‘I'm not a family therapist. OK?’ Working Constructively with Families in Aged Psychiatry

This paper reports on the first phase of a larger study aimed at investigating factors hindering family work and exploring ways to improve the amount and quality of family contact within a community aged mental health service in Melbourne, Australia. During the first phase of the project, 28 mental health professionals were interviewed about their views and experiences. Interviews were transcribed, coded, and analysed in terms of repeating themes. The range of attitudes, beliefs and feelings about family work is summarised in this paper. Polarities emerged around questions of whether or not to engage family members, and if so, what function family work fulfils. The interviews also provided useful information on clinicians' beliefs about what would increase the possibility of family work. The paper concludes with a discussion about how to recognize and value family work in this area and target sustainable interventions during the second phase of the study.     

I'm Not a Bad Mother — Stories of Mothering‐on‐the‐Edge

This article is located in the field of custody and day‐to‐day care, with a focus on experiences of mothering where mothers no longer have everyday care of their children. At the time of writing, tens of thousands of mothers live separately from their children in Aotearoa, New Zealand. However, there is a general perception of rarity associated with non‐resident mothers, partly due to their reluctance to speak of loss of custody. In this article, we develop a theoretical discussion around the inside/outside relationships between non‐resident mothers and their children that informs therapeutic practice. We argue that mothers who live apart from their children are situated at the edge or periphery of their children's day‐to‐day lives and experience this as outside the lives of their children. Nevertheless, mothers' stories speak of qualities of (m)othering that have been born of and nurtured by longstanding and long‐term commitment to their children.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Mindful of the Intersession Break in Family Therapy: The Time to Think Experiment

The Time to Think Experiment researches the experience of clinicians, consumers, and families of an intersession break, which has been used historically in various models of family therapy training. This qualitative pilot study explores the experiences of 21 clinicians, 19 consumers, and six family members using this break for reflection, across the domains of family and couple therapy, individual therapy, group work, and supervision in a mental health service covering the whole age range. Using a phenomenological design, the analysis included narrative, thematic, content, and comparative techniques. The paper considers the impact of privileging reflection in the therapy process, in a climate where models, work cultures, and general lifestyles may not encourage it. Using the intersession break to create space to ‘be’ in the therapy process is one way to integrate mindful and family therapy practice. The emerging themes of an intersession break to promote a richer and deeper therapy experience, and the apparent shift of responsibility for change from clinicians to consumers is discussed.     

Separations: A Personal Account of Bowen Family Systems Theory

This paper is a personal account of my own family of origin research. It explores the impact of separations from parents, nuclear family, and extended family through a Bowen family systems theory perspective using concepts pertaining to Bowen theory such as chronic anxiety, differentiation of self, multigenerational family process, and the emotional system. An outline of the process of doing research in ‘vivo’ with my mother as well as conversations with my supervisor are included. Theoretical differences between individual and system models are discussed. A Bowen theoretical approach to the anxiety of separations is investigated. The efficacy of engaging in family of origin work and the effects of thinking systems is examined in light of how it assisted me to view family members, family system disturbances, and clients’ emotional systems more objectively.     

Relational problems and psychiatric symptoms in couple therapy

This article describes couples attending family counselling in Sweden. The study group is compared with clinical groups and non-clinical groups. Self-rating instruments were com-pleted by 317 women and 312 men to evaluate the following: marital satisfaction (DAS), expressed emotion (QAFM), family climate (FC), psychiatric symptoms (SCL-90) and sense of coherence (SOC). This group had several problems: marital relationships, disrupted family functioning, dyadic interactions characterised by criticism and open arguments, and multiple psychological symptoms. The women were espe-cially discontent in the relationship, and they exhibited higher symptom strain and lower sense of coherence than the men did. Compared with non-clinical populations, this group was severely distressed and was similar to in-patient families in child psychiatric clinics. The low sense of coherence of the individuals in the group under study means that their sense of having a meaningful life and their ability to comprehend and manage problems were severely compromised. Adequate and comprehensive treatment within the framework of social pro-grammes should be made available to these couples and others in a similar situation.     

A Quality Risk Management Model Approach for Cell Therapy Manufacturing

International regulatory authorities view risk management as an essential production need for the development of innovative, somatic cell‐based therapies in regenerative medicine. The available risk management guidelines, however, provide little guidance on specific risk analysis approaches and procedures applicable in clinical cell therapy manufacturing. This raises a number of problems. Cell manufacturing is a poorly automated process, prone to operator‐introduced variations, and affected by heterogeneity of the processed organs/tissues and lot‐dependent variability of reagent (e.g., collagenase) efficiency. In this study, the principal challenges faced in a cell‐based product manufacturing context (i.e., high dependence on human intervention and absence of reference standards for acceptable risk levels) are identified and addressed, and a risk management model approach applicable to manufacturing of cells for clinical use is described for the first time. The use of the heuristic and pseudo‐quantitative failure mode and effect analysis/failure mode and critical effect analysis risk analysis technique associated with direct estimation of severity, occurrence, and detection is, in this specific context, as effective as, but more efficient than, the analytic hierarchy process. Moreover, a severity/occurrence matrix and Pareto analysis can be successfully adopted to identify priority failure modes on which to act to mitigate risks. The application of this approach to clinical cell therapy manufacturing in regenerative medicine is also discussed.     

德育答辩:叙事疗法在大学生思想政治工作领域的实践探索

"德育答辩"是基于叙事疗法的工作理念对大学生进行思想政治教育的有益尝试，二者具有以故事叙说为基本途径、注重营造温暖支持的氛围、外化与解构问题、寻找特殊意义事件、引入见证人巩固正向力量等共同特征。德育答辩活动帮助大学生实现了自我教育，变"隐患"为教育资源，使良好的校风学风通过朋辈教育得以传承，使教育过程由"被动接受"变为"主动教育"，使学生从"受教育者"变为"故事叙说者"，使教师由"教书匠"变为"见证人"，有效促进了大学生思想政治教育工作的开展。