The relationships of change in work climate with changes in burnout and depression: a 2-year longitudinal study of Chinese mental health care workers

Mental health care workers face heavy emotional demand and are prone to work burnout. Work burnout has been associated with poor mental health and work climate, which refers to individual perceptions about work setting. The purpose of this study was to examine whether intra-individual changes in work climate were associated with intra-individual changes in burnout and depression over two years. The present sample included Chinese mental health care workers (N = 312; mean age = 38.6, SD = 9.9) working in a psychosocial rehabilitation institution. The participants completed questionnaires on work climate, work burnout and depression at seven time points across two years. Parallel process latent growth modeling was used to analyze the associations of change between work climate and burnout and depression. Work climate displayed a logarithmic decreasing trend while burnout and depression displayed logarithmic increasing trends over two years. Baseline levels of work climate were negatively and moderately associated with baseline levels of burnout and depression (r = ?.44 to ?.60, p < .01). Changes in work climate were negatively and moderately associated with change in burnout (r = ?.43, p < .01) and change in depression (r = ?.31, p < .05). Change in burnout was positively and strongly associated (r = .58, p < .01) with change in depression. The current results support temporal relationships among changes in work climate, burnout and depression across time. Practical implications for future preventive work in burnout interventions were discussed within this population.     

Forgiveness and Health: Age Differences in a U.S. Probability Sample

Forgiveness is a variable closely related to religiousness and spirituality that has been hypothesized to be protective of mental and physical health. However, we do not clearly understand which aspects of forgiveness are most clearly associated with health outcomes, and the conditions under which these relationships occur. This study used national probability data to systematically examine age differences in the association between forgiveness, religiousness/ spirituality, and respondent reports of mental and physical health. Results showed age differences in the levels of forgiveness of others and feeling forgiven by God. In both cases, middle and old age adults showed higher levels of these forms of forgiveness than young adults. Furthermore, the relationship between forgiveness of others and respondent reports of mental and physical health varies by age. Forgiveness of others was more strongly related to self-reported mental and physical health for middle and old age adults than for young adults.     

Incorporating a Psychological Counselor in a Cancer Risk Assessment Program: Necessity, Acceptability, and Potential Roles

Evidence suggests that cancer risk assessment may be associated with increased psychological distress. This exploratory study assessed the necessity and acceptability of incorporating psychological counseling into routine clinic procedures at a cancer risk program. Following a visit to a university-based cancer risk clinic, patients (N = 102) completed an anonymous self-report instrument. Participants reported experiencing current stress and anxiety (41%), depression (29%), and suicidal ideation (2%). Patients with a history of cancer were more likely to be experiencing current emotional difficulties. Sixty-nine percent of the participants found the visit with the psychological counselor to be helpful, while 41% of the participants reported interest in follow-up psychological services. Interest in receiving future psychological services was positively correlated with levels of anxiety, depression, and cancer worry. This pilot study demonstrates the acceptability and potential role for psychological counselors in increasing adjustment in high-risk patients undergoing genetic counseling for inherited cancers.     

Chinese students in Japan: The mediator and the moderator between their personality and mental health

To clarify the influence of personality traits on the psychological acculturation of Chinese international students in Japan, the present study used three structuring questions: (a) What personality trait makes the students vulnerable to psychological distress? (b) What mediates between personality and psychological distress? (c) What buffers personality from psychological distress? The study examined personality traits (Harm‐Avoidance, HA; and Self‐Directedness, SD; two dimensions of the Temperament and Character Inventory), acculturation attitudes (integration, assimilation, separation, and marginalization), and the mental health (General Health Questionnaire (GHQ)‐30) of 253 Chinese students in Japan (17–30 years of age) using self‐report questionnaires. The hypotheses are: For the Chinese international students in Japan, (a) the individuals with high HA or low SD are more vulnerable to psychological distress; (b) the acculturation strategy mediates between personality (HA/SD) and mental health (GHQ); (c) social support can moderate the effect of personality on acculturation adaptation. The results show that the Chinese international students in Japan had higher GHQ scores compared to normative standards, and marginalization (a less adaptive strategy) was their second most preferred acculturation strategy, next to integration. Individuals with high HA or low SD were more likely to have a marginalization attitude and suffer from more psychological distress. The mediation effect of marginalization and the moderation effect of social support in life (SSL) between HA/SD and GHQ were confirmed. Most of the hypotheses were supported by the results. Explanations of these findings and their implication for acculturation adaptation are discussed.     

