTRACT FROM AUTHOR]

Complex trauma is a significant public health problem in the United States (U.S.), occurring in families with chronic and compounding exposures to traumatic stressors like substance misuse, intimate partner violence (IPV) and child maltreatment (Cook et al., 2017). Yet, few programs exist to treat their intersection, challenging our ability to respond effectively and restore positive trajectories for children and families. In this context, there is a need for innovative approaches to treat these intersecting phenomena. In this conceptual paper, we identify three innovative programs that offer integrative approaches to these intersecting challenges. We analyze common elements among these programs, offering a theoretical foundation for fundamental elements of transformative services. Finally, we consider how the Families First Prevention Act could be leveraged for states to adopt and implement these programs. The goal of this conceptual paper is to advance empirical and practical discussions regarding programmatic and policy options for more effectively responding to substance misuse, and IPV in families, and the associated traumas incurred by maltreated children and their caregivers. • Substance misuse, IPV, and child maltreatment, frequently co-occur. Yet, few programs exist to address their inter-related effects. • This conceptual paper reviews three exemplar integrative programs: Child Development Community Policing, Family-Based Recovery, and Child Parent-Psychotherapy. • We identify key and common elements of these integrative programs. Specifically, we find that: 1 warm handoffs, 2) removing barriers to access, 3) relationship-based practice, 4) a trauma-informed approach, 5) strong case management, 6) providing access to services when families are in crisis, and 7) breaking down silos are important components for integrated approaches. • The federal Family First Prevention Act (FFPSA) could be leveraged to fund innovative, integrative approaches to substance misuse, intimate partner violence, and child maltreatment. • Integrative programs are important for promoting resilience and restoring positive trajectories for children and families. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach - The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings - The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications - This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programs. Originality/value - This paper provides mental health professionals with a review of the growth in understanding of the enormous, unmet mental health needs of people intellectual disabilities, and of the critical role of ID in development of mental health problems. Moreover, this paper builds the case for an important revision in the training of psychologists to include competence in understanding and treating mental health problems across the full spectrum of intellectual functioning. [ABSTRACT FROM AUTHOR]

Mentalization-based interventions show promise in improving mental health outcomes for children and parents through increasing a family's reflective functioning, or ability to mentalize. Mentalizing involves the ability to understand behavior in relation to mental states, such as thoughts and feelings, and typically develops within the context of secure attachment relationships. One area not given much consideration when training foster parents is their capacity to mentalize. This study evaluated Family Minds, a newly developed psychoeducational intervention for foster parents, designed to increase their ability to mentalize. The current paper reports on the development and preliminary empirical evaluation of Family Minds in a quasi-experimental study where 102 foster parents received either Family Minds or a typical foster parenting class, which served as a control group. Results indicate that parents who received Family Minds significantly increased their levels of reflective functioning as assessed with the Parental Reflective Functioning Questionnaire and a new Five-Minute Speech Sample procedure coded using the Reflective Functioning Scale, and revealed a tendency to show decreased levels of parenting stress on the Parenting Stress Index, while the control group showed no such improvements. These findings support the hypothesis that a short-term psychoeducational intervention may improve foster parents' ability to mentalize themselves and their children. These skills are very beneficial for foster parents, as they frequently deal with children who come into their home with challenging behaviors, attachment issues, and negative internal working models of relationships. This type of intervention has the potential to lower placement breakdowns and improve the mental health of foster children. [ABSTRACT FROM AUTHOR]

Background: Mild traumatic brain injuries (mTBI) are the most common of traumatic brain injuries and patients often experience a wide range of symptoms such as headache, fatigue, dizziness, sleep problems and subjective cognitive deficits. Whilemost symptomatic patients recover quickly, a sub-group of ~ 10-20% of patients experience prolonged symptoms. There is currently a lack of evidence-based treatment for these patients. Objective: The objective of the present paper was to conduct a systematic review of the literature on psychotherapeutic interventions specifically for patients with prolonged symptoms (> 3 months after injury) after mTBI. Methods: With a more precise definition of psychotherapy than previous reviews, an extensive literature search was conducted that yielded 2332 hits, of which five were considered to meet the criteria. Only two of the studies were randomized controlled trials. Results and conclusions: Results revealed several methodological limitations in the included studies, leading to the conclusion that it is premature to make any strong recommendations on psychotherapeutic treatment of prolonged symptoms after mTBI. With in-depth methodological analyses of the included studies and comprehensive recommendations for future research, the present review aims to inform clinicians and to encourage scientists to engage in collaborative effort towards increasing the number of methodologically sound clinical trials in the field. [ABSTRACT FROM AUTHOR]

