Parallel process and the forced termination of a milieu group

Parallel process has been observed in the social work and psychiatric literature as an element in the psychodynamics of individual treatment and supervisory relationships. This paper suggests that it is present during group treatment as well and examines its emergence during the termination phase of a milieu group. A review of the literature on both parallel process and termination with groups is presented. It is noted that the conditions necessary for the emergence of parallel process are exactly those found during the termination period of group treatment. Clinical illustrations from the forced termination of a milieu group are presented, documenting a variety of parallel processes which were observed. The dynamics of these processes are examined. Potential indicators of parallel process are discussed, as well as implications for both treatment and supervision.     

Depressed College Students and Tricyclic Antldepressant Therapy

Abstract

Charts of all outpatients (n = 267) seen during three consecutive months of 1977 by a university student mental health clinic were retrospectively reviewed for reports of depression. Over one-fourth of university students (n = 76) seen during this period were noted to present with significant symptoms and signs of depression. Charts of depressed patients were further analyzed for distribution by final diagnostic category, demographic data, and treatment outcome results. The majority of depressed patients were diagnosed as depressive neurosis while the second most common diagnosis was adjustment reaction. A significant proportion of patients with a final diagnosis of depressive neurosis had initially been diagnosed as adjustment reaction. Vegetative signs of depression were Infrequently noted In patients with adjustment reaction. These patients were usually treated with psychotherapy alone and showed symptomatic Improvement in one-half of cases. Vegetative signs, especially sleep disturbance, were noted in one-half of patients with depressive neurosis. These patients were often treated with tricyclic antidepressants plus psychotherapy, which resulted in significantly greater Improvement in both dysphoria and vegetative signs than treatment with psychotherapy only. Treatment outcomes for depressed patients thought to have concomitant character disorders were uniformly poor.

Thus, depressed college students In the present study represented several distinct diagnostic groups, of which patients with depressive neurosis showed optimal treatment outcomes following tricyclic antidepressant therapy.     

Firearm advertising: product depiction in consumer gun magazines

In contrast to tobacco, alcohol, and other consumer products associated with health risks, we know very little about how firearm manufacturers advertise their products. The authors examined advertisements for firearms in all 27 ad-accepting magazines listed in Bacon's Magazine Directory "guns and shooting" category. Sixty-three manufacturers spent an estimated $1,195,680 on firearm advertising during the month studied. Annual advertising costs ranged widely; manufacturers spent an estimated $28.16 in advertising per firearm produced. Firearms generally were presented as a part of a lifestyle. Self-protection was noted infrequently in the advertisements. By contrast, attributes of the gun, typically technological characteristics, were noted in almost every advertisement.     

DEMAND AND SUPPLY OF HOUSING IN THE U.S.: 1929–1978

Annual data for the period 1929–1978 are used to estimate a complete model of demand and supply of housing services and consumption goods in the U.S. by maximum likelihood methods. The demand functions are derived by maximizing a utility function characterized by weak inter-temporal separability. Utility in each period is assumed to be of a generalized CES type with housing services and consumption goods as arguments. The estimating demand relation is transformed into a relatively simple form by focusing on the relative demand of housing to consumption goods. It is found that the intra-temporal elasticity of substitution between housing and consumption goods is unitary. The maximum likelihood estimates of the other parameters of the elementary utility function are also presented. Finally, it is noted that by estimating the structure of individual preferences a basis is established for the calculation of long-run efficiency gains of a change in the tax treatment of housing.     

Attributional Analyses of Child Sexual Abuse Episodes

Attribution theory provides the cornerstone for an examination of victim self-blame in clinical and research literature. It is argued that other-blame often is presented in such literature as the preferable attributional outcome for abuse victims, while the empirical evidence is less than supportive of this claim. Important differences in definition of self and other-blame across studies are noted, and it is suggested that further research examine the attributions more broadly, assess their accuracy, and allow for the possibility of evaluating interactional hypotheses. Clinical issues and connections are discussed.     

Work with a “Neglectful” mother

Abstract

The main themes in a year's pyschotherapeutic treatment of a woman whose child was referred for investigation of neglect are presented and discussed from a point of view prevalent in American clinical social work practice. Some differences between English and American social work practice are noted.     

Taking up the Challenge of Grief: Film as Therapeutic Metaphor and Action Ritual

The case is presented of an eleven year old boy who has twice suffered the loss of his mother —first through his adoption and second through her subsequent suicide. Four years after these events he presented with a number of behavioural problems attributed to a block in his grieving process. Initially therapy was difficult because of the client's inability to express his feelings verbally and because of a number of restraints noted to be operating within the family system. A breakthrough was made through the use of the film ‘The Never Ending Story’? as a therapeutic metaphor and as the basis of an action ritual. Relevant literature (bereavement, cybernetic theory, metaphor and ritual) is discussed. Therapy is detailed.     