Treatment Foster Care in a System of Care: Sequences and Correlates of Residential Placements

We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group homes or residential treatment). Two-thirds of youth remained in TFC throughout the follow-up year. Of those who left, nearly half returned home, and slightly fewer were discharged to group homes. By the end of the 12-month follow-up period, rates of group home use were similar to those seen in the pre-TFC period. Movement out of TFC during the year was associated with being older at placement and with increased problem behavior (particularly externalizing behaviors). TFC serves as a step-down placement for a substantial number of youth. However, this is not the only way it is used, and models based on short-term transitioning or reunification with families may not be widely implemented or relevant in practice. Additional research is needed to understand current functions of TFC in residential trajectories and to maximize its utility in systems of care.     

Treatment of Deaf Clients: Ethical Considerations for Professionals in Psychology

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the American Psychological Association’s Ethics Code and other relevant issues (e.g., Americans with Disabilities Act) necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population.     

Impact of a System of Care on a Community's Children's Social Services System

Researchers and practitioners have questioned how the implementation of a system of care influences the broader context of children's social services within a community. We examined the impact that the Dawn Project system of care had on children's services in Marion County, Indiana. A series of semi-structured interviews were conducted in order to gain a broad understanding of stakeholder perspectives related to how system-level and other community leaders viewed system of care influences. Qualitative analyses uncovered several common themes including positive impact at the community level, challenges to implementation, and feelings of ambivalence related to program impact. Results were generally positive and suggested that most respondents saw core system of care principles beginning to emerge within the community related to the establishment of the care system. In addition, challenges to implementing the system of care also were uncovered, including some underlying resistance to system-level changes. Implications from our study highlight the importance of continuously working to enhance strengths and collaboration among systems, integrate and coordinate across systems and services, and authentically involve families at all levels.     

A Sex Difference on a Novel Spatial Working Memory Task in Humans

Neurophysiological and behavioral evidence suggests that the prefrontal cortex (PFC) may be sexually differentiated in nonhuman primates. The present study examined whether there are sex differences in working memory in humans that might reflect sexual differentiation of human PFC. Male and female undergraduates were administered a novel multitrial spatial working memory task (SPWM) and a verbal working memory task. In three experiments, females committed significantly fewer working memory errors and took significantly less time to reach criterion than males on the SPWM task. The female advantage was not accounted for by differences in general intellectual ability, attention, perceptual speed, incidental memory, or speed of verbal access. In Study 3, a sex difference was also observed on a measure of verbal working memory. The findings suggest that some prefrontal functions may be sexually differentiated in humans.     

大学生信任倾向与心理健康的关系：个体差异的视角

通过对203名大学生进行人际信任量表（ITS）和新版明尼苏达多相人格问卷（MMPI-2）的施测,从个体差异的角度来考察大学生信任倾向与各心理健康症状之间的关系。结果表明,MMPI-2临庆量表中的抑郁、精神衰弱、精神分裂症和社会内向性,内容量表中的焦虑、恐惧、强迫性、抑郁、怪异思维、愤怒、愤世嫉俗、反社会行为、A型行为、低自尊、社会不适、家庭问题、工作障碍、治疗反感,均与信任倾向呈负相关。此外,四类不同心理健康特征的被试在信任倾向上存在差异,适应良好型被试的信任倾向得分显著高于其他三类,适应不良型的信任倾向显著低于其他三类,精神敏感型和外向冲动型的信任倾向居中．且这两娄之间没有显薯差异。     

Supervision in Community Mental Health: Understanding Intensity of EBT Focus

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the supervisor level and implementation climate was the only significant factor associated with EBT supervision intensity. While individual clinician and supervisor factors may play a role in EBT coverage in supervision, our results suggest that an implementation climate that supports EBT may be the most critical factor for improving intensity of EBT coverage. Thus, implementation efforts that address the extent to which EBTs are expected, rewarded, and supported within an organization may be needed to support greater coverage of EBT during workplace-based supervision.     

The Effect of Mental Practice on Performance in a Sequential Reaction Time Task

The effect of mental practice on performance in a dot-location RT task was investigated. Participants (N = 40) were required either to mentally practice, physically practice, or do no practice on an RT task in which the signals appeared in a repeating sequence. Correct mental practice, as opposed to incorrect mental practice and no practice, was predicted to have a positive (enhancing) effect on performance of the RT task. Despite previous evidence that mental rehearsal does enhance performance in many perceptual-motor tasks, neither correct nor incorrect mental rehearsal affected subsequent sequence learning; that is, no mental practice effect was observed. That surprising result is discussed in terms of motivational, psychoneuromuscular, separate memory systems, and transfer-appropriate processing explanations of mental practice.     

