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From Victim to Victor: The Development of the BASIC PH Model of Coping and Resiliency

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This article summarizes my personal journey in the field of trauma starting in 1975 and tries to trace its “origin” in my early life experiences. It mostly focuses on my field experience as a pioneer professional (academician and practitioner) in a rural area of Israel in the late 70s and early 80s. In this personal and professional encounter with the harsh reality of a community living under constant threat of shelling and of terrorists’ infiltration, I realized there was a huge gap between my clinical training and the real life of these people who were forced to cope with this situation for years. This has led to one of the first attempts worldwide to research and develop an integrative model of coping and resiliency. The results yielded a new model: the BASIC Ph Model. This model builds on an understanding of the community impacted and the ability of the inhabitants to withstand disasters and crisis and led to the development of one of the first comprehensive resiliency programs. Among other things, the program using the BASIC Ph Model ensured that there would be a professional role of Emergency Behavioral Officer(s) with the job of enhancing trauma resilience city-wide. A diagram and table are presented and discussed to help to explain the elements and approaches covered in the BASIC Ph Model. The latter section of the article discusses the cross-sectional studies of the model and recent developments in its many uses.
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From Victim to Victor: The Development of the BASIC PH Model of
Coping and Resiliency
Mooli Lahad
Tel Hai College Israel
This article summarizes my personal journey in the field of trauma starting in 1975 and tries to trace its
“origin” in my early life experiences. It mostly focuses on my field experience as a pioneer professional
(academician and practitioner) in a rural area of Israel in the late 70s and early 80s. In this personal and
professional encounter with the harsh reality of a community living under constant threat of shelling and
of terrorists’ infiltration, I realized there was a huge gap between my clinical training and the real life of
these people who were forced to cope with this situation for years. This has led to one of the first attempts
worldwide to research and develop an integrative model of coping and resiliency. The results yielded a
new model: the BASIC Ph Model. This model builds on an understanding of the community impacted
and the ability of the inhabitants to withstand disasters and crisis and led to the development of one of
the first comprehensive resiliency programs. Among other things, the program using the BASIC Ph
Model ensured that there would be a professional role of Emergency Behavioral Officer(s) with the job
of enhancing trauma resilience city-wide. A diagram and table are presented and discussed to help to
explain the elements and approaches covered in the BASIC Ph Model. The latter section of the article
discusses the cross-sectional studies of the model and recent developments in its many uses.
Keywords: PTSD, resilience, BASIC Ph, community, education
I was born in 1953 in Haifa to a family of three. My father was,
on the one hand, an author, autodidact scholar, the most respected
expert on Jewish theater and drama, with a private collection of
4,000 manuscripts of drama plays, and on the other hand, a
lieutenant colonel in the Israeli navy. My mother was born in
Jerusalem to her parents who left Berlin in the early 1920s to go
and live in Jerusalem for pure Zionism. Her father left a judge’s
position and her mother was from a family of bankers; both left an
affluent life but died very young, leaving her a young orphan.
We lived in a very modest rented flat from our Arab landlord in
the German colony in Haifa, which was a small neighborhood with
an outstanding mixture of Israel Defense Forces (IDF) high offi-
cers, Sabras, Christian Arabs, newcomers from Morocco, Ruma-
nia, Bulgaria, Poland (Holocaust survivors), and Greek and Turk-
ish families. The houses’ doors were always open, and we grew up
in a delicate balance of diverse mentalities. Whenever a major
conflict aroused, my mother, the only Israeli-born adult, with
extreme sensitivity to human suffering and a particular way to
build bridges to the ones in need, was running to the scene
(sometimes between raveling knives) to calm the parties and instill
peace. Thus, she was known as “Dag Hammarskjöld,” the then
United Nations (UN) secretary general. I believe that a lot of what
influenced my personality, beliefs, and attitudes was planted then.
I grew up in other places in Haifa and left the city for the army
service where I served in the air force as a noncommissioned
officer (NCO) in the Israeli Air Force Command headquarters.
Being less than 20 years old, I was involved in the Yom Kippur
war side by side with the air force commander, the late Gen. Benny
Peled, and spent most of the harsh hours and days of the war beside
him as one of his command staff. Watching the way he led the air
force staff and commanders throughout unprecedented losses of
planes and pilots, many of them his friends and colleagues falling
in combat almost “in front” of our eyes, was a significant experi-
ence. His ability to control his emotions, instill hope in a despair-
ing command post, and cleverly look for unique solutions while
keeping his appearance intact, always clean and tidy, was an
amazing image and a lesson on how to manage the crisis.
Personally, I lost friends in the war, and close friends were
captured and held in Syria. I was intensively involved in support-
ing their families, spending all my “spare time” and weekends with
them, going with them to the Red Cross prisoners of war identi-
fying center. Indeed, this was another significant experience in
coping and resiliency even before I came to know these concepts
professionally.
I volunteered for an extra year in the military to help in the
postwar rehabilitation efforts, left the army after those years, and
started my studies in psychology, first and second degree. In 1975,
I joined the first project working with bereaved families launched
by the Israeli Ministry of Defense (MoD) and lead by Dr. Nira
Kfir. I was exposed to families and their different ways of griev-
ing. My supervisor at that time was Prof. Jacob Frenkel, a student
of Carl Rogers, and this humanistic existentialist approach was
very influential on who I am as a mental health professional.
Throughout my studies, I worked in the most neglected areas in
Tel Aviv and Bet Shemesh neighborhoods.
In 1979, I left Tel Aviv with my late wife for the Kiryat
Shmona, a Northern town that was infiltrated by a terrorist in 1974
and was under constant shelling of rockets since the 1970s. We
This article was published Online First November 7, 2016.
Correspondence concerning this article should be addressed to Mooli
Lahad, Tel Hai College Israel, Upper Galilee, Israel 1220800. E-mail:
mooli.lahad@icspc.org
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Traumatology © 2016 American Psychological Association
2017, Vol. 23, No. 1, 27–34 1085-9373/17/$12.00
http://dx.doi.org/10.1037/trm0000105
27
came for a year and stayed 20 years. We built a home and raised
four amazing children.
