Changes in verbalizations during sandplay: an empirical study

This is a quantitative study of an 11-year-old boy diagnosed with major depression who in all but one session made a sandplay. A computerized system was used to analyse the written verbalizations on four dimensions of positive and negative: emotions, contracts (psychosocial agreements, relationships, etc.), performance (behaviour) and rewards. It was hypothesized that the verbalizations made by the patient (recorded by the therapist) would become more positive and less negative during the course of therapy. The positive and negative values of the four dimensions were correlated with the session number. This was supported on two (performance & contract) of the four positive dimensions (statistically significant). The hypothesis that the negative dimensions would become less negative was supported on all four dimensions (statistically significant). Thus, six of the eight hypotheses were supported. This uninvestigated area of research illustrates verbal interactions between patient and therapist were an important aspect of sandplay therapy. Through reanalysing the sessions for quantitative content, written recording of direct quotes and observation of behaviour, data was entered into a valid and reliable coding system to quantitatively analyze the verbalizations. This analysis of verbalizations of the patient and observations made by the therapist indicates sandplay therapy is multifaceted.     

Judicial gatekeeping on scientific validity with risk assessment tools

Risk assessment tools driven by algorithms offer promising advantages in predicting the recidivism risk of defendants. Jurisdictions are increasingly relying upon risk tool outcomes to help judges at sentencing with their decisions on whether to incarcerate or whether to use community-based sanctions. Yet as sentencing has significant consequences for public safety and individual rights, care must be taken that the tools relied upon are appropriate for the task. Judges are encouraged to act as gatekeepers to evaluate whether the forensic risk assessment tool offered has a sufficient level of validity in that it is fit for the purposes of sentencing, provides an acceptable level of accuracy in its predictions, and achieves an adequate standard of reliability with regard to its outcomes.     

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

Domain Compensation in Quality of Life of Individuals with Vasovagal Syncope: a Test of Homeostasis Theory

Although health-related quality of life is often diminished in populations characterised by physical illness, this does not necessarily imply lower overall assessments of general life satisfaction (GLS) and greater incidence of mental illness. According to Homeostasis Theory, this limited impact of health on these more global wellbeing indices may be due to internal and external buffers that serve to maintain one’s overall sense of wellbeing and GLS in the face of adversity. Thus, the present study tested in a sample of 212 individuals (48 with vasovagal syncope, 62 cardiac patients, and 102 healthy control participants) the possibility that poor health-related quality of life (as expected for the cardiac and vasovagal syncope groups) may be offset by relatively higher satisfaction with other aspects of one’s life (the domain compensation hypothesis). Consistent with this view, present findings showed that although individuals in the two health-risk groups reported lower health satisfaction (HSat) than the control group, they had comparable levels of mental health, GLS satisfaction, and subjective wellbeing (minus health; PWI-H). Moreover, moderation analyses confirmed that the relationship between HSat and GLS reduced to non-significance for individuals with PWI-H higher than nationally representative, normative levels. Collectively, these findings suggest that a broader context is necessary to understand the impact that illness may have on one’s sense of GLS and mental health. In particular, the provision of support and satisfaction with other life domains may serve to buffer concerns about one’s health.     

Enhancing Critical Consciousness Through a Cross‐Cultural Immersion Experience in South Africa

Using phenomenological approaches, the author explored the meanings and essences of a cross‐cultural immersion experience in South Africa among counseling master's‐level students. Five core themes—the meaning of being American, sociopolitical awareness, engagement with South Africans and their communities, appreciation of life, and commitment to change—characterized the development of critical consciousness (Freire, 1973 , 2000 ). Findings support positive influences of cross‐cultural immersion as an experiential pedagogical method for multicultural development. Usando enfoques fenomenológicos, se exploraron los significados y esencias de una experiencia de inmersión transcultural en Sudáfrica entre estudiantes de nivel máster en consejería. Cinco temas centrales (el significado de ser estadounidense, la conciencia sociopolítica, la interacción con individuos sudafricanos y sus comunidades, la valoración de la vida y el compromiso con el cambio) caracterizaron el desarrollo de la conciencia crítica (Freire, 1973 , 2000 ). Los hallazgos confirman influencias positivas de la inmersión transcultural como un método pedagógico basado en la experiencia para el desarrollo multicultural.     

Some correlates of health locus of control among multicultural individuals

The relationship of locus of control to depression, anxiety, hostility, and physical health was assessed in a sample of multicultural college students (N = 162). Powerful Others Health Locus of Control was correlated with depression, anxiety, hostility, and recent physical symptoms while Chance Health Locus of Control (CHLC) was correlated with all of the above as well as chronic physical symptoms and major health problems. When controlling for a variety of health risk factors (viz., age, sex, body mass, exercise, smoking, salt, alcohol, and caffeine), only CHLC remained significant in the physical health models. Results support the cognitive model of mental health which emphasize the importance of adaptive beliefs. Specifically, they suggest that issues about control are related to negative affect and indicate that the often-cited relationship of an external locus of control to depression and anxiety also holds for hostility. The findings do not, however, support the view that anxiety and depression are associated with different types of external locus of control but rather suggest a unified set of locus of control beliefs underlying the three types of negative affect. In addition, evidence is provided for the external validity of the Multidimensional Health Locus of Control (MHLC) Scales with respect to mental health. Further, the results indicate that belief about one’s health may play a significant role in one’s physical health and that the health behavior model of the relationship between locus of control and physical health is insufficient to explain the relationship. As the Chance and Powerful Others MHLC scales were not related to health habits in this sample but were related to mental health (viz., depression, anxiety, and hostility), locus of control beliefs may be related to physical health via their relationship with mental health.