Engagement With Self‐Practice/Self‐Reflection as a Professional Development Activity: The Role of Therapist Beliefs

A number of research studies support self‐practice/self‐reflection (SP/SR) as an experiential learning process that facilitates the acquisition of therapeutic skill in a number of cognitive‐behavioural therapy (CBT) competencies and as showing potential as a valuable professional development activity. Engaging therapists to participate in SP/SR programmes is sometimes difficult, and when they are offered the option to participate in SP/SR programmes as part of professional development, relatively few volunteer. This study investigates the role of therapist beliefs about SP/SR as a potential obstacle to engagement. An online survey was developed to assess the strength of 14 commonly held therapist beliefs concerning the consequences of participating voluntarily in a SP/SR programme. Participants were a combined sample of 44 Psychological Wellbeing Practitioners and high‐intensity CBT therapists employed by an Improving Access to Psychological Therapies service in the United Kingdom. Few negative beliefs about SP/SR emerged. The majority of respondents believed SP/SR programmes were relevant to their work situation, but perceived “lack of time” as a significant barrier to participation. Three factors are considered in relation to introducing SP/SR as a workforce professional development activity: (a) The importance of managing therapist perceptions regarding time; (b) SP/SR as a mechanism to increase self‐care and reduce burnout; and (c) The need to focus mental health services' attention on the potential of SP/SR programmes to increase staff morale and improve service delivery.     

Spontaneous Self‐Practice of Cognitive Behavioural Therapy (CBT) by Aboriginal Counsellors During and Following CBT Training: A Retrospective Analysis of Facilitating Conditions and Impact

Previous cognitive behavioural therapy (CBT) training studies have suggested that therapists who practice CBT strategies on themselves during training may experience professional and personal benefits. However, it has also been reported that some CBT trainees are reluctant to engage in self‐practice. The present study reports an incidental finding from a CBT training study with Aboriginal counsellors: all five counsellors reported that they practiced CBT techniques on themselves without specific encouragement by the trainers to do so. This paper therefore posed three questions: (a) Why—in contrast to some other trainees—did this group choose to apply CBT to themselves? (b) How did they apply it—with what purpose, in what contexts, and which skills? (c) What was the impact of CBT self‐practice? Data from the group's reflections were qualitatively analysed by two of the researchers, and “member checked” by the remainder. Results indicated that the counsellors were motivated to practice CBT on themselves for two principal reasons: the value they placed on CBT, and their personal need resulting from the high number of crises experienced while living and working in their communities. The counsellors reported practicing CBT in a wide variety of contexts as part of their learning. As in previous studies, the impact of CBT self‐practice was that it increased their confidence and competence as therapists. It also appeared to be a valuable burnout prevention strategy. If the results are generalisable, they suggest that self‐experiential training in CBT may be a culturally responsive and adaptive way for Aboriginal counsellors to enhance their learning of CBT skills.     

Alcohol Intoxication and Metamemory: Little Evidence that Moderate Intoxication Impairs Metacognitive Monitoring Processes

There is minimal research on metacognition in alcohol‐intoxicated participants. Study 1 examined metacognition across sober, intoxicated, and placebo groups, with the intoxicated group's breath alcohol concentration reaching 0.074 g/210 L on average immediately prior to the metacognition task. Participants answered cued recall general knowledge questions and provided confidence ratings and feeling‐of‐knowing judgments. They then completed a recognition (i.e., multiple choice) version of the same task, indicating an answer and a confidence rating for each question. Findings suggest that metacognitive accuracy generally did not vary across intoxication levels, although the control group's retrospective confidence judgments better discriminated between accurate and inaccurate responses than the alcohol groups in the recognition task. Study 2 surveyed academic psychologists about their expectations regarding the relation between alcohol and metacognition. Study 1's results were counter to their expectations, as respondents generally predicted a relation would be present. We discuss the implications for alcohol and memory.Copyright © 2017 John Wiley & Sons, Ltd.     

‘Pain Always Asks for a Cause’: Nietzsche and Explanation

Those who have emphasised Nietzsche's naturalism have often claimed that he emulates natural scientific methods by offering causal explanations of psychological, social, and moral phenomena. In order to render Nietzsche's method consistent with his methodology, such readers of Nietzsche have also claimed that his objections to the use of causal explanations are based on a limited scepticism concerning the veracity of causal explanations. My contention is that proponents of this reading are wrong about both Nietzsche's methodology and his method. I argue for this by: first, showing that Nietzsche was suspicious of causal explanations not only on sceptical grounds but also for reasons provided by his psychological analysis of our tendency to look for causes; and second, arguing for a non‐causal interpretation of Nietzsche's approach to psychological explanation.     

