Psychotherapeutic practitioners’ views of the efficacy of mindfulness for the treatment of obsessive compulsive disorder: A qualitative key informant analysis

Objectives: A substantial proportion of individuals affected by obsessive compulsive disorder (OCD) are not experiencing adequate therapeutic outcomes from current standard psychotherapeutic treatments. Mindfulness has had a positive therapeutic impact on many symptoms associated with OCD. This study investigated the views of experienced psychotherapeutic practitioners concerning the potential efficacy of mindfulness as a therapeutic intervention for individuals with OCD.

Method: Six psychotherapeutic professionals experienced in using mindfulness with individuals affected by OCD were interviewed. Data were subjected to thematic analysis.

Results: Participants reported that engaging in mindfulness enabled people with OCD to experience an altered relationship with their symptoms and self. This new attitude, in conjunction with cognitive behavioural therapy, was perceived as helping individuals manage their OCD in an effective and healthy way. However, participants were unsure whether an exclusively mindfulness-based treatment would be effective.

Conclusion: This study indicates the potential for mindfulness practice to constitute a valuable therapeutic resource in helping people manage their OCD experience. Implications for future research and practice are considered.     

The effect of contemplation and meditation on ‘great compassion’ on the psychological well-being of adolescents

This study aimed to evaluate the effect of contemplation and meditation (CM) training, with a focus on developing great compassion, on the psychological well-being (PWB) of adolescents. Participants (N = 51, mean age = 15.8) were randomly allocated to either CM training (n = 26) or a comparison group (n = 25). Both groups completed measures of PWB before and after the intervention. Adolescents who received CM training showed statistically significant increases in environmental mastery and personal growth, as well as decreased negative affect compared to the comparison group. Girls in the experimental group also showed a significant decrease in negative affect compared with boys in the experimental group. Both the experimental and comparison groups demonstrated increased life satisfaction, environmental mastery, self-acceptance, autonomy, and purpose in life. There were no changes in positive affect and positive relations with others for both groups.     

A meditation on the nature of self‐healing and personality change in psychotherapy based on Gendlin's theory of experiencing

Abstract

From a humanistic point of view psychotherapy is a creative transformational process in which therapists assist clients’ intrinsic self‐healing tendencies. However the nature of the self‐healing process is poorly understood. I briefly consider two theories of self‐healing, Rogers’ self‐actualization theory and dialectical theory, but focus on Gendlin's theory of experiencing as providing a more complete explanation. I consider the fundamentally implicational nature of change and portray personal change as “paradigm evolution” rather than paradigm revolution. I conclude with an examination of the self‐healing process in therapies that provide minimal prosthetic assistance to the client: client‐centered therapy, eye movement desensitization and reprocessing, and focusing‐oriented therapy. I conclude that the self‐healing/self‐change process occurs when intellectual, “top‐down” cognitive and self‐critical activity is interrupted, and when clients adopt a receptive, listening attitude towards inner experience.     

Trainee therapists’ views on the alliance in psychotherapy and supervision: a longitudinal study

The shape of alliance in psychotherapy and supervision using growth curve modeling was examined for clinically inexperienced trainee therapists, who were engaged in long-term cognitive behavioral - or psychodynamic individual psychotherapy at a Psychology Clinic in Sweden. Trainee therapists rated their view of the alliance with their clients and their supervisors on the Working Alliance Inventory at five time points. The alliance to the client show a consistent, positive development throughout the therapy. The alliance to the supervisors show initially a decrease, followed by an increase, and then again, the rate of increase in the supervisory alliance ratings slowed down indicating a more complex view of the supervisory alliance compared to the view of the alliance in psychotherapy.     

