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Forensic Interventions for Therapy and Rehabilitation Case Studies and Analysis 1st Edition Taylor & Francis Group
“Present-Centered Group Therapy for PTSD: Embracing Today represents an important new evidence-based approach for treating PTSD. Suitable for therapists of virtually all theoretical orientations, this interpersonal skillsbased treatment can be readily applied to all sources of trauma from military combat, sexual assault, and domestic violence, to moving vehicle accidents. Its success rates parallel those found in all other effective treatments for PTSD.”
Terence M. Keane, PhD, director, Behavioral Science Division, National Center for PTSD, professor and assistant dean for research, Boston University School of Medicine
“Drawing upon years of research findings, academic rigor and clinical practice, authors Melissa Wattenberg, Dan Gross, Barbara Niles, Bill Unger, and M. Tracie Shea bring Present-Centered Group Therapy to the forefront as an evidenced-based and clinically sustaining group treatment for addressing PTSD. Their book, Present-Centered Group Therapy for PTSD: Embracing Today, is as comprehensive as it is a clear and compelling. The chapters move from the origins, components, and evidence of PCGT to a complete three chapter manual which invites the reader to learn from experts who have spent years helping veterans open a space and place for their present self in a trusted group. Followed by chapters which expand the readers understanding of 'present' in PCGT, the efficacy of group in trauma treatment and the effective application of PCGT to other treatment contexts, this book is a unique contribution to trauma survivors and those working with them. We have come to a place and time where research and treatment inform each other with a true understanding of what trauma takes and what treatment works to return. The book Present-Centered Group Therapy for PTSD: Embracing Today epitomizes that place and time.”
Suzanne B. Phillips, PsyD, ABPP, is a licensed psychologist, psychoanalyst, diplomate in Group Psychology, Certified Group Therapist, fellow of the American Group Psychotherapy Association
“Present Centered Group Therapy (PCGT) is an excellent alternative to traumafocused treatment for PTSD that focuses on the here-and-now and not on traumatic memories. Through a combination of psychoeducation, problem solving, and group support, participants develop a better understanding of their PTSD symptoms and themselves, and learn how to embrace today by directly facing and overcoming the challenges in their lives. With over 20 years of research supporting its efficacy, PCGT is an effective, low stress option for treating PTSD, and helping people affected by trauma move on with their lives.”
Kim T. Mueser, PhD, professor, Departments of Occupational Therapy and Psychological and Brain Sciences Center for Psychiatric Rehabilitation, Boston University
Present-Centered Group Therapy for PTSD
Present-Centered Group Therapy for PTSD integrates theory, research, and practical perspectives on the manifestations of trauma, to provide an accessible, evidenceinformed group treatment that validates survivors’ experiences while restoring presentday focus.
An alternative to exposure-based therapies, present-centered group therapy provides practitioners with a highly implementable modality through which survivors of trauma can begin to reclaim and invest in their ongoing lives. Chapters describe the treatment’s background, utility, relevant research, implementation, applications, and implications. Special attention is given to the intersection of group treatment and PTSD symptoms, including the advantages and challenges of group treatment for traumatized populations, and the importance of member-driven processes and solutions in trauma recovery.
Compatible with a broad range of theoretical orientations, this book offers clinicians, supervisors, mentors, and students a way to expand their clinical repertoire for effectively and flexibly addressing the impact of psychological trauma.
Melissa S. Wattenberg, PhD, is a clinical psychologist, co-developed PCGT, and supervises VA Boston’s Psychosocial Rehabilitation & Recovery Center. She is assistant professor of psychiatry, Boston University.
Daniel Lee Gross, LICSW, is a clinical social worker at the Veterans Administration Hospital and in private practice in Seattle. He is an associate professor at Seattle University’s Master of Social Work program.
Barbara L. Niles, PhD, is a psychologist at VA Boston National Center for PTSD and assistant professor of psychiatry, Boston University, and investigates impact of psychotherapy and health enhancement for veterans with PTSD.
William S. Unger, PhD, is a psychologist in the Trauma Recovery Services at Providence VA Medical Center and associate clinical professor in the Department of Psychiatry and Human Behavior, Brown University. He served as the chief of the PTSD Program for 16 years.
M. Tracie Shea, PhD, is a psychologist in the Trauma Recovery Services, Providence VA, and professor, Department of Psychiatry and Human Behavior, Brown University, developed PCGT, and has played a key role in many clinical trials of PTSD psychosocial treatments.
Present-Centered Group Therapy for PTSD
Embracing Today
Melissa S. Wattenberg,
Daniel Lee Gross,
Barbara L. Niles,
William S. Unger, and M. Tracie Shea
First published 2021 by Routledge
52 Vanderbilt Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
The right of Melissa S. Wattenberg, Daniel Lee Gross, Barbara L. Niles, William S. Unger, M. Tracie Shea to be identified as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.
Library of Congress Cataloging-in-Publication Data
Names: Wattenberg, Melissa S., author.
Title: Present-centered group therapy for PTSD: embracing today / Melissa S. Wattenberg [and four others].
Description: New York, NY: Routledge, 2021. | Includes bibliographical references and index. | Summary: “Present-Centered Group Therapy for PTSD integrates theory, research, and practical perspectives on the manifestations of trauma, to provide an accessible, evidence-informed group treatment that validates survivors’ experiences while restoring present-day focus. An alternative to exposure-based therapies, present-centered group therapy provides practitioners with a highly implementable modality through which survivors of trauma can begin to reclaim and invest in their ongoing lives. Chapters describe the treatment’s background, utility, relevant research, implementation, applications, and implications. Special attention is given to the intersection of group treatment and PTSD symptoms, including the advantages and challenges of group treatment for traumatized populations, and the importance of member-driven processes and solutions in trauma recovery. Compatible with a broad range of theoretical orientations, this book offers clinicians, supervisors, mentors, and students a way to expand their clinical repertoire for effectively and flexibly addressing the impact of psychological trauma.” – Provided by publisher
Identifiers: LCCN 2020048631 (print) | LCCN 2020048632 (ebook) | ISBN 9780367257439 (hardback) | ISBN 9780367338831 (paperback) | ISBN 9780429322617 (ebook)
Subjects: LCSH: Post-traumatic stress disorder--Treatment. | Group psychotherapy.
LC record available at https://lccn.loc.gov/2020048631
LC ebook record available at https://lccn.loc.gov/2020048632
ISBN: 978-0-367-25743-9 (hbk)
ISBN: 978-0-367-33883-1 (pbk)
ISBN: 978-0-429-32261-7 (ebk)
Typeset in Times by MPS Limited, Dehradun
As therapists and researchers who have worked in VA settings for many years, we dedicate this book to the veterans, from whom we have learned so much. We extend appreciation to the many individuals, veterans and non-veterans, who have participated in PTSD treatment over the past decades, who have selflessly shared their insights and experiences toward the furtherance of treatments that will continue to benefit survivors of trauma.
