Posts Tagged Psychotherapy

Challenges of Co-Parenting


Challenges of Co-ParentingDivorce frequently brings the challenge of how best to raise the kids. In today’s environment, it is common for both ex-spouses to share legal and physical custody of children after divorcing.

However, few studies have looked at the process of co-parenting, so little is known about how divorced parents negotiate the co-parenting process. A new study identifies factors that influence the success of co-parenting.

Researchers from Kansas State University discovered that the type of relationship a woman has with her ex-partner is a factor in how the couple shares custody of children.

Investigators followed divorced or separated mothers who were sharing physical custody of their children with their former partners.

Mindy Markham, Ph.D., an assistant professor of family studies and human services divided the study group into three patterns of co-parenting — continuously contentious, always amicable and bad to better.

Markham also looked at additional negative and positive factors that influenced the mothers’ co-parenting relationships.

The study included 20 predominately white, well-educated women between the ages of 26 to 49 who were divorced or separated from the father of their children.

The mothers, from two Midwestern states, shared with their former partners legal and physical custody of the children, who ranged in age from 21 months to 12 years.

At the time of the study, the couples had been separated or divorced from six months to 12 years.

“The findings of this study suggest that shared physical custody relationships are dynamic and can vary greatly,” Markham said.

In current study, nine mothers (45 percent) had continuously contentious co-parenting relationships with their ex-partners from the time of separation to the present.

This stressful negative relationship fueled the mother’s perception of her ex’s parenting abilities; financial concerns, including the ex not having a job or not paying child support; control or abuse by the ex-partner; and the inability of the ex to separate marital — or personal — issues from the co-parenting relationship.

“All mothers in this type of co-parenting relationship reported differences in parenting styles and were concerned with how the ex was raising the children,” Markham said.

“Parenting practices that concerned the mothers varied greatly and included putting children in harmful situations, not bathing the children, not disciplining them and having no rules or routines.

“It was especially difficult for these mothers to share custody with ex-partners who were uninvolved during the marriage. They didn’t believe their exes were responsible parents.”

Markham said eight of the women in the continuously contentious relationships didn’t want to share custody of the children with their ex-partner, but most were told by lawyers or the court that they would have to do so.

Twenty percent of mothers reported an amicable co-parenting relationship — where they reported always getting along with their ex-partners from separation to the present.

In this form of relationship the mothers believed their ex-partners were responsible parents, money wasn’t a source of conflict and the mothers chose to share physical custody.

Seven of the mothers in the study (35 percent) had bad-to-better co-parenting relationships, where co-parenting was contentious at the time of separation, but greatly improved over time.

At the time of the study, these women’s relationships were similar to those of women with always amicable relationships. These mothers wanted to share physical custody, thought the father was a responsible parent and most said money was not a source of conflict.

Significantly, all mothers in bad-to-better relationships said they were unable to co-parent amicably with their ex-partner in the beginning because personal issues were not kept separate from parenting responsibility.

“Although ex-partners with bad-to-better relationships originally allowed their feelings about one another to negatively affect their co-parenting, at some point they realized this was not beneficial and made a conscious effort to change the relationship for the sake of their children,” Markham said.

Being able to communicate with the ex-partner is a major factor during co-parenting. In the always amicable and bad-to-better relationships, mothers were able to communicate well with ex-partners.

The ability to communicate with the ex-partner made discussing differences in parenting styles easier, reported this group of women.

However, for women in continuously contentious relationships, lack of communication was a big issue, Markham said.

These mothers limited direct in-person or phone communication with their ex, preferring alternative methods like texting or email. They also avoided seeing their ex in person when it came time to exchange children by having them picked up at day care or school.

Markham said she was surprised by the level of animosity that accompanies shared custody, at least from some mothers’ perceptions.

“Nearly half of the mothers in this study continue to have conflicted relationships with their ex-partners, and conversations with these women negate the notion that shared physical custody ensures cooperative, less conflicted relationships,” she said.

“This study can be important for helping professionals recognize that shared physical custody is not a panacea for postdivorce problems — and that in some cases it exacerbates them.”

Source: Kansas State University

Parents arguing while child covrs his ears photo by shutterstock.

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Virtual Simulations Help Train Psychologists, Psychiatrists


Virtual Simulations Train Psychologists, PsychiatristsFollowing on the heels of flight simulation training, medical simulation and now virtual mental health simulations train health professionals by realistically mimicking patient symptoms.

