Bringing life into the group experience: The power of immediacy

One of the great advantages of group treatment is the potential for immediacy. It is possible to charge interpersonal exchanges with a therapeutic power rarely achieved in other modalities. Members responses to one another occur in front of the group as a whole, which makes the dynamics more available and comprehensive than if such interchanges were merely reported. The art of group treatment may be said to consist of fostering this immediacy. It calls for systematically removing blocks to the living moment. This paper presents four techniques for resolving impediments to immediacy: 1. Translating the remote past into the living present; 2. Resolving tendencies of members to fixate rather than to engage in progressive interchanges; 3. Converting oblique communications into their true interpersonal messages; 4. Resolving any tendency to construe oneself as a victim, in order to ward off meaningful and immediate give- and-take.     

The Collaborative Assessment and Management of Suicidality (CAMS): An Evolving Evidence‐Based Clinical Approach to Suicidal Risk

The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence‐based clinical intervention that has significantly evolved over 25 years of clinical research. CAMS is best understood as a therapeutic framework that emphasizes a unique collaborative assessment and treatment planning process between the suicidal patient and clinician. This process is designed to enhance the therapeutic alliance and increase treatment motivation in the suicidal patient. Central to the CAMS approach is the use of the Suicide Status Form (SSF), which is a multipurpose clinical assessment, treatment planning, tracking, and outcome tool. The original development of CAMS was largely rooted in SSF‐based quantitative and qualitative assessment of suicidal risk. As this line of research progressed, CAMS emerged as a problem‐focused clinical intervention that is designed to target and treat suicidal “drivers” and ultimately eliminate suicidal coping. To date, CAMS (and the clinical use of the SSF) has been supported by six published correlational studies and one randomized clinical trial (RCT). Currently, two well‐powered RCTs are under way, and various new CAMS‐related projects are also being pursued. The clinical and empirical evolution of CAMS—how it was developed and what are the next steps for this clinical approach–are described here.     

Bringing ethics into focus: How regulatory focus and risk preferences influence (Un)ethical behavior

In four laboratory studies, we find that regulatory focus induced by situational cues (such as the framing of an unrelated task) or primed influences people’s likelihood to cross ethical boundaries. A promotion focus leads individuals to be more likely to act unethically than a prevention focus (Studies 1, 2, and 3). These higher levels of dishonesty are explained by the influence of a person’s induced regulatory focus on his or her behavior toward risk. A promotion focus leads to risk-seeking behaviors, while a prevention focus leads to risk avoidance (Study 3). Through higher levels of dishonesty, promotion focus also results in higher levels of virtuous behavior (Studies 2 and 3), thus providing evidence for compensatory ethics. Our results also demonstrate that the framing of ethics (e.g., through an organization’s ethics code) influences individuals’ ethical behavior and does so differently depending on an individual’s induced regulatory focus (Study 4).     

The importance of problem-driven research: Bringing Wachtel's argument into the present

There is no one best way to do psychological research. Rather, the “best” way depends on the fit to the problem. Research should be problem-driven rather than method-driven. Psychologists sometimes envy certain natural scientists, and over-reward those who do research with a surface structure more like that of research in the natural sciences, leading to sub-optimal progress in the field.     

The Psychosocial Impact of Undergoing Prophylactic Total Gastrectomy (PTG) to Manage the Risk of Hereditary Diffuse Gastric Cancer (HDGC)

Individuals identified as at high risk of developing Hereditary Diffuse Gastric Cancer (HDGC) are advised to undergo prophylactic surgery - have their stomach removed - in their early twenties. Research with (older) cancer patients who undergo gastrectomy for curative reasons suggests that gastric resection has a number of physical and psychosocial sequelae. Because it is difficult to extrapolate the findings of studies of older cancer patients to younger healthy patients who are considering prophylactic total gastrectomy (PTG), the aim of this qualitative interview study was to determine the psychosocial implications of undergoing prophylactic surgery to manage genetic risk. Fourteen men and 13 women from the UK’s Familial Gastric Cancer study who had undergone PTG were invited to participate in qualitative interviews. Most reported that undergoing surgery and convalescence was easier than anticipated. There was evidence that age affected experiences of PTG, with younger patients tending to report faster recovery times and more transient aftereffects. All saw the benefits of risk reduction as outweighing the costs of surgery. Surgery was described as having a range of physical impacts (disrupted appetite, weight loss, fatigue, GI symptoms) that had related psychological, social and economic implications. Those considering PTG need to be aware that its impact on quality of life is difficult to predict and negative sequelae may be ongoing for some individuals.     

