Bindungsrelevante Situationen in der Psychotherapie

Background

The therapeutic relationship is a central factor for psychotherapy, which may be at least partially explained by attachment theory. However, research concerning the conditions under which attachment-related needs are activated in treatment followed by possibly dysfunctional coping strategies is rare.

Patients and methods

Semi-structured interviews on attachment-related situations in psychotherapies were conducted with 36 inpatients and then rated with regard to content.

Results

Triggers for attachment-related needs in therapies were interpersonal conflict and loss, beginning and end of therapy, symptom burden, specific interventions, addressing the therapeutic relationship and change of setting from outpatient to inpatient treatment. This was related to themes of desire for help and support, experience of rejection, self-disclosure and desire for understanding.

Conclusions

The attachment system is activated in therapies similar to other interpersonal situations. The results may help to become more sensitive to attachment-related situations and needs.     

Computer-Assisted Therapies: Examination of Therapist-Level Barriers to Their Use

Despite enthusiasm in the field for their potential ease of dissemination, little work has examined whether practicing clinicians are willing and able to use computer-assisted therapies (i.e., computerized treatments designed to be administered with therapist support). For therapists to use these tools, they require access to computer equipment, the skills needed to use the equipment, and willingness to adopt the technology in treatment. This study examined these three factors using survey data from a national sample of mental health clinicians (N = 1,067). Respondents reported on their access to technology and computer fluency, in addition to completing the Computer-Assisted Therapy Attitudes Scale (CATAS), a measure of therapist attitudes designed for this study. Overall, the majority of therapists (90.7%) reported access to at least one computer at work and self-reported computer fluency levels were high. On average, therapists held positive attitudes towards computer-assisted therapies, although expressed concern that these technologies might damage rapport and did not feel that these technologies would improve treatment outcomes. Predictors of positive attitudes included greater general openness toward new treatments, greater comfort with computers, and easier access to technology at work (all ps < .01). Results suggested that, on the whole, therapists may be likely to integrate computer-assisted therapies into their clinical practice. However, therapists vary both in their ability and willingness to use these tools. Implications for the dissemination of computer-assisted therapies are discussed.     

Predictors of Response and Mechanisms of Change in an Organizational Skills Intervention for Students with ADHD

The purpose of the study was to evaluate predictors of response and mechanisms of change for the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD). Twenty-three middle school students with ADHD (grades 6–8) received the HOPS intervention implemented by school mental health providers and made significant improvements in parent-rated materials organization and planning skills, impairment due to organizational skills problems, and homework problems. Predictors of response examined included demographic and child characteristics, such as gender, ethnicity, intelligence, ADHD and ODD symptom severity, and ADHD medication use. Mechanisms of change examined included the therapeutic alliance and adoption of the organization and planning skills taught during the HOPS intervention. Participant implementation of the HOPS binder materials organization system and the therapeutic alliance as rated by the student significantly predicted post-intervention outcomes after controlling for pre-intervention severity. Adoption of the binder materials organization system predicted parent-rated improvements in organization, planning, and homework problems above and beyond the impact of the therapeutic alliance. These findings demonstrate the importance of teaching students with ADHD to use a structured binder organization system for organizing and filing homework and classwork materials and for transferring work to and from school.     

Supporting Universal Prevention Programs: A Two-Phased Coaching Model

Schools are adopting evidence-based programs designed to enhance students’ emotional and behavioral competencies at increasing rates (Hemmeter et al. in Early Child Res Q 26:96–109, 2011). At the same time, teachers express the need for increased support surrounding implementation of these evidence-based programs (Carter and Van Norman in Early Child Educ 38:279–288, 2010). Ongoing professional development in the form of coaching may enhance teacher skills and implementation (Noell et al. in School Psychol Rev 34:87–106, 2005; Stormont et al. 2012). There exists a need for a coaching model that can be applied to a variety of teacher skill levels and one that guides coach decision-making about how best to support teachers. This article provides a detailed account of a two-phased coaching model with empirical support developed and tested with coaches and teachers in urban schools (Becker et al. 2013). In the initial universal coaching phase, all teachers receive the same coaching elements regardless of their skill level. Then, in the tailored coaching phase, coaching varies according to the strengths and needs of each teacher. Specifically, more intensive coaching strategies are used only with teachers who need additional coaching supports, whereas other teachers receive just enough support to consolidate and maintain their strong implementation. Examples of how coaches used the two-phased coaching model when working with teachers who were implementing two universal prevention programs (i.e., the PATHS^® curriculum and PAX Good Behavior Game [PAX GBG]) provide illustrations of the application of this model. The potential reach of this coaching model extends to other school-based programs as well as other settings in which coaches partner with interventionists to implement evidence-based programs.     

