Developing coherence in community and clinical psychology: the integration of idealism and pragmatism

Illustrations of how ideas from community psychology may be integrated with clinical psychological thinking and practice are described from the perspective of a clinical psychologist working in the NHS. The intentions are to consider socially relevant conceptualizations of the causes of people's well-being and distress, and to develop ways of helping individuals and communities to clarify and address these causes. Incorporating an analysis of social power also necessitates a critical awareness of the limited potency of psychological interventions. © 1998 John Wiley & Sons, Ltd.     

Exploring the trainees' view of a socio‐political approach within UK clinical psychology

This paper aims to provide preliminary insights into the relationship between clinical psychology and a socio‐political approach known as Critical Community Psychology (CCP). Methodologically, it uses statements about CCP as stimulus material, and utilizes both quantitative and qualitative exploratory techniques, to survey the opinions of 354 UK trainee clinical psychologists. Participants' ratings of the stimulus material and their qualitative comments reveal many positive endorsements of the socio‐political approach. However, themes from the qualitative data raise questions about how socio‐political ideas can be incorporated into clinical practice and highlight uncertainty over the relationship between clinical psychology and politics. Copyright © 2006 John Wiley & Sons, Ltd.     

Training clinical psychologists for rural and northern practice: Transforming challenge into opportunity

Abstract: The Rural and Northern Program (R&NP) of the University of Manitoba's Department of Clinical Health Psychology (DCHP) is a unique training and service delivery platform that was developed in response to the scarcity of psychological services in rural and northern areas of the province of Manitoba, Canada. Since 1996 rural and northern‐based psychologists, in conjunction with the faculty based in Winnipeg (Manitoba's largest city) have offered training to two interns and one postdoctoral resident (resident) yearly. The current article discusses the nature of the program, the regions of Manitoba that the program services, and recruitment and retention data. The authors conclude by offering suggestions for creating sustainable rural/northern psychological practice.     

A rose by any other name: Maintaining the name and highlighting the uniqueness of psychology as a health care profession

In this article, we reply to the comments made by Holden and Levant (preceding articles). While we agree with their goals of expanding the scope of practice of psychology, standardizing training, and educating the public and other health care professionals about the field of clinical psychology, we do not agree that changing the discipline's name to psychological physician is a necessary or sufficient means to these ends. We outline the bases for our disagreement with the name change proposal and provide other proposals for reaching the goals set forth by Holden and Levant.     

A role for clinical psychology in health care and policy concerning the physical environment

Some persons adversely react to specific environments, while others are impervious or actually thrive. Medical attention often overlooks such sensitivities to the physical environment. Such sensitivities, including phobias and seasonal affectivity, fall within clinical psychology's purview. A theoretical/clinical approach called the Synchronous Systems Model, which defines and uses individual differences in people and in settings, could serve medical health care and policy. When specific people are matched appropriately with specific treatments within the most propitious settings, cost effectiveness and medical efficacy rise. Such documented accountability could make clinical psychologists central to triage of medical services as well as health care policy in these days of the shrinking health care dollar. The Synchronous Systems Model provides theory, supportive data, and clinical assessment devices to strengthen clinical psychology's role in medical settings.     

Using client feedback in training of future counseling psychologists: An evidence-based and social justice practice

Training in counseling psychology has evolved to emphasize both evidence-based practice (EBP) and social justice, though these two dimensions have often seemed disconnected, or even at odds in the practice of psychotherapy. The Partners for Change Outcome Management System (PCOMS), an EBP that monitors treatment outcomes and the therapeutic alliance across treatment (often called “client feedback”), may offer a means to connect evidence-based and socially just practices. The purpose of this article was to outline how the use of PCOMS in psychotherapy and supervision can serve as a useful training tool that is a form of EBP and also promotes a socially just paradigm in psychotherapy. We also offer an implementation example from a counseling psychology doctoral program to demonstrate how PCOMS can be used with clients in psychotherapy and included within the supervisory process.     

Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

Quantitative and qualitative analysis of a set of goal attainment forms in primary care mental health services

Aims: The aim of this paper is to present an attempt to collate the results of the client‐completed Goal Attainment Form (GAF) and to explore the usefulness of analysing the data in this way. The GAF is used primarily to add qualitative idiosyncratic data to the quantitative data collected by the CORE‐OM (Clinical Outcomes for Routine Evaluation Outcome Measure) questionnaire. Method: A sample of 477 completed GAF were used during short‐term therapy through primary care mental health services to investigate potential correlations in various different aspects between the GAF and the CORE outcome measure (CORE‐OM). The themes from these forms were qualitatively analysed to compare how clients describe their experience of therapy with clinical perspectives. Results: The results reveal several significant correlations. Themes used by clients to describe their problems and benefits of therapy were different from clinicians' perspectives. Discussion and recommendations: Several suggestions and recommendations are offered regarding evaluation, therapy and primary care short‐term therapy services.     

Health and behavior: The coming together of science and practice in psychology and medicine after a century of benign neglect

For thousands of years, physicians had available only a few drugs with which to minister to patients and the practice of psychology was an integral and therapeutically powerful component in the practice of medicine. Thus, good bedside medicine consisting of empathy, compassion, and a nurturant attitude toward the ill individual was a major component of the physician's armamentarium until relatively recently. However, the explosion in scientific knowledge in biology, physiology, chemistry, and microbiology which began a century ago and has continued through the twentieth century helped produce several generations of physician specialists and subspecialists with little knowledge of the powerful role psychological factors play in health and illness. As a result, practitioners of medicine and practitioners of psychology have had little or no contact during most of this century. However, as advances in microbiology, public health, and nutrition have eradicated many of the infectious diseases, infirmities associated with one's lifestyle have replaced the latter as the major causes of death today. One offshoot of this shift is that after a century of benign neglect, physicians and psychologists have rediscovered a common ground in the arena labeled health and behavior. Some factors responsible for these recent developments are highlighted.This article was an invited address delivered to a group of Japanese health psychologists as part of a Health Sciences Seminar in Tokyo on July 24, 1993. Concurrent with its publication here in English, it is being published in the Japanese language in the March 1994 issue of the journal,Japanese Health Psychology.     

The Teaching Alliance Inventory: Evaluating the student-instructor relationship in clinical and counselling psychology training

The Teaching Alliance Inventory (TAI) was developed to measure the quality of the student-instructor relationship in graduate clinical and counselling psychology classrooms. Based on Bordin's (1983) original concept of the alliance as fundamental to the change process in psychotherapy, we developed the TAI to measure aspects of the classroom relationship that may be fundamental to learning essential skills of counselling and clinical psychology. Factor analysis revealed six subscales, four representing interpersonal variables not evaluated in traditional teaching effectiveness measures. We demonstrated internal consistency and split-half reliability with a large sample of graduate students and described evidence for the scale's face validity and content validity. Construct validity was supported by significant correlations between the TAI and its subscales with an established measure of teaching effectives and its logically related subscales (SEEQ; Marsh, 1987 Marsh, HW. 1987. Students’ evaluations of university teaching: Research findings, methodological issues, and directions for future research. International Journal of Educational Research, 11(Whole Issue 3): 253–288.  [Google Scholar]). The TAI may supplement traditional assessments of instructor quality by providing feedback regarding interpersonal impact in the classroom.     

Positive psychology,the classification of character strengths and virtues,and issues of measurement

ABSTRACT

This essay raises concerns about positive psychology’s classification of character strengths and virtues and issues of measurement. Part I examines the process whereby the classification was compiled. Part II turns to issues of measurement and questions about positive psychologists’ sensitivity to variations in the meanings of the constructs they purport to measure, both within and across cultures. I argue that attempts to find a ‘deep structure’ of the character strengths and virtues should proceed hand in hand with efforts to render positive psychology and its measurement tools more sensitive to variability in character strengths and virtues across and within cultures. The essay concludes with suggestions for future research.     

