Challenges in Developing a Cultural Evidence‐Based Psychotherapy in the USA: Suggestions for International Studies

In this article, we underscore some of the cultural challenges and limitations of the evidence‐based psychotherapy (EBP) utilised within the USA with the hope that these problems will be avoided or ameliorated in Australia and other countries. Although the EBP research is very diverse and complex, we categorise this fast‐growing literature using a threefold classification system that underscores culture. This classification system is proposed to examine the influence of culture on EBPs. The three categories used are (a) universal evidence‐based psychotherapies or universal psychotherapies, (b) race and ethnic minority evidence‐based psychotherapies or racial/ethnic psychotherapies, and (c) cultural evidence‐based psychotherapies or cultural psychotherapies. After each category is described, its benefits and limitations are discussed, emphasising implications for culturally diverse and international studies. We conclude with suggestions to promote the advancement of a more effective and inclusive cultural EBP in which researchers from different countries can collaborate and learn from each other.     

A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

The control of saccade trajectories: direction of curvature depends on prior knowledge of target location and saccade latency

Recent reports have shown that saccades can deviate either toward or away from distractors. However, the specific conditions responsible for the change in initial saccade direction are not known. One possibility, examined here, is that the direction of curvature (toward or away from distractors) reflects preparatory tuning of the oculomotor system when the location of the target and distractor are known in advance. This was investigated by examining saccade trajectories under predictable and unpredictable target conditions. In Experiment 1, the targets and the distractors appeared unpredictably, whereas in Experiment 2 an arrow cue presented at fixation indicated the location of the forthcoming target prior to stimulus onset. Saccades were made to targets on the horizontal, vertical, and principal oblique axis, and distractors appeared simultaneously at an adjacent location (a separation of +/- 45 degrees of visual angle). On average, saccade trajectories curved toward distractors when target locations were unpredictable and curved away from distractors when target locations were known in advance. There was no overall difference in mean saccade latencies between the two experiments. The magnitude of the distractor modulation of saccade trajectory (either toward or away from) was comparable across the different saccade directions (horizontal, vertical, and oblique). These results are interpreted in terms of the time course of competitive interactions operating in the neural structures involved in the suppression of distractors and the selection of a saccade target. A relatively slow mechanism that inhibits movements to distractors produces curvature away from the distractor. This mechanism has more time to operate when target location is predictable, increasing the likelihood that the saccade trajectory will deviate away from the distractor.     

Curiosity and exploratory behaviour towards possible and impossible events in children and adults

In four experiments with 4‐, 6‐, and 9‐year‐old children and adults, the hypothesis was tested that, all other conditions being equal, a novel and unusual event elicits stronger curiosity and exploratory behaviour if its suggested explanation involves an element of the supernatural than if it does not (the impossible over possible effect – the I/P effect). Participants were shown an unusual phenomenon (a spontaneous disintegration of a physical object in an apparently empty box) framed in the context of either a magical (the impossible event) or scientific (the possible event) explanation. In the verbal trial, participants showed a clear understanding of the difference between the effect of genuine magic and the effect of a trick. In the behavioural trial, both children and adults showed the I/P effect. They were more likely to run the risk of losing their valuable objects in order to explore the impossible event than the possible event. Follow‐up experiments showed that the I/P effect couldn't be explained as an artifact of the different degrees of cost of exploratory behaviour in the possible and impossible conditions or as a result of misinterpreting magic as tricks. The I/P effect emerged when the cost of exploratory behaviour was moderate and disappeared when the cost was perceived as too high or too low.     

Cognitive-behavioral treatment of childhood obsessive-compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy

Objective

To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive-behavioral treatment (CBT) for childhood obsessive-compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic.

Method

This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement.

Results

Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment.

Conclusions

This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes.     

Wallas’ Four-Stage Model of the Creative Process: More Than Meets the Eye?

Based on a detailed reading of Graham Wallas’ Art of Thought (1926 Wallas, G. (1926). The art of thought. London, UK: Jonathan Cape. [Google Scholar]) it is argued that his four-stage model of the creative process (Preparation, Incubation, Illumination, Verification), in spite of holding sway as a conceptual anchor for many creativity researchers, does not reflect accurately Wallas’ full account of the creative process. Instead, it is suggested that a four-stage model that gives due recognition to the detailed treatment Wallas gave to the Intimation stage is a more authentic representation of his explanation of creativity. A version of this model with three levels of proximity to consciousness (nonconsciousness; fringe consciousness; consciousness) and five stages (Preparation; Incubation; Intimation; Illumination; Verification) is presented as a general conceptual architecture within which relevant concepts and theories from more recent creativity research, including neuroscience and intuition, are positioned and from which a number of implications are drawn.     

The validity of psychotherapy 1

How good is psychotherapy as a tool of research into human nature? There is an orthodox defence of it as a research tool, which relies on showing that interpretations are true of the patient when they satisfy certain criteria. This defence is examined and rejected. The reply is considered that an interpretation which ‘keeps things moving’ is true, or an approximation to the truth. This reply is rejected by comparing and contrasting an interpretation in psychotherapy with one from brainwashing sessions. Two suppositions about psychotherapy (which weaken its discovery powers) are deliberately adopted — the suppositions that the material produced is ‘perspective’ and ‘method’ dependent. An unorthodox defence of psychotherapy is then offered — by means of a watery sense of ‘discover’. This enables us to outline a weak sense in which psychotherapy is a valid enterprise, but one which is still strong enough for research purposes.