Content and Focus: The identity of counselling psychology in Britain has been described as nebulous and vague; this paper takes a provocative stance designed to initiate debate and goes quite a bit further in its critique. Beginning with an outline of how counselling psychology in Britain self-describes, the paper draws on research findings and practice examples to argue that counselling psychology in Britain has an overly rigid and often irrelevant identification with phenomenology and humanistic values. Next the paper explores the identity of counselling psychology in other countries to make two points; first, that there is actually more than one identity for the discipline and, second, that British counselling psychology is disappointingly insular in outlook. Lastly the paper outlines the commitment to diversity and multiculturalism which is becoming the defining feature of American counselling psychology. Conclusions: The paper concludes by arguing that a serious commitment to the agenda of diversity would create: (1) a strong platform for the type of critiques of mainstream psychology which British counselling psychology has historically engaged in; (2) a socially important research focus for the discipline; and (3) a special expertise in working with diverse others which would be hugely advantageous in terms of employability. More important, a commitment to this agenda would actually matter in a real world way. [ABSTRACT FROM AUTHOR]

In this paper, the authors present a brief personal account of the senior author's 30 years of exploration in behavioral gerontology. The main thesis of the paper is that behavioral methods and interventions have found a home both in mainstream gerontology and at the National Institutes of Health (NIH). There are three sections: (a) a personal vignette discussing the problems inherent in using operant terminology in a nonoperant world; (b) a discussion, with examples from NIH sources, of the Institutes' views on behavior change; and (c) using Burgio and Burgio (1986) as a reference point, the authors show evidence of progress and vitality of behavioral gerontology in 2011. [ABSTRACT FROM AUTHOR]

As the psychology field moves towards establishing more evidence-based treatment (EBT), the applicability of EBT for different racial and immigrant groups (i.e., African American, Asian Americans and Pacific Islander, and Native American/Native Alaskan) is paramount. The current paper highlights the process of culturally adapting an EBT group cognitive behavioral therapy (CBT) intervention for use with Haitian American adolescents diagnosed with depression. Overall the main objective of this project was to culturally adapt the Adolescent Coping with Depression Course (ACDC) to ensure that it includes cultural factors that are likely to engage and retain Haitian adolescents in mental health treatment. The paper summarizes the cultural training of the focus group leaders, the focus group sessions with a group of Haitian middle-school students, and the feedback received from the participants regarding the intervention. [ABSTRACT FROM AUTHOR]

This paper outlines the recent history of LGBT psychology and psychotherapy in the United Kingdom, focusing on key publications, and the current terrain, highlighting similarities and differences between the UK and the US contexts. The paper is divided into four sections: the first focuses on the early development of the field in the late 1960s. The second section explores the 1980s--a decade that witnessed the publication of two key texts that had a strong influence on the development of the field and, in particular, on the development of critical and discursive approaches. The third section details the rapid changes that occurred in the 1990s including the establishment of a Lesbian and Gay Psychology Section within the British Psychological Society. The final section considers the current terrain and the similarities and differences in the theoretical commitments of researchers and practitioners working in the UK and in the US. [ABSTRACT FROM AUTHOR]

The professional identity of counsellors and guidance practitioners in Aotearoa New Zealand is currently under review as a result of the passing of legislation regulating health professionals and the proposed introduction of national registration of counsellors. In this paper I explore this debate, and examine the professional identities claimed by counsellors, counselling psychologists and psychotherapists. The current discussion in this country is both informed by and provides an illuminating lens on professional identity issues in Australia, the UK and the US. An alternative construction of professional identities that are localised and dynamic, yet distinctly of Aotearoa New Zealand, is proposed. [ABSTRACT FROM PUBLISHER]

A growing body of research focusing on African Americans' mental health is showing that this group relies heavily on their religious/spiritual beliefs and practices to cope with mental health issues including depression. Unfortunately, the psychotherapy literature provides little guidance on how to incorporate religion/spirituality into psychotherapy with African American women. With the growing cultural diversity of the U.S. population, there has been more emphasis on providing patient-centered culturally sensitive care, which involves providing care that is respectful of, and responsive to, individual patient preferences, needs, and values. This paper provides a synthesis of literature that psychotherapists could use to become more culturally sensitive and patient-centered in their clinical practices; that is, to recognize and integrate religion/spirituality into their work with African American women experiencing depression, and possibly other groups with similar needs. [ABSTRACT FROM AUTHOR]

