Exploring the Effectiveness of a Mixed-Diagnosis Group Cognitive Behavioral Therapy Intervention Across Diverse Populations

Depression and anxiety are the most common mental health disorders seen in clinical practice and they are highly comorbid. Cognitive behavioral therapy (CBT) has been demonstrated as an effective treatment for both depression and anxiety but is often not available to all individuals who could benefit from it. This paper investigates the effectiveness of a mixed-diagnosis group CBT intervention that incorporates mindfulness meditation for individuals presenting with depression and/or anxiety: CBT Basics II. This intervention was evaluated across two distinct mental health programs to determine both if it can demonstrate positive results and if it is feasible to implement in these types of programs. Sample 1 (n = 42 completers) consisted of higher-functioning individuals in a general mental health program. Sample 2 (n = 53 completers) consisted of individuals with more chronic and severe mental health diagnoses. Overall, intent-to-treat analyses revealed improvements in psychiatric symptoms, and increases in CBT knowledge and mindfulness skill across both programs. This indicates that CBT Basics II is effective across diverse mental health populations and shows promise for improving access to CBT.     

Neuropsychological profile following suicide attempt by hanging: two adolescent case reports

Hippocampal damage and amnesia following hypoxia and ischemia are described in the few published adult cases of suicide attempt by hanging. However, a recent review (Caine &; Watson, 2000 Caine, D. and Watson, J. D. 2000. Neuropsychological and neuropathological sequelae of cerebral anoxia: A critical review. Journal of the International Neuropsychology Society, 6: 86–99. [CROSSREF][Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) suggests a variable pattern of brain involvement and neuropsychological impairments following hypoxic-ischemic injury that may or may not involve amnesia. To help clarify the impact of hanging on the developing brain, we examined neuropsychological functioning in two adolescents who survived suicide attempt by hanging. Despite differences in Glasgow Coma Scale (GCS), coma duration, and structural imaging findings, both patients had similar IQ (VIQ > PIQ) and presented with various combinations of deficits in expressive/receptive language, visual-constructional and perceptual ability, processing speed, attention, working memory, and/or executive functioning shortly after injury. In spite of their similarities, only one of the patients presented with classic amnesia symptoms in his early recovery. This patient was evaluated 1 year postinjury, and persistent deficits in processing speed and memory encoding were noted. Several hanging-related variables, including longer estimated hanging duration, greater weight, and severe airway edema, were thought to place this patient at increased risk for cognitive deficits. Clinical MRI scans of this patient obtained 6 weeks postinjury revealed mild volume loss as well as abnormalities in bilateral superior cortex. However, CT and MRI scans obtained throughout early recovery did not reveal overt evidence of injury to specific memory-related structures. Comprehensive neuropsychological evaluation of all adolescent survivors of suicide attempt by hanging is recommended, as a variety of postacute cognitive deficits were observed in these patients despite relatively short (≤ 15 minutes) estimated hanging durations.     

Pyrrhonism in the Political Philosophy of Thomas Hobbes

The importance of Pyrrhonism to Hobbes's political philosophy is much greater than has been recognized. He seems to have used Pyrrhonist arguments to support a doctrine of moral relativity, but he was not a sceptic in the Pyrrhonist sense. These arguments helped him to develop his teaching that there is no absolute good or evil; to minimise the purchase of natural law in the state of nature and its restrictions on the right of nature; virtually to collapse natural law into civil law; and to make the sovereign the political, moral and theological epicenter of his political system.     

Approaching Homelessness: An Integral Re-Frame

This article explores a metaview of the many faces of homelessness. It analyzes an evolutionary meaning of home and suggests that ever-complexifying life conditions influence how societies enforce conformity to the status quo of homefulness. It goes on to describe how homelessness might be reframed as a complex adaptive form of survival for diversity generators who cannot or will not conform to the status quo. The article proposes an integral framework on which intervention strategies could be structured to provide evolutionary, appropriate, and flexible approaches to homelessness.     

