New Jersey History (NJH - E-Journal)
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The Art of Communication Through Drawing: The Case of "Mr. R," a Young Man Professing Misanthropy While Longing for Connection With Others
No full textThis case study reports the psychotherapy process of "Mr. R," who was 18 years old at the time when the therapy started. A total of 10 sessions were held in a period of six months. As the therapist, I was still at an early stage in my career, in the process of forming an integrative approach, which values an authentic and genuine therapeutic relationship with the client on the one hand, and the client’s adjustment to his living environment, on the other. Mr. R initially presented intense aggression and violence toward his family. He had been given a diagnosis of personality disorder, possible schizoaffective disorder, and atypical mental illness by different psychiatrists who had seen him. Because a past attempt with conventional talking therapy and pharmacological treatment did not produce positive results, I attempted to create a therapeutic relationship characterized by genuineness and authenticity, and I used Mr. R's drawings to help him express his emotions. The series of drawings that he created are presented in the article. These depict historical figures who parallel the therapeutic changes that occurred. Over the course of therapy, Mr. R's aggression was alleviated and he started relating to me not through hostility, but through his need for contact and respect. After termination, Mr. R's family members informed me that he had found peace with himself since therapy. I explain the reasoning behind my rather unconventional treatment decisions in terms of (a) contexts surrounding the practice of psychotherapy in Japan at that time; (b) the particular needs at that time of Mr. R, who had dropped out of all his previous treatment; and (c) other factors associated with Mr. R and his family. 
Providing Psychotherapy to People with Neuropsychological Impairment: Complexities and Issues Raised by the Case of "Judith"
No full textWard and Hogan (2015) present a case study of "Judith" where a combination of client-centered psychotherapy, cognitive rehabilitation and social support result in very positive outcomes despite neuropsychological impairments being present and these posing challenges to the intervention. The case study highlights a number of very important issues when providing psychotherapy to clients with cognitive impairments. These include: 1) the common requirement that issues of self identity are explored; 2) the common need for adaptations to be made to the delivery of psychotherapy to mitigate against the effects of cognitive impairments on psychological interventions; 3) the need for specialist neuropsychological rehabilitation services to be available to such clients in the long-term and for specialist neuropsychological supervision to be available to clinicians working psychotherapeutically in this area; and 4) the demonstration that emotional growth and positive psychotherapeutic results are possible even when neuropsychological challenges are present. The extent to which these important issues are fully demonstrated by the case of ‘’Judith’’ is limited in three main ways: a) there being some lack of clarity regarding the severity of the head injury sustained; b) there being a lack of psychometric data to confirm the type and severity of the cognitive impairments present; and c) there being some ambiguity regarding the relative contribution of organic and psychological factors to Judith’s neuropsychological problems
New Wine in Old Bottles: Lempriere’s Classical Dictionary and the Development of Scholarly Publishing in America—A Bibliographic Essay
No full textThe history of Lempriere's Classical Dictionary and its various editions and revisions charts the course of a publishing enterprisethat began in 1788 in England and continued in various formsfor 200 years. According to Edelman, “the publication history ofthe book ... parallels that of a considerable number of Britishbooks that were used in post-revolutionary America as vesselsfor the introduction of new knowledge and scholarship in thetime that the indigenous book industry evolved from a cottage industry to a truly national enterprise.
Introduction to Case Study Special Issue-- Case Studies in Japan: Two Methods, Two Worldviews
No full textThis issue of PCSP presents two case studies in Japan, commentaries from four prominent psychologists representing various research backgrounds, and the responses to the commentaries by the two authors. Japanese clinical psychology has historically emphasized the central role of the case study in psychotherapy and the inseparability of it from practice, research, and training. There is a plethora of case studies published in academic journals of clinical psychology and many practicing psychologists are engaged in case study activities as a part of their professional development as a result. However, this centrality of focus has not led to the examination of methodological issues associated with case studies. What constitutes a good case study or what kinds of evidence are necessary for a valid inference in case study research are both largely untouched topics. The wide variety of case studies in Japanese psychology form a continuum from one pole consisting of the traditional narrative case study to the other, consisting of a scientifically precise single case design to objectively track the change in targeted symptoms. In this issue, we present two outstanding examples of each type of case study. While different in type, each of the two case studies presented in this issue represents a model of how systematic and rigorous case studies can be conducted and documented as a form of psychotherapy research. We provide these two models (a) to encourage more case studies that meet these methodological standards, and (b) to promote the discussion on differing case study methodologies. 
The Case of "Judith": Reflections on Combining a Psychoneurological Perspective Within a Client-Centered and Pluralistic Therapy Framework
No full textIn this article, we respond to three commentaries by King (2015), Hyer and Brandon (2015), and Webb (2015) concerning our case study of Judith (Ward and Hogan, 2015). We organize our response in terms of five themes. First we discuss the positive features of the case study that were identified, specifically, viewing Judith's case as a successful example of combining the client-centered approach with cognitive training. Second, we consider the various ideas put forward about why the case was successful. For example, Hyer and Brandon suggest that the client-centered approach was the essential catalyst that helped Judith effectively utilize the cognitive training. Third we consider an issue common across the three commentaries, namely, the possible utility of additional neuropsychological testing and medical evidence. We acknowledge that such additional information might have been useful, but question its congruence with Cooper's and McLeod's (2011) "pluralistic psychotherapy" model that we employed, and the likely real-term benefits to the client. Fourth, we review the questions raised by the commentaries that remain unanswered about this case. We suggest that despite not being able to be precise about the severity of Judith's head injury, it is clear that a significant injury did occur, resulting in considerable disruption Judith's work and family life. Finally, we consider what the overall contribution of Judith's case study might be. We conclude by agreeing with King (2015) that, because cases like Judith's can derive great benefit from therapy, considerably more resources should be available for clients like her. 