MELISSA S. WATTENBERG, DANIEL LEE GROSS, BARBARA L. NILES, WILLIAM S. UNGER, AND M. TRACIE SHEA
REGINA DOLAN-SEWELL
4 Present-Centered Group Therapy Guide & Manual Part II: Invitation to the Present
MELISSA S. WATTENBERG, M. TRACIE SHEA, DANIEL LEE GROSS, AND WILLIAM S. UNGER
5 Guide & Manual Part III: Addressing PTSD Symptoms, Trauma-Related Issues, and Group Patterns in PCGT
MELISSA S. WATTENBERG, M. TRACIE SHEA, WILLIAM S. UNGER, AND DANIEL LEE GROSS
6
Present
MELISSA S. WATTENBERG, DANIEL LEE GROSS, AND WILLIAM S. UNGER
7 Group Psychotherapy and Treatment of Trauma: A History
DANIEL LEE GROSS AND MELISSA S. WATTENBERG
WILLIAM S. UNGER AND DANIEL LEE GROSS
About the Authors
Foreword Author
Matthew J. Friedman, MD, PhD, served for 24 years as executive director of the US Department of Veterans Affairs’ National Center for PTSD. He stepped down in 2014 to become a senior advisor to the Center as well as founder and director of the National PTSD Brain Bank. In addition, he remains professor and vice chair for research in the Department of Psychiatry at the Geisel School of Medicine at Dartmouth. He has over 45 years of experience as a clinician and researcher, with approximately 350 publications, including 28 books. Dr. Friedman is a Distinguished Lifetime Fellow of the American Psychiatric Association, past president of the International Society for Traumatic Stress Studies, past chair of the APA’s DSM-5 and DSM-5-TR PTSD Work Groups, and past chair of the Scientific Advisory Board of the Anxiety Disorders Association of America. He has served on many national research, education, and policy committees. Past honors include the ISTSS Lifetime Achievement Award in 1999 and Public Advocacy Award in 2009. He was a finalist for the 2011 Samuel J. Heyman Service to America Medal.
Author-Editors
Melissa S. Wattenberg, PhD, Dr. Wattenberg is a clinical psychologist who has worked with PTSD and persistent psychiatric conditions for over 30 years at Veterans Affairs Boston Healthcare System. She has presented and published on group therapy for PTSD. She has been program manager of the VA Boston Healthcare’s Psychosocial Rehabilitation and Recovery Center (PRRC) for individuals with lived experience with serious mental health conditions (including severe and prolonged PTSD) since 2006, and collaboratively incorporated VA Boston’s first peer support providers. Prior to initiating the PRRC, she developed and ran a short-term intensive program for veterans with significant mental health conditions. She has trained in a variety of evidence-based practices, including behavioral family therapy, integrated behavioral couples therapy, illness management and recovery, and motivational interviewing. She is also a tele-mental-health practitioner co-facilitating PCGT virtually for veterans with PTSD and significant lived
experience with co-occurring mental health conditions. Dr. Wattenberg was clinical supervisor of present-centered group therapy (PCGT) in VA Cooperative Study 420 across ten VA sites, and participated in development of its manual in collaboration with its originator, M. Tracie Shea, PhD. She is a primary mental health supervisor for physician assistant trainees at VA Boston as adjunct clinical professor at Mass. College of Pharmacy and Health Sciences, and is assistant professor of psychiatry at Boston University School of Medicine. She received her doctorate in clinical and cognitive psychology from the University of Illinois at Chicago. She is a focusing practitioner and trainer, and has a small private practice north of Boston.
Daniel Lee Gross, LICSW, Daniel Gross received his bachelor’s degree in psychology from Cornell College in 1988, and his MSW from University of Washington in 1999. A licensed independent social worker, he has worked in various mental health settings, serving youth, older adults, and veteran clients. Mr. Gross has worked at the Veterans Affairs Puget Sound Healthcare System since 2012, where he introduced presentcentered group therapy to the mental health clinic for veterans coping with significant PTSD symptoms. He currently holds the position as clinical social worker in the Intensive Outpatient Program. In his role as clinical social worker, Mr. Gross also designed and initiated Seattle VA hospital’s first LGBTQ support group. He is versed in a variety of evidence-based interventions, including present-centered group therapy (PCGT) for PTSD, motivational interviewing, and cognitive processing therapy for PTSD. Mr. Gross also has a private practice and teaches as an associate professor at Seattle University’s MSW Program. He has presented PCGT workshops on both a local and national level.
Barbara L. Niles, PhD, Dr. Niles is a staff research psychologist at the Behavioral Sciences Division of the National Center for PTSD at Veterans Affairs Boston Healthcare System, and an assistant professor of psychiatry at the Boston University School of Medicine. She has extensive experience providing treatment to veterans with PTSD as well as investigating the impact of psychotherapy and health enhancement for these veterans. Dr. Niles is well versed in state-of-the-art methods of assessment and current best practices for carrying out clinical trials to address PTSD. She has been a member and supervisor in the VA Boston PTSD Clinic Treatment Team for over 25 years and has served as PI or Co-PI on several randomized trials of interventions for veterans with PTSD. She has worked closely with the developers of presentcentered group therapy (PCGT), served as a clinician on two trials of this treatment, and has led several workshops at national conferences. Dr. Niles received her doctorate in clinical psychology from Rutgers, the State University of New Jersey.
William S. Unger, PhD, Dr. Unger has worked as a clinical psychologist at the Providence Veterans Administration Medical Center for 31 years. He served as the clinical director of the PTSD Program for six years and as the chief of the PTSD Program for 15 years. Dr. Unger was selected as a VA regional PTSD Program Mentor to other VA program leaders to assist with the management of administration, program development, and treatment. Dr. Unger currently serves as the Evidence-based Psychotherapy Coordinator for the Providence VA Medical Center and as a VA national training consultant for cognitive behavioral conjoint therapy for PTSD. He works in the Trauma Recovery Service at the Providence VA Medical Center. He is an associate clinical professor in the Department of Psychiatry and Human Behavior at Brown University. Dr. Unger has extensive experience conducting clinical trials through involvement with multiple VA Cooperative Studies, including the VA Cooperative Study that examined the efficacy of trauma-focused group therapy for PTSD compared with present-centered group therapy (PCGT). During the past ten years, he has been involved in the development of peer-to-peer services for veterans in the PTSD program at the Providence VA Medical Center. He has been offering PCGT to veterans in both inpatient and outpatient settings via face-to-face and telehealth formats. Dr. Unger completed his doctorate in clinical psychology at State University of New York at Binghamton, and his masters in experimental psychology from Villanova University.
