Pulling together: building a community debriefing team.

1. Research shows that many emergency workers are affected physically and emotionally by critical incident stress. 2. Debriefings conducted by trained team members are an effective method to mitigate the impact of critical incident stress. A debriefing is a structured, time-limited group intervention. 3. Cooperation among community agencies is essential for the development and effective functioning of a critical incident stress debriefing team. 4. Several teams in Illinois have organized to form a Critical Incident Stress Debriefing Network. The Illinois network is part of an international organization composed of critical incident stress debriefing providers.     

Problem gambling and policy advice: The mutability and relative effects of structural,associational and attitudinal variables

Research on gambling has the double mandate of public service and the advancement of science. This paper is meant to carry forward that mandate. Latent in research on the causes of problem gambling is the policy insight that these causes represent different types of phenomena and are unequally mutable to practitioners' efforts to prevent and/or treat problem gambling. By making the issue of mutability manifest in research, findings from research would have more policy relevance and practical import. Data from a 1989 Iowa survey on lottery play and problem gambling are analyzed to illustrate this point. 1,226 respondents were contacted by phone and phone interviews were completed with 1,011 of these 1,226 eligible respondents. With multiple regression, we assessed the contributions of mutable and immutable variables to the explained variance in problem gambling. The results show mutable correlates explain enough variance in problem gambling to recommend their consideration in treatment/prevention. The results also suggest a social as well as a psychological etiology to problem gambling. Future research should, however, do a more complete comparison of social and psychological causes of problem gambling.This research was partially supported by the Iowa Department of Human Services and the National Institute of Mental Health (1 R01 MH50369-01A1). The authors wish to thank Willis Goudy, anonymous readers and the editor of this journal for helpful comments.     

The availability of personal and external coping resources: Thier impact on job stress and employee attitudes during organizational restructuring

This study examines the relationships among personal coping resources, social support, external coping resources, job stressors and job strains in a sample of 110 American Telephone and Telegraph employees undergoing a major organizational restructuring. The study expanded on a model suggested by Ashford (1988) by defining another category of coping resources that employees may draw upon to deal with the stressors and strains which occur during major organizational changes. External coping resources were defined as those which provided employees with a sense of 'vicarious control' in stressful situations. Results indicated that personal coping resources, social support and external coping resources had a direct effect upon job stressor and strain levels. No 'buffering' effect of these coplng resources was found. Hierarchical regression analyses indicated that external coping resources added to the prediction of job stressors and strains even when pertonal coping resources and social support were entered first into the prediction questions.     

Childhood parental loss and adult depression

Previous research demonstrates convincingly that childhood parental deaths and parental divorces have implications for adult well-being as defined by levels of depression, educational attainment, early age at marriage, and risk of divorce. What this research has failed to examine are the interconnections among these outcomes. Specifically, are the socioeconomic and marital outcomes of parental loss implicated in the observed higher levels of depression? This analysis takes a first step in answering this question. Using data from a sample of 1,755 married men and women, I estimated regression models which examine the extent to which adult socioeconomic status and current marital quality mediate and/or modify the loss-depression relationship. Parental divorce was strongly related to socioeconomic and marital outcomes. Furthermore, current marital quality contributed importantly to understanding the higher levels of depressed mood observed among persons from divorced homes. Parental death was much more weakly related to socioeconomic and marital outcomes, and these outcomes played little role in explaining its relationship to depression. Finally, all of these relationships were stronger among women than men. These findings support the utility of life-course approaches to understanding adult mental health.     

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.