Method in the Madness: The Strategic Uses of Absurdity and the Unexpected in Psychotherapy

This article explores some of the uses of absurdity and the unexpected in psychotherapy. Case examples are used to ground the discussion of some key ideas that inform an understanding of how absurdity and the unexpected might serve as catalysts or primers for change in the psychotherapeutic context. Erickson's confusion technique and some ideas derived from Bateson's understanding of cybernetics also serve an explanatory purpose.     

The Overestimation Phenomenon in a Skill-Based Gaming Context: The Case of March Madness Pools

Over 100 million people are estimated to take part in the NCAA Men’s Basketball Tournament Championship bracket contests. However, relatively little is known about consumer behavior in skill-based gaming situations (e.g., sports betting). In two studies, we investigated the overestimation phenomenon in the “March Madness” context. In Study 1 (N = 81), we found that individuals who were allowed to make their own predictions were significantly more optimistic about their performance than individuals who did not make their own selections. In Study 2 (N = 197), all subjects participated in a mock competitive bracket pool. In line with the illusion of control theory, results showed that higher self-ratings of probability of winning significantly increased maximum willingness to wager but did not improve actual performance. Lastly, perceptions of high probability of winning significantly contributed to consumers’ enjoyment and willingness to participate in a bracket pool in the future.     

The Sea Monster: An Ethnographic Drama

The characters are Laurel, a sociologist, and Ernest, a novelist. They live together, and they have been writing, and talking about writing for years. There is also a discussant who lives in Laurel's study. The drama begins in a neo-colonial home in the heartland of America, where Laurel—who has been invited to be a “Discussant” of “Ethnographic Novels” at the Society for the Study of Symbolic Interactionism-Stone Symposium at St. Petersburg Beach—is waking up.     

Uses of Systems Theory in Casework I and II: A Proposal

This paper identifies possible problems, issues, and solutions in the practice implementation of the clinical-research methodology. The areas addressed include confusion in the conceptualization of accountability, misconceptions of the clinical-research model, and institutional constraints working against the implementation of the model.     

Issues in Portability of Evidence-based Treatment for Adolescent Depression

Depression is one of the most commonly diagnosed psychiatric disorders among school-aged youth, with high prevalence and far-reaching consequences. However, even though there are two evidence-based practices for treating adolescent depression (Cognitive-Behavioral Therapy and Interpersonal Therapy), most adolescents referred for treatment are unlikely to receive either. In part, this is due to the difficulty of transporting an evidence-based practice from laboratory to real-world setting, and determining how to transport an empirically validated treatment has thus become a focus of concern for social work researchers and practitioners. A host of client, clinician, setting, and treatment delivery variables can influence portability. Taking all these factors into consideration is a daunting task—but less daunting if done at the onset, during the initial process of efficacy research, rather than afterward as a separate stage. The thesis of this paper is that the only solution to the problem of portability is a combined, rather than sequential, approach to treatment development in which effectiveness and application concerns are included in the original research design. A review of suggested approaches, as well as discussion of factors that contribute to variance in outcome, is followed by recommendations for future research.     

Current Practices in Residential Treatment for Adolescent Sex Offenders: A Survey

SUMMARY

A list of all treatment facilities for adolescent sex offenders that described themselves as inpatient or residential was requested from the Safer Society Foundation in Brandon, Vermont. A total of 203 such facilities were identified in this manner. Each was sent a questionnaire regarding their policies and practices. Of the 50 questionnaires that were returned, 49 were usable. Items on the questionnaire dealt with major phases of operating a residential program, including number of beds, average daily census, number of males and females in treatment, testing and assessment procedures, most frequent diagnoses, average IQ of patients, abuse history, therapeutic approaches used, number and types of individual/group treatment sessions per week, qualifications of therapists, average length of treatment, and follow-up research on treatment.     

The Arab Spring and Revolutionary Theory: An Intervention in a Debate

The so-called Arab Spring of the 2010s that toppled six dictators has spurred productive debates about the character of these political happenings and their implications for revolutionary theory broadly. One such debate that appeared recently on the pages of Historical Sociology questions whether or not we are moving into a fifth-generation revolutionary theory. This essay is an attempt to partake in this conversation, not only because my work is under discussion but because I wish to engage with some of the key arguments in the debate to clarify some misunderstandings and suggest ways that the Arab Spring allows for a new thinking about revolution and revolutionary theory. Whether or not new perspectives have emerged may be contested, but there is surely a need for them.     