M. Tracie Shea, PhD, Dr. Shea is a staff psychologist in the Trauma Recovery Clinic, director of PTSD Research at the Providence Veterans Administration Medical Center, and professor in the Department of Psychiatry and Human Behavior at Brown University. In addition to 30 years of clinical work with veterans, she has extensive experience in conducting multi-site clinical trials, including investigations of the efficacy of trauma-based therapies for veterans with PTSD. Dr. Shea, together with Dr. Wattenberg and Dr. Dolan, developed the present-centered group therapy (PCGT) model and manual for use as a nonspecific therapy control for examining the effectiveness of trauma-focused group therapy in VA Cooperative Studies Program (CSP)-420, the largest randomly controlled trial of group treatment for PTSD. As a training site PI, she oversaw therapist training and supervision in PCGT at ten participating sites. Dr. Shea also developed and oversaw training and supervision of an individual therapy version of present-centered therapy (PCT) for CSP494, a subsequent multisite VA CSP study. Dr. Shea was formerly at the National Institute of Mental Health, where she was chief of the Personality Disorders Program, and associate coordinator of the NIMH Treatment of Depression Collaborative Research Program. She was a member of the work group on personality disorders for DSM-IV; has served on numerous advisory and monitoring boards; and on review committees for NIMH,
DOD, and VA. Her recent research includes two VA merit-funded randomized clinical trials (RCTs) testing the effectiveness of treatments for veterans. These include an RCT testing the efficacy of a cognitive behavioral intervention for the treatment of anger problems in veterans returning from Iraq and Afghanistan, and an RCT comparing interpersonal therapy and prolonged exposure for treatment of PTSD in veterans. She has also received funding from the National Institute of Mental Health and the Department of Defense and has approximately 180 peer-reviewed publications. Dr. Shea received her PhD in psychology from Catholic University.
Authors on Specific Chapters
Scott D. Litwack, PhD, Dr. Litwack is the director of the PTSD Clinical Team at the Jamaica Plain VA Medical Center of the Veterans Administration Boston Healthcare System, and is an assistant professor of psychiatry at the Boston University School of Medicine. Dr. Litwack has had extensive training in a number of evidence-based practices for PTSD, including achieving VA certification status for cognitive processing therapy, prolonged exposure, and motivational interviewing. Over the past decade he has been a project coordinator, clinician, and supervisor in multiple randomized clinical trials comparing present-centered therapy to other evidence-based treatments for PTSD and related disorders. He received his doctorate from University of Connecticut.
Regina Dolan-Sewell, PhD, Following her work on the Treatment of Depression Collaborative Research Program at the National Institute of Mental Health, Dr. Dolan Sewell’s research career continued at Brown University on the research faculty in the Department of Psychiatry. There she contributed to the Collaborative Longitudinal Study of Personality Disorders as well as a number of other longitudinal studies in mood and anxiety disorders. Dr. Dolan-Sewell also served as director of the Mood, Anxiety, Eating and Sleep Disorders Program in the Division of AIDS and Treatment Development at the NIMH and was the NIMH-wide coordinator for both the Sleep Disorders Research and Eating Disorders Research portfolios. At the NIMH, Dr. Dolan-Sewell received Director’s Leadership and Merit awards. The Academy for Eating Disorders Research awarded Dr. Dolan-Sewell the Power of Action Award and twice awarded her special recognition for contribution to research. Dr. Dolan-Sewell is currently a volunteer for the Virginia Medical Reserve Corps with the Virginia Department of Health and serves on the board of Rush Homes. She graduated from the University of Virginia with a degree in psychology and completed her PhD at the Catholic University of America.
Daniel H. Grossman, BS, Daniel Grossman is a research assistant working under Dr. Barbara Niles at the Behavioral Science Division of the National Center for PTSD, VA Boston Healthcare System. Prior to this position, Mr. Grossman conducted research at Tel Aviv University and Yale School of Medicine. His work in psychology and neuroscience has spanned several research topics, including neural markers of decisionmaking processes, the impact of mindfulness training on stress-related symptoms of chronic liver disease, and most recently, a clinical trial of Tai Chi for Gulf War veterans with multi-symptom illness. He holds a BS in neuroscience from Union College in Schenectady, NY.
Foreword
Matthew J. Friedman
In the early 1990s the Department of Veterans Affairs (VA) Cooperative Studies Program (CSP) directed the National Center for PTSD to conduct a multi-site, randomized clinical trial (RCT) of the best treatment for PTSD. It was CSP’s first RCT (CSP-420) on PTSD treatment. At the time we really didn’t know what that treatment might be. A recently published metaanalysis (Solomon, Gerrity, & Muff, 1992) had shown that among the few rigorous studies that had been published up to that time, psychotherapy produced better results than pharmacotherapy, and treatments utilizing direct therapeutic exposure seemed to have the best outcomes. It should also be noted that, at that time, there were still great misgivings about the safety of exposure therapies because of concerns that they might precipitate relapse through therapy-induced exacerbation of PTSD symptoms.
Paula Schnurr and I convened a meeting of the top PTSD treatment experts in VA who concluded that group, rather than individual, therapy, would be best. We all believed that in addition to promoting recovery through psychoeducation, cognitive restructuring, a developmental perspective, relapse prevention, and coping skills training, the cohesion and safety of the group would buffer veterans against any potential toxic side effects of exposure therapy (Schnurr, Friedman, Lavori, & Hsieh, 2001).
Since the presumed therapeutic ingredient in our experimental treatment, trauma-focused group therapy (TFGT), was to focus on details of the traumatic event through exposure and cognitive restructuring, we needed a strong comparison treatment in which processing of traumatic material is actively prevented while the focus is kept on here-and-now problems that have resulted from PTSD symptoms. We also needed a treatment that would control for the “nonspecific” effects that all group therapies have in common. These include: therapist contact, a supportive milieu, group cohesion, instillation of hope, and expectation of improvement (Yalom, 1995).
At that time, Edna Foa and Patricia Resick were beginning to publish and present their positive findings with prolonged exposure and cognitive processing therapy, respectively, showing the efficacy of trauma-focused treatment for PTSD. Therefore, we knew that in order to rigorously test the effectiveness of TFGT, present-centered group therapy (PCGT) had
to be a very strong comparison treatment that would embody the best elements of non-trauma-focused supportive group therapies. In addition, PCGT had to be a credible treatment that therapists believed would be an effective treatment for PTSD.
