Selfobject intervention in brief treatment with patients inappropriate for traditional brief psychotherapy models

This article discusses brief psychodynamic intervention with patients who are likely not to benefit from a primarily verbal, insight-oriented or explorational treatment. The major models of brief psychodynamic psychotherapy and their range of effective applicability are discussed. The function of selfobjects throughout the life-cycle are explored. Interventions designed around these selfobject functions are presented for patients unlikely to benefit from a more traditional approach. These interventions are developed through a thorough assessment of the patient's difficulties and include the setting of time limits for treatment (i.e. both within sessions and for the treatment as a whole). Interventions specifically directed toward reestablishing effective selfobject functioning in the mirroring, idealizing and twinship/alterego spheres are also presented. Vignettes are used to illustrate such interventions.     

ADAPTING THE MODEL: THERAPEUTIC WORK WITH CHILDREN FROM ARMY FAMILIES

This paper describes the development of a specialised therapeutic service for parents and their young children in an inner city social services family centre. The Under five's counselling service, based on the Tavistock Model, offers brief psychoanalytic interventions to parents who are worried about their young child's development e.g. crying, eating, persistent crying etc. The premise behind setting up such a service was to provide therapeutic intervention to the parent-child relationship at the earliest possible stage, preventing further ongoing difficulties. The paper draws upon observations and interventions with families I have seen in the first year the service was opened. Particular themes which emerged in the work with these families will be highlighted. In particular a link is made between early childhood difficulties and unresolved loss in the mother's lives. Furthermore, the impact of the service upon the rest of the social services family support services is commented upon.     

Brief Family Therapies

A modified version of Guerin's (1976) classification was used to categorise the principal models of brief family therapy according to theoretical and technical dimensions. While all models stemmed from common origins, either psychodynamic or systems theory, they differed in three particular areas: the premises regarding the origin of symptoms, the aims of therapy, and the major strategies employed. Nevertheless, all models were in agreement on several aspects, including the principles underlying brief family therapy techniques, the focus on the family's current level of functioning, the importance of clearly defining the problem (but not necessarily in terms of traditional psychiatric diagnoses), and other family variables. A survey of the literature indicated that there was a paucity of scientifically acceptable investigations of brief family therapy, and thus, a lack of valid evidence that any model provided an effective approach to therapy.     

Guidance,counselling, therapy: responses to ‘marital problems’ 1950–901

This paper makes a contribution to the still relatively undeveloped literature on the sociology of counselling, using a detailed case study of one organisation. Styles of intervention are explored in the work of the National Marriage Guidance Council/Relate. The paper rejects a simple linear development model based on transitions from ‘guidance’, to ‘counselling’ to ‘therapy’ Influences deriving from Rogerian models of counselling, from psychodynamic and behavioural theory are explored and are placed in the context of wider organisational factors. Attention is given to the varying fortunes of the medical model within Marriage Guidance. The paper concludes with an examination of the contradictions thrown up by recent attempts to develop an eclectic model of marital counselling, which appear to founder on the absence of any clearly defined goals for intervention.     

Change and Paradox in Family Therapy

This paper shows that when the interpersonal context in a family alters, solutions which have previously been successful may paradoxically increase the family's difficulties rather than resolve them. Therapy minors this process, in that when the family system is flexible, “commonsense” interventions may be effective, whereas with a rigid dysfunctional family system therapeutic interventions may be necessary which, among other things, paradoxically imply that no change is required. Some concepts derived from Watzlawick, Weakland and Fish are redefined and the mathematical group theory used by these authors is replaced by system theory in combination with the theory of logical types. A “behaviour disorder” family is used to illustrate the paradoxical mode of symptom development and also the use of a number of paradoxical therapeutic interventions. Possible reasons for the therapeutic power of these interventions are discussed; the concept of first and second order therapeutic paradoxes is introduced.     

