Supervision in Community Mental Health: Understanding Intensity of EBT Focus

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the supervisor level and implementation climate was the only significant factor associated with EBT supervision intensity. While individual clinician and supervisor factors may play a role in EBT coverage in supervision, our results suggest that an implementation climate that supports EBT may be the most critical factor for improving intensity of EBT coverage. Thus, implementation efforts that address the extent to which EBTs are expected, rewarded, and supported within an organization may be needed to support greater coverage of EBT during workplace-based supervision.     

Parameters of Time-out: Research Update and Comparison to Parenting Programs,Books, and Online Recommendations

In reviews published more than 30 years ago, eight parameters important to the use of time-out were identified and available research was summarized. The purpose of the current paper is to provide an updated summary of existing research for each parameter of time-out. Within each parameter, we conducted a thorough review of the published literature and identified all peer-reviewed articles addressing each parameter. We identified and summarized a total of 46 articles across the eight parameters, including 32 not cited in previous reviews. Sufficient findings were available to draw conclusions regarding time-out warning, schedule of time-out, contingent versus noncontingent release, and duration. Tentative conclusions based on only a few studies could be drawn in regard to instructional versus physical administration and verbalized reason for time-out. No conclusions could be drawn regarding time-out signal and specific time-out location. While we know much more today regarding effective implementation of time-out, there is a clear need for further exploration within these identified parameters. In addition to summarizing the literature, we reviewed recommendations made by behavioral parent training programs, parenting books, and parenting Web sites, and compared how well their recommendations matched current research based on the conclusions drawn from our review. We found that parenting sources made strong and specific recommendations on several of the parameters that were either not consistent with available research or simply lacked a sufficient research base.     

The Individual Career Counseling Needs and Experiences of Female Survivors of Partner Violence

The impact of partner violence on women's employment and career development is profound. Career counselors may contribute substantially to these women's rehabilitation. This study examined employment and career counseling needs, barriers experienced, and counseling satisfaction of female survivors of partner violence (N = 71). The women participated in community‐ and research‐based individual career counseling services designed to promote their short‐ and long‐term career development. The authors conducted correlational, t‐test, and logistic regression analyses and found that barriers differed by race/ethnicity, age, number of children, and career service needs. Results provide important information about survivors' career counseling service access and needs.     

Identity Fusion,Extreme Pro‐Group Behavior,and the Path to Defusion

Identity fusion refers to a visceral sense of oneness with an ingroup. For fused individuals, group membership is not a means to an end (e.g., a positive social identity). Rather, membership is an all‐absorbing goal in itself; little other than the group matters. Group membership is also seen as enduring, sustained by chronically activated psychological structures as well as features of the context. Fellow group members are likewise seen as permanent members of the group, as they are members of the ingroup “family”. And just as family members are compelled to make extreme sacrifices for their family, so too are highly fused individuals – including even the ultimate sacrifice. These efforts to protect the ingroup can have negative consequences when, for example, people become strongly fused to groups that are devoted to extreme, anti‐social behaviors. In such instances, it may be prudent to encourage “defusion” from the group, but the emotional investment associated with fusion may thwart such efforts. We discuss the implications of these and related considerations.     

Realities and Myths of Safety Issues for Community Researchers Working in a Marginalized African American Community

Community psychologists often conduct research in collaboration with marginalized communities in which safety is an issue. However, we rarely talk about what specific safety issues we experience and how we deal with them. Our story describes the realities and myths of neighborhood safety that were experienced in a low-income African American neighborhood of Chicago, while collaborating on a project designed to increase access to the Internet to obtain health information. We examine both the challenges experienced and our responses in the context of a community intervention planned, implemented, and evaluated by a partnership team composed of various stakeholders. Critical lessons such as the importance of building on community strengths and the need to be aware of our own biases are discussed.     

Grateful individuals are not suicidal: Buffering risks associated with hopelessness and depressive symptoms

With suicidal behavior serving as a leading cause of injury and death around the world, researchers must expand ongoing efforts to uncover protective factors. In this study, we examined if gratitude mitigated existing risk factors for suicide. Specifically, we predicted that gratitude moderates the relationship between suicidal ideation and (a) hopelessness and (b) depressive symptoms in a sample of 369 diverse undergraduate students. Results indicate that for people who are highly grateful, both hopelessness and depressive symptoms are less likely to be associated with thoughts and intentions to kill oneself. The findings demonstrate the value of integrating protective factors against suicidality, including character strengths such as gratitude, into existing theories that tend to be limited to vulnerability factors. We offer tentative ideas for enhancing the impact of suicide prevention and intervention programs by directly addressing gratitude, which has been shown to be highly modifiable.     

Pacifiers Disrupt Adults’ Responses to Infants’ Emotions

Research shows that pacifiers disrupt infants' mimicry of facial expressions. This experiment examines whether pacifiers interfere with caretakers' ability to mimic infants' emotions. Adults saw photographs of infants with or without a pacifier. When infants had pacifiers, perceivers showed reduced EMG activity to infants' smiles. Smiles of infants using a pacifier were also rated as less happy than smiles depicted without a pacifier. The same pattern was observed for expressions of distress: adults rated infants presented with pacifiers as less sad than infants without pacifiers. We discuss deleterious effects of pacifier use for the perceiver's resonance with a child's emotions.     

Judgements of others’ emotional appropriateness are multidimensional

This study investigated the multidimensional structure of judgements of emotional appropriateness, the degree to which an observer judges a target's emotion to conform to observer-valued expectations for emotion in that context. Participants (N=169) were shown one of two brief video clips of an actor either showing anger or neutral expressions in an anger-evoking situation of either low, medium, or high severity. Participants rated the target's emotion on the Perception of Emotion Appropriateness Rating Scale (PEARS), which taps observers’ perceptions of a target's emotional appropriateness for a specific situation. We found that appropriateness ratings are comprised of three factors, assessment of Type Present (type of emotion in expression); Type Absent (missing key emotions); and Intensity (intensity with which the emotion is felt or expressed). Results are discussed in terms of the usefulness of a multidimensional conceptualisation of emotional appropriateness.     

Transitioning Between Systems of Care: Missed Opportunities for Engaging Adults with Serious Mental Illness and Criminal Justice Involvement

Individuals with serious mental illness are overrepresented in the criminal justice system and face difficulties accessing mental health services both during incarceration and upon re‐entry into the community. This study examines how such individuals describe their experiences receiving care both during and after their time in custody and explores the perspectives of mental health service providers who treat this population upon re‐entry. Semi‐structured interviews were conducted with 43 individuals identified as having a history of serious mental illness and criminal justice involvement, as well as with 25 providers who have worked with this population. Clients noted the stress of transitioning to criminal justice settings, the uneven availability of services within jail and prison, and the significant challenges faced upon re‐entry. Providers reported barriers to working with this population, including minimal coordination with the criminal justice system and challenging behaviors and attitudes on the part of both clients and providers. Findings identify potential target areas for improved care coordination as well as for additional provider education regarding the unique needs of this population. Copyright © 2013 John Wiley & Sons, Ltd.