Development and evaluation of the positive psychology intervention for older adults

Although research suggests that positive psychology intervention can enhance subjective well-being and reduce depression, its effectiveness on older adults remains largely unknown. Therefore the present study aimed to develop and evaluate a custom-tailored positive psychology intervention program for older adults. The program offered nine-week group sessions to 74 older people recruited from district community centers and nursing homes in Hong Kong. The intervention program covers eight themes, including optimism, gratitude, savoring, happiness, curiosity, courage, altruism, and meaning of life. The participants consisted mostly of females aged between 63 and 105?years. One-group pre-test/post-test design was adopted to evaluate the effectiveness of the intervention on depression, life satisfaction, gratitude, and happiness. Results revealed that the intervention reduced the number of depressive symptoms and increased the levels of life satisfaction, gratitude, and happiness. Effectiveness of the intervention is discussed in relation to self-awareness, education, self-reinforcement, and sensitivity to age and culture.     

Use of religious and spiritual interventions by trainees in APA-accredited Christian clinical psychology programs

Little is known about the effectiveness of Christian clinical programs accredited by the American Psychological Association in training students to use religious and spiritual interventions in therapy. We surveyed 162 student therapists from three such programs regarding their training experiences and use of religious and spiritual interventions. Self-reported competency and use of religious and spiritual interventions correlated with a number of training components. However, none of the training components predicted unique variance in regression equations above and beyond that of general professional training, personal religiousness, and intervention-specific training. Suggestions are offered regarding intervention-specific training in both Christian and secular programs, the role of personal therapy in training, and the development of guidelines for competency in using religious and spiritual interventions.     

Comparison of counseling and clinical psychology graduates on the examination for professional practice in psychology

Doctoral recipients in clinical psychology scored higher than doctoral recipients in counseling psychology on the national licensing exam, the Examination for Professional Practice in Psychology. The largest discrepancies between the 2 groups were on Subtest I (diagnosis), Subtest II (intervention), and Subtest III (research). The differences were less large for Subtest IV (professional/ethical/legal issues) and for Subtest V (social application). The authors recommend that both counseling and clinical psychology graduate students take more course work in the department of the other discipline.     

Interdisciplinary research and interprofessional collaborative care in a memory clinic for rural and northern residents of western Canada: Unique training ground for clinical psychology graduate students

Abstract: In Canada, interprofessional education (IPE) and interdisciplinary health research initiatives are beginning to transform the academic health sciences, including graduate training programs for clinical psychologists. In response to mandates and directives from national health policy and research funding bodies, academic training programs are re‐structuring course offerings, practicum training experiences, and research activities to better prepare students for their future roles within interdisciplinary research groups and collaborative patient‐centred clinical teams. As an example of this transformative movement in IPE, described herein are the recent training initiatives in the Graduate Program in Clinical Psychology at the University of Saskatchewan, and the role of clinical neuropsychology in an innovative interprofessional rural and remote memory clinic.     

Energy psychology and psychotherapy: A study of the use of energy psychology in psychotherapy practice

Aim: The aim of the study was to increase understanding of how energy psychology informs and affects counselling/psychotherapy practice. By undertaking phenomenological interviews with experienced clinicians, the aim was to enrich and expand on the scientific approaches to energy psychology research. Method: This research is based on in‐depth semi‐structured interviews using interpretative phenomenological analysis (IPA). Five experienced psychotherapists who are also practitioners of energy psychology were interviewed. Findings: Four main themes emerged from the analysis: energy psychology as a potent intervention that facilitates shifts in emotions, cognitions, behaviours and physiology; the safety of energy psychology techniques; the role of the therapeutic relationship when using energy psychology techniques; and the challenges of integrating energy psychology into the work context, highlighting the need for more complex, systemic models to understand how people experience distress and how change is facilitated. Conclusion: Overall, participants in this study found energy psychology to be a valuable supplement to counselling and psychotherapy. The implications for current practice are discussed.