Do group-based mindfulness meditation programs enhance executive functioning? A systematic review and meta-analysis of the evidence

Research examining the effects of group-based mindfulness interventions on executive functioning have yielded inconsistent findings, with some reports of enhanced performance and other reports of null findings. Inconsistencies in the literature may be due to methodological differences across studies, including the type of control group employed and sample characteristics (e.g., clinical vs. non-clinical samples). The current systematic review and meta-analysis examined the effect of group-based mindfulness programs on executive functioning in persons 18+ years of age. Following the standards for systematic review, a total of 29 studies were included in the meta-analysis, of which 21 comparisons contributed to the analysis of inhibition; nine to working memory; nine to attention shifting; and four to the analysis of verbal fluency. After removing outliers, random effects models suggested a small but significant synthesized effect of group-mindfulness training on overall executive functioning (95% CI = 0.256, 0.725). Examination of executive subdomains after removing outliers suggested a small, statistically significant effect for inhibition (95% CI = 0.055, 0.387), working memory (95% CI = 0.010, 0.437), and verbal fluency (95% CI = 0.071, 1.931). No significant pooled effects were found for attention shifting. A priori subgroup analysis by randomization, type of control group, and sample cohort revealed inconsistent results. Overall, the current review suggests that the effect of group-based mindfulness training on executive functioning is not robust.     

A qualitative study of preadolescent boys’ and girls’ body image: Gendered ideals and sociocultural influences

This qualitative study examined preadolescent boys’ and girls’ body ideals, and peer and media factors that shape these ideals. Sixty-eight children aged 8–10 participated in semi-structured interviews: 19 boys and 17 girls in individual interviews and 16 boys and 16 girls in eight group interviews. Techniques from grounded theory were used to analyze the data. Findings demonstrated that fitness was an important element of boys’ and girls’ body ideals. For boys the emphasis was on sport, and this was promoted by their peer interactions and the sportsmen they admired. For girls the focus was on looking good, and this was reinforced by their peer conversations, and the actresses and singers they admired. Focus groups further highlighted how peers both reinforced media messages, yet also helped children critique media messages. Implications are discussed for prevention programs that need to be specifically tailored for boys and girls.     

Commentary on ‘mentoring and the impact of the research climate’

Conclusions First of all, I would like to commend Roberts and colleagues for taking on a difficult but very important topic. It would be valuable if someone could follow up with a broader sample of universities and laboratories — paying careful attention to possible sampling and non-sampling errors. In general, I recommend that mentors explicitly both learn and teach ethical theory and practice within the context of their scientist development programs. Finally, while it is important to emphasize sound and ethical research standards and processes in mentoring programs, this should not be at the expense of an appropriate emphasis on skills essential to professional competitiveness, such as responsible, effective publication, grant winning, and demonstrably strong performance on the grants won. Dr. Gardenier is a survey statistician at the National Center for Health Statistics of the Centers for Disease Control and Prevention. The views presented are his personal opinions only.     

Internet-based cognitive behavioral therapy for anxiety in an outpatient specialized care setting: A qualitative study of the patients’ experience of the therapy

Knowledge about user experiences of internet-based cognitive behavioral therapy (iCBT) has mostly been drawn from non-clinical groups or with iCBT offered via self-referral. The present study therefore focused on patients who had undergone iCBT with minimal support while actively awaiting outpatient psychological treatment in the form of face-to-face CBT. To seek out barriers to adherence the study also included patients who had withdrawn from the iCBT treatment before completion. The study was performed in an outpatient clinic for anxiety disorders where twelve participants with a primary diagnosis of either social anxiety disorder or panic disorder were recruited from an ongoing randomized control trial for semi-structured interviews. Statements from the interviews showed that the iCBT treatment was unfavorably compared to the usual face-to-face treatment at the clinic. Despite this, a majority of the interview participants still expressed to have experienced various benefits from the treatment. Some participants did however, experience difficulties putting the materials to practical use. Furthermore, a large majority of the participants expressed a need for additional support, with a strong tendency for non-completers specifically expressing a need for face-to-face contact with a clinician. Implications for future research and implementation of iCBT in clinical practice are discussed.     

‘The lesser of two evils…’ – views of persons with rheumatoid arthritis on medication adherence: a qualitative study

Objective: This study aimed to explore medication adherence among adherent and non-adherent persons suffering from rheumatoid arthritis (RA). A special focus was put on the reasons accounting for successful medication adherence and on potential barriers or facilitating factors.