Coming to the North, I encountered a phenomenon I did not hear
nor learn about. I was expecting (as many years later I heard in
meetings with professionals during my visits to New York follow-
ing 9 –11) that the vast majority of the population that was under
attacks, with no alert nor shelters, would suffer from severe symp-
toms. To my amazement, I realized that they are managing normal
life and that the clients we had in the mental health center were
very similar to the ones I met in the heart of Israel. Sometimes I
say that the only difference is that in central Israel there were a
variety of reasons for the suffering, and we needed the Diagnostic
and Statistical Manual of Mental Disorders (DSM), whereas in
Kiryat Shmona there was a single etiology: “Katusha,” the
Russian-made rockets that were launched on the town quite often.
Of course, there were people affected by the situation with what
was known as stress neurosis or traumatic war neurosis.
So my colleagues and I at the combined mental health and
school psychology services in the town started to question what
happened. Why do we have the same type of complaints, the
almost same size of clients’ loads, where such life-threatening
events happen constantly? There was virtually no literature to
describe what we saw. In the late 70s, there was so much on
pathology and very little on coping. So we started to study the local
population. The first study (Lahad & Abraham, 1983) was with
400 children and some 300 adults asking them an open-ended
question: “What helps you in such conditions”? Moreover, we
administered many tests (including the State and Trait Anxiety
Inventory [STAI], client drawings and symptoms, and sentence
completion tests).
1
The results were thousands of responses that
had to be categorized. To this day, I cannot believe how “coura-
geous” we were, without computers, Statistical Package for the
Social Sciences (SPSS), and Natural Language Programs, to look
into these responses.
Dr. Ofra Ayalon, a pioneering psychologist who was doing
much work after the Yom Kippur war (1973) with schools and
children was an inspiration and amazing help because she had
already designed an intervention program for children called “Res-
cue.” Particularly useful were her conceptual maps or categories
that helped explain and apply her work.
She was very generous and offered to help me design the
first-ever prevention intervention program to work with school
teachers and children who were directly exposed to ongoing at-
tacks. This was the beginning of a lifelong friendship, and we
coauthored three foundation books for the Israeli mental health and
education system written in Hebrew on how to cope with stress
and crisis. The books, hereafter referred to as the “life books,”
focus on coping with traumatic events that were human-caused,
natural disasters, and industrial accidents, from individuals, fam-
ilies, groups, and organizational.
The three “life” books are: Life on the edge (Ayalon & Lahad,
1990), On life and death (Lahad & Ayalon, 1995; still the only
death education book in Israel), and Your life ahead (suicide
prevention; Ayalon & Lahad, 1996). These textbooks and inter-
vention guides are widely used by professionals and semiprofes-
sionals even 20 years after their publication. Parts of these books
were translated into other languages.
In the summer of 1980, following a massive 10-day rocket
attack on the town of Kiryat Shmona, with thousands fleeing away
or staying in shelters, the Israeli Ministry of Education asked the
school psychology service to open the first Stress Center for the
whole of Israel’s Northern Education system. Because I had al-
ready developed my program, I was asked to manage it. The
Ministry of Education asked us to focus on four areas: studying
how the “normal” population copes with stress (with a focus on
children and education system), developing psychoeducation pre-
vention/intervention/rehabilitation models tools and measures and
compiling all knowledge in the form of a library, and creating the
first ever school crisis intervention teams to be on site within 4 hr
of any crisis. Within 10 years of its establishment, this project
became an independent nongovernment organization (NGO), with
its professional steering committee known as the Community
Stress Prevention Center, celebrating to date its four decades of
service to professionals and the community as a whole.
Historical Overview of Stress and Coping: “The
Survival Game”
The question of survival of the human race as a philosophical,
psychological, and physical query has long routes. The field of
psychology was not different in asking why the most vulnerable
mammal with the longest maturation process survived from times
ago. Historically, most of the foundation theories in psychology
looked at the development of the human child and described their
construct or theory on “How do we make it?” Some of these
attempts tried to present an exclusive explanation, while others
tried to highlight one aspect of previous theories. One can construe
from these attempts six fundamental elements in explaining human
survival (Lahad, 1992). B for beliefs, A for affect or emotions, S
for social, I for imagination, C for cognition, and Ph for physiol-
ogy.
Freud (1933) stressed the affective world, both inner (i.e., un-
conscious) and overt (projection and transference), and it is Freud
who stated that early emotional experiences, conflicts, and fixa-
tions determine the way a person meets the world. Often, this
unconscious part overrides the transactions in reality.
His colleagues, Erikson (1963) and Adler, (1956), albeit from
different angles, highlighted the role of society and the social
setting in the way a person meets the world—Adler in his theory
of inferiority and the drive for power and Erikson in his eight
stages of development. Jung and Chodorow (1997), who was
originally a student of Freud, emphasized the symbolic and arche-
typal element, imagination, “the culture heritage,” and the fantastic
inner and outer world. Jung also mentioned intuition as one of his
personality types.
Other psychological theories have dismissed the whole idea of
psyche and emotion and have attempted to describe the human
behavior regarding stimulus and response. This has been called
behaviorism, but we suggest that they should be called physiolo-
gist because their theory suggests instinctual chains of reactions
resulting in behavior (Pavlov, 1927). Before long, the cognitive
school found its theory about the way a person meets the world and
they phrased it “It’s all in the mind,” or cognitive processes with
errors of thought or perception (Beck, Rush, Shaw, & Emery,
1979).
1
STAI-State and Trait Anxiety Inventory (Spielberger, Gorsuch, Lush-
ene, Vagg, & Jacobs, 1983).
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28 LAHAD
Last but not least, we have the belief and meaning stream,
presented by Maslow (1954) and Rogers (1961). Moreover, Frankl
(1959) developed psychological theory and psychotherapeutic ap-
proaches. Logotherapy by Victor Frankl (1959) and client-centered
therapy by Carl Rogers (1951,1961) was based on his existential
theory and practice, and to an extent Pearls, Hefferline, and Good-
man (1951) with Gestalt therapy.
