Perceived lack of training moderates relationship between healthcare providers’ personality and sense of efficacy in trauma-informed care

ABSTRACT

Background and Objectives: Medical patients often have trauma histories that are not routinely assessed, which can adversely affect health outcomes. Despite growing awareness of this issue, there is limited understanding of factors that influence provider competency in trauma-informed care (TIC). The study examined healthcare providers’ personality traits in relation to their sense of TIC efficacy, taking into account perceived barriers to TIC and professional quality of life.

Study Design: The study used cross-sectional survey methods to examine our central hypothesis that provider personality traits and perceived barriers to TIC would be associated with TIC-efficacy, and to explore interactions among study variables.

Methods: Survey data were collected from 172 healthcare providers examining TIC knowledge, TIC-efficacy, perceived barriers to TIC, personality traits, and professional quality of life.

Results: TIC-efficacy was positively correlated with “intellectence/openness” and inversely correlated with “neuroticism” and perceived lack of training as a barrier. “Intellectence/openness” interacted with perceived lack of training to predict TIC-efficacy, suggesting that providers with lower “intellectence/openness” report greater TIC-efficacy when lack of training is not perceived as a barrier.

Conclusions: Provider personality traits and perceived barriers to TIC appear related to providers’ TIC-efficacy. Implications for overcoming barriers to TIC through training and implementation are discussed.     

Making Space for Every Body: Ending Sizeism in Psychotherapy and Training

Abstract

The importance of addressing weight bias as a social justice issue in psychotherapy and psychology education and training is introduced. The history of the development of fat studies is briefly reviewed. Current coverage of size and sizeism in psychology is critically examined and contrasted with the increasing adoption of the medical model of “obesity.” Fat shaming in the practice of mental health professionals is examined as a barrier to clients’ physical and mental health. Alternatives to medicalized weight management and fat shaming are introduced. Models that emphasize size acceptance and resist negative embodiment are encouraged. The potential for a future that makes space for every body is assessed.     

Disability,inclusive adventurous training and adapted sport: Two soldiers' stories of involvement

ObjectivesTo generate insights into the personal meaning and value of an inclusive adventurous training and adapted sport course for military personnel who have experienced physical disability as a result of injuries sustained during active service.DesignNarrative storytelling approach based on collaboratively written creative nonfictions.MethodFirst-person stories were constructed with two male soldiers on the basis of informal interviews and conversations across five days of a residential adventure training and sport course.ResultsThe stories portray the personal benefits, meaning, and value of adventurous training and sport by illuminating each individual's experiences since injury/trauma, his experiences while on the course, and how these interact to shape psychological wellbeing and future life horizons. They reveal a complex interplay between physical, psychological, and social disability among some military personnel.ConclusionsThe story as analysis expands current understanding of the psychological effects of physical activity for injured military personnel through: (i) providing an alternative analytical approach; (ii) revealing subjectivities, personal meaning, and biographical connections to generate a holistic understanding of the individual; (iii) preserving the complexity and ambiguity that characterize lived experience to support plural understandings; (iv) sharing an embodied representation as an ethical act of witnessing another's life. We suggest these kinds of understandings are necessary for physical activity practitioners who wish to support military personnel who have sustained a disability.     

Perfectionism and performance in a new basketball training task: Does striving for perfection enhance or undermine performance?

ObjectivesIn the psychology of sport and exercise, the question of how perfectionism affects performance is highly debated. While some researchers have identified perfectionism as a hallmark quality of elite athletes, others see perfectionism as a maladaptive characteristic that undermines, rather than helps, athletic performance. Against this background, the purpose of the present study was to investigate how different aspects of perfectionism predict performance and performance increments.MethodA study was conducted with 122 undergraduate athletes to investigate how perfectionism during training affects performance and performance increments in a series of trials with a new basketball training task. Two aspects of perfectionism were examined: striving for perfection and negative reactions to imperfection.DesignThe design was a correlational prospective design.ResultsResults showed that striving for perfection during training predicted higher performance in the new task. In contrast, negative reactions to imperfection predicted lower performance when athletes attempted the task for the first time, once the positive influence of striving for perfection on task performance was partialled out. However, negative reactions to imperfection did not undermine performance in the consecutive trials. On the contrary, athletes with both high levels of striving for perfection and high levels of negative reactions to imperfection showed the greatest performance increments over the series of trials.ConclusionThe findings suggest that perfectionism is not necessarily a maladaptive characteristic that generally undermines sport performance. Instead, when learning a new training task, perfectionism may enhance performance and lead to performance increments over repeated trials.     