No templates for rejection: a failure to configure attention to ignore task-irrelevant features

ABSTRACT

Knowing the colour of an upcoming target allows one to bias attention towards objects of that colour. It is far less clear whether knowing the colour of an up-coming distractor can allow one to suppress attention to items of that colour. Arita, Carlisle, and Woodman (2012) suggest that people can create a template for rejection. However, the method used in Arita et al. may have allowed people to adopt a strategy of internally generating a positive cue for the target colour or target hemifield. Here we use a method very similar to theirs, but manipulate the display layouts and the number of un-cued colours in ways that should thwart such strategies. Across three experiments, we find a negative cuing benefit only in a very special circumstance that encourages a strategic shift to internally generating a positive cue (the same circumstance used by Arita et al.). We conclude that people are unable to use a negative feature-cue on a trial-by-trial basis to suppress attention to upcoming distractors, and attribute the finding in Arita et al. to a strategic shift rather than a template for rejection.     

A reversal of the search asymmetry favouring negative schematic faces

Quite a number of studies have tested whether the affective valence of stimuli can guide attention in visual search. Studies using schematic affective faces frequently found a relative search asymmetry (RSA), with more efficient search for a negative face in a friendly crowd than vice versa. Whether, however, this effect relates to differences in affect or to the confounded differences in perceptual features is unknown. The present study proposes and tests a similarity-based account for the RSA. Experiments 1a and 1b first replicate the typical RSA. Experiment 2 shows that the stimulus could be simplified to some degree without losing the RSA. Experiments 3 and 4, finally, demonstrate that the RSA could be reversed by a rather simple stimulus change, that leaves the facial expression intact. It is concluded that the strong dependence of the RSA on stimulus factors seriously questions the claim that emotional factors drive the RSA.     

Substitutes for leadership in anaesthesia teams and their impact on leadership effectiveness

In this study we aim to increase our understanding of leadership in anaesthesia teams by investigating the relationship between substitutes for leadership, leadership behaviour, and team performance in situations with varying levels of routine and standardization. The present study relied on video recordings of 12 anaesthesia teams in a simulated setting with the occurrence of a nonroutine event. Clinical team performance was measured by the speed of adequate team reaction to this event. The leadership behaviours observed were coded either as content oriented (e.g., information transmission) or structuring (e.g., assigning tasks). Results showed that leadership behaviour changed depending upon the level of routine of a situation, the degree of standardization, and, to some extent, on the experience of team members. Leadership tends to be positively related to team performance during nonroutine and low standardized situations but negatively related to team performance in routine and highly standardized situations. Furthermore, leadership is only slightly related to team member experience. This study improves our understanding of influences of substitutes for leadership on successful leadership behaviour in anaesthesia teams. The findings also lead to suggestions for both further research and the enhancement of team leadership in critical care.     

A Group of Sexually Abused Adolescents' Perceptions of their Future Life-Roles: An Exploratory Study

Sexual abuse of adolescents can have detrimental effects on their perceptions of their different future life-roles. We investigated such perceptions of students with a history of sexual abuse (n=163) as well as typically developing others (n=237). Participants completed the Life-role Inventory of the then called Human Sciences Research Council (Langley, 1990). Between-group comparisons were carried out. Adolescents with a history of sexual abuse reported negative perceptions of themselves fulfilling some of their roles in the future, being committed to these roles and attaching value to them, compared to typically developing others.     

A severe capacity limit in the consolidation of orientation information into visual short-term memory

Previous research has suggested that two color patches can be consolidated into visual short-term memory (VSTM) via an unlimited parallel process. Here we examined whether the same unlimited-capacity parallel process occurs for two oriented grating patches. Participants viewed two gratings that were presented briefly and masked. In blocks of trials, the gratings were presented either simultaneously or sequentially. In Experiments 1 and 2, the presentation of the stimuli was followed by a location cue that indicated the grating on which to base one’s response. In Experiment 1, participants responded whether the target grating was oriented clockwise or counterclockwise with respect to vertical. In Experiment 2, participants indicated whether the target grating was oriented along one of the cardinal directions (vertical or horizontal) or was obliquely oriented. Finally, in Experiment 3, the location cue was replaced with a third grating that appeared at fixation, and participants indicated whether either of the two test gratings matched this probe. Despite the fact that these responses required fairly coarse coding of the orientation information, across all methods of responding we found superior performance for sequential over simultaneous presentations. These findings suggest that the consolidation of oriented gratings into VSTM is severely limited in capacity and differs from the consolidation of color information.