Resolution Of Ambivalence Research Articles

Cultural Mistrust and Counseling: A Review of Factors Impacting African Americans Males

African American males are less likely to engage in mental health services. Racial discrimination, cultural mistrust, mental health disparities, and racial identity roles are significant factors impeding African American men from pursuing or continuing counseling. Unfortunately, counselors subliminally acknowledge the stereotypical labels ascribed to African American males lead to a poor or non-existing rapport, and tend to create solutions for the clients, disregarding their intrinsic motivation and autonomy. This conceptual article discussed racial discrimination, microaggression, and community ties as the barriers to counseling engagement among African American males. The article also highlighted the history of counseling African American males and the present urgency for a culturally sensitive model using the concepts of Motivational Interviewing for encouraging counseling engagement and autonomous resolution of ambivalence.

Adherence to Treatment in First Episode Psychosis: Acceptance, Refusal, or Ambivalent Process?

Drawing from the perspectives of 18 youth (characterized as adherent, ambivalent, nonadherent), 13 relatives and 8 clinicians, this qualitative study, using semi-structured individual interviews and a focus group, explores why individuals suffering from early psychosis accept or refuse treatment. Identity and relationships, understanding of the diagnosis and significance given to treatment are key themes. Varying degrees of ambivalence and nonadherence can be seen as normal stages of a process to rebuild their sense of self and construct their identity. A trusting relationship may facilitate gradual resolution of ambivalence, promoting the individuals’ sense of ownership and empowerment in the context of treatment.

Mixed feelings: the case of ambivalence

Mixed feelings come in many forms. We focus on mixed feelings resulting from conflicting evaluations of a single attitude object, that is, attitudinal ambivalence. Research on attitudinal ambivalence has led to specific measures that assess the presence, intensity, and resolution of ambivalence, shedding new light on underlying dynamics and moderators. This work has also spawned an interest in the metacognitive experiences of conflict that arise from ambivalence and their downstream consequences for judgment and choice. Because research into mixed emotions may benefit from these conceptual and methodological developments, the current article provides an introductory overview of attitudinal ambivalence and its measurement.

Enhancing Parent–Child Interaction Therapy With Motivational Interviewing Techniques

Parent–child interaction therapy (PCIT) is an evidence-based family intervention for young children with disruptive behavior. Parents and children who complete PCIT show greater immediate and long-term treatment gains than those who discontinue treatment prematurely. PCIT is a time- and effort-intensive treatment, and parents ambivalent about its value for their child or their ability to master the treatment skills may discontinue treatment before engaging sufficiently to experience change. Motivational interviewing (MI) is a client-centered therapeutic method of increasing motivation for change through the resolution of ambivalence. This paper describes how clinicians may incorporate MI strategies into PCIT to enhance parental motivation when signs of ambivalence arise. Vignettes and scripted therapy exchanges illustrate use of the strategies to decrease ambivalence in PCIT, improve homework adherence, increase parenting self-efficacy, and reduce attrition, thereby improving outcomes for young children with disruptive behaviors and their families.

Ambivalence: Prerequisite for success in motivational interviewing with adolescents?

The exploration and resolution of ambivalence play an essential role in motivational interviewing (MI) theory. However, most adolescent MI studies have not examined ambivalence as a contributor to behaviour change. This paper reviewed research findings on the role of ambivalence in the adolescent change process. We undertook a narrative review of the published empirical and theoretical literature on ambivalence and mechanisms of change in MI for adolescents and found that current MI evaluations appear not to have access to reliable and valid measures of ambivalence in adolescence or neuroimaging methods to evaluate the mechanisms of treatment response. Improved instrumentation is needed to assess adolescents' ambivalence in clinical and research settings. Innovative methodology, including neuroimaging, may help identify factors mediating relationships between adolescents' ambivalence and treatment response.

Motivational Interviewing and Decisional Balance: Contrasting Responses to Client Ambivalence

A recommendation in original descriptions of motivational interviewing (MI) was to "explore ambivalence". Contrasting procedures for doing so have been clarified through the evolution of MI. This article describes two conceptually distinct methods for responding to ambivalence: decisional balance (DB) and MI's evocation of change talk, and reviews empirical evidence to recommend when each procedure is appropriate (and inappropriate) in clinical practice. The authors summarize findings of clinical outcome research to examine how these two interventions impact the resolution of client ambivalence. With ambivalent people, a DB intervention tends to decrease commitment to change, whereas evocation (a key element of MI) promotes change. When a person has already made the decision to change, evocation is unnecessary and may deter change, whereas DB may further strengthen commitment. DB is an appropriate procedure when the clinician wishes to maintain neutrality and not favor the resolution of ambivalence in any particular direction. Evocation is appropriate when the clinician intends to help clients resolve ambivalence in the direction of change.

