中国心理健康服务从业者的职业压力现状及影响因素

本研究目的是考察心理健康从业者的压力现状及其影响因素。769名来自全国20个省份的心理健康从业者填写了研究者自编的有93个多项选择题和填空题的问卷,其中2个从本问卷中抽取的5点量表具有可接受的心理测量学指标。主因素分析表明,心理健康从业者的职业压力可分为三类:专业能力不足、缺乏单位支持、工作负担过重。回归分析表明:影响职业压力的非专业因素有:年龄,性别,教育水平,全职或兼职,场所是否专用,以及每周咨询的小时数。在专业因素中,督导和培训能显著地缓解心理健康从业者的职业压力。治疗中的困难情况会显著地引发心理健康从业者的职业压力。     

A Survey of Behavior Analysis and Behavioral Consultation Courses in School Psychology: Implications for Training School Psychologists

All 216 doctoral and specialist level school psychology training programs were mailed a seven question survey to determine how much behavioral consultation and behavior analysis course work school psychology students are offered. One hundred and twenty-eight surveys were returned, yielding a return rate of 58.26%. The results indicated that almost all programs offer didactic courses in consultation (98.79%) and behavior analysis/behavior modification (91.52%). The percentage of practicum devoted to behavioral consultation and behavior analysis/modification was considerably less (about 25% for each) than other subject areas. The results are discussed within the context of training needed to meet the needs of practitioners in the areas of behavioral consultation and behavior analysis/behavior modification.     

Transition to the Clinical Doctorate: Attitudes of the Genetic Counseling Training Program Directors in North America

In North America, genetic counseling is an allied health profession where entry level practitioners currently must hold a master’s degree earned from a graduate program accredited by the American Board of Genetic Counseling. This is one of many health care professions that could transition to an entry level clinical doctorate degree. This study explored the attitudes of genetic counseling training program directors toward such a transition. Thirty-one North American program directors were invited to complete an online survey and a follow-up telephone interview. Twenty-one program directors completed the survey and ten directors also completed a follow up phone interview. There was disagreement among the respondents on the issue of transitioning to a clinical doctorate degree (nine in favor, six against and six undecided). Respondents disagreed about whether the transition would lead to higher salaries (six yes, eight no, and seven unsure) or increased professional recognition (eight yes, eight no, and four unsure). Approximately half (n = 10) of directors were not sure if the transition to a clinical doctorate would help or hurt minority recruitment; six thought it would help and four thought it would hurt. However, the majority (n = 13) thought a clinical doctorate would help genetic counselors to obtain faculty positions. If the field transitions to a clinical doctorate, 11 of the directors thought their program would convert, seven were unsure and one thought their program would shut down. Themes identified in interview data included 1) implications for the profession 2) institution-specific considerations and 3) perception of the unknown. Opinions are quite varied at this time regarding the possible transition to the clinical doctorate among genetic counseling training program directors.     

Client Outcomes Across Counselor Training Level Within a Multitiered Supervision Model

The authors examined client outcome data to evaluate treatment effectiveness across counselor training level. They used a multitiered supervision model consisting of professional staff, interns, and practicum students. Clients (N = 264) demonstrated significant improvement with no significant outcome differences between professional staff and supervised trainees. Limitations and future directions are discussed.     

Evaluating the “possums” health professional training in parent–infant sleep

Infant sleep problems are among the most common issues reported by parents in the postnatal period. Yet, infant sleep and infant sleep interventions remain controversial. This study evaluated health professional training in a novel approach to parent–infant sleep: the Possums Sleep Intervention. Health professionals (n = 144) completed a short survey before and after the training, which focused on the sleep component. The Possums Sleep Intervention training included the following topics: sleep science, cued care, sleep hygiene, relaxation for parents and babies, problem solving, and acceptance and commitment therapy (ACT). Health professionals reported: improvements in knowledge on infant sleep regulation, the mother–infant relationship and ACT; improvements in health professionals’ own sleep quality; improvements in psychological flexibility; and a reduction in professional burnout and secondary traumatic stress. Moreover, the health professional training was received positively. Overall, this study is supportive of the Possums Sleep Intervention health professional training.     

