How nice is good for patients and for therapy outcome? The role of confrontation in the process of psychotherapy

It is well established that the therapeutic relationship contributes about as much to therapy outcome as ‘technical’ intervention. Furthermore, it follows clear prescriptive concepts in the same manner as technical interventions do. ‘Motive Oriented Therapeutic Relationship’ is such a concept for establishing a solid basis for whatever therapeutic work the patients’ problems require (Grawe, 1980, 1992; Caspar, 1996). Yet, the therapeutic relationship doesn’t explain everything because other factors play a significant role too. Previous studies showed that outcome is clearly better when therapists achieved a generally high quality of a therapeutic relationship when they did not shy away from possibly threatening interventions such as confrontations. This ratio of a fruitful alliance and marginally present confrontations in the same session also showed significant correlations with patient’s assessment of alliance and progress in therapy (Figlioli et al., 2009). These findings are also very much in line with Sachse’s metaphor of accumulating, but then also using ‘relationship credits’ and Farrelly’s ‘Provocative Therapy’ (1986), as well as the ‘Intensive Short-Term Dynamic Psychotherapy’ by Davanloo (1980).Aim: The current state of research in the field does not give any answers to questions like how good and bad confrontations can be characterized or what role does the intensity, respectively frequency of confrontations play in the process of psychotherapy.Methods: A sample of 80 therapies of 3 sessions each representing either good or bad outcome was judged moment by moment by independent raters if and how therapists used confrontative interventions. Results / Discussion: The results will be discussed in terms of their implications for the clinical daily work. Preliminary analyses show that successful confrontations are explicitly uttered, short but intense, related to important patients goals in therapy and embedded in prior complementarity.

Regional Cooperation of Small & Medium Firms in Japanese Industrial Clusters

This study examines the effects of intra-regional cooperation among firms and institutions on the growth of firms, using the unique data set of questionnaire survey collected in the three major industrial clusters in Japan. In contrast to the existing studies on regional innovations or agglomeration economies, this study explicitly focuses on the detailed contents of cooperative activities with two specific viewpoints: 1) the contents of regional cooperation in each of the three production stages of R&D, commercialization, and marketing, and 2) the detailed types of alliance partners. Our results demonstrate three points: 1) positive correlations are observed between the intensity of regional cooperation and the firm growth rate and R&D expenditure, 2) horizontal cooperation such as alliances with universities and cross-industry exchange organizations has positive significant effects on the growth rate of firms, which is in contrast with the previous studies that stressed only the role of vertically integrated inter-firm linkages in Japan, and 3) contents and partners of regional cooperation are different among the three clusters based on different dominant industries.

The Ti plasmid increases the efficiency of Agrobacterium tumefaciens as a recipient in virB-mediated conjugal transfer of an IncQ plasmid

The T-DNA transfer apparatus of Agrobacterium tumefaciens mediates the delivery of the T-DNA into plant cells, the transfer of the IncQ plasmid RSF1010 into plant cells, and the conjugal transfer of RSF1010 between Agrobacteria. We show in this report that the Agrobacterium-to-Agrobacterium conjugal transfer efficiencies of RSF1010 increase dramatically if the recipient strain, as well as the donor strain, carries a wild-type Ti plasmid and is capable of vir gene expression. Investigation of possible mechanisms that could account for this increased efficiency revealed that the VirB proteins encoded by the Ti plasmid were required. Although, with the exception of VirB1, all of the proteins that form the putative T-DNA transfer apparatus (VirB1–11, VirD4) are required for an Agrobacterium strain to serve as an RSF1010 donor, expression of only a subset of these proteins is required for the increase in conjugal transfer mediated by the recipient. Specifically, VirB5, 6, 11, and VirD4 are essential donor components but are dispensable for the increased recipient capacity. Defined point mutations in virB9 affected donor and recipient capacities to the same relative extent, suggesting that similar functions of VirB9 are important in both of these contexts.

A yeast-like mRNA capping apparatus in Plasmodium falciparum

Analysis of the mRNA capping apparatus of the malaria parasite Plasmodium falciparum illuminates an evolutionary connection to fungi rather than metazoans. We show that P. falciparum encodes separate RNA guanylyltransferase (Pgt1) and RNA triphosphatase (Prt1) enzymes and that the triphosphatase component is a member of the fungal/viral family of metal-dependent phosphohydrolases, which are structurally and mechanistically unrelated to the cysteine-phosphatase-type RNA triphosphatases found in metazoans and plants. These results highlight the potential for discovery of mechanism-based antimalarial drugs designed to specifically block the capping of Plasmodium mRNAs. A simple heuristic scheme of eukaryotic phylogeny is suggested based on the structure and physical linkage of the triphosphatase and guanylyltransferase enzymes that catalyze cap formation.

