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161.
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The purpose of this paper is to promote thought and discussion around how and why we treat patients in chosen ways. In the present climate practitioners are required to treat patients following NICE guidelines in which cognitive behavioural therapy (CBT) is the treatment of choice in the majority of diagnoses. This paper raises concerns that this may lead to an homogenization of treatment, loss of invaluable skills and understanding from other treatment approaches, and loss to the patient who may be best cared for by a combination of treatments and approaches, most notably patients presenting with complex pathology. This paper aims to present this as a general principle, and by way of example, will focus on coupling two specific treatment orientations, cognitive behavioural therapy with psychodynamic psychotherapy, with the specific diagnosis of obsessive compulsive disorder (OCD).

Methods: Clinical material is drawn from case studies from practice in secondary adult mental health care services within the NHS. All patients were referred to the psychological services for treatment for OCD and provided with 1:1 therapy with UKCP‐registered therapists. Details have been anonymized by describing fictitious cases re‐constructed from clinical material. A theoretical understanding is included which provides both an overview for integrating treatment for the specific example of OCD and is intended by extension to other diagnoses.

Results: Working with the commonalities of therapeutic approaches, and integrating specific skills of CBT and psychodynamic psychotherapy, appears to offer a viable mode of treatment for cases resistant to single‐orientation therapies.

Conclusions: Coupling the skills of different therapies can be effective in treating complex patients that are referred to the secondary mental health services. Conversely, restricting practice to single orientation therapies can lead to an impoverished care for patients and diminution of invaluable therapeutic skills which may become underused, undervalued and lost in the practice of mental health care within the NHS. Acknowledgement of the skills of others, valuing these and learning from each other can help to avoid the defensive reactions of practitioners, where each may defensively retreat to their corners of specialism. Respecting and sharing skills from different orientations, and acknowledging this in the NICE guidelines, is good for both mental health services and patient care and addresses the concerns raised by practitioners exemplified by Bateman (2000 Bateman, A. 2000. Integration in psychotherapy: An evolving reality in personality disorder.. British Journal of Psychotherapy, 17(2): 147156.  [Google Scholar], p. 147) that ‘psychotherapy continues to be bedeviled by ideological schisms with practitioners apparently ignoring alternative conceptualizations and potentially superior interventions’.  相似文献   
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Harold Cohen is a renowned painter who has developed a computer program, AARON, to create art. While AARON has been hailed as one of the most creative AI programs, Cohen consistently rejects the claims of machine creativity. Questioning the possibility for AI to model human creativity, Cohen suggests in so many words that the human mind takes a different route to creativity, a route that privileges the relational, rather than the computational, dimension of cognition. This unique perspective on the tangled web of mind, machine, and creativity is explored by an application of three relational models of the mind to an analysis of Cohen's talks and writings, which are available on his website: www.aaronshome.com .  相似文献   
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Counselor education programs and professional associations of behavioral and social sciences have failed to assist counselors, teachers, and parents in understanding and relating to youth in this technological era. Rebelliousness, alienation, and even rioting engaged in by youth represent cries for help to which adults respond, sometimes with indifference but more often with confusion, resentment, or active antagonism. Empathic and informed counselors may be able to reduce the basic feeling of guilt that leads to such negative reactions by helping school staff and parents recognize that rapid and dramatic changes in modern society have irrevocably influenced attitudes, values, and behaviors of youth. Youth have much right on their side. However, they need wisdom of perceptive adults to guide them in working in acceptable ways for legitimate goals which the older generation has preached but often disregarded in practice. “There is, of course, a teenage problem, but that problem is not the teenager but the adult.”—Ashley Montagu.  相似文献   
166.
The paper describes the development of a short Spanish-language version of the General Well-Being Questionnaire (GWBQ; Cox and Gotts, 1987), based on the 12 items of its Worn Out scale. Research has shown the English