远程心理健康服务：应用、优势及挑战

远程心理服务(Telepsychology)是利用远程通讯技术提供心理服务的新兴心理服务方式,虽然在COVID-19疫情期间得到了广泛应用,但仍缺乏相关行业应用规范及专业培训体系。现有的远程心理服务三维模型以应用环境、应用领域、应用方式为服务框架,结合九个应用领域开展远程心理服务。我们根据已有研究提出了以咨询师、治疗方法、远程技术手段为主要因素、以来访者为中心的远程心理服务应用模型。人工智能在远程心理服务领域的应用主要包括三个方面:机器学习与人工神经网络、自然语言处理与情感分析、虚拟现实与增强现实。目前,远程心理服务正以蓬勃的态势极速发展:其在提高心理服务督导效率、减少服务成本等方面有着显著优势,同时在心理服务从业人员对远程心理服务的接受度、来访者的适应性、重视程度方面也面临着挑战。未来远程心理服务可以在监管体系、从业者培训、远程应用技术三个方面进行深入探索。     

Training the next generation of counseling psychologists in the practice of telepsychology

Training programs that integrate the use of technology are needed to prepare students for the future of service delivery in psychology. Training opportunities in telepsychology can equip students to develop, implement, and evaluate innovative modalities for mental health care. However, few options are available for trainees seeking to acquire these experiences, and while guidelines for service provision using technology are emerging, guidelines for and documented examples of training programs in telepsychology are virtually non-existent. The Telehealth Counseling Clinic, located at the Texas A&M Health Science Center, has developed a training model to prepare the next generation of psychologists to work with new technology to provide counseling services to low-income and uninsured individuals living in designated Mental Health Professional Shortage Areas in rural Texas. Training competencies necessary to serve this population through telepsychology are discussed and preliminary evaluation data of the training program are presented.     

父母对儿童青少年媒介使用的积极干预

积极干预是指父母在孩子使用媒介前后或者使用过程中, 通过解释和讨论等互动形式对媒介内容、使用方式等提供指导。随着电子媒介在家庭中的普及, 父母如何正确引导儿童青少年的媒介使用行为受到了研究者的关注。父母对媒介使用进行积极干预对儿童青少年认知发展、社会性发展等诸多方面产生了积极作用, 例如提高儿童对媒介内容的批判能力, 有效减少暴力内容可能产生的消极影响等。影响积极干预行为的因素可归纳为两大类：家庭因素和儿童个体因素。未来研究可从完善测量方法, 探究父母干预行为与儿童青少年媒介使用之间相互影响的机制, 建构影响因素模型, 提高积极干预的有效性等角度进行深入探索。     

The Role of Schools in Outcomes for Youth: Implications for Children's Mental Health Services Research

We explore the role of schools in children's mental health services research. Recent literature has suggested that schools play an important role in delivering services to children and adolescents with emotional and behavioral problems. Research in services research, though, has taken a fairly narrow view of which dimensions of school environments are relevant for inclusion in studies. We suggest that a broader view of school environments is appropriate and potentially beneficial to the field. Using Bronfenbrenner's ecological model as a guide, we conceptualize schools as microsystems. Such an approach suggests that all aspects of school environments (treatment as well as non-treatment) are likely to influence many of the outcomes that children's mental health services research frequently targets (e.g., behavioral problems, problematic peer relationships, academic achievement, school attendance). We review literature from a variety of disciplines to suggest relevant features of schools, with particular attention to the role of peer dynamics within schools. We conclude with implications of this expanded conceptualization of schools for children's mental health services research.     

