Thinking about romantic/erotic love.

The implications for therapy of the salient characteristics of romantic/erotic love are discussed. 1. We do not have control over our feelings of romantic/erotic love. 2. These feelings occur relatively infrequently during most people's lives. 3. Being with a partner whom one loves is valued and regarded as a good; it sometimes conflicts with other values and goods. There are no clear criteria for resolving this conflict. 4. Love is regarded as one essential basis for marriage. 5. In addition to romantic/erotic love, other qualities and capacities are important in sustaining a long-term relationship such as a marriage.

Developing family planning services for female chronic mentally ill outpatients.

The family planning needs of chronic mentally ill women outpatients, many of whom do not use contraceptives and are at high risk for unwanted pregnancies, have been rarely addressed. Taking a thorough sexual history is the first step in assessing patients' need for family planning services. Patient education, including instruction about physiological processes and contraceptive methods and assertiveness training, is the most important service component. Offering family planning services in the mental health center has many advantages, including better communication between mental health care providers and family planning specialists about patients' special needs and enhanced opportunities for integrating family planning with other programs such as parenting classes, substance abuse treatment, and services for preventing sexually transmitted diseases.

Infants at social risk: maternal depression and family support services as mediators of infant development and security of attachment.

31 infants at high social risk due to the combined effects of poverty, maternal depression, and caretaking inadequacy were assigned to weekly home-visiting services. At 18 months infant age, the home-visited infants were compared with 2 groups of socioeconomically similar unserved infants on measures of infant development, infant attachment, mother-infant interaction, maternal depression, and maternal social contacts. Home-visited infants of depressed mothers outperformed unserved infants of depressed mothers by an average of 10 points on the Bayley Mental Scale and were twice as likely to be classified as securely attached, with unserved high-risk infants showing a high rate of insecure-disorganized attachments. Duration of services was positively correlated with maternal involvement at 12 months. Results of the study point both to the negative developmental consequences associated with severe social risk conditions and to the buffering effects of developmentally oriented home-visiting services for infants at greatest social risk.

Building collaborative relationships with families of the mentally ill.

Studies of the expressed emotion construct have demonstrated that educational programs aimed at helping families deal with a mentally ill member can reduce patient relapse rates and improve family coping. The authors describe a clinical approach to family psychoeducation focused on building collaborative relationships with mental health professionals. The approach is based on the assumption that family education will benefit the patient, but any implication that the family is to blame for the patient's illness is studiously avoided. Five tasks that must be addressed in beginning work with families of the mentally ill are discussed. They are ensuring that the family has a chance to be heard, imparting information, helping the family deal with the feelings engendered by the patient's illness, identifying the family's coping patterns, and helping the family face the ethical and existential conflict between their own needs and those of the patient.

Harmful psychotherapy experience.

This paper reports on an interview study of 47 patients, all mental health professionals, who believed they had been harmed by psychotherapy or analysis. The harmful therapies were therapies characterized as distant, cold, unengaged, and lacking in "human quality," or therapies characterized by intense emotional and/or sexual involvement.

A study of therapists' choice of a therapist.

Twenty-three psychotherapists discussed the criteria that they used when seeking a therapist for themselves. Most of the subjects had had more than one experience with psychotherapy. They sought a therapist who had a reputation for competence, whom they would not encounter frequently outside of therapy sessions, whom they experienced as warm and caring, and who talked rather than remaining silent during the sessions. The significance of these findings for conducting psychotherapy is discussed.

Superkids: competent children of psychotic mothers.

In a follow-up study of children of psychotic mothers, the authors examined a subgroup of outstandingly talented, colorful, and competent "high-risk" children. These children and their mothers were given a variety of psychological tests and were interviewed individually. They were then compared with a control group of children whose mothers had no psychiatric illness. The 6 most socially and intellectually competent high-risk children were strikingly more competent, colorful, creative, and talented than the 6 highest functioning control children. They more often reported having a best friend and had extensive and positive contact with an extrafamilial adult. Another important variable in the prediction of high social competence among children at high risk is a warm relationship with the mother.

Family planning for the mentally ill.

PIP: An increase in the birth rate among mentally ill women and the fact that pregnancy and childcare often exacerbate psychotic and depressive events, indicate a need for family planning services for mentally ill patients. These services should be integrated with various mental health programs because of the special attention and time required when working with mentally ill clients. An example of a coordinated family planning and mental health program exists in Massachusetts where family planning services were instituted in 3 state mental hospitals, in both community and private hospitals with psychiatric wards, and in a mental health guidance center. Follow-up studies show significant contraceptive continuation rates after the patient has been discharged from the hospital.^ieng