Evidence‐Based Effective Practices With Older Adults

Older persons constitute an increasingly large population with significant mental health challenges. The authors review outcome research for both diagnosable conditions and late‐life transitions as a basis for evidence‐based practice with this population. Implications for clinical practice in professional counseling, counselor education and supervision, and research are considered.     

A Mental Imagery Intervention to Increase Future Self‐Continuity and Reduce Procrastination

This research examined how mental imagery practice can increase future self‐continuity to reduce procrastination. A total of 193 undergraduate students were randomly assigned to a present‐focused meditation or to a future self‐focused mental imagery condition. Participants in both conditions were asked to listen to their respective audio recording twice per week for four consecutive weeks and to complete a pre‐intervention, half‐point, and post‐intervention questionnaire. At the four‐week mark, hierarchical regression analyses revealed that both future self‐continuity and empathic perspective taking were significantly higher for the mental imagery condition than the meditation condition. While vividness of future self moderated change in future self‐continuity, affective empathy for future self mediated the relation between vividness of future self and future self‐continuity. Lastly, only empathic perspective taking was a significant moderator of change in procrastination across time. The influence of empathy and future self‐continuity on procrastination is discussed.     

Treating Adults With Complex Trauma: An Evidence‐Based Case Study

This article presents an overview of complex trauma and a case study describing the evidence‐informed treatment of a 25‐year‐old woman with chronic complex trauma symptoms resulting from childhood sexual, physical, and psychological abuse from a caregiver. Treatment followed a relationship‐based, cognitive behavior therapy model across 3 treatment phases. Significant reductions in trauma and general distress symptoms occurred from pre‐ to posttreatment, although firm conclusions about cause cannot be drawn from case studies. Verbatim vignettes illustrate specific interactions.     

Attachment to the Nation and International Relations: Dimensions of Identity and Their Relationship to War and Peace

Since the rise of mass politics, the role national identities play in international relations has been debated. Do they produce a popular reservoir easily tapped for war or bestow dignity thereby fostering cooperation and a democratic peace? The evidence for either perspective is thin, beset by different conceptions of identity and few efforts to identify its effects independent of situational factors. Using data drawn from new national surveys in Italy and the United States, we advance a three‐dimensional conception of national identity, theoretically connecting the dimensions to conflictive and cooperative dispositions as well as to decisions to cooperate with the United Nations in containing Iran's nuclear proliferation and Sudan's humanitarian crisis in Darfur. Attachment to the nation in Italy and the United States is found to associate with less support for militarist options and more support for international cooperation as liberal nationalists expect. This depends, however, on containing culturally exclusive conceptions of the nation and chauvinism.     

Self‐Stigma of Mental Illness and Help Seeking Among School Counselors

The authors reported the findings from a correlational investigation examining the relationship between school counselors' (N = 333) self‐stigma of mental illness, help‐seeking behaviors, burnout, stress, and life satisfaction. The authors used a path analysis to test a hypothesized causal framework that self‐stigma of mental illness contributed to help‐seeking behaviors, which contributed to stress and burnout. The findings showed that the data fit the hypothesized model. The authors discuss the implications of the findings.     

Counseling and Guided Self‐Help Outcomes for Clients With Bulimia Nervosa: A Meta‐Analysis of Clinical Trials From 1980 to 2010

This meta‐analysis included 111 clinical trials exploring the effectiveness of counseling/psychotherapy and guided self‐help approaches in the treatment of bulimia nervosa. In general, single‐group studies supported higher efficacy of counseling/psychotherapy, whereas wait‐list, treatment‐as‐usual, and placebo studies indicated both approaches were equally effective at termination (posttest) and follow‐up in altering binging, purging, laxative use, and self‐reported bulimia or body dissatisfaction perceptions in nearly all comparisons.     

Encouraging People With Mood Disorders to Attend a Self‐Help Group1

Using an intervention based on referent power, self‐help sponsors sought to encourage attendance at self‐help meetings. They encouraged patients with major depression or bipolar disorder to attend self‐help meetings following their hospitalizations. The intervention successfully increased the attendance of the experimental group compared to those in the control group. Implications for practice are discussed.     

The Role of Self‐Identity,Past Behavior,and Their Interaction in Predicting Intention to Purchase Fresh and Processed Organic Food1

This study examined the impact of moral norms, self‐identity, and past behavior on intention to buy organic tomatoes and organic tomato sauce, using the theory of planned behavior (TPB). The questionnaire, which included measures of attitudes, subjective norm, perceived behavioral control, moral norms, past behavior, and self‐identity was completed by approximately 500 people for each food. Multiple regressions showed that for both foods, moral norms and self‐identity added significantly to the prediction of intention over and above the other variables, even when the effect of past behavior was included. There was some evidence of past behavior moderating the self‐identity/intention relationship for processed organic tomato sauce, but not for fresh organic tomatoes. Implications of the findings are discussed.     