The influence of pre-training evaluative responses on approach-avoidance training outcomes

ABSTRACT

Approach-avoidance training (AAT) has been shown to be effective in both clinical and laboratory research. However, some studies have failed to show the effects of AAT. Therefore, finding moderators of the AAT effect is a priority for further research. We investigate the moderating effect of pre-training evaluative responses towards familiar AAT targets. In particular, we test predictions: (a) that congruent responses (i.e. approach to positive targets and avoidance of negative targets) increase liking, whereas incongruent responses decrease liking; (b) that training is more effective when it can strengthen existing positivity or negativity; and (c) that ambivalence increases AAT effects. Two experiments (total N?=?132) implemented an AAT with local soft-drink brands after measuring initial positive/negative explicit evaluative components and implicit liking towards the brands. Results show no reliable evidence for training effects on consumption or rating of drinks, but participants showed more implicit liking of approached drinks than avoided drinks. Furthermore, the magnitude of implicit liking measured pre-training was positively related to the size of the training effect. Ambivalence had no direct effect on the training outcomes. These results partially support the congruency prediction and underline the importance of implicit liking prior to AAT as a moderator for AAT effects.     

Understanding Hope. Persons in the Process of Dying

Changes both within the profession of psychoanalysis and in society as a whole have affected our psychoanalytic training programs and presented new ethical challenges. Whereas in earlier decades training programs needed to be concerned primarily about the inviolability of the training analysis and the choice of appropriate analytic candidates, today there is little support for psychoanalysis as a treatment modality. Institutes are experiencing greater competition in attracting quality candidates and in providing them with adequate training experiences. This strain encourages institutes to operate in unethical ways to attract candidates. On the other hand, within the profession itself we are experiencing much theoretical ferment and the increasing feminization of the profession. These changes are affecting our training institutes and our ethical values in both positive and negative ways.     

Psychodynamic counsellor training integrating difference

Abstract

Psychodynamic counselling has been criticized for being inflexible, authoritarian, antiquated and unresponsive to the issues of modern-day society. Psychodynamic counsellor training is sometimes seen as a poor relation of ‘proper’ psychotherapy therapy training. This article is written by two psychodynamic counselling course trainers who have wresded with the above criticisms and who have striven to deliver a training course that is coherent in its adherence to a psychodynamic counselling model but which embraces equal opportunities issues and takes account of a diverse society. The article focuses on ways in which sexual identity, race and culture are integrated into the course curriculum and indeed into the course philosophy and community. Traditional psychoanalytic interpretations of homosexuality are challenged and multicultural counselling ideas are merged with psychodynamic counselling theory and skills.     

Additional effects of a cognitive task on dual-task training to reduce dual-task interference

ObjectiveWhen we perform dual-tasks in daily life, task performance is generally reduced. As these reductions in performance (i.e., dual-task interference) are responsible for various accidents such as falls, the repeated practice of dual-task (i.e., dual-task training) is often implemented to reduce dual-task interference. However, the risk of various accidents increases with longer dual-task training, as dual-task interference cannot be avoided. Therefore, it is important to achieve training goals more rapidly during dual-task training. This study sought to determine whether a combination of dual-task training and cognitive tasks would accelerate training effects.DesignThe experimental design included four groups: 1) cognitive task training group, 2) dual-task training group, 3) cognitive task and dual-task training group, and 4) non training group.MethodWe assessed single- and dual-task performance before and after the 2-week training sessions. We adopted a dual-task involving knee extension and an auditory reaction, and used N-back task as a cognitive task. On the other hand, dual-task training was the same method to assess dual-task performance.ResultDual-task interference was reduced in all groups in both the tasks. However, the number of participants in the cognitive task and dual-task training group who achieved a reduction in dual-task cost was significantly higher than those in other groups.ConclusionThese findings could contribute to the development of an effective method for reducing dual-task interference and resolving issues caused by dual-task interference in daily life.     

