The common sense of counseling psychology: introducing the Common-Sense Model of self-regulation

Abstract

The goal of therapy is typically to improve clients’ self-management of their problems, not only during the course of therapy but also after therapy ends. Although it seems obvious that therapists are interested in improving clients’ self-management, the psychotherapy literature has little to say on the topic. This article introduces Leventhal’s Common-Sense Model of Self-Regulation, a theoretical model of the self-management of health, and applies the model to the therapeutic process. The Common-Sense Model proposes that people develop illness representations of health threats and these illness representations guide self-management. The model has primarily been used to understand how people self-manage physical health problems, we suggest it may also be useful to understand self-management of mental health problems. The Common-Sense Model’s strengths-based perspective is a natural fit for the work of counseling psychologists. The model has important practical implications for addressing how clients understand mental health problems over the course of treatment and self-manage these problems during and after treatment.     

Career self-management: Its nature, causes and consequences

In a recent special issue [Journal of Vocational Behavior 59 (2001) 284], scholars noted that the field of vocational psychology needs a better understanding of career self-management. This article proposes a conceptual framework of career self-management, based on Crites’ [Vocational Psychology, McGraw-Hill, New York, 1969] model of vocational adjustment. It argues that people use three types of career self-managing behavior (positioning, influence, and boundary management) as adaptive responses to career development tasks. These behaviors are used to respond to or eliminate thwarting conditions or career barriers, and thereby lead to vocational adjustment. Suggested determinants of this behavior are self-efficacy, desire for control, and career anchors. Career self-management can enhance perceptions of control over the career, leading to career satisfaction, but it may also be associated with negative outcomes and maladjustment. The framework is suggested to apply both to bounded ‘organizational’ careers and to more flexible, improvised careers. The article concludes by considering the implications for research and practice.     

Determinants associated with self-management behavior among type 2 diabetes patients in China: A structural equation model based on the theory of planned behavior

BackgroundDiabetes self-management (DSM) is essential for patients to achieve better health outcomes. However, previous studies have demonstrated that the performance of DSM is not optimal. This study was designed to identify the significant determinants of self-management behavior in type 2 diabetes(T2DM) patients to improve DSM.MethodA convenient sampling method was employed in this study. Data were collected from a community health center from January to February 2021 in Nanjing city, China. A total of 431 patients completed the self-administered questionnaires. A structural equation model based on the theory of planned behavior(TPB) was adopted for analysis.ResultsTPB model presents excellent goodness of fit of data. Attitude (β=0.161, P < 0.01), subjective norms (SN) (β=0.239, P < 0.001), and perceived behavior control (PBC) (β=0.197, P < 0.001) were strong predictors of intention. Intention (β=0.230, P < 0.001) and PBC (β=0.259, P < 0.001) had a direct effect on self-management behavior. The impact of attitude and SN on behavior was significantly mediated via behavioral intention.ConclusionThe application of TPB to self-management behavior in T2DM patients can significantly enhance our understanding of theory-based self-management behavior. This predictive model could potentially be a valuable tool and provide a feasible approach for formulating more targeted and population-specific DSM interventions in future research.     

Body image and cystic fibrosis: a critical review

A slight frame and poor appetite are common among patients with cystic fibrosis (CF) yet healthy body weight has been related to a better prognosis. A review of studies exploring body image (BI) among adults and adolescents with CF was conducted. Seven electronic databases were searched for potential papers. They located 128 references, of which 24 were read in full and 12 included in the review. Accepted papers suggested females with CF had a better BI compared to males, but this could compromise survival, given their preference for a low body weight. Males may be more motivated to adhere to nutritional advice because they favor a larger form. Practitioners should broach the topic of BI at clinic appointments to ensure this does not have a detrimental impact on self-management, although more research is required to guide professionals in this task.     

乳腺癌患者自我管理行为与生活质量的相关性研究

探讨乳腺癌患者自我管理行为、生活质量及两者之间的相关性.应用慢性病自我管理研究测量表中的自我管理行为量表、乳腺癌患者生活质量测定量表调查260例乳腺癌患者的自我管理行为和生活质量.乳腺癌患者自我管理行为及生活质量现状均不理想,自我管理行为与生活质量呈正相关（P＜0.05）.乳腺癌患者自我管理行为与生活质量间有密切关系,临床护理工作中可对患者进行护理干预来增强其自我管理行为,进而提高生活质量.     