Implementation in a Changing Landscape: Provider Experiences During Rapid Scaling of Use of Evidence-Based Treatments

This study examined 133 service providers’ perspectives on a rapid shift to mandated evidence-based treatment delivery, utilizing an inductive coding process to capture themes present in their qualitative feedback. The majority of provider comments were negatively valenced, but attitudes varied considerably across response categories: comments regarding practice context and support were nearly uniformly negative, while comments regarding treatment fit and therapeutic consequences were more balanced. Treatment fit was the most commonly cited category; the fit to therapist (e.g., ease of use) subcategory was predominantly positive in contrast with the fit to client (e.g., flexibility) subcategory, which was predominantly negative. Results illustrate the intended and unintended consequences of large-scale implementation efforts on community providers, and may aid implementation researchers and system decision makers optimize the conditions under which community providers are asked to implement evidence-based treatment.     

Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment

Mental health systems need scalable solutions that can reduce the efficacy–effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers’ fidelity to evidence-based treatment models and children’s and caregivers’ engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27 families. Provider fidelity and child engagement in treatment were observationally measured via session audio recording. Parent and child perceptions of the tablet application were assessed using structured interviews and mixed-method analyses. Providers actively and appropriately used tablet TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is accepted by providers and families and may be integrated into mental health treatment with minimal training. Further study is needed to examine the extent to which technology-based applications may enhance the reach, quality, and clinical outcomes of mental health treatment delivered to children and families.     

Rate-decreasing effects of the atypical neuroleptic risperidone attenuated by conditions of reinforcement in a woman with mental retardation

Effects of two doses of risperidone on the performance of a matching task under tangible reinforcement and nonreinforcement conditions were measured in a woman with mental retardation. In both conditions, time to complete the task increased and response rates decreased under two doses of risperidone. Accuracy was generally unchanged. These changes were much smaller in the tangible reinforcement condition; thus, reinforcement seemed to protect performance from the rate-decreasing effects of risperidone.     

数据-笔墨比率对过程监控任务绩效的影响

以24名参加飞行员心理选拔的大学生为被试,采用模拟过程监控任务,以反应时、心理负荷与情境意识为指标,考察了数据-笔墨比率在动态图形显示设计中的应用。研究结果表明,低数据-笔墨比率显示条件下的反应时较短、情境意识较高,即适当增加表达数据点之间关系的笔墨虽然会降低数据一笔墨比率,但有助于监控绩效。实验结果说明,在将静态图形显示的设计原则运用于动态显示设计时,应对其适用性进行检测。     

精神卫生领域行使代理同意的伦理风险及其应对

在精神卫生领域,行使代理同意虽然获得了医学伦理的有力辩护,但同时也存在诸多伦理风险。精神卫生领域行使代理同意的伦理风险主要包括家长主义、至上主义和专制主义三大方面。它的形成与代理同意人性预设“扬善蔽恶”始源缺陷导致的“错位性解读”“非理性旁观”“非理性自信”以及“无原则纵容”等问题紧密相关。推广知情同意能力培训、建构代理同意承诺制、建立代理同意定期检查制是防范和抑制精神卫生领域代理同意伦理风险的针对性措施。

     

A narrative review: arguments for a collaborative approach in mental health between traditional healers and clinicians regarding spiritual beliefs

This review explores the possibility of a more collaborative approach between mental health clinicians and traditional healers, from a clinical psychology perspective, for clients with spiritual beliefs. Spiritual beliefs are incorporated into the identity and functioning of clients within a cultural context and prevalence rates reveal this is not uncommon. It is argued that working collaboratively would address many access difficulties to mental health services and support is generated through a number of studies and case reports in the United Kingdom, worldwide and across cultures. This approach appears to be in accordance with current theories of acculturation. The problems in the current system when working non-collaboratively are also explored. Counter arguments and pragmatic difficulties of collaboration have been discussed. Research in the United Kingdom is limited and it is suggested that more research is needed in the field. Pragmatic solutions are suggested to stimulate discussion.     

Depressed and Anxious COPD Patients: Predictors of Psychotherapy Engagement from a Clinical Trial

This study examined patient-level factors associated with engagement in mental health treatment in a sample of medically ill patients with clinically significant symptoms of depression and/or anxiety. A total of 248 patients was enlisted from a randomized controlled trial of cognitive-behavioral therapy for depression and anxiety in patients with chronic obstructive pulmonary disease (COPD). Logistic regression analysis was used to predict mental health engagement, defined as attending at least one intervention session. Results indicated that patient-perceived mastery over COPD was negatively related to mental health engagement. Further, mastery was the only significant predictor of mental health engagement after controlling for patient demographic characteristics, severity of COPD, depression, and anxiety. To improve engagement for medically ill patients with comorbid mental health difficulties, clinicians should explore patients’ attitudes about their mental health within the context of their perceived ability to cope with their medical disease.