Does knowing translate to doing? Practitioners’ experiences of Circle of Security-Parenting (COS-P) training and implementation

This study sought to understand how practitioners perceive and experience the Circle of Security-Parenting (COS-P) training, and further, how they integrate and implement it into practice, and how these experiences influence their use and understanding of the program and its underlying model. A thematic analysis of semistructured interviews at two time points (shortly after training and 3–6 months after training) was used to explore 12 practitioners’ experiences of COS-P training and subsequent implementation. Three main themes were identified; clinical salience, personal salience, and partial use of the program. The findings reflected participants’ common perception that the model is relevant and generalizable to a wide variety of contexts. It also highlighted potential barriers to implementation, particularly practitioners’ experiences using only components of the COS-P program in isolation. The results suggest practitioners’ assumptions about client complexities, vulnerabilities, and/or incapacities, can prompt practitioners to withhold the use of COS-P (in part or whole), thereby potentially neglecting key components required for client change. The only participants who implemented the COS-P training in full had additional training in Circle of Security.     

Issues in Professional Training to Implement Evidence‐based Parenting Programs: The Preferences of Indigenous Practitioners

Indigenous children have elevated risk for poor health, behavioural, emotional, and social outcomes. Significant evidence exists that parenting programs can reduce family risk factors and improve outcomes for children and families; however, mainstream programs have had slower uptake in Indigenous communities than other communities. Culturally sensitive delivery of evidence‐based programs can enhance engagement of parents, yet the development of a workforce to deliver programs to Indigenous parents faces many obstacles. This project seeks to identify professional training processes that enhance Indigenous practitioners’ skills and confidence in delivering an evidence‐based parenting program. A survey of trained parenting practitioners via an online practitioner network assessed their views of the training and post‐training support processes they had experienced. Respondents were 57 Indigenous and 720 non‐Indigenous practitioners from 15 countries. Most training processes were rated equally helpful by Indigenous and non‐Indigenous practitioners. However, several training processes were identified as important for the delivery of culturally competent training, such as tailoring the pace of training and simplifying the language in teaching resources. Practitioners with higher ratings of the helpfulness of peer support following training reported higher program uptake and implementation. Qualitative themes also focused on the helpfulness of program resources, and having a peer support network and mentoring. Increasing access to appropriate, flexibly delivered training and post‐training support for Indigenous professionals will support the development of a skilled workforce with local knowledge and connections, and further increase the reach of evidence‐based services in Indigenous communities.     

Necessity and Opportunity: the 1-Year Master’s ABA Program at Auburn University

The Auburn University Master of Science program in Applied Behavior Analysis was designed to accommodate not only the requirements of the Behavior Analyst Certification Board for approved course sequences and practicum training, but unavoidable limitations in faculty and other resources. These limitations were incompatible with the more traditional 2-year curriculum model, so a 1-year program was designed that met the necessary conditions. This article describes the resulting academic and practicum curriculum, the key funding mechanisms that allowed the program to develop, and the opportunities and benefits that this model afforded.     

Extended problem solving treatment for depression

Introduction: Effective brief psychological approaches for depression that can be delivered by a variety of health professionals with minimal training increase access to treatment by patients. Problem Solving Treatment (PST) was developed for primary care and was modified for this study (EPST) to better meet the needs of mental health patients. Method: A total of 92 therapists from different professional backgrounds completed EPST workshops and treated 92 patients with major depression with interval clinical and treatment process assessments. Results: EPST achieved a significant reduction in depressive symptom scores, life problem scores, and there were few treatment non‐completers. Treatment outcome was predicted by process and therapist variables. Discussion: EPST is an effective and easy to teach treatment that can be delivered by a variety of practitioners and suitable for busy primary mental health care settings.     

