Ethical Issues in Psychologists' Professional Practice: Agreement Over Problematic Professional Behaviors Among Spanish Psychologists

A sample of 703 Spanish psychologists completed an online survey containing 114 behaviors related to professional practice in different areas. The aim of the study was to learn which professional behaviors create ethical dilemmas most often for psychologists and how they respond to these issues. Findings suggest that psychologists who have actually faced a particular dilemma are less strict on judging the inappropriateness of a possible ethical transgression than those psychologists who have not experienced it. Also, four clusters can be identified according to the attitude of respondents toward the dilemmas, namely “rejection,” “aprioristic,” “utilitarian,” and “no conflict.”     

Psychologists in Academic Health Settings: Key Contributors to Dynamic Interplay Among Research, Clinical Practice, and Policy Domains

Psychologists in academic health systems are in a unique position to impact the dynamic interplay among research, clinical practice, and policy domains. In addition to their specialty expertise in psychopathology, particular types of physical illness and disease, and health promotion, psychologists have substantial knowledge of human behavior, refined scientific skills, knowledge and experience in the effective delivery of clinical services, strengths in written expression, and a collaborative orientation. This combination of strengths makes psychologists extremely well-suited for (a) interdisciplinary efforts to develop and implement evidence-based assessment and intervention strategies with biological, psychological, behavioral, and social components, and (b) leadership and advocacy efforts that impact the quality and availability of health care services.     

Role of Psychologists in Academic Medicine

With an interdisciplinary approach to understanding human psychosocial development and behavior, psychologists in academic medical settings have much to offer in the areas of administration, research, teaching, and service, including in the realm of organizational systems and behavior within medical schools. In these ways, psychologists can play a large role in the fulfillment of the mission of academic medicine and enhance psychology’s stature in the medical school organization. Two case studies are presented that exemplify the varied roles and responsibilities of psychologists in a medical school. To be successful within medical schools, the following generalizable principles are offered: (1) “add value” to the medical school by demonstrating the diverse and relatively unique abilities of psychologists; (2) be flexible and adaptive to the different requirements of medical academic settings; (3) make a concerted effort to work well with medical students, residents, and physicians who may not be well-versed in certain aspects such as rigorous research methodology and statistics; and (4) find a “good match” between one’s strengths, the needs of the medical setting, and the attributes of the M.D. leader. With such an approach, remarkable accomplishments can be made.     

An Exploratory Study: Perceptions of Ethical Behaviors Among Psychologists Practicing in the Caribbean

A sample of 44 psychologists who practice in the Caribbean completed a web-based survey containing 73 behavioral items related to ethical issues in professional practice. The aim of this exploratory study was to learn about perceptions regarding ethical behaviors that create ethical dilemmas and the level of agreement to their responses and to identify how demographic variables influenced their perceptions of ethical behaviors. Findings suggest that there was approximately an equal level of agreement on behaviors such as being an advocate for your client and being sexually involved with a current client rated as ethical and unethical, respectively. Several demographic variables and ethical behaviors such as level of degree and confidentiality issues were statistically significant. Finally, psychologists prefer the presence of a professional psychological association with an ethics committee.     

Pilot randomised controlled trial of counselling in a community mental health setting: Pitfalls and learnings

The establishment of counselling and psychotherapy as “evidence‐based” interventions is contingent on the effective implementation of randomised controlled trials (RCTs) in real‐world clinical settings. This paper identifies some of the pitfalls that led to the termination of a practical RCT in a community mental health setting. It reflects upon the significance of the lessons learned by drawing on similar challenges that are documented in the wider literature. Issues surrounding staff turnover, counsellor engagement and procedural clarity are discussed, as is the conflict between the time required for research procedures and counsellors’ clinical time constraints. In our recommendations, we recognise the decisive role of collaboration and counsellor motivation in research partnerships, and the significance of clinical relevance, communication, training and research co‐production in achieving them. Time commitment is identified as the pivotal challenge in the formation and maintenance of collaborative research, but one that also must be overcome for the advancement of the counselling and psychotherapy field.     

