Responding to Allegations of Unethical Conduct

Although relatively few professional counselors will be accused during their careers of unethical conduct, all are susceptible to such charges. This article explains the process used by boards in reviewing charges of unethical conduct, gives advice regarding actions that accused counselors might take to protect themselves legally and emotionally, and offers preventive steps that should be taken to avoid such charges.     

Children's Earliest Experiences with Death: Circumstances,Conversations, Explanations,and Parental Satisfaction

Parents (n = 140) of children 2 to 7 years responded to an online survey regarding their children's experiences and conversations about death. A total of 75% of parents indicated that they had spoken to their child about death, and the majority of conversations were first initiated when children were between 3 and 3.5 years of age. Binary logistic regression analysis was used to explore factors that could predict conversations about death. Parents (n = 88) provided narratives of the explanations of death that they gave their child and subsequently reported their level of satisfaction with their explanation. The content of the explanations was coded and examined in relation to children's age and parental satisfaction. Results revealed that parents who provided explanations to a continued existence after death reported significantly higher levels of satisfaction than those parents who discussed the absence of a future physical relationship after death. Finally, explanations of a continued existence were not always in reference to an afterlife and could include discussing the memory of the deceased or their continued impact even after death. Thus, when talking to young children about death, parents may feel greater satisfaction in finding ways to discuss the continued legacy of those who have died compared to more biological explanations. Copyright © 2014 John Wiley & Sons, Ltd.     

Assessing the Clinical Competence of Psychology Students Through Objective Structured Clinical Examinations (OSCEs): Student and Staff Views

Objective Structured Clinical Examinations (OSCEs) are a well‐known, reliable, and valid assessment method used across the healthcare sector. In the present study, we applied OSCEs in three units within professional postgraduate psychology courses, with the broad aims of identifying staff and student perceptions of the assessment. At the conclusion of each OSCE, staff and students completed a feedback questionnaire that contained both scaled and open‐ended questions. Results suggest that clinical psychology OSCEs can be stressful for students, but are also well regarded. Both staff and students felt that the OSCEs were realistic, valid, and aligned well with professional practice. Students reported differences in the way in which they prepared for the OSCEs compared with a written exam or other form of assessment, while staff noted that models of OSCE development must be flexible, to adequately assess the objectives of individual units. Further, because they can be a costly exercise, OSCEs need to be applied judiciously within the tertiary sector.     

Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City

There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community‐academic partnered approach, we designed a multi‐community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish‐speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter‐related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.     

Psychosoma in crisis: an autoethnographic study of medically unexplained symptoms and their diverse contexts

In this study, we examine autoethnographic data from three critical incidents as experienced by the first author demonstrating the importance of context in understanding medically unexplained symptoms, their incidence and underlying patterns. We make the case for ethnographies as a crucial research strand in discerning the finer aspects of the patient or client experience; aspects that might be missed where people are directed along protocolised pathways of care. The article describes care as fragmented and depersonalising, leading to disembodied exchanges, as reflected in other autoethnographic studies, particularly those that highlight the complex relationship and controversies surrounding diagnostic uncertainty. We observe that psychological therapists, given the quality of the therapeutic relationship and sustained attention to the person’s experience, are well placed to assist in the necessary processes of re-contextualisation and re-embodiment.