Is it a Sin to Talk about Sin in Therapy?

The role of morality and sin in therapy is a controversial topic. However, therapy has a distinctly moral nature, and the Christian concept of sin provides a helpful framework within which the therapist can effectively respond to clients' feeling guilt for their wrong doing as they present in therapy. This paper discusses how the moral nature of therapy must be understood and embraced if it is to encourage both insight and increased self-efficacy in treatment. The Christian concept of sin is discussed as well as a psychological definition of sin and its effects. A potential treatment approach is presented which emphasizes responsibility and restoration through insight, compassion, and increased self-efficacy. This approach is then displayed through a case example.

A reconsideration of the theological conception of sin in the light of the psychoanalytic conceptions of shame and guilt

Boston University Graduate School of Arts and Sciences. Department of Religion.

XERODERMA PIGMENTOSUM: LIVING IN THE DARK BUT WITH HOPE IN THERAPY

Xeroderma pigmentosum patients suffer from extreme photosensitivity caused by a genetic defect in DNA repair pathways. This condition obliges them to live in darkness and avoid sunshine. Although the molecular basis of the defect has been known for more than 40 years now, the treatment possibilities are very limited, and to date all have been focused on the skin. Herein, we summarize the effects of sunlight and the molecular mechanisms implicated in the defects that lead to this syndrome, as well as the strategies that have been tested to alleviate skin manifestations, including cancer. Preclinical attempts to correct genetic defects by means of different gene therapy approaches are also described. All these efforts are now bringing hope and some light into the life of patients and their families.

Motivating offenders to change in therapy: an organizing framework

Objectives. Motivating offenders to change in therapy is an important aspect of effective offender treatment, yet despite this, offenders' motivation to change has received little close attention in the academic and professional literature. This situation is a result of an over-emphasis on the risk management model of rehabilitation, and a consequent failure to construe motivation within an overarching theory of offender rehabilitation.

Method. We present a social cognitive model of offender motivation — the Good Lives Model (GLM) — that provides a framework for incorporating factors that have been shown to be of importance in enhancing offender motivation. This is based upon the notion that all humans strive to achieve primary goods that are intrinsically rewarding and essential to well-being. Where offenders are concerned, criminogenic problems relate, not to the goods offenders seek, but to the way they seek them. Any treatment approach should take this into account and focus positively on equipping people with the skills required to achieve goals rather than simply look to manage risk. The motivational construct that we use here is that of goals. In the GLM, goals are the less abstract depictions of primary human goods and it is with these that people are typically engaged in their day-to-day activities and lives. Looking at therapeutic goal-setting, methods and styles of therapy, and therapist approaches, we derive theoretically-based key issues in motivating offenders to change in therapy.

Conclusion. In conclusion, we present a summary of 12 strategies and techniques that will not only help practitioners enhance their therapeutic effectiveness, but hopefully also act as a catalyst in the development of research on offenders' motivation to change.

Facilitating the highly bonded cohort : should more be done to anticipate and reduce the potential for hyper-cohesiveness and deindividuation in therapy training cohorts in universities?

Successfully facilitating learning for small therapy training programmes requires a special understanding of the psychological work of group processes. Students in therapy training spend almost every class together over two or more years. In these student groups, or cohorts, individuals manage themselves within a unique interpersonal and intragroup dynamic. Course instructors must develop their capacity to work effectively with this specific learning milieu. At the same time, the particular dynamics of the cohort context might not be understood by university management where increasingly few cohort contexts exist for students. Consequently, phenomena arising from the specialised nature of the group environment may not be well understood outside of the expertise of the course. In the first part of the paper, the international literature about learning in cohorts is reviewed. In the second part, this reflection is further developed to explore facilitation of a group that has some features of what might be described as negative cohesiveness, or what is described in family theory as enmeshment. Some consideration as to how to anticipate and off-set potential difficulties for groups in therapy training courses is also contributed.

Sustained acute voltage-dependent blood pressure decrease with prolonged carotid baroreflex activation in therapy-resistant hypertension

Chronic carotid baroreflex stimulation (Rheos system) has been shown to effectively reduce blood pressure in patients with resistant hypertension. Upon acute stimulation blood pressure also falls as a function of voltage. the aim of this study is to evaluate whether this voltage-dependent blood pressure decrease is preserved after long-term carotid baroreflex stimulation.