临床科研:大有潜力

科研已经成为临床医生一个非常重要的工作内容。多数临床医生受时间、基金、平台建设及思想认识等因素的限制不能正常开展科研。但是科研是促进学科建设、提高个人思维能力和技术发展的根本保障。医学科研分为基础研究和临床研究。条件有限的临床医生,科研不必囿于基础研究,可以依靠我们丰富的临床资源,借助逐步完善的卫生信息系统,进行易于开展的诸如观察性临床研究、二次研究、心理学及卫生经济学等方面的研究。但是,临床数据个体差异大,这要求我们进行临床科研时更要严格遵循科研原则,这样才能做出较高质量的结果。     

Bridging the Gap Between Prevention Research and Practice: The Interactive Systems Framework for Dissemination and Implementation

If we keep on doing what we have been doing, we are going to keep on getting what we have been getting. Concerns about the gap between science and practice are longstanding. There is a need for new approaches to supplement the existing approaches of research to practice models and the evolving community-centered models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats); the Prevention Support System (which provides training, technical assistance or other support to users in the field); and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

“She was on my side,and grounded me when I needed it:” Research supervision in the field of therapy,based on counsellors’ and psychotherapists’ views on their engagement with research

Research‐supported practice is increasingly emphasised within counselling and psychotherapy at all stages of training. Guided by an interest in how to support therapists in their efforts to develop research knowledge during doctoral training, this paper focuses on research supervision. Research supervision is a surprisingly under‐researched area. Little is known to date about how supervisors “go about their supervision” (Bruce & Stoodley, 2013, p. 5), despite the fact that “high failure rates for research dissertations in the social sciences have been partly attributed to student dissatisfaction with supervision and poor student–supervisor relationships” (Armstrong, 2004, p. 134). Between 2016 and 2019, we explored accredited counsellors' and 'psychotherapists engagement with research during or after their doctoral training. This paper explores research supervision with these two previous studies serving as the backdrop (Bager‐Charleson et al., 2018; Bager‐Charleson et al., 2018b), together with a literature review into research supervision within social sciences and psychotherapy. Supervision is discussed as a crucial coping/support strategy to (a) link research with practice in therapy work, practically and epistemologically; (b) contain and make sense of the use of transformative learning; (c) balance “enculturation” with critical thinking and emancipation; and (d) support reflective and reflexive development. This paper discusses an adaptive research supervision model, akin to a “holding bond” (Stevens, 2016) which supports the student to reflexively position her/himself personally, intersubjectively, theoretically and socio‐culturally, whilst “negotiating the tension” (Lee, 2008) during a process of enculturation into the discipline, and also fostering critical thinking and emancipation to contribute to new knowledge.     

肝癌基础研究如何向临床转化

肝癌基础研究在过去数十年取得了长足的进步,而肝癌临床研究则相对滞后,二者间存在巨大的反差。如何将基因组时代发现的大量有重要意义的基础研究成果及时有效地转化为临床可用的技术方法,以进一步提高肝癌治疗效果是亟待解决的难题。转化医学研究为其搭建了一条重要桥梁。     

护理学专业学位硕士研究生临床实践体验研究

采用质性研究中的现象学研究方法,对来自全国各地10所院校的12名护理学专业学位研究生进行半结构式深度访谈。通过对录音访谈内容进行三级编码,逐步归纳提炼出三个主题,每个主题下涵盖不同的副主题：（1）临床实践获益感方面：提升核心能力、体现自身价值;（2）心理体验：归属感、失落感;（3）影响临床实践效果的瓶颈因素：缺乏明确的临床能力考评标准、临床带教师资队伍薄弱。因此,教育者和管理者应重视专业学位硕士研究生,晦床核心能力培养,构建一个充满人文关怀的临床实习环境,消除瓶颈因素,以提高其临床实践效果。     

Employment Characteristics and Salaries of Psychologists in United States Medical Schools: Past and Current Trends

In 1997 the Research Office of the American Psychological Association (APA) collaborated with the Association of Medical School Psychologists (AMSP) to conduct a comprehensive employment and salary survey of psychologists employed in medical schools and academic health centers. Questionnaires were mailed to 3894 psychologists; postcard reminders and a follow-up mailing to nonresponders resulted in a final 50% response rate. The questionnaire addressed appointment characteristics, department and school characteristics, employment activities, salary information, demographics, and changes in the medical school work environment that have occurred as a result of managed care. This survey, the 1997 Employment Characteristics and Salaries of Medical School Psychologists, is the most comprehensive analysis to date of the practice of psychology in U.S. schools of medicine and academic health centers. This article reports the most salient findings from this survey.     