The Case of "Judith": A Neuropsychologist's Perspective
No full textExecutive Functioning (EF) deficits may be the most catastrophic form of brain injury, as they alter one’s personality and sense of self while impeding the ability to make use of rehabilitation, compensatory strategies, psychotherapy and social support. The injury itself can produce a loss of appreciation for the deficits, as well as depression, apathy and a lack of empathy. Although EF deficits can be nuanced, individuals with EF deficits are often presumed incapable of benefiting from higher order interventions. Ward and Hogan’s (2015) case study of Judith effectively contradicts this assumption. While this case does not offer traditional neuropsychological assessment results, it highlights how the value of such measures rests in their ecological validity. The years of psychotherapy and intervention that Judith underwent offer ample ecological data and an opportunity to comment on the neurobiological aspects of Judith’s injury and recovery beyond the assessment setting.  
Sudden Gains and Sudden Losses in the Clients of a "Supershrink": 10 Case Studies
No full textSudden gain or sudden loss in psychotherapy is a statistically exceptional decrease or increase, respectively, in a client's symptoms and distress between two treatment sessions. In psychotherapy research, such sudden gains have been found to be strong predictors of outcome at termination and follow-up. To obtain further in-depth knowledge of the nature and process of sudden gains, this article presents qualitative and quantitative case studies of the clients of a clinical psychologist who is a private practitioner, Erigoni Vlass (the third author). Vlass's caseload presented numerous examples of this phenomenon—she had a sudden-gain base rate over five times higher than the established rate for similar types of clients (and a sudden-loss rate one third less than expected)—classifying her as a "supershrink" (Okiishi, Lambert, Nielsen, & Ogles, 2003). Specifically, a randomized sample of five of Vlass's sudden-gain clients and five of her sudden-loss clients were selected and their results compared with quantitative and qualitative data collected at two-year-plus follow-up. The quantitative results indicated, consistent with previous research, that the sudden-gains clients made dramatic improvements in reducing distress and increasing functioning, while the sudden-loss clients showed little such improvement. Also, a statistically significant higher overall working alliance was found in the sudden-gain as compared to the sudden-loss clients. The qualitative results supported the quantitative results, providing rich, narrative details of how the clients experienced the process and impact of the therapy. The article concludes with a discussion of the distinctive aspects of the results, including the role of the therapist as an outcome variable; the uneven rate of change reflected in the sudden gain/sudden loss phenomena; and the ability of a supershrink therapist like Vlass to achieve dramatically positive results—as measured over two years after the end of therapy—in an average of little more than four therapy sessions. 
描画を通したコミュニケーション: 人間不信を標榜しながらも, 他者とのつながりを希求する青年R氏の事例
No full text本事例研究は,介入開始時に18歳だったR氏との心理療法プロセスを報告する。6ヶ月のあいだに全10回の面接を実施した。当時,筆者は,臨床家としてまだ経験も浅く,一方では人を人として遇する態度,そしてもう一方では現実生活の場への適応を大切にする統合アプローチを思惟する最中であった。来談当初,R氏は,家庭内暴力がひどかった。異なる精神科医から,パーソナリティ障害,統合失調性情動障害,非定型の精神病等の診断がつけられていた。それまでの話すことを介した通常の心理療法も薬物療法も成果が上がらなかったため,筆者は,人を人として遇し,素直さと真剣さに特徴づけられる関係を作れるよう心がけ,感情を表すため一方法として描画を用いた。R氏が描いた一連の作品を本論文に提示した。これらには,歴史的人物が次々に描かれるが,その変移が治療的変化と並行している。心理療法を通して,R氏の攻撃性は和らぎ,筆者に対しても敵意ではなく,つながりと尊重を求める欲求からかかわるようになっていった。終結後40年近い年月が流れたあと,R氏のご家族が,別人のように落ち着きを取り戻し,平穏に暮らしていることを報告してくださった。筆者は,本事例のいくらか特異な臨床的判断についての根拠を(a)当時の日本における心理療法実践の文脈,(b)それまでのすべての治療を中断したR氏が当時求めていたこと,(c)R氏および彼のご家族と関連する他の要因との関連から述べる
Acceptance and Commitment Therapy for "Taro," a Japanese Client with Chronic Depression: A Replicated Treatment-Evaluation
No full textThis single case study examined the effectiveness of Acceptance and Commitment Therapy (ACT) for "Taro," a chronically depressed Japanese man in his thirties. After his baseline functioning was recorded, 9 one-hour weekly sessions, 3 biweekly one-hour booster sessions (bibliotherapy using ACT self-help reading materials), and then 4 monthly follow-up sessions, were conducted. The study examines the outcome of each of the treatment components, which were introduced in a step-by-step manner. In addition, the effects of interventions directed at each core process were also tested. As a result, the effectiveness of ACT was demonstrated with a chronically depressed Japanese client. The effectiveness of interventions was remarkably high during weekly therapy until the booster sessions; in the follow-up stage previous gains were first maintained, but then showed some regression as the client's job situation deteriorated. Future directions include the identification of factors that maintain an increase in the effectiveness of ACT interventions.