Non-verbal techniques can provide added means to the working through of different issues and themes in therapy. The introduction of a gong--an exotic instrument with very potent effects upon both listener and player--in the process of psychotherapy or hypnotherapy brings in many opportunities for change, intensification, and breaking of impasses, as well as dangers and complications. The unique and multiple properties of the gong are described as they are related to their effect upon the listener in therapy. The indications for the use of non-verbal techniques, including the gong, are discussed, as welt as the many issues involved in its introduction and use within the context of the psychotherapeutic relationship and process. Through developing a mode of working with the gong (Livnay, 1995), the whole area of non-verbal techniques has been opened up, with its many facets providing further means for exploring and working through issues in therapy. This paper deals with the various issues, complications, and complexities, as well as opportunities, which are created in the psychotherapeutic process through the introduction of non-verbal methods, including the gong. Though the gong has been widely used in various Asian countries (Indonesia, China, Korea) for at least 2,000 years (Simbringer, 1939), it is only during the last two decades that it has begun to be applied to psychological and medical practice in Western Europe and the US (Oehlmann, 1990a; Hess, 1999). Since its exposure and consequent incorporation into psychotherapeutic practice in the West, the gong has had a dramatic and almost magical impact. As a result of its special qualities (described below). The gong has also led to increased frequency in rapidly reaching depth in altered states of consciousness, loosening boundaries, over-enthusiasm, and fascination (Oehlmann, 1990a). [ABSTRACT FROM AUTHOR]

This paper examines the impact of World War II and its aftermath on the mental health sector, and traces the resulting transformations in US psychiatry and psychology. Focusing on the years between 1940 and 1970, it analyses the growing federal role in funding training and research in the mental health sector, the dominance of psychoanalysis within psychiatry in these years, and the parallel changes that occurred in both academic and clinical psychology. [ABSTRACT FROM PUBLISHER]

This paper highlights the present day value of Carl Rogers' many contributions. It argues that we should understand psychotherapy paradigms as value-laden social constructions that reflect predominant sociocultural biases, often creating an excessive power differential between therapist and client. Person-centered and experiential practitioners are encouraged to contribute to the larger discourse concerning the helping professions and to take the opportunities offered by the growing field of health promotion, which is person-people-community-centered. [ABSTRACT FROM PUBLISHER]

Background: The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the relationship between authorized marijuana use and substance abuse treatment utilizing data from a preliminary pilot study that, for the first time, uses a systematic methodology to collect data examining possible effects on treatment. Methods: Data from the California Outcomes Measurement System (CalOMS) were compared for medical (authorized) marijuana users and non-marijuana users who were admitted to a public substance abuse treatment program in California. Behavioral and social treatment outcomes recorded by clinical staff at discharge and reported to the California Department of Alcohol and Drug Programs were assessed for both groups, which included a sample of 18 reported medical marijuana users. Results: While the findings described here are preliminary and very limited due to the small sample size, the study demonstrates that questions about the relationship between medical marijuana use and involvement in drug treatment can be systematically evaluated. In this small sample, cannabis use did not seem to compromise substance abuse treatment amongst the medical marijuana using group, who (based on these preliminary data) fared equal to or better than non-medical marijuana users in several important outcome categories (e.g., treatment completion, criminal justice involvement, medical concerns). Conclusions: This exploratory study suggests that medical marijuana is consistent with participation in other forms of drug treatment and may not adversely affect positive treatment outcomes. These findings call for more extensive sampling in future research to allow for more rigorous research on the growing population of medical marijuana users and non-marijuana users who are engaged in substance abuse treatment. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate the feasibility and impact of dialectical behaviour therapy (DBT) for patients with borderline personality disorder (BPD) in a clinical outpatient setting. Eighteen clinicians were trained and supervised in using DBT. Twenty-seven female patients were assessed on a number of variables before the treatment, as well as 5 and 12 months after the start of the DBT. Despite some barriers, DBT could be implemented successfully, and the professionals reported increased competence 1 year after the start of the therapy. Low treatment dropout rates suggested that DBT was well accepted by the patients. One year after the start of treatment, the patients reported significant decrease on most variables measuring psychological distress and number of parasuicidal behaviours. The study provides preliminary support for the feasibility and impact of DBT in the outpatient treatment of BPD in a cultural setting outside the United States. [ABSTRACT FROM AUTHOR]