New simulators mimic the symptoms of a patient with clinical psychological disorders, according to new research presented at the American Psychological Association’s 120th Annual Convention.

“As this technology continues to improve, it will have a significant impact on how clinical training is conducted in psychology and medicine,” said psychologist and virtual reality technology expert Albert “Skip” Rizzo, Ph.D.

Technological advances including artificial intelligence and expert systems allow a highly interactive interaction with simulators even allowing the simulators to carry on a conversation with real humans.

“This has set the stage for the ‘birth’ of intelligent virtual humans to be used in clinical training settings,” Rizzo said. He showed videos of clinical psychiatry trainees engaging with virtual patients called “Justin” and “Justina.”

Justin is a 16-year-old with a conduct disorder who is being forced by his family to participate in therapy. Justina, the second and more advanced iteration of this technology, is a sexual assault victim who was designed to have symptoms of post-traumatic stress disorder.

In an initial test, 15 psychiatry residents, of whom six were women, were asked to perform a 15-minute interaction with Justina.

Video of one such interaction shows a resident taking an initial history by asking a variety of questions. Programmed with speech recognition software, Justina responds to the questions and the resident is able to make a preliminary diagnosis.

Rizzo’s virtual reality laboratory is working on the next generation of virtual patients using information from this and related user tests, and will further modify the characters for military clinical training, which the U.S. Department of Defense is funding, he said.

Researchers are working to develop simulated or virtual veterans with depression and suicidal thoughts, for use in training clinicians and other military personnel how to recognize the risk for suicide or violence.

Over time, Rizzo hopes to create a comprehensive computer training module that has a diverse library of virtual patients with numerous “diagnoses” for use by psychiatric and psychology educators and trainees.

Currently, psychology and psychiatry students are trained by role-playing with other students or their supervisors to gain experience to treat patients. They then engage in supervised on-the-job training with real patients to complete their degrees.

“Unfortunately, we don’t have the luxury of live standardized ‘actor’ patients who are commonly used in medical programs, so we see this technology as offering a credible option for clinical psychology training,” he said.

“What’s so useful about this technology is novice clinicians can gain exposure to the presentation of a variety of clinical conditions in a safe and effective environment before interacting with actual patients. In addition, virtual patients are more versatile and can be available anytime, anywhere. All you need is a computer.”

Source: American Psychological Association

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Mindfulness Practice Helps Seniors Combat Loneliness


Mindfulness Practice Helps Elders Combat LonelinessLoneliness can be a major risk factor for health conditions such as depression, cardiovascular disease and Alzheimer’s. It is especially problematic among seniors, for whom seclusion and isolation may even lead to death.

Experts say that modern strategies to reduce loneliness in the elderly population — by participation in social networking programs in community centers — have not been successful. But a new study finds that a new/old approach may provide an innovative solution.

In the investigation, J. David Creswell, Ph.D., from Carnegie Mellon University looked at the use of mindfulness meditation to reduce loneliness in older adults.

In the review, researchers found that mindfulness meditation — a 2,500-year-old practice dating back to Buddha that focuses on creating an attentive awareness of the present moment — not only reduced loneliness but also lowered inflammation levels.

Inflammation is believed to promote the development and progression of many diseases.

These findings, published in Brain, Behavior & Immunity, provide valuable insights into how mindfulness meditation training can be used as a novel approach for reducing loneliness and the risk of disease in older adults.

“We always tell people to quit smoking for health reasons, but rarely do we think about loneliness in the same way,” said Creswell.

“We know that loneliness is a major risk factor for health problems and mortality in older adults. This research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults.”

For the study, the research team recruited 40 healthy adults aged 55-85 who indicated an interest in learning mindfulness meditation techniques. Each person was assessed at the beginning and end of the study using an established loneliness scale. Blood samples also were collected.

The participants were randomly assigned to receive either the eight-week Mindfulness-Based Stress Reduction (MBSR) program or no treatment.

The MBSR program consisted of weekly two-hour meetings in which participants learned body awareness techniques — noticing sensations and working on breathing — and worked their way toward understanding how to mindfully attend to their emotions and daily life practices.

They also were asked to practice mindfulness meditation exercises for 30 minutes each day at home and attended a daylong retreat.

Investigators determined that eight weeks of the mindfulness meditation training decreased the participants’ loneliness.