Quadrupedal movement training improves markers of cognition and joint repositioning

IntroductionExercise, and in particular balance and coordination related activities such as dance, appear to have positive effects on cognitive function, as well as neurodegenerative conditions such as dementia and Parkinson’s disease. Quadrupedal gait training is a movement system requiring coordination of all four limbs that has previously been associated with cognitive development in children. There is currently little research into the effect of complex QDP movements on cognitive function in adults.PurposeTo determine the effects of a novel four-week quadrupedal gait training programme on markers of cognitive function and joint reposition sense in healthy adults.MethodsTwenty-two physically active sports science students (15 male and 7 female) were divided into two groups: a training group (TG) and a control group (CG). All participants completed the Wisconsin Card Sorting Task (WCST) and were tested for joint reposition sense before and after a four-week intervention, during which time the TG completed a series of progressive and challenging quadrupedal movement training sessions.ResultsParticipants in the TG showed significant improvements in the WCST, with improvements in perseverative errors, non-perseverative errors, and conceptual level response. This improvement was not found in the CG. Joint reposition sense also improved for the TG, but only at 20 degrees of shoulder flexion.ConclusionsPerformance of a novel, progressive, and challenging task, requiring the coordination of all 4 limbs, has a beneficial impact on cognitive flexibility, and in joint reposition sense, although only at the specific joint angle directly targeted by the training. The findings are consistent with other studies showing improvements in executive function and joint reposition sense following physical activity.     

Examining the accuracy and in-game performance effects between pre- and post-performance routines: A mixed methods study

ObjectivesResearchers have identified that pre-performance routines improve performance under pressure, yet have not investigated the effects of post-performance routines. Thus, the purpose of the current study was to examine whether the type of performance routine training could improve tenpin bowling accuracy and in-game performance.DesignA mixed-method design was adopted, whereby the impact of a performance routine intervention on performance accuracy and in-game performance was examined. This was followed by participants completing semi-structured interviews which explored the perceived effect of those routines.MethodThirty-six experienced tenpin bowlers completed 30 accuracy shots pre- and post-intervention training, with league scores obtained for in-game performance comparison. Four groups (i.e., pre-performance routine [PPR], post-performance routine [POST], combined pre-post routine, and a control group) practiced 12 games across four weeks while listening to the group specific routine instruction on an IPod.ResultsIt was noted that accuracy improved (albeit non-significantly) for the PPR and combined pre-post routine group, but not the other groups. Critically, all intervention groups (PPR, POST & COMBO) improved in-game performance. The qualitative data indicated that both the PPR and POST was perceived to influence positively performance, attentional and emotional control, self-awareness, self-confidence, motivation. The PPR was also considered to enhance a state of readiness, and perceived control.ConclusionsResults indicate that the PPR training enhanced accuracy and in-game performance, with the POST training acting as a supportive role for in-game performance as evidenced by the qualitative and quantitative data. Future research should continue to investigate the effects of POSTs.     

The association between gender role stereotypes,resistance training motivation,and participation

ObjectivesTest the relationships between implicit gender stereotypes and perceptions of resistance training pleasantness, resistance training motivation, and participation among men and women. Test whether gender role moderates the effect of stereotypes on resistance training participation in men and women.DesignImplicit associations between resistance training and masculinity and pleasantness were measured using an Affect Misattribution Procedure (AMP). Moderated mediation analyses were conducted to test motivation as a mediator of the relationship between implicit associations and behavior.MethodParticipants (n = 170; 46% male) completed an AMP and measures of motivation for and participation in resistance training.ResultsWomen's implicit associations between exercise and masculinity were not associated with their motivation for or participation in resistance training. The strength of men's implicit masculinity-resistance training association was negatively related to minutes of resistance training per week, mediated by lower autonomous motivation, 95%CI [−419.15 to −11.10]. The association between implicit resistance training pleasantness and behavior was mediated by autonomous motivation in women, 95%CI [2.54 to 313.55], with similar trends in men 95%CI_men [−3.00 to 320.38].ConclusionBased on these findings, implicit associations with masculinity are not associated with women's participation in exercise. However, implicitly endorsing gender-stereotypes for resistance training is associated with lower participation rates in men.     

The Effect of Removing Superstitious Behavior and Introducing a Pre-Performance Routine on Basketball Free-Throw Performance

Abstract

A meta-analysis was conducted on 40 studies (76 effects) in order to examine exercise training as a method of stress-management treatment for adults. It offered evidence of a low-to-moderate positive effect in anxiety reduction. Exercise training studies that examined change from pre to post-treatment and studies that examined both change over time and between group differences were examined separately. The unbiased weighted average effect sizes were .45 and .36, respectively. Thus, exercise training improved anxiety levels an average of .36 standard deviations over alternative or control conditions. Adults who were more likely to have a stressful lifestyle benefited more from the exercise training than those who did not. Recommendations are made for both practice and research.     