Developing a Family Risk Assessment Tool in Adolescent Offenders: An Exploratory Study

The quality of family relations it is a relevant risk or protective factor in the adolescent criminal involvement, being the interplay between family and adolescent individual features, fundamental issues in the understanding of the adolescent risk and strengths assessment. This study aims to contribute to the validation of the Structured Interview of Family Assessment Risk (SIFAR) tool for the adolescent offenders’ family, based in nine family living items as risk factors and four protective factors. In an exploratory design, the structural consistency of SIFAR was analyzed using Cronbach’s alpha, mean inter-item correlation and exploratory factor analysis over risk items, because of the protective items dichotomous scale. The participants were a sample of 130 male adolescent delinquents detained in Portuguese facilities of the Directorate-general of Social Rehabilitation and Imprisonment, and their parents, paired analyzed. The SIFAR presents a structured professional judgment design for adolescent offender’s family protective and risk assessment. A reliability value of .75 was obtained for the risk items education, employment, housing/transport, legal problems, social dissonance, poverty, social net, social security and parenting, and an .79 was registered to the protective items family involvement, high discipline, low physical punishment and low parental stress. The risk items revealed a two-factor structure (social-economics and social conformity factors) explaining 48.15 % of the total variance. Results show the potential usefulness of SIFAR in the assessment the family protective and risk factors of adolescent offenders, presenting adequate structural reliability and construct validity. However further investigation it is necessary to the validation process of this tool.     

Adolescent mourning: The sudden death of a peer

This paper examines adolescents who are mourning the traumatic death of peers. A psychodynamic model is employed in offering crisis intervention to individuals and groups of grieving adolescents within a school setting. Case vignettes highlight the psychological impact of the death of a peer on an adolescent's functioning and ego development.     

An mHealth Approach to Extend a Brief Intervention for Adolescent Alcohol Use and Suicidal Behavior: Qualitative Analyses of Adolescent and Parent Feedback

Abstract

Mobile health (mHealth) tools that supplement inpatient psychiatric care can maintain and enhance intervention effects following hospitalization. Adolescents hospitalized following a suicidal event represent a vulnerable population who could greatly benefit from such an mHealth intervention. In specific, suicidal adolescents who drink alcohol are in need of robust interventions that address the bidirectional relationship between alcohol use and suicidal thoughts and behaviors, because it puts them at especially high risk for suicide upon discharge. The purpose of this study was to conduct qualitative interviews to gather feedback to improve a brief alcohol intervention provided to suicidal adolescents during psychiatric hospitalization, and to develop a mHealth tool to extend care after discharge. Participants, eight adolescents and their parents, identified the need for a smartphone application to deliver intervention content to adolescents and parents during the posthospitalization period. Adolescents sought support in meeting alcohol- and mood-related goals, while parents desired general resources as well as tips for conversations with their adolescent about mood and alcohol use.     

The Clinical Uses of Video Therapy in the Treatment of Childhood Sexual Trauma Survivors

The power of visual images, combined with the increased availability of video taping equipment, has dramatically expanded the use of recorded images in psychotherapy over the past three decades. However, it appears that earlier video feedback techniques may not have fully capitalized on this modality's potential for catalyzing therapeutic change. Further, we have found scant literature on the use of video therapy in the treatment of adult survivors of sexual trauma. Drawing conceptually from a trauma model, as well as from cognitive behavioral and systemic/cybernetic frameworks, this article describes the therapeutic use of video therapy in the treatment of childhood sexual abuse. In video therapy, the patient is directed to independently view video recordings of therapy sessions to help correct cognitive and affective distortions resulting from trauma. How these distortions develop within the context of an incest "family trance" and how they are connected with processes of conditioning and programming are discussed. Further, the use of video therapy for marital therapy, perpetrator confrontations, and addressing suicidal impulses is described. The need for further empirical research is highlighted.     

The Effect of Support Expectations on Prenatal Attachment: An Evidence-Based Approach for Intervention in an Adolescent Population

This study was designed to determine the significant variables predicting prenatal attachment in an adolescent population. Scientifically supported knowledge of the factors enhancing attachment plays a crucial role in assisting social workers and other health care professionals to accurately assess and intervene to decrease pregnancy risks. Previous prenatal attachment studies demonstrated conflicting findings due to problems from using different theoretical frameworks and research methodologies. In order to ensure consistency, this study infused an attachment theory perspective. Bowlby’s attachment theory, Levitt’s support expectations model, and research from prenatal relationship studies were integrated. The social survey sampled 129 minority status pregnant adolescents attending public school. Measurements included the Prenatal Attachment Inventory (PAI) and the Support Expectations Index (SEI). Regression analyses revealed that support expectation was a powerful predictor of prenatal attachment with pregnancy planning and less stress adding importantly to explain over 33% of the variance. Support expectation was a greater predictor of prenatal attachment than the actual support available. Findings also supported the construct of prenatal attachment as the initial stage of development of the life cycle. Janis B. Feldman is an Assistant Professor, University, of Texas-Pan American.     