Quinolone antibiotics in therapy of experimental pneumococcal meningitis in rabbits

Using a rabbit model of pneumococcal meningitis, we compared the pharmacokinetics and bactericidal activities in cerebrospinal fluid (CSF) of older (ciprofloxacin, ofloxacin) and newer (levofloxacin, temafloxacin, CP-116,517, and Win 57273) quinolones with those of the beta-lactam ceftriaxone. All quinolones penetrated into the inflamed CSF better than ceftriaxone, and the speed of entry into CSF was closely related to their degrees of lipophilicity. At a dose of 10 mg/kg.h, which in the case of the quinolones already in use in clinical practice produced concentrations attainable in the sera and CSF of humans, ciprofloxacin had no antipneumococcal activity (delta log10 CFU/ml.h, +0.20 +/- 0.14). Ofloxacin (delta log10 CFU/ml.h, -0.13 +/- 0.12), temafloxacin (delta log10 CFU/ml.h, -0.19 +/- 0.18), and levofloxacin (delta log10 CFU/ml.h, -0.24 +/- 0.16) showed slow bactericidal activity (not significantly different from each other), while CP-116,517 (delta log10 CFU/ml.h, -0.59 +/- 0.21) and Win 57273 (delta log10 CFU/ml.h, -0.72 +/- 0.20) showed increased bactericidal activities in CSF that was comparable to that of ceftriaxone at 10 mg/kg.h (delta log10 CFU/ml.h, -0.80 +/- 0.17). These improved in vivo activities of the newer quinolones reflected their increased in vitro activities. All quinolones and ceftriaxone showed positive correlations between bactericidal rates in CSF and concentrations in CSF relative to their MBCs. Only when this ratio exceeded 10 did the antibiotics exhibit rapid bactericidal activities in CSF. In conclusion, in experimental pneumococcal meningitis the activities of new quinolones with improved antipneumococcal activities were comparable to that of ceftriaxone.

Shell size variation of Neogloboquadrina pachyderma sin. in the Norwegian-Greenland Sea during the last 1.3 Myr

We present measurements of the maximum diameter of the planktonic foraminifer Neogloboquadrina pachyderma sin. from six sediment cores (Ocean Drilling Program sites 643, 644, 907, 909, 985 and 987) from the Norwegian-Greenland Sea. Our data show a distinct net increase in mean shell size of N. pachyderma sin. at all sites during the last 1.3 Ma, with largest shell sizes reached after 0.4 Ma. External factors such as glacial-interglacial variability and carbonate dissolution alone cannot account for the observed variation in mean shell size of N. pachyderma sin. We consider the observed shell size increase to mirror an evolutionary trend towards better adaptation of N. pachyderma sin. to the cold water environment after 1.1-1.0 Ma. Probably, the Mid Pleistocene climate shift and the associated change of amplitude and frequency of glacial-interglacial fluctuations have triggered the evolution of this planktonic foraminifer. Oxygen and carbon stable isotope analyses of different shell size classes indicate that the observed shell size increase could not be explained by the functional concept that larger shells promote increasing sinking velocities during gametogenesis. For paleoceanographic reconstructions, the evolutionary adaptation of Neogloboquadrina pachyderma sin. to the cold water habitat has significant implications. Carbonate sedimentation in highest latitudes is highly dependent on the presence of this species. In the Norwegian-Greenland Sea, carbonate-poor intervals before 1.1 Ma are, therefore, not necessarily related to severe glacial conditions. They are probably attributed to the absence of this not yet polar-adapted species. Further, transfer function and modern analog techniques used for the reconstruction of surface water conditions in high latitudes could, therefore, contain a large range of errors if they were applied to samples older than 1.1-1.0 Myrs.

