Competences and occupational standards for systemic family and couples therapy

This article reports on the recent government initiative of 2007–2010 to delineate, for the major forms of psychological therapy, expected professional standards of practice and conduct in workplaces (the national occupational standards) and to specify expected levels of competent practice (the competences). The article focuses on the processes and outcomes of this initiative for systemic therapy and its clinical and political relevance. The rationale, research and consultation processes by which these formulations were achieved are described and the outcomes of the work are reported. We also discuss their wider implications, including the various ways in which these achievements might be used and their potential value for the field of systemic family and couples therapy.     

Just world beliefs, causal beliefs, and acquaintance: Associations with stigma toward eating disorders and obesity

The current study investigated the relationship between just world beliefs and stigmatizing attitudes toward eating disorders and obesity. Further, the associations between stigma and causal beliefs, and between stigma and acquaintance with these conditions, were examined. Participants (n = 447) read four vignettes describing an individual with anorexia nervosa, bulimia nervosa, binge eating disorder, or obesity. After each vignette, participants completed questionnaires assessing stigmatizing attitudes, just world beliefs, causal beliefs, and acquaintance with the condition depicted in the vignette. Stronger just world beliefs were associated with greater stigma toward all three eating disorders, as well as obesity (rs ranging from −.11 to −.18). More stigmatizing attitudes were associated with greater attribution of individual responsibility for the development of the disorder. However, participants with personal experience or who knew someone with the depicted problem did not have lower stigma scores than those who did not. The current study suggests that justification ideologies such as just world beliefs and controllability beliefs may underlie the stigmatization of eating disorders and obesity. These findings provide support for stigma reduction efforts aimed at targeting justification ideologies and altering causal beliefs.     

Models,monitoring, and the mind: Comments on Wansink and Chandon's “Slim by Design”

Wansink and Chandon have examined the “mindlessness” that is often evident in everyday food intake. In this commentary, we focus on four issues raised by Wansink and Chandon's paper: (1) the distinction between food choice and food intake; (2) their model of food intake (and how it compares and contrasts with our own model of food intake); (3) the role of monitoring in the control of food intake; and (4) the meaning of “mindless” eating. In each case we find value in Wansink and Chandon's proposals but also an opportunity for further analysis and refinement.     

An Assessment of Time Involved in Pre-test Case Review and Counseling for a Whole Genome Sequencing Clinical Research Program

Whole genome sequencing (WGS) is being used for evaluation of individuals with undiagnosed disease of suspected genetic origin. Implementing WGS into clinical practice will place an increased burden upon care teams with regard to pre-test patient education and counseling about results. To quantitate the time needed for appropriate pre-test evaluation of participants in WGS testing, we documented the time spent by our clinical research group on various activities related to program preparation, participant screening, and consent prior to WGS. Participants were children or young adults with autism, intellectual or developmental disability, and/or congenital anomalies, who have remained undiagnosed despite previous evaluation, and their biologic parents. Results showed that significant time was spent in securing allocation of clinical research space to counsel participants and families, and in acquisition and review of participant’s medical records. Pre-enrollment chart review identified two individuals with existing diagnoses resulting in savings of $30,000 for the genome sequencing alone, as well as saving hours of personnel time for genome interpretation and communication of WGS results. New WGS programs should plan for costs associated with additional pre-test administrative planning and patient evaluation time that will be required to provide high quality care.     

Youth’s Help-Seeking Intentions for ADHD and Depression: Findings from a National Survey

This study investigates the role that youth-level factors play in predicting help-seeking intentions in a nationally representative sample. Eleven help-seeking intentions were examined separately by target conditions (ADHD and depression), gender, race/ethnicity, and self-reported diagnosed/non-diagnosed in respect to the target conditions, and interaction effects were tested. Using factor analysis, a traditional help-seeking scale was created, which captured four help-seeking items, and predictive power of youth-level factors in accounting for traditional help-seeking was tested. Study findings provide practitioners and researchers with fresh evidence on what youth-level factors are associated with which help-seeking intentions, and illustrate the challenges involved in better understanding the complexity of the help-seeking process among youth in the context of ADHD/Depression. With increased understanding of youth’s perceptions and the complexity of their help-seeking behavior, community-based efforts to develop effective strategies that support active help-seeking behavior and eliminate barriers to appropriate care can have a greater likelihood of success.     

