Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.     

Compression of environmental representations following interactions with objects

Previous work reveals that interacting with all objects in an environment can compress spatial memory for the entire group of objects. To assess the scope and magnitude of this effect, we tested whether interacting with a subset of objects compresses spatial memory for all objects in an environment. Participants inspected objects in one or two unmarked regions of space, then recalled the distances between pairs of objects from memory. One group of participants picked up objects in both regions, a second group picked up objects in one region and passively viewed objects in the other region, and a third group passively viewed objects in both regions. When participants manually interacted with objects, they recalled shorter object-pair distances throughout the environment. The magnitude of this effect was the same, regardless of whether participants interacted with all objects in the environment or just a subset of them. Together, these findings suggest that interacting with objects can compress environmental representations in memory, even when observers interact with a relatively small subset of objects.     

Self-Disclosure and Spiritual Well-Being in Pastors Seeking Professional Psychological Help

Pastoral mental health is a topic that has only rarely been researched empirically in the psychological literature, yet a pastor’s mental health can have a significant impact on churches, communities, and even nations (Royal and Thompson, Journal of Psychology and Christianity, 31(3), 195–204, 2012). One of the thoughts prompting this research is that evangelical pastors might be expected to resist the findings of psychological research and lack understanding of specific mental illnesses they are potentially facing. Combined with historical and cultural dynamics that could influence resistance to professional psychological help, evangelical pastors have personal, internal factors that could also strengthen resistance, including the researched issues of self-disclosure flexibility and spiritual well-being. A correlational research design with multivariate regression was used to determine potentially significant or predictive relationships between the relevant factors. Among evangelical seminary students (N = 251) preparing for parish-based pastoral ministry, this research determined that no significant relationship, predictive or otherwise, existed between self-disclosure flexibility, spiritual well-being, and attitudes toward seeking professional psychological help. Implications include a shift in focus toward external factors influencing pastors’ help-seeking attitudes, such as the need for the mental health community to develop connections with evangelical pastors and the development of more support for Christian mental health professionals in the larger evangelical community.     

Particularism about Composition

Unwilling to adopt the radical ontologies that leading answers to van Inwagen's special composition question imply, Ned Markosian proposes that there is no true, non‐trivial, and finitely long answer to the SCQ. On my usage, this makes Markosian a particularist about composition. I argue that an improved version of Markosian's particularism fails because it cannot explain how sense perception justifies many of the ordinary‐object beliefs we base on it. I further argue that psychologists' research on object perception suggests that general principles govern how we perceptually discriminate unified wholes from mere pluralities, and this narrows the range of answers to the SCQ available to commonsense ontologists.     

A Cyber Phenomenon: A Q-Analysis on the Motivation of Computer Hackers

In computer security parlance, a hacker is an individual who actively seeks and takes advantage of flaws and weaknesses of a computer network or system. In recent years, one has seen the rise of hacking, often as a form of protest and retaliation for reasons ranging from political to social, but the question remains as to what really motivates an individual to hack a computer network? Using the Q-method, the study aimed to develop a classification of the motivation of computer hackers. This was done with the use of 43 participants who were subjected to preliminary interviews and the sorting method. The statements from the interviews were categorized that resulted in seven conceptual themes, namely social-positive, social-negative, intellectual gain, self-satisfaction, economic rewards, technological-positive and technological-negative. From these themes, three distinct profiles emerged and were used to describe the motivation of hackers.     

Minority Stress and the Risk of Unwanted Sexual Experiences in LGBQ Undergraduates

Sexual assault is prevalent among lesbian, gay, bisexual, and queer (LGBQ) college students, but its relationship to anti-LGBQ stigma has not been established. The goal of the present study was to determine whether minority stress, specifically internalized homophobia, predicted unwanted sexual experiences among LGBQ undergraduates (N = 763), whether routine behaviors (number of consensual sexual partners and alcohol use) mediated this relationship, and whether sense of LGBTQ community was a protective factor. Significant proportions of sexual minority men (10 %), women (18 %), and non-binary or transitioning students (19 %) reported an unwanted sexual experience since entering college. Internalized homophobia was associated with greater risk of unwanted sexual experiences. It also had a negative indirect effect on unwanted sexual experience risk through a negative association with number of sexual partners. Alcohol use did not mediate the relationship between internalized homophobia and unwanted sexual experiences. Sense of LGBTQ community was associated with lower risk, mediated by lower levels of internalized homophobia. The relationships between internalized homophobia and unwanted sexual experience risk were similar for women and men. These findings demonstrate that minority stress increases LGBQ students’ risk of sexual victimization and that in-group social relationships can mitigate this risk. We argue that minority stress is an important risk factor for sexual violence. Violence prevention interventions should attempt to reduce internalized homophobia, and colleges and high schools should establish LGBQ-affirming social climates and provide resources for LGBQ students, including targeted violence prevention efforts and programs that foster a sense of supportive community.     

Associating a time‐based prospective memory task with an expected context can improve or impair intention completion

Three experiments investigated time‐based prospective memory defined here as remembering to fulfil an intention during a later window of time. When people associated the response window with a future context, time‐based responding was better if that context expectation was correct as compared with having no context expectation at all. By contrast, if the response window occurred in a context that preceded the expected context, time‐based performance was worse than having no context expectation at all. An explicit reminder about the intention was sufficient to ameliorate the decrement found with an incorrect context association. However, successfully completing a different, event‐based prospective memory intention was not sufficient to overcome the incorrect context association. The authors assert that possessing such associations alters normal monitoring of the passage of time which in turn leads to the pattern of results obtained. Copyright © 2004 John Wiley & Sons, Ltd.     

Reasoning about make-believe and hypothetical suppositions: Towards a theory of belief-contravening reasoning

The present study explores how suppositions which conflict with accepted beliefs are represented and reasoned about. Two studies test the predictions regarding the nature and developmental changes in children's ability to represent and reason about hypothetical or make-believe suppositions which violate their everyday knowledge and beliefs. In Study 1, 46 4th- and 5th-graders were introduced to a hand puppet, Freddy, who made claims inconsistent with generally accepted beliefs (e.g., “all dogs meow”) because he was pretending (Make-Believe Condition) or believed them (Hypothetical Condition). Participants were asked to think like Freddy and judge whether a conclusion (“There's a dog; does it meow?”) follows logically from the claim. In Study 2, 40 kindergarten (6-year-olds), 3rd–4th grade (10-year-olds), and college students were asked to represent belief contravening make-believe (pretend in a make-believe world that dogs meow) and hypothetical (imagine what the real world would be like if dogs meow) premises, evaluate conclusions of the premises (Rover is a dog, does Rover meow?) and make judgments about the attributes (growl, wag tail, purr, and eat mice) of the entity (a meowing dog) they created. The prediction that it would be easier to represent and reason from belief-contravening suppositions in the Make-Believe than Hypothetical conditions was confirmed in each study, although the two forms of reasoning were directly correlated (Study 2). The results were discussed in terms of the similarities (compartmentalization and integration) and differences (reconciliation) of processes involved in fancifully (make-believe) or seriously (hypothetical) representing and reasoning about belief-contravening suppositions.