The social reality of the imaginary audience: a grounded theory approach

Traditional approaches to understanding the imaginary audience are challenged in this study. Three hundred sixty-one British schoolchildren (aged 14 and 15 years) were asked to express their worries and concerns, using grounded theory methodology. Qualitative responses were collated and coded according to emerging categories, with "what other people think" identified as the central concern. In particular, the findings are used to critique Elkind's (1967) theory of adolescent egocentrism. Data presented in this study suggest that adolescents worry about what other people think because there are real personal and social consequences. Such concerns are seen as being based in social reality and are not imaginary as Elkind suggested. In conclusion, new methodologies which place young people at the center of the analysis are advocated.     

Experiences of Christian clients in secular psychotherapy: a mixed-methods investigation

Eleven Christian former clients were sampled to uncover factors contributing to positive versus negative experiences in secular psychotherapy. The qualitative results indicated that although many participants felt hesitant to discuss their faith due to uncertainty about their therapists' reactions, positive experiences were reportedly facilitated by therapists' openness to understanding clients' faith and giving clients control over how much, when, and how to discuss their religious beliefs and practices. Dissatisfied clients reported that their therapists expressed opposing religious views or avoided discussing religious or spiritual issues. Participants' self-reports of the working alliance and of their therapists' expertness, attractiveness, and trustworthiness were largely consistent with the narrative data, but the alliance scores were somewhat more sensitive to participants' positive versus negative evaluations of their therapy experience. That is, several participants rated their therapists' personal characteristics quite favorably but indicated poor agreement with their therapists on the goals or tasks of treatment.     

Client-therapist intimacy: responses of psychotherapy clients to a consumer-oriented brochure

Psychotherapy clients read two consumer-oriented brochures: a general brochure on psychology and a brochure on the topic of client-therapist intimacy. Half of the participants read the general brochure first and the brochure on client-therapist intimacy second, and half the participants did the reverse. Participants reported favorable reactions to the brochures, indicating they thought both should be made available to psychotherapy clients; that neither were too long, too sensitive, or too difficult to read; and that the brochures should be made available early during the therapeutic process. After reading the client-therapist intimacy brochure, participants also showed some changes in Likert-type scores measuring attitudes regarding intimate contact between clients and therapists. Although participants were more negative about issues of sexual misconduct after reading the client-therapist intimacy brochure, they did not indicate a decrease in trust of therapists, nor did they indicate a greater likelihood of filing a false complaint. We concluded that therapists' reservations about presenting clients with factual information regarding therapist sexual exploitation of clients are not empirically founded.     

Recognizing the infant as subject in infant-parent psychotherapy

Drawing on Winnicott's view of infants as subjects entitled to an intervention in their own right, infants as the referred patient have been seen in infant-parent psychotherapy for 20 years at the Royal Children's Hospital, Melbourne, Australia. This is a radically different view of infant symptomatology than viewing it as only expressing an aspect of the mother's unconscious. The clinical pathway differentiates the therapy from much parent-infant psychotherapy. The author describes the theoretical model of a twofold approach to understanding the infant's experience through interactive dialogue between therapist and infant, and sharing this understanding with the parents, and illustrates it with cases of failure-to-thrive infants. She discusses two criticisms: first, that infant-parent psychotherapy may undermine the parents and, second, that brief parent-infant psychotherapy does not alter parents' insecure attachment status. Videotaped sessions often show rapid improvement; parents generally feel relieved. This approach potentially shapes not only parents' and infants' representations, but also their implicit knowledge of relationships-partly, it is suggested, through activating the mirror neuron system to bring about implicit memory change. Change may therefore be longer lasting than psychoanalytic theory presently conceives. The approach is relevant in an outpatient setting: gains were maintained long term in 90% of out-patient cases.     

Health care utilization by low-income clients of a community clinic: an archival study

An archival study was done of 500 medical records from a community clinic serving a low income predominantly Hispanic area of Los Angeles. The data collected included demographic characteristics and presented symptoms or reasons for visit, as well as diagnosis and treatment. The greatest number of patient visits were made for family planning services. A large porportion of the patients who received initial family planning services failed to return to the clinic for follow ups or additional supplies. A total of 208 pregnancy tests were performed in 151 of the 500 cases sampled. Of these, 152 were positive. The most frequently stated reason for requesting pediatric services was for physical exams, accounting for 30% of the visits. It should be noted that the discontinuity of care and insufficient utilization of preventive care seen in these results deserve serious attention by medical clinic administrators. The rate of patients who do not return for family planning after the initial visit is worrisome. A greater effort to attract women to family planning services at the time they request pregnancy verification could reduce the need for abortion of unwanted pregnancy. The data also indicate that changes in the wording of certain questions commonly asked of clients may be needed. This study allowed service providers to obtain important information about their performance, their needs, and the future direction that their services might take. This type of analysis is relatively low in cost and can yield important benefits, espicially if done on a periodical base in a search for policy implications.     

Dissatisfied psychotherapy patients: A tentative conceptual model grounded in the participants' view

Usually, between 5% and 20% of psychotherapy patients are dissatisfied with their treatments. This naturalistic study explores seven clearly dissatisfied patients' view of the therapeutic process and outcome. Interviews at termination of psychoanalytic psychotherapy and at a 1.5-year follow-up were analysed to create a tentative conceptual model of patient dissatisfaction using grounded theory approach. At the core of the model is an experience of abandonment by a therapist felt to be insufficiently flexible, a therapy lacking intensity, and links missing between therapy and everyday life. Dissatisfied patients lacked confidence in their relationship with the therapist, described their therapists in negative terms and concluded that their therapies lacked direction. They wanted more response from the therapist. Paying greater attention to the patient's emerging dissatisfaction may prevent lasting disappointment, unnecessary continuation of fruitless treatment, and probably increase efficiency.     

