Gaby Shefler

Stigma of mental illness, religious change, and explanatory models of mental illness among Jewish patients at a mental-health clinic in North Jerusalem

During 3 months in 2004, 38 recent referrals to a Community Mental Health Clinic in North Jerusalem, a substantially Ultra-Orthodox Jewish neighborhood, were evaluated by the Explanatory Model Interview Catalogue. This questionnaire, which includes a 13-item scale measuring stigma towards mental illness, was adapted and translated into Hebrew. Patients with a more religious upbringing expressed a greater sense of stigma towards mental illness; however, patients who now had a more religious affiliation did not. The 14 patients who had experienced a religious change toward a more religious affiliation reported a lower level of stigma than the 24 non-returnees. Even when controlling for religious upbringing, the partial correlation between stigma score and religious change was significant. Stigma was lower among younger but not older returnees. Findings from this study support the hypothesis that a stigma of mental illness may be a deterrent to the use of a public mental-health clinic for religious Jews in Israel. Ultra-Orthodox Jewish patients (especially non-Hasidic) used a nonreligious explanatory model (perception and understanding) of mental illness more often than a religious explanatory model. This last finding could reflect a shift in the Ultra-Orthodox Jewish communities from a religious to a more medical and psychological explanatory model.

Seek and Ye Shall Find: Test Results Are What You Hypothesize They Are

The Hebrew University, IsraelABSTRACTExpert clinicians were given batteries of psychodiagnostic test results (Rorschach,TAT, Draw-A-Person, Bender-Gestalt, Wechsler) to analyze. For half, a batterycame along with a suggestion that the person su•ers from Borderline Personalitydisorder, and for half, that battery was accompanied by a suggestion that hesu•ers from Paranoid Personality disorder. In Study 1, the suggestion was madeindirectly, through a background story that preceded the test results. In Study 2,the suggestion was made directly, by the instructions given. The experts saw in thetests what they hypothesized to be there. In particular, the target diagnoses wererated higher when they were hypothesized than when they were not. #1998 JohnWiley & Sons, Ltd.

Changes in rigidity and symptoms among adolescents in psychodynamic psychotherapy

Abstract The present study examined changes in the rigidity of interpersonal patterns and symptoms in adolescents (ages 15–18) in a year-long psychodynamic psychotherapy. Seventy-two adolescents (30 in treatment and 42 in a non-treatment “community group”) underwent Relationship Anecdote Paradigm (RAP) interviews according to the Core Conflictual Relationship Theme method (CCRT; Luborsky & Crits-Christoph, 1998), and completed outcome measures at two time points. Results: Adolescents in the treatment group became less rigid in their interpersonal patterns and improved significantly in their symptoms, whereas no such changes were observed in the community group. Levels of rigidity were not related to initial symptom distress; however, changes in rigidity were related to improvement in symptoms within the treatment group.

Changes in interpersonal conflicts among adolescents during psychodynamic therapy

Abstract The core conflictual relationship theme (CCRT) method was used in psychodynamic therapy with 10 adolescents to study change in interpersonal conflicts in the course of treatment. Relationship anecdote paradigm interviews were conducted at the beginning of therapy and before termination 8 to 9 months later. Adolescents were asked to describe 4 relationship episodes for each of the following significant others: parents, peers, and therapist. The CCRTs for the 3 relationships were different: The main wishes toward the parents were to be close and to be given independence; toward friends, to be close and to be open; and toward the therapist, to be helped and to be understood. The responses of other and self toward parents were significantly more negative than responses in other relationships. Responses of self and other in the therapeutic relationship were significantly more positive. At the end of therapy the interactions with parents were more positive, whereas those with the therapist grew more ambivalent.

A Systematic Comparison of Two Cases in Mann's Time-Limited Psychotherapy: An Events Approach

In this study we combined the events approach and Strupps design in order to conduct a systematic comparison of two cases in Manns Time-Limited Psychotherapy (TLP). Two patients treated by the same therapist, yet resulting in divergent outcomes, were drawn from the Jerusalem Time-Limited Psychotherapy Project. A change event in TLP that begins with a “central issue” marker was identified and the client performances and therapist operations leading to successful event-outcome were described. Using the event as the unit of analysis, in-therapy event processes were rated on the Vanderbilt Psychotherapy Process Scale (VPPS). A comparison of the VPPS ratings across the three phases of treatment (initial, middle, and termination) showed a rise in patient participation in the successful case, and a decline in patient exploration in the unsuccessful case. This context-specific approach seems to yield clinically relevant findings for the practice and training of TLP therapists.

Therapists’ honesty, humor styles, playfulness, and creativity as outcome predictors: A retrospective study of the therapist effect

Abstract Objective: This study examined whether therapists’ honesty, humor style, playfulness, and creativity would retrospectively predict the outcomes of therapies ended five years earlier. Method: In the Jerusalem-Haifa study, 29 therapists treated 70 clients in dynamic psychotherapy for 1 year. The Outcome Questionnaire 45 scores were collected at five time points. Five years later, the therapists were contacted via email and asked to fill out honesty, humor styles, playfulness, and creativity self-report questionnaires. Five were excluded since they had only one client in the study each. The remaining 24 therapists treated 65 clients out of whom 20 therapists with 54 clients completed the questionnaires. Results: Therapists’ Aggressive Humor Style (AHS) was a significant negative predictor of clients’ symptom change over time. The therapists’ honesty scores were positively correlated with symptom change. That is, higher AHS therapists were more effective, while higher honesty therapists were less effective. Conclusions: Therapists’ inferred traits of Honesty–Humility and AHS may influence the effectiveness of their treatments.

Do biometric parameters of the hand differentiate schizophrenia from other psychiatric disorders? A comparative evaluation using three mental health modules

The link between schizophrenia and anomalies in the distal upper limb is well documented. Preliminary studies have identified a number of biometric parameters of the hand by which schizophrenics can be distinguished from matched controls. The current study seeks to determine whether patients with schizophrenia can be singled out from a disparate group of other mental disorders by using the same parameters. We studied three groups, totaling 134 men: 51 diagnosed with schizophrenia, 29 with anxiety and mood disorders, and 54 comprising a control group. Seven parameters were studied: the proximal interphalangeal joint, the eponychia of the middle and ring digits, two dermatoglyphic features, and two constitutional factors. Examiners evaluated the parameters based on photographs and prints. An initial Mann Whitney comparison showed no significant difference between the control group and those identified with anxiety and mood disorders. We therefore accounted for them as a single group. In a discriminant analysis, an overall accuracy of 78.4% was established with a sensitivity of 80.4% (schizophrenics identified correctly) and a specificity of 77.1% (controls identified correctly). These results suggest that the biometric parameters employed may be useful in identifying patients with schizophrenia from a disparate group of other mental disorders.