Human TAFII31 protein is a transcriptional coactivator of the p53 protein.

The p53 protein activates transcription of a target gene by binding to a specific DNA response element and interacting with the transcriptional apparatus of RNA polymerase II. The amino-terminal domain of p53 interacts with a component of the TFIID basal transcription complex. The human TATA-binding-protein-associated factor TAFII31, a component of TFIID, has been identified as a critical protein required for p53-mediated transcriptional activation. TAFII31 and p53 proteins bind to each other via amino acid residues in the amino-terminal domain of p53 that are essential for transcription. Antibodies directed against TAFII31 protein inhibit p53-activated but not basal transcription in vitro. These results demonstrate that TAFII31 is a coactivator for the p53 protein.

Examining the Alliance-Outcome Relationship: Reverse Causation, Third Variables, and Treatment Phase Artifacts

Psychotherapy research reveals consistent associations between therapeutic alliance and treatment outcomes in the youth and adult literatures. Despite these consistent findings, prospective associations are not sufficient to support the claim that the alliance is a change mechanism in psychotherapy. The current study examined the direction of effect of the alliance- outcome relationship, the contribution of early symptom change in treatment to the development of therapeutic alliance, and the potential for pretreatment interpersonal functioning characteristics to be third variables that account for the association between alliance and outcome. Participants were adolescents with depression and a history of interpersonal trauma that presented to a community mental health center for treatment. Findings demonstrated that a more positive therapeutic alliance predicted greater subsequent symptom improvement, even after removing symptom change occurring before the measurement of alliance. Results also suggested that early change only slightly contributed to alliance development. Finally, though pretreatment interpersonal functioning was related to the first session alliance, these pretreatment client characteristics were not related to later alliance or symptom change. Overall, results provided some support for therapeutic alliance as a mechanism of change in psychotherapy. Methodological and clinical issues are discussed.

The treaties of 1778, and allied documents;

I. The preliminaries: Plan of treaties; Instructions to the agent.--II. The treaties: Treaty of amity and commerce; Treaty of alliance; Act separate and secret.--III. The ratification.

Laboratory-based simulation of freezing profiles of beef trim for Escherichia coli O157 survival determinations

This study was undertaken to develop a simple laboratory-based method for simulating the freezing profiles of beef trim so that their effect on E. coli 0157 survival could be better assessed. A commercially available apparatus of the type used for freezing embryos, together with an associated temperature logger and software, was used for this purpose with a -80 degrees C freezer as a heat sink. Four typical beef trim freezing profiles, of different starting temperatures or lengths, were selected and modelled as straight lines for ease of manipulation. A further theoretical profile with an extended freezing plateau was also developed. The laboratory-based setup worked well and the modelled freezing profiles fitted closely to the original data. No change in numbers of any of the strains was apparent for the three simulated profiles of different lengths starting at 25 degrees C. Slight but significant (P < 0.05) decreases in numbers (similar to 0.2 log cfu g(-1)) of all strains were apparent for a profile starting at 12 degrees C. A theoretical version of this profile with a freezing plateau phase extended from 11 h to 17 h resulted in significant (P < 0.05) decreases in numbers (similar to 1.2 log cfu g(-1)) of all strains. Results indicated possible avenues for future research in controlling this pathogen. The method developed in this study proved a useful and cost-effective way for simulating freezing profiles of beef trim. (c) 2005 Elsevier B.V. All rights reserved.

The Soft Budget Constraint. An introductory study to volume IV of the Life’s Work series

The author’s ideas on the soft budget constraint (SBC) were first expressed in 1976. Much progress has been made in understanding the problem over the ensuing four decades. The study takes issue with those who confine the concept to the process of bailing out loss-making socialist firms. It shows how the syndrome can appear in various organizations and forms in many spheres of the economy and points to the various means available for financial rescue. Single bailouts do not as such generate the SBC syndrome. It develops where the SBC becomes built into expectations. Special heed is paid to features generated by the syndrome in rescuer and rescuee organizations. The study reports on the spread of the syndrome in various periods of the socialist and the capitalist system, in various sectors. The author expresses his views on normative questions and on therapies against the harmful effects. He deals first with actual practice, then places the theory of the SBC in the sphere of ideas and models, showing how it relates to other theoretical trends, including institutional and behavioural economics and theories of moral hazard and inconsistency in time. He shows how far the intellectual apparatus of the SBC has spread in theoretical literature and where it has reached in the process of “canonization” by the economics profession. Finally, he reviews the main research tasks ahead.

