Clinical Geropsychology: Implications for Practice in Medical Settings

Older adults are a rapidly growing segment of the population, who have high rates of chronic illness and who utilize health care resources heavily. Psychologists must become better prepared to work with older patients in geriatric settings, including geriatric assessment units, memory disorders clinics, and nursing homes. In addition, all psychologists will increasingly encounter older patients in environments such as primary care clinics, rehabilitation settings, and disease management programs focusing on problems that are prevalent in older patients (e.g., cancer, diabetes). Suggestions are offered for adaptation of usual clinical practice to address the special needs of older patients and their families, and recommendations made for advancing and expanding the practice of clinical geropsychology.     

Medical Psychology in Israel

Medical Psychology in Israel has been recently recognized as a separate specialty. Therefore, the thoughts and efforts of our professional community are mainly directed toward defining the concept of medical psychology and developing the field and the profession. In this article I discuss some of these issues and describe present achievements and future prospects.     

Assessing the Clinical Competence of Psychology Students Through Objective Structured Clinical Examinations (OSCEs): Student and Staff Views

Objective Structured Clinical Examinations (OSCEs) are a well‐known, reliable, and valid assessment method used across the healthcare sector. In the present study, we applied OSCEs in three units within professional postgraduate psychology courses, with the broad aims of identifying staff and student perceptions of the assessment. At the conclusion of each OSCE, staff and students completed a feedback questionnaire that contained both scaled and open‐ended questions. Results suggest that clinical psychology OSCEs can be stressful for students, but are also well regarded. Both staff and students felt that the OSCEs were realistic, valid, and aligned well with professional practice. Students reported differences in the way in which they prepared for the OSCEs compared with a written exam or other form of assessment, while staff noted that models of OSCE development must be flexible, to adequately assess the objectives of individual units. Further, because they can be a costly exercise, OSCEs need to be applied judiciously within the tertiary sector.     

Psychology in Medical Settings in Thailand

This article explores the development of psychology as a profession in Thailand, its challenges, and future trends. There are currently very few Thai psychologists who are active in the medical fields in comparison to other health care professions. Being held back by limited education and training, many psychologists see their future career as less than promising. The lack of professional licensing standards and dominance of psychiatry further limit their career advancement. However, tremendous opportunities await those who persevere to expand their roles beyond the traditional assessment, treatment, and research models. A small number of them have ventured out into unexplored territories such as behavioral medicine, AIDS counseling, health promotion, and prevention of mental health problems. There is a strong potential for Thai psychologists to make significant contributions in these areas. It is clear that higher standards of education and more rigorous training are needed if this goal is to be realized in the near future.     

How special are the specialties? Workplace settings in counseling and clinical psychology in the United States

How special are the specialties? Although clinical and counseling psychology each have distinctive origins, past research suggests their potential convergence across time. In a survey of 5666 clinical and counseling psychologists, the similarities and differences between their workplace settings were examined during early-, mid-, and late-career phases to explore the distinctiveness of the two specialties. Overall, clinical and counseling psychologists reported markedly similar workplace settings. However, some significant differences remained; a greater proportion of counseling psychologists reported working in counseling centers, while a greater proportion of clinical psychologists reported working in medical settings. In addition, during late-career, substantially more counseling and clinical psychologists worked in independent practice contexts than in community mental health centers, medical settings, academia, or university counseling centers. Findings are discussed in relation to the ongoing distinctiveness of the two specialties and the implications of this for training and service in the field of professional psychology.     

Morality and Responsibility

Abstract

This paper addresses the need to (1) support the personal moral belief system that each individual brings into the therapy room, (2) help the individual nourish and develop her/his own system of being in the world that is congruent with her/his sense of right, and (3) incorporate a sense of morality and responsibility into the therapy process when it is lacking. Case studies will present the dilemmas that two women faced concerning the conflict they experienced between their responsibility to their families and their responsibility to themselves.     

Inside it was orange squash concentrate: trainees’ experiences of reflective practice groups within clinical psychology training

Despite many clinical psychology training programmes utilising reflective practice groups (RPGs) to develop reflective practice (RP) skills, there remains little research examining how trainees experience these groups. This study uses interpretative phenomenological analysis (IPA) to explore the experiences of eight qualified clinical psychologists who attended RPGs on one United Kingdom (UK) clinical psychology training programme. A purposive sample was recruited for single, semi-structured interviews. Five superordinate themes were identified: ‘The process: there were so many layers’; ‘The impact: an ongoing process’; ‘Commitment: I hated it, but I still went’; ‘The facilitator: a presence who was not always present’; and ‘Getting through it: finding ways to cope’. The findings illustrate the varied and complex experiences of the participants. Whilst the experience was often difficult, the participants were committed to attending and sought out ways to navigate it. The results are conceptualised in terms of existing psychological theory and literature. A critique of the research and suggestions for future studies are offered, including exploring the views of group facilitators and comparing how groups are utilised within different training programmes. Recommendations are made on the development of future RPGs, which include consideration of the facilitation style and the groups’ frequency and size.     

