“Stay in the Game”: Collecting Data on Symptom Improvement in Naturalistic Settings in Order to Increase Reimbursement Rates

An industrious approach to increasing reimbursement rates from third-party payers is reviewed. Balancing fidelity to treatment with real-world demands at a local hospital is discussed, as well as ways we were able to increase reimbursement within our own department. Data in naturalistic settings, though not always able to adhere to randomized controlled trials, offers evidence of improvement in symptoms. This reaction paper encourages other clinical programs to "stay in the game" of data collection while balancing treatment fidelity.     

Book Reviews

Abstract

This paper is an attempt to think about the competing factors which shape the nature of university education now. The funders, potential employers and students all approach die university with particular needs and ideologies, and it seems that die actual providers, the university personnel, have the task of managing the conflicts and the anxieties underlying the needs. However, they also have their needs, their beliefs about the purpose of education and their worries. Drawing broadly on psychodynamic concepts and using examples from my experience as a lecturer, counsellor and organizational consultant, I look at the effect of these tensions on the functioning of the university.     

Word Mapping and Executive Functioning in Young Monolingual and Bilingual Children

The effect of bilingualism on the cognitive skills of young children was investigated by comparing performance of 162 children who belonged to one of two age groups (approximately 3- and 4.5-year-olds) and one of three language groups on a series of tasks examining executive control and word mapping. The children were monolingual English speakers, monolingual French speakers, or bilinguals who spoke English and one of a large number of other languages. Monolinguals obtained higher scores than bilinguals on a receptive vocabulary test and were more likely to demonstrate the mutual exclusivity constraint, especially at the younger ages. However, bilinguals obtained higher scores than both groups of monolinguals on three tests of executive functioning: Luria's tapping task measuring response inhibition, the opposite worlds task requiring children to assign incongruent labels to a sequence of animal pictures, and reverse categorization in which children needed to reclassify a set of objects into incongruent categories after an initial classification. There were no differences between the groups in the attentional networks flanker task requiring executive control to ignore a misleading cue. This evidence for a bilingual advantage in aspects of executive functioning at an earlier age than previously reported is discussed in terms of the possibility that bilingual language production may not be the only source of these developmental effects.     

Enhancing Empathy and Theory of Mind

Social cognitive skills such as empathy and theory of mind are crucial for everyday interactions, cooperation, and cultural learning, and deficits in these skills have been implicated in pathologies such as autism spectrum disorder, sociopathy, and nonverbal learning disorders. Little research has examined how these skills develop after early childhood and how they may be trained. We tested the hypothesis that experience in acting, an activity in which one must step into the shoes of others, leads to growth in both empathy and theory of mind. In two studies, we followed children (elementary school aged) and adolescents (high school freshmen) receiving 1 year of either acting or other arts training (visual arts, music) and assessed empathy and theory of mind before and after training. In both studies, those receiving acting (but not other arts) training showed significant gains in empathy scores; in Study 2, adolescents receiving acting training also showed significant gains on a naturalistic measure of theory of mind, the Empathic Accuracy Paradigm. These findings demonstrate plasticity in empathy and theory of mind long past the watershed age of 3 to 4 years and suggest that both capacities are enhanced by role-playing.     

Psychometrics and Validity of the Dutch Experiences in Close Relationships–Revised (ECR–r) in an Outpatient Mental Health Sample

The Experiences in Close Relationships–Revised (ECR–r) is a self-report instrument to assess adult attachment style that seems to have appropriate psychometric qualities. The ECR–r has been most widely studied in student and community samples. In this study we report factor structure, reliability, and construct validity of the Dutch translation of the ECR–r in an outpatient mental health sample (N = 262). The original factor structure could satisfactorily be replicated, the reliability of the ECR–r was also stable over time, and there was good evidence for its construct validity.     

Using Innovative Outliers to Detect Discrete Shifts in Dynamics in Group-Based State-Space Models

Outliers are typically regarded as data anomalies that should be discarded. However, dynamic or “innovative” outliers can be appropriately utilized to capture unusual but substantively meaningful shifts in a system's dynamics. We extend De Jong and Penzer's 1998 approach for representing outliers in single-subject state-space models to a group-based framework. The group-based model enables model predictions concerning the group as a whole while individualized change points are incorporated to capture discrete shifts in each individual's trajectory. An illustrative example using cognitive performance data from N = 38 older adults over 60 days is presented. Results indicated that a subset of older adults showed sudden shifts in learning dynamics in several forms, including sudden jumps in level, slope, and linkage between perceived control and actual performance level. The broader implications of incorporating innovative outliers into studies of intraindividual change are discussed.     

Religion and Spirituality in Lonely Planet's India

For years, the authors of the best-selling guide to India, Lonely Planet, has shaped the perspectives of many travellers. This article considers how religion is constructed as a category and how it is made relevant to travellers. I argue that ‘religion’ comes in two versions, one pertaining to the Indian hosts and one to travellers. Religion is based on tradition, faith and historical institutions, whose members, rituals and sacred sites are of interest to travellers. Spirituality has to do with the personal development of travellers and is exclusively referred to as philosophy.     

How much can you bend before you break: An experience of using constructionist consulting as a tool for organizational learning in the corporate world

This article reflects upon the experience the authors had in the process of designing and facilitating a year-long leadership development class within a division of a high-tech manufacturing corporation in the USA. The design reflected narrative (Simons, 1997; Epston & White, 1990), feminist (Ferguson, 1984; Ramsey & Calvert, 1994), and constructionist principles, and was implemented as a “learning-in-organizing process” (Abma, this issue). We have structured the article to capture the dynamic nature of this process. This includes a discussion of how we as “outsider” class instructors and “insider” participants negotiated and renegotiated the design of the class as well as the effects of these “relational negotiations” on our collective learning. We end with a consideration of the implications of our “learning-in-organizing” for other constructionist consultants (Campbell, Caldicott, & Kinsella, 1994) who are translating organizational learning theories into practice.     

Self-improvement and cooperation: How exchange relationships promote mastery-approach driven individuals' job outcomes

In the present research we argue that mastery-approach goals may be beneficial in social achievement contexts because these goals lead to constructive exchange relationship building. An examination of three methodologically complementary studies revealed that mastery-approach goals lead to more cooperative and higher-quality exchange relationships than performance-approach goals and are, ultimately, associated with better job outcomes, as well. The results of a questionnaire study demonstrated that mastery-approach goals are more strongly related to cooperative motives and more weakly related to competitive motives than performance-approach goals. Furthermore, an experimental study indicated that mastery-approach driven individuals show a higher concern for others and are more strongly inclined to cooperate with an exchange partner when engaged in a complex reasoning task than performance-approach driven individuals. Finally, an organizational field study showed that team–member exchange mediates the effect of mastery-approach goals on job performance, job satisfaction, and organizational commitment.