Recognizing that we needed a strong, credible manualized PCGT treatment, everyone we asked said that we would be lucky if we could convince Tracie Shea to design and manualize PCGT. Tracie had played a major role in the National Institute of Mental Health’s large multisite Treatment of Depression Collaborative Research Program (Elkin et al., 1989) that had randomized almost 250 patients to either psychotherapy, medication or placebo conditions. We were thrilled when Tracie said “yes.” She quickly recruited Melissa Wattenberg and they have remained a creative, durable, and effective team for 25 years. Since the epicenter of this activity was at the Providence VA Medical Center, where Bill Unger was director of all PTSD programs, he became site director and therapist at the Providence VA, one of the ten sites included in CSP-420. Barbara Niles was also a PCGT therapist in the study and Dan Gross joined this group of PCGT experts some years later.
In order to control for therapist bias, we randomized all study therapists to deliver either TFGT or PCGT. In other words, some therapists who strongly believed that trauma-focused treatments were better, found themselves assigned to provide PCGT. After they started treating veterans, skeptical (pro-TFGT) therapists assigned to deliver PCGT came to not only believe in its efficacy but to also to believe that they might have better therapeutic outcomes than their colleagues who were providing TFGT. As it turned out, both treatments were associated with modest improvements and neither was significantly better than the other.
Some years later, Paula and I called upon this same group to convert the PCGT manual from group to individual present-centered therapy (PCT) for our 15-site RCT (CSP-494) of prolonged exposure versus PCT (Schnurr, Friedman, Engel, Foa, Shea, et al., 2007). In this study of individual psychotherapy, PCT competed directly with PE, one of the most effective CBT treatments for PTSD. Although PE produced significantly better outcomes, it was a real horse race and PCT did quite well. Indeed, among those who received PCT (based on intent-to-treat analysis), 58.7% had significant clinical improvement, 20% no longer met criteria for PTSD, and 7% had a complete clinical remission (Schnurr et al., 2007).
These results with PCT were much better than clinical outcomes with conventional psychotherapy for PTSD. More importantly, they raised the fundamental question of whether there were effective psychotherapies for PTSD that did not include a trauma-focused component. Earlier studies with stress inoculation therapy suggested that this might be the case (Foa et al., 1999).
Approximately ten years later, while participating in the 2017 revision of the clinical practice guideline for PTSD jointly sponsored by the Department
of Veterans Affairs and Department of Defense (VA/DoD0), I was frankly surprised to discover how well PGCT had performed in a number of studies (that are thoughtfully reviewed in chapter two of this book). As both group and individual therapy, PGCT/PCT had also done well in other studies, replicating our CSP-494 results, reported above. In other words, although PGCT and PCT had been employed as the comparison therapy in every single RCT testing a variety of index treatments, it had performed quite well with regard to clinical improvement, loss of diagnosis and complete remission. As a result, the latest VA/DoD clinical practice guideline (VA/DoD, 2017) recommends PCT as an evidence-based treatment for PTSD. It should be noted that the recommendation for trauma-focused treatments is “strong” whereas that for PCT is “weak,” but the bar is set pretty high for any treatment to receive even a “weak” recommendation in the VA/DoD guideline. Given that there are many fewer trials of PGCT/ PCT than of PE, CPT, and other trauma-focused treatments, and given that PGCT/PCT has always been the comparison, rather than the index, treatment in these RCTS, I agree strongly with the authors that the time has come to recognize PGCT/PCT as a treatment, in its own right, and that future research should test the efficacy of PGCT/PCT as the index, rather than as the comparison treatment.
It is also important to keep in mind that all participants in all RCTs with trauma-focused treatments gave informed consent to receive that treatment. We don’t really know how many PTSD patients declined to do so because they didn’t want to be randomized to a treatment in which they would have to focus intensely on their traumatic memories. Nor do we know how many of those who declined a trauma-focused therapy would have consented to receive a non-trauma-focused treatment such as PGCT/PCT.
Indeed, treatment preference is a very important factor that clinicians need to consider. There is emerging evidence that patients have better outcomes when they receive their preferred treatment, whether it is psychotherapy or pharmacotherapy (Zoellner, Roy-Byrne, Mavissakalian, & Feeny, 2018). In my own experience, some treatment-seeking patients would much rather focus on here-and-now PTSD-related problems instead of revisiting the traumatic material that dominates their conscious thoughts during the day and nightmares when they are asleep. Clinically, it would be of great value to know how well patients can be expected to benefit from PGCT/PCT when they strongly prefer such treatment to a trauma-focused approach.
Another major benefit of PGCT/PCT is that dropout rates are considerably lower than with trauma-focused treatments. So, even if we accept the VA/DoD guideline’s conclusion that trauma-focused treatments are more efficacious than PGCT/PCT, a major trade-off for a clinician to consider is the relative utility of assignment to a stronger treatment with higher dropouts versus assignment to an effective, but
less efficacious, treatment such as PCGT/PCT with fewer dropouts. A related question is the potential benefit of reassigning trauma-focused dropouts to PGCT/PCT.
There are also some very interesting clinical and theoretical issues to consider with regard to treatment matching and mechanism of action, respectively. Right now, we don’t have very much information to guide optimal treatment assignment. Besides patient preference, there is very little data to help us identify the round pegs for the round peg therapeutic options versus the square pegs for square peg treatments. We have argued elsewhere that, given the heterogeneity of PTSD, as we identify future types, subtypes, phenotypes, and endophenotypes of posttraumatic psychopathology (Friedman, 2016; Friedman, Schnurr & Keane, in press), we will discover that the best treatment for one type may not be optimal for others. For example, we already know that the best trauma-focused treatments for patients with PTSD’s dissociative subtype are not the best for non-dissociativetype PTSD patients (Lanius et al., 2013). In short, it is entirely possible that non-trauma-focused therapy will prove to be the treatment of choice for some posttraumatic syndromes while trauma-focused treatment (or pharmacotherapy) are best for others.
These speculations also suggest that the mechanism of action for PGCT/ PCT may differ greatly from that for trauma-focused treatments (and from different types of pharmacotherapy). Using brain imaging, as an example (although the same arguments can be made with psychological indices or biomarkers), a few studies have shown that alterations in neurocircuitry activity and neuronal connectivity are associated with improvement with trauma-focused psychotherapy (Fonzo et al., 2017; Zantvoord, Diehle, & Lindauer, 2013). It would be of great interest to find out whether nontrauma-focused psychotherapy (or pharmacotherapy) works through the same or different mechanisms. Such research would not only help us understand how PGCT/PCT achieves positive therapeutic outcomes but would also advance our fundamental understanding of post-traumatic psychopathology itself. For example, concurrent benzodiazepine use suppressed the efficacy of PCT, whereas it did not reduce the effectiveness of PE (Rosen, et al., 2013). This may indicate that PE is a more potent treatment with an efficacy that cannot be blunted by benzodiazepines, although an alternative explanation is that PCT is mediated by a distinct benzodiazepine-sensitive pathway in contrast to PE, which is mediated by an entirely different mechanism of action.