An exploration of attitudes toward the use of patient incentives to support diabetes self-management

Objective: To improve our understanding of the potential of incentives to enhance diabetes self-management (type 1 and type 2) and to integrate incentives into a conceptual model of diabetes self-management over time.

Design: A qualitative analysis of in-depth individual interviews with 12 patients and 9 providers.

Main outcome measures: Influence of time on patients’ needs for diabetes self-management technologies and on the use of incentives to drive behavioural changes.

Results: Ten of the 12 participants with diabetes (83%) were interested in using financial incentives to improve their diabetes self-management. We found that incentives can play two key roles in diabetes self-management: guide the learning phase during the creation of habits; and serve as an acknowledgement of efforts made in the stable phase, when providers typically only focus on the patients’ failures at self-management.

Conclusion: Patients seem receptive to the idea of financial incentives, which have the potential to support diabetes self-management through either small monetary amounts or tangible rewards. Incentives hold promise for supporting behaviour changes, especially in early stages of diabetes, but they require careful planning to avoid the undesired consequence of decreased intrinsic motivation.     

A Self-Management Program for Adolescents and Children with Renal Transplantation

This paper describes the development and implementation of a self-management program designed to address noncompliance in adolescents with renal transplants. Transplantation provides the best treatment alternative for End-Stage Renal Disease (ESRD), but is a procedure that subsequently demands recipients follow a life-long medication regimen. Nonadherance to medical therapy is a serious problem for adolescents; it is one of the most common causes of chronic graft rejection in this population. To improve compliance rates for this population, a self-management program was designed: (1) to provide social support; (2) to review information about medications and transplant management; and (3) to both teach and provide transplantation patients the opportunity to practice self-management skills. Details about the program, including recruitment issues and session content, are provided. Evaluations by participants indicated that the program was effective in creating a supportive environment for both patients and their parents, and in addressing health-related concerns.     

糖尿病自我管理的面面观

糖尿病是慢性终身性疾病。糖尿病患者的自我管理处于中等或偏低的水平,导致患者出现各种急慢性并发症,严重影响了患者的生活质量。患者的自我效能影响患者的自我管理行为。因此,有必要介绍糖尿病自我管理理论及研究现状,为提高糖尿病患者的自我管理水平提供参考资料。     

An analysis of self-management

We discuss topics related to a theoretical analysis of self-management, including theories of self-management, self-reinforcement and self-management, antecedent stimuli for self-management, teaching of self-management behaviors, and applications of self-management. Our analysis indicates that self-management's roots in behavioral explanations of phenomena are solid, but that there are important issues yet to be examined in developing a thorough understanding of self-management. We argue that self-management behaviors almost certainly must be examined in relation to the contexts in which they occur and the consequences that they produce.     

Process Evaluation of A Physical Activity Self-Management Program For Children: Spark

Abstract

SPARK is a controlled field study of a multi-component elementary school program to promote physical activity. One component is a weekly classroom-based self-management program, with the goal of increasing physical activity outside of school. The curriculum included goal setting, behavioral skills training, a reward system, and parent involvement. An evaluation of curriculum implementation and association between process and outcome was conducted using direct observation of lessons, subjective ratings by 24 teachers and 391 parents, and participation records of 549 students. Teachers viewed the self-management curriculum less positively than the physical education curriculum. Teachers were observed implementing an average of 65% of curriculum elements, which may have contributed to the limited effects of the self-management program. Student participation in the program, measured by points earned for doing out of school physical activity, was correlated significantly with changes in body mass index and multiple psychosocial variables among boys but not girls. Barriers to full program implementation were identified, and a remaining challenge is to improve self-management curriculum implementation by teachers.     