We believe that these exclusive attempts to describe human
psychic life have many disadvantages and that human psyche is
more complex than the theoretical attempts to describe it in one or
two dimensions. Our study of coping and resilience in both ongo-
ing and short-term emergencies lead us to identify six dimensions
that in our experience underlie the coping style of the client: belief
and values, affect (emotional), social, imaginative, cognitive, and
physiological. We have named it BASIC-Ph.
2
It is the integrative
multifaceted approach that suggests a combination of these ele-
ments in the unique coping style of each person (see Table 1).
Obviously, people react in more than one of these modes, and
everyone has the potential to cope in all six modes. Still, each
person develops his special configuration. Most of us, at different
times, have a preferred mode or modes of coping and will use this
extensively. From hundreds of observations and interviews with
people under stress summarized in Lahad, Shacham, and Ayalon
(2013) and Lahad, Leykin, Rozenblat, and Fajerman (2014),itis
apparent that each has a special coping mechanism or resources
that characterizes his or her special way “to meet the world.” But
it is important to note that most people have more than just one
mode, and many have up to three or four (Lahad, 1997).
Across research and practice, there has been considerable debate
over the definition and operationalization of resilience (Luthar,
Cicchetti, & Becker, 2000). Is resilience best categorized as a
process, an individual trait, a dynamic developmental process, an
outcome, or all of the above? Where does one draw the line at
successful and resilient adaptation versus nonresilient responses?
Resilient personalities are characterized by traits that reflect a
strong, well- differentiated, and integrated sense of self (self-
structure) as well as traits that promote strong reciprocal interper-
sonal relationships with others (Garmezy, 1991;Greeff & Ritman,
2005;Shiner, 2000).
Zautra et al., (2008) suggest, for example, that “Whereas resil-
ience ‘recovery’ focuses on aspects of healing of wounds, ‘sus-
tainability’ calls attention to outcomes relevant to preserving valu-
able engagements in life’s tasks at work, play, and social relations”
(p. 44).
We define resilience as self-stabilizing and overall healthy pat-
terns of development, which lead neither to a life of disordered
behavior (drugs, delinquency, etc.) nor to manifest mental or
psychosomatic syndromes. It is noteworthy that temporary oscil-
lations of individual behavior on the health– disorder spectrum
under the impact of an acute stressor are implied, but in the
medium and long-term, a remission of symptoms should occur.
The individual degree of resilience is understood as being relative
in so far as quantitative and qualitative variations cannot be ruled
out (Lösel & Köferl, 1989).
As early as 1992, we were referring to resiliency as the ability
of the individual to withstand and recover from adversities and
crisis by oneself or with the help of others. Our references were as
follows: (a) observation and direct questioning of people who lived
under constant threat; What is helping you to make it day by day?;
and (b) a psycholinguistic approach asserting that the way some-
one describes his experience represents inner structure of making
sense by which that person perceives/absorbs and transmit com-
munication inside and outside.
The Integrative Model of Coping and Resiliency
BASIC Ph
In retrospect, research into coping with stress produced decisive
contributions. Coping was defined by Folkman and Lazarus as a
process of constantly changing cognitive and behavioral efforts to
manage specific external and/or internal demands that are ap-
praised as taxing or exceeding the resources of the person. They
defined two forms of coping: problem-focused coping and
emotion-focused coping (Folkman & Lazarus, 1988). The primary
appraisal category, “challenge” in their stress model, is particularly
worthy of consideration. Two significant trends are important for
stimulating resilience research: (a) the transformation of the trend
toward negative pathogenic effects of a stressful life event through
2
Only when I submitted my first PhD in 1984 in the United Kingdom
I was introduced to Multimodal Therapy (MMT) of Arnold Lazarus and his
BASIC ID (Lazarus, 1981). My mentor even suggested that we call it a
different name, but because my thesis was already printed, we looked into
the difference between the two models, and the most apparent was that
most of the modalities were defined in negative terms (unlike my work that
be seen as “predecessor” of positive psychology), and the acronyms are not
the same: B behavior, A affect, S sensation, I imagery, C
cognition, I interpersonal relationships, D drugs.
Table 1
The Psycholinguistic Model of BASIC Ph
BA S I C PH
Belief Affect Social Imagination Cognition Physical
Self, Ideology Emotions Role, others, organization Intuition, humor Reality, knowledge Action, practical
Frankl Freud Erikson Jung Lazarus Pavlov
Maslow Rogers Adler De Bono Ellis Watson
Attitudes Listening skills Social role Creativity Information Activities
Beliefs Emotions Structure Play Order of preference Games
Life-span Ventilation Skills Psychodrama Problem solving Exercise
Value Acceptance Assertiveness “As-if” Self-navigation Relaxation
Clarification Expression Group Symbols Self-talk Eating
Meaning Role play Guided imagery/fantasy Work
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29
FROM VICTIM TO VICTOR
coping; and (b) the reappraisal processes into a new homeostasis
promoting psychological and physical health.
Since the mid-80s, most stress models have taken into account
not only the psychopathological syndromes but also variables in
psychological health and well-being (e.g., Lazarus & Folkman,
1984;Moos, 1984). However, it is only in this decade that empir-
ical psychology has begun to conceptualize resilience applying
models that are based explicitly on the idea of healthy or adaptive
development in the face of stressful influences, rather than by
using derivatives of stress– disturbance models.
As mentioned previously, it was in the early 80s (Lahad &
Cohen, 1998), that we identified different coping styles and coping
mechanisms used by various people under stress. The following
will be a general description of each of the modes. Despite its
variety, our studies showed time and again that the dominant
coping modes are rather stable over time (Leykin, 2013).
There are those whose preferred mode of coping is cognitive
mode. They are the C-cognitive oriented copers. The cognitive
strategies include information gathering, problem solving, self-
navigation, internal conversation, or lists of activities or prefer-
ence. Another type will demonstrate an emotional or A-“affective”
coping mode and will use expressions of emotion: crying, laughter,
or talking with someone about their experiences; or will use
nonverbal methods such as drawing, reading, or writing to express
themselves.
A third type will opt for S-a social mode of coping. They receive
support from belonging to a group, taking a role, and being part of
an organization.
