Family Therapy With Gifted and Talented Adolescents

2002 ◽  
Vol 14 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Sidney M. Moon ◽  
Volker Thomas

Family therapy has been recommended as a counseling modality for gifted adolescents and their families. The purpose of this article is to propose and discuss 3 guiding questions that can help counselors conceptualize and differentiate family therapy with gifted and talented adolescents: (1) What is the problem? (2) Who is in the room? and (3) What approach to family therapy will be most effective? For each question, we first summarize relevant family therapy theory and research. Then, we provide recommendations based on a small, but growing literature on counseling with families of gifted and talented youth plus our own clinical experience as family therapists working with families of gifted and talented adolescents. We conclude with a discussion of the implications of this literature for clinical practice, counselor training, parents of gifted adolescents, and future research.

2017 ◽  
Vol 27 (67) ◽  
pp. 84-92
Author(s):  
Gabriela Silveira de Paula-Ravagnani ◽  
Carla Guanaes-Lorenzi ◽  
Emerson Fernando Rasera

Abstract: In the field of family therapy (FT), theoretical and methodological perspectives coexist. This article aims to comprehend how family therapists use different theories, especially social constructionism. We describe a qualitative study, carried out through semi-structured and individual interviews with 14 Brazilian family therapists, men and women. Our analysis and discussion present four types of discourse by which the participants combine theoretical perspectives: conciliatory-constructionist, conciliatory-reflexive, conciliatory-descriptive and eclectic. The analysis presents features that characterize and differentiate each discourse, and implications they have on the participants’ practice. We conclude that the combination of theories is an effort to enhance clinical practice, at the same time as it creates tensions in the FT field. This article invites family therapists to construct practices based on an epistemological investigation, by which they will be able to identify theoretical premises that guide their actions, as an effort to achieve congruence between practices and the theories behind them.


2002 ◽  
Author(s):  
Carolyn M. Mazure ◽  
Laura J. Bierut ◽  
Steven D. Hollon ◽  
Susan G. Kornstein ◽  
Charlotte Brown

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1271.1-1272
Author(s):  
S. Derham ◽  
J. Lewis ◽  
E. Dures ◽  
F. Cramp

Background:Adults with fibromyalgia frequently report symptoms of cognitive dysfunction, often referred to as fibrofog. However primary research exploring cognitive dysfunction in the lives of adults with fibromyalgia is very limited (Kravitz and Katz, 2015).Objectives:The aim of this review was to (i) synthesise the qualitative literature on the lived experiences of cognitive dysfunction in adults with fibromyalgia, (ii) develop common themes through thematic analysis and (iii) identify knowledge gaps to inform future research and clinical practice in this area.Methods:Seven electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Amed, Scopus and OpenGrey), reference lists of key articles and two high impact qualitative journals were searched from 1990 to November 2018. Articles were eligible for inclusion if they reported primary qualitative data exploring the experiences of cognitive dysfunction in adults with fibromyalgia. Included studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist and extracted data analysed using narrative synthesis. SD conducted critical appraisal and data extraction on all included studies. FC, JL and ED reviewed five papers each. All papers were reviewed by two co-authors. Of the 1413 records identified, 15 studies were selected for inclusion.Results:These studies included 208 women and 22 men with fibromyalgia, aged 18 to 72 years and representing seven different countries. Duration of diagnosis was four months to 34 years. Fourteen studies used interviews and one used focus groups. None of the included studies focussed exclusively on cognitive function in adults with fibromyalgia. Three studies identified themes specific to cognitive dysfunction and fibromyalgia symptoms. The remaining 12 studies presented relevant data intertwined with the overall lived experiences of fibromyalgia.Cognitive dysfunction, as a part of fibromyalgia, was often unpredictable. Problems with memory and concentration that were most commonly reported were emotionally distressing and affected functional and vocational activities. Participants found communication effortful, with a negative impact on work, leisure and social activities. Stress, fear and worry around perceived cognitive changes were commonly expressed. Lost employment or changed work roles and relationships, due to cognitive difficulties, had negative impacts for many participants. The terms cognitive dysfunction and fibrofog were used interchangeably within the studies, but lacked common definition. This introduced uncertainty around whether participants and authors were describing the same phenomenon.Conclusion:Adults with fibromyalgia experience unpredictable and emotionally impactful difficulties related to cognitive dysfunction. Functional impact was broad-reaching, particularly around work ability and lost employment opportunities. It is unclear how cognitive symptoms in fibromyalgia related to co-morbid symptoms such as pain, fatigue and poor sleep. Further research focusing on the full impact of cognitive function on the lives of adults with fibromyalgia is recommended to inform clinical practice. Research to establish clarity of definition of the terms cognitive dysfunction and fibrofog within fibromyalgia is highly recommended.References:[1]Kravitz H, Katz R. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice. Rheumatology International. 2015;35(7):1115-25.Acknowledgments:This work is supported by the National Institute for Heath Research [ICA-PCAF-2018-01-078 to SD]Disclosure of Interests:Sandra Derham: None declared, Jenny Lewis: None declared, Emma Dures Grant/research support from: Independent Learning Grant from Pfizer, combined funding for a research fellow from Celgene, Abbvie and Novartis, Paid instructor for: A fee from Novartis to deliver training to nurses., Fiona Cramp: None declared