The Corporate Family: Theory and Treatment*

The authors define characteristics of a corporate family style of functioning. An emphasis is placed on the need for sensitivity to the value structure of the family. Crisis is seen coming from a disruption in the support system of one or more members of the family. A treatment strategy with a case illustration is introduced based on strengthening the family using natural coping mechanisms in the community. The objective of treatment is to reinforce the family without necessarily challenging their values or style of functioning.     

The Shared Etiology of Attentional Control and Anxiety: An Adolescent Twin Study

We investigated the etiology of attentional control (AC) and four different anxiety symptom types (generalized, obsessive‐compulsive, separation, and social) in an adolescent sample of over 400 twin pairs. Genetic factors contributed to 55% of the variance in AC and between 43 and 58% of the variance in anxiety. Negative phenotypic associations between AC and anxiety indicated that lower attentional ability is related to increased risk for all 4 anxiety categories. Genetic correlations between AC and anxiety phenotypes ranged from −.36 to −.47, with evidence of nonshared environmental covariance between AC and generalized and separation anxiety. Results suggest that AC is a phenotypic and genetic risk factor for anxiety in early adolescence, with somewhat differing levels of risk depending on symptomatology.     

Boundary Ambiguity and Borderline Personality Traits: Implications for Treatment for Adolescent Girls in Foster Care

This article explores the relationship between boundary ambiguity and borderline personality traits in adolescent girls in foster care. Boundary ambiguity is a family systems concept: family members are uncertain about who is in or out of the family—in either psychological or physical presence or absence. In foster care, it can be assumed that an adolescent girl has experienced trauma significant enough to be removed from her family. The connection between early childhood trauma and attachment disruption in addition to the connection between insecure/disorganized attachment and borderline personality disorder leads to the conclusion that these same adolescents are at high risk for developing borderline personality traits. The sample consists of 40 caseworkers from New England’s child protection departments and therapists from residential programs working with adolescent girls. They completed the Shedler-Westen Assessment Procedure for Adolescents to determine the presence of personality disruption as well as a variation of Pauline Boss’s Boundary Ambiguity Scale #1, and demographic questionnaires. The results find a significant correlation between boundary ambiguity and borderline personality traits. These findings provide directions for future research in clinical treatment and child welfare policy making.     

The Distinctive Uses of Evaluation and Research:

No abstract available for this article.     

Collaborative Treatment for Sexual Behavior Problems in an Adolescent Residential Center

Abstract

Many residential treatment and sex offender programs for adolescents historically have used coercion-based interventions. Treatment programs employing coercive techniques often replicate the same destructive and intrusive behaviors they seek to eliminate. Tension between departments coupled with poor communication and discomfort around sexual behavior issues within the staff of residential treatment centers are more likely to inhibit the progress of the youths they serve.

Collaboration among residential, educational, and clinical components enables staff to work in a direct, genuine, and respectful fashion with students who have histories of sexually abusive behavior. It further assists in maintaining a safe and predictable environment for these students. Finally, it helps students eliminate destructive behaviors by directly and consistently addressing four key areas: sexually abusive behavior, antisocial attitudes, social/emotional functioning, and overall self-care. It is not the author's intention to hold Bennington School, Inc.up as a model residential treatment program or to criticize other residential facilities. Rather, it is hoped that what is working in Bennington may be helpful to others.

Many who have worked on the front lines of residential treatment with sexually abusive adolescents have received training in elements specific to sexually abusive behavior. The origins of treatment for youth who have sexually abused were noteworthy for their lack of offense-specific interventions (National Adolescent Perpetration Network, 1993). However, a wealth of literature soon emerged addressing the need for assessment and treatment techniques specific to this population (Perry & Orchard, 1992; Barbaree, Marshall & Hudson, 1993). Much of this literature made assumptions regarding high levels of chronicity (Perry & Orchard,1992) while other contributions stressed the role of denial and minimization (Barbaree & Cortoni, 1993). As a result, while many issue-specific forms of assessment and treatment were developed, they often did not take into account other developmental needs and issues in the lives of sexually abusive youths (Lane, 1997).

Concurrent with this emerging research was a substantial increase in the number of treatment programs for juvenile sex offenders (National Adolescent Perpetration Network, 1993). In this context, it is not surprising that many treatment programs relied heavily on treatment targeting denial, minimization, and perceived sexual deviance without taking into account other treatment needs of youths. Although a recent literature review of adolescent residential programs (Curwen, 2000) notes a trend away from shame-based approaches, there appears to be less clarity on specific criteria on which to base residential treatment of adolescents who have sexually abused (Curwen, 2000).

Finally, recent research shows that among adult populations, accepting responsibility for abusive behavior in treatment is more likely to result from a warm, genuine, and empathic treatment style (Marshall, Fernandez, & Anderson, 1999). Group therapy participation, similarly, results from encouragement, open questions, and nonconfrontational challenge. The emerging themes of recent trends and research should inspire those at the front lines of residential treatment to reconsider not just basic treatment approaches, but the most minute elements of their interactions with youths.