Raising the Stakes in Child-at-Risk Cases Eliciting and Maintaining Parents' Motivation

This paper, the third in a series concerned with family therapy in cases involving children at risk of abuse, describes an approach to maximising parents' interest and commitment to therapy. After overviewing the difficulties faced by therapists in working with parents who are notorious for their ‘resistance’, we provide guidelines for minimising the negative consequences of notification and for constructing therapeutic leverage in order to elicit and maintain parents' motivation throughout the course of therapy.     

Beyond the Bedroom: Cognitive,Affective, and Behavioral Responses to Partner Touch in Women With and Without Sexual Problems

Women with female sexual problems (FSP) are more likely than unaffected women to demonstrate negative appraisals, negative affect, and avoidance of sexual activity. Research suggests affected women also experience negative affect and avoidance in response to intimate partner contact for fear it will lead to sex. This online study examined whether women with FSP (N = 157) and without FSP (N = 129) exhibited different perceptions, affective reactions, and behavioral responses to hypothetical touch occurring outside sexual activity. Women (M_age = 30.70; SD = 6.66) were randomly assigned to one of three conditions representing hypothetical interactions with their partner (affectionate, sexual, or no touch), and answered questions about their perceptions of their partner’s sexual intentions and their own anticipated negative affect and behavioral avoidance. Women with FSP reported higher perceptions of sexual intent, negative affect, and avoidance in the sexual touch condition, and higher negative affect in the affectionate touch condition, than women without FSP. Results highlight that women with FSP have more negative reactions to partners’ hypothetical affectionate and sexual touch than women without FSP. Interventions for FSP may benefit from targeting women’s perceptions, affective reactions, and behavioral reactions to partner touch when it occurs outside of explicitly sexual contexts.     

Deactivating the Buttons: Integrating Radical Exposure Tapping with a Family Therapy Framework

The purpose of this paper is to describe and illustrate with case examples a brief intervention termed Radical Exposure Tapping (RET). RET can be integrated with family therapy to address stuck points where the therapy is hindered by a family member's affective block, an intense and unchangeable emotional reactivity to a specific trigger. RET draws from the methodology of Eye Movement Desensitization and Reprocessing (EMDR) and combines it with the tapping sequence of the Emotional Freedom Technique (EFT) to produce an intervention that is more flexible than EMDR, provides greater rigor than using the EFT technique alone and can be effective in a single session within the context of family therapy. The paper puts this work into context by first over viewing definitions of trauma and Post‐Traumatic Stress Disorder, arguing that family members' emotional reactivity may be a symptom of PTSD even when they would not qualify for the diagnosis because they had not experienced a life threatening event.     

Bootstrap tests: how many bootstraps?

In practice, bootstrap tests must use a finite number of bootstrap samples. This means that the outcome of the test will depend on the sequence of random numbers used to generate the bootstrap samples, and it necessarily results in some loss of power. We examine the extent of this power loss and propose a simple pretest procedure for choosing the number of bootstrap samples so as to minimize experimental randomness. Simulation experiments suggest that this procedure will work very well in practice.     

Multilevel mediation modeling in group-based intervention studies

This article proposes and evaluates a method to test for mediation in multilevel data sets formed when an intervention administered to intact groups is designed to produce change in individual mediator and outcome variables. Simulated data of this form were used to compare ordinary least squares (OLS) and two multilevel estimators of the mediated effect. OLS and multilevel standard error approximations were also evaluated and recommendations given for optimal estimator choice. These methods were applied to data from an existing substance use intervention to show the impact multilevel mediation modeling can have on the conclusions drawn from real-world evaluation studies.     

THE MEANING OF OCCUPATIONAL PRESTIGE SCORES:

This research reexamines the meaning of occupational prestige scores from the social psychological perspective of identity theory. Using comparable data for Canada and the United States, it analyzes the degree to which the education and income levels of occupations influence occupational prestige judgements by evoking affective associations (feelings about the goodness, powerfulness, and liveliness of occupational identities), as well as the extent to which these social sentiments are independent determinants of prestige. There has been a longstanding controversy about the normative content of occupational prestige scores. We find that moral worthiness (as measured by the Evaluation dimension of the semantic differential) is a determinant of the prestige of occupations with low and middle but not high levels of education and income. We also find that the impact of education on prestige scores is direct and cognitive, while a considerable proportion of the total effect of income is processed through feelings about the potency of occupations. The results for the two countries are very similar. One exception is that moral worthiness is a more important determinant of prestige in the United States than in Canada. We connect this finding to the literature comparing value differences between the two countries.     

The Neurosequential Model of Therapeutics: An Interview with Bruce Perry

In this interview with Bruce Perry, MD, PhD, Senior Fellow of The Child Trauma Academy, Laurie MacKinnon discusses with Dr Perry developmental trauma and the Neurosequential Model of Therapeutics, an approach to clinical problem solving that utilises a developmental lens and incorporates advances in neurobiological development. Dr Perry gives his perspective on the causal connection between childhood abuse and later psychiatric diagnosis, the child's contact with a violent parent post‐separation, the importance of interventions that address the organisation and functioning of lower parts of the brain and his perspective on the use and limitations of psychotropic medications, cognitive behaviour therapy and family therapy.     

THE NEW EPISTEMOLOGY AND THE MILAN APPROACH: FEMINIST AND SOCIOPOLITICAL CONSDDERATIONS*

While the new epistemology and related models of therapy are claimed to have radical social implications, the Milan approach is in ill repute amongst feminists who see it as conservative in relation to women's issues. This paper explores the sociopolitical implications of the new epistemology and the Milan approach, concluding that, while second order cybernetics has greater potential to incorporate a radical social analysis, it has, nevertheless, failed to do so. The application of second order cybernetics in family therapy appears to be constrained by the sociopolitical conservatism of its proponents.     

Initial Meetings in Child-At-Risk Cases: Developing a Therapist-Family Alliance

Child at risk cases pose some of the greatest challenges to family therapists. This paper outlines an approach to these cases based on a therapy project which incorporated the results of a qualitative research study investigating parents' perceptions of intervention in child-at-risk cases. This paper focuses on initial meetings between therapists and family members, outlining ways to connect with parents, to establish ground rules for subsequent therapy and to develop relationships based on mutual respect and trust.     

Systems in Settings: The Therapist as Power Broker*

Family therapy discourse has given little recognition to either the specificities of the settings in which family therapy is employed or to the specificites of our clients. Clients are frequently constituted into the culturally subordinate position of ‘other’ to the therapist. This paper examines the ethical imperatives of the position therapists occupy in relation to their others.