Developing a measure of local agency adaptation to emergencies: a metric

Local public health agencies often must respond to health-related emergencies or disasters, while continuing to fulfill all public health functions for which they are funded. This article reports the development and initial pilot test of a method for measuring the nature and degree of a public health agency's response to such an emergency or disaster. How the instrument was developed as well as the initial results from the pilot study of four local public health systems (LPHSs) are presented and discussed. The instrument measured the extent to which each function and division of each of the four LPHSs were affected and provided a metric that could be used across LPHSs to indicate the burden experienced by each due to the emergency. Results obtained from the pilot study indicate that size and complexity of an LPHS was not predictive of its ability to respond to the emergency. These results support the use of the framework and associated measurement procedures to provide valuable information to managers responsible for such LPHSs. Such information should provide a foundation for comparing variations in performance and outcomes to various types of emergencies that vary in their severity and focus.     

Developing a measure of local agency adaptation to emergencies: A metric

Local public health agencies often must respond to health-related emergencies or disasters, while continuing to fulfill all public health functions for which they are funded. This article reports the development and initial pilot test of a method for measuring the nature and degree of a public health agency's response to such an emergency or disaster. How the instrument was developed as well as the initial results from the pilot study of four local public health systems (LPHSs) are presented and discussed. The instrument measured the extent to which each function and division of each of the four LPHSs were affected and provided a metric that could be used across LPHSs to indicate the burden experienced by each due to the emergency. Results obtained from the pilot study indicate that size and complexity of an LPHS was not predictive of its ability to respond to the emergency. These results support the use of the framework and associated measurement procedures to provide valuable information to managers responsible for such LPHSs. Such information should provide a foundation for comparing variations in performance and outcomes to various types of emergencies that vary in their severity and focus.     

Interruptions and nonverbal gender differences

The purpose of this study was to examine gender differences in selected nonverbal behaviors associated with interruptions. Six graduate student groups involving 18 female and 17 male subjects were videotaped. The data for the study were 140 cross-sex interruption sequences and a matched, randomly selected sample of noninterruption sequences. A category system using self-related activity, gestures, body lean, facial expression and eye gaze was developed and used to code the data. There were no significant findings related to interruptions in the categories of self-related activity or gestures. Women leaned away from the group significantly more often than did men and when leaning away, women were more likely to be interrupted. Women were also more likely to be interrupted when smiling than were men, and women smiled significantly more when taking the speaking turn. Finally, women were interrupted significantly more often than men when they did not look at the turn-taker. The high educational status of the subjects was examined in the discussion of the findings.     

From Consensus to Division: Tracing the Ideological Divide Among American Catholic Women, 1950–1980

This article examines the changing images of womanhood within two American Catholic publications: Catholic Mind and Catholic Digest. In the early 1950s, the periodicals had similar constructions of women, with a divergence in thought in the 1960s. Catholic Mind wrote very little on women for the majority of the decade. Catholic Digest in the 1960s featured women who worked in traditionally male roles while they also maintained that women’s primary sphere was in the home. The difference between the two publications becomes stark in the 1970s. Catholic Digest leaned conservative to mainstream and focused on women’s roles in home and secular society without asking ecclesial questions. Catholic Mind’s articles on women primarily examined ecclesial roles (e.g., women’s ordination) and demanded equality in the secular world. This fissure in female identity among American Catholics coincides with the political divide in the United States more generally.     

Analysis and treatment of self-neglectful behaviors in three elderly female patients

Three cases of self-neglect in elderly female patients are presented. Ranging in age from 84 to 92, subjects suffered from chronic, non-terminal illnesses, and engaged in such behaviors as refusal to eat, non-adherence to a prescribed therapeutic regimen, and extreme social withdrawal.One lived in the community and two resided in assisted living facilities in Louisville, Kentucky. Initial interviews strongly suggested that the patients' engagement in self-neglect was an inappropriate yet purposeful response to aversive events or other negative stimuli. Goals of treatment were to (1) identify specific factors which precipitated patient use of potentially life-threatening behavior, and (2) employ behavioral methods of intervention in response to the identified precipitators. Outcomes were moderately positive. Behavioral interventions reduced engagement in self-neglectful behaviors for each of the participants to a clinically significant degree. Positive results were maintained during the three-month period following treatment termination.     