A fourth will use their I-imagination either to mask the brutal
facts, by day-dreaming, having pleasant thoughts, or diverting their
attention by using guided imagery; or trying and to imagine
additional solutions to the problem that go beyond the facts—
improvisation and surely arts and creative methods, improvisation,
and humor.
The fifth type will rely on their B-belief and values to guide
them through times of stress or crisis: not only religious belief, but
also political stands beliefs or feeling of the mission (meaning), as
well as the need for self-fulfillment and strong “self” expressions.
The last group will use some physiological focus methods-Ph.
These are people who mainly react and cope by using physical
expressions together with body movement. Their methods of cop-
ing with stress may include meditation, relaxation, desensitization,
sports, hikes, drinking, eating, smoking, and taking medications.
Following the formation of our BASIC Ph model, based on the
previously mentioned interviews, we were looking for an “outside
validation” of our concept. Thus, we reviewed hundreds of studies
on coping or related issues and tried to see whether their results
can be categorized according to the BASIC Ph Model. In 2012, we
performed a much larger Internet and sites search (Leykin, 2013)
and found similar results to the first review. As was expected,
some of the studies found more than just one dominant mode,
because people use more than a single mode.
The following is an example of those early studies and their
classifications:
B, Ph: The way of coping and managing a single stressor or
multiple risk factors, the decisive question being whether a person
merely reacts or also acts (e.g., Rutter, 1985).
C, B: A low tendency toward problem avoidance or fatalism
(e.g., Lösel & Köferl, 1989).
B, C: Cognitions, self-efficacy, and self-esteem (e.g., Rutter,
1985. (A, S: Availability of an emotionally stable and trustworthy
person during early childhood; e.g., Brandt, 1984.)
A, C: The ability of the child to accept delay in gratification
(e.g., Murphy, 1987).
I, C: Curiosity, motivation and joy in exploratory behavior
already as an infant, as well as motivation to observe and listen
(e.g., Murphy, 1987).
C: Higher IQ (e.g., Felsman & Vaillant, 1987).
S: Socially competent behavior, despite chronic stress; helpful-
ness; popularity with peers and taking on of responsibility for
siblings and sometimes also for ill parents (e.g., Werner, 1989).
Ph: Physical attractiveness, particularly in girls (e.g., Cunning-
ham, 1986).
Thus, we saw that BASIC Ph Model could serve as a model for
understanding coping and resilience and made it into a practical
model.
The Psycholinguistic Aspect of the BASIC Ph Model
Once we had the model and found some support from other
researchers, we were satisfied with the idea that people have a
variety of coping resources but were struggling with how to
quickly assess these models to guide crisis support or crisis inter-
vention. It was then that we realized that if we listen to the way a
person describes his or her experience, we can trace their coping
“channel” by simply listening to the content and the way the story
is built.
3
We tried it out in various real events and then in studies
conducted by myself and Leykin (2013).
Stressful situations challenge our abilities and coping resources.
If the stress is either very severe (a personal appraisal) or pro-
longed, we may find that some people cannot cope and that their
resources were either exhausted or ineffective. Under circum-
stances where repeated attempts to cope do not avail, the situation
could turn into a crisis. Sometimes it is a sudden major incident
that finds the person weak (physically or emotionally), depleted, or
unprepared to meet the challenge, and causes the distress or even
the posttraumatic reaction.
There are times when in a crisis the individual uses “more of the
same patterns” to rid themselves of the distress, but find these coping
attempts are not effective anymore. In other words, a person becomes
set in the mold (or rut), using the same mode of coping endlessly,
neither progressing nor changing anything. In this case, the crisis
stems from being stuck or from inflexibility. It is fair to state that
although many symptomatically react at the onset of the crisis, we
need to remember that the vast majority of people recover on their
accord (Cherry et al., 2015). That is to say that for the majority of
those who react, the symptoms displayed during the acute phase are
not “ill”; simply, their current distress is too hard for them to cope
with or contain and these symptoms will subside in reasonable time.
As we know, out of those who seek help in the acute phase Acute
Stress Reaction (ASR), not many will stay for lengthy treatment, most
will be seen once or twice, some will meet with us a few times, and
3
Indeed, some will find certain similarities to the Neuro Linguistic
Programming (NLP) model of Bandler and Grinder (1979); however, they
refer to the Neuro, which are the sense that governs the absorption of
information (visual, tactile, auditory). We focus on the Psycho linguistic,
which is aspects such as cognition, emotions, imagination, and more.
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30 LAHAD
a minority will have a longer treatment as needed. Besides, it is
questionable as to what crisis intervention should contain, are we
interfering with the natural course of healing when we intervene too
early and too much? It is only after 9 –11 that studies indicated we
need to focus and activate the coping resources of the client (McNally,
Bryant, & Ehlers, 2003)
In light of this, we concluded that the best practice of acute
intervention should be to start with tracing and then communicate
with the affected person through his or her apparent language
(Figure 1), which is the way they meet the world, so that we could
focus on strength and known patterns of relating the inside out in
order to make sense. We call it “interventions based on the quick
assessment of the client’s coping modalities.” This is mostly based
on careful listening to the client’s modes of recounting the inci-
dent. Based on this quick resource assessment, we provide feed-
back to the client using questions to see if we “hit” the right coping
modes, confirm to him or her their abilities, and check whether that
is correct. We found that this is what most ASR clients need.
Furthermore, this type of listening continues throughout the
process even, with those who stay for an elaborate intervention or
trauma-focused therapy. The main difference is that if the inter-
vention based on the client’s apparent modes of “meeting the
world” does not prove effective within 3 to 4 weeks, we may
suggest moving to other modalities. In this case, we will base our
short-term psychotherapy on adjacent modes or forgotten modes
(see Lahad, Shacham, & Ayalon, 2013).
The practical difference between crisis intervention and short-
term therapy will be that in crisis intervention, the therapist will
use the models that he found to be active based on the BASIC Ph
model. For example, if the client used Cognitive and Social modes,
we will ask questions like “Would you like to know what will
happen next?” “Do you have any idea of what you want to do
next?” “Do you need more information/explanation?” Moreover,
on the S channel: “Do you know anyone here, whom would you
like to notify/call to come and be with you?” We will refrain from
using models that were not apparent such as Imagination or Belief
system as the first choice.