Book Reviews

Abstract

The aim of this paper is to identify what I take to be the main conceptual problem in Lewis’ semantics for counterfactuals when the Limit Assumption (LA) is not satisfied, what I call the Discrimination Problem (DP), and to present and discuss a modification of Lewis’ semantics that aims at solving DP. First, I outline Lewis’ semantics, highlighting the aspects that will be relevant for our discussion. Second, I present DP and discuss it with a heuristic example. Third, I present the new proposal and comment some formal consequences and the objections they give rise to. Fourth, I present an allegedly equivalent version of the proposal and discuss the difference between counterfactuals and strict conditionals. Finally, I defend that the two proposals are different and argue for the first one as the best way of capturing two intuitions that seem in conflict when the LA is not satisfied. I conclude with a dilemma: either the proposal here defended works or LA is inescapable. Thus, if the proposal doesn’t work, the paper must then be considered as an indirect defense of the Limit Assumption.     

Representation of mental illness in Christian self-help bestsellers

The present study examined messages about mental illness in 14 contemporary Christian self-help bestsellers. Content analysis revealed that most texts focused upon depression. Categories of textual units included Underlying Assumptions Regarding Depression, Representations of Depression, Roots/Causes/Reasons for Depression, and Christian Responses to Depression. Demonic influence was the most frequently cited reason for depression. Other reasons included negative cognitions, failure as a Christian, and negative emotions. Christian responses to depression included trusting God, religious activity, and individual willpower. Discussion of these results focused upon the problematic impact of these messages upon individuals with depression, and upon suggestions for reducing mental illness stigma in religious communities.     

Therapeutic Assessment With Children: A Pilot Study of Treatment Acceptability and Outcome

Therapeutic Assessment (TA) with children is a hybrid of psychological assessment and short-term intervention. It uses the ongoing process and results of psychological assessment to enhance parents' understanding of their child and to facilitate change. Clinical reports and single case studies suggest that TA with children is an acceptable and effective brief intervention. However, no aggregate data have been published to support this claim. This pilot study investigated the acceptability and preoutcome–postoutcome of TA with 14 clinically referred children with emotional and behavior problems and their parents. Results indicated high treatment acceptability as well as significantly decreased child symptomatology and enhanced family functioning as reported by children and mothers. In addition, mothers demonstrated a significant increase in positive emotion and a significant decrease in negative emotion pertaining to their children's challenges and future. The findings, although limited due to the design and small sample size, support assertions from published single case studies that TA is possibly an efficacious child and family intervention for children with emotional and behavioral problems and should be studied in a larger, comparison design.     

Personality,Demographic, and Intellectual Variables Associated with Readiness for Discharge from Psychiatric Treatment

This study examined the relationship between staff rated discharge readiness and patient personality, demographic, and intellectual variables. Chi square and t test analyses were performed on data of 88 male and female adult patients of a short-term residential psychiatric treatment program. Patient diagnosis, trait anxiety level, marital status, age, and abstract intelligence scores assessed at admission were found to be significantly associated with staff ratings of patients’ readiness for discharge following six weeks of treatment. Findings were discussed in terms of prior process and outcome literature and implications for future research.     

Predicting Psychologists' Intentions to Integrate Complementary and Alternative Therapies Into Their Practice

Drawing on an extended Theory of Planned Behaviour (TPB) framework, we employed a cross‐sectional design study to investigate psychologists' intentions to integrate complementary and alternative therapies (CAT) into their practice via recommending CAT to clients or referring clients to CAT practitioners. Participants were registered practicing psychologists from a range of therapeutic orientations (e.g., narrative, cognitive behavioural, psychodynamic). The psychologists were either recruited by phone, following a search of the Internet, or were contacted through their place of employment (hospitals, university counselling service). Those who agreed to participate (N = 122; n = 88 females, n = 34 males) completed a questionnaire that included standard TPB items of attitude, subjective norm, and perceived behavioural control, along with items measuring perceived risk, past behaviour, CAT knowledge, and gender. The outcome variables of interest were (a) intention to recommend CAT to clients and (b) intention to refer clients to CAT practitioners. Structural equation modelling revealed that the extended model was a good fit, explaining 69% (recommending CAT) and 51% (referring to CAT practitioners) of the variance in intentions. For both behaviours, direct paths from attitude and subjective norm to intentions were observed, with perceived risk and past behaviour influencing the TPB predictors of attitudes, subjective norm, and perceived behavioural control. The findings illustrate the role that cognitive and risk factors have on psychologists' decisions to integrate CAT into their practice. Understanding psychologists' cognitions and decisions about CAT integration forms an important basis on which to consider future changes in policy or practice.