Practitioners’ perspectives on the use of clinical supervision in their therapeutic engagement with asylum seekers and refugee clients

The present study is the first study undertaken in Australia that seeks to explore practitioners’ perspectives on the use of clinical supervision in their therapeutic engagement with asylum seekers and refugees. We used thematic analysis to analyse extracts of interviews that were conducted with nine professionals who worked therapeutically with asylum seekers and refugees and had experience of participating in individual and peer supervision. The findings of the study suggest that supervision encouraged practitioners to develop multicultural awareness and explore therapeutic ways of working that are compatible with their clients’ frame. In addition, supervision provided the context in which practitioners explored the impact of the asylum legislative framework on their clinical work and reflected upon their feelings of powerlessness and political impotence. Implications for practice that derive from supervisory needs of practitioners who work with asylum seekers and refugees are explored.     

The housing situation of refugees in Montréal three years after arrival: The case of asylum seekers who obtained permanent residence

This article presents the results of a secondary analysis of the housing-related variables contained in a survey of the settlement experiences of some 400 regularized refugee claimants living in Greater Montréal. It examines housing as a vector of settlement and integration, as well as the related neighbourhood context. The data indicate that the refugees are relatively well housed in terms of dwelling quality, but spend inordinately high percentages of their income on rent, essentially because of their low incomes. More optimistically, the refugees have access to social support from within their ethnolinguistic group, and in their neighbourhoods they are not isolated from the majority cultural groups of Québec society.     

Why do citizens want to keep refugees out? Threats,fairness and hostile norms in the treatment of asylum seekers

A social identity framework was employed to understand why people support the exclusionary treatment of refugee claimants (‘asylum seekers’) in Australia. Over and above individual difference effects of social dominance orientation and individuals' instrumental threat perceptions, insecure intergroup relations between citizens and asylum seekers were proposed to motivate exclusionary attitudes and behaviour. In addition, perceived procedural and distributive fairness were proposed to mediate the effects of social identity predictors on intergroup competitiveness, serving to legitimise citizens' exclusionary behaviours. Support for these propositions was obtained in a longitudinal study of Australians' social attitudes and behaviour. Small and inconsistent individual‐level effects were noted. In contrast, after controlling for these variables, hostile Australian norms, perceived legitimacy of citizen status, and threatening socio‐structural relations were strongly and consistently linked to intentions to support the harsh treatment of asylum seekers, and exclusionary attitudes and action at Time 2. Moreover, perceived procedural and distributive justice significantly mediated these relationships. The roles of fairness and intergroup socio‐structural perceptions in social attitudes and actions are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

An exploratory study of psychodynamic therapists’ working with people with multiple sclerosis

There is little published on working psychodynamically with chronic illness and even less on the clinical insights of therapists working with people with multiple sclerosis. The objective of this study was to consider therapists’ reflections on the impact of multiple sclerosis on the internal worlds of clients with multiple sclerosis. I would also like to think about the challenges multiple sclerosis presents and how these challenges are worked with therapeutically. Finally, the impact of my multiple sclerosis diagnosis upon the research interviews was considered. Twelve counsellors / psychotherapists who had experience of working with clients with multiple sclerosis were interviewed. Data was analysed thematically and the findings revealed a number of significant themes. Denial appeared significant both for those with multiple sclerosis and those therapists working with them. Therapists also identified that people with multiple sclerosis hold a range of conscious and unconscious feelings in relation to their multiple sclerosis. Also, the meanings and impact of multiple sclerosis are broad and idiosyncratic. Therapists also faced a number of challenges in their work with people with multiple sclerosis: powerful countertransference feelings which could disable the therapy, embodied countertransference, the tendency to make generalisations, the physical reality of multiple sclerosis and its impact upon continuity, therapists’ unconscious phantasy and associations which if unaddressed could impact their ability to work with illness and the pressure multiple sclerosis placed on therapeutic boundaries. Therapists within the study recognised the need to work with both the physical reality of multiple sclerosis, as well as its psychological impact while at the same time keeping themselves open to powerful countertransference feelings and using them in the service of the therapy. The study has implications for theory, practice and future research.     

Are practitioners incorporating a strengths‐focused approach when working with multi‐problem poor families?