Operationalizing the Assessment and Management of Violence Risk in the Short-term

Assessing risk of violence in the short term is crucial for managing and preventing violence, especially in institutions such as psychiatric units and prisons. Despite a lack of consensus on the definition of "short term", a number of recent tools and guidelines have been developed to aid short-term clinical decision-making. Whereas the supporting evidence for the new tools is impressive, limitations remain in terms of the focus on prediction, limited consideration of strengths, and poor integration with formulation and risk management. The Short-Term Assessment of Risk and Treatability (START) is a brief clinical guide for the dynamic assessment of risks, strengths and treatability. It focuses on short-term risks and the characteristics of the individual that, if changed, might lead to an increase or decrease in risk. The START has the potential to operationalize the structured professional judgment (SPJ) approach in order to inform the evaluation of multiple risk domains relevant to everyday psychiatric clinical practice. However, explicit guidance on integrating risk assessment, formulation and management is limited in the START and this paper describes the SPJ approach, reviews recent developments in approaches to risk, and considers how the START can be used to inform SPJ approaches and link risk assessment, formulation, and management. Copyright ? 2012 John Wiley & Sons, Ltd.     

Social Media in Disaster Risk Reduction and Crisis Management

This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.     

Characterization of the Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) in Lung Transplant Candidates

The SIPAT is a standardized measure for pre-transplant psychosocial evaluation. Previous SIPAT studies utilized a relatively small lung transplant sample and only included listed patients. This study characterized the SIPAT in 147 lung transplant candidates to better elucidate its utility. The average score corresponded to a minimally acceptable rating and nearly half of the patients had relative or absolute contraindications. Interstitial Lung Disease (ILD) patients scored more favorably than non-ILD patients (U?=?7.69, p?<?.05). The Total (β?=?? .05, SE?=?.018, p?<?.01), Social Support Subscale (β?=?? .133, SE?=?.058, p?<?.05), and Psychosocial Stability and Psychopathology Subscale (β?=?? .103, SE?=?.040, p?<?.05) significantly predicted listing status. The SIPAT has a unique profile in lung transplant candidates and demonstrated utility for guiding transplant decisions. Future research should examine which lung transplant outcomes are significantly associated with SIPAT scores.

     

Evaluating Self-Concept and Ego Development Within Erikson's Psychosocial Framework: A Formulation

The purpose of this article is to suggest criteria developed within the context of Erikson's first five psychosocial stages that may be helpful in evaluating self-concept and ego development. The strength of Erikson's theory has been in its contribution to the understanding of the self's development over a series of psychosocial stages. A weakness, however, has been in the ambiguity about what behaviors to look for during any particular stage that allow one to evaluate the status of a person's psychological growth. To assess areas of strengths and weaknesses in the self's growth as it progresses through these stages, five behavioral expressions tables are presented, each illustrating possible behaviors and implicit attitudes associated with positive and negative ego resolutions at each stage. Implications for the evaluation of problem areas and counseling are noted.     

Assessment and Management of Suicide Risk in Children and Adolescents

This article presents a pragmatic approach to assessing and managing suicide risk in children and adolescents. We first present general recommendations for conducting risk assessments with children and adolescents, followed by an algorithm for designating risk. Risk assessment and designation should be based on both distal (i.e., a prior history of self-harm behaviors) and proximal (i.e., suicide ideation, plans, intent, and preparations) predictors of suicide attempt. We then discuss safety planning as an easy-to-implement approach for intervening and managing suicide risk when working with children and adolescents. We end with a case example illustrating the implementation of risk assessment, risk designation, and safety planning with an adolescent client and her mother.     

Translating Genetics Leaflets into Languages Other Than English: Lessons from an Assessment of Urdu Materials

Genetic counselors frequently counsel clients whose first language is not English, relying on interpreters and on supplementary translated written material. This paper highlights factors that counselors need to consider before using or commissioning translated leaflets. It is based on an assessment of leaflets translated into Urdu, the national language of Pakistan, which are available through U.K. genetics clinics for use with Pakistani-origin clients. The 2 authors, who know Urdu as their 2nd and 1st languages respectively, independently read each leaflet, checking for accuracy of information, ease of reading and understanding, cultural sensitivity, and contact details for Urdu-speaking professionals. There were factual errors and confusing or very difficult text in all leaflets; some leaflets also contained culturally insensitive messages that could alienate users of genetics services. The paper discusses the reasons for these pitfalls and makes recommendations to guide the future production of translated genetics leaflets.     

