哀伤辅导视角下儿童丧亲主题绘本的疗愈效用——基于对9本绘本的叙事分析

为探究儿童丧亲主题绘本的疗愈效用,以哀伤辅导理论为指导框架对《小伤疤》等9本丧亲主题绘本进行叙事分析。研究发现,丧亲主题绘本多数都构建了完整的哀伤历程,分为5个阶段：“故事开端：叙述过去映射正向情感联结;第一次转折：以委婉言语表达死亡事实;情绪高潮：主人公强烈宣泄负面情绪;第二次转折：寻求超越死亡的生命意义;故事结尾：与过去挥手告别开启新生活。”但仍存在一些不足之处可以优化。例如,绘本创作要直面亲人死亡的生物性事实,建构亲人“永生”的现实意义,结合中国本土文化进行创新。作为家长及教育工作者,要关注丧亲儿童的心理健康,灵活运用绘本对儿童进行死亡教育,帮助丧亲儿童走出哀伤。     

Optimal design of clinical trials comparing several treatments with a control

Clinical trials are often designed to compare several treatments with a common control arm in pairwise fashion. In this paper we study optimal designs for such studies, based on minimizing the total number of patients required to achieve a given level of power. A common approach when designing studies to compare several treatments with a control is to achieve the desired power for each individual pairwise treatment comparison. However, it is often more appropriate to characterize power in terms of the family of null hypotheses being tested, and to control the probability of rejecting all, or alternatively any, of these individual hypotheses. While all approaches lead to unbalanced designs with more patients allocated to the control arm, it is found that the optimal design and required number of patients can vary substantially depending on the chosen characterization of power. The methods make allowance for both continuous and binary outcomes and are illustrated with reference to two clinical trials, one involving multiple doses compared to placebo and the other involving combination therapy compared to mono-therapies. In one example a 55% reduction in sample size is achieved through an optimal design combined with the appropriate characterization of power.     

Work as a cure for mental illnesses? Opportunism and seeking ways in psychology and psychiatry in the first decades of state socialism in Hungary

ABSTRACT

In Hungary, until the end of the 1940s, there were two main established methods of occupying the mentally ill who were fit for work. From the end of the nineteenth century, a lesser number of patients underwent work therapy in mental asylums, whereas the others were treated with so-called family therapy (otherwise known as the heterofamilial system), exploiting the capacities of families in the countryside. As an important part of this, the mentally ill helped in housekeeping and agricultural work. However, following the political and ideological turn of 1948, the latter form of treatment became debated, and then it was gradually superseded. Parallel to this process, work therapy came to be the most popular type of treatment for mental illnesses, as work formed the basis of the ideology of the communist state, and thus, healing through work harmonized with the general tendencies of the era. This article examines texts related to work therapy published in neurological–psychiatric and psychological journals and monographs between 1954 and 1964. However, although work therapy appeared to be the “handmaiden of ideology,” and even though it was supposed to fulfil a particular role, in reality, the role and perception of work therapy were a lot more complicated.     

Power To Our Journeys: Re‐membering Michael

The following personal reflections are in honour of Michael and all that he contributed to our lives. And, we honour Brigitte a key member of the group who died in 2006. Mem, Sue and Veronica, December 2008.     

Some Reflections on the Legacies of Michael White: An Australian Perspective

This article, which appears in a special 30‐year anniversary edition of the Australian and New Zealand Journal of Family Therapy, reflects on the legacies of the work of Michael White. It begins by looking back on Michael's time as editor of the Australian Journal of Family Therapy. Of the many themes that were discussed in the Editorials and Letters to the Editor section of this journal in the early 1980s, this article focuses on three in particular to explore the legacies of the work of Michael White. The author describes how Michael has bequeathed not only a profound body of work, but also a distinctive spirit of originating, and ways of working that consider the effects of social issues and that examine the politics of experience. It is the author's hope that this approach to considering Michael White's legacies honours his work and also honours the contributions of the Australian and New Zealand Journal of Family Therapy in its 30th year.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

Participation in Everyday Life Before and After a Housing Adaptation

Housing adaptation aims to enable clients to live independently in their own homes. Studies focusing on participation in everyday life following a housing adaptation are lacking and needed. This study aimed to explore housing adaptation clients' experiences of participation in everyday life before and after a housing adaptation, through the lens of a housing adaptation, using a qualitative follow-up design, with 11 participants. It was found that when the housing adaptation met the participants' needs, performance of activities improved and the housing adaptation opened doors to engagement and participation in everyday life. Thus, focus on performance and engagement in everyday life at the onset of the housing adaptation process, combined with regular follow-ups, may enhance participation.     

Open Dialogue: Frequently Asked Questions

Open Dialogue is an approach to working with people and their families experiencing psychosocial distress. Interest in Open Dialogue in Australia has been growing recently, raising questions about its adaption and implementation to local contexts. This article is an attempt to answer some of the frequently asked questions we have encountered in training and discussions about Open Dialogue. We attempt to provide responses to questions of how Open Dialogue is different to what is done already, how it fits with current approaches, how you know if you are doing it, whether it is passive or just about doing reflections, issues about including the social network, and concerns about the evidence base. This article aims to present a variety of viewpoints in relation to these questions and to hopefully further discussions on how Open Dialogue can be implemented and adapted to Australian health care and social care contexts.