As a godparent who was present at the births of both PGCT and her little sister, PCT, it is very exciting to see that non-trauma-focused treatments are finally being considered as index, rather than comparison, treatments for PTSD. I commend the authors of this book and of the PGCT manual for persevering with this important work. At a time when
trauma-focused therapy has commanded the lion’s share of PTSD treatment research, it is extremely important to consider alternate treatment approaches, especially in view of the heterogeneity of PTSD, variation in patient preference, low dropout rates, and optimal treatment matching. Finally, learning more about PGCT/PCT’s mechanism of action will enable us to learn much more about the etiology of PTSD, itself.
Preface
Present-Centered Group Therapy for PTSD: Embracing Today was written to offer a flexible, present-oriented, evidence-based treatment for survivors of trauma. A number of factors have suggested a growing need for, and receptiveness to, this modality. Among these factors are:
• A distinctly thoughtful and generative period1 in PTSD research and theory (as reflected on in the foreword), that has resulted in not only questioning and debate regarding the pre-eminent role of traumafocused approaches (Steenkamp et al., 2020a; Litz et al., 2019; Hoge et al., 2018; Niles et al., 2018; Najavits, 2015; Schnurr et al. response to Steenkamp et al., 2020, and Steenkamp et al. (2020b) reply), but also a call for individualized, collaborative, and tailored approaches to treating the sequelae of trauma. While there are differences, there is agreement that there is not a “one-size-fits-all” treatment for PTSD. This discourse is consonant with a general call for broader and more nuanced approaches to psychotherapy research and evidence-based practice (Wachtel, 2010).
• As noted in chapter eight, DSM-5’s (American Psychiatric Association, 2013) expansion of disorders related to trauma
• Acknowledgment of a potential role of trauma in previously nontrauma-identified disorders, at least as an exacerbating factor (see chapter eight)
• Clinician interest and requests over the years (personal communications with authors)
• Responses from presentations to national conferences (especially American Group Psychotherapy Association (AGPA) over the past 18 years)
• The publisher’s inquiry leading to this publication, in response to a PCGT workshop offering at American Group Psychotherapy Association (AGPA)
• Developing evidence for this therapy from the mid-1990s through 2020 (as delineated in chapters one and two)
The Authors
Present-centered group therapy (PCGT) brought this team of authors together. We have among us researchers, clinical consultants, clinical administrators, trainers, teachers, and practitioners, each uniquely connected to PCGT. We owe much to a number of marvelous connectors: our colleagues and projects and organizations that support work in the field. We have acknowledged many of them at the beginning of this book, and apologize if there are any we have left out inadvertently.
Several of the authors were connected at the outset through the Veterans Health Administration’s National Center for PTSD, in Cooperative Study Program 420 (CSP-420), a groundbreaking ten-site randomly controlled trial of PTSD treatment for Vietnam veterans with longstanding PTSD (Schnurr et al., 2003; detailed in chapter one). Others of us connected through the American Group Psychotherapy Association (AGPA), including during the period of training of practitioners in the days after the 9/11 attack on New York’s World Trade Towers, and in the years afterward.
Our five major authors are trauma treatment providers and trainers. Geographically we span the country, hailing from three VA sites (two in New England, one on the West Coast). Three of our authors are currently providing PCGT virtually during the COVID-19 pandemic (described in chapter eight). In creating this book, we have drawn on our varied clinical backgrounds, and our range of theoretical orientations (from behavioral to cognitive-behavioral to analytic to person-centered to psychosocial rehabilitation). We have common ground in our interest in this treatment for PTSD, and in our wish to make it understandable and accessible for practitioners and trainers. Ultimately, we would like survivors of trauma to have PCGT among their options when they make choices about their treatment.
Context of This Time in the Field
A confluence in a number of forces in the field make this treatment particularly relevant:
• There is ongoing work in fields from brain science to psychotherapy to social justice regarding the impact and meaning of human suffering, and how to treat it across cultural contexts, across the many challenges of making things better for the survivors. This work calls for meeting people and cultures where they are, individualizing interventions, inclusion, and support for diverse communities (e.g., Black Advocacy, Resistance & Empowerment for Mental Health and Wellness website for trainings, articles and other resources (GrahamLoPresti & Abdullah-Swain, 2020; https://www.baremhw.com/)).
• The Recovery Movement in mental health (Resnick 2005, 2019; Smith et al., 2016), and the psychosocial rehabilitation approach for “lived experience” with potentially disabling psychiatric diagnoses (Anthony, 1993; Gagne, White, & Anthony, 2007) have been increasingly accepted by medical and treatment institutions, from departments of mental health to major hospital systems, and have been widely implemented. These approaches are strengthsbased, focused on functional goals, empowerment, and community involvement, aimed at countering stigma and fostering inclusion.
• In synchrony with the recovery movement and psychosocial rehabilitation, person-centered care and whole health approaches are moving the needle toward broader and more personalized care. Each of these movements contributes to shifting the traditional medical model toward flexibility and inclusivity in two major ways:
• Through an array of additional treatment options understood collectively as “complementary and integrative medicine,” which includes interventions such as acupuncture, chiropractic treatment, massage therapy, as well as practices such as yoga, Tai Chi, mindfulness, and meditation
• Through identifying the person served as the center of treatment decisions, in a collaborative approach that:
• Emphasizes personal choice
• Acknowledges the whole person
• Incorporates functional and health goals across many domains of human experience.
Most major medical centers have mind-body medicine approaches to pain management. And the Veterans Health Administration (VHA), through its national Office of Patient Centered Care and Cultural Transformation, has implemented a Whole Health Initiative2 promoting yoga, Tai Chi, and health behavior counseling across primary care and mental health services.
These movements and programs, while their details are beyond the scope of this book, have had and are having significant influence that will take the field beyond this moment (and likely into the next edition of this book). Present-Centered Group Therapy for PTSD: Embracing Today is consonant with these movements and the philosophies behind them. PCGT’s flexibility, opportunity for expression, and practice of both self-determination and collaboration allows individuals to identify and pursue a broad array of goals driven by personal choice.