User satisfaction surveys and cognitive question testing in the public sector: the case of personal social services in England

Obtaining feedback from service users is a key element of the UK Labour Government's agenda for modernization of the public sector. This reflects a growing international trend in Europe and North America. Recognized difficulties in taking an approach to performance assessment based on the concept of user satisfaction are outlined. Ascertaining the views of people who use personal social services poses particular challenges which result from the levels of impairment and illness in the population, local variations in service provision and the 'care and control' functions of social care. It is argued that cognitive testing of questions, based on research knowledge about user views, provides a way of overcoming some of the pitfalls of traditional satisfaction surveys, while developing questions that are meaningful to respondents. The origins and principles of cognitive testing are described, followed by an example of their application in the development of a questionnaire for home care users. Strengths and limitations of the approach are identified.     

Navigating the ‘shadow of loss’ in mental health social work

ABSTRACT

The human experience of loss has been at the centre of psychoanalytic understandings of the human condition since Freud’s first writings on ‘melancholia’. This essay draws on psychodynamic theory to show how workers who are attuned to the experience of loss in service users can shape their interventions accordingly. By reflecting on how a diagnosis of ‘depression’ might better be understood as the rippling wave of past grief, professionals can utilise the dynamics of projection, transference and containment to help understand the emotional pain of individuals they support. But this essay also suggests that the use of psychodynamic practice works best when it is bolstered by other frameworks – in this case an understanding of systems theory. When the two traditions are utilised together, they provide an understanding of psychic phenomena which can enable social workers to build a basis for effective interventions with service users experiencing mental distress.     

Fundamentals of Theory and Practice Revisited: Adult Clients With Mild ‘Intellectual Disability’: Rethinking Our Assumptions

There is considerable confusion surrounding the concept of ‘intellectual disability’ and great stigma attached to this label. This paper questions whether the concept is a useful one when applied to adults with mild learning difficulties and encourages less rigidity in categorisation. Some implications of a pseudo‐medical model are examined. Counselling for adults with mild intellectual disabilities has been much neglected. Some aspects of counselling these individuals are briefly discussed: expectations; communication style; exploring the client's idea of ‘disability’; accepting versus challenging ‘disability’; importance of relationships; exploring discrimination and abuse; depression and anxiety; and the danger of assuming a lack of understanding.     

Social support networks of care leavers: Mediating between childhood adversity and adult functioning

Care leavers' social support networks have often been theorized as having a salient role in explaining youths' functional outcomes and the way these relate to their adverse pasts. The goals of the present study are to examine the association between childhood adversity and adult functioning among youth aging out-of-care, and to explore how attributes of their social support networks mediate this association.The sample consisted of 345 Israeli care leavers (ages 18 to 25), formerly placed in residential or foster care. Standardized self-report questionnaires were administered to assess various attributes of youths' support networks (e.g., network size or adequacy) vis-à-vis three types of social support (emotional, practical, information and guidance), indices of childhood adversity, and markers of adult functioning (adjustment to post-school settings, economic well-being, and housing difficulties).Structural equation modeling indicated that a significant portion of youths' functioning outcomes was attributable to childhood adversity. This relationship was fully or partially mediated by social support, across the various types of support and outcomes examined. Network size and network adequacy were the most prominent predictors of functioning; the latter more consistently so. Whereas emotional, practical, and information and guidance supports all significantly contributed to greater adjustment to post-school settings and economic well-being, only practical support was related to fewer housing difficulties.The differential effects of the attributes and functions of care leavers' support networks on functioning outcomes are discussed in reference to social network literature. The paper also presents recommendations for practice and policy with a focus on social network intervention.     

A social capital approach to improving public relations’ efficacy: Diagnosing internal constraints on external communication

This article extends Heath's (2006) concept of fully functioning society theory (FFS) and argues that public relations can be used as a force to enhance collective social capital in communities. To serve this purpose, however, the effectiveness of an organization to serve its external publics is often dependent on the status and relationships the public relations function has developed within the organization. This paper provides a network analysis of a government agency in Jordan that illustrates the relationship between internal organizational social capital and the potential problems for establishing external relationships with publics. Implications for public relations research methods and theory are also discussed.     