Background: 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) is a form of psychotherapy specifically developed for patients with chronic depression. In a study in the U.S., remarkable favorable effects of CBASP have been demonstrated. However, no other studies have as yet replicated these findings and CBASP has not been tested outside the United States. This protocol describes a randomized controlled trial on the effectiveness of CBASP in the Netherlands. Methods/Design: The purpose of the present paper is to report the study protocol of a multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) for chronic depression in the Netherlands. In this study, CBASP in combination with medication, will be tested versus usual secondary care in combination with medication. The aim is to recruit 160 patients from three mental health care organizations. Depressive symptoms will be assessed at baseline, after 8 weeks, 16 weeks, 32 weeks and 52 weeks, using the 28-item Inventory for Depressive Symptomatology (IDS). Effect modification by co morbid anxiety, alcohol consumption, general and social functioning and working alliance will be tested. GEE analyses of covariance, controlling for baseline value and center will be used to estimate the overall treatment effectiveness (difference in IDS score) at post-treatment and follow up. The primary analysis will be by 'intention to treat' using double sided tests. An economic analysis will compare the two groups in terms of mean costs and cost-effectiveness from a societal perspective. Discussion: The study will provide an answer to the question whether the favorable effects of CBASP can be replicated outside the US. Trial Registration: The Dutch Cochrane Center, NTR1090. [ABSTRACT FROM AUTHOR]

This paper describes the process of modifying and transporting an evidence-based treatment, Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), from a university setting to school-based health clinics. It addresses conceptual issues involved in the shift from efficacy to effectiveness research as well as operational issues specific to the transport of IPT-A into school-based health clinics. Consideration is given to the rationale for an IPT-A effectiveness study, methodological concerns, and the timing of the move from the "lab" to the community. The authors identify challenges and barriers to initiating effectiveness and transportability research and provide suggestions for overcoming these barriers. Recommendations for conducting research in school-based practice settings are provided. [ABSTRACT FROM AUTHOR]

There are many challenges to transporting evidence-based treatments from laboratories into real-world settings. However, if we hope to make our evidence-based treatments accessible and available to children and usable by community professionals, effectiveness research is imperative. We argue that schools represent an ideal real world setting in which to conduct such research. The goals of this paper are to present the advantages of conducting effectiveness research in the school setting and to encourage clinical researchers to engage in effectiveness research in this "location," as there are benefits to children, pre-service professionals, communities, and researchers. We attempt to further advance the literature by discussing the challenges associated with this work and by providing a case example (The Youth Experiencing Success in School [Y.E.S.S.] Program) that demonstrates real world application of our recommendations. [ABSTRACT FROM AUTHOR]

This paper, cowritten by Kingsley Norton, since 1989 Director of Henderson Hospital (a therapeutic community founded by Maxwell Jones in 1947 in the United Kingdom), and Sandra Bloom, Founder of the Sanctuary Model in the United States, compares and contrasts the practice of the democratic therapeutic community (TC) as applied to the notion of long-term care (up to twelve months), to that of the democratic therapeutic milieu (TM) as applied to short-term care (up to one month). [ABSTRACT FROM AUTHOR]

The term "boundary violation" has become synonymous with unethical practice in psychotherapy, prompting a "black-or-white" view among clinicians and boards of review. But the current conceptual ambiguity about boundary interventions subjects clinicians to after-the-fact second-guessing that can be professionally ruinous at worst and may contribute to stultifying defensive therapeutic rigidity at best. It is crucial to demarcate the differences between boundary violations and boundary crossings (to be defined below) as clearly as possible, to describe the "gray areas" of each, and to recognize the heterogeneity of boundary violations and boundary crossings. These matters are of additional importance to those who teach, train, and supervise the next generation of clinicians. This paper will attempt to delineate a more clinically realistic and useful view of boundary crossings than has been proposed before, and illustrate the practical advantages of recognizing the spectrum of boundary interventions. [ABSTRACT FROM AUTHOR]

Infertility affects 6 million American women and their partners, about 10% of the reproductive age population. Recent improvements in medication, microsurgery, and assisted reproductive technology (ART) make pregnancy possible for more than half the couples pursuing treatment, yet infertility is more than a medical condition. Infertility touches all aspects of a person's life. It affects how individuals feel about themselves, their relationships, and their life perspective. Stress is only one of a myriad of emotional realities that couples facing infertility deal with, often for extended periods of time. In addition to ongoing stress, infertility creates issues of guilt, anxiety, tension within the relationship, and feelings of depression and isolation. Treating couples and individuals who are involved in the journey of dealing with infertility is an opportunity for clinical specialists in psychiatric mental health nursing. The expertise of clinical specialists both in providing psychotherapy services as well as providing a bridge of understanding of sophisticated medical and surgical procedures places them in a unique position among the various disciplines offering mental health services. This paper provides an overview of the psychological issues that play a role in psychotherapy with this population and suggests specific clinical interventions and potential role expansion for psychiatric clinical specialists. [ABSTRACT FROM AUTHOR]

