A Rationale for Evidence-Based Clinical Supervision

Although modern mental health systems increasingly require evidence-based practice (EBP), clinicians continue to object to restrictions on their professional independence, which they may perceive as counterproductive, divisive and even demeaning. In the face of such deep-seated objections, do we really need to strive for an evidence-based approach to supervision? We believe so, and begin our argument by noting a colourful illustration of the problems that can exist in the absence of EBP, those of poor training, therapist drift and weak professional regulation. Next, we present EBP as a mechanism to reduce such unacceptable variability in the way that treatments are delivered. We then apply the lessons from this divisive situation to the practice of clinical supervision, outlining a rationale for an inclusive, synergistic way forward. A number of fundamental psychological motives for this integration are noted, including supervisor training that is informed by practice-based research, corrective feedback on supervision, and a supportive professional system. Illustrative examples are provided in each of these areas. It is concluded that the traditional gulf between research and practice can and should be bridged in relation to supervision.     

Applicability of a cognitive model of worry to children and adolescents

BackgroundIntolerance of uncertainly (IU), cognitive avoidance (CA) and positive beliefs about worry (PB) independently predict worry frequency in older adolescents and adults, and when targeted together in treatment produce significant reductions in both worry and anxiety in this age range. The present study addresses a gap in the literature by testing whether a cognitive model of excessive worry and anxiety incorporating these process variables is applicable to children and adolescents.MethodPrimary and secondary school students (n = 515; aged 7–19 years) completed modified self-report measures of worry frequency, anxiety, IU, CA and PB and a path analysis undertaken to test whether IU was a higher order variable for CA and PB and whether the relationship between IU/CA/PB and anxiety was mediated by worry frequency.ResultsSignificant (bivariate) correlations were observed between the measures of IU, PB, CA, worry and anxiety across the age range. However separate path models had to be fitted for children (aged 7–12 years) and adolescents (aged 13–19) with PB being dropped from the child model. CA was related to anxiety only through worry in children while IU showed direct paths to worry and anxiety in both children and adolescents.ConclusionsCognitive models of persistent worry in adults and older adolescents may, with some modification, have applicability to children. Further testing and refinement of these cognitive models of worry may lead to improvements in existing treatments for anxious youth.     

Reading aloud: New evidence for contextual control over the breadth of lexical activation

Computational accounts of reading aloud largely ignore context when stipulating how processing unfolds. One exception to this state of affairs proposes adjusting the breadth of lexical knowledge in such models in response to differing contexts. Three experiments and corresponding simulations, using Coltheart, Rastle, Perry, Langdon, and Ziegler’s (2001) dual-route cascaded model, are reported. This work investigates a determinant of when a pseudohomophone such as brane is affected by the frequency of the word from which it is derived (e.g., the base word frequency of brain) by examining performance under conditions where it is read aloud faster than a nonword control such as frane. Reynolds and Besner’s (2005a) lexical breadth account makes the novel prediction that when a pseudohomophone advantage is seen, there will also be a base word frequency effect, provided exception words are also present. This prediction was confirmed. Five other accounts of this pattern of results are considered and found wanting. It is concluded that the lexical breadth account provides the most parsimonious account to date of these and related findings.     

On the asymmetric effects of mind-wandering on levels of processing at encoding and retrieval

The behavioral consequences of off-task thought (mind-wandering) on primary-task performance are now well documented across an increasing range of tasks. In the present study, we investigated the consequences of mind-wandering on the encoding of information into memory in the context of a levels-of-processing framework (Craik & Lockhart, 1972). Mind-wandering was assessed via subjective self-reports in response to thought probes that were presented under both semantic (size judgment) and perceptual (case judgment) encoding instructions. Mind-wandering rates during semantic encoding negatively predicted subsequent recognition memory performance, whereas no such relation was observed during perceptual encoding. We discuss the asymmetric effects of mind-wandering on levels of processing in the context of attentional-resource accounts of mind-wandering.     

Stress in telephone helpline nurses is associated with failures of concentration,attention and memory,and with more conservative referral decisions

Nurses working for telephone‐based medical helplines must maintain attentional focus while quickly and accurately processing information given by callers to make safe and appropriate treatment decisions. In this study, both higher levels of general occupational stress and elevated stress levels on particular shifts were associated with more frequent failures of attention, memory, and concentration in telephone nurses. Exposure to a stressful shift was also associated with a measurable increase in objectively assessed information‐processing errors. Nurses who experienced more frequent cognitive failures at work made more conservative decisions, tending to refer patients on to other health professionals more often than other nurses. As stress is associated with cognitive performance decrements in telephone nursing, stress‐reduction interventions could improve the quality and safety of care that callers to medical helplines receive.     

Discussing Adolescent Sexual Health in African-American Churches

This study describes the ways in which two African-American churches discuss adolescent sexual health topics. Six focus groups were conducted in two churches in Flint, Michigan, that reported no formal sexual health programming for their congregants. Three themes emerged to highlight the different perspectives about the role of churches in adolescent sexual decision-making and sexual health education: (1) churches as sources of sexual information, (2) churches as complex communities, and (3) recommendations for sexual education in churches. Participant responses suggest that churches can and should serve a resource for sexual health information. Implications for practice and research are discussed.     

Assessment of cognitive function across pregnancy using CANTAB: A longitudinal study

Significant changes in endogenous plasma hormone levels are required to sustain pregnancy which provides a unique opportunity to study their effect on cognitive function.