The evolution of chronic back pain problems: a longitudinal study.

A longitudinal evaluation of the recovery from an acute back pain episode was undertaken on 117 sufferers, with assessments at the onset, 3 and 6 months. The number of individuals still reporting pain at 6 months, and therefore qualifying for 'chronic pain', was considerably higher than expected (40%). At 6 months, the persisting pain problems were found to be moderate to severe in intensity in approx. 20% of cases. Despite the pain, the chronic sufferers showed gradual continuing adjustments to it, re-establishing activities despite pain. Most of the change in the pain components (cognitive, subjective, behavioral, depression, anxiety) occur in the first 3 months, after which considerable stability is evident in the residual problem. In contrast, the impact of the pain and the consequent disability decline more markedly and continue to do so right up to the 6 month point. There was no evidence of chronic pain evolving and growing, but rather of a persistence of the acute presentation.     

A high-risk method for studying psychosocial antecedents of chronic pain: the prospective investigation of herpes zoster.

Although patients with chronic pain are often psychologically distressed, it has been difficult to determine whether this distress is an antecedent of chronic pain or whether it is caused by the experience of living with chronic pain. The aim of this investigation was to develop a method that would allow individuals who are at risk for the development of chronic pain to be studied before their pain has become chronic. Patients with acute herpes zoster were assessed with demographic, medical, pain, and psychosocial measures. Pain was assessed in follow-up interviews at 6 weeks and 3, 5, 8, and 12 months after these initial assessments. There were no significant differences between patients who developed short-term herpes zoster pain and patients who did not develop short-term pain for any of the measures at the initial assessment, except for one measure of pain intensity. Patients who developed chronic herpes zoster pain, however, had significantly greater pain intensity, higher state and trait anxiety, greater depression, lower life satisfaction, and greater disease conviction at the initial assessment than patients who did not develop chronic pain. In discriminant analyses, disease conviction, pain intensity, and state anxiety each made a unique contribution to discriminating patients who did and who did not develop chronic pain. This study demonstrates the feasibility of investigating psychosocial antecedents of the development of chronic pain by prospectively examining the longitudinal course of herpes zoster.     

Predictors of distress following an acute stroke: Disability,control cognitions,and satisfaction with care

Abstract

Whilst clinical predictors of distress following acute stroke have been identified (e.g., lesion site), this study hypothesised that greater prediction would be achieved by addressing individual differences in patients' cognitions (e.g., perceived control, satisfaction with care, recovery confidence) and coping responses. We examined these relationships in a longitudinal study of 71 survivors of acute stroke. Measures were collected at three time points: 10-20 days after the stroke, and one month and six months after hospital discharge. Stepwise multiple regression analyses were performed using only significant bivariate correlates and where the dependent variables were residualised scores which controlled for baseline levels of anxiety and depression. Satisfaction with treatment and confidence in recovery at one month predicted anxiety outcome at six months, and satisfaction with advice and confidence in recovery at one month predicted depression outcome at six months. These results offer tentative suggestions for interventions targeting patient cognitions and improving patient satisfaction.     

Midwives’ Approach to Genetic Diseases and Genetic Counseling in Denizli, Turkey

The purpose of this study was to evaluate Denizli midwives’ self-reported knowledge of genetic diseases and genetic counseling. Data was collected on forms that obtained information about midwives approaches to basic genetics, genetic disorders, and genetic counseling (response rate = 70.1%). The highest response rate of midwives describing themselves as “knowledgeable” about basic genetic information was for mitosis and meiosis with 4.8%, about genetic disorders was for phenylketonuria with 61.1%, and about genetic counseling was for recommending ultrasonography during pregnancy with 98.1%. The source for basic genetics information for 56.4% of participants was in their school level classes. None of the midwives felt that they had sufficient knowledge about genetic counseling or screening and 76.4% would like to attend an educational course. Even though the midwives have recognized their knowledge deficit they occasionally give genetic counseling. As a result of this study a genetics course is planned for midwives so they can actively participate in the prevention and early diagnosis of genetic diseases.     

心理咨询和治疗的知情同意原则及其影响因素

随着心理咨询和治疗的发展,患者的知情同意成为临床心理学实践的一个基本伦理观念和原则。首先提出心理咨询和治疗实践中的知情同意问题,介绍心理咨询和治疗知情同意的要素、过程、内容、意义和影响因素,并附心理咨询和治疗提供给患者的知情同意问卷,旨在引起从业者的注意和重视,并在临床实践中自觉地遵守。     

Patterns of recovery of autonomic dysfunctions and neurocognitive deficits in schizophrenics after acute psychotic episodes

In this study, the authors aimed to identify patterns of autonomic dysfunction and neurocognitive deficit recovery. The authors performed laboratory assessments on 66 patients with schizophrenia immediately after an acute psychotic episode and 6, 12, and 18 months later. Shortly after the psychotic episode, the patients displayed cardiovascular hyperarousal at rest, cardiovascular and electrodermal hyporeactivity during 2 Continuous Performance Tasks (CPTs) and deficits in 2 behavioral CPT measures (i.e., reaction time and omission error rate) compared with 29 normal controls. In the subsequent postpsychotic course, changes indicative of a process of recovery occurred in all measurement areas, although with regard to autonomic hyporeactivity amelioration was limited to a subgroup of schizophrenics with complete and persistent symptomatic remission. Neurocognitive improvement in CPTs did not appear to depend on unimpaired autonomic reactivity mechanisms.     