Design: A qualitative study with semi-structured interviews was conducted. Eighteen participants were recruited through stratified purposive sampling according to their medication adherence level. Interviews were analysed by interpretative phenomenological analysis.

Results: Medication adherence behaviour was described on a continuum ranging from non-adherent to adherent. Participants’ current adherence level was represented as a result of inner negotiations between a variety of influential factors and the successful application of a range of strategies. The influential factors were: experiences with medication, outcome expectations, knowledge of therapeutic options, the traits ‘openness’ and ‘conscientiousness’, belief in medical progress, characteristics of the medication, level of trust in one’s physician, and perceived autonomy. Facilitating strategies were: establishing routines, using social support and the deliberate suppression of information about potential adverse events.

Conclusion: The experience of and the reasons for medication (non-)adherence from the perspective of people with RA were explored comprehensively. Participants’ ongoing negotiations between adherence and non-adherence emerged as a key finding with implications for health service providers.     

The impact of children’s lexical and morphosyntactic knowledge on narrative competence development: A prospective cohort study

The authors investigate the contribution of children's early comprehension of relational terms and morphosyntactic knowledge to the development of narrative competence in kindergarten and Grade 1. Narrative competence was assessed through the cohesion, coherence, and structure of children’s productions. The participants in this study were 714 Italian children. The authors measured their oral narrative competence through a storytelling task at the beginning and end of the kindergarten year. A total of 115 children were randomly selected and followed through Grade 1, and their narrative competence was measured again. According to the path analysis model, early morphosyntactic knowledge contributes to explain narrative competence in Grade 1. Early comprehension of relational terms contributes to narrative competence at the end of the school year. These findings confirm the importance of exploring the influence of early language skills on narrative competence development and suggests early intervention at the level of language antecedents of narrative competence.     

Children’s conception of heroes,villains, the self,and others in China: A developmental study

ABSTRACT

Children learn about good and bad people from storybooks and cultural representations of heroes and villains. To probe their ideas about good and bad people, two experiments were conducted. In Experiment 1, 8-year-olds in China proved able to conceptualize goodness and badness in a graded rather than a dichotomous fashion. They located heroes at the upper end of a vertical scale, villains at the lower end, and ordinary children in between. In Experiment 2, a wider age range of children evaluated five figures (a hero; a villain; the self; a best friend; and an ordinary child). Children again showed a non-dichotomous scaling. They positioned the hero at the upper end and the villain at the lower end. In the intervening space, children positioned a best friend above the self and the self above an ordinary child. With age, children’s differentiation between the self and an ordinary child decreased.     

The pregnant therapist and the psychotic client: A phenomenological understanding of the impact of the therapist’s pregnancy on the therapeutic process

This original paper examines the underresearched area of therapist pregnancy. It explores the impact of psychosis as an additional complicating factor to the therapeutic process and the experience of one British counselling psychologist working in the National Health Service whilst pregnant. Five brief client summaries/clinical examples are presented to explore the common themes of anger, rejection, abandonment and envy that often emerge following the disclosure of a therapist’s pregnancy or the opposite reactions of over-protectiveness and an unwillingness to engage in therapy for fear of harming the therapist. Recommendations are made for further research within this neglected area and the need to incorporate the themes within training for therapists and training for supervisors.     

Driving examiners’ views on data-driven assessment of test candidates: An interview study