Occupational stress of professional nurses in South Africa

The objective of this study was to identify occupational stressors for professional nurses in South Africa. A cross-sectional survey design was used. A stratified random sample of professional nurses (n=818; females?=?97%) in hospitals in South Africa was used. The Nursing Stress Indicator (NSI) was administrated together with a biographical questionnaire. Three internally consistent stress factors, namely lack of organisational support, job demands and nursing-specific demands, were extracted. The most severe stressors for professional nurses included staff shortages, inadequate salaries and excessive administrative duties. Work overload, fellow workers not doing their job, health risks posed by contact with patients and demands of patients were also identified as stressors. Stress was associated with specific factors, including age, position (rank), care unit, and work experience.     

Ethics in the Teaching of Mental Health Professionals

Summary

It is the position of the authors that mental health professionals-in-training must be well versed in the ethical/legal matters of clinical practice. Indeed, most graduate programs in the field of mental health require formal training in Ethics. The California School of Professional Psychology (Alliant International University) San Diego campus has developed a model that requires (a) an ethics course integrated with the student's on-campus supervision in the Fall and Spring semesters at the practicum level, focusing on the American Psychological Association's Ethics Code (2002) and California's Licensing Laws; and (b) an advanced ethics course (in the fourth year of training) that focuses on the integration of ethical and legal issues in clinical practice and providing a knowledge base of sound ethical judgment. Syllabi for these two courses are included.     

From the institute to the ivory tower: The live supervision stage approach for teaching supervision in academic settings

Abstract

In this paper, we describe an experimental academic course on marriage and family therapy supervision. The course, an adapted version of an institute program, was taught in four stages, combined a seminar and a practicum, and culminated with live supervision of live supervision.     

Family Processes and Mental Health among Children and Caregivers in a Family Strengthening Program

Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b?=?0.034, SE?=?0.01, p?<?0.001), child ODD (b?=?0.053, SE?=?0.02, p?<?0.01), and caregiver depression (b?=?0.049, SE?=?0.02, p?<?0.01). Family rules significantly related to caregiver depression (b?=?0.228, SE?=?0.11, p?<?0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective.

     

Size and Structure of the Holistic Milieu: A Comparison of Local Mapping Studies in Austria and Sweden

This article presents the results of two local mapping studies in Sweden and Austria that follow the methodological procedure of the British Kendal project. All practitioners offering courses, therapies or counseling in the areas of holistic spirituality and complementary health methods (such as yoga, Reiki, kinesiology, astrology, and shamanism) were mapped. A sub-sample of the mapped practitioners were contacted in person and asked about their professional situation and the number of their clients. On the basis of these data, the proportion of persons participating in the holistic milieu was estimated. The article discusses the similarities and differences between the two regions in regard to the supply of specific types of holistic activities, the professional situation of the practitioners, and the proportion of the population involved in holistic activities. The level of engagement in holistic activities in the Swedish, Austrian, and British mapping areas is also compared with the level of church attendance in the three countries.     

Stress Management in Bus Drivers: A Pilot Study Based on the Model of Effort–Reward Imbalance

A number of studies documented associations between work stress and elevated morbidity in professional drivers. The model of effort–reward imbalance (ERI) identifies distinct situational and personal characteristcs which elicit chronically stressful experience at work in terms of a mismatch between high costs and low gain. Fifty-four highly stressed male inner-city bus drivers (mean age 49,5 ± 5,3) were recruited to participate in a 12 weeks stress management program based on the ERI model (intervention group (IG) n = 26, control group (CG) n = 28). Intervention included relaxation, coping with anger and excessive work commitment (“high need for control”), management of conflicts with superiors, and recommendations for structural changes at work. After 12 weeks, mean level of “need for control,” a critical, health adverse style of coping with job demands, was significantly reduced in IG vs. CG, and this effect persisted after 3 months. In conclusion, a theory-based worksite stress management program in an occupational risk group is feasible and shows beneficial psychological effects.     