In short-term psychotherapy, the therapist combines resourceful
work (i.e., communicating through the apparent modes) with addi-
tional focus on channels that were less active (such as B or Ph in the
previous example) and on the negative aspects or ineffective out-
comes of the attempt to cope with the situation, encouraging the client
to expand his existing modes as well as less active BASIC Ph
channels referred in the model as “adjacent language” or even “for-
gotten language.”
In this way, we established the BASIC Ph model as a framework
that enables the therapist to assess and connect with the client’s
strengths, and at the same time, serves as a map to decide
whether to suffice with crisis intervention; that is, to stay with
the operating modes or to introduce new modes. This aspect of
the model is widely used by emergency rooms in hospitals in
Israel and abroad, as well as by first responders and mental
health providers worldwide (see Figure 2).
Measuring the BASIC Ph
There are three ways of assessing the BASIC Ph modes (lan-
guages) of the client. First is a clinical psycholinguistic option
described previously, focusing on the “apparent language” that is
the modes operating at that given moment. This assessment is
based on the assumption that the clients will describe their expe-
rience using the most developed/available modes they have. This
will be the basis for the crisis intervention.
The second method of assessment is the Six Part Story-Making—
projective technique, described in detail in Lahad, Shacham, and
Ayalon (2013). Analyzing the verbatim based on the BASIC Ph
categorization, the therapist is able to decide on the best course of
operation; that is, to go for an intervention that is focusing only on
apparent language or to devise a treatment plan based on the adjacent
(less developed models) or the forgotten (modes that the client does
not use).
The third way is a metric assessment of the BASIC Ph using Q-sort
statements on a 5-point Likert scale. (Leykin, 2013). The first attempt
to transform the BASIC Ph model into a self-report inventory was
carried by Craig (2005) in his doctoral dissertation. Craig’s transitu-
ational (i.e., an incorporation of both dispositional and situational
aspects of coping), the 36-item instrument consisted of six items
representing six hypothesized factors on the new Multi-Modal Coping
Inventory (MMCI). Craig’s (2005) study was the only one to examine
the test–retest reliability of the MMCI, which was found adequate
over 4 6 weeks. Further evaluation of the validity of the MMCI
yielded several significant associations with measures of well-being
(i.e., The Mental Health Inventory; Veit & Ware, 1983), as well as
with other coping measures (i.e., Coping Orientation with Problem
Experiences Inventory; Carver, Scheier, & Weintraub, 1989). When
examining its’ criterion-related validity, five MMCI dimensions (all
but the A mode) were found to have adequate to strong concurrent
validity as indicated by moderately strong positive correlations with
dimensions of the COPE Inventory (Carver et al., 1989) that had
similar item consistency (Craig, 2005).
The Cross-Sectional Study of BASIC Ph
To further explore the configuration of BASIC Ph model in the
broader population, Leykin (2013) conducted a cross-sectional study
to investigate BASIC Ph manifestation among the Israeli Jewish
population. The short MMCI-Revised (18 items) was administered
online together with the Brief Resiliency Scale (BRS, six items; Smith
et al., 2008). Final data analysis was conducted on 949 individuals
(n512 female and 437 male) between the ages of 15 and 65.
The most dominant coping mode among the whole population was
the Cognitive channel, and the second most dominant mode was the
Figure 1. The Psycho-linguistic Model of BASIC Ph.
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31
FROM VICTIM TO VICTOR
Social channel. The cognitive channel was significantly more domi-
nant than the other channels. The least dominant coping mode statis-
tically found among the participants was the Imaginative channel.
Correlates of BASIC PH Model
When examining gender effects on coping models, statistically
significant effects were observed for all modes. On five out of six
channels females outscored males, the most significant different
was found on the Affective mode, while men utilized more fre-
quently the cognitive coping mode than women did.
These findings are from previous studies suggesting that women
are more likely than men to engage in most coping strategies
(Tamres, Janicki, & Helgeson, 2002). The described gender effects
were emerged in later studies as well using similar scale (Erez &
Laviod, 2011;Gelber & Dodek, 2011).
A series of recent research studies investigated the association
between BASIC Ph and mental well-being among various civil and
first responders populations. Erez and Laviod (2011) examined psy-
chological correlates of BASIC Ph and tested associations between
coping modes and self-efficacy, optimism and locus of control, which
are psychological constructs related to resilience, and found signifi-
cant and positive correlations between belief and optimism on the on
hand, and between cognition and trait resilience on the other. Gelber
and Dodek (2011) examined associations between coping modes, trait
anxiety, self-efficacy, and social support among college students and
found that self-efficacy had a negative correlation with effect and
positive correlation with cognition. Perceived social support was
positively associated with cognition but negatively with physiology.
Ogni Ben-Dov, and Cohen (2011) explored ways of coping with
sexual harassments and its relation to psychopathology among Israeli
adult women. Controlling for peritraumatic distress and history of
sexual harassments, utilizing belief and imagination resources during
the most prominent sexual harassment incident predicted present
posttraumatic symptoms. Utilization of positive emotional coping
(also assessed in this study) interacted with peritraumatic distress, thus
high levels of positive affect during the event predicted less posttrau-
matic symptoms when peritraumatic distress was great. Participants
exceeding the threshold on the Impact of Event Scale (IES-R; Weiss
& Marmar, 1997) for probable posttraumatic stress disorder (PTSD)
significantly were more likely to utilize all coping modes, except
positive affect coping.
Applications of the BASIC Ph Model
The Basic Ph model has been used as a model for a variety of
projects and practices.