Vehicles are increasingly equipped with sensors that capture the state of the driver, the vehicle, and the environment. These developments are relevant to formal driver testing, but little is known about the extent to which driving examiners would support the use of sensor data in their job. This semi-structured interview study examined the opinions of 37 driving examiners about data-driven assessment of test candidates. The results showed that the examiners were supportive of using data to explain their pass/fail verdict to the candidate. According to the examiners, data in an easily accessible form such as graphs of eye movements, headway, speed, or braking behavior, and color-coded scores, supplemented with camera images, would allow them to eliminate doubt or help them convince disagreeing test-takers. The examiners were skeptical about higher levels of decision support, noting that forming an overall picture of the candidate’s abilities requires integrating multiple context-dependent sources of information. The interviews yielded other possible applications of data collection and sharing, such as selecting optimal routes, improving standardization, and training and pre-selecting candidates before they are allowed to take the driving test. Finally, the interviews focused on an increasingly viable form of data collection: simulator-based driver testing. This yielded a divided picture, with about half of the examiners being positive and half negative about using simulators in driver testing. In conclusion, this study has provided important insights regarding the use of data as an explanation aid for examiners. Future research should consider the views of test candidates and experimentally evaluate different forms of data-driven support in the driving test.     

A qualitative study of Indian and Indian immigrant adolescents’ perceptions of the factors affecting their engagement and performance in school

Although a growing body of quantitative research has examined the non-cognitive factors affecting the school engagement and performance of adolescents across cultures, there is relatively sparse qualitative research investigating the perceptions of adolescents regarding the factors influencing their engagement and performance in school. This focus group study comprising 32 Indian adolescents from India (mean age = 16.78 years) and 20 Indian immigrant adolescents from Canada (mean age = 17.05 years), therefore, using a self-determination theory perspective, explored the perceptions of Indian and Indian immigrant adolescents about the factors affecting their school engagement and performance in India and Canada, respectively. Thematic analysis of eight focus group discussions suggested that Indian and Indian immigrant adolescents were primarily extrinsically motivated toward school and academics. Further, both the Indian and Indian immigrant adolescents perceived their classroom teachers as controlling rather than autonomy-supportive. Implications of the findings are briefly discussed.     

Solving problems or seeing troubles? A day-level study on the consequences of thinking about work on recovery and well-being,and the moderating role of self-regulation

This study examined, using a within-person design, how fluctuations in work-related affective rumination and problem-solving pondering are related to recovery and well-being (N = 171; 677 day-level data points over five consecutive work days). We hypothesized that trait self-regulation moderates the relationship between problem-solving during the evening and the state of being recovered at bedtime. We analyzed our data using a moderated multilevel mediation approach. The results showed that affective rumination during the evening was indirectly related to impaired well-being in the subsequent morning through its negative relationship with the state of being recovered at bedtime. Problem-solving was indirectly related to well-being in the subsequent morning through its relationship with the state of being recovered at bedtime. However, this indirect effect was moderated by trait self-regulation in a way that problem-solving pondering was positively related to the state of being recovered, and consequently, to improved well-being for employees higher in self-regulation, whereas it was negatively related to the state of being recovered, and consequently, to impaired well-being for those lower in self-regulation. These findings suggest that problem-solving pondering may be beneficial or unfavorable for recovery and well-being depending on the degree to which employees can regulate their cognitions and feelings.     

Experts’ memory: an ERP study of perceptual expertise effects on encoding and recognition

This study examined how perceptual expertise facilitates encoding and recognition. The electroencephalogram of car experts and car novices was recorded in the study as well as test phases of a remember/know task with car and bird stimuli. Car expertise influenced performance and event-related potentials (ERPs) for cars but not birds. Experts recognized and “recollected” cars more accurately, while novices had more false alarms. The ERPs provided neural evidence for theoretical assumptions about expert memory. Memory encoding in the study phase was less effortful and more elaborate for experts than novices, as indicated by lower mean amplitudes for subsequently “recollected” cars and by indistinguishable differences due to memory for recollection and familiarity. The parietal old/new effect, a correlate of recollection measured during recognition testing, was only found for experts. The results show that refined perceptual and semantic processing, characteristics of perceptual expertise, facilitate both memory encoding and recognition memory.     

A response to Nguyen’s article, ‘Identification: A qualitative study of the experiences of bilingual therapists with their monolinguals and bilingual clients’

Noticing a certain lack of reflections directly related to language per se, I emphasise and discuss the importance of language issues in any bilingual or multilingual therapy. I try to illustrate this both with some of the existing literature on the subject and by offering my own take on some of the comments made by the interviewees.