Interdependencies in corporate development: Relationship between strategic alliance and acquisition activities

A substantial amount of work in the field of strategic management has attempted to explain the antecedents and outcomes of organizational learning. Though multinational corporations simultaneously engage in various types of tasks, activities, and strategies on a regular basis, the transfer of organizational learning in a multi-task context has largely remained under-explored in the literature. To inform our understanding in this area, this dissertation aimed at synthesizing findings from two parallel research streams of corporate development activities: strategic alliances and acquisitions. Structured in the form of two empirical studies, this dissertation examines: 1) the strategic outcomes of alliance experience of previously allying partners in terms of subsequent acquisition attempts, and 2) the performance implications of prior alliance experience for acquisitions. The first study draws on the relational view of inter-organizational governance to explain how various deal-specific and dyadic characteristics of a partnership relate to partnering firms' post-alliance acquisition attempts. This model theorizes on a variety of relational mechanisms to build a cohesive theory of inter-organizational exchanges in a multi-task setting where strategic alliances ultimately lead to a firm's decision to commit further resources. The second study applies organizational learning theory, and specifically examines whether frequency, recency, and relatedness of different dimensions of prior alliances, beyond the dyad-level experience, relate to an acquirer's superior post-acquisition performance. The hypotheses of the studies are tested using logistic and ordinary least square regressions, respectively. Results analyzed from a sample of cross-border alliance and acquisition deals attempted (for study I) and/or completed (for study II) during the period of 1991 to 2011 generally support the theory that relational exchange determines acquiring firms' post alliance acquisition behavior and that organizational routines and learning from prior alliances influence a future acquirer's financial performance. Overall, the empirical findings support our overarching theory of interdependency, and confirm the transfer effect of learning across these alternate, yet related corporate strategies of alliance and acquisition.^

The use of treatment process variables to differentiate between completers and dropouts for a guided self -change adolescent substance abuse intervention

This study documented differences between substance using adolescent participants who either completed or dropped out of a brief motivational intervention. Therapeutic alliance, working alliance and patient involvement were used to describe differences in treatment process ratings in a sample of majority Latino males who either (a) completed a adolescent substance abuse intervention called Alcohol Treatment Targeting Adolescents In Need (ATTAIN) or (b) dropped out after the first or second Guided Self-Change therapy session. Fifteen-minute segments were copied from the midpoint of previously recorded audio-tapes of Guided Self-Change therapy sessions. Raters were trained to a criterion level of interrater reliability for both the Working Alliance Inventory-Short and Vanderbilt Psychotherapy Process Scale. Correlations among Working Alliance Inventory- Short and Vanderbilt Psychotherapy Process Scale subscales reflected a general similarity in the assignment of ratings to client-therapist dyads. Findings underscore why these concepts are often used interchangeably in the treatment process literature. The Vanderbilt Psychotherapy Process Scale patient participation subscale demonstrated substantial empirical differentiation from overall therapeutic alliance. Discriminant function analysis demonstrated the Working Alliance Inventory-Short goal subscale and the Vanderbilt Psychotherapy Process Scale patient participation and therapist warmth and friendliness subscales as successful classifiers of groups of mostly Latino youth based on completion status. Follow-up logistic regression analyses confirmed major findings and successfully predicted group membership. Treatment process constructs can be used as clinical tools to identify participants who may be susceptible to dropping out of treatment services. Further investigation of treatment process may enhance understanding of the influence of alliance between clients and Guided Self-Change therapists. Investigating the role of treatment process as a critical component of brief motivational interventions for substance-using adolescents will inform both practitioners and researchers regarding the effectiveness of community-based substance abuse interventions for adolescents.

Frederick Douglass and Ireland, 1845: The "Vertiginous Twist[s]" of an Irish Encounter