移动社交媒介使用行为对青少年友谊质量的影响:网络自我表露和网络社会支持的中介作用

随着移动智能设备和移动互联网的出现,移动社交媒介已日益成为人们网络活动和人际交往的新平台。为考察移动社交媒介使用行为、网络自我表露、网络社会支持和友谊质量之间的关系,本研究采用问卷法对473名青少年进行了调查。结果发现:(1)移动社交媒介使用行为会对网络自我表露和网络社会支持产生显著的直接正向影响,网络自我表露会对网络社会支持产生显著的直接正向影响,网络社会支持会对友谊质量产生显著的直接正向影响。(2)移动社交媒介使用行为可以通过网络社会支持的中介作用对友谊质量产生显著的间接影响,还可以通过网络自我表露和网络社会支持的链式中介作用对友谊质量产生显著的间接影响。     

The Promotional Role of School and Community Contexts for Military Students

This article examines how supportive public school environments can serve as a promotional context for the development of children and adolescents from military families. The authors integrate theory and research from multiple research strands (e.g., human development, studies of at-risk youth, educational reform, goodness of fit theory, and school climate) to outline how public schools can support the development of all children and adolescents. This article provides further support for the supposition that school climates and the social-ecological contexts surrounding a school (e.g., universities, communities, school districts) have the potential to protect at-risk children and adolescents from an array of negative social, emotional, and psychological outcomes. The authors draw linkages between these research domains and the development of military children and adolescents. Promotional civilian school environments embedded within supportive and inclusive contexts can create a social infrastructure that supports the development of military children and adolescents. The authors argue that this conceptual approach can create a foundation for interventions and research that focuses on schools as normative supportive developmental settings for military children and youth during challenging times of war (e.g., deployments and multiple school transitions). This article concludes with a discussion of future directions in research on the development of military children and adolescents. Based on a heuristic conceptual model that outlines areas needing further research, the authors call for a deeper theoretical and empirical integration of school climate and external contextual factors surrounding the school. Investigating the social and organizational dynamics within these contexts can result in a more comprehensive picture of the development of military children and adolescents.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

“‘Ninja’ levels of focus”: Therapeutic holding environments and the affective atmospheres of telepsychology during the COVID-19 pandemic

The COVID-19 crisis in Australia led to a rapid increase in the use of telehealth services to offer psychological therapy (often referred to as ‘telepsychology’). In this article, we discuss the intersection of the social psychology concepts of therapeutic holding spaces and containment with more-than-human theory as it relates to Australia's mental health sector during the COVID-19 crisis. Drawing on our recent qualitative survey research into Australian psychologists' use of telepsychology during the crisis, we consider the ways that they worked to build and maintain therapeutic holding spaces and alliances over teleconferencing platforms during this extraordinary time of social crisis and isolation. We explore and contextualise three important findings from our study: 1) the limited viewing area of a flat screen makes it difficult for therapists to read and respond to their client's body language and requires different forms of returned bodily gestures in order to show empathy; 2) most respondents implemented different affective and relational strategies online to ensure they were not missing important non-verbal cues from their clients; and 3) the traditionally ‘safe’ therapeutic holding space created in face-to-face therapy can be easily subverted by client-end interruptions, and concerns around safety or personal privacy in the client's home environment. In bringing these issues to the fore, we highlight the online therapeutic holding space as a temporally and socially situated human-technological assemblage in which a series of affective, spatial, relational and sense-making agencies coverage, opening or closing off capacities for therapists and their clients.     

Parasocial Relationships with Media Personae: Why They Matter and How They Differ Among Heterosexual,Lesbian, Gay,and Bisexual Adolescents

Parasocial relationships are social bonds audiences develop with media personae. Parasocial relationships may be particularly meaningful for those who experience obstacles developing real-life social bonds. The objective of this study was to examine parasocial relationships among a relationally vulnerable population by surveying lesbian, gay, and bisexual (LGB) adolescents (n = 106). Heterosexual adolescents (n = 321) were surveyed for comparison purposes. Results suggest that LGB adolescents have more other-gender favorite media personae than heterosexual male adolescents. LGB adolescents were more likely to select LGB media personae as their favorites, particularly if they lacked real-life LGB friends. Repeated media exposure, perceived similarity, and attraction were positively correlated with parasocial relationship strength for all adolescents, but loneliness contributed to parasocial relationship strength for LGB adolescents only. LGB adolescents were more likely to report their favorite media personae as important sources of information on a range of issues related to socialization. Though previous research suggests that parasocial relationships supplement real-life social relationships, parasocial relationships may be compensatory for LGB adolescents attempting to fill a relational void left by the absence of real-life LGB peers. Scholars must better dissect parasocial relationships with media characters when considering media’s influence on special populations like LGB adolescents.     