Update on master's genetic counseling training programs: Survey of curriculum content and graduate analysis summary

The field of genetic counseling is a recognized specialty in medical genetics with the primary practitioners being masters degree prepared individuals. Since the inception of the first master's degree genetic counseling (MGC) training program in 1969, more than 1000 genetic counselors have graduated from established training programs in United States and Canada. The MGC programs involve a 2-year academic curriculum of both didactic course work and supervised clinical field work (clinical praticums). A recent survey of 17 existing MGC training programs (16 U.S. and 1 Canadian) reveals that MGC graduates average a total of 1349 actual contact hours (range 854–1952 hours) during their 2-year degree program course of study. Clinical experience gained through clinical practica accounts for 58% of required coursework, followed by didactic coursework in basic science (21%) and counseling (16%), respectively. A few programs also have requisite laboratory practica, which accounts for 5% of overall content hours. The 17 existing MGC programs produce approximately 100 graduates annually. Although the number of programs has grown since inception of the first MGC program in 1969, the mean number of graduates per program remains fairly constant. By year 2002, the estimated total number of master's degree trained genetic counselors will approach 2200.     

Investigating Occupational Stress,Racial Identity,and Mentoring for African American Women in Health Care

This study examined the influence of racial identity and mentoring experiences on occupational stress among African American women in health care (N = 76). The women were surveyed about their occupational stress (role stress, psychological strain, and personal resources), racial identity, demographic information, and mentoring experiences. Results indicated that racial identity was negatively related to role stress and psychological strain, and level of education was closely related to personal resources. Mentoring was not found to have a significant impact on occupational stress as hypothesized. The implications for enhancing occupational satisfaction were discussed in relation to advocacy for career development professionals.     

The good,the bad and the uncertainty: Trainees' perceptions of the personal development group

Background: Views about the purpose and role of personal development groups (PD group) in the counsellor training process are varied. Some argue they enhance self‐awareness, self‐exploration, the ability to be congruent and, ultimately, that they make for better practitioners. Others argue there is no clear evidence for such benefits and that they can actually be damaging to trainees. Aims: This study aimed to explore the beliefs of 25 trainees enrolled on counselling diploma or counselling psychology doctoral courses. It looked in particular at their perceptions of the purpose of PD groups and their expectations regarding support, difficulties and the scope of their participation. Method: Data was collected using open‐ended questions in an anonymous survey and was subjected to a thematic analysis. Results: Trainees appeared to hold mixed – and sometimes conflicting – views about the PD group. For some it was a positive endeavour that facilitated learning about self and clients, and helped in the processes of developing counselling skills and keeping the training group healthy. For others it was a feared space, which could elicit negative emotional experiences, and impact negatively on both learning outside of the PD group and the health of the group itself. Still others were unclear about its purpose. Hope/idealisation (of the process, the facilitator and course tutors) were also evident in the trainees' responses. Implications: Implications of these findings for counselling training are discussed.     

Building Resilience in Families,Communities, and Organizations: A Training Program in Global Mental Health and Psychosocial Support

This article describes the Summer Institute in Global Mental Health and Psychosocial Support, a brief immersion training program for mental health, health, and allied professionals who work with populations that have endured severe adversities and trauma, such as domestic and political violence, extreme poverty, armed conflict, epidemics, and natural disasters. The course taught participants to apply collaborative and contextually sensitive approaches to enhance social connectedness and resilience in families, communities, and organizations. This article presents core training principles and vignettes which illustrate how those engaging in such interventions must: (1) work in the context of a strong and supportive organization; (2) appreciate the complexity of the systems with which they are engaging; and (3) be open to the possibilities for healing and transformation. The program utilized a combination of didactic presentations, hands‐on interactive exercises, case studies, and experiential approaches to organizational team building and staff stress management.