Self‐Stigma,Mental Health Literacy,and Attitudes Toward Seeking Psychological Help

This study examined self‐stigma of seeking psychological help and mental health literacy as predictors of college students’ (N = 1,535) help‐seeking attitudes, with additional attention to psychological and demographic correlates. Results indicated that mental health literacy predicted help‐seeking attitudes above and beyond self‐stigma. Asian American race/ethnicity, male gender, current psychological distress, and help‐seeking history were also significant predictors. Implications for addressing mental health literacy and self‐stigma while attending to demographic and psychological variations in help seeking are discussed.     

Using Real‐World and Standardized Spatial Imagery Tasks: Convergence,Imagery Realism,and Gender Differences

Can realistic spatial scenarios be used to measure spatial mental imagery? Can people accurately evaluate their spatial imagery? Does gender moderate the relationship between performance on realistic spatial imagery tasks and ratings of imagery realism? Forty‐two female and 31 male undergraduates first rated the realism of their images after reading spatial scenarios based on actual spatial tasks. In phase 2, they solved closely related spatial scenario problems, and then completed the VZ‐2 Paper Folding test. Performance on realistic spatial scenarios predicted performance on the VZ‐2. Men's evaluation of their spatial imagery realism predicted their actual spatial performance, but women's did not. More task experience was positively related to more realistic images and higher scores on the VZ‐2. These results were generally consistent with those found with more artificial stimulus materials, but also demonstrated the importance of considering gender differences in spatial problem strategy and/or rating scale interpretation. Copyright © 2014 John Wiley & Sons, Ltd.     

Peace,Self‐Determination and Reckoning with the Past: A Reply to Butt,Lippert‐Rasmussen,Pasternak, Wellman and Stemplowska

In this article, I offer responses to five commentaries on my recently published book, Cosmopolitan Peace. Those articles address my conception of individual and collective agency, my account of self‐determination (and its implication for the problem of annexation during and after the war), and my accounts of, respectively, reparations and remembrance after war. I revise or provide further defences of those accounts in the light of my commentators’ probing remarks.     

Depression and Anxiety in Older and Middle‐aged Adults With Diabetes

This study aims to compare rates of depressive and anxious symptoms among older adults with and without diabetes. The study also examines differences in depression, anxiety, and diabetes‐related emotional distress between middle‐aged and older adults with diabetes. A total of 224 participants completed a range of questionnaires measuring depression, anxiety, and diabetes‐related emotional distress (if applicable). One hundred and three adults with diabetes (55 middle‐aged, mean age = 47 years, range 40–59 years and 48 older, mean age = 69 years, range 60–81 years) were recruited from a tertiary diabetes clinic. One hundred and twenty‐one adults without diabetes (72 middle‐aged, mean age = 52 years, range 40–59 years and 49 older, mean age = 65 years, range 60–76 years) were recruited from either a university student pool or a registry of adults aged 50 and above. Older adults with diabetes had significantly higher levels of depression and comparable levels of anxiety with older adults without diabetes. Older adults with diabetes had significantly lower levels of depression, anxiety, and diabetes‐related distress than middle‐aged adults with diabetes. Diabetes is associated with high rates of depression and anxiety, with middle‐aged adults more adversely affected than older adults.     

God,Purpose in Life,and Mental Well‐Being Among Older Adults

This research note uses mixed methods on data from a nationwide sample of 1,525 Americans age 40 and older to make two theoretical contributions to the literatures on purpose and religion. First, by categorizing open‐ended responses to an item asking “Please describe a few of the things, feelings, ideas, etc. that give you a sense of purpose in your life,” we present a categorization framework to group sources of purpose (SPs) in life. Next, we run multivariate models, using mental well‐being as a dependent measure, which simultaneously enter dummy variables reflecting each of the SPs categories within our framework. We hypothesize no relative differences in the effect that any specific source of purpose category would have on mental well‐being. This prediction is undercut by finding a positive link between mental well‐being and a single SP—citing one's “relationship with God”—although this relationship is noted only among respondents age 60 and older. Beyond this research's theoretical contributions, we offer some practical guidance in arguing that research on SPs, particularly when claiming comprehensiveness or examining mental well‐being, should not preclude religious measures and should consider that SPs may have differing effects between age groups.     

Emotion Regulation of Events Central to Identity and Their Relationship With Concurrent and Prospective Depressive Symptoms

Dispositional emotion regulation is related to the severity and maintenance of depressive symptoms. However, whether emotion regulation specific to an event highly central for an individual’s identity is predictive of depressive symptoms has not been examined. Nonclinical participants (N = 220) reported the extent to which they employed a selection of emotion regulation strategies when recalling low- and high-centrality events. Dispositional emotion regulation and depressive symptoms were also assessed. A 7-week follow-up was conducted. High-centrality events were associated with more emotion regulation efforts. Greater brooding and expressive suppression in relation to high-centrality memories predicted concurrent depressive symptoms after controlling for event valence and dispostional emotion regulation. Effects were absent for low-centrality memories. Emotion regulation in response to high-centrality memories did not predict depressive symptoms at follow-up beyond baseline depressive symptoms. Overall, the findings showed that maladaptive emotion regulation in response to memories of high-centrality events is important for explaining depressive symptomatology.     