Mothers’ and Adolescents’ Perceptions of Family Environment and Adolescent Social-Emotional Functioning

Research has emphasized the importance of the relationship between family functioning and adolescent behavioral development. The present study examines family environment and social-emotional functioning of primarily minority adolescents, viewed from both adolescents’ and mothers’ perspectives. Participants were a school-based sample of adolescents with and without risk for emotional and behavioral disabilities and their mothers (N = 86 dyads). Results suggested an association between the mothers’ views of their adolescent children’s problem behaviors and the adolescents’ self-ratings of risk-taking behaviors across 5 years. Overall, mothers of the at risk youth receiving special education services reported higher ratings of youth problem behaviors, but results also indicated that mothers of the at risk adolescent boys not receiving special education services perceived greater depressive symptoms in their children and more family conflict in their homes. Mothers of youth at risk but not receiving special education services experienced higher levels of stress associated with being a parent than mothers of the not-at-risk adolescents. The parent measures of adolescent behavior and depressive symptoms, family conflict, and parental stress were not predictive of the social-emotional functioning of these adolescents in the multilevel models. Implications of these findings for early identification and family focused intervention programs are discussed.     

Developing a Brief Sensation Seeking Scale for Children: Establishing Concurrent Validity With Video Game Use and Rule-Breaking Behavior

Despite the importance of life-cycle models to sensation seeking research, past studies have typically focused on adolescents and adults. This is especially problematic for researchers studying the role of media use in the development of risky behaviors (e.g., violent video game consumption and aggressive behavior). To facilitate research with child populations, a brief sensation seeking scale for children (BSSS-C) is developed and validated with a sample of fourth, fifth, and sixth graders (N = 136). The BSSS-C is found to be internally reliable (α = .82) as well as a strong predictor of several risky child behaviors. Higher sensation seeking children were more likely to play video games, including violent subgenres (e.g., shooters), and to enjoy playing video games that contained specific acts of violence (e.g., weapon use). Higher sensation seekers were also more likely to engage in rule-breaking behavior, such as bringing prohibited cell phones to school. The results suggest that sensation seeking may be related to risky behavior at a very young age.     

United we stand, divided we fall: the education and training needs of clinical child psychologists

Reviews efforts to delineate training needs for psychologists who are providing clinical services to children, adolescents, and families. In particular, this article (a) describes efforts of clinical child and other psychologists who work with children, adolescents, and families to develop education and training guidelines; (b) discusses the overlap among various child and adolescent providers within psychology; and (c) highlights several key competencies that have been identified as important for all psychologists in practice roles with children and adolescents. In particular, we emphasize the need for greater collaboration and integration among various psychological specialties that focus on children, adolescents, and families and for greater system-wide discussion of training needs and priorities.     

iCOPE With COVID-19: A Brief Telemental Health Intervention for Children and Adolescents During the COVID-19 Pandemic

The COVID-19 pandemic has prompted extensive disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase in anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care was initially reduced, causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.     

Israeli adolescents' coping strategies in relation to terrorist attacks

Exposure to terrorism seriously threatens the well-being of children and adolescents. Israeli citizens have witnessed massive ongoing terrorist attacks during the last few years. The present research, conducted among 330 Israeli adolescents, examined coping strategies in relation to terrorist attacks. We found that adolescents utilize more productive than non-productive coping strategies when dealing with terrorist attacks. Moreover, they rarely seek professional help. Male adolescents use more non-productive coping strategies and female adolescents seek more social support as a coping strategy. The impact of exposure to media reports and life satisfaction on adolescents' use of coping strategies is discussed, and potentially effective approaches to coping with terrorist attacks are proposed.     