Feedbackarbeit in Lehr-Lern-Prozessen

Working with feedback in schools is often based on the (mis-)understanding that it is a form of teacher assessment carried out by the students. Therefore, this paper starts with demarcating feedback from patterns of expectation and of actions that equate feedback with assessment. It unfolds a concept of feedback which is based on methodically structured discussions, shared responsibility, a dialogue practice and designed working alliances. It reconstructs a practice that avoids assessment and seeks possibilities to support learning processes and lesson development. This concept of working with feedback as a motor for a systematic and collaborative lesson development hasn't been a result of an armchair decision. It is grounded on experiences of teachers in four schools who, for one year, continuously worked with feedback methods in their lessons—not by themselves but collaboratively in a network with other schools and in the context of a scientifically accompanied project.     

Self‐Soothing — A Recursive Intrapsychic and Relational Process: The Contribution of the Bowen Theory to the Process of Self‐Soothing

The concept of self‐soothing originating in the psychodynamic tradition has attracted interest from therapists as a key skill in the managing and regulating of strong affect and emotional discomfort. While a capacity for self‐soothing is implicit in, and a vital prerequisite to, the process of differentiation, Murray Bowen also predicted that the outcome of increased differentiation is improved emotional equilibrium and a capacity for self‐soothing, clearly a recursive process. The attention of Bowen family systems theory to both the relational and intrapsychic aspects of human functioning provides a useful framework through which to explore these aspects of the dynamics of self‐soothing. This article describes some of the key processes involved in developing a self‐soothing capacity within an effort to define a more autonomous self in significant relationships. The author contrasts Family Systems thinking with other theoretical perspectives that speak to the importance of self‐soothing. Finally, the role of the therapist as a facilitator of an environment in which the self‐soothing resources of clients can emerge is considered alongside suggestions and strategies for how a therapist may contribute to a client's own efforts.     

Predictors of accuracy in perceiving informal social networks

One's ability to accurately perceive the existence of informal social networks, referred to as cognitive accuracy, has recently been shown to play an important role in explaining various social phenomena. This paper addresses the research question of what predicts cognitive accuracy by developing a simple theory which links one's accuracy to the amount of information one exchanges with co-workers. To test the predictions of my theory, I analyze friendship and advice network data from a small entrepreneurial firm. The results of the analysis show that predictors of accuracy tend to be workers' degree centrality in the friendship or advice network and demographic and social distances between workers.     

Web-Based Education in the Human Services: Use of Web-Based Video Clips in Counselling Skills Training

SUMMARY

This use of web-based video clips for counsellor skills training is used in the Campus Alberta Applied Psychology Counselling Initiative which provides Master's-level counsellor education at a distance. The core counselling skills course is delivered through the Web using digital video clips of counselling skills demonstrations, chat room skills practice and weekly discussion forums. A follow-up face-to-face Summer Institute allows learners to receive live feedback on their skill development. Course content is grounded in the construct of the working alliance (Bordin, 1979). Course activities use Bloom's taxonomies of learning objectives. Program evaluation suggests that learners are meeting competencies as they move from this course to practicum placements.     

Exploring changes in family functioning when a child participates in a School-Based Filial Therapy program

Child focus is a central construct within Bowen family systems theory (Bowen theory). A clinical implication is that mental health treatment focusing on a child may unwittingly reinforce the operation of child-focused processes, which undermine rather than enhance child well-being. The concept of child focus in Bowen theory presents significant implications for professionals working in school settings and in fields such as children's mental health, which are inherently child-focused. Bowen theory is the guiding theoretical framework for School-Based Filial Therapy (SBFT). SBFT is a play therapy intervention that was initially established in remote and outer-regional New South Wales, Australia in response to the low availability of children's mental health services and the significant barriers associated with caregiver engagement in children's mental health treatment. It involves trained school personnel facilitating therapeutic play sessions with children experiencing emotional–behavioural problems. The intervention occurs on school grounds, during school hours, and children's family members do not participate in the intervention. This mixed-methods study examines the impact of children's participation in SBFT upon family functioning. Interviews with caregivers (n = 10) of children who participated in 10 SBFT sessions were analysed using content analysis. Quantitative data were collected using the Differentiation of Self Inventory – Short Form and Visual Analogue Scale – Family Functioning. A Wilcoxon signed rank test was used to analyse the pre- and post-data. Qualitative outcomes indicated changes in the categories of child functioning, caregiver functioning, and extended family functioning, whilst child-focused processes remained dominant but changed in intensity and valence following SBFT.     