They also discovered that participants reduced genetic blood inflammatory responses as well as a measure of C-Reactive Protein (CRP).

These findings suggest that mindfulness meditation training may reduce older adults’ inflammatory disease risk.

“Reductions in the expression of inflammation-related genes were particularly significant because inflammation contributes to a wide variety of the health threats including cancer, cardiovascular diseases and neurodegenerative diseases,” said study collaborator Steven Cole.

While the health effects of the observed gene expression changes were not directly measured in the study, Cole noted that “these results provide some of the first indications that immune cell gene expression profiles can be modulated by a psychological intervention.”

Creswell added that while this research suggests a promising new approach for treating loneliness and inflammatory disease risk in older adults, more work needs to be done.

“If you’re interested in using mindfulness meditation, find an instructor in your city,” he said. “It’s important to train your mind like you train your biceps in the gym.”

Source: Carnegie Mellon University

Elderly woman meditating photo by shutterstock.

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Research Uncovers Yoga’s Stress Reduction Secrets


Research Uncovers Yoga's Stress Reduction SecretsResearchers have determined that yoga can help to relieve stress by reducing the associated cellular inflammation.

The recent study is a follow up to the discovery by UCLA scientists that a specific type of yoga — used for brief, simple daily meditation — reduced the stress levels of people who care for those stricken by Alzheimer’s and dementia.

Researchers discovered a certain form of chanting yogic meditation, practiced for 12 minutes daily for eight weeks, led to a reduction in the biological mechanisms responsible for an increase in the immune system’s inflammation response.

Scientists now that inflammation, if constantly activated, can contribute to a multitude of chronic health problems.

In a study of 45 family dementia caregivers, psychiatrist Dr. Helen Lavretsky and colleagues found a difference in genetic response after the Kirtan Kriya Meditation (KKM). The discovered that 68 genes responded differently after KKM, resulting in reduced inflammation.

The study is reported in the current online edition of the journal Psychoneuroendocrinology.

Caregivers are the unsung heroes for their yeoman’s work in taking care of loved ones that have been stricken with Alzheimer’s and other forms of dementia, said Lavretsky.

However, caring for a frail or demented family member can be a significant life stressor. Older adult caregivers report higher levels of stress and depression and lower levels of satisfaction, vigor and life in general.

Moreover, caregivers show higher levels of the biological markers of inflammation. Family members in particular are often considered to be at risk of stress-related disease and general health decline.

The issue is salient given the aging of America and the expected dramatic increase in prevalence of dementia. Currently, at least five million Americans provide care for someone with dementia.

“We know that chronic stress places caregivers at a higher risk for developing depression,” she said.

“On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress.”

Caregivers tend to be older themselves, leading to what Lavretsky calls an “impaired resilience” to stress and an increased rate of cardiovascular disease and mortality.

Experts have surmised that psychosocial interventions like meditation reduce the adverse effects of caregiver stress on physical and mental health. However, the pathways by which such psychosocial interventions impact biological processes are poorly understood.

In the study, the participants were randomized into two groups. The meditation group was taught the 12-minute yogic practice that included Kirtan Kriya, which was performed every day at the same time for eight weeks.

The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes daily for eight weeks. Blood samples were taken at the beginning of the study and again at the end of the eight weeks.

“The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression,” said Lavretsky. “Our analysis showed a reduced activity of those proteins linked directly to increased inflammation.

“This is encouraging news. Caregivers often don’t have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful too.”

Source: UCLA

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Video: About Psychodynamic Psychotherapy


Video: About Psychodynamic Psychotherapy
By JOHN M. GROHOL, PSYD
Founder & Editor-in-Chief

Joseph Burgo, one of our bloggers here at Psych Central, has recently inaugurated a new series of videos about psychodynamic psychotherapy, aimed at people who may be considering treatment and don’t know quite what to expect from this particular type of therapy.

His first video deals with the intake or initial consultation, focusing on the anxieties felt by both client and therapist as they embark upon a new relationship with a total stranger. His next video will focus on the types of issues that come up during the first few sessions; in future, he plans to cover other issues such as: the emergence of the transference, vacation breaks, the role of humor, therapist errors, etc.

These videos will appear on his YouTube channel and Dr. Burgo will announce each new one via his Therapy Case Notes blog. Even if you’re already familiar with psychodynamic psychotherapy, his thoughts about first sessions apply to all types of treatment and may be of interest:

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