Adults With Attention‐Deficit/Hyperactivity Disorder: Assessment and Treatment Strategies

Attention‐deficit/hyperactivity disorder (ADHD) among adults is characterized by inattentiveness and impulsivity. This article provides counselors with information about the etiology, assessment, and treatment of adult ADHD. The identification of the genetic and neurological features of ADHD has led to improvements in evaluation and treatment. Assessment of ADHD requires knowledge of the defining characteristics, subtypes, comorbid features, and functional aspects of ADHD. Effective treatments include both medical management and counseling to address psychosocial deficits.     

Patient Responsiveness to a Sleep and Circadian Intervention in a Sample of Adults With Serious Mental Illness

Understanding patient responsiveness, a component of fidelity, is essential as it impacts treatment outcome and ongoing use of treatment elements. This study evaluated patient responsiveness—operationalized as receptivity to treatment modules and ratings of the usefulness and the utilization of treatment elements—to the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in a sample of adults with serious mental illness (SMI) and sleep/circadian dysfunction. Adults with SMI and sleep/circadian dysfunction (N = 104) received TranS-C in a community mental health setting. Independent raters rated TranS-C sessions to assess receptivity. At posttreatment and 6-month follow-up, participants completed a usefulness scale, utilization scale, the PROMIS Sleep Disturbance (PROMIS-SD) and Sleep-Related Impairment (PROMIS-SRI) scales, DSM-5 Cross-Cutting Measure (DSM-5-CC), and Sheehan Disability Scale (SDS). Receptivity was rated as somewhat to fully understood, and predicted a reduction on the DSM-5-CC. On average, participants rated TranS-C as moderately useful and utilized treatment elements occasionally. Ratings of usefulness were associated with the PROMIS-SD, PROMIS-SRI, and DSM-5-CC at posttreatment, but not with the SDS. Ratings of utilization were not associated with outcome. The findings add to the literature on patient responsiveness, an implementation outcome, and provide data on the utility of TranS-C within a community mental health setting.     

Ethnic Identity in Emerging Adults in Sub‐Saharan Africa and the USA,and Its Associations with Psychological Well‐Being

Ethnic identity as a social dimension of identity is argued to be developmentally important for psychological well‐being. However, the relationships between these constructs are mainly examined in Western contexts, amongst dominant–non‐dominant groups. We investigate ethnic identity across the mainstream group of a prototypical Western society (the USA) and several multi‐ethnic sub‐Saharan African countries (Cameroon, Kenya, South Africa, and Zambia), as well as how it relates to psychological well‐being. A total of 1255 university students (61.8% females, M_age = 20.94 years, SD = 2.97) completed a questionnaire with ethnic identity and psychological well‐being measures. Results indicated that ethnic identity was most salient in two different South African ethnocultural samples and least salient in a mainstream US sample. These results suggest that groups that are more exposed to ethnic strain in multicultural societies tend to have more salient ethnic identities. Furthermore, the underlying structure in the ethnic identity psychological well‐being relationship was similar across groups. Copyright © 2015 John Wiley & Sons, Ltd.     

The Empathy‐Prospect Model and the Choice to Help1

This paper presents a model of the cognitive processes that precede decisions to help another person. The empathy‐prospect model predicts that potential helpers make decisions in much the same way as decision makers in other contexts do (i.e., they evaluate prospects) and that perceptions of need and the empathic reactions and intentions to help that they generate will be stronger for people observing losses rather than gains. The model also predicts that intentions to help should increase when (a) the predicament is serious, (b) money is not involved, or (c) help entails few costs for the potential altruist. The results from 2 experiments provide clear support for these predictions. The findings suggest that (a) the gains or losses of another person contribute to perceptions of that person's needs and feelings of empathy, (b) empathy is the primary proximal determinant of prosocial motivations, and (c) potential losses that are serious accentuate altruistic reactions.     

Why Clinical Psychology Needs to Engage in Community‐Based Approaches to Mental Health

The aim of this article is to advocate for clinical psychology to engage with community‐based approaches to mental health. This engagement will be challenging given community work is antithetical to the individualism that defines much of clinical psychology. It would also result in a direct challenge to the core tenets of our profession, including an emphasis on individualism, psychopathology, and expert‐driven intervention. We need clinical psychology, however, to decolonise itself to respond to the needs of Aboriginal communities and those from non‐Western collectivist cultures. We also need clinical psychology to consider the sociopolitics of human distress and lend itself to social action for complex problems. Specific examples of community‐based practices will be provided, focusing specifically on those that relate to mental health. Implication for the reform of research methodologies and classroom pedagogies will also be discussed.