2021 ◽  
Vol 14 ◽  
Author(s):  
Alison Bennetts

Abstract Treatment recommendations for mental health are often founded on diagnosis-specific models; however, there are high rates of co-morbidity of mental health presentations and growing recognition of the presence of ‘transdiagnostic processes’ (cognitive, emotional or behavioural features) seen across a range of mental health presentations. This model proposes a novel conceptualisation of how transdiagnostic behaviours may maintain co-morbid mental health presentations by acting as a trigger event for the cognitive biases specific to each presentation. Drawing on existing evidence, psychological theory and the author’s clinical experience, the model organises complex presentations in a theory-driven yet accessible manner for use in clinical practice. The model offers both theoretical and clinical implications for the treatment of mental health presentations using cognitive behavioural approaches, positing that transdiagnostic behaviours be the primary treatment target in co-morbid presentations. Key learning aims (1) To understand the strengths and limitations of existing transdiagnostic CBT formulation models. (2) To learn about a novel, transdiagnostic and behaviourally focused formulation for use in clinical practice. (3) To understand how to use the tool in clinical practice and future research.


2004 ◽  
Vol 34 (4) ◽  
pp. 613-622 ◽  
Author(s):  
PETER M. LEWINSOHN ◽  
STEWART A. SHANKMAN ◽  
JEFFREY M. GAU ◽  
DANIEL N. KLEIN

Background. In previous studies of subthreshold conditions, co-morbidity has been largely ignored. The purpose was to examine rates of co-morbidity among subthreshold disorders and between subthreshold and full-syndrome disorders for the major non-psychotic classes of disorders from DSM-IV.Method. Participants came from the Oregon Adolescent Depression Project (mean age=16·6 years; females=52·1%). On the basis of a diagnostic interview (K-SADS), participants were assigned to eight subthreshold disorders (MDD, bipolar, eating, anxiety, alcohol use, substance use, conduct, ADHD).Results. Of the 1704 adolescents in the analyses, 52·5% had at least one subthreshood disorder. Of those, 40·0% had also experienced a co-morbid subthreshold condition, and 29·9% of those had a second co-morbid subthreshold condition. Of those with a subthreshold, 36·4% also had a full syndrome. The subthreshold forms of externalizing disorders were co-morbid with each other. As expected, subthreshold anxiety was co-morbid with subthreshold MDD but subthreshold anxiety was also co-morbid with subthreshold alcohol, conduct, and ADHD. The pattern of co-morbidities was nearly identical for males and females.Conclusions. The hypotheses that externalizing disorders would be co-morbid with other externalizing disorders and that internalizing disorders would be co-morbid with other internalizing disorders was partially supported. Co-morbidities between subthreshold disorders and between subthreshold disorders and full syndrome should impact future research and clinical practice. The assessment of subthreshold disorders needs to include the assessment of other subthreshold and full-syndrome conditions.


2016 ◽  
Vol 33 (S1) ◽  
pp. S528-S529
Author(s):  
A. D’Agostino ◽  
S. Covanti ◽  
M. Rossi Monti ◽  
V. Starcevic

IntroductionOver the past decade, emotion dysregulation has become a very popular term in the psychiatric and clinical psychology literature and it has been described as a key component in a range of mental disorders. For this reason, it has been recently called the “hallmark of psychopathology” (Beauchaine et al., 2007). However, many issues make this concept controversial.ObjectivesTo explore emotion dysregulation, focusing on problems related to its definition, meanings and role in many psychiatric disorders.AimsTo clarify the psychopathological core of emotion dysregulation and to discuss potential implications for clinical practice.MethodsA literature review was carried out by examining articles published in English between January 2003 and June 2015. A search of the databases PubMed, PsycINFO, Science Direct, Medline, EMBASE and Google Scholar was performed to identify the relevant papers.ResultsAlthough, there is no agreement about the definition of emotion dysregulation, the following five overlapping, not mutually exclusive dimensions were identified: decreased emotional awareness, inadequate emotional reactivity, intense experience and expression of emotions, emotional rigidity and cognitive reappraisal difficulty. These dimensions characterise a number of psychiatric disorders in different proportions, with borderline personality disorder and eating disorders seemingly more affected than other conditions.ConclusionsThis review highlights a discrepancy between the widespread clinical use of emotion dysregulation and inadequate conceptual status of this construct. Better understanding of the various dimensions of emotion dysregulation has implications for treatment. Future research needs to address emotion dysregulation in all its multifaceted complexity.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 974 ◽  
Author(s):  
Luke E. Grzeskowiak ◽  
Mary E. Wlodek ◽  
Donna T. Geddes