Irrational Beliefs and Self-Management as Separable Predictors of Anxiety and Depression

Irrational beliefs and self-management are both cognitive-behavioral constructs that are integral in modern Rational-Emotive Behavior Therapy and Self-Management Therapy, respectively. Both irrational beliefs and self-management have been linked to anxiety and depression, and there is evidence for their usefulness for these types of distress. This is the first study to consider irrational beliefs and self-management as simultaneous predictors of anxiety and depression. An outpatient clinical sample (n = 51) completed measures of irrational beliefs, self-management, and emotional symptoms. Results indicated that as simultaneous predictors of fear and worry, self-management did not account for any additional variance accounted for by irrational beliefs. However, both irrational beliefs and self-management predicted unique variance in depression, negative affect, and positive affect. Exploratory analyses with single diagnosis (n = 26) and multiple diagnoses (n = 25) subsamples provided some divergent results. These results are discussed in terms of case conceptualization and potential future applications in the treatment of affective disorders, in particular depression.     

Effectiveness of Family Systems Theory Interventions on Adolescents with Type 1 Diabetes: A Meta-analysis

The purpose of this review is to synthesize the evidence and determine the efficacy of interventions based on family systems theory in diabetes-related family conflict, self-management, and glycemic control among adolescents with type 1 diabetes. A systematic search of five English databases was conducted. Interventions based on family systems theory in adolescents with type 1 diabetes that reported diabetes-related family conflict, self-management, and glycemic control as outcome variables were included. A total of 14 articles from ten interventions were included. Meta-analysis results revealed that, compared to adolescents who received usual care, adolescents who received family systems theory interventions reported fewer diabetes-related family conflicts with a medium effect size of 0.32 (p?<?0.05), but there was no significant improvement on self-management or glycemic control (p?>?0.05). Family systems theory interventions appear to have beneficial effect on reducing diabetes-related family conflicts for adolescents with type 1 diabetes. Adolescents who have type 1 diabetes and their families may need multidimensional psychosocial programs accompanied by diabetes education to improve glycemic control.

     

The Complexity and Challenges of Genetic Counseling and Testing for Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is an umbrella term referring to two chronic idiopathic intestinal diseases: ulcerative colitis (UC) and Crohn’s disease (CD). Both UC and CD are characterized by immune activation that leads to symptoms, but the location, severity and behavior of the inflammation varies among individuals and in characteristic ways between UC and CD. A majority of patients with IBD are diagnosed in young adulthood, but the response to therapy is variable and difficult to predict, with some patients demonstrating a prompt and effective remission while others have continuous symptoms that do not respond to existing medical options. Surgery remains a frequent and necessary occurrence among patients with IBD, but in UC it is considered curative, while in CD only temporizing. Clinical observations, epidemiological studies, and molecular genetics have provided strong evidence that both genetic and environmental factors are important determinants for disease susceptibility. In recent years, a number of genes have been identified that associate with CD and UC, although the clinical utility of these discoveries in patients or in susceptible family members has not been determined. Nonetheless, it is hoped that these fundamental advances in our understanding of IBD will lead to better therapies for patients and prevention strategies for those who are susceptible. Effective incorporation of clinical genetic testing for IBD into practice will require appropriate education and counseling.     

Increasing On-Task Behavior in Students in a Regular Classroom: Effectiveness of a Self-Management Procedure Using a Tactile Prompt

Self-management strategies have been shown to be widely effective. However, limited classroom-based research exists involving low performing but developmentally normal high school-aged participants. This study examined the effectiveness of a self-management strategy aimed at increasing on-task behavior in general education classrooms with students without a diagnosed disability, behavior disorder, or exceptionality. The self-management package included provision of a tactile prompt, training in self-monitoring and data recording, self-monitoring, and the plotting of the results on a cumulative graph. A multiple baseline design across three participants was used to evaluate the effects of the intervention. An increase in on-task behavior was observed with all participants on implementation of the self-management package, and questionnaire-based social validity findings suggest this was an acceptable and effective procedure for the classroom context. Limitations, implications, and future directions of these findings are discussed.     

EXAMINATION OF SITUATIONAL AND ATTITUDINAL MODERATORS OF THE HESITATION AND PERFORMANCE RELATION

The hesitation dimension of action-state orientation refers to the behavioral capacity to start action on tasks. In this study, job characteristics (autonomy and routineness) and job attitudes (satisfaction and involvement) were examined as moderators of the relation between hesitation and supervisor ratings of work behaviors (overall job performance and self-management performance) in 2 different samples. In both samples, routineness moderated the hesitation and self-management performance relation such that individuals low in hesitation performed better than individuals high in hesitation when routineness was low, but no differences in performance were observed when routineness was high. In addition, job satisfaction and job involvement were significant moderators of the relation between hesitation and self-management performance, with individuals low in hesitation performing better than individuals high in hesitation when satisfaction or involvement was low, but no differences in performance were observed when satisfaction or involvement was high.     