Intraindividual Variability in Narrative Identity: Complexities,Garden Paths,and Untapped Research Potential

This paper introduces key concepts for studying intraindividual variability in narratives (narrative IIV). Narrative IIV is conceptualized in terms of sources of within-person variation (events and audiences) and dimensions of variation (structural and motivational/affective dimensions of narratives). Possible implications of narrative IIV for well-being and self and social development are outlined. Considering narrative IIV leads to complexity in both theory and method, raising the issue of whether some avenues might be more productive than others. Using previously collected data, we sought to evaluate the research potential of different indices of narrative IIV (n = 106 participants; n = 1272 narratives). All analyses were preregistered: doi: 10.17605/OSF.IO/SXV4W . Findings show that narrative IIV is distinct depending on source and dimension, replicating previous work. However, narrative IIV was largely unrelated to the measures of well-being and self and social development used in the present study. These findings support the practice of aggregating across narratives in existing research, at least for these outcomes and sources of variation, and provide important guidance for investigators who remain interested in the possible insights that narrative IIV may reveal about the person. © 2020 European Association of Personality Psychology     

The Difficulty of Making Psychology Research and Clinical Practice Relevant to Medicine: Experiences and Observations

Psychology and medicine research and practice have demonstrated substantial and unique bodies of knowledge designed to both improve patient care and respond to contemporary health care needs for use of evidence and cost consciousness. At their full potential they represent a significant paradigm shift in healthcare. Despite impressive successes, it is clear that we are just on the cusp of such a change. These findings have had limited impact and penetration into medical practice, particularly outside of academic medicine and large, organized systems of health care, and there are multiple examples of such limitations in various arenas of health care. There also appear to be common themes to such examples which provide us opportunities to consider how psychologists might move things ahead. They also suggest how our unique position in academic medicine can both limit our impact and provide ways of creating continued shifts in the healthcare paradigm. This paper is based in part on the author’s presentation at the Association of Psychologists in Academic Health Centers 3rd National Conference in Minneapolis, Minnesota, May 2007.     

Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy. The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.     

How to Conduct Research in Your Private Practice

Mental health professionals who work in private practice and other clinical settings have huge opportunities to contribute to the science of our field. But they rarely do so. This article describes ways that practitioners who have research training can capitalize on recent developments in practice, science, and technology to conduct research in their private practice. I describe a model for conducting research as a practitioner that entails tightly integrating the research into clinical practice, and I point out why conducting research in your private practice is worth doing. The remainder of the paper provides a primer, describing strategies for implementing in a clinical setting all the elements of the research enterprise: addressing ethical and legal issues, keeping up to date with the scientific literature, selecting a good research question, conducting a single-case experimental design, finding collaborators and assistants, collecting the data, analyzing the data, writing the paper and getting it published, and handling time and money. Although this paper focuses on research in a solo or group private practice setting, many of the strategies described here can also prove useful in the conduct of research in hospital or community settings.     

关于医疗、科研的一点认识

临床医疗是医院的根本使命,在权重上医疗自然重于科研.医疗实践是科研的出发点与归宿,决定了科研的基本走向.当前,科研工作受到前所未有的重视,科研作为医疗人员绩效考核的权重过大,偏离了医院的根本使命,会对科研、医疗、医护人员乃至整个社会造成伤害.SCI论文与临床关系不密切,不宜用来评价临床医师的水准.应该建立科学的考评机制,考核标准应细化、全面,对科研的奖励应适度.对于医护人员的考核应以医疗为主、科研为辅.     

Community‐Based Learning and Critical Community Psychology Practice: Conducive and Corrosive Aspects

Community‐based learning (CBL) has been more recently introduced into some psychology programmes in the UK than in the USA, where it has existed for a number of decades in the form of ‘service learning’. CBL holds promise as a means of promoting and developing critical community psychology practice, but there are risks involved in its acritical adoption in the psychology curriculum. If associated power dynamics are not considered, CBL has the capacity to serve neoliberal interests and perpetuate, rather than challenge, oppressive social relations. This article examines ways in which CBL can be both conducive and corrosive to critical community psychology practice. Drawing on interdisciplinary literature, it explores ways in which students participating in CBL can be vulnerable to exploitation—both as victims and perpetrators—through collusion and cultural voyeurism. Consideration is given to ways of resisting institutional and other pressures to comply uncritically with the demands of the ‘employability agenda’. These include the importance of facilitated reflective processes in associated modules, to consider aspects of the interactions of people and systems. The article concludes that whilst CBL is inherently risky and involves discomfort for students, this enables development of a more informed consciousness where truly participatory work evolves towards greater social justice. Copyright © 2016 John Wiley & Sons, Ltd.     

循证医学指导医疗实践

循证医学的发展强调医疗决策物制定应将个人的临床经验与现有的最可信的临床研究证据进行完善结合。促进了医学模式的转化,对医疗实践起指导作用。现就循证医学对心血管病临床实践的指导作用的必要性和可能性及其内容作一简述。