Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

Induction with cross-classified categories

One of the main functions of categories is to allow inferences about new objects. However, most objects are cross-classified, and it is not known whether and how people combine information from these different categories in making inferences. In six experiments, food categories, which are strongly crossclassified (e.g., a bagel is both a bread and a breakfast food), were studied. For each food, the subjects were told fictitious facts (e.g., 75% of breads are subject to spoilage from Aspergillus molds) about two of the categories to which it belonged and then were asked to make an inference about the food (e.g., how likely is a bagel to be subject to spoilage from Aspergillus molds?). We found no more use of multiple categories in these cases of cross-classification than in ambiguous classification, in which it is uncertain to which category an item belongs. However, some procedural manipulations did markedly increase the use of both categories in inferences, primarily those that focused the subjects’ attention on the critical feature in both categories.     

Young Adults' Anticipated Identity Importance of Career, Marital, and Parental Roles: Comparisons of Men and Women with Different Role Balance Orientations

This article discusses two studies that exploredcollege students' role balance expectations for theirfuture career, marital, and parental identities.Participants were primarily Caucasian. In the first study, men and women who were family, balanced,career, or career/marriage oriented were compared.Variation within gender, especially for women, in theareas of gender attitudes, gender attributes, role identity salience, and anticipated roleacquisition were found. Similarities between gender alsoemerged. The second study examined young adults'perceptions of their parents' identity importance androle balance orientations. Although some genderdifferences emerged, young men and women holding thesame role balance orientation were often similar intheir perceptions of their parents. Taken together,these studies provide evidence that contradictsprevious assumptions about gender differences inexpectations for work and family roles.     

Effects of Directed Thinking on Intentions to Engage in Beneficial Activities: Actions Versus Reasons1

An important application of psychological principles involves increasing intentions to engage in activities that, although admittedly beneficial, are often not initially appealing (e.g., studying, quitting smoking, dieting). The present study tests the utility of directed thinking as a tool for eliciting intentions to engage in such activities. Undergraduate students were directed to think either about the reasons why people should find studying enjoyable or about the actions that people might take to make studying enjoyable. Regardless of whether they thought as individuals or in cooperating dyads, students who thought about actions later reported greater intentions to spend time studying than did students who thought about reasons. The results have both theoretical and practical significance.     

The Effects of Leader and Subordinate Characteristics in the Development of Leader–Member Exchange Quality1

This study investigated the contribution of both subordinate and leader characteristics in the development of leader-member exchange (LMX) quality. Data from 56 subordinate-superior dyads working at a large West-coast media company revealed that subordinates high in work self-efficacy were liked more by their supervisors, perceived to be more similar to their supervisors, experienced more positive LMX quality, and were rated as better performers than subordinates low in self-efficacy. Previous job experience, was related only to one outcome; supervisor's liking of the subordinate. Subordinates initially low in self-efficacy benefited from high LMX, as evidenced by increased end-of-program self-efficacy. Perceptions of similarity between supervisor and subordinate were found to be more important to LMX quality than actual demographic similarity. Leader self-efficacy and optimism predicted subordinates' ratings of LMX quality only for female supervisors. Unexpectedly, leader self-efficacy and optimism were related to the leaders' own ratings of LMX and subordinate performance.     

The Effects of Feedback Equivocality on Escalation of Commitment: An Empirical Investigation of Decision Dilemma Theory1

The effects of feedback equivocality on escalation of commitment were examined in a laboratory study. Subjects had multiple opportunities to allocate money to market a software product. During the initial phase, subjects received feedback that was of either low or high equivocality. Half of the subjects in each equivocality level were given a standard by which to judge the feedback. In the second phase, all subjects received negative feedback. Consistent with Bowen's (1987) decision dilemma theory, subjects who received low equivocality feedback did not escalate allocations, and subjects who received high equivocal feedback escalated allocations. The presence of a standard or goal attenuated escalation. These results are consonant with a dynamic, temporally based account of escalation and are discussed in a synthesis of the literatures in behavior analysis, economics, forecasting, and psychology.     

Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

Wisdom at the end of life: Hospice patients’ reflections on the meaning of life and death

The processes of aging and confronting mortality are often accompanied by unique psychological challenges. From the perspective of positive psychology, such challenges can yield opportunities for growth, including increased wisdom. This qualitative study explored 15 terminally ill hospice patients’ perspectives on wisdom, the dying process, and the meaning of life using consensual qualitative research methods. Most participants cited humility as a key component of wisdom, emphasizing that “Wisdom is when we realize ‘I don’t really know much’.” Other components of wisdom included self-knowledge, rationality, experiential learning, listening to and learning from others, and sharing knowledge with others. Participants also suggested that the process of facing illness and death presents opportunities for positive growth, including changing priorities and learning to appreciate life more fully in the present moment. In considering the sources of meaning in their lives, participants emphasized relational connections, personal growth, spirituality, vocational fulfilment, and living a full life. Participants also shared their reflections on important past experiences and regrets. Lastly, participants offered advice to others based on their experiences facing illness and mortality. Implications for psychological care of the dying and future research are discussed.     

An Evaluation of an Ambiguous Loss Based Psychoeducational Support Group for Family Members of Persons Who Hoard: A Pilot Study

The current study is a pilot evaluation of a six-week psychoeducational-support group based in an ambiguous loss framework for family members of people who hoard. Findings suggest that participants who completed the six-week intervention group (N?=?8) indicated positive results at the two-month follow up interview, reporting an increased understanding of family members’ hoarding behaviors and their own experiences related to the hoarding behavior and its impact on the family system. Participants also reported that having personal and professional support from others who understand hoarding behavior was helpful to them in lowering psychological distress and improving interactions with their family members.