Mirror mirror on the ward: who is the unfairest of them all? Reflections on reflective practice groups in acute psychiatric settings

Consultant psychiatrists in medical psychotherapy, adult psychotherapists, child and adolescent psychotherapists and clinical psychologists increasingly complement their direct therapeutic activity with applications of their psychotherapeutic thinking in acute mental health work through facilitating reflective practice groups for staff working in mental health teams. The authors offer their reflections on facilitating National Health Service reflective practice groups using the metaphor of a mirrored dialogue between patient and professional, and professional and institution as a basis for informing the development of reflective practice for colleagues. Their reflections are based on working on three acute in-patient wards, in a crisis resolution team and in community mental health teams. They describe the practicalities of setting up and facilitating reflective practice groups, and offer insights into some of the issues that arise in reflective practice groups. They conclude that these groups are mutually beneficial in forging links between psychotherapy professionals and professionals working in other disciplines and areas of mental health. Facilitating these groups often requires a challenging adaptation of technique, which will not suit all psychotherapists, as well as a wider understanding of organisational dynamics and the interplay between clinicians and management.     

Language Enrichment Teacher Preparation and Practice Predicts Third Grade Reading Comprehension

First and second grade public school teachers were trained through interactive video-conferencing to implement Language Enrichment, an Orton-Gillingham-based literacy instruction. The effectiveness of the linguistically informed training was demonstrated by documenting the longitudinal third grade reading comprehension achievement of their students. Student achievement was measured on the state-mandated achievement test, Texas Assessment of Academic Skills (TAAS). Hierarchical linear modeling (HLM) showed that students whose teachers were trained in Language Enrichment instruction had higher third grade reading comprehension achievement than students whose teachers were not trained. Additionally, a significant effect of the length of Language Enrichment teaching experience of the second grade teacher on third grade reading comprehension was found. Earlier occurring second grade teacher training was associated with higher reading scores than later training. Based on these findings it is suggested that teachers who have content-rich knowledge known to support literacy acquisition can provide reading instruction that results in a level of reading comprehension that is significantly higher than that resulting from teachers who do not have a well-developed domain of knowledge concerning the reading process. This study also indicates that teacher competence was enhanced through practice because student reading achievement of the more-experienced Language Enrichment teachers was higher than that of the less-experienced Language Enrichment teachers.     

The buzz trap: Speeded-up lives,distractedness, impulsiveness and decreasing empathy

This paper examines a set of traits and bodily reactions that are often seen in people who suffer stress and anxiety. These include speeded-up metabolisms and less ability to concentrate, regulate emotions as well as reduced empathy. The paper suggests that early trauma and stress give rise to a range of bodily and metabolic changes that affect the very speed of the life-course. It is also suggested that many factors in contemporary society, such as stress, increased reliance on screens and technology and a more consumerist and individualistic lifestyle, might be linked to an increase in such ‘buzzy’ character traits. More hopefully, such developments can be countered by positive experiences such as those provided in psychotherapy, secure attachment relationships, mindfulness and less-stressed social environments.     

Using the Scenario Method to Analyze Cheating Behaviors

Using student self-reported cheating admissions and answers from a hypothetical cheating scenario, this paper analyzes the effects of individual and situational factors on potential cheating behavior. Results confirm several conclusions about student factors that are related to cheating. The probability of cheating is associated with younger students, lower GPAs, alcohol consumption, fraternity/sorority membership, and having cheated in high school. Student perceptions of the certainty and severity of punishment appear to have a negative and significant impact on the probability of cheating on in-class assignments. Students who report a belief that cheating is never acceptable appear to be significantly less likely to cheat in any circumstance. This study illustrates the context-dependent nature of academic dishonesty, and the associated difficulty in understanding the relationships between measurable factors and cheating behavior.     

Correlates of MMPI–A Scales in Acute Psychiatric and Forensic Samples

The purpose of this study was to expand the empirical basis for interpretation of the Minnesota Multiphasic Personality Inventory–Adolescent (MMPI–A; Butcher et al., 1992). Participants were 157 boys from a forensic setting and 197 girls from an acute psychiatric inpatient setting. Criterion variables were identified from sources such as psychiatrist report, parent report, and psychosocial history. Results generally support the construct validity of MMPI–A scales. Scales measuring internalizing problems were more highly correlated with criterion measures of internalizing behaviors than measures of externalizing behaviors, whereas scales measuring externalizing problems were more highly correlated with externalizing variables than with internalizing criteria. Implications of this study include an expanded empirical foundation for interpretation of the MMPI–A, greater understanding of the constructs it measures, and evidence supporting the generalizability of these constructs across settings.     

From scapegoating to thinking and finding a home: delivering therapeutic work in schools

This paper discusses how the child psychotherapist's core skills can be usefully applied in a school setting. It outlines some of the important policy changes that have necessitated a move towards delivering therapeutic work in community settings such as schools. It is argued that the role of the child psychotherapist in schools has much in common with the role played by the psychotherapist in a therapeutic community. The paper suggests that therapy in schools is in many ways less simple than therapy in clinic settings, and in particular it is often unclear who exactly the client is and at what level to intervene when a referral is made. The referred patient is not necessarily the ‘problem’, so that the child psychotherapist must be prepared to tackle issues in the system to ensure that splitting and projection are reduced, and systems around children can become more containing. Clinical vignettes and one main clinical illustration are used to try to illustrate these points.     

Strategic and automatic effects of visual working memory on attention in visual search

Previous research indicates that visual attention can be automatically captured by sensory inputs that match the contents of visual working memory. However, Woodman and Luck (2007) showed that information in working memory can be used flexibly as a template for either selection or rejection according to task demands. We report two experiments that extend their work. Participants performed a visual search task while maintaining items in visual working memory. Memory items were presented for either a short or long exposure duration immediately prior to the search task. Memory was tested by a change-detection task immediately afterwards. On a random half of trials items in memory matched either one distractor in the search task (Experiment 1) or three (Experiment 2). The main result was that matching distractors speeded or slowed target detection depending on whether memory items were presented for a long or short duration. These effects were more in evidence with three matching distractors than one. We conclude that the influence of visual working memory on visual search is indeed flexible but is not solely a function of task demands. Our results suggest that attentional capture by perceptual inputs matching information in visual working memory involves a fast automatic process that can be overridden by a slower top-down process of attentional avoidance.