Citizens' Sense of Justice and the Legal System

When an actor commits a wrong action, citizens have perceptions of the kind of responsibility the actor incurs, the degree to which the act was mitigated or justified, and the appropriate punishment for the actor. The legislatively mandated law of criminal courts, statutes, and criminal codes deals with the same issues. Experimental evidence shows that there are important discrepancies between the principles that people and legal codes use to assign responsibility. That is, the moral retributive-justice principles that people use are sometimes in conflict with the directions in which modern code drafters are taking criminal law. These discrepancies may cause citizens to feel alienated from authority, and to reduce their voluntary compliance with legal codes.     

Clinical Psychology in India

Scientific Psychology in India has seen steady development since its inception in the early 1900s. With clinical psychology developing as an independent profession, clinical psychologists have been functioning in various roles, offering a wide range of services in consultation, training, research, and private practice on multidisciplinary teams as well as in independent practice. This paper focuses on the historical roots of clinical psychology in India and highlights the role of clinical psychologists in the general mental health care and the contributions made by the profession in a wide range of public and private health care settings. Ancient Indian systems of Medicine, mental health care and psychotherapy in India, and training-related and organizational issues are discussed. This paper reflects on the growth and development of clinical psychology that has occurred in India in spite of current difficulties and the challenges that lie ahead.     

责任伦理视角下临床决策支持系统的伦理责任考量

从责任伦理的视角,提出临床决策支持系统（clinical decision support system,CDSS）在确保准确性、尊重自主性、保护隐私安全等责任中存在的合作意识缺失、职业责任薄弱、社会责任缺位等伦理责任问题,针对上述问题,通过以人为本、共存共生的责任伦理原则指出CDSS各方承担责任的主要路径,包括增强合作意识提高CDSS准确性、明确医生与开发者职业责任确保CDSS应用的自主性、加强企业社会责任保障隐私保护等,期望为责任相关者更好地承担伦理责任提供思路,为CDSS未来发展提供新的视角。

     

How does crime pay? The differentiation of criminal specialisms by fundamental incentive

Most attempts to determine offence specialisms have not benefited from any formal psychological framework of behavioural differentiation. Bandura's framework (Social foundations of thought and action, 1986) of the fundamental incentives to human action offers an interesting perspective on what might underlie differential patterns of offending. The framework draws attention to the distinction between Material, Power/Status, and Sensory incentives, leading to the hypotheses that crimes which share any one of these incentives will be more likely to be committed by the same person, as revealed through high inter‐correlations, but be less highly correlated with crimes with different fundamental incentives. To test these hypotheses the correlations between 42 offending behaviours as self‐reported by 185 convicted young offenders were examined. A Multidimensional Scaling analysis of the inter‐correlations revealed three distinct styles of offending that could be related to Bandura's Material (Cronbach's α = 0.94), Power/Status (α = 0.90) and Sensory (α = 0.76) incentives. The identification of this psychological basis for the differentiation of criminal styles provides a model for considering offenders' patterns of specialisation which is of value both in clarifying the aetiology of different types of crime and in considering which crimes may be behaviourally equivalent when trying to link them to a common offender or infer offender characteristics from crime scene information. Copyright © 2006 John Wiley & Sons, Ltd.     

Interdivisional Healthcare Committee: Speaking with One Voice on Cross-Cutting Issues in Health Care Psychology

One of the greatest challenges facing psychology in health settings today is the need for unification on critical issues of client access, workforce oversupply, education and training, and outcomes evalutions. Health care psychology specialty areas can no longer afford to operate in parallel. A unified vision is needed to overcome threats to the viability of the profession and to maximize the potential for achieving common goals. The current paper describes the formation of the Interdivisional Healthcare Committee (IHC), whose purpose is to establish a common agenda for promoting the professional, educational, and scientific goals of health care psychology. The IHC's initiative to develop new CPT codes for increasing access to psychologists' services in health care settings is outlined.     

Clinical psychologists' attitudes to lesbians

This study begins the process of examining clinical psychologists' competence in dealing with lesbian clients by assessing their attitudes to lesbians and lesbianism. Attitudinal questionnaires were sent to 200 chartered clinical psychologists and 69 (34.5%) were returned. Respondents displayed generally positive attitudes, with only two out of 12 attitudinal items failing to attract attitudinally positive responses from more than three-quarters of the sample. Yet, because of the possible unrepresentativeness of the sample and the potentially tenuous attitude–behaviour link, it is recommended that consideration of lesbian issues should be explicitly addressed in clinical psychology training.     

The Current State of Medical Psychology in Iran

This paper reviews medical psychology in Iran and describes the two major professional associations representing the profession. The unique role of religion in Iran is stressed, and limitations of the current health care system are described. The paper also addresses human resource issues and the educational requirements for the practice of psychology in Iran.