Analysis of the decision-making process leading to appendectomy: a grounded theory study

The aim was to develop a theoretical understanding of the decision-making process leading to appendectomy. A qualitative interview study was performed in the grounded theory tradition using the constant comparative method to analyze data. The study setting was one county hospital and two local hospitals in Sweden, where 11 surgeons and 15 surgical nurses were interviewed. A model was developed which suggests that surgeons' decision making regarding appendectomy is formed by the interplay between their medical assessment of the patient's condition and a set of contextual characteristics. The latter consist of three interacting factors: (1) organizational conditions, (2) the professional actors' individual characteristics and interaction, and (3) the personal characteristics of the patient and his or her family or relatives. In case the outcome of medical assessment is ambiguous, the risk evaluation and final decision will be influenced by an interaction of the contextual characteristics. It was concluded that, compared to existing, rational models of decision making, the model presented identified potentially important contextual characteristics and an outline on when they come into play.     

Determinants of social support among low-income mothers: a longitudinal analysis

This study examined the reciprocal relationships between perceived mastery, stress, and three functional areas of social support: tangible support, informational support, and belongingness support. Data were collected during two face-to-face interviews with a sample of low-income, primarily African-American mothers, conducted approximately 1 year apart. Consistent with predictions, initial levels of mastery predicted higher subsequent levels of instrumental social supports (tangible and advice support), but were unrelated to belonging support. Conversely, initial levels of tangible support were predictive of later mastery. Perceived stress did not account for any additional variance in subsequent support, although initial levels of belonging support only did predict reduced stress at Time 2. Results suggest that successful attempts to garner instrumental supports is an important contributor to individuals' sense of self-efficacy, at the same time, self-efficacy leads to more successful use of existing social support systems. These findings point to the importance of having both available tangible support networks as well as close emotional supports for low-income parents. The importance of using longitudinal, multidimensional analyses to better understand the social support process is discussed.     

Toward a grounded theory of self-regulation in mixed martial arts

ObjectivesThe purpose of the current study was to use a grounded theory methodology to better understand the psychological factors involved in training and competition in MMA.DesignA grounded theory methodology underpinned by an interpretivist epistemology was utilized in the current study.MethodsNine MMA athletes participated in formal, recorded interviews with one athlete participating in two recorded interviews. Additionally, observations and field notes from the first author were collected over a one-year period, and aided data collection and analysis. In line with grounded theory methodology (Weed, 2009), an iterative and constant comparison approach to data collection and analysis was employed until saturation was reached.ResultsThroughout data collection and analysis, self-regulation during a training camp emerged as integral to optimal performance. Motivation and ongoing evaluation aided fighters in their ability to self-regulate both external and internal factors related to training and performance. External factors associated with self-regulation consisted of the creation and maintenance of an ascetic routine through environmental regulation, social support, and structured amnesty. Internal factors associated with self-regulation consisted of deliberately induced pain and distress, which facilitated self-efficacy, and produced stress and fatigue.ConclusionsResults of the current study advance the scientific literature in sport psychology by examining the role of self-regulation in the performance of MMA fighters. As the popularity of MMA continues to increase, future research should also examine the role of self-regulation in other aspects of MMA (e.g., injury rehabilitation, life balance).     

Construct validity of the Self-Compassion Scale-Short Form among psychotherapy clients

Interest has been growing in the mental health benefits of self-compassion. Whereas, most research on this topic has been conducted with the 26-item Self-Compassion Scale (SCS), a briefer 12-item version of the instrument, the Self-Compassion Scale-Short Form (SCS-SF), also exists. The SCS-SF has demonstrated good validity and reliability in non-clinical samples, but it has not been used often in research with psychotherapy clients. This study was designed to examine the factor structure and construct validity of the SCS-SF in a clinical population. Data for this study were collected from 1609 college students receiving services at 10 campus counseling centers. The previously proposed factor structure of the SCS-SF was not supported. Instead, analyses revealed two factors, Self Care and Self Disparagement. Evidence for the construct validity of these factors was found via expected relationships with indices of depression, anxiety, social anxiety, hostility, academic distress, eating concerns, family distress, maladaptive perfectionism, suicidality, self-injurious behavior, and social support. SCS-SF scores were unrelated to various measures of substance use. Implications for clinical work and future research are discussed.     

Dyadic coping in coach-athlete relationships: A grounded theory

ObjectivesThe purpose of this study was to make an original contribution to sport psychology literature by offering a substantive grounded theory of dyadic coping in coach-athlete relationships. Specifically, this study aimed to capture the development and manifestation of dyadic coping for coaches and athletes operating in individual sports.DesignUsing constructionist grounded theory methodology as a guide, a theory of dyadic coping was constructed by the authors, 13 coaches, 15 athletes, and five sport and exercise psychology practitioners.MethodTheoretical sampling procedures ensured that data collection was directed by the developing theoretical concepts, rather than a set of predefined criteria. We conducted individual interviews (n = 16) with coaches and athletes, and one 90-min workshop with coaches, athletes, and sport and exercise psychology practitioners. Methodological rigor was enhanced by focusing on credibility, originality, resonance, and usefulness.ResultsThe theory proposes that when coaches and athletes appraise a stressor communicated in their dyad as significant and meaningful, they use dyadic coping to protect themselves and their coach-athlete relationships. This process is moderated by a number of personal (e.g., personality), relationship (e.g., length), and organizational (e.g., leadership behaviors) characteristics.ConclusionThe theory presented here represents a notable shift in thinking away from coping as an individual process and toward coping as an important interpersonal phenomenon. This type of coping can have long-term effects on coaches’ and athletes’ relationship functioning, well-being, and performance.