Inadequate breast milk supply is a frequently reported reason for early discontinuation of breastfeeding and represents a critical opportunity for intervening to improve breastfeeding outcomes. For women who continue to experience insufficient milk supply despite the utilisation of non-pharmacological lactation support strategies, pharmacological intervention with medications used to augment lactation, commonly referred to as galactagogues, is common. Galactagogues exert their pharmacological effects through altering the complex hormonal milieu regulating lactation, particularly prolactin and oxytocin. This narrative review provides an appraisal of the existing evidence regarding the efficacy and safety of pharmaceutical treatments for lactation insufficiency to guide their use in clinical practice. The greatest body of evidence surrounds the use of domperidone, with studies demonstrating moderate short-term improvements in breast milk supply. Evidence regarding the efficacy and safety of metoclopramide is less robust, but given that it shares the same mechanism of action as domperidone it may represent a potential treatment alternative where domperidone is unsuitable. Data on remaining interventions such as oxytocin, prolactin and metformin is too limited to support their use in clinical practice. The review provides an overview of key evidence gaps and areas of future research, including the impacts of pharmaceutical galactagogues on breast milk composition and understanding factors contributing to individual treatment response to pharmaceutical galactagogues.


1980 ◽  
Vol 61 (7) ◽  
pp. 394-399 ◽  
Author(s):  
Philip Rich

The essential nature of family therapy, the role of the therapist in the therapeutic process, and the need for family therapists to possess a high degree of differentiation of self are examined. As a prerequisite to conducting successful family systems therapy, therapists must examine their own family of origin.


2021 ◽  
Author(s):  
Luxsiya Waraan ◽  
Erling W. Rognli ◽  
Nikolai Olavi Czajkowski ◽  
Marianne Aalberg ◽  
Lars Mehlum

Abstract Background: Major Depressive Disorder (MDD) is a disabling mood disorder, profoundly affecting a large number of adolescent’s quality of life. To date, no obvious treatment of choice for MDD in adolescents is available and progress in the treatment of depressed adolescents will have important public health implications. Attachment-Based Family Therapy (ABFT), as the only empirically supported family therapy model designed to treat adolescent depression, aims to repair interpersonal ruptures and rebuild an emotionally protective parent-child relationship. Objective: To study the effectiveness of ABFT compared with treatment as usual (TAU) delivered within child- and adolescent mental health services (CAMHS) to adolescents with MDD.Method: Sixty adolescents (86.7% girls), aged 13-18 years (M = 14.9, SD = 1.35), with MDD referred to two CAMHS were randomized to 16 weeks of ABFT or TAU. ABFT consisted of weekly therapy sessions (family/individual or both) according to the treatment manual. TAU was not monitored. Primary outcomes were assessed by blinded evaluators at baseline and post-treatment with the Hamilton Depression Scale (HAMD). Self-reported (Beck Depression Inventory-II, BDI-II) depressive symptoms were assessed at baseline, and after 4, 6, 8, 10,12, 14, and 16 weeks. Analyses were performed according to intent-to-treat principles. Results: At post-treatment, clinician-rated remission rates on the HAMD (5 % in ABFT and 3.33% in TAU, p =1, OR=1.54, Fisher’s exact test) and self-reported symptoms of depression on the BDI-II did not differ significantly between groups (X2[2, N = 60] =0.06 , p = 0.97). In both treatment groups participants reported significantly reduced depressive symptoms, but the majority (63.3 %) of adolescents were still in the clinical range after 16 weeks of treatment. Conclusion: ABFT was not superior to TAU. Remission and response rates were low in both groups, suggesting none of the treatments were effective in treating MDD in adolescents. Findings must be viewed in the context of the study’s small sample size, missing data, and implementation challenges. Continued efforts to improve treatment for MDD in outpatient clinics are warranted . Future research should examine moderators of and mechanisms for individual differences to treatment response, as well as the feasibility and cost-effectiveness of implementing treatment models which may require extensive training and expertise to yield clinically meaningful improvements in non-research settings. Trial Registration: Clinicaltrials.gov identifier: NCT01830088 https://clinicaltrials.gov/ct2/show/NCT01830088?term=Villab%C3%B8&draw=2&rank=1 Date of registration: April 12, 2013


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