Accelerometer feedback to promote physical activity in adults with type 2 diabetes: a pilot study

This study examined whether giving activity feedback to obese, sedentary adults with Type 2 diabetes would improve their adherence to a home-based walking program. 49 subjects were recruited. Ten failed a treadmill cardiovascular test. Another 9 dropped out before the intervention, and 4 dropped out during the intervention. The remaining 26 adults (14 women, 12 men; age M = 48.1 yr., SD = 7.1) received behavioral counseling monthly for 3 mo. regarding exercise. All subjects wore a triaxial accelerometer during these 3 months. Randomly, half of the subjects were blind to the data from the accelerometers, i.e., no feedback, and had counseling based on their self-report diaries. The other half had access to the accelerometer data, got a computerized graph of their physical activity for the period between counseling sessions, and had counseling based on these objective data, i.e., feedback. The feedback group showed an increase in exercise over the 3 mo. The nonfeedback group showed an increase in activity at 1.5 mo. but reverted to their baseline exercise levels at 3 mo. However, analysis of variance showed there was at least an 8% probability that this effect was due to chance, so the hypothesis that feedback would improve exercise adherence could not be supported. Further studies with larger sample sizes and greater control of experimental conditions are needed to determine the utility of objective activity feedback.     

Medical help-seeking by different types of chronic pain patients

Abstract

This paper reports on a study of the use of health services by different types of patients with chronic benign pain. The purpose of the study was to identify differences in medical consumption between different types of pain patients. In the course of one year 586 patients were selected by 45 general practitioners: they included patients who had had almost daily chronic pain symptoms for at least six months, without a medical diagnosis (such as cancer or arthritis) to explain the pain. Patients were categorized according to the Multidimensional Pain Inventory which distinguishes four categories: the dysfunctional, who perceive severe pain and gain social support; the interpersonally distressed, who combine pain with affective and relational distress; adaptive copers, who cope with their pain in a number of ways; the average type, with characteristics of all three other types. It was hypothesised that adaptive copers would make less use of health services and would be more involved in self-help activities than dysfunctional or interpersonally distressed patients. Frequent use of psychological services by the interpersonally distressed group was expected. It was predicted that difference in health services use would continue during the subsequent year.

No differences were found between the four groups in location, temporal characteristics, or possible medical causes of the pain symptoms. Dysfunctional patients used more services than the others. Adaptive copers used the least. The four groups did not differ in self-care activities. Group-membership as well as pain severity are related to the use of health services. None of the groups showed a significant decline in the use of health services during the year. It is concluded that chronic pain is invalidating, but that not all patients are equally excessive in their use of medical services.     

Teaching group treatment in doctoral programs for counseling psychology

We surveyed the 71 doctoral programs in counseling psychology approved by the American Psychological Association to examine whether and how group counseling or therapy was taught. Responses from 31 programs listed at least one graduate course in group counseling; over half offered more than one. In most cases the introductory course was required. Analysis also indicated that introductory courses often included an in-class or an out-of-class experiential component, focused either primarily or exclusively on outpatient therapy and used Yalom's interpersonal approach. Discussion focused on the importance of courses in group interventions in doctoral programs in counseling psychology and the differences and similarities in academic training of group interventions in programs in counseling and clinical psychology.     

Self‐regulatory deficits associated with unpracticed mindfulness strategies for coping with acute pain

Training in mindfulness is a well‐supported therapeutic strategy for pain conditions, though short‐term mindfulness training for acute pain is not always effective. To explore the possibility that initial attempts at mindfulness in people without previous training may drain self‐regulatory resources, the current study used a student sample (N = 63) to test the hypothesis that brief instruction in mindfulness would lead to reduced pain tolerance on a cold pressor task, compared to more familiar strategies for coping with acute pain. We also investigated whether high heart rate variability (HRV), a physiological indicator of self‐regulatory capacity, would predict pain tolerance. Higher HRV predicted greater pain tolerance only in the control group, suggesting that applying unfamiliar mindfulness strategies while attempting to tolerate pain more rapidly sapped self‐regulatory strength.     

