Grieving in community: Accompanying bereaved parents.

This study explored relational grieving in community by examining how community members grieve with bereaved parents after the death of a child. Three bereaved parent couples and their community members were interviewed together using the qualitative action-project method to examine their shared grieving actions. Data was analyzed through top-down and bottom-up processes to understand the shared intentions of their grieving actions together. The findings of this research elicited thick descriptions of relational grieving at a community level. Four main assertions of how communities grieve with bereaved parents emerged, and include: (a) selflessly offering emotional and practical support, (b) engaging in and honouring vulnerability, (c) holding the complexity of grieving, and (d) fostering remembrance of the deceased child together. The novel descriptions of relational grieving in community contributed to the growing area of relational bereavement research. The theoretical, empirical, and clinical implications of this study are discussed.

Women's Postpartum Sexual Health Program: A Collaborative and Integrated Approach to Restoring Sexual Health in the Postpartum Period.

The postpartum period presents unique challenges to couples' relationships and sexuality, yet these factors are often left unaddressed by health care providers. The Women's Postpartum Sexual Health Program (WPSHP), a four-session, group- and couples-based program delivered by an interdisciplinary care team at a family practice center, was designed specifically to address common concerns among postpartum women and their partners. The interrelated, biopsychosocial aspects of women's sexuality in the postpartum period are summarized, followed by a detailed description of the WPSHP content and structure. This information is intended to serve as a practical resource for implementation and adaptation of the WPSHP across different practice settings.

Enhancing the hermeneutic single-case efficacy design: Bridging the research-practice gap.

Systematic case study designs are emerging as alternative paradigm strategies for psychotherapy and social science research. Through enhanced sensitivity to context, these designs examine idiographic profiles of causal processes. We specifically advocate the use of the hermeneutic single-case efficacy design (HSCED). HSCED has recently been used to investigate the efficacy of an existing therapy with a new population (Observed and Experiential Integration for athlete performance barriers) and an emerging therapy (Lifespan Integration Therapy). We describe innovations in HSCED that were implemented for these studies. These developments include (a) integrating psychotherapists as case developers, (b) incorporating multiple cases in one investigation, and (c) tailoring the repertoire of assessment tools. These extensions strategically incorporated principles of contextual paradigms in HSCED, thus complementing single-case designs that neglect idiographic contexts. We discuss recommendations for using HSCED in practice-based research, highlighting its potential as a bridge to address the research-practice gap.

The social process of involuntary separation and the search for connection.

Placing a loved one in care does not relieve informal caregivers' physical and emotional stresses. This study identified the unique psycho-social-spiritual processes of involuntary separation among spouses following long-term care admission. Participants were 17 spouse-caregivers (12 women and 5 men) with a mean age of 84 years who had been involuntarily separated for an average of 20 months. The basic psycho-social-spiritual process of spouse-caregiver involuntary separation was connecting in disconnection, which had three distinct stages: (1) Initial coping, (2) Adjusting to the new situation, and (3) Moving forward. Movement through the three stages was influenced by individuals' capacity and willingness to reach out for connection and by the abilities of others to extend accurate empathy and practical help. The implications of this study highlight spouse-caregivers' needs for connection and support not only during the crisis of separation, but in the months and years that follow.

Integrating Attachment Processes with Lifespan Integration Therapy: a Hermeneutic Single Case Efficacy Design with an Adopted Child.

PURPOSE: Adopted children are at heightened risk for developing attachment insecurity due to relational disruptions experienced early in life. A newly developed therapy, Lifespan Integration (LI; Pace in Lifespan Integration: Connecting ego states through time (5th ed.), 2012), shows promise in reducing psychopathology and other detrimental outcomes with individuals exhibiting disrupted attachment. In this study, the efficacy of LI for addressing attachment processes with adopted children in middle childhood was investigated. METHODS: A Hermeneutic Single Case Efficacy Design (Elliott in Psychotherapy Research, 12(1), 1-21, 2002 & The handbook of humanistic psychology: Theory, research and practice (2nd ed., pp. 351-360), 2015) was used to gather quantitative and qualitative data from an adoptive parent-child dyad experiencing LI therapy for the first time. The research participant, a 12-year-old male, received 10 sessions of LI therapy with his adoptive mother present to facilitate a more secure attachment. RESULTS: Client change and the contribution of LI to this change was advocated by expert case developers, and adjudicated by three experts, who concluded that change occurred and that this change was due to LI therapy. Changes in internal attachment processes, and the attachment bond between the parent and child of this dyad, was observed. CONCLUSIONS: This case provides evidence that attachment disruptions can potentially be repaired in middle childhood and ought to be targeted for intervention in early childhood and beyond to prevent later socio-emotional and psychological issues.

Lifespan Integration Therapy with Trauma-Exposed Children: a Hermeneutic Single Case Efficacy Study.

Childhood trauma is a devastating reality with immense psychological impact to a child. Outcome research of therapy with trauma-exposed children is scarce and mostly focuses on cognitive and behavioural changes. Anecdotal evidence suggests that Lifespan Integration (LI) therapy purports to integrate traumatic experiences into a cohesive autobiographical narrative. In this research study, we investigate the efficacy of LI with children through the careful examination of one participant. We applied Robert Elliott's Hermeneutic Single Case Efficacy Research Design (HSCED; 2002, 2014), which uses quantitative and qualitative data to argue for and against therapy efficacy. The 12-year-old research participant received nine sessions of LI over 3 months, and data was collected before, throughout, and after therapy. The extent of the client's change over the course of therapy was investigated, as well as LI's contribution to the change, and what parts of LI were most helpful in bringing about change. Findings indicate that the client changed significantly over the course of therapy with lasting effects at follow-up, and that LI was substantially responsible for this change. Conclusions: The results provide evidence for LI as an important tool that mental health professionals can use to help trauma-exposed children.

Working together for women's empowerment: Strategies for interdisciplinary collaboration in perinatal care.

Women's experiences of pregnancy, birth, and postpartum adjustment are often characterized by feelings of disempowerment, trauma, and emotional pain. Psychosocial perinatal care has not kept up with medical advances in perinatal care. Access to psychosocial care appears to be inadequate because of the following: (a) perinatal health care providers are insufficiently prepared to address emotional aspects of maternal care and (b) traditional, compartmentalized psychological services benefit only a subsection of perinatal women, often in an untimely manner. Practical and innovative psychosocial services, integrated into routine perinatal care, can provide widespread access to psychosocial resources for mothers and supports providers in delivering optimal care.