Records on Nationalist and Opposition Movements in Late Imperial Russia: The Police Fonds of the State Archives of the Russian Federation

This article examines collectivization as a crucial aspect of the Soviet state’s ambitious effort to “Sovietize” its postwar western borderlands. Given the enormity of this task, the state leaned heavily on local agitators to convince residents to join the farms, and to manage the farms and their workforce. This put heavy responsibility on local activists to get results, but it also gave them power. This article provides a microhistory of these dynamics in the Transcarpathian village of Bila Tserkva. Faced with a failing collective farm and increased state scrutiny in 1949, village activists blamed the local Jehovah’s Witness community for allegedly subverting a successful collectivization effort. In reality, religion provided convenient scapegoats for villagers and the state to disguise a broader indifference and animosity to Sovietization. This case study demonstrates that state control of its borderlands was limited and dependent upon locals for information and the projection of power.     

Existential Therapy of Panic Disorder: A Single System Study

Recently there has been an emphasis on biomedical and behavioral aspects of the treatment panic disorder. The symptom-based nature of these treatments may cause elements of the life context, such as systems of meaningfulness and symbolism, to be overlooked in some cases. In this paper, the successful treatment of a case of panic disorder of three years duration is presented, in which complete remission of symptoms occurred within the third week of existential psychotherapy. Prior to this therapy, the client had exhibited a deteriorating course while following a purely psychopharmacological treatment plan. Implications are discussed.     

The use of color-coded genograms in family therapy

A variable color-coding system has been added to the standard family genogram. Characteristics or issues associated with a particular presenting problem or for a particular family are arbitrarily assigned a color. The family is then asked to mark each family member with the colors that represent characteristics that fit. Advantages of the color-coding are presented, followed by clinical examples of the color-coding as an assessment tool and as a family task during treatment.     

A Trust-Based Intervention for Complex Developmental Trauma: A Case Study from a Residential Treatment Center

This case study, conducted in a Midwest residential treatment center, reports results from an attachment-based intervention that addressed the needs of a 16-year-old female, Rachel. Rachel had a long and documented history of severe abuse and neglect before her adoption from a Bulgarian orphanage at age 12 and numerous psychiatric hospitalizations in the years subsequent. Upon entering this residential treatment center, Rachel did not respond to traditional residential treatment modalities and was considered one of the most difficult children the facility had ever attempted to help. After the intensive attachment-based intervention for Rachel, her adoptive parents, and facility staff, dramatic increases in pro-social and attachment behaviors were noted, as well as a significant decrease in violent and self-injurious behaviors. The intervention consisted of three phases of differing levels of intensity and was designed to address the attachment system and related sub-systems in order to facilitate the development of healthy attachments.     

Laughing Through This Pain: Medical Clowning During Examination of Sexually Abused Children: An Innovative Approach

This study examined the role of medical clowns during medical examinations of children who were sexually abused. Three case studies are described, illustrating diverse interactions among the victimized child, the medical clown, and the medical forensical examiner during medical forensic examinations held at the Tene Center for Sexually Abused Children, Poria-Pade Medical Center, Israel. The results indicated that medical clowns play a unique role both in lowering anxiety and fear among children before and during the unpleasant forensic examination as well as in mitigating potential retraumatization of the sexual abuse event resulting from the medical examination. The medical clown was found to assist in creating a pleasant and calm atmosphere, thus improving the child's cooperation during the examination.     

Analysis and Treatment of Self-Neglectful Behaviors in Three Elderly Female Patients

ABSTRACT

Three cases of self-neglect in elderly female patients are presented. Ranging in age from 84 to 92, subjects suffered from chronic, non-terminal illnesses, and engaged in such behaviors as refusal to eat, non-adherence to a prescribed therapeutic regimen, and extreme social withdrawal. One lived in the community and two resided in assisted living facilities in Louisville, Kentucky. Initial interviews strongly suggested that the patients' engagement in self-neglect was an inappropriate yet purposeful response to aversive events or other negative stimuli. Goals of treatment were to (1) identify specific factors which precipitated patient use of potentially life-threatening behavior, and (2) employ behavioral methods of intervention in response to the identified precipitators. Outcomes were moderately positive. Behavioral interventions reduced engagement in self-neglectful behaviors for each of the participants to a clinically significant degree. Positive results were maintained during the three-month period following treatment termination.     

Video/Filmography on Single Parenting

The purpose of this video/filmography is to provide potential users with a sampling of recent videotapes that deal with various aspects of single parenting. Titles were gleaned from film and video directories, distributor catalogues, and video review publi- cations which are identified in Appendix A. Date of release, running time in minutes, address and telephone number of distributors are given with each title along with purchase/rental prices. The titles presented are organized into the following five categories: (1) The Single Parent Experience, (2) The Childs Experience, (3) Teenage Single Parenting, (4) General Interest, and (5) Feature-Length Tele- vision and Film Releases. Awards received are noted at the end of each synopsis and intended audience levels are provided.