中学生厌学心理及其干预与学习效率的相关研究

本研究旨在考察两个问题：1．心理咨询是否是改变中学生厌学心理的有效途径,如果是,它能够在多大程度上改变厌学心理;2．厌学心理的改善能否有效提高中学生学习效率。本实验用问卷调查法从183名中学生中筛选出有厌学心理的学生24名。运用个体心理咨询、团体心理咨询等手段对这24名学生进行为期4个月干预、结果表明：心理咨询能够有效且明显地改善厌学心理。但要完全消除厌学心理则还需要辅以其他干预手段;随着学生厌学心理的改善,其学习效率也相应有了明显的提高。     

Teaching self-modification in an adjustment course

This article reports a project in which students in a college level adjustment course were taught to apply a model of behavior change in order to gain greater control over their own behavior. Pilot data suggest that students found the experience worthwhile, that many of them learned to make substantial changes in their behavior, and that some of them maintained a high degree of transfer to new problems that confronted them after the class had ended. The approach appears to have a great deal of potential for those who would like to extend their counseling beyond the confines of their offices and who would like to combine their counseling and teaching interests.     

Effectiveness of the GATB and Counseling Combined: Reducing Vocational Training Dropout Rates

Seventy-three male vocational trainees, aged 16 to 22 years, were assigned to one of two groups. The 36 trainees in Group 1 were assigned to a particular vocational course consistent with their GATB profiles and received 3 or more counseling sessions. The 37 trainees in Group 2 received neither prescreening nor counseling sessions but were assigned to their courses because of personal interest and in order to fill vacancies. A phi coefficient of .69, significant at the .01 level, between the combination preparation procedures (prescreening and counseling) and graduation from vocational course was obtained. Further analysis suggests that the combination of counseling and prescreening may reduce dropout rate to a greater extent than prescreening alone.     

Counseling Past and Present: Is There a Future?

Major criticisms directed at counseling are identified and prominent suggestions for their elimination are described through an analysis of the counseling literature of the past 10 years. A brief outline of the history of counseling offers a historical perspective to the discussion. One suggestion to improve counseling, that counselors become change agents in their institutions, is examined and described with steps for its implementation. The implementation of the change-agent role for counselors would address much of the substantive criticism directed at counseling, and would remold the profession to more effectively meet today's needs.     

大学生心理健康教育教学模式的构建与实践研究

采用自然教学实验法,探索提高大学生心理健康水平的有效途径与教学模式。结果表明（1）开设心理健康教育课程并辅以心理咨询是眼下提高大学生心理健康水平的有效措施之一;（2）不同系科心理健康教育的效果不同,心理健康教育课程应根据学生的个别差异有针对性地进行;（3）大学生心理健康教育课程的教学模式为“面上集中释疑,线上互相解疑,点上个别辅导”。     

Computer assisted versus traditional vocational counseling with high and low readiness clients

This study tested Hershenson's hypothesis that different vocational counseling methods would be differentially effective for clients at different levels of readiness. The top 54 and bottom 54 high school sophomores from a class of 853 were selected on the basis of their Educational Development Series test scores. Half of each group (highs and lows) received individual counseling; the other half interacted with a computerized vocational information program (CVIS). It was predicted that high readiness subjects would change more with CVIS and lows would change more with counseling. Only the latter prediction was confirmed. The groups did not differ in satisfaction with their posttreatment vocational choices. Findings suggest that individual counseling be emphasized with low readiness clients when both options are available.     

Need for approval and counseling outcomes

The intent of this study was to determine the effects of a clients' need for approval on the outcomes of counseling. The expectation was that clients who have a high need for approval by others would cooperate more with the counseling process and would more often be successful in the sense of being rehabilitated. The Marlowe-Crowne Social Desirability Scale was administered to 167 applicants at a state rehabilitation agency immediately after the initial interview. It was hypothesized that successfully rehabilitated clients would obtain significantly higher social desirability scores than those clients who were not successful. The results confirmed the hypothesis at the .01 level of significance.     

Internet als Ratgeber bei psychischen Problemen

Communication serves as an integral part of every psychotherapeutic treatment. Consequently, in the last decade modern information and communication technologies in the therapeutic context gained in importance. How important are Internet-based therapeutic information and intervention sources for potential patients and how are they appraised when already known or used? In the course of a representative study the health-related Internet use behavior of 2,411 Germans was examined. There was a focus on the usage of health-related websites and counseling services in the past and (potentially) in the future. More than one third (37.3%) of the German population and almost two thirds (63.5%) of German Internet users search for medical information on Internet. However, physicians, psychologists, pharmacists, family members and friends have a greater impact on health behavior than the Internet. Of German Internet users 54.1% are not informed about the possibilities of psychosocial online counseling. Nevertheless, they would maybe use the Internet in the future. The 2.2% who already used Internet in case of psychosocial problems are content with the service. In fact new media have not yet found their way into psychotherapy and counseling as much as in our daily lives. With regard to manifest mental disorders, Germans would prefer the conventional psychotherapeutic milieu to media-assisted kinds of treatment.     

In Defense of Radical Social Constructivism

This article is a response to Alex North's ( 2016 ) critique of radical social constructivism (RSC). North claimed that RSC was a movement in counseling that would be monumentally problematic in its future application to counseling theory. In this article, the author defends RSC and posits that RSC is closely aligned with the values of counseling. RSC encourages counselors to look at the social understanding of clients' experiences as paramount to the behaviors they exhibit.