Updates in the PCGT Manual Since the Original Manual Was
Developed
While this may be the reader’s first exposure to the PCGT manual (chapters three through five), it is important to state that, given the evidence for PCGT, the targeted revisions in this book were made with an eye to preserving the structures and processes on which that evidence is based. While revising aspects of the PCGT manual to acknowledge developments in the field, the authors have been consistent concerning PCGT’s essential therapeutic elements. The updates include the following:
• Recovery Language and Attitude: While the original manual was created with Yalom’s (1995) therapeutic factors in mind, and was largely consistent with a humanistic perspective, the field has become even more egalitarian in terms of recovery language, empowerment, and inclusivity. Some of the language, and perspective concerning the survivors of trauma who are in treatment, have been honed to reflect the respect and acceptance needed to deliver this treatment effectively and collaboratively.
• Diagnostic Criteria: The Diagnostic and Statistical Manual (DSM-5, American Psychiatric Association [APA], 2013) has significantly refashioned the diagnosis of PTSD. Specifically relevant to the PCGT manual are: the articulation of PTSD-related feelings and actions that were recognized previously in treatment but not explicitly stated in the prior diagnostic manual; and the separation of avoidance and numbing as distinct criteria. Accordingly, in the updated manual and related chapters:
• Some of the “secondary features” of PTSD identified in the original manual (which were included additionally because DSM-IV (APA, 1994) did not include them) are now listed as primary symptoms of PTSD.
• Our references to PTSD symptoms and diagnostic criteria have been updated to reflect the current (DSM-5) criteria. Currently, Avoidance, Criterion C, “Persistent avoidance of stimuli associated with the traumatic event(s)” (page 271), is listed separately from numbing. Meanwhile, the quality of ‘numbing’ formerly included DSM-IV’s Criterion C (“...numbing of general responsiveness”) is now included in DSM-5’s Criterion D, “Negative alterations in cognition and mood” (pages 271–272), and is described as the symptom of “Persistent inability to experience positive emotions” (page 272). This shift in diagnostic criteria does not substantially change the treatment itself, and is represented in chapter six when discussing potential mechanisms behind PCGT and interventions.
• Developing Concepts in the Field: Concepts such as post-traumatic growth (Tedeschi & Calhoun, 2004) and moral injury (Litz et al., 2009, Griffin et al. 2019), developed further during the period since the original manual was created, and are incorporated or referenced where relevant in the manual. Both are considered important concepts on which facilitators may draw to understand the dynamics within their groups.
• New Evidence-Based Present-Centered Approaches: New treatments have become prominent in the field, whether developed for PTSD or adapted to serve a traumatized population. Most can be delivered in a group or individual format. Their formats are distinct from each other, and even more distinct from PCGT (in the extent to which PCGT enlists the group process, utilizing a less structured format). These therapies include: seeking safety for dual diagnosis of PTSD and substance dependence (Najavits, 2002); acceptance and commitment therapy (Walser & Westrup, 2007; Hayes et al., 2012; Hayes et al., 2013); dialectical behavioral therapy (Linehan, 2014) for borderline personality disorder, adapted for complex PTSD (Bohus et al., 2019); and cognitive processing therapy in some of its forms that may omit a trauma statement (Resick, Fontana, Lehman, & Rosenheck, 2015). Motivational interviewing (MI; Miller & Rollnick, 2014) has been included in the section on motivation in chapter five. This modality has been referenced by a variety of therapies as an approach to enhancing potential for behavior change. In the context of this book and the included manual, MI offers certain general tools compatible with PCGT (such as reflective listening, use of metaphor, and shifting emphasis toward potential rather than limitations).
• Conceptualizations of Trauma Treatment: In order to enhance the provider’s understanding of trauma and recovery, especially as related to PCGT, some additional theory relevant to practice of PCGT is offered in chapter six.
Summary
How to Use This Book
This book is designed for flexible use across a variety of clinical, recovery, academic, and public health settings. Key uses are for trauma therapists across a variety of contexts. The book may be used as a guide in training and educational settings, including clinical supervision classes, practica, and internships. It may also be used in clinical research settings. The manual guide in chapters three through five covers the structure and interventions. The education provided in these chapters can be considered a unit in terms of implementation and delivery of services. Chapters one and two provide the practitioner or supervisor with the research background relevant to
PCGT, while chapters six and seven introduce PCGT’s context through theoretical considerations and history. Chapter eight broadens the arena through suggestions and brief “how-to” on potential applications of PCGT in clinics, agencies, Department of Defense, first-responder and postdisaster response contexts, forensic settings, private practice, telehealth, and with diverse or heterogeneous populations.
Secondarily but importantly, this book is offered within a trauma field that is moving increasingly toward researching and implementing staging of treatment, and individualizing selection of treatment according to both choice of the client, and identification of indicators for a particular approach or set of approaches (Hoge, 2018; Litz, 2019; Steenkamp, 2020). The unique particulars of the development of PCGT, its growing evidence base (covered in chapters one and two), and its foundation in the “common factors” of group psychotherapy blended with trauma awareness and trauma education, may have implications for addressing the needs of survivors of trauma in an increasingly nuanced and articulated manner. In this sense, Present-Centered Group Therapy for PTSD: Embracing Today may be of interest not only to trauma research institutes, but also public health organizations, professional organizations, and academic settings.
Finally, this book is offered to underscore the needs and the right of survivors of trauma to have and to personally navigate a life in the present, and to be connected and present within that life.
Notes
1 It would be painting with too broad a brush to see this discourse as the ancient dialectic of “covering” vs “uncovering” described in chapter seven. There are now very few who would deny the importance of traumatic experience and the right of survivors to share their stories and create a personal narrative of healing for themselves and their culture. Nevertheless, the current field appears to be shifting toward an understanding in which these approaches are not in opposition to one another, and, as Dr. Friedman points out in the foreword, may instead serve in the interest of “optimal treatment matching.” There is a sense of something not-yet-formed in the discourse in this literature, as though the field is reaching toward new definition. While Thomas Kuhn (1970) cautioned against social sciences adopting his ideas of paradigm competition (as he saw social sciences as inveterately preparadigmatic), we may be seeing at least the “shadow” of such a process. Or it may be that we are simply seeing exponential growth in this still relatively new field of trauma, in which the rapidly developing area of brain science (Friedman and Pitman, 2007) and the substantial field of trauma treatment research are leading into a period of recalibration and a shift in ideas and methodology. In any case, in
light of the broadening and tailoring trends in this field, we see an opportunity for present-centered group therapy to more fully “take a seat at the table,” as both an available treatment, and a subject for additional inquiry regarding mechanisms of healing and recovery from trauma.
2 https://www.va.gov/wholehealth
References
American Group Psychotherapy Association. (n.d.). American Group Psychotherapy Association. Retrieved August 28, 2020, from https://www.agpa.org/ American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.: Author.
Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11–23. https://doi.org/10.1037/h0095655
Bohus, M., Schmahl, C., Fydrich, T., Steil, R., Müller-Engelmann, M., Herzog, J., & Priebe, K. (2019). A research programme to evaluate DBT-PTSD, a modular treatment approach for complex PTSD after childhood abuse. Borderline Personality Disorder and Emotion Dysregulation, 6(1), 1–16. https://doi.org/10.11 86/s40479-019-0099-y
Department of Veterans’ Affairs. (2013). Whole health. Retrieved August 28, 2020, from https://www.va.gov/wholehealth/ Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., & Collins, J. F. (1989). NIMH treatment of depression collaborative research program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971–982.
Foa, E. B., Dancu, C. V., Hembree, E. A., Jaycox, L. H., & Meadows, E. A. (1999). A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. Journal of Consulting and Clinical Psychology, 67, 194–200.
Fonzo, G. A., Goodkind, M. S., Oathes, D. J., Zaiko, Y. V., Harvey, M., and Peng, K. K. (2017). PTSD psychotherapy outcome predicted by brain activation during emotional reactivity and regulation. American Journal of Psychiatry, 174, 1163–1174.
Friedman, M. J. (2016). Deconstructing PTSD. In E. J. Bromet (Ed.) In: Long term outcomes in psychopathology research: Rethinking the scientific agenda (pp. 123–139). Oxford: Oxford University Press.
Friedman, M. J., & Pitman, R. K. (2007). New findings on the neurobiology of posttraumatic stress disorder. Journal of Traumatic Stress, 20(5), 653. https:// doi.org/10.1002/jts.20299
Friedman, M. J., Schnurr, P. P. & Keane, T. M. (in press). Key questions and an agenda for future research. In, M. J. Friedman, T. M. Keane & P. P. Schnurr (Eds.), Handbook of PTSD: Science and practice, (3rd ed.). New York, NY: Guilford Publications.
Gagne, C., White, W., & Anthony, W. A. (2007). Recovery: A common vision for the fields of mental health and addictions. Psychiatric Rehabilitation Journal, 31(1), 32–37. doi.org/10.2975/31.1.2007.32.3
Griffin, B. J., Purcell, N., Burkman, K., Litz, B. T., Bryan, C. J., Schmitz, M., Villierme, C., Walsh, J., & Maguen, S. (2019). Moral injury: An integrative review. Journal of Traumatic Stress, 32, 350–362.
Graham-LoPresti, J., & Abdullah-Swain, T. (2020). Black advocacy, resistance and empowerment for mental health and wellness Retrieved August 28, 2020, from https://www.baremhw.com/
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy, 42(2), 180–198.
Hoge, C. W., & Chard, K. M. (2018). A window into the evolution of traumafocused psychotherapies for posttraumatic stress disorder. JAMA, 319(4), 343–345. https://doi.org/10.1001/jama.2017.21880
Kuhn, T. S. (1970). The structure of scientific revolutions. Chicago, IL: The University of Chicago Press.
Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. American Journal of Psychiatry, 167, 640–647.
Linehan, M. (2014). DBT Skills training manual. New York, NY: Guilford Publications.
Litz, B. T., Stein N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. 2009. Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706.
Litz, B. T., Berke, D. S., Kline, N. K., Grimm, K., Rusowicz-Orazem, L., Resick, P. A., Peterson, A. L. (2019). Patterns and predictors of change in trauma-focused treatments for war-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology , 87 (11), 1019–1029. https://doi.org/10.1037/ccp0000426
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change New York, NY: Guilford Publications.
Najavits, L. (2002). Seeking safety: A treatment manual for PTSD and substance abuse New York, NY: Guilford Publications.
Najavits, L. M. (2015). The problem of dropout from “gold standard” PTSD therapies. F1000prime Reports, 7, 43–43. https://doi.org/10.12703/P7-43
Neisser, U. (1976). Cognition and reality: Principles and implications of cognitive psychology New York, NY: W H Freeman/Times Books/Henry Holt & Co.
Niles, B. L., Polizzi, C. P., Voelkel, E., Weinstein, E. S., Smidt, K., & Fisher, L. M. (2018). Initiation, dropout, and outcome from evidence-based psychotherapies in a VA PTSD outpatient clinic. Psychological Services, 15(4), 496–502. doi:10.1037/ser0000175
Resnick, S. G., Fontana, A., Lehman, A. F., & Rosenheck, R. A. (2005). An empirical conceptualization of the recovery orientation. Schizophrenia Research, 75(1), 119–128.
Resnick, S. G., & Goldberg, R. W. (2019). Psychiatric rehabilitation for veterans and the evolution of the field. Psychiatric Rehabilitation Journal, 42(3), 207.
Another random document with no related content on Scribd:
Mr Hoffman, of the University of Kansas, went abroad in 1915 to do relief work. He reached Berlin in August of that year and remained in Germany as Secretary of the War prisoners’ aid of the Y. M. C. A. thruout the war. He then staid on for eight months after the armistice to continue the work in behalf of the Russian prisoners still held in Germany. Among the chapters are: First impressions of Berlin; The Britishers at Ruhleben; Christmas in a prison hospital; Prisoners at work and hungry; Help in both worship and study; Working under surveillance; The day of food substitutes; Visiting the first American prisoners; Real Americanism in evidence; First days of the German revolution; Russian prisoners and their guards; A concluding judgment. In one of the appendixes Mrs Hoffman writes of the experiences of an American woman in Berlin.
HOFFMAN, MARIE E. Lindy Loyd; a tale of the mountains. *$1.75 Jones, Marshall
20–8234
“The southern mountains of the Blue ridge, presumably, where the moonshiners find inaccessible places to hide their illicit stills from the ever-vigilant ‘ revenoors, ’ are the scene of ‘Lindy Loyd.’ Against their background with alluring descriptions of their wild scenery, their birds and animals, the rushing of the mountain torrent, and the tinkling of the hidden stream, Mrs Hoffman places the love story of Lindy Loyd, the course of which, perfect in its beginning, encounters the traditional rough places over which true love is doomed to pass. ” Boston Transcript
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customs engendered by the ruggedness, almost inaccessibility of their environment.”
F. M. W.
Boston Transcript p4 My 12 ’20 400w
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Cleveland p71 Ag ’20 30w
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HOFMANNSTHAL, HUGO HOFMANN, edler von. Death of Titian. (Contemporary ser.)
*75c Four seas co. 832
20–6845
This dramatic fragment, written in 1892, was translated from the German by John Heard, Jr. The prologue was added in 1901 when it was acted in Munich as a memorial to Arnold Böcklin. It depicts a scene on the terrace of Titian’s villa, in 1576, at the time of Titian’s death.
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Boston Transcript p6 S 8 ’20 270w
“The dramatic form, unfortunately for the translator, is only skindeep. Essential drama, apart from its verbal expression, loses nothing in a new language: poetry, and ‘The death of Titian’ in particular, lose most everything.”