To name but few: (a) General hospital’s emergency room pro-
tocol for ASR intervention (Lahad Kutz, 2004); (b) comprehensive
local authority preparedness training of the psycho-social, health,
and education interdisciplinary teams (Lahad & Ben Nesher,
2008); (c) the impact of mass media on the audience in critical
incidents and how to use it for enhancement of public resiliency
(Lahad, Shacham, & Niv, 2000); (d) the development of a new role
for the home front command, the emergency behavior officer as a
consultant to commanders and other decision-makers and its ap-
plication to civic and commercial settings (Lahad, Rogel, & Cri-
mando, 2012); (e) developing international postdisaster psychos-
ocial recovery programs (Lahad et al., 2011;Shacham, 2013;
Rogel, 2013); (f) school-based resiliency training and preparedness
(Ayalon, 2013;Ayalon & Lahad, 1990;Krkeljic & Pavlicic, 2013;
Lugovic, 2013); (g) helping parents to enhance resiliency for their
kids (Kaplansky & Lahad, 2013;Lahad & Kaplansky, 2005; (h)
Crisis intervention with various target groups; with children (Ay-
alon, 2013), women living under ongoing threat of rocket attacks
(Spanglet & Tal-Margalit, 2013), and the application to small- and
medium-sized business (Elmaliach, 2013).
One of the most rewarding experiences with this model has been
the ability to use it in diverse cultures and places around the globe.
The fact that both in Sri Lanka, Japan, and Europe professionals
and paraprofessionals who were exposed to the model as a map for
coping and resiliency found the most useful or almost the most
useful tool they received and implemented in the field is for me an
affirmation of its cross-cultural sensitivity and applicability (Lahad
& Leykin, 2015). In Japan, an NGO called BASIC Ph Japan was
formed as an outcome of the training post the tsunami of 2011 (see
https://ja-jp.facebook.com/BasicPh/).
Conclusion
Over 35 years ago my journey into trauma crisis coping and
recovery began. I truly hoped some 15 and 20 years ago that I
would be able to move on and leave this themes behind, but the
older I grew I realized the amount of suffering is not reduced, the
extent of people exposed to traumatic incidents is not lessened, and
that my small mission to help as long as I can, has not ended.
Indeed, I developed many more creative methods to help in non-
Western cultures (Lahad et al., 2011); how to organize interna-
tional, cross-cultural intervention (Cohen & Lahad, 2014); and a
protocol to treat PTSD using imagination and playfulness (see Far
Figure 2. Crisis intervention according to the BASIC Ph Model.
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32 LAHAD
cognitive– behavioral therapy method for the treatment of PTSD;
Lahad & Doron, 2010) as Creative methods to be used in super-
vision (Lahad, 2000) helping children and youth cope with fears
and anxiety (Lahad & Ankor, 1994).
I have managed, supervised, developed, and trained many crisis
intervention projects and teams. I have been fortunate to witness
and study the amazing phenomena of how individuals, families,
groups, and communities recover from traumatic events. These
studies and surveys never failed to amaze me and help me to
admire the spirit of humankind. My leitmotif is a Confucius
proverb, which I keep close to mind to remind me of the purpose
of my work and the way I meet the world despite all that I have
been through personally and all the many pains, hurts, and sorrow
I have witnessed and tried to alleviate:
You cannot prevent the birds of sorrow from flying over your head,
but you can prevent them from building nests in your hair.”
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Received July 29, 2016
Revision received September 20, 2016
Accepted September 21, 2016
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34 LAHAD
... Objective 2: To identify the strengths of coping using Six-Part Story Method (6PSM) Belief Blief is an aspect of resilience that brings clarity to a society, group, or an individual (Cohen, 2003). The representation of one's self, accompanied by overflowing ideas are often associated as way of coping through belief (Lahad, 2017). In conjunction to that, Lahad (2017) had stated that consistent clarity, value, and meaning conveyed by an individual reflects a high level of belief and it is often linked with Abraham Maslow's hierarchy of needs. ...
... The representation of one's self, accompanied by overflowing ideas are often associated as way of coping through belief (Lahad, 2017). In conjunction to that, Lahad (2017) had stated that consistent clarity, value, and meaning conveyed by an individual reflects a high level of belief and it is often linked with Abraham Maslow's hierarchy of needs. Based on the table 4.3 above, respondent B and F had presented high level of belief because all three of their stories represented themselves accompanied by overflowing ideas that contained clarity, meaning, and values. ...
... Sigmund Freud had spoken about the affectionate world in one of his writings in which it was stated that emotional well-being determines the way an individual perceives the world. This transacts an individual's reality because they tend to manifest their emotions as a strategy to get through life as well as to cope grief (Lahad 2017). By validating those feelings and emotions, an individual will be able to share their fear, sorrow and anger (Cohen, 2003). ...
Article
Full-text available
The purpose of this research was to explore the coping strategies among bereaved young adults using Six-Part Story Method (6PSM). More specifically, this study was meant to identify the strengths of coping using 6PSM and the suitability of 6PSM among young adults in counselling approach. Counselling session was adapted as a medium for data collection with the aid of 6PSM as an intervention technique. Purposive sampling and snowball sampling was used to identify the most suitable participants to contribute in this study. The ethics of research and counselling such as anonymity, confidentiality, information disclosure, and the acquisition of informed consent were followed strictly throughout this research. The data collected was then analyzed using content analysis by categorizing the data into themes that present in the BASICPh model introduced by Mooli Lahad (Belief, Affect, Social, Imagination, Cognitive, and Physical) Other than that, this study had also showed that themes such as belief, affect, and social are highly used among young adults as a way of dealing with bereavement. Not only that, this study had also found that the process of completing 6PSM enables an individual to express themselves in a way that synchronizes with the BASICPh model of coping. Based on the findings, this study would like to implicate that the coping strategies of bereaved young adults falls under the themes of belief, affect, and social. In addition, it also implicated that 6PSM is suitable to be used as an intervention in counselling young adults.
... Individuals react to short-and long-term emergencies and stressful situations by using a combination of these six CSs; however, each individual develops a unique coping pattern that is used consistently in various situations (Lahad, 2017). The BASIC PH model has been widely explored in war and terrorist events (e.g., Shacham, 2015), as well as in crisis situations (e.g., Vladislav & Marc, 2015). ...
... In the second stage of the analysis, we used a deductive approach whereby the codes, themes, and teachers' descriptions of their CSs were compared with the definitions of strategies in Gross's (2014) information processing model and in the BASIC PH model (Lahad, 2017). As a result, we decided to combine the two BASIC PH CSs of physical expression and body movements and imagination into one overarching CS: self-relaxation because teachers inclined to use both of these strategies as means to relax and calm down. ...