Children Exposed to the Arrest of a Family Member: Associations with Mental Health

The arrest of a parent or other family member can be detrimental to children’s health. To study the impact of exposure to the arrest of a family member on children’s mental health and how said association may change across developmental periods, we examined baseline data for children (birth through 11 years) entering family-based systems of care (SOC). Children exposed to the arrest of a family member had experienced significantly more 5.38 (SD = 2.59) different types of potentially traumatic events (PTE) than children not exposed to arrest 2.84 (SD = 2.56). Multiple regression model results showed that arrest exposure was significantly associated with greater behavioral and emotional challenges after controlling for children’s age, gender, race/ethnicity, household income, caregiver’s education, parenting factors, and other PTE exposure. Further analyses revealed differences in internalizing and externalizing behaviors associated with arrest exposure across developmental levels. This study highlights some of the mental health challenges for children exposed to the arrest of a family member, while adding to our knowledge of how such an event affects children across different developmental periods. More trauma-informed, developmentally appropriate systems need to be in place at all levels to assist children and families experiencing arrest.     

Working with Older Adults: Predictors of Attitudes Towards Ageing in Psychology and Social Work Students,Faculty, and Practitioners

The Australian population is experiencing a rapid ageing of the population, and as such, an increased need for gerontological practitioners in the helping professions will continue to grow. Terror management theory (TMT), which was used to frame this study, posits that because of the fact that humans are aware of their own mortality, they are compelled to avoid the anxiety associated with it. Personal ageing and interaction with older adults may be reminders of the unavoidable decline and death that faces us all. The purpose of this study is to examine comfort in spending time with older adults amongst students, academic teaching staff, and practitioners in the fields of psychology and social work. We sought to determine if TMT helped predict fear of being with older adults. Ageism, contact with older adults, and known demographic factors associated with attitudes towards older adults were also examined. Hierarchical multiple regression explained nearly 46% of the variance in comfort with older adults and indicated that fear of ageing, positive ageism, negative ageism, contact with older adults, and sex were significant predictors. Educational efforts aimed at addressing beliefs about ageing and older adults may contribute to further comfort in working with older adults.     

Threats to the Internal Validity of Spinal Surgery Outcome Assessment: Recalibration Response Shift or Implicit Theories of Change?

A recalibration response shift will cause the patient to think about a self-report measure’s response options differently after a health state change. Commonly assessed using the retrospective-pretest design (“then-test”), recent guidelines suggest adjusting then-test estimates for competing explanations. This prospective longitudinal study investigated recalibration response shift after adjusting for implicit theories of change in patients undergoing spinal surgery. The Oswestry Disability Index (ODI) and Short Form-36 (SF-36) were collected before surgery and at 6 weeks and 3 months after spinal decompression surgery. Then-tests of the measures were also collected at all post-tests. Recalibration response shift was operationalized as the then-minus-pre difference score on the evaluative SF-36. Implicit theories of change were operationalized as the then-minus-pre difference score on the perception-based ODI. Improved vs. No-Effect patient groups were compared using the Minimally Important Difference (±15 points) as a cut-off on the Visual Analogue Scale (VAS) items for back and leg pain. Logistic regression analyses investigated whether recalibration response shift had an independent effect distinguishing patient groups, after adjusting for implicit theories of change. The sample (baseline n?=?169, mean age 52, 39 % female) was well-educated, and 1/3 were working. All then-minus-pre difference scores were non-zero at each time point and were stable over time. In the adjusted models distinguishing Improved versus No Effect groups, then-minus-pre ODI difference scores were significant in the majority of the adjusted models at all timepoints, but only one then-minus-pre SF-36 difference score—for physical functioning recalibration—was significant and only at 6-weeks post-surgery. This suggests that implicit theories of change bias the estimation of post-surgical outcomes, but that recalibration response shift biased only the estimation of physical functioning and only at 6 weeks post-surgery. Recalibration response shift and implicit theories of change can both be sources of bias in patient-reported outcome assessment. Our findings suggest that implicit theories of change are a greater threat to validity in this patient sample. Future research using the then-test should control for implicit theories of change to minimize misspecification of effects.