Distributive Justice in the Household

Abstract

We analyze the theoretical basis on which wives and husbands evaluate the fairness of the division of household labor. Using distributive justice theory, we argue that evaluations are based on beliefs about equality and equity rules and social comparisons. We developed a number of formal models to account for evaluations of housework fairness and compare these with data from the 1987 National Survey of Families and Households. We find that husbands' evaluations of fairness of the division of household labor are based on more traditional gender-based division of labor as their comparisons tend to be based on comparisons to other men's participation in housework. In contrast, wives' evaluations are based on both gender role norms and the justice principle of marital equality, as they tend to be based on comparisons between their spouse and themselves.     

Thinking from experience in psychosocial practice: reclaiming and teaching ‘use of self’

A course based on psychosocial theory and students' experiences in practice has been taught in the UK, Norway and Quebec. It departs from the classical social work concept ‘use of self’ and aims to help novices in health and social work to understand how the social world is internalised and re-produced and the value of thinking from experience. International developments such as, competency-based education, New Public Management and evidence-based practice reduce opportunities for experiential learning. This trend has been exacerbated by a focus on anti-oppressive practice without a corresponding understanding of how oppressive relations are internalized and enacted by defended and conflicted subjects. Attempts to rectify a relational deficit through traditions of reflective practice and critical reflection are important developments, but could be further strengthened by psychosocial and psychodynamic perspectives. The course combines critical, contextual and relational thinking for students in caring professions.     

Working with neglected children and their families

Child neglect has proved a particularly difficult area for social work to address. In the first part of the paper a number of reasons for this are discussed. We go on to suggest that chronic child neglect characteristically involves the breakdown or absence of a relationship of care. Therefore, the social work response needs to include a focus on the relationship difficulties between parent and child which manifest as either an unwillingness or inability on the part of the primary carer to offer reliable, adequate care, and on broader relationship difficulties within the family. In arguing for an approach that pays attention to the intra-personal and relational dynamics of neglect, we draw specifically on attachment theory and consider how Ainsworth's (1978) typology of attachment patterns can shed light on parenting styles and patterns of family functioning associated with chronic neglect. We use the concept of the 'internal working model' to develop an understanding of the ways in which family members understand and live out their relationships—with each other and with the worker. We conclude by suggesting that this relational approach requires an ability on the part of the social worker to work both with and within relationships, and look at the contribution that a critically informed relationship-based approach can make to work with families where child neglect occurs.     

PROBLEM MAINTENANCE IN FAMILY SYSTEMS: AN INTEGRATIVE MODEL*

Cybernetic theory, social learning theory and psychodynamic theory often have been put forth as competing models of the maintenance of family problems. It is argued here that the relative absence in the field of attempts to integrate these perspectives has restricted severely the development of family assessment and therapy. After highlighting the essential features of these three models, an integrative model of family problem maintenance is proposed, and the model's applicability is demonstrated in an illustrative discussion of three major types of clinical problems: symptomatic spouse, symptomatic child, and conflictual couple. Implications of the model for clinical practice are also discussed.     

TOO LITTLE FEAR CAN KILL YOU. STAYING ALIVE AS A SOCIAL WORKER

This paper provides a psychodynamic exploration of risk assessment of service users who might represent a danger to others and, in particular, to the social workers involved in their care and treatment. Substantive quotations from participants in a qualitative research study enquiring into experiences of fear in social work and counselling are provided and discussed in the light of psychodynamic theory. Fear is seen to be of crucial and life‐enhancing significance while not listening to the ‘survival signals’ transmitted from fear responses is shown to be potentially dangerous, even fatal. The need for workers to locate themselves accurately on the continuum of the depressive/paranoid‐schizoid position is highlighted throughout as is the need for them to appear to disturbed and disturbing service users as whole people rather than part objects. The importance of clearing a space through the fear to think about what is happening between service user and worker is emphasised and the parts played by the eyes and the emotions in this are also considered. The paper concludes with the contention that workers should aim to cultivate an attitude of appropriate fearfulness as this is a helpful albeit complex balance worth striving for.