Narrative therapy for adults with major depressive disorder: Improved symptom and interpersonal outcomes

Abstract This study investigated depressive symptom and interpersonal relatedness outcomes from eight sessions of manualized narrative therapy for 47 adults with major depressive disorder. Post-therapy, depressive symptom improvement (d=1.36) and proportions of clients achieving reliable improvement (74%), movement to the functional population (61%), and clinically significant improvement (53%) were comparable to benchmark research outcomes. Post-therapy interpersonal relatedness improvement (d=.62) was less substantial than for symptoms. Three-month follow-up found maintenance of symptom, but not interpersonal gains. Benchmarking and clinical significance analyses mitigated repeated measure design limitations, providing empirical evidence to support narrative therapy for adults with major depressive disorder. RÉSUMÉ Cette étude a investigué les symptômes dépressifs et les relations interpersonnels d'une thérapie narrative en huit séances chez 47 adultes souffrant d'un trouble dépressif majeur. Après la thérapie, l'amélioration des symptômes dépressifs (d=1.36) et la proportion de clients atteignant un changement significatif (74%), le mouvement vers la population fonctionnelle (61%), enfin l'amélioration clinique significative (53%) étaient comparables aux performances des études de résultats. L'amélioration des relations interpersonnelles (d=0.62) était inférieure à l'amélioration symptomatique. Le suivi à trois mois montrait un maintien des gains symptomatiques mais pas pour les relations interpersonnelles. L’évaluation des performances et les analyses de significativité clinique modèrent les limitations du plan de recherche à mesures répétées et apportent une preuve empirique qui étaie l'efficacité des thérapies narratives pour des adultes avec un trouble dépressif majeur. Este estudo investigou sintomas depressivos e resultados interpessoais relacionados em oito sessões de terapia narrativa manualizada para 47 adultos com perturbação depressiva major. No pós terapia, melhoria de sintomas depressivos (d=1,36) e proporção de clientes que alcançam melhoria válida (74%), movimento para a população funcional (61%) e melhoria clinicamente significativa (53%) foram comparáveis com os resultados da investigação reportados. As melhorias pós terapia nos resultados interpessoais relacionados (d=.62) foi menos substancial do que para os sintomas. Aos três meses de seguimento houve a manutenção dos sintomas mas não dos ganhos interpessoais. As análises de benchemarking e de melhoria clinicamente significativas atenuam as limitações de um design de medidas repetidas, fornecendo evidência empírica para a terapia narrativa para adultos com perturbação depressiva major. Questo lavoro ha valutato i sintomi depressivi e gli outcome nella capacità di relazionarsi a livello interpersonale in 8 sedute di psicoterapia narrativa manualizzata in un gruppo di 47 adulti con depressione maggiore. I risultati ottenuti relativamente a: post terapy, miglioramento dei sintomi depressivi (d_1.36), proporzione di pazienti che hanno raggiunto un miglioramento affidabile e consistente (74%), movimento verso il funzionamento atteso nella popolazione (61%) e miglioramento clinicamente significativo (53%) sono paragonabili ai valori di riferimento della ricerca sull'outcome. I miglioramento della capacità di relazionarsi valutata alla fine del trattamento (d_.62) si è rivelata meno sostanziale rispetto ai sintomi. Un follow-up dopo 3 mesi ha dimostrato che il miglioramento sintomatologico è stato mantenuto, ma non quello degli obiettivi interpersonali. Valori di riferimento e analisi della significatività clinica hanno fatto fronte ai limiti del disegno a misure ripetute, offrendo prove empiriche sulla rilevanza della terapia narrativa in pazienti adulti con depressione maggiore