Extended network learning error: A new way of conceptualising chronic fatigue syndrome

Abstract

The cause of chronic fatigue syndrome (CFS) is controversial: psychological, hypothalamic and immune mechanisms have been proposed as well as the possibility of some form of interaction between these mechanisms. Patients' own conceptual models vary and sometimes adversely affect self-management. This paper suggests an interactional way of conceptualising CFS using developments in complexity theory (networks, parallel processing or connectionism). I propose that the neurological, immune and endocrine systems are pan of a single, self-regulatory, extended brain-body network. Furthermore, that CFS is caused by self-organisational change in this extended network created by normally adaptive error-sensitive learning rules that malfunction when physiological and psychological challenges coincide. This psychoneuroimniunoendocrinological model shows how previously proposed mechanisms could interact to cause CFS. explains the heterogeneity of the presentation of the disease, and provides a conceptual model that may be acceptable to patients but is also consistent with effective self-management.     

Spontaneous recovery

Spontaneous recovery from extinction is one of the most basic phenomena of Pavlovian conditioning. Although it can be studied by using a variety of designs, some procedures are better than others for identifying the involvement of underlying learning processes. A wide range of different learning mechanisms has been suggested as being engaged by extinction, most of which have implications for the nature of spontaneous recovery. However, despite the centrality of the notion of spontaneous recovery to the understanding of extinction, the empirical literature on its determinants is relatively sparse and quite mixed. Its very ubiquity suggests that spontaneous recovery has multiple sources.     

Analysis of self-recording in self-management interventions for stereotypy

Most treatments for stereotypy involve arrangements of antecedent or consequent events that are imposed entirely by a therapist. By contrast, results of some studies suggest that self-recording, a common component of self-management interventions, might be an effective and efficient way to reduce stereotypy. Because the procedure typically has included instructions to refrain from stereotypy, self-recording of the absence of stereotypy, and differential reinforcement of accurate recording, it is unclear which element or combination of elements produces reductions in stereotypy. We conducted a component analysis of a self-management intervention and observed that decreases in stereotypy might be attributable to instructional control or to differential reinforcement, but that self-recording per se had little effect on stereotypy.     

Food‐Safety Practices in the Domestic Kitchen: Demographic,Personality, and Experiential Determinants1

The impact of consumer behavior in determining the safety of foods prepared at home has focused so far on the role of isolated consumer practices. In addition, demographic factors have been applied primarily to explain differences between individuals. In this paper, the use of psychological factors to predict scores on the integrated food‐safety score is advocated. In order to assess the relevance of psychological constructs to food‐safety behaviors, several relations are tested at the same time in a structural equation model in which it is demonstrated that the inclusion of psychological determinants leads to a better model for the prediction of food‐related behaviors in comparison to demographic factors alone.     

Examining neurochemical determinants of inspection time: Development of a biological model

Inspection time (IT), an information-processing correlate of psychometric intelligence, has been extensively studied. Previous research has shown that IT is a reliable correlate of psychometric intelligence across different developmental periods, mirroring developmental trends of fluid intelligence. Despite this extensive previous literature, very little is known about the biological basis of IT. In the present review, we discuss recent results from our laboratories examining the neurochemical determinants of IT. In this review, we outline the significance of several studies in which performance on the IT task is measured before and after modulating key human central nervous system (CNS) neurotransmitters and receptor systems (e.g., cholinergic, serotonergic, noradrenergic, and dopaminergic systems). The results of these studies indicate a primarily cholinergic basis for IT, although other aspects of psychometric intelligence may have serotonergic and dopaminergic determinants in addition to a cholinergic basis. The results are consistent with data reporting cholinergic depletion and impaired IT performance in dementia of the Alzheimer's type (DAT). Speculatively, we propose that compounds that enhance the release of the neurotransmitter acetylcholine (Ach) will improve IT and the variance that IT shares with IQ test performance.