MLL is fused to CBP, a histone acetyltransferase, in therapy-related acute myeloid leukemia with a t(11;16)(q23;p13.3)

The recurring translocation t(11;16)(q23;p13.3) has been documented only in cases of acute leukemia or myelodysplasia secondary to therapy with drugs targeting DNA topoisomerase II. We show that the MLL gene is fused to the gene that codes for CBP (CREB-binding protein), the protein that binds specifically to the DNA-binding protein CREB (cAMP response element-binding protein) in this translocation. MLL is fused in-frame to a different exon of CBP in two patients producing chimeric proteins containing the AT-hooks, methyltransferase homology domain, and transcriptional repression domain of MLL fused to the CREB binding domain or to the bromodomain of CBP. Both fusion products retain the histone acetyltransferase domain of CBP and may lead to leukemia by promoting histone acetylation of genomic regions targeted by the MLL AT-hooks, leading to transcriptional deregulation via aberrant chromatin organization. CBP is the first partner gene of MLL containing well defined structural and functional motifs that provide unique insights into the potential mechanisms by which these translocations contribute to leukemogenesis.

Once Upon a Time in Therapy: Crafting Therapeutic Narratives to Help Familiarize Children with the Therapeutic Process.

Young children often harbor misconceptions about psychotherapy and the role of psychologists. These misconceptions are ignited by rumors and misinformation that are provided to the child by a variety of sources and can compromise both the effectiveness of therapy and the therapeutic dyad. In this paper we explore how recent trends in patient engagement in child psychotherapy, cultural dynamics between patients and practitioners, and children's lack of knowledge surrounding mental health services can negatively impact therapy. Wednesday Afternoons with Dr. J. (WADJ) is a whimsical fictional therapeutic narrative created to inform children about aspects of the therapeutic process while providing adults with tangible structure surrounding how to talk to children about mental healthcare. The advantages of utilizing this narrative to prime children for therapy are discussed, as are methods for promoting the narrative to the greater community.

The Use of Humor in Therapy : Research-Based Training Recommendations

Despite its essential and universal nature, humor has historically received limited attention from the behavioral sciences, particularly as compared to other affective experiences like anger and sadness. Some authors (e.g., Bell & Malhi, 2009; Provine, 2000a; Roeckelein, 2002) suggest that this is because researchers have traditionally failed to "take humor seriously" and, according to O'Connell (cited in Roeckelein, 2002), have too often pursued its study in a piecemeal manner lacking scientific rigor, resulting in "no comprehensive network of facts about the development and purposes of humor in human existence" (p. 1). Roeckelein (2002) found not a single mention of humor, laughter, wit, comedy, or theories relating to these topics in introductory psychology textbooks published between 1930 and 1996.While research interest in the area has grown, especially over the last decade, it remains an elusive and nebulous topic, more likely to be examined in specialty psychology texts (e.g., social psychology and child development) than general ones (Martin, 2007; Roeckelein, 2002). Organizations (e.g., The International Society for Humor Studies; The Association for the Advancement of Therapeutic Humor), journals (e.g., Humor: International Journal of Humor Research) and internet phenomena such as "The Humor Project" (www.humorproiect.com) have made great strides in integrating information about humor from discreet fields such as the arts and humanities, biological and social sciences, education, and business management. Still, the therapeutic potential of humor remains a relatively young subject of serious scientific inquiry (Marci, Moran, & Orr, 2004; Sala, Krupat, & Roter, 2002). While humor does make appearances in self-help books and publications addressing clinical applications, these sources are much ...

Do Things Change in Therapy That Are Not Measured By Self-report Instruments?

This study investigates a new way of assessing change in psychotherapy, with the goal of decreasing the schism in the field of psychology between research and clinical practice. Change in psychotherapy was assessed in clients presenting with depressive symptoms who were seeking therapy at the Professional Psychology Center (PPC) at the University of Denver. Prior to beginning treatment, the subjects completed the Beck Depression Inventory- II (BDI-II) and the Symptom Checklist-90-R (SCL-90), and were also assessed by independent clinicians using the Shedler-Westen Assessment Procedure II (SWAP-II). Six to nine months later, after completing at least 12 psychotherapy sessions (range 12-21 sessions), the assessment procedure was repeated.There were no significant differences pre- to post-treatment on any measure. However, two subjects in the sample appeared to benefit from treatment, as assessed by both the self-report measures and the SWAP-II. The findings for these two subjects suggest that the SWAP-II can provide a greater depth of understanding about what can change in therapy than self-report measures alone. Possible reasons for the lack of treatment effects in the larger sample are discussed.