CACREP Accreditation: A Solution to License Portability and Counselor Identity Problems

A confluence of forces addressing counselor identity occurred with the 20/20: A Vision for the Future of Counseling initiative, the 2009 Standards of the Council for Accreditation of Counseling and Related Education Programs (CACREP), and the quest by the American Association of State Counseling Boards to establish license portability. This article provides a historical context for the profession's struggles with these issues, 1 state's experience, TRICARE's impact, and the role CACREP standards can play in their resolution.     

A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes.     

‘Goals’ are not an integral component of imitation

Several theories suggest that actions are coded for imitation in terms of mentalistic goals, or inferences about the actor’s intentions, and that these goals solve the correspondence problem by allowing sensory input to be translated into matching motor output. We tested this intention reading hypothesis against general process accounts of imitation using the pen-and-cups task. The task has three components: participants place a pen in one of two cups, using their right or left hand, and one of two grips. Previous research has revealed a colour minimum error pattern; when one of the components is differentially coloured (e.g., one cup is red and the other blue), accuracy is greatest on the coloured dimension. We found the colour minimum error pattern, not only in the standard version of the task, where participants imitate the actions of a human model, but also in three novel variants of the task, in which participants responded on the basis of spatial or arbitrary stimulus–response mappings to ‘geometric’, non-biological stimuli. These stimuli do not afford the attribution of intentions, and therefore our results support generalist theories of imitation by showing that the colour minimum error pattern is due, not to intention reading, but to the operation of task-general processes of perception, attention and motor control.     

Tracking the first two seconds: three stages of visual information processing?

We compared visual priming and comparison tasks to assess information processing of a stimulus during the first 2 s after its onset. In both tasks, a 13-ms prime was followed at varying SOAs by a 40-ms probe. In the priming task, observers identified the probe as rapidly and accurately as possible; in the comparison task, observers determined as rapidly and accurately as possible whether or not the probe and prime were identical. Priming effects attained a maximum at an SOA of 133 ms and then declined monotonically to zero by 700 ms, indicating reliance on relatively brief visuosensory (iconic) memory. In contrast, the comparison effects yielded a multiphasic function, showing a maximum at 0 ms followed by a minimum at 133 ms, followed in turn by a maximum at 240 ms and another minimum at 720 ms, and finally a third maximum at 1,200 ms before declining thereafter. The results indicate three stages of prime processing that we take to correspond to iconic visible persistence, iconic informational persistence, and visual working memory, with the first two used in the priming task and all three in the comparison task. These stages are related to stages presumed to underlie stimulus processing in other tasks, such as those giving rise to the attentional blink.     

Modeling Interactions Between Latent Variables in Research on Type D Personality: A Monte Carlo Simulation and Clinical Study of Depression and Anxiety

Several approaches exist to model interactions between latent variables. However, it is unclear how these perform when item scores are skewed and ordinal. Research on Type D personality serves as a good case study for that matter. In Study 1, we fitted a multivariate interaction model to predict depression and anxiety with Type D personality, operationalized as an interaction between its two subcomponents negative affectivity (NA) and social inhibition (SI). We constructed this interaction according to four approaches: (1) sum score product; (2) single product indicator; (3) matched product indicators; and (4) latent moderated structural equations (LMS). In Study 2, we compared these interaction models in a simulation study by assessing for each method the bias and precision of the estimated interaction effect under varying conditions. In Study 1, all methods showed a significant Type D effect on both depression and anxiety, although this effect diminished after including the NA and SI quadratic effects. Study 2 showed that the LMS approach performed best with respect to minimizing bias and maximizing power, even when item scores were ordinal and skewed. However, when latent traits were skewed LMS resulted in more false-positive conclusions, while the Matched PI approach adequately controlled the false-positive rate.     

‘I don't want to be the mother of a paedophile’: the perspectives of mothers whose adolescent sons with learning disabilities sexually offend

The subject of sexual abuse is a major focus of professional and public concern. Sexual abuse of (and by) people with learning disabilities evokes even greater disquieting emotions, and makes severe demands on the social services, and the criminal justice system. The aims of the project were: 1) to determine whether group psychotherapy produced effective outcomes for adolescent boys with learning disabilities who exhibit sexually abusive behaviour, 2) to explore the perspectives of parents and other care-givers, and 3) to document the nature and extent of service support to families. This paper focuses solely on the mothers' perspectives. This was a three-year project with six boys (under 16) receiving group psychotherapy, using both quantitative and qualitative methods. Clinical measures were used to track changes throughout the course of psychotherapy. Semi-structured interviews (taped and transcribed) were held (separately) with the boys, their parents, paid care-givers and the therapists. The mothers tried hard to make sense of, and come to terms with, what was happening to their sons and to themselves, they struggled to reconcile their own confused and often conflicting emotions, and to maintain their own sense of identity. They felt almost totally unsupported by the services, both in the past and present, and could see little hope for the future. There is an urgent need for development of effective and sympathetic services for the parents of boys with learning disabilities who have been abused, and who are now showing abusive behaviour.     

Examining the role and functions of self-development in healthcare therapy trainings: A review of the literature with a modest proposal for the use of learning agreements

Many healthcare trainings with a psychodynamic orientation encourage or require students to commit to a process of personal development, such as provided through attending individual psychotherapy and/or an experiential ‘as if therapy’ group. This paper reviews recent literature about training in psychodynamically oriented practices within counselling psychotherapy, psychiatry, the creative arts therapies and clinical psychology. The results indicate that the mandatory personal development dimension of therapy training needs urgent reassessment. Results of studies consistently call for further research about the direct benefits of personal development on students’ development of skills for therapy practice. There is minimal evidence to indicate what self-development through individual psychotherapy can specifically deliver in terms of eventual professional competence. To address some aspects of the current lacuna, this paper summarises the recommendations for training programmes available from the current research, and makes a modest proposal for the use of learning agreements, rather than only mandated hurdle requirements, to ensure that the incremental steps by which the student attains expected requirements is negotiated and agreed within regularised, and widely accepted university course procedures.     

Chaotic attractors in the therapeutic system 1

Because little research had been done on the presence and role of latent communication in the context of team‐conducted family therapy, the writers set out to monitor unconscious responses generated under these conditions. Specifically, they investigated an ongoing family treatment situation conducted according to the “reflecting team model.” One team of therapists handles the actual treatment session, while the other observes from behind a one‐way mirror. During the course of a session, the second team makes suggestions to the treatment team either by telephone or by calling the therapists out of the treatment room.

As the project developed, the writers found that the unconscious responses of both family and treatment teams indicated a process at work beyond the conscious intentions of the participants. That is, the therapeutic enterprise was functioning as a dynamical system, whose increasing complexity suggested a self organizing principle at work. This paper traces the development of the system's movement toward greater complexity, identifies the specific interventions that indicate this process, describes how all participants demonstrated a high degree of resonance and synchronization with this overarching‐self organizing pattern. This paper serves to alert therapists to the role of unconscious communication within the therapeutic system and postulates that the generation of form within psychotherapy follows many of the same self organizing processes found in other human and non human systems.