Multi‐problem poor families have been characterized as dysfunctional and chaotic, and problem‐centred interventions have been developed. However, the activation of families' strengths has shown itself to be an important tool for intervention, hence the relevance of promoting the incorporation of a strengths‐focused approach. So, it becomes important to determine to what extent practitioners are thinking of incorporating a strengths‐focused approach when working with these families. To achieve this goal, a semi‐structured interview was administered to 23 practitioners. The findings suggest that practitioners are able to identify strengths but do not think in a strengths‐focused way. The main obstacles are: ambiguity in the definition of strengths, a focus on problems, lack of confidence in the possibility of improvement in the lives of families. Copyright © 2006 John Wiley & Sons, Ltd.     

Does working memory change with age? The interactions of concurrent articulation with the effects of word length and acoustic confusion

ABSTRACT

The effects of acoustic confusion (phonological similarity), word length, and concurrent articulation (articulatory suppression) are cited as support for Working Memory's phonological loop component (e.g., Baddeley, 2000 Baddeley, A. D. 2000. The phonological loop and irrelevant speech effect: Some comments on Neath. Psychonomic Bulletin and Review, 7: 544–549. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar], Psychonomic Bulletin and Review, 7, 544). Research has focused on younger adults, with no studies examining whether concurrent articulation reduces the word length and acoustic confusion effects among older adults. In the current study, younger and older adults were given lists of similar and dissimilar letters (Experiment 1) or long and short words (Experiment 2) for immediate serial reconstruction of order. Items were presented visually or auditorily, with or without concurrent articulation. As expected, younger and older adults demonstrated effects of acoustic confusion, word length, and concurrent articulation. Further, concurrent articulation reduced the effects of acoustic confusion and word length equally for younger and older adults. This suggests that age-related differences occur in overall performance, but do not reflect an age-related deficiency in the functioning of the phonological loop component of working memory.     

The effects of the constancy of location and order in working memory visual–phonological binding of children with dyslexia

It has been suggested that children with dyslexia have difficulties in visual–phonological working memory (WM) binding, supporting the hypothesis that this ability is crucial in the formation of associations between written forms and phonological codes required by reading. However, research on this topic is currently scarce and has not clarified to what extent binding may be supported by spatial and temporal information. The present study examined visual–phonological WM binding performance in a group of children with dyslexia compared to a control group of typically developing children matched for age, gender, and grade. Children had to memorize ephemeral associations between meaningless shapes and nonwords, with stimuli presented in either fixed or variable spatial locations, and in either fixed or variable temporal order across trials; performance was assessed using a recognition task. Results showed that children with dyslexia have a deficit in visual–phonological WM binding in every presentation condition and that, unlike control children, they are not able to use fixed spatial locations as an aid to bind information. Crucially, however, children with dyslexia still benefit from the presentation of stimuli in a fixed temporal order. These findings support the hypothesis that a WM binding deficit is crucial in children with dyslexia, and have potential implications for treatment strategies.     

Mirroring patients – or not. A study of general practitioners and psychiatrists and their interactions with patients with depression

For mentalization theorists, implicit mentalization is a key component of all forms of therapy. However, it has been difficult to grasp and to describe precisely how implicit mentalization works. It is said to take place partly by mirroring others in posture, facial expression and vocal tone. Based on studies of imitative behaviour within linguistics and psychology, we argue that interactional mirroring is an important aspect of displaying implicit mentalization. We aimed to explore if, and in that case how, mirroring is displayed by general practitioners (GPs) and psychiatrists in consultations with patients with depression. We wanted to see how implicit mentalizing unfolds in physician–patient interactions. Consultations were video-recorded and analysed within the framework of conversation analysis. GPs and psychiatrists differed substantially in their propensity to mirror body movements and verbal and acoustic features of speech. GPs mirrored their patients more than psychiatrists in all modalities and were more flexible in their interactional behaviour. Psychiatrists seemed more static, regardless of the emotionality displayed by patients. Implicitly mirroring and attuning to patients could signify enactment of implicit mentalization, according to how it is described by mentalization theorists. We discuss reasons for the differences between GPs and psychiatrists, and their implications.     

‘Who owns my pain?’ An aspect of the complexity of working with looked after children

This paper underlines the difficulties of working with looked after children and their carers. The author discusses a particular approach to respond to the complexity of looked after children's emotional difficulties, and their impact on the network of professionals making decisions about their life in care. As their own parents are no longer in a position to take responsibility for them, their trauma and past abuse make for a lack of clarity amongst this network when establishing the responsible role in loco parentis. In order to provide effective therapeutic work with these children, it is crucial to consider their disturbance as affecting the network around them. Enabling the network to understand and process powerful feelings around the child enhances its self-reflective function, so crucial for thinking about the child's needs and emotional development.     