Negativity and lies in analytic group therapy: an inquiry into Bion's ideas of K and -K

In this paper a kind of therapeutic failure in psychoanalytic group work, one that is common but frequently overlooked, is described. Essentially this failure is the result of patients who mislead the therapist by lying and by a negative process of thought that works against analytic aims of acquiring understanding and emotional truth. These processes and their effects, as they are manifested by an individual patient in a group and by the therapist, are described. Bion's later theory of K and -K offers a framework for the discussion of the group events.     

An Empowerment Evaluation Model for Sexual Assault Programs: Empirical Evidence of Effectiveness

Using an empowerment evaluation approach, the Sexual Assault and Rape Prevention (SARP) Evaluation Project brought together university researchers, public health evaluators, state funders, and program staff to provide evaluation training and consultation to all state-funded rape prevention and victim services programs in Michigan. In this paper, the specific activities of the SARP project are described, and process and outcome data are presented that address the effectiveness of this empowerment evaluation approach. Based on subjective reports from program staff and objective data obtained from state funders, results suggest that this evaluation model was successful in helping 90% of the prevention programs and 75% of the victim services programs successfully develop and launch program evaluations. One-year follow-up data indicate that 90% of the programs had sustained their evaluation efforts after the formal work of the SARP project had ended.     

Short- and Long-Term Impact of Receiving Genetic Mutation Results in Women at Increased Risk for Hereditary Breast Cancer

Forty-seven unaffected women from high-risk breast cancer families who had received results for hereditary breast/ovarian predisposition genes between 1 month and 5 years ago were interviewed regarding their experiences. Women responded to open-ended questions. The initial emotional turmoil reported by most was generally short lived. However, the impact of genetic testing went beyond the individual to the extended family and social context, particularly in the short-term. A common theme was the difficulty associated with divulging a result to family members, who were also adjusting to their own result. The majority of carriers reported advantages that were both physical (options for surveillance programs and prophylactic surgery) and emotional (reduced uncertainty, increased awareness of options and knowledge about risk, preparation time). Most carriers reported no change in lifestyle although some reported discovering their mutation status as a positive life-changing experience. Implications for genetic counseling and further research are discussed.     

Reactive vs. proactive antisocial behavior: differential correlates of child ADHD symptoms?

This study examines the relation between proactive and reactive antisocial behavior with Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. Caregivers of children aged 8 to 15 (n = 84) being evaluated at a child psychiatry outpatient clinic served as participants. Given the conceptual similarity between reactive antisocial behavior (ASB) and particular ADHD symptoms, we hypothesized that ADHD symptoms would be more closely related to reactive than to proactive ASB. Based on peer deviancy training models of ASB, we also hypothesized that the relation between ADHD symptoms and proactive ASB would increase from middle childhood to adolescence. Both hypotheses were supported. These findings suggest that reactive ASB is relatively specific to ADHD symptoms, and that intervening before early adolescence may be critical to prevent the onset of comorbid proactive ASB.     

Optimizing treatment in social phobia: a review of treatment resistance

Over the last 25 years, there has been a rapid expansion of our knowledge base of social phobia (SP). Although there are a number of well-validated treatment modalities, including pharmacotherapy and cognitive-behavioral therapy, significant gaps remain in our ability to achieve full remission in most patients. Despite advances in the neurobiology of SP, the etiology has yet to be determined. Investigations examining potential predictors of response have provided little guidance in selecting an appropriate treatment modality. These gaps in our knowledge have pushed us to examine issues related to treatment resistance. This paper presents a review of the current literature and issues related to treatment-resistant SP, including a discussion of the functional impairment associated with SP, definitions of treatment response and remission, as well as outcome measures that have been used in clinical investigations of SP. In addition, criteria for a standard treatment trial, predictors of treatment response, a review of treatment resistance studies, and potential directions for future research are examined. The most promising strategies to attain remission, will likely involve augmenting selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors with agents such as anticonvulsants, benzodiazepines, and antipsychotics as well as combining pharmacotherapy with cognitive-behavioral therapy. Our current treatment target of simply attaining a response needs to be refocused, so that an asymptomatic state and high end state functioning become the final goal of treatment.