Independent cinema in the Chinese film industry

Chinese independent cinema has developed for more than twenty years. Two sorts of independent cinema exist in China. One is underground cinema, which is produced without official approvals and cannot be circulated in China, and the other are the films which are legally produced by small private film companies and circulated in the domestic film market. This sort of ‘within-system’ independent cinema has played a significant role in the development of Chinese cinema in terms of culture, economics and ideology. In contrast to the amount of comment on underground filmmaking in China, the significance of ‘within-system’ independent cinema has been underestimated by most scholars. This thesis is a study of how political management has determined the development of Chinese independent cinema and how Chinese independent cinema has developed during its various historical trajectories. This study takes media economics as the research approach, and its major methods utilise archive analysis and interviews. The thesis begins with a general review of the definition and business of American independent cinema. Then, after a literature review of Chinese independent cinema, it identifies significant gaps in previous studies and reviews issues of traditional definition and suggests a new definition. After several case studies on the changes in the most famous Chinese directors’ careers, the thesis shows that state studios and private film companies are two essential domestic backers for filmmaking in China. After that, the body of the thesis provides an examination of the development of ‘within-system’ independent cinema. Specifically, three factors: government intervention, the majors’ performance (state studios and, later, the conglomerates) and the market conduct of independent cinema at various points in their trajectories are studied. The key findings of the study are as follows: First, most scholars have overlooked the existence and the significance of within-system Chinese independent cinema. Drawing on an American definition of the independent sector, this thesis proposes a definition of the sector in China: namely, any film that has not been financed, produced, and/or distributed by majors. The thesis also notes important contradictions in applying this definition: i.e. film-making is still dependent on policies that frame industry development. The thesis recognises that major tensions apply to filmmaking in China, which significantly differentiates the Chinese independents from those in the US. Second, the development of Chinese independent cinema is the result the rise of the private sector and the decline of the state studio system. As state studios encountered difficulties the private sector moved forward; consequently the environment improved for independent cinema. Third, before 2003, the film industry in China had little commercialisation. The government controlled independent cinema by means of license and censorship. State studios produced main melody films and Hollywood attracted most of the audiences. Many independent filmmakers focused on commercial films, thus contributing to film commercialisation. Fourth, after 2003, the film industry became increasingly fragmented. The government created distribution and exhibition opportunities for main melody films; conglomerates collaborated with Hong Kong players; Hong Kong co-productions and Hollywood occupied the film market; and small private film companies produced main melody films in order to earn meagre profits. The original contribution of the thesis is to advance the study of Chinese independent cinema. The study suggests a reasonable and practical definition of Chinese independent cinema. It shows how the Chinese government authorities have implemented economic measures to gain ideological control in the film industry. Finally, this the first study on Chinese independent cinema applying a synthesis of economic, political and historical perspectives.

Journalism in the cinema

This chapter explores the representation of journalism in one of the most important popular culture forms, cinema. It advocates the use of movies about journalism in journalism studies teaching and research, and reviews the existing literature on the subject.

Adventure as the metaphoric basis for constructing a narrative to defuse a collective critical incident

This article describes an exercise in collective narrative practice, built around the metaphor of adventure. This metaphor helped to scaffold the development of stories of personal agency for a group of Australian primary school children whose teachers were afraid they might be traumatised by events which occurred during a school excursion. During the excursion, the group of 110 Year 5 and 6 school children had their accommodation broken into on two separate occasions and various belongings stolen. The very brief period made available for ‘debriefing’ was used to introduce the metaphor of adventure, and open up space for the children to begin constructing a story in which they were ‘powerful’, as an alternative to the story of powerlessness and victimhood in which they were initially caught up.

Dietary modification for women after breast cancer treatment : a narrative review

Diet is thought to account for about 25% of cancers in developed countries. It is well documented that the risks associated with both the breast cancer itself and its treatments are important for women previously treated for breast cancer. Women are at risk of recurrence of the primary disease and prone to develop treatment-induced co-morbidities, some of which are thought to be modified by diet. With a view to making dietary recommendations for the breast cancer patients we encounter in our clinical nursing research, we mined the literature to scope the most current robust evidence concerning the role of the diet in protecting women against the recurrence of breast cancer and its potential to ameliorate some of the longer-term morbidities associated with the disease. We found that the evidence about the role of the diet in breast cancer recurrence is largely inconclusive. However, drawing on international guidelines enabled us to make three definitive recommendations. Women at risk of breast cancer recurrence, or who experience co-morbidities as a result of treatment, should limit their exposure to alcohol, moderate their nutritional intake so it does not contribute to postmenopausal weight gain, and should adhere to a balanced diet. Nursing education planned for breast cancer patients about dietary issues should ideally be individually tailored, based on a good understanding of the international recommendations and the evidence underpinning them

Arterial travel time estimation : revisiting the classical procedure

Travel time is an important network performance measure and it quantifies congestion in a manner easily understood by all transport users. In urban networks, travel time estimation is challenging due to number of reasons such as, fluctuations in traffic flow due to traffic signals, significant flow to/from mid link sinks/sources, etc. The classical analytical procedure utilizes cumulative plots at upstream and downstream locations for estimating travel time between the two locations. In this paper, we discuss about the issues and challenges with classical analytical procedure such as its vulnerability to non conservation of flow between the two locations. The complexity with respect to exit movement specific travel time is discussed. Recently, we have developed a methodology utilising classical procedure to estimate average travel time and its statistic on urban links (Bhaskar, Chung et al. 2010). Where, detector, signal and probe vehicle data is fused. In this paper we extend the methodology for route travel time estimation and test its performance using simulation. The originality is defining cumulative plots for each exit turning movement utilising historical database which is self updated after each estimation. The performance is also compared with a method solely based on probe (Probe-only). The performance of the proposed methodology has been found insensitive to different route flow, with average accuracy of more than 94% given a probe per estimation interval which is more than 5% increment in accuracy with respect to Probe-only method.

