Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial

The aim of this study was to evaluate specific effects for patients with adjustment or exhaustion disorder, the Stress subgroup (n = 152), regarding symptom severity and sick leave after CBT, a return-to-work intervention (RTW-I), and a combination of them (COMBO), using data from a randomized trial. In the original study, primary care patients on sick leave (N = 211) were randomized to CBT (n = 64), RTW-I (n = 67), or COMBO (n = 80). Blinded Clinician Severity Rating (CSR) of symptoms and sick leave registry data were primary outcomes. Subgroup analyses showed that for the Stress subgroup, CBT led to greater reduction of symptoms than RTW-I posttreatment, but COMBO did not differ from CBT or RTW-I. Regarding sick leave, there was no difference between treatments in the Stress subgroup. An exploratory analysis of the treatment effects in a subgroup of patients with depression, anxiety or insomnia indicates that RTW-I reduced sick leave faster than CBT. We conclude that CBT may be promising as an effective treatment of stress and exhaustion disorder.     

Postidentification feedback affects real eyewitnesses

Many studies of simulated eyewitness situations have shown that under certain laboratory conditions, people's confidence about their identifications predicts their accuracy, but that their reported confidence can be affected by telling them that they chose the suspect. In this study, eyewitnesses (n= 134) to real crimes took part in lineups at an identification suite in the United Kingdom and were asked questions about their memory both before and after they were told whether they had identified the suspect or a filler. Before the eyewitnesses were told whether they had identified the suspect or a filler, their responses to several questions reliably differentiated between those who identified the suspect and those who identified a filler. In addition, responses to the memory questions were affected by telling the eyewitnesses whether or not they had identified the suspect. These results show that postidentification feedback affects real eyewitnesses and highlight the importance of recording meta-memory variables before an eyewitness discovers whether he or she has identified the suspect.     

From chaos and insecurity to understanding and coping: experienced benefits of a group-based education programme for people with chronic fatigue syndrome

The aim of this study was to elicit participants' experiences with a multidisciplinary patient education programme and their views regarding the usefulness of the programme. Focus group interviews were conducted with 10 participants immediately and nine months following participation in the programme and analysed using thematic analysis. Initially, the participants experienced confusion and insecurity regarding coping with the illness. Participation in the programme appeared to promote understanding, acceptance and coping through gaining greater knowledge, learning coping strategies and exchanging experiences, as well as receiving understanding and acceptance. Thus, the programme was experienced to be a beneficial intervention. However, the participants expressed a need for more guidance or follow-up to maintain the practice of coping strategies for better coping with their illness.     

Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout

Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017, 95% CI_asymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CI_asymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.     

A Case of Child and Family Therapy: Is Anger Permissible in This Home?

This article illustrates the impact of a peer supervision group on the treatment of an Orthodox Jewish child and her family system. Examples of treatment difficulties encountered when Orthodox therapists treat Orthodox patients are also presented. It highlights the use of a peer supervision group as a means to manage some of these treatment difficulties.     

A disadvantage in bilingual sentence production modulated by syntactic frequency and similarity across languages

Bilingual speakers access individual words less fluently, quickly, and accurately than monolinguals, particularly when accessing low-frequency words. Here we examined whether the bilingual speech production disadvantage would (a) extend to full sentences above and beyond single word retrieval and whether it would be modulated by (b) structural frequency and (c) syntactic properties of the bilingual speakers’ other language. English monolinguals, Spanish–English bilinguals and Mandarin–English bilinguals were tested in a sentence production task conducted exclusively in English. Response times were modulated by bilingualism, structural frequency, and structural similarity across the bilingual speakers’ two languages. These results refine our knowledge regarding the scope of the bilingual disadvantage, demonstrate that frequency effects apply to syntactic structures, and also suggest that syntax is partially shared across bilinguals’ two languages.     

Children's memory for the duration of a paediatric consultation

To learn about children's ability to estimate the duration of an event many days after it occurred, 6–12‐year‐old children were asked to judge the amount of time (range 5–45 minutes) they spent in the treatment room as part of a paediatric visit. Judgements were made 1 week or 1 month after the visit occurred. Children showed an average error of about 13 minutes. Retention interval did not significantly affect estimates. Other judgements of the length of the interview itself (mean length 8 minutes) provided what may be the first data on children's ability to make immediate retrospective duration estimates. The results also include information about children's capacity to judge how long ago they visited the clinic. Copyright © 2009 John Wiley & Sons, Ltd.     

Adoption Counselors' Perspectives of Counseling Postadoptive Families

This study was conducted to explore the mental health needs of families who adopted from the state welfare system. Using consensual qualitative research, the authors examined the perspectives of 8 clinical mental health counselors who provided counseling services to postadoptive families. Findings represented by 5 domains and supported by 15 categories include the counselors' perspective of (a) strength of the current program, (b) families in crisis, (c) parents' construction of their child's problem, (d) programmatic limitations, and (e) systemic limitations.