Cultural and ethical issues concerning research on American Indian youth

A study of American Indian youths illustrates competing pressures between research and ethics. A stakeholder-researcher team developed three plans to protect participants. The first allowed participants to skip potentially upsetting interview sections. The second called for participants to skip potentially upsetting interview sections. The second called for participants flagged for abuse or suicidality to receive referrals, emergency 24-hr clinical backup, or both. The third, based on the community's desire to promote service access, included giving participants a list of service resources. Interviewers gave referrals to participants flagged as having mild problems, and reported participants with serious problems to supervisors for clinical backup. Participants seldom chose to skip sections, so data integrity was not compromised. However, participants did have more problems than expected (e.g., 1 in 3 had thought about suicide, 1 in 5 had attempted suicide, and 1 in 4 reported abuse), so service agencies were not equipped to respond. Researchers must accept the competing pressures and find ethically appropriate compromises that will not undermine research integrity.     

A fresh look at perversion

The history of ideas about perversion is considered, along with an examination of whether the concept is clinically useful. Three cases of varying degrees of severity are presented, illustrating the clinical value of the concept in the analytic situation. All three cases are women, and the particular usefulness of the concept of perversion for women is noted. The place of aggression and the pleasure resulting from its expression are highlighted.     

Therapist training in video chat technology for use in an adaptive digital mental health intervention: Challenges,facilitators and implications for training models

Objective

This qualitative study investigated therapist training experiences, elements of skill acquisition, and barriers and facilitators associated with conducting assessments, and the delivery of low- and high-intensity therapist assistance delivered via video chat technology, adjunctive to a transdiagnostic digital mental health intervention programme for anxiety and depression.

Methodology

In total, 34 semistructured interviews were conducted with 20 therapists. Twenty interviews explored experiences of training to administer a clinical assessment tool, and 14 additional interviews explored training experiences of delivering low- and high-intensity therapist assistance via video chat technology.

Results

Reflexive thematic analysis identified three themes: video chat skill acquisition, competencies transferrable to video chat and video chat service quality. Training and supervision were identified as important to scaffold skill development, and therapists described surprise that their skill set was transferrable to video chat. The most cited barrier to the adoption of video chat was the management of risk and distress, along with environmental suitability. Frequently cited facilitators to the adoption of video chat included stable Internet connection, protocols and resources.

Conclusion

The benefits of video chat technology and digital mental health interventions can be maximised through the expansion and integration of training into existing teaching curricula. If therapists are familiarised and competent to deliver mental health services via the Internet, as well as in person, the future adoption of blended and stepped-care models is likely to be increased.     

Selective looking by infants

Previous studies of selective looking have shown that adults and young children can easily follow one visually specified event while ignoring another on which it is optically superimposed. The present experiments show that 4-month-old infants have the same ability. Two films were shown superimposed on the same screen, while one soundtrack was played in an attempt to influence the subjects' perceptual selection. When the films were separated during test periods, the infants looked mostly at the previously silent film, suggesting that it was novel for them. Control experiments showed that completely unfamiliar films elicited comparable novelty preferences in the same situation, that the soundtrack could also influence perceptual selection during side-by-side presentation of the same films, and that cross-modal habituation to the soundtrack alone could not account for the results. Perception is inherently selective, even in the first months of life.     

The best teacher: Mediating effects of experience with employed women on men managers' responses to subordinates' mistakes

What role does experience with working women play in determining men managers' views of women managers? To investigate this question, we analyzed responses of a small sample of experienced men managers with varying degrees of experience with working women. Of primary concern were men managers' attribution of causes for a woman manager's poor performance and their choice of response to such poor performance. The data confirmed that experience with women managers as colleagues and with employed wives affects the stability of men managers' causal attributions as well as the severity of their responses to a woman manager's poor performance. The implications of these findings are discussed.     

Introducing a school social worker into schools

A DES-sponsored school-based social work programme is described, in which six social workers collaborated with teachers in attempts to optimise the school and home environments of 'at risk' and 'maladjusted' junior and senior pupils. The principal components of the scheme included teacher-social work consultation, attempts to increase parent-teacher understanding, and a casework approach with the families.     

American Indian Youth: Personal,Familial, and Environmental Strengths

We present data from interviews with 401 youths on the relationship of personal, familial, and environmental strengths to the outcomes of urban and reservation American Indian youths. Urban youths consistently nominated more strengths than tribal youths, except in the area of tribal strengths. Quantitative data show how those strengths relate to their school success, daily functioning, mental health, and ethnic identity. Personal and familial strengths are related to positive school success and functioning. Environmental strengths demonstrate complex relationships in which tribal strengths are related to increased mental health problems and school strengths are related to fewer problems. The results of our study speak to the need to include multiple categories of different strengths in research and to focus on strengths as well as problems in clinical interventions.     

Systemic therapy and attachment narratives

In this paper we describe how we bring together three major systems of thought: attachment theory; family systems theories; and theories of narrative development, in an integrated approach to systemic practice that we call attachment narrative therapy (ANT). ANT provides a four‐stage framework for practice: creating a secure base; exploring narratives and attachment experiences within a systemic framework; considering alternatives and taking action; and the future and maintenance of the therapeutic base. Formulation, especially regarding the role of emotions and attachments in family dynamics and narratives, is at the heart of our approach and helps us hold ourselves accountable for our particular weave of theory and practice.