Mind games : applying White’s principles of narrative therapy to the creation of a cabaret about depression and bipolar disorder

This PhD represents my attempt to make sense of my personal experiences of depression through the form of cabaret. I first experienced depression in 2006. Previously, I had considered myself to be a happy and optimistic person. I found the experience of depression to be a shock: both in the experience itself, and also in the way it effected my own self image. These personal experiences, together with my professional history as a songwriter and cabaret performer, have been the motivating force behind the research project. This study has explored the question: What are the implications of applying principles of Michael White’s narrative therapy to the creation of a cabaret performance about depression and bipolar disorder? There is a 50 percent weighting on the creative work, the cabaret performance Mind Games, and a 50 percent weighting on the written exegesis. This research has focussed on the illustration of therapeutic principles in order to play games of truth within a cabaret performance. The research project investigates ways of telling my own story in relation to others’ stories through three re-authoring principles articulated in Michael White’s narrative therapy: externalisation, an autonomous ethic of living and rich descriptions. The personal stories presented in the cabaret were drawn from my own experiences and from interviews with individuals with depression or bipolar disorder. The cabaret focussed on the illustration of therapeutic principles, and was not focussed on therapeutic ends for myself or the interviewees. The research question has been approached through a methodology combining autoethnographic, practice-led and action research. Auto ethnographic research is characterised by close investigation of assumptions, attitudes, and beliefs. The combination of autoethnographic, practice-led, action research has allowed me to bring together personal experiences of mental illness, research into therapeutic techniques, social attitudes and public discourses about mental illness and forms of contemporary cabaret to facilitate the creation of a one-woman cabaret performance. The exegesis begins with a discussion of games of truth as informed by Michel Foucault and Michael White and self-stigma as informed by Michael White and Erving Goffman. These concepts form the basis for a discussion of my own personal experiences. White’s narrative therapy is focused on individuals re-authoring their stories, or telling their stories in different ways. White’s principles are influenced by Foucault’s notions of truth and power. Foucault’s term games of truth has been used to describe the effect of a ‘truth in flux’ that occurs through White’s re-authoring process. This study argues that cabaret is an appropriate form to represent this therapeutic process because it favours heightened performativity over realism, and showcases its ‘constructedness’ and artificiality. Thus cabaret is well suited to playing games of truth. A contextual review compares two major cabaret trends, personal cabaret and provocative cabaret, in reference to the performer’s relationship with the audience in terms of distance and intimacy. The study draws a parallel between principles of distance and intimacy in Michael White’s narrative therapy and relates these to performative terms of distance and intimacy. The creative component of this study, the cabaret Mind Games, used principles of narrative therapy to present the character ‘Jo’ playing games of truth through: externalising an aspect of her personality (externalisation); exploring different life values (an autonomous ethic of living); and enacting multiple versions of her identity (rich descriptions). This constant shifting between distance and intimacy within the cabaret created the effect of a truth in ‘constant flux’, to use one of White’s terms. There are three inter-related findings in the study. The first finding is that the application of principles of White’s narrative therapy was able to successfully combine provocative and empathetic elements within the cabaret. The second finding is that the personal agenda of addressing my own self-stigma within the project limited the effective portrayal of a ‘truth in flux’ within the cabaret. The third finding presents the view that the cabaret expressed ‘Jo’ playing games of truth in order to journey towards her own "preferred identity claim" (White 2004b) through an act of "self care" (Foucault 2005). The contribution to knowledge of this research project is the application of therapeutic principles to the creation of a cabaret performance. This process has focussed on creating a self-revelatory cabaret that questions notions of a ‘fixed truth’ through combining elements of existing cabaret forms in new ways. Two major forms in contemporary cabaret, the personal cabaret and the provocative cabaret use the performer-audience relationship in distinctive ways. Through combining elements of these two cabaret forms, I have explored ways to create a provocative cabaret focussed on the act of self-revelation.

Digital Disruption : Cinema Moves Online

Digital Disruption: Cinema Moves On-line helps to make sense of what has happened in the short but turbulent history of on-line moving image distribution. It provides a realistic assessment of both the genuine and the not-so-promising methods that have been experimented in response to the disruptions that moving from ‘analogue dollars’ to ‘digital cents’ have provoked in the film industry. Paying close attention to how the Majors have dealt – often unsuccessfully – with the challenges it poses, it also focuses closely on the innovations and practices that have taken place beyond the mainstream, showcasing important entrepreneurial innovations such as Mubi, Jaman, Withoutabox and IMDb. Written by leading academic commentators and experts close to the fluctuating fortunes of the industry, Digital Disruption: Cinema Moves On-line is an indispensable guide to the changes currently facing film and its audiences.