Considerations on medical training for gender-affirming care: Motivations and perspectives

Abstract

Background: Many transgender individuals lack access to needed medical care, partially due to a lack of providers with experience in gender-affirming healthcare.

Aims: The purpose of this study was to identify professional motivators for medical providers seeking out training in gender-affirming care and to define which training experiences were most beneficial to their career development. By identifying experienced providers’ recommendations on which training modalities are most relevant to their practice, we aim to suggest future directions for medical education initiatives to effectively expand the transgender care workforce.

Methods: A voluntary cross-sectional electronic survey was distributed through professional listservs and publicly-available referral lists to interdisciplinary providers who self-identified as having experience in providing care to transgender individuals.

Results: One hundred and fifty-three (n?=?153) physicians, physician assistants, or advance-practice nurses responded to the survey. The majority (96.7%) were located in the United States, representing 37 states. The two most common motivators for seeking out training in gender-affirming care were filling a need in the community (73.0%) and/or having met a transgender-identified person in a clinical setting who requested care (63.8%). While many providers gained skills independently (57.3%), the two most commonly-available training opportunities were professional conferences (57.3%) and mentorship (41.3%). Respondents were most likely to recommend that others in their field be trained via structured clinical experience (e.g., a rotation or longitudinal exposure during training), rather than additional didactic training.

Discussion: This study identifies key high-yield training methodologies which could improve access to quality gender-affirming healthcare. Through integration of structured clinical experiences during training, direct clinical mentorship, and professional development at conferences on gender-affirming care, the workforce of welcoming and prepared healthcare providers for transgender patients will increase. This will lead to a tremendous improvement on access to gender-affirming care in our communities.     

Sources of influence on the professional development of psychologists and psychiatrists in Norway and Germany

Background: There are many professional psychotherapists, but no psychotherapy profession. The psychotherapists’ professions vary between countries, the most frequent being psychiatry and clinical psychology.

Aim: As these professions have different basic training and also may be impacted differently by other factors, we wanted to study potential differences as to perceived influences on their development as psychotherapists across career level, theoretical orientation, and gender.

Methods: More than 2500 Norwegian and German psychiatrists and psychologists reported data on their professional development in the DPCCQ/2000, a lengthy multi-part survey instrument developed within the ‘Collaborative Research Network’ of the Society for Psychotherapy Research. The four groups were compared for differences, and a series of multiple regression analyses were conducted to examine the impact of profession on a variety of aspects of therapist experiences.

Results: Although a few therapist experiences (e.g. teaching, treating patients, institutional conditions) had a significantly different impact between the two professions, as a main effect, they only accounted for less than 1% or the variance.

Conclusion: Profession seems to have little influence on perceived development as a psychotherapist, and it is reasonable to conclude that other therapist qualities, often personal qualities, are more important for therapeutic processes and outcomes.     

Effects of motor-cognitive coordination training and cardiovascular training on motor coordination and cognitive functions

ObjectivesNumerous recent studies showed that physical training can enhance cognitive abilities, such as attention, spatial ability, memory performance, and executive functions. However, most of these studies focused on the efficiency of cardiovascular training, whereas evidence for combined motor-cognitive training emphasizing coordination abilities is scarce. Therefore, the aim of the present study was to investigate the effects of motor-cognitive coordination training and moderate cardiovascular training on cognitive functions and to test whether these effects were related to participant's fitness level.Design and methodWe tested 50 physically active (mean age = 23.5 years, SD = 3.2) and 56 sedentary participants (mean age = 23.4 years, SD = 3.2) in a pretest-training-posttest design with 12 sessions of moderate cardiovascular training (≈60% HRmax) or motor-cognitive coordination training. The training groups were compared to a passive control group. At pretest and posttest, participants performed an untrained motor-cognitive coordination task, measures of executive control (cognitive flexibility, inhibition, working memory), spatial ability, and fluid intelligence.Results and conclusionsWe found improved coordination abilities in the coordination training group, but no transfer of training to cognitive measures in physically active participants. However, sedentary participants showed larger improvements in terms of inhibition in the coordination training group compared to the remaining groups, while the cardiovascular training group improved in cognitive flexibility compared to the remaining groups. In sum, there are positive but differential effects of cardiovascular training and coordination training on cognitive performance in sedentary young participants, suggesting that coordination training may be a useful intervention especially for individuals that cannot perform cardiovascular training.     