Frederick Douglas was a reader of and writer on the nineteenth-century political and social texts and contexts of oppression, which he experienced at home and witnesed while in Ireland and Britain, 1845-47. This thesis is unique in its identification of several surprising lacunae in the research and critical evaluation of Frederick Douglass’ activities of reading and writing and the texts and contexts that supported these activities. This thesis takes Douglass’ relationship with Ireland and the Irish as its starting point, and offers several moments in the transnational space engendered by Douglass’ readerly and writerly experience of the transatlantic axes of Ireland, Britain and America. This thesis draws upon archival research to recover information regarding Douglass’ trip and subjects his reading and writing on Ireland and the Irish to the critical rigours of narratolgical, cultural and discourse analysis. One lacuna is Douglass’ favourite and neglected school primer, the Columbian Orator, which Douglass signified upon across his autobiographical project. The speech by the Irish patriot and exile, Arthur O’Connor, included in the Orator, is crucial to Douglass’ understanding and expression of justice and equality. Genette’s narratological analysis gives theoretical traction to the ways in which, in his autobiographical representations of his British trip, Douglass recalibrates his autobiographies to reflect his changing perspectives on his life and work. Contrary to popular assumptions, Douglass did, in two letters to Garrison address and comment on Irish poverty. This thesis interrogates the strategic anglophilia of these letters. While the World’s Temperance Convention (WTC) refused to discuss African- American slavery, analysis of Douglass’ speech in Covent Garden and of the paratextual apparatus of the published proceedings of the WTC demonstrates the impossibility of separating these closely interrelated reform causes. When a newly discovered poem from Waterford that admonished the city for its disregard for Douglass’ message is juxtaposed with an uncomfortable moment in Cork, we understand that Douglass became a pawn to bolster sectarian rivalries between nationalist and establishment factions. Though Douglass believed imperial politics was the best vehicle for modernity, he recognised that it had failed Ireland: consequently, in Thoughts and Recollections of a Trip to Ireland (1886), he advocates for Home Rule for Ireland.

“I am in a constant state of insecurity trying to make ends meet, like our service users”: Shared austerity reality between social workers and service users: Towards a preliminary conceptualization

This article introduces the concept of an emerging shared austerity reality, which refers to the socio-economic context of austerity that is shared both by social workers and service users, albeit to different degrees. Traditionally, the concept of the shared reality has been utilized to encompass the experiences of welfare professionals working in situations where both they and service users are exposed to the adverse effects of a natural disaster, war or terrorist attack. Here, the concept of shared reality is expanded through the introduction of the context of austerity. Drawing on 21 in-depth interviews with public sector social work practitioners in Greece it discusses, among other things, social anxieties about their children’s future, and their inability to take care of their elderly relatives that suggest an emerging shared austerity reality, reflecting the deterioration of socio-economic conditions. The paper ends with a discussion about the possibilities of alliance and division that emerge from the concept and future research directions. Moreover, it concludes with a reflection on the role of the social work profession and recent political developments in Greece in anti-austerity struggles.

Late Devonian (Famennian) jaws: the icriodid multielement apparatus and its function

In this study the conodont multielement apparatus of Late Devonian (Famennian) Icriodus altematus is described which has been reconstructed from clustered group findings and separated elements. This apparatus is markedly different from classical ozarkodinid apparatuses and needs further consideration of its functional morphology. Since bedding plane assemblages of Icriodus altematus are yet unknown, a spatial reconstruction of this apparatus and a feeding mechanism are proposed which are based on the oropharyngal apparatus of recent lampreys. Though the extant representatives of petromyzontoids are not close phylogenetic relatives of extinct conodonts, there exist intriguing analogies concerning the morphology of the tooth types and the presumed spatial distribution within the oral cavity of both taxa.

HOLDING HANDS WHILE PARTING WAYS: EXAMINING ALLIANCE TREATY RENEGOTIATION

This study investigates the renegotiation of security alliances, specifically the structural conditions surrounding their revision. Although the field of international relations offers a rich discussion of the formation and violation of alliance treaties, few scholars have addressed the reasons why alliance members amend security obligations. After the formation of an alliance, a member may become dissatisfied owing to changes in the external and domestic security environments. A failure to address this discontent increases the risk of alliance breakdown. Members manage their alliance relationship through a negotiation process or intra-alliance bargaining in the search for a new arrangement that can endure. Factors that help to show commitment to the alliance and communicate a set of feasible solutions are crucial if members are to find a mutually acceptable arrangement. By taking these factors into account, allies are more likely to revise an existing treaty. Examining a set of bilateral alliances dating from 1945 to 2001, this research demonstrates that public requests for renegotiation compel allies to change the status quo. It is found that alliance-related fixed assets and the formation of external alliances increase the likelihood of treaty revision, though institutionalization of an alliance does not help to resolve interest divergence. In addition, this study examines the strategy of delay in intra-alliance bargaining. Allies may postpone a dispute by ignoring it while working to maintain the alliance. Tension among allies thus increases, but the alliance endures. I examine three alliances in order to illustrate this renegotiation process. Among these, the Anglo-Japanese alliance demonstrates two successful renegotiations that prolonged a wavering alliance relationship; the Sino-Soviet alliance is an example of failure owing to the lack of substantive cooperation; and the US-Taiwan alliance during the 1970s demonstrates successful use of a strategy of delay that appeases a dissatisfied member.