Dial 69:322 S ’20 50w
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E. E. H.
Freeman 1:478 Jl 28 ’20 150w
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Nation 111:18 Jl 3 ’20 110w
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HOLDEN, GEORGE PARKER. Idyl of the split bamboo. il *$3 Stewart & Kidd 799
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While the author’s previous book, “Streamcraft,” deals mainly with the open season and actual streamside technic, this one is more a book for winter evenings and the fireside and for the workshop. Building a split-bamboo rod is an operation, the author avows. He describes this operation in every detail but he prepares the reader’s mind for this more tedious process by a long chapter on “The joys of angling.” Nine chapters of the book are devoted to the rod-making. Edwin T. Whiffen contributes a chapter on “Cultivating silkworm-gut at home,” and the two remaining chapters are on Landing-nets and other equipment and The angler’s camp. Besides many full-page illustrations there are diagrams showing the different stages of rod building and details of camp outfit.
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what she wants for herself regardless of the results to others. Minnie hasn’t even beauty or charm, but she takes away her sister’s lover, marries him and wrecks his life, marries a second man while the first still lives, bears him a child and accepts his support for the child of the first man, justifies herself when her guilt is discovered and forever after lives on the bounty of the man she has wronged. She is an incompetent housekeeper and a criminally bad mother but she succeeds in creating the impression that she is the true woman, and perhaps she is, writes the author, “perhaps those others, with hearts, with brains, with souls, are ... only the freaks of nature.”
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HOLLAND, RUPERT SARGENT. Refugee
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Three American boys cruising along the coast of Maine land on what is supposed to be a deserted island and find it inhabited by a charming mannered young foreigner, his two servants and his dog. The stranger, Pierre Romaine, is practicing fencing strokes when the boys first come upon him and he at once arouses their curiosity and admiration. They find that two other groups of men are interested in the island, the first, the crew of a fishing smack, the second, a party of three foreigners, apparently Russians. The secret of their interest is solved, Romaine’s enemies are driven off, the treasure he is
guarding is saved, and he consents to join his new friends on their cruise.
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HOLMES, CHARLES JOHN.[2] Leonardo da Vinci. (British academy. Fourth annual lecture on a master-mind. Henriette Hertz trust) *90c Oxford 759.5
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Spec 122:584 N 1 ’19 160w
“A brilliant, though concise, study.”
Nation 110:660 My 15 ’20 460w
HOLMES, JOHN HAYNES. Is violence the way out of our industrial disputes? *$1.25 (5c) Dodd 331
20–7773
Is violence the way out of our industrial disputes, which the war, far from curing as it was hoped, has aggravated into a condition of chaos comparable only to the military chaos that went before? In the three addresses in the book, originally prepared for the Community church of New York, the author outlines a doctrine of non-resistance which alone can solve the problem satisfactorily. Between the struggle of capital and labor there can be no compromise. Labor must win but neither can win through violence. The presence of certain psychological elements, not impossible of achievement, are necessary to solve the problem: co-operative good-will on the part of labor, renunciation and confidence on the part of capital, and on both a viewpoint of human relationships taught by the prophet of Nazareth. Contents: The answer for capital; The answer for labour; The better way; Conclusion.
Booklist 17:53 N ’20
Freeman 2:46 S 22 ’20 270w
Ind 103:319 S 11 ’20 30w
“Mr Holmes is nothing if not forthright. His mind works through his topic from start to finish with a steady momentum; there is no beating about the bush, no dallying finesse of language, no straining after mere rhetorical or stylistic effect. Even if you are not convinced, you instinctively recognize that you have been listening to the passionate and able pleading of an incorruptible mind.” R. R.
+ Nation 111:220 Ag 21 ’20 600w
Reviewed by Ordway Tead
New Repub 25:210 Ja 12 ’21 50w
R of Rs 61:671 Je ’20 80w
Springf’d Republican p9a O 3 ’20 250w
Reviewed by Alexander Fleisher
Survey 44:638 Ag 16 ’20 130w
HOLMES, OLIVER WENDELL. Collected legal papers. *$4 Harcourt 340
20–22316
These papers are of general interest and consist of speeches and articles collected from various publications between 1885 to 1918. They are: Early English equity; The law; The profession of the law; On receiving the degree of LL.D; The use of law schools; Agency; Privilege, malice and intent; Learning and science; Executors; The bar as a profession; Speech at Brown university; The path of the law; Legal interpretation; Law in science and science in law; Speech at Bar association dinner; Montesquieu; John Marshall; Address at Northwestern University law school; Economic elements; Maitland; Holdsworth’s English law; Law and the court; Introduction to
continental legal historical series; Ideals and doubts; Bracton; Natural law.
“Every paper has its own virtues, but there is one which they all share, a rare and delicate charm. These papers bring the touch of romance to philosophy but this must not detract from our realization that the philosophy itself is fine and deep.” S. L. Cook
Boston Transcript p4 D 4 ’20 1400w
Reviewed by T: R. Powell
Nation 112:237 F 9 ’21 2250w
“The forbiddingly colorless title does grave injustice to an extraordinary book of thoroughly matured human wisdom.” M. R. Cohen
New Repub 25:294 F 2 ’21 2450w
Springf’d Republican p8 D 18 ’20 40w
HOLT, HENRY. Cosmic relations and immortality. 2d ed 2v *$10 Houghton 134
20–26562
“Mr Holt’s two volumes on ‘The cosmic relations and immortality’ are a new and enlarged edition of the two-volume work he published just before the breaking out of the war under the title ‘On the cosmic
relations.’ He has added a new preface and several new chapters and has modified and brought to date the final summary of the subject in his last section. In the new chapters he takes up what he considers the three most important developments during the years since the work first appeared, which, in his opinion, ‘have added force to the spiritistic hypothesis.’ These are, first, the investigations and conclusions of Dr William J. Crawford, the well-known physicist of Queen’s university, Belfast; second, the appearance of many new sensitives, whose manifestations differ much from one another and from their predecessors; third, the agreement of these sensitives in depicting virtually the same future state.” N Y Times
Booklist 16:356 Jl ’20
“He guesses frequently and variably; he admits uncertainty; he has a vigorous prejudice against dogmatism. But this philosophy takes its form as rigidly from these bantering guesses, as though other guesses did not exist.... The consequences are lamentable. Standards of credibility are abandoned; subjectivism replaces criticism; and miracles are rampant.” Joseph Jastrow
Dial 69:204 Ag ’20 820w
“The notable thing about this book, now as in the earlier edition, is the nobility of spirit which informs it.”
Nation 111:278 S 4 ’20 130w N Y Times 25:18 Jl 4 ’20 370w