This paper presents the case of a 9-year-old African American male who received psychotherapy from an Anglo-American social worker. She describes her effort to provide active cross-cultural treatment. Her colleague, an African American social worker, offers her critique of this work. The authors discuss the challenges of communicating cross-culturally about treatment and provide a ‘diary’ of the process. [ABSTRACT FROM AUTHOR]

Abstract: This paper describes a multi-dimensional, ongoing approach to evaluation in a sex therapy training program. The Yale Sex Therapy Training program set out to train psychotherapists working in public agencies throughout Connecticut who would meet or surpass pre-determined standards for sex therapists. Because sex therapy is a new discipline, it was deemed essential that program evaluation be developed and carried out from the very beginnings of the program and throughout its course. Evaluative findings proved essential to monitoring the quality of teaching and supervisory efforts, in assessing change in knowledge and professional activity of trainees, and in measuring impact upon the communities served. Continuous feedback led to changes in program content and format through identification of needs and problem. The experience in the Yale program confirms the recommendations of others regarding the conduct of a continuing education program. These findings strongly imply that multi-dimensional, ongoing evaluation should be an integral component in any continuing education program. [ABSTRACT FROM AUTHOR]

This paper presents a methodology for estimating costs of delivering specific substance abuse treatment services. Data collected from 13 programs indicate that the mean cost of residential treatment is $2,773 per patient per month, and outpatient treatment costs average $636 per patient per month. Data are presented on the cost patient per month for individual treatment and nontreatment services, average number of services, cost per unit of service, and intensity of services. In addition to their application to insurance benefit cost estimation, these data illustrate the costing of best-practice adolescent treatment consistent with a Center of Substance Abuse Treatment (CSAT) Treatment Improvement Protocol. In the emerging policy environment, detailed cost estimates like these will aid the design of cost-effective treatment programs, and serve the development of the substance abuse benefit in a health care reform insurance package. [ABSTRACT FROM AUTHOR]

This article discusses the much-misunderstood Tarasoff decision that requires psychotherapists to protect third parties from patients' violent acts. Through a normative approach, the paper analyzes four important issues: what to do when potential victims are unknown; what to do about the fact that the patients' potential for violence may be incorrectly perceived; the value of warning potential victims; and, the problem of discharging potentially violent patients from the hospital. The author proposes that the courts adopt a more flexible substantial departure test in most cases that involve psychiatric negligence. [ABSTRACT FROM AUTHOR]

Contemporary person-centered psychotherapy often references empathy as a basic component of the therapeutic alliance and, thus, effective treatment, such that nascent clinicians study this basic skill early in training. However, the psychotherapy literature often presumes a collective agreement about how empathy manifests as a clinical tool, in the process institutionalizing the ideal of omnipresent alignment with a client, applied across populations of patients, regardless of their conditions, ages, and personal and cultural characteristics. Misalignments between clinicians and clients have the potential to bely broadly imagined ethics of empathy (and the notion of collective agreement about what it is) by demonstrating the ways tension, difference, and incongruence promote treatment. Through an autoethnography of a 12-month psychotherapy dyad with an elderly woman committed for treatment at a U.S. psychiatric hospital, we discuss how moments of incongruence between clinician and client expand conceptualizations of empathy in treatment of psychosis. Specifically, in this context, deployment of empathy-as-alignment becomes a fallacy of care, risking the effectiveness of treatment through impossible epistemological assumptions of and counterproductive joining with the client. As such, this transtheoretical discussion presents two types of incongruence in the dyad—developmental and subjective—as a backdrop for expressing empathy. This paper makes space for a theory of empathy as the practice of working in genuine and careful service of the client's psychology through acts of incongruence as much as alignment. • Definition of the construct of empathy lacks consensus in the clinical literature. • Clinicians may struggle struggle to empathize with the life stage and extra-realistic perceptions of elderly clients with psychosis. • Unavoidable elements of incongruence between clinician and client do not need to point to empathic failure. • Use of incongruence through metaphor and radical genuineness may build experiences of empathy and the therapeutic alliance. • Empathy may be delineated as both affective and cognitive affirmation and as shifts between congruence and incongruence. [ABSTRACT FROM AUTHOR]