Therapist effects and the dissemination of cognitive behavior therapy for chronic fatigue syndrome in community-based mental health care

ObjectiveThe purpose of the present study was to explore the role of the therapist in the dissemination of manualized cognitive behavior therapy (CBT) for chronic fatigue syndrome (CFS) outside specialized treatment settings.MethodWe used the routinely collected outcome data of three community-based mental health care centers (MHCs) which implemented and sustained CBT for CFS during the course of the study. Ten therapists, who all received the same training in CBT for CFS, and 103 patients with CFS were included.ResultsRandom effects modeling revealed a significant difference in mean post-treatment fatigue between therapists. The effect of the therapist accounted for 21% of the total variance in post-treatment fatigue in our sample. This effect could be explained by the therapists’ attitude toward working with evidence-based treatment manuals as well as by the MHC where CBT for CFS was delivered.ConclusionThe context in which CBT for CFS is delivered may play an important role in the accomplishment of established therapy effects outside specialized treatment settings. Due to the small sample size of MHCs and the different implementation scenarios in which they were engaged, our findings should be interpreted as preliminary results which are in need for replication.     

And who thinks on the baby? Thoughts on the method of infant observation

Abstract

After the method of infant observation, as developed by Esther Bick, and its significance for psychoanalytic training have been outlined, the method is critically assessed. The suggestion is then made that infant observation should be supplemented by video-analytic infant observation. Finally, thoughts on modifications of the process of infant observation are presented.     

Behind the scene: cognitive benefits of playing a musical instrument. Executive functions,processing speed,fluid intelligence and divided attention / Detrás de la escena: beneficios cognitivos de tocar un instrumento musical. Funciones ejecutivas,velocidad de procesamiento,inteligencia fluida y atención dividida

Abstract

The relationship between music training and cognitive performance has been much explored over the last decades. A variety of evidence shows a different neurological and cognitive processing in the population who have undergone instrumental music training compared to people who have not. A review of the literature shows the many advantages in cognitive skills musicians have gained from musical training, such as benefits to their executive functions and other aspects of cognition, in children as well as adults and the elderly. This study investigates in greater depth certain cognitive aspects associated with musical training in the adult population. Specifically, it explores its relationship with inhibition, working memory (verbal and visual-spatial), flexibility, processing speed, fluid intelligence and divided attention. Our results suggest that there is indeed a relationship between musical training and improvements in cognitive performance, both in executive functions and in other areas of cognition.     

Ethical and Legal Considerations in the Training of Mental Health Professionals

Summary

A discussion is provided regarding ethical and legal considerations that relate to the training of mental health professionals. A training program which emphasizes a proactive approach to identifying and resolving potential ethical and legal problems, and their close connection with clinical issues is described, as are the responsibilities of supervisors and supervisees in such a program. For illustrative purposes, a training vignette and a clinical vignette conclude the article.     

The effect of a virtual reality environment on gaze behaviour and motor skill learning

ObjectiveVirtual reality (VR) systems hold significant potential for training skilled behaviours and are currently receiving intense interest in the sporting domain. They offer both practical and pedagogical benefits, but there are concerns about the effect that perceptual deficiencies in VR systems (e.g. reduced haptic information, and stereoscopic display distortions) may have on learning and performance. ‘Specificity of learning’ theories suggest that VR could be ineffective (or even detrimental) if important differences (e.g. perceptual deficiencies) exist between practice and real task performance conditions. Nevertheless, ‘structural learning’ theories suggest VR could be a useful training tool, despite these deficiencies, because a trainee can still learn the underlying structure of the behaviour. We explored these theoretical predictions using golf putting as an exemplar skill.MethodIn Experiment 1 we used a repeated measures design to assess putting accuracy (radial error) and quiet eye duration of expert golfers (n = 18) on real putts before and after 40 VR ‘warm up’ putts. In Experiment 2, novice golfers (n = 40) were assigned to either VR or real-world putting training. Putting accuracy and quiet eye durations were then assessed on a real-world retention test.ResultsBoth visual guidance (quiet eye) and putting accuracy were disrupted temporarily when moving from VR to real putting (Experiment 1). However, real-world and VR practice produced comparable improvements in putting accuracy in novice golfers (Experiment 2).ConclusionOverall, the results suggest that: (i) underlying skill structures can be learned in VR and transferred to the real-world; (ii) perceptual deficiencies will place limits on the use of VR. These findings demonstrate the challenges and opportunities for VR as a training tool, and emphasise the need to empirically test the costs and benefits of specific systems before deploying VR training.