Children’s and Adolescents’ Conceptions of Happiness at School and Its Relation with Their Own Happiness and Their Academic Performance

Previous research on children’s and adolescents’ well-being at school has been focused on the possible determinants. However, no previous research has analysed children’s and adolescents’ lay-beliefs or conceptualizations of happiness at school. In the present work, we studied children’s (N = 104, 9–10-year-olds) and adolescents’ (N = 113, 15–16-year-olds) conceptualizations of happiness at school and its link with self-reported happiness (assessed 3 months later) and academic achievement (assessed 7 months later). For both samples, seven conceptualizations emerged: happiness as ‘being with friends’, ‘being praised’, ‘getting good grades’, ‘learning’, ‘leisure’, ‘enjoyment’, and ‘helping’. Age differences appeared for the conceptualizations of ‘being friends’ and ‘helping’, as children mentioned significantly more the former and adolescents the latter. No gender differences emerged. For adolescents, the conceptualizations of happiness at school as ‘being with friends’, ‘being praised’, ‘helping’, and not ‘having leisure time’ were positively related to self-reported happiness, which was positively related to academic achievement. For children, none of the conceptualizations were positively related to self-reported happiness. The conceptualization of happiness as ‘learning’ was positively related to academic achievement. The results are discussed in regards to their implications for children’s and adolescents’ well-being at school.     

How to Fix Peer Review: Separating Its Two Functions—Improving Manuscripts and Judging Their Scientific Merit—Would Help

Adequate access to child and adolescent mental health services for young people in high need populations is an important concern of service systems researchers and program evaluators. We present results of a statewide study of access to community mental health services for eight populations of special concern. The analysis relied exclusively on existing databases in conjunction with innovative statistical techniques to provide comprehensive measures of access to care. Our findings indicate that access to care varied substantially across special populations, although children and adolescents in each of our eight “special populations” had greater access to public mental health services than members of the general population of the state. The interpretation of the findings and directions for future research are discussed.Reprinted with permission from The Scientist. Originally published in the June 6, 2005 issue of The Scientist (www.the-scientist.com).     

Use of interactive voice response (IVR) technology in health research with children

This article reports on the feasibility of using interactive voice response (IVR) technology to obtain daily reports of attitudes toward alcohol and tobacco use among children 9–13 years of age. Two studies were conducted. The first was an investigation of the use of IVR technology to obtain daily data from a sample of primary school children over a period of 8 weeks. The second was an extension of the research to a large sample of primary and secondary school children in urban and rural areas who provided daily data over a 4-week period. Retention and compliance rates comparable to those obtained with adults were evident in both studies, supporting the feasibility of this technology with children. The results are discussed in relation to the benefits of this methodology for health research, particularly for studies of sensitive topics conducted with children and adolescents.     

Guided Internet-Based CBT for Common Mental Disorders

The Internet has become a part of most people’s lives in many parts of the world. Since the late 1990s there has been an intensive research activity in which psychological treatments, such as cognitive behavior therapy (CBT), have been found to be effective when delivered via the Internet. Most research studies indicate that the effects are larger when some form of guidance is provided from a therapist, and unguided treatments tend to lead to more dropout and smaller effects. Guided Internet treatments often consists of book length text materials, but can also include other components such as audio files and video clips. Homework assignment is often included and feedback is given for completed homework. Guided Internet-based CBT (iCBT) has been found to work for problems such as depression, panic-, social anxiety-, and generalized anxiety disorders. There are many research trials in which participants have been recruited via media, and there has been less research conducted in representative clinical settings. Most research has been conducted on adults and in university settings with nationwide recruitment. There is a need for treatments and studies on older adults, children and adolescents. In conclusion, dissemination of the research findings on guided iCBT to regular clinical settings is warranted.