Counsellors’ and psychologists’ experience of working with male survivors of sexual trauma: a pilot study

A qualitative study was undertaken to enhance awareness of the therapeutic needs of the male survivor of sexual trauma through exploration of counsellors’ and psychologists’ experience of working with this client group. The participants were 32 counsellors and psychologists who work for an NHS Trust department. Interpretative Phenomenological Analysis was used to analyse the data which was gathered by means of a postal questionnaire. Six categories emerged from the analysis that highlighted prevalent experience. These were: (a) that the therapist's gender was important, (b) professional concerns, (c) the importance of the relationship, (d) transference/counter transference, (e) that male and female abusive experiences are the same and (f) attention to client's presenting problems. The main conclusions derived from these results and implications for practice are considered.     

Is working memory still working?

The current state of A. D. Baddeley and G. J. Hitch's (1974) multicomponent working memory model is reviewed. The phonological and visuospatial subsystems have been extensively investigated, leading both to challenges over interpretation of individual phenomena and to more detailed attempts to model the processes underlying the subsystems. Analysis of the controlling central executive has proved more challenging, leading to a proposed clarification in which the executive is assumed to be a limited capacity attentional system, aided by a newly postulated fourth system, the episodic buffer. Current interest focuses most strongly on the link between working memory and long-term memory and on the processes allowing the integration of information from the component subsystems. The model has proved valuable in accounting for data from a wide range of participant groups under a rich array of task conditions. Working memory does still appear to be working.     

“Playful” therapy: working with autism and trauma

This paper proposes that psychoanalytic psychotherapy can be a helpful form of treatment for certain autistic children. Some of the misconceptions surrounding this kind of treatment are discussed. The literature identifying a particular sub‐group of autistic children is then reviewed and the characteristics of this group, and the relationship of their difficulties to early trauma, are described. Using clinical material from work with a child who probably fell within this sub‐group, and who had very marked autistic features, the paper illustrates the importance of the therapist taking an active role in the therapy and how this helped the child to emerge from his withdrawn state. Particular emphasis is placed on the importance of introducing themes of aggression, and of this being done in a playful way. The impact of trauma on children's development, with particular reference to the acquisition of language, is considered. The role of sibling rivalry as a factor is emphasised.     

Identification of scientists making long‐term,high‐impact contributions,with notes on their methods of working

A two decade (1958–1978) study was made of 40 male scientists, including four Nobel Prize winners. Multiple psychological tests were administered, along with interviews and analysis of publication rates and citations. The data yielded two factors that had very high predictive ability for identifying long‐term, high‐impact investigators: a series of five or more high‐impact papers published by the age of 45 accompanied by simultaneous involvement in research in several areas. Scientists meeting these criteria all went on to produce high‐impact papers into their late‐50s and 60s, whereas the other scientists in the study did not. Other factors, such as number of publications, membership in the National Academy of Sciences, and the award of a Nobel Prize were not significantly predictive of continued impact. Thus, previous impact should not be used as a basis for further funding independent of other measures. Methods of working peculiar to long‐term, high‐impact individuals, such as frequent changes in the focus of their research, working on several problems simultaneously, and abhorrence of administrative duties, are also examined in light of Gruber's concept of networks of enterprise. The common preconceptions that a scientist's best work is done by the age of 40 and that productivity and creativity decline necessarily thereafter are shown to be common but unnecessary concomitants of aging. Possible reasons for exceptional cases are discussed.     

Does working memory training promote the use of strategies on untrained working memory tasks?

Adaptive computerized training has been associated with significant enhancements in untrained working memory tasks, but the nature of the cognitive changes that underpin these improvements are not yet fully understood. Here, we investigate the possibility that training stimulates the use of memory-related strategies. In a randomized controlled trial, participants completed four tests of working memory before receiving adaptive working memory training, nonadaptive working memory training with low memory loads, or no training. Open-ended interviews about strategy use were conducted after the administration of untrained working memory tasks at two time points. Those in the adaptive and nonadaptive groups completed the assessments before (T1) and after (T2) 10 training sessions. The no-training group completed the same set of tasks at T1 and T2, without any training between assessment points. Adaptive training was associated with selective improvements in untrained tests of working memory, accompanied by a significant increase in the use of a grouping strategy for visuospatial short-term memory and verbal working memory tasks. These results indicate that training-related improvements in working memory may be mediated by implicit and spontaneous changes in the use of strategies to subsegment sequences of information into groups for recall when the tasks used at test overlap with those used during training.     

