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101.
Case conceptualization is an important skill for counselors to master in order to meet treatment needs of clients. Some students struggle while learning this skill, as it requires advanced cognitive complexity, reflection skills, and affective awareness. Further, it is difficult for developing counselors to understand the interconnectedness of clients’ presenting problems, history, and strengths to form a holistic case conceptualization. The authors of this article describe a role-play for teaching the complexity of case conceptualization, in which students role-play various perspectives of psychosocial information and process the experience to create a holistic conceptualization. Activity steps are outlined with examples, and process questions to facilitate classroom discussion are included. Suggestions for implementation are also provided. 相似文献
102.
103.
Background
Despite five decades of increasingly elegant studies aimed at advancing the pathophysiology and treatment of mental illness, the results have not met expectations. Diagnoses are still based on observation, the clinical history, and an outmoded diagnostic system that stresses the historic goal of disease specificity. Psychotropic drugs are still based on molecular targets developed decades ago, with no increase in efficacy. Numerous biomarkers have been proposed, but none have the requisite degree of sensitivity and specificity, and therefore have no usefulness in the clinic. The obvious lack of progress in psychiatry needs exploration.Methods
The historical goals of psychiatry are reviewed, including parity with medicine, a focus on diagnostic reliability rather than validity, and an emphasis on reductionism at the expense of socioeconomic issues. Data are used from Thomas Picketty and others to argue that our failure to advance clinical care may rest in part on the rise in social and economic inequality that began in the 1970s, and in part on our inability to move beyond the medical model of specificity of disease and treatment.Results
It is demonstrated herein that the historical goal of specificity of disease and treatment has not only impeded the advance of diagnosis and treatment of mental illness, but, in combination with a rapid increase in socioeconomic inequality, has led to poorer outcomes and rising mortality rates in a number of disorders, including schizophrenia, anxiety, and depression.Conclusions
It is proposed that Psychiatry should recognize the fact of socioeconomic inequality and its effects on mental disorders. The medical model, with its emphasis on diagnostic and treatment specificity, may not be appropriate for investigation of the brain, given its complexity. The rise of scientific inequality, with billions allocated to connectomics and genetics, may shift attention away from the need for improvements in clinical care. Unfortunately, the future prospects of those suffering from mental illness appear dim.104.
J. Mitchell Vaterlaus Linda Skogrand Cassandra Chaney Kassandra Gahagan 《Family process》2017,56(4):883-899
The current exploratory study utilized a family strengths framework to identify marital expectations in 39 strong African American heterosexual marriages. Couples reflected on their marital expectations over their 10 or more years of marriage. Three themes emerged through qualitative analysis and the participants' own words were used in the presentation of the themes. African Americans indicated that there was growth in marital expectations over time, with marital expectations often beginning with unrealistic expectations that grew into more realistic expectations as their marriages progressed. Participants also indicated that core expectations in strong African American marriages included open communication, congruent values, and positive treatment of spouse. Finally, participants explained there is an “I” in marriage as they discussed the importance of autonomy within their marital relationships. Results are discussed in association with existing research and theory. 相似文献
105.
Cassandra Foursha-Stevenson Taylor Schembri Elena Nicoladis Cody Eriksen 《Journal of psycholinguistic research》2017,46(2):329-343
This paper describes an investigation into the function of child-directed speech (CDS) across development. In the first experiment, 10–21-month-olds were presented with familiar words in CDS and trained on novel words in CDS or adult-directed speech (ADS). All children preferred the matching display for familiar words. However, only older toddlers in the CDS condition preferred the matching display for novel words. In Experiment 2, children 3–6 years of age were presented with a sentence comprehension task in CDS or ADS. Older children performed better overall than younger children with 5- and 6-year-olds performing above chance regardless of speech condition, while 3- and 4-year-olds only performed above chance when the sentences were presented in CDS. These findings provide support for the theory that CDS is most effective at the beginning of acquisition for particular constructions (e.g. vocabulary acquisition, syntactic comprehension) rather than at a particular age or for a particular task. 相似文献
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107.
Galen Joseph Rena J. Pasick Dean Schillinger Judith Luce Claudia Guerra Janice Ka Yan Cheng 《Journal of genetic counseling》2017,26(5):1090-1104
As genetics and genomics become part of mainstream Medicine, these advances have the potential to reduce or exacerbate health disparities. Gaps in effective communication (where all parties share the same meaning) are widely recognized as a major contributor to health disparities. The purpose of this study was to examine GC-patient communication in real time, to assess its effectiveness from the patient perspective, and then to pilot intervention strategies to improve the communication. We observed 64 English-, 35 Spanish- and 25 Chinese-speaking (n = 124) public hospital patients and 10 GCs in 170 GC appointments, and interviewed 49 patients who were offered testing using the audio recordings to stimulate recall and probe specific aspects of the communication. Data analyses were conducted using grounded theory methods and revealed a fundamental mismatch between the information provided by GCs and the information desired and meaningful to patients. Several components of the communication that contributed to this mismatch and often resulted in ineffective communication included: (1) too much information; (2) complex terminology and conceptually difficult presentation of information; (3) information perceived as not relevant by the patient; (4) unintentional inhibition of patient engagement and question-asking; (5) vague discussions of screening and prevention recommendations. Our findings indicate a need to transform the standard model of genetic counseling communication using evidence-based principles and strategies from other fields of Medicine. The high rates of limited health literacy in the US, increasing access of diverse populations to genetic services, and growing complexity of genetic information have created a perfect storm. If not directly addressed, this convergence is likely to exacerbate health disparities in the genomic age. 相似文献
108.
109.
Subtyping obsessive-compulsive disorder: A taxometric analysis 总被引:2,自引:0,他引:2
Nick Haslam Ben J. Williams Michael Kyrios Dean McKay Steven Taylor 《Behavior Therapy》2005,36(4):381-391
Obsessive-compulsive disorder (OCD) is a heterogeneous condition comprising multiple symptoms. Researchers have identified OCD subtypes using a range of symptom-based research methods, including factor and cluster analyses and examination of differential treatment response. These methods can be challenged on the grounds that they fail to demonstrate the existence of discrete taxonomic entities. Furthermore, no study has examined subtyping on the basis of cognitive characteristics. In the present study, the categorical vs. dimensional status of 6 possible subtypes of OCD was examined using taxometric methods. Three potential cognitive subtypes (based on high levels of responsibility/threat estimation, perfectionism/certainty, and importance/control of thoughts) and 3 potential symptomatic subtypes (based on elevated levels of contamination obsessions and cleaning compulsions, checking, and obsessionality) were examined using the MAXEIG and MAMBAC procedures in a sample of 404 diagnosed cases of OCD. Findings favored dimensional models of the potential responsibility, perfectionism, checking, and contamination subtypes, but offered qualified support for taxonic models of the importance/control of thoughts and obsessional subtypes. Implications for the subclassification of OCD are discussed. 相似文献
110.
The Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) is a computer-based categorization task that measures concept association strengths. Greenwald et al. (1998) demonstrated that participants completed the categorizations more quickly when pleasant and flower shared a response key than when pleasant and insect shared a response key, and when pleasant and White shared a response key than when pleasant and Black shared a response key. In Study 1, we reversed the typical IAT effect for flowers and insects, and eliminated the typical IAT effect for White and Black, by changing the affective valence of the stimulus items. In Study 2, we replicated the reversibility effect for an animal and plant IAT, and supported a category re-definition hypothesis. Our results have implications for understanding the IAT, and suggest that the IAT not only measures stereotypic responses, but can also be influenced by individuating information of the stimulus items. 相似文献