Transformations in O Online: Group Process in the Virtual Realm.

The authors describe their experiences as members of an international online study group, initiated before the COVID-19 pandemic to read aloud and discuss Bion's (1965) . The three separately authored essays and commentary included here reflect the multifaceted phenomena in which images and voices in Zoom rectangles are transformed into shared emotional experience, the O of the group in Bion's language. These observations show how group members translate online experience into a felt sense of being with others, and suggest that oscillations in the sense of being inside or outside the group demonstrate the dialectical and constantly changing nature of the analytic field in an online group.

Meeting the AACN's Essentials for Competency-Based Education With Hands-Free Video-Recorded Skills Assessment.

Background: In the American Association of Colleges of Nursing's updated Essentials, competency-based education (CBE) is the expected standard for nursing curricula. CBE approaches include observation, practice repetition, demonstration, and video supervision guided by a framework of competency, feedback, and self-reflection.

Method: The promotion of skills competency among nursing students was facilitated by self-regulated learning using video skills-based competency testing.

'A Home to the Lie': The Contemporary (Per)version of Truth.

This paper explores the contemporary trend towards relativization and perversion of truth increasingly prominent in American culture, which, in Bion's terminology (1970), has become an ever more hospitable "home to the lie." The anti-COVID vaccine movement emerging in the United States in 2021, and its related network of conspiracy theories, is presented as an example. To make sense of these phenomena the author presents clinical vignettes illustrating (1) Bion's (1970) notions of catastrophic change, the lie/thinker relation, and the messianic idea; (2) Freud's (1921) thinking on group leaders; and (3) Matte-Blanco's (1975) bi-logical theory of mind.

Autoimmunity and its expression in the analytic situation: A contemporary reflection on our inherent self-destructiveness.

This article explores the psychical expression of autoimmunity in the analytic situation; it is informed by biological theories of autoimmunity in contemporary immunology. Several of my patients developed autoimmune conditions in the course of their analyses, leading me to consider the role of psychical change in disrupting one's somatopsychic equilibrium. In the psychoanalytic literature, autoimmunity is used metaphorically for attack against what is foreign or unwanted in ourselves.

The wraparound approach in systems of care.

Child and adolescent psychiatrists and general psychiatrists who serve children and adolescents with complex mental health needs, generally find themselves interfacing with multiple child-serving systems, including mental health, child welfare, juvenile justice, developmental disabilities, addictions services, and primary health care. In these systems of care, psychiatrists will likely encounter the term "wraparound," which describes a key intervention ushered in with the system-of-care model of service delivery. This article describes the wraparound approach, which has been at the forefront of mental health service delivery for children and youth with serious emotional disturbance since the mid-1980s.

Trends and shifting ecologies: Part II.

Community-based systems of care offer some promising ecologically based approaches to child psychiatric emergencies. More community-based effectiveness research is needed on child and adolescent mental health crisis services. To meet the needs of real-world children with serious emotional disorders and their families, however, research should include integration of multiple evidence-based modalities (such as psychopharmacology, behavioral, and cognitive approaches) and the effectiveness of single modalities.