Australian speech-language pathologists’ experiences and perceptions of working with children who stutter: A qualitative study

PurposeEffective early intervention is recommended to ameliorate the potential long term negative effects of stuttering. Efficacious treatments are available, but speech-language pathologists (SLPs) report finding implementation to be challenging due to a range of clinician, client and clinical context factors. Previous survey-based research has found that SLPs lack self-efficacy working with CWS, however the reasons contributing to this are not well understood. This study presents the first in-depth analysis of the current practices and perceptions of SLPs working with children who stutter (CWS).MethodsIn this qualitative study 18 Australian SLPs who provide services to CWS were interviewed using a semi-structured interview approach. Data were analysed using reflexive thematic analysis.ResultsThe thematic analysis identified four themes: (1) A stronger sense of self-efficacy is needed in stuttering management compared to other areas of clinical practice; 2) SLPs’ sense of self-efficacy in stuttering management is influenced by early career experiences, client factors and the practice context; 3) Professional development and collaboration strengthen self-efficacy; and 4) Parental involvement and engagement are crucial to treatment success.ConclusionSLP self-efficacy for working with CWS appears a critical factor in the provision of effective management for this population. This study provides an in-depth analysis of the role of SLP self-efficacy and the factors that influence it.     

Do objects in working memory compete with objects in perception?

It is generally assumed that “perceptual object” is the basic unit for processing visual information and that only a small number of objects can be either perceptually selected or encoded in working memory (WM) at one time. This raises the question whether the same resource is used when objects are selected and tracked as when they are held in WM. In two experiments, we measured dual-task interference between a memory task and a Multiple Object Tracking task. The WM tasks involve explicit, implicit, or no spatial processing. Our results suggest there is no resource competition between working memory and perceptual selection except when the WM task requires encoding spatial properties.     

Does working memory training lead to generalized improvements in children with low working memory? A randomized controlled trial

Children with low working memory typically make poor educational progress, and it has been speculated that difficulties in meeting the heavy working memory demands of the classroom may be a contributory factor. Intensive working memory training has been shown to boost performance on untrained memory tasks in a variety of populations. This first randomized controlled trial with low working memory children investigated whether the benefits of training extend beyond standard working memory tasks to other more complex activities typical of the classroom in which working memory plays a role, as well as to other cognitive skills and developing academic abilities. Children aged 7–9 years received either adaptive working memory training, non‐adaptive working memory training with low memory loads, or no training. Adaptive training was associated with selective improvements in multiple untrained tests of working memory, with no evidence of changes in classroom analogues of activities that tax working memory, or any other cognitive assessments. Gains in verbal working memory were sustained one year after training. Thus the benefits of working memory training delivered in this way may not extend beyond structured working memory tasks.     

Do new ways of working foster work engagement?

Although New Ways of Working (NWW) are increasingly implemented in organizational practice, few studies have addressed its pros and cons for employee outcomes. NWW enable employees to choose when and where to work, while being supported by electronic communication. We examined the effects of NWW on work engagement and exhaustion, and investigated whether communication quality mediated these relationships. The results of a five-day diary study (n= 550) showed that daily use of NWW was positively related to daily engagement and negatively to daily exhaustion due to increased effective and efficient communication. In addition, NWW enhanced connectivity among co-workers, resulting in enhanced daily engagement and reduced exhaustion. However, we also found a positive relationship between NWW and exhaustion, because NWW increased interruptions during the work process. Although some caution is needed, we conclude that NWW have the potential to foster work engagement.     

Internal state of emergency – working with an international student suffering from trauma in a student counselling service

In this paper I look at the suicidal state of mind of an international student who comes from a country at war and has been traumatized by a violent event. The student is tortured by an internal dilemma surrounding unbearable feelings of guilt and shame that arise when she leaves her home country to study abroad. Her dilemma or survivor guilt triggers an internal contract with herself, whereby she is internally persecuted when she makes an attachment to the university and her course. I suggest that an individual in this state of mind, suffering from post-traumatic stress, has regressed to a primary state of unintegration where the self is at the mercy of psychotic anxieties and the student is at risk of suicide. It is suggested that a safety net made up of the student services and the wider health service can provide a symbolic or mental space and containment for the student's state of mind until she can function as a student.