Clinical work with adolescents and their parents during family transitions: Transference and countertransference issues

This paper describes specific transference and counter-transference issues that commonly emerge in therapeutic work with adolescents and parents who are in the midst of family transitions such as divorce and remarriage. Psychoanalytic understanding and definitions of transference and countertransference are applied to short-term family-centered cases in which the parent-adolescent relationship is at particular risk. Case vignettes are presented in order to illustrate how transference and countertransference may guide or interfere with clinical interventions that are especially indicated with adolescents whose family structure has changed. Such interventions as well as the use of consultation are briefly described.At the time this paper was prepared, Ms. Springer was Associate Director and a senior clinician at the Center for the Family in Transition in Corte Madera, California. Funds for the research and clinical work that provided the basis for this paper were supplied by grants from the San Francisco Foudation. An earlier version of this paper was presented at the 66th Annual Meeting of the American Orthopsychiatry Association, New York City, March 31–April 4, 1989.     

The psychodynamically oriented clinical social worker as sports consultant: A preliminary report

This paper explores an unusual and innovative application of psychodynamically oriented clinical social work method to the sports area. The coach of a national Olympics team requested a clinical consultation because he suspected that there might be psychosocial reasons why a certain number of world class atheletes he was coaching were not performing up to their full potential.     

Cognitive and behavioral therapies for pathological gambling

The purpose of this paper is to provide an overview of behavioral and cognitive treatment approaches in the management of pathological gambling disorders. Disappointingly, the literature to date contains only one controlled outcome study in which two differing behavioral techniques were compared. Although research in general has focussed on identifying the nature of cognitive distortions in gambling, findings from these studies have not been systematically translated into treatment programs. It is concluded that methodological limitations including small sample size, absence of control groups, multiple concurrent interventions and poorly defined outcome criteria preclude conclusive statements to be drawn regarding the active ingredient of either behavioral or cognitive strategies. The program offered within the Impulse Disorders Research Centre is outlined.The authors wish to gratefully acknowledge the assistance and contribution of Zachary Steel, Research Assistant, in the preparation of this paper.     

Clinical Writing of a Therapy in Progress: Ethical Questions and Therapeutic Challenges

Clinical implications and ethical dilemmas of the use of confidential case material in clinical writing are examined, including a review of the discourse among professionals who publish clinical work. This literature is applied to a clinical illustration of psychotherapy with a client who gave consent for publication and read the clinical write-up of her case material. It is suggested that clinical writing may increase client “self-reflection” if there is a “secure base” of attachment between therapist/author and the client. The impact on the client’s treatment process is examined, in addition to a discussion of ethical questions and professional recommendations. ²Dr. Susanne Bennett is an Assistant Professor, National School of Social Service of the Catholic University of America. Dr. Bennett is also a psychotherapist in private practice in Falls Church, VA.     

Leaving Home Early: Passing from Girlhood to Womanhood

This paper presents a case study of a young woman’s narrative of leaving home and her transition to adulthood. The case study is part of a larger research project about young women with an experience of an early break-up from home, through running away or being thrown out. Empirical material underlying this paper consists of a qualitative study of 12 young women that have been interviewed. The aim of the study is to understand how events like running away/being thrown out of home influences their transition to adulthood. The particular narrative demonstrates how a young woman presents and accounts for such a dramatic event as running away or being thrown out from home, and how that is understood in relation to her adulthood. A further aim is to illustrate how social services efforts are reflected in her narrative.     

The humorous construction of disability: 'stand-up' comedians in the United States

We examine how stand-up [sic] comedy constructs, circulates, perpetuates and/or disrupts stereotypical images of disabled persons in the United States. We use disabled people, rather than people-first language, to remind readers that disability is an ill-defined, culturally imposed attribute. Although humor is culturally specific, we draw on works of an international cadre of humanities scholars and social scientists to ground our analyses. We conclude that disability humor constitutes an emerging, liberatory art form. Disabled and non-disabled comedians elicit thought-provoking laughter and present disability as an interesting way to live. However, disabling humor still perpetuates stereotyping and isolation.     

Liability in child welfare

Child welfare workers and agencies are vulnerable to lawsuits. Recent court rulings have more clearly defined the liability of workers. The distinguishing variable is custody. Children injured while in the custody of the state are entitled to sue for damages. Children injured by their parent, even if under the supervision of a child welfare agency, are not entitled to claim a violation of their 14th Amendment rights. These cases are reviewed and strategies designed to minimize vulnerability are offered.     

An uncertain future: children of mentally ill parents.

Research reports the uncertain outcome of variables affecting the life of a child of an MI parent. Nurses must avoid stereotyping children before assessment; they are to be in the forefront in assessing self-care skills and deficits to guide planning individual interventions for children and MI parents. Long-term research theory-based interventions will enhance mental health in high-risk children and families.     

Diagnosis and therapy of male gamblers in a university psychiatric hospital

From 1980 to mid-1990 fifty-one gamblers were evaluated and treated at the psychiatric university hospital of Homburg/Saar in Germany. All were men with a mean age of 33.7 years. Gambling had lasted 5.2 years on average. Most patients were motivated to undergo therapy by members of their family. The majority of them had been in psychotherapeutic treatment before. Thirty-six of the 51 patients had committed punishable acts including fraud and embezzlement and, in 7 cases, robbery. The sample could be divided into three clinical subgroups. The first group consisted of patients with severe psychiatric diseases such as schizophrenia, manic-depressive illness or organic brain disorder. Patients of the second group suffered from serious personality disorders. Those of the third group showed deep-rooted problems in their current relationships.This article is an extension of the special issue on Gambling in Europe edited by Iver Hand, M.D.     

Rates of pathological gambling in publicly funded outpatient substance abuse treatment

Rates of problem or probable pathological gambling were assessed in substance abusers seeking outpatient treatment in a publicly funded outpatient substance abuse treatment program. The South Oaks Gambling Screen (SOGS) was administered to 467 consecutive admissions at three different sites. Problem gamblers comprised 6.2 percent of the total (n=29), and 4.5 percent scored as probable pathological gamblers (n=21). These rates are two and one-half times greater than would be expected according to a recent state survey using the SOGS. Implications for assessment and treatment of problem gambling are discussed.The author expresses his appreciation to John Ramsay and the staff of Epoch Counseling Center for data collection; to Les Franklin for computational analysis; and Dr. Rachel Volberg for providing supplemental data from her Maryland State Gambling Survey.