Guided Recovery: An Interpretative Phenomenological Analysis of Service Users’ Experiences of Guided Self-Help for Bulimic and Binge Eating Disorders

The efficacy of Cognitive Behavioral Therapy–based Guided Self-Help for mild to moderate bulimia and binge eating disorders has been well supported. However, limited research has explored in-depth individual experiences of this treatment approach. In-depth semi-structured interviews were conducted with 4 individuals who had completed Cognitive Behavioral Therapy–based Guided Self-Help (CBT-GSH) for bulimic or binge eating disorders. The interviews were transcribed verbatim and subsequently analyzed using Interpretative Phenomenological Analysis (IPA). Three superordinate themes emerged: Autonomy and volition; A dynamic relationship: the guided and the guide; and The unwanted friend. The reciprocal nature of the guide/guided relationship was identified as integral to the success of the therapeutic approach. However, participants expressed initial uncertainty towards the therapeutic process, and experienced an uncomfortable dissonance between a lack of volition in therapy seeking and the need to continually self-prescribe CBT-GSH. The findings affirm the central role of the guide in promoting motivation to engage with therapy and highlight the potential benefits of in-session weighing. However, it may be necessary to provide additional support on commencing CBT-GSH to address concerns about the therapeutic approach in this group.     

The tail-elicited tail withdrawal reflex of Aplysia is mediated centrally at tail sensory-motor synapses and exhibits sensitization across multiple temporal domains

The defensive withdrawal reflexes of Aplysia californica have provided powerful behavioral systems for studying the cellular and molecular basis of memory formation. Among these reflexes the tail-elicited tail withdrawal reflex (T-TWR) has been especially useful. In vitro studies examining the monosynaptic circuit for the T-TWR, the tail sensory-motor (SN-MN) synapses, have identified the induction requirements and molecular basis of different temporal phases of synaptic facilitation that underlie sensitization in this system. They have also permitted more recent studies elucidating the role of synaptic and nuclear signaling during synaptic facilitation. Here we report the development of a novel, compartmentalized semi-intact T-TWR preparation that allows examination of the unique contributions of processing in the SN somatic compartment (the pleural ganglion) and the SN-MN synaptic compartment (the pedal ganglion) during the induction of sensitization. Using this preparation we find that the T-TWR is mediated entirely by central connections in the synaptic compartment. Moreover, the reflex is stably expressed for at least 24 h, and can be modified by tail shocks that induce sensitization across multiple temporal domains, as well as direct application of the modulatory neurotransmitter serotonin. This preparation now provides an experimentally powerful system in which to directly examine the unique and combined roles of synaptic and nuclear signaling in different temporal domains of memory formation.     

Near-term fetuses process temporal features of speech

The perception of speech and music requires processing of variations in spectra and amplitude over different time intervals. Near-term fetuses can discriminate acoustic features, such as frequencies and spectra, but whether they can process complex auditory streams, such as speech sequences and more specifically their temporal variations, fast or relatively slow acoustic variations, is unclear. We recorded the cardiac activity of 82 near-term fetuses (38 weeks GA) in quiet sleep during a silent control condition and four 15 s streams presented at 90 dB SPL Leq: two piano melodies with opposite contours, a natural Icelandic sentence and a chimera of the sentence--all its spectral information was replaced with broadband noise, leaving its specific temporal variations in amplitude intact without any phonological information. All stimuli elicited a heart rate deceleration. The response patterns to the melodies were the same and differed significantly from those observed with the Icelandic sentence and its chimera, which did not differ. The melodies elicited a monophasic heart rate deceleration, indicating a stimulus orienting reflex while the Icelandic and its chimera evoked a sustained lower magnitude response, indicating a sustained attentional response or more focused information processing. A conservative interpretation of the data is that near-term fetuses can perceive sound streams and the rapid temporal variations in amplitude that are specific to speech sounds with no spectral variations at all.     

Organisational interventions to improve employees' health and wellbeing: A realist synthesis

Although organisational interventions have shown promising results in improving employees' health and wellbeing, reviews of the effectiveness of such interventions conclude results are inconsistent. Realist synthesis is considered an appropriate method of literature review to improve the consistency of empirical evidence by developing generalisable statements of ‘what works for whom in which circumstances’. In this article, to identify and synthesise existing evidence from the empirical studies of organisational interventions, we conducted a realist synthesis according to the RAMESES publication standards. We reviewed 28 articles. Six realist programme theories were developed that explain how different mechanisms of organisational interventions may bring about different outcomes in different contexts. These realist programme theories are based on the process mechanisms of implementation adherence, communication, employees' participation, senior management support, middle management support and external consultants/researchers support. This realist synthesis enhances the understanding of how organisational interventions may improve employees' health and wellbeing, in which contexts, and for which group of employees. As such, it makes an important potential contribution to designing, implementing and evaluating future organisational interventions.     

Training parents to help their children read: A randomized control trial

Background . Low levels of literacy and high levels of behaviour problems in middle childhood often co‐occur. These persistent difficulties pose a risk to academic and social development, leading to social exclusion in adulthood. Although parent‐training programmes have been shown to be effective in enabling parents to support their children's development, very few parent interventions offer a combination of behavioural and literacy training. Aims . This paper (1) reports on a prevention programme which aimed to tackle behaviour and literacy problems in children at the beginning of school, and (2) presents the effects of the intervention on children's literacy. Sample . One hundred and four 5‐ and 6‐year‐old children selected from eight schools in an inner city disadvantaged community in London participated in the intervention. Methods . This is a randomized control trial with pre‐ and post‐measurements designed to evaluate the effectiveness of an intervention. The behavioural intervention consisted of the ‘Incredible Years’ group parenting programme combined with a new programme designed to train parents to support their children's reading at home. Results . Analyses demonstrated a significant effect of the intervention on children's word reading and writing skills, as well as parents' use of reading strategies with their children. Conclusion . A structured multicomponent preventive package delivered with attention to fidelity can enable parents to support their children's reading at home and increase their literacy skills. Together with the improvement in child behaviour, these changes could improve the life chances of children in disadvantaged communities.     

A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders

While a plethora of cognitive behavioral empirically supported treatments (ESTs) are available for treating child and adolescent anxiety and depressive disorders, research has shown that these are not as effective when implemented in routine practice settings. Research is now indicating that is partly due to ineffective EST training methods, resulting in a lack of therapist competence. However, at present, the specific competencies that are required for the effective implementation of ESTs for this population are unknown, making the development of more effective EST training difficult. This study therefore aimed to develop a model of therapist competencies for the empirically supported cognitive behavioral treatment of child and adolescent anxiety and depressive disorders using a version of the well-established Delphi technique. In doing so, the authors: (1) identified and reviewed cognitive behavioral ESTs for child and adolescent anxiety and depressive disorders, (2) extracted therapist competencies required to implement each treatment effectively, (3) validated these competency lists with EST authors, (4) consulted with a panel of relevant local experts to generate an overall model of therapist competence for the empirically supported cognitive behavioral treatment of child and adolescent anxiety and depressive disorders, and (5) validated the overall model with EST manual authors and relevant international experts. The resultant model offers an empirically derived set of competencies necessary for effectively treating children and adolescents with anxiety and depressive disorders and has wide implications for the development of therapist training, competence assessment measures, and evidence-based practice guidelines for working with this population. This model thus brings us one step closer to bridging the gap between science and practice when treating child and adolescent anxiety and depression.