Interviews were conducted with therapists (N ϭ 12) nominated by peers as especially effective in working with clients with adult interpersonal problems. Open-ended questions asked how these therapists would approach 2 adult clients described in brief vignettes as having high attachment avoidance or anxiety. A coding team used a grounded theory approach to identify 8 higher order themes in the interviews: Conceptualization, Client Defenses, Managing Boundaries, Markers of Progress, Therapist Reactions, Targeted Interventions, Corrective Relational Patterns, and Internal Representations and Models. These themes were integrated into an inclusive theoretical model based on the core concept of therapists' strategic management of therapeutic distance. The distance necessary to engage clients initially is adjusted later in therapy to create a corrective attachment in the psychotherapy relationship that facilitates change. Therapists described how, after engagement, they gradually increase therapeutic distance for clients with attachment anxiety who must then manage resulting frustration while learning to function more autonomously. Therapists gradually insist on decreased therapeutic distance to help clients with attachment avoidance overcome their fears of intimacy. Therapists discussed the specific techniques they use to manage therapeutic distance.

Background: Menstrual cycle function may continue to be altered after

Growing evidence supports the use of reflective writing activities centered around the human cadaveric dissection experience to support and assess elements of medical student wellness. Dissection may promote personal and professional development, increase resilience, and foster a sense of connection and community. This study employed a qualitative analysis of a reflective writing exercise to explore the question: "What is the impact of the cadaveric dissection anatomy experience on the personal and professional development of medical students?" This cross-sectional study was conducted at the conclusion of the first-year anatomy module. A total of 117 United States allopathic medical students were given a questionnaire designed to elicit the students' experiences and introspection. The exercise included four reflective questions that were provided to 20 groups of six students. Grounded theory analysis was used to explore themes that arose in students' responses. Participants exhibited several common reactions to cadaveric dissection. After analyzing all responses, 266 unique open codes were identified for all four questions. These open codes were sorted into ten distinct axial codes, which are broader categorical themes of open codes. The aims of our study were to identify themes that emerged as students reflected on the impact of their dissection experience using reflective writing as a tool to capture these themes and to gather information to inform pedagogical methodologies. The researchers observed that the educational effects of dissection captured in the reflective writing resembled those found in other areas of medical education that emphasize professional identity formation and important humanistic qualities. Anat Sci Educ 14: 658-665.

The TDS is a promising measure for assessing the in-therapy corrective emotional experiences of clients with hyperactivating attachment (i.e. increasing autonomy) and deactivating attachment (i.e. increasing engagement).