Disseminating Motivational Interviewing in Psychiatric and Adolescent Populations: Optimism and a Few Worries

Can J Psychiatry. 2011;56(11):641-642. Since the publication of the seminal text 2 decades ago,' motivational interviewing (Ml) has seen a steady rise in popularity in the behavioural health community. In 2 decades, it has grown from a treatment that was focused solely on unmotivated substance abusers to a mainstream behavioural intervention adapted for various health-related and psychiatric problems. Information from dissemination theory2 indicates that MI is relatively early in the adoption curve, so we can expect that it will continue to be a vital area of research and clinical practice for some time to come. The rising tide of MI dissemination and adaptation proceeds, in many ways, without critical science to allow its thoughtful and prudent use. For example, there is no answer in sight concerning the question of what problem is not amenable to Ml. IfMI is indeed an efficacious behavioural intervention (as opposed to a panacea or placebo) it must surely have some boundaries to its effectiveness, yet what are they? The current state of the research base shows that this treatment works moderately well for almost every problem area in which it is applied, and also that there is often no difference between MI and other treatments.3 How then does the well-intentioned clinician make plans to use, or set aside, this method? The 2 In Review articles4·5 in this issue will help the reader to answer this question by examining both the available research within a specific area (adolescents and psychiatric disorders) and the advantages and limitations inherent in applying MI outside its original domain of substance abuse. One theme that recurs when MI grows away from the substance abuse problems that were its home is the question of whether client ambivalence is a necessary condition for using MI, and if so, how much ambivalence must be present to begin. Formal MI theory assigns client ambivalence a central role in facilitating motivation for change.6 Interviewers are seen as eliciting rather than creating motivation, which instead arises from the resolution of ambivalence. But what happens when the client is genuinely unconcerned about changing and seeks treatment only to avoid aversive consequences? What if clients have very little ambivalence about self-destructive behaviours? How far can a treatment that was developed within a collaborative, humanistic psychotherapeutic context be adapted to situations where the client views him or herself as being manipulated into making a change that is not one they would ever likely choose? This issue is particularly relevant to psychiatric populations where ambivalence may represent a core characteristic of the disorder, such as schizophrenia or borderline personality disorder. It is reasonable to ask what results we might expect when selecting a treatment with the explicit goal of enhancing and enlarging ambivalence for a population in whom ambivalence is a chronic and enduring feature of their inner life. Similarly, how do we expect that MI will work with adolescents who often show very little ambivalence about the problems that bring them to the attention of concerned others? The In Review articles4·5 deal directly with this issue by presenting the research showing that MI is indeed effective, both for clients with severe mental illness and for adolescents. Both articles4·5 offer hints about the ways that MI must be tailored for these groups, and readers will find especially helpful the hands-on and practical examples, including dialogue, of how to approach adolescents using an MI framework. A second theme in the current Zeitgeist of MI is how to integrate it with other treatments. MI is now commonly married with cognitive-behavioural therapy (CBT) for various problems, and indeed almost never occurs as a stand-alone intervention outside the substance abuse treatment arena. The question of how MI can be combined with CBT necessarily requires us to consider how MI works, and whether it may carry intentions that are not compatible with other approaches. …

Ambivalence

The phenomenon of ambivalence is an important one for any philosophy of action. Despite this importance, there is a lack of a fully satisfactory analysis of the phenomenon. Although many contemporary philosophers recognize the phenomenon, and address topics related to it, only Harry Frankfurt has given the phenomenon full treatment in the context of action theory – providing an analysis of how it relates to the structure and freedom of the will. In this paper, I develop objections to Frankfurt's account, all revolving around the charge that his account contains a serious ambiguity between willing and identifying. With such objections in place, I then develop an analysis that avoids the difficulties and ambiguities that Frankfurt's analysis is prey to. I briefly distinguish ambivalence from other types of internal conflict. This paper aims to offer conceptual clarification on the phenomenon of ambivalence, which will then allow for discussions about the normative merits and demerits of ambivalence, the effects of ambivalence on autonomous action, and methods of resolution of ambivalence.

Brief Motivational Interventions for HIV/STI Risk Reduction among Individuals Receiving Alcohol Detoxification

This HIV/STI risk reduction clinical trial implemented in short-term alcohol detoxification employed a randomized block design to evaluate three intervention conditions for feasibility, safety, and potential for changing sexual risk attitudes, motivations, and behavior: (a) nonintervention control (standard HIV information dissemination), (b) brief motivational intervention (BMI) for resolution of ambivalence and sex risk reduction planning, and (c) BMI with biological feedback based on testing for sexually transmitted infections (STIs). Findings revealed that BMI can be feasibly implemented during detoxification treatment with individuals with significant substance impairment. BMI, whether coupled with biological feedback or not, enhanced motivation for increasing behaviors that protect from STI. Sexual risk behavior did not change in any of the groups to a statistically significant degree; however, additional analyses suggest negative biological feedback may have resulted in slightly increased level of sexual activity, undoing behavioral effects of increased motivation for sexual risk reduction, perhaps by distorting participants' perception of risk.