Legal education and the 'idealistic student': using Foucault to unpack the critical legal narrative

It appears that few of the students holding ‘socially idealistic’ goals upon entering law school actually maintain these upon graduation. The critical legal narrative, which explains and seeks to act upon this shift in the graduate’s ‘legal identity’, posits that these ideals are repressed through power relations that create passive receptacles into which professional ideologies can be deposited, in the interests of those advantaged by the social and legal status quo. Using the work of Michel Foucault, this paper unpacks the assumptions underpinning this narrative, particularly its arguments about ideology, power, and the subject. In doing so, it will argue this narrative provides an untenable basis for political action within legal education. By interrogating this narrative, this paper provides a new way of understanding the construction of the legal identity through legal education, and a new basis for political action within law school.

'The comfort lies in all the things you can do': the Australian drive-in: cinema of distraction

Contrary to the claims of some film historians, the drive-in was not a uniquely American invention. Australian drive-in cinemas were, at least in the 1950s and 1960s, distinguishable from their American counterparts by virtue of the profusion of additional amusements (or distractions) they offered alongside film-viewing. This article traces the history of Australian drive-ins as ‘entertainment centres’ and ‘high temples of modernity’. It argues that the drive-in can usefully be understood as a mid-point between the domestic and public spheres, and a powerful symbol of post-WWII Australia, signifying prosperity, gathering consumer confidence and, in metropolitan areas, marking the path of urban development through its concentration in new, outer suburban areas.

A bureaucratic cinema: the fraught relationship between government and film

The interventions by the government in the production and circulation of film in late 1960s transformed the Australian cinema industry into a bureaucratic cinema because of its established agencies and institutions for the benefit of filmmakers. Training options expanded by the commencement of the Australian Film and Television School and the Film, Radio and Television Board of the Australia Council, which ran compulsory orientation seminars and workshops on the use of new equipments, helped the aspiring filmmakers to access money from the council's Basic Production Fund.

Outward-looking Australian cinema

Over the last twenty years or so, Australian cinema's international relations in production and policy have expanded and become more complex, while those with Hollywood have been transformed. The boundaries of the national cinema stretch much further than the national territory. Australian production and postproduction companies work in Australia with international partners or on international projects. In this article I will trace some of the material and discursive entailments of this new international turn to explore how dynamic and shifting relations between the local/national and the international have transformed the ways in which we might think about what constitutes Australian cinema, and to illustrate how relations of commonality and continuity with the international called up in the new arrangements challenge the dominant articulation in policy of difference from 'other kinds of filmmaking' as the basis of Australian cinema. I draw on Deb Verhoeven's work on simultaneously national and international films and filmmakers, and adapt Doreen Massey's concept of 'outwardlookingness' to consider Australian cinema's international aspects.

Digital intermediary: Korean transnational cinema

Since censorship was lifted in Korea in 1996, collaboration between Korean and foreign filmmakers has grown in both extent and visibility. Korean films have been shot in Australia, New Zealand and mainland China, while the Korean digital post-production and visual effects firms behind blockbusters infused with local effects have gone on to work with filmmakers from greater China and Hollywood Korean cinema has become known for its universal storylines, genre experimentation and high production values. The number of exported Korean films has increased, as has the number of Korean actors starring in films made in other countries. Korea has hosted major international industry events. These milestones have facilitated an unprecedented international expansion of the Korean film industry. With the advent of the 'digital wave in Korea the film industry's transition to digital production practices this expansion has accelerated Korean film agencies the pillars of the national cinema have played important parts in this internationalisation, particularly in promoting Korean films and filmmakers outside Korea and in facilitating international events in Korea itself Yet, for the most part, projects involving Korean filmmakers working in partnership with filmmakers from other countries are the products of individuals and businesses working outside official channels. That is, they are often better understood as 'transnational rather than 'national' or 'international' projects. In this article, we focus on a range of collaborations involving Korean, Australian, New Zealand and Chinese filmmakers and firms. These collaborations highlight some of the forces that have shaped the digital wave in the Korean film industry, and illustrate the increasingly influential role that the 'digital expertise of Korean filmmakers is playing in film industries, both regionally and around the world.

The national specificity of horror sources in Asian horror cinema

This dissertation explores the relationship between horror films and the national contexts in which they are produced by analyzing several Asian horror movies – Ringu (Japan), The Eye (Hong Kong) and Shutter (Thailand). Utilizing these films as case studies, the dissertation examines the degree to which genre cinemas are nationally-specific, and the degree to which it is possible to make genre films that can enter international markets and be comprehensible in various national markets as well. The dissertation also makes the following claims on the national specificity of genre cinema: i) The sources of frightening elements in horror films are nationally-specific. ii) There is a regional "Asian" horror because of the intertwining national histories and shared cultural elements across several Asian countries.