... The multiple CSs found in this study were classified as emotional regulation strategies (Gross, 2014) and/or as BASIC PH coping strategies (Lahad, 2017). For example, perspective thinking was classified as a cognitive strategy (i.e., cognitive style). ...
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... Most definitions of resilience describe physical and emotional health that coexists with vulnerability and/or hardship, as well as competence to cope with/adapt to adversity (Kalish et al., 2017). Resilience can be learned and developed through dynamic processes (Chmitorz et al., 2018), assuming that we possess strengths and resources that can be mobilized under stress (Lahad, 2017). ...
... As noted, there are many definitions to resilience. We approached resilience as the ability to cope flexibly with crisis and loss, and to recover (Lahad, 2017). Three features of resilience were found, manifested throughout the research: beholding pain; faith; composition and support. ...
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This chapter describes an art-based research that examined what transpires when the reality of sickness and death enters an art-therapy learning group, and how facilitators and students cope with a topic of a taboo nature, which is absent from the syllabus, yet present in the academic classroom. The research inquired which elements in our facilitation enable working through sickness and loss? How did these elements encourage the development of resilience? And is all this related to art-based pedagogy? The study population comprised nine students enrolled in their third year of an art-therapy master program, and three art-therapists and facilitators in the program. The study process included six modes of inquiry: group experiential session, group discussion, researchers’ discussion and art-responses, art-making-meaning, triangulation of findings, and concluding works. The chapter proposes a creative pedagogical approach to research and facilitation that encourages development of resilience, in which reality functions as study material.
... For example, the money as the main character shows that there is information that could be detected in terms of imagination coping strategies used by the participants. A study by Lahad (2017) mentioned that it Vol. 3, No. 1, 2022, pp. ...
... The researcher considered that maybe this study was conducted among adults, hence adults have a low imagination process compared to the children. This study coincides with studies by Lahad (2017) indicating that data analyses among children have the tendency to have high imagination compared to adults. This may be the fact that adults engage in others self-care strategies that involve more towards behavioral and cognition. ...
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Self-care practices regarded as one of the most important components for the profession of counselling. Besides, self-care practices are also recognized as an essential necessity for trainee counsellors in becoming helping professionals in future. Nonetheless, there is insignificant in previous studies regarding self-care practices among trainee counsellors. The purpose of this study is to explore self-care practices from a coping style perspective among trainee counsellors. This study adopted a descriptive qualitative research design in exploring the self-care practices among trainee counsellors at one of the universities in Sarawak, Malaysia using Six Part Story Method. The application of Six Part Story Method helps in exploring the self-care practices by illustrating the drawing through the six boxes. The data was collected through group counselling sessions and data was analyzed using the BASIC Ph Model. Overall, six themes have emerged from the findings. The results from these findings shows that trainee counsellors are highly dominant in Social and Physical Dimensions. Besides that, this study also proposes on determining the suitability of Six Part Story Method in counselling approach. This study has contributed to the existing knowledge on the self-care practice in context of trainee counsellors. It enhances awareness to the society especially people in counselling field on the importance of practicing self- care when experiencing stressful circumstances.
... In general, activity in social networks on religious topics acts as a coping strategy, which is meaningful and activates the values of the individual, which reduces the need to receive psychological support. Reducing isolation along with increasing social responsibility can restore emotional safety (Lahad, 2017). ...
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The war in Ukraine, in addition to significant human and financial losses, affected the mental health of Ukrainians. This study was carried out within the framework of the population psychological support program in the first month of the war. The objective of the research was to empirically study the interrelationship between media religiosity level and psychological coping given the effects of war. In order to accomplish the research objective, we used the Questionnaire for Media Religious Individual (QMRI: Kostruba, 2021), which involved writing a narrative: “What helps me to cope with negative emotions caused by war?” The survey was conducted during the first month of the war in Ukraine (March 2022) within the framework of the online psychosocial support program for the population. The sample consisted of 66 young volunteers, with the average age of 18.85 years (SD = 1.94), including 8 males and 58 females. The study was conducted using standardized questionnaires and writing a narrative. For statistical analysis, we used Statistica 12 and Linguistic Inquiry and Word Count (LIWC-2015) software. The results demonstrate a tendency for media religious people to use more positive content markers [less emphasis on anger, painful feelings, less focus on the past and thoughts about death, more focus on religious coping (prayer, faith, etc.)].
... Personal Resilience is defined as a trajectory of healthy functioning after a highly adverse event [10]. Lahad [11] claims that some individuals have a unique resource repertoire that helps them deal with crises. Studies of personal resilience during the COVID-19 pandemic have shown a link between high personal resilience and decreased anxiety, distress, feelings of danger, depression and anxiety [12]. ...
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Objectives: The Conservation of Resources (COR) theory suggests that stress results from threatened or actual loss of resources following significant life events. This study used COR theory as the framework to explore the reflection of loss of resources during the COVID-19 pandemic on psychological distress and resilience, in an adult Jewish Israeli population. Methods: We examined the association between background variables, stress, loneliness, concern, COVID-19-related post traumatic symptoms (PTS), resilience factors and COR via an online survey among 2,000 adults during April 2020. Results: Positive relationships were identified between resource loss and PTS ( r = 0.66, p < 0.01), and between resource gain and resilience ( r = 0.30, p < 0.01). Psychological variables were significantly associated with PTS and explained 62.7% of the variance, F (20, 1,413) = 118.58, p < 0.001. Conclusion: Loss of resources, stress, loneliness and concern were found to be risk factors for distress and PTS, whereas resilience factors played a protective role. We thus recommend using the COR theory to explore COVID-19 effects elsewhere.
... Important questions were raised in the groups such as 'what are the roles of art in this situation: is it a trigger for speech, and does it generate implicit communication, besides culturalsocietal expression?' Western art psychotherapists and psychosocial therapists who work with trauma survivors often encourage verbal sharing as a means of release, connecting with others, and emotional regulation (Hass-Cohen, 2016;Huss, Kaufman, Avgar, & Shouker, 2015;Lahad, 2017). By contrast, Japanese culture often emphasises non-verbal communication, and uses implicit communication through artistic forms (Chervenkova, 2017;Davies & Ikeno, 2002). ...
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This study focuses on an arts-based mental health and psychosocial support (MHPSS) intervention in the form of TOT (training of trainers) conducted under the auspices of IsraAID in the aftermath of the Yolanda typhoon in the Philippines in 2013. Interviews were conducted with 10 female education and healthcare professionals, who also made drawings of their experiences. The goal was to better understand how they evaluated the training program, both for themselves and their communities. Analysis of the interviews and drawings, based on the principles of Consensual Qualitative Research (CQR), identified three main domains: (1) Supportive and inhibiting factors for participants in the training course; (2) Supportive and inhibiting factors with respect to the participants’ implementation of the training goals in their local communities; (3) Perceptions of the benefits of the training program for the participants and their communities. The discussion centers on the value of the creative process, the importance of the group in the training course and in the context of multiculturalism, and the impact these factors in interventions applying the TOT model.
... As central and vital in everyday life, imagination uses a variety of areas in the brain, dominating all cerebral lobes and hemispheres (Fox et al., 2015). Based on our clinical, theoretical research of trauma and recovery (Lahad, 2017(Lahad, , 2019, we claim that as much as imagination is a source of pain and suffering during loss, trauma, and severe mental conditions (e.g., depression, schizophrenia), it is also a source of hope, optimism, and comfort in distressing situations. Hence, we argue it can be used in the treatment of trauma adopting the known concept of Hippocrates; "By similar things a disease is produced and through the application of the like is cured," meaning, if imagination is capable of causing illness, it is also capable of curing it. ...
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The objective of this study is to examine the role of imagination, playfulness, and creativity in healing or coping with trauma. A range of evidence-based trauma-focused treatments use imagination effectively, though often without theoretical references. This article provides an up-to-date, nonsystematic literature review, exploring the presented objective and focusing on the role of imagination in the treatment of posttraumatic stress disorder (PTSD). A computerized literature search, defined inclusion criteria, and synthesis aim to promote understanding in the field. We review brain overlaps pertaining to imagination and PTSD, presenting a hypothesis that the hippocampus and the default mode network play an important role in both. Creativity is presented as a significant predictor of resilience after traumatic exposure. Moreover, we discuss how resilience to, and coping with, a traumatic event is enabled by using playfulness. Finally, we discuss the gap between the frequent use of imagination in the treatment of PTSD and the lack of intended understanding of its mechanisms that bring about change. The fantastic reality model is presented as a theoretical and applied concept used in the utilization of imagination and playfulness to support therapeutic change. SEE FAR CBT protocol is presented as a therapeutic integrative approach that combines body and cognition, accommodating imagination and playfulness as sources of recovery. It interweaves imagination as part of the renarration of trauma, allowing wishful/fantastic elements to foster healing and promote resolution.
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This article presents some of the elements of artmaking as sources of resilience within the process of bereavement and grief. It builds upon findings from an art-based research project conducted during the period of coronavirus disease 2019 pandemic that explored properties of resilience in the face of sickness and death, which suggests three active elements to resilience: the capacity to observe pain, possession of faith, and the support circle. The article ties these findings, with other artistic projects in which artmaking responded to and alleviated sorrow and loss.
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When an infant is hospitalized on the neonatal intensive care unit (NICU) it can have a profound influence on the psychosocial well-being of the infant and their older sibling(s). This article presents a case vignette of the use of the Six-Part Storymaking Method with the sibling of an infant hospitalized on the NICU. The article reviews the therapeutic aims and benefits of the intervention, including: supporting emotional expression, providing opportunity for the sibling to be deeply witnessed by caregivers, therapist and hospital staff, empowering the sibling to inhabit the big sibling role and fostering insight into the sibling’s thoughts, feelings and behaviours as related to their infant’s hospitalization. Considerations for facilitation and assessment are also discussed.
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The aim of the present study is to describe the accumulated knowledge and experience of experts working, treating and living under ongoing threat setting, an understudied research topic. Using focus group approach, psychologists, clinical social workers and art therapists, staff members of the Sha'ar HaNegev Psychological Services Center (PSC) located in South Israel, were asked to describe their clinical experience of working with trauma affected children, adolescents and adults. Effective use of techniques and protocols along phases of treatment, indication of less effective techniques, newly developed techniques and clients' experience are reported and discussed.
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This chapter will focus on the various systemic models that have been developed in Israel since the 1980s, in response to the needs of the population during emergency situations, and will point out those areas not currently covered by those models. Based on this analysis, we will propose a multi-dimensional or meta-model that is a blueprint for future responses. We will also provide recommendations for maintaining and developing community resilience, in light of the research and current practice in this field.
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This chapter describes an integrative model of coping with individual and community stress, developed by the Community Stress Prevention Center (CSPC) in Kiryat Shmona, a border town in the north of Israel. Two studies will illustrate the implementation of this working model. The first focuses on children evacuated from their homes during a military operation, and the second evaluates interventions in a school following two traumatic events involving children and teachers alike. The central theme across the studies is that of resiliency and the use of individual and community resources.
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Lessons LearnedThe Importance of Understanding and Anticipating Disaster-Related BehaviorsPublic BehaviorFirst RespondersThe Role of Emergency Behavior Management Systems (EBMS): Public and Private Sector ApplicationsThe Role of the Emergency Behavior Officer (EBO): Public and Private Sector ApplicationsPublic Behavior Evaluation (PBE)Conclusion References
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Compared with the United States and several West European countries, the institutionalization of treatment for criminals is only a relatively recent development in the Federal Republic of Germany (FRG). In 1969 § 65 StGB (Strafgesetzbuch; Penal Law) on placement in a sociotherapeutic prison was introduced as a major legal basis and one of the major advances in penal reform. The goal of this legislation was that the courts would order placement in a sociotherapeutic prison for the following groups of prisoners: 1. Recidivists with serious personality disorders 2. Dangerous sexual offenders 3. Young adult criminals who have been assessed as especially crime-prone 4. Criminally nonresponsible or reduced responsibility offenders, if placement in a sociotherapeutic prison would appear to provide a better opportunity for resocialization than treatment in a psychiatric clinic