The use of hypnosis with an injecting heroin user: brief clinical description of a single case

AbstractThis paper describes the use of hypnosis with an injecting heroin user. This client was finding it very difficult to keep to his methadone prescription and was frequently using heroin ‘on top’. He received three sessions of hypnosis in order to facilitate relaxation and visualization, and resolution of ambivalence concerning his drug use. The results suggest the client has responded well to treatment. Details both of the client and of the three hypnosis sessions are given and the outcome is discussed. Copyright © 1996 British Society of Experimental and Clinical Hypnosis

Emergence and Resolution of Ambivalence in Expectant Mothers

Little has been written about the perceptions of expectant mothers with previous histories of psychiatric disturbance and their affective oscillations during pregnancy. This paper discusses the case of a 22-year-old primigravida with a history of schizoaffective disorder who was referred to our mother-infant psychotherapy service. Despite the patient's initial defensive style, she was asked to discuss several dreams that she had had since learning about her pregnancy. A wealth of information about the patient's unconscious ambivalence and destructive wishes toward her unborn infant emerged. The patient was also unable to engage in any predictive imagery about the future of her infant or to anticipate intuitively what the experience of mothering would be like. This paper reveals that pregnant women with a history of psychological disturbances often have highly aberrational fantasies and ambivalent impulses toward their unborn infant, and some of these fantasies threaten to manifest in the form of abusive behavior after the birth. Techniques for predicting how new mothers with previous psychiatric histories will interact with their infants after birth are outlined. It is hoped that this treatment may avert child abuse.

Genet's Fantastic Voyage in Miracle de la Rose: All at Sea about Maternity

Together psychoanalytical and feminist criticism appear to uncover the very composition of Jean Genet's inversion. Indeed, in this regard the Miracle de la Rose dream sequence which focuses on an extraordinary voyage through the body of Harcamone, the very imprimatur of bisexuality defined in Cixous' Le rire de la méduse, holds singular importance. Abandoned by his biological mother, Genet sees himself as a "produit synthétique" who has to belong to someone in order to be. Genet simply does not exist unless he can establish, not the Lacanian Name-of-the-Father, but rather the Name-of-the-Mother. The dream reveals a Freudian resolution of ambivalence when its author "kills" the Mother by becoming her through a mediation of Subject and Other which parallels Irigaray's interpenetration of mother and child. Mediation becomes transformation as Genet's fantastic voyage allows him to say, "je nais."

The universal resolution of ambivalence by paranoia with an example in black and white.

Back to table of contents Previous article Next article ArticlesNo AccessThe Universal Resolution of Ambivalence by Paranoia with an Example in Black and WhiteCharles A. Pinderhughes†, M.D.Charles A. Pinderhughes†Boston, Mass.†Associate Clinical Professor of Psychiatry, Tufts University School of Medicine, Boston, Mass.; Lecturer in Psychiatry, Harvard Medical School, Boston, Mass.; Director of Psychiatry Research, Veterans Administration Hospital, Boston, Mass. 02130Search for more papers by this author, M.D.Published Online:30 Apr 2018https://doi.org/10.1176/appi.psychotherapy.1970.24.4.597AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - APT - American Journal of Psychotherapy $35.00 Add to cart PPV Articles - APT - American Journal of Psychotherapy Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byPsychiatric Contributions to Understanding Racism30 June 2016 | Transcultural Psychiatry, Vol. 37, No. 2Book Reviews25 June 2016 | Journal of the American Psychoanalytic Association, Vol. 44, No. 3Psychoanalytic Inquiry, Vol. 6, No. 2An unconscious source of opposition to the liberation of women.1 January 1979 | American Journal of Orthopsychiatry, Vol. 49, No. 1Community Transference: Toward a Psychiatry-of-the-Community27 July 2016 | International Journal of Social Psychiatry, Vol. 21, No. 1Community Psychiatry — A Hard Look at Feasibility toward a Socioanalytic Understanding26 April 2017 | Canadian Psychiatric Association Journal, Vol. 19, No. 6International Journal of Group Psychotherapy, Vol. 23, No. 2A Service of Liaison to the Isolated North: A Proposal for ‘Community Transference’26 April 2017 | Canadian Psychiatric Association Journal, Vol. 17, No. 6 Volume 24Issue 4 1970, pp. 545–728Pages 597-610 Metrics PDF download History Published online 30 April 2018 Published in print 1 October 1970

Perception experiments in a study of ambivalence.

This investigation is concerned with the perception aspects of a larger study on the problem of ambivalence. The over-all goal in the total project is to find specific etiological factors which can be correlated with success or failure in the resolution of ambivalence. These etiological factors deal with the character of the object relations in early life, the opportunities for object relations in general, and, more specifically, the opportunities for warm object relations. Against these etiological factors a set of measurements of the resolution of ambivalence is being worked out. Two of these measurements are presented in this study. One measurement is a structured interview in which we classify our subject material according to degrees of organization or failure in the handling of impulses. The other measurement is a tachistoscopic perceptual test, a measurement of the accuracy of perception and also measurement of the range and breadth of subsequent visual