Growing Up Wired: Social Networking Sites and Adolescent Psychosocial Development

Since the advent of social networking site (SNS) technologies, adolescents’ use of these technologies has expanded and is now a primary way of communicating with and acquiring information about others in their social network. Overall, adolescents and young adults’ stated motivations for using SNSs are quite similar to more traditional forms of communication—to stay in touch with friends, make plans, get to know people better, and present oneself to others. We begin with a summary of theories that describe the role of SNSs in adolescents’ interpersonal relationships, as well as common methodologies used in this field of research thus far. Then, with the social changes that occur throughout adolescence as a backdrop, we address the ways in which SNSs intersect with key tasks of adolescent psychosocial development, specifically peer affiliation and friendship quality, as well as identity development. Evidence suggests that SNSs differentially relate to adolescents’ social connectivity and identity development, with sociability, self-esteem, and nature of SNS feedback as important potential moderators. We synthesize current findings, highlight unanswered questions, and recommend both methodological and theoretical directions for future research.     

The Short-Term Assessment of Risk and Treatability (START): a prospective validation study in a forensic psychiatric sample

A new assessment scheme--the Short-Term Assessment of Risk and Treatability (START)--presents a workable method for assessing risks to self and others encountered in mentally and personality disordered clients. This study aimed to demonstrate (a) prevalence and severity of risk behaviors measured by the START, (b) psychometric properties of START, (c) similarities and differences in START scores across different mental health professionals, and (d) concurrent validity of START with diverse negative outcomes. Treatment team members completed the 20-item, dynamically focused START for 137 forensic psychiatric inpatients. Prevalence and severity of START risk domains were measured for 51 patients detained in the hospital for 1 year. Results revealed high rates of generally low-level adverse events. With some exceptions, START scores were meaningfully associated with outcomes measured by a modified Overt Aggression Scale.     

Global Virtual Sales Teams (GVSTs ): A Conceptual Framework of the Influence of Intellectual and Social Capital on Effectiveness

International sales opportunities, consolidation of global accounts, and advancements in communication technologies have led to the prevalence of global virtual sales teams (GVSTs). GVSTs enable salespeople from different geographical areas, time zones, and cultural backgrounds to use virtual interfaces and work closely together on interdependent global sales objectives. However, as technology-enabled, culturally diverse, and globally separated teams have not lived up to their potential, researchers have called for furthering our understanding of such teams. Therefore, drawing from literature streams on traditional sales teams, global sales teams, virtual teams, teamwork in organizations, intellectual capital, and social capital, we offer a framework for enhancing the effectiveness of GVSTs. Specifically, we define GVST effectiveness, identify effectiveness enhancing components of the GVST environment, and examine unique dimensions of GVST intellectual and social capital that influence the GVST environment. We conclude with several directions for future research in this promising, yet underresearched, area and implications for practice.     

Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk

The purpose of this study was to evaluate the utility of a breast cancer risk assessment (BCRA) at the time of screening mammogram. Women whose BCRA indicated a high risk for cancer received a letter with instructions for breast health care and genetic counseling if appropriate. After 6 months this group received surveys to evaluate their risk perception and their recall of, and compliance with, recommendations. We also explored the impact of other variables such as a recommendation for genetic counseling and physician communication with the women. After the BCRA, the majority of high risk women reported no change in their perceived risk of cancer. A woman’s perceived risk of cancer after a BCRA was significantly associated with her recall of recommendations for breast health care, but not with compliance. A recommendation for genetic counseling was not significantly related to women’s perceived risk of cancer after the BCRA. Ten percent of women who should have obtained genetic counseling actually completed an appointment. Women who discussed their BCRA results with their physicians were more compliant with a six month breast exam with a doctor (53% vs 17%, p = 0.018). Overall, women felt that the BCRA was helpful and did not cause undue stress or anxiety. Although the cohort’s compliance with recommendations was suboptimal, physicians’ interactions with their patients may have a positive influence on their compliance.     

Assessment of Time Management Skills (ATMS): A Practice-Based Outcome Questionnaire

This study assessed test–retest reliability and internal consistency of the Assessment of Time Management Skills (ATMS), a self-report questionnaire designed to assess awareness and use time management strategies to plan and manage daily life tasks. Participants included 18 to 65 year-old people (N = 241) from the general population. The questionnaire's content validity was established. The tool demonstrated good internal consistency (α = 0.86). Test–retest reliability for the score revealed a Pearson Coefficient of Correlation (PCC) r = 0.89. The ATMS may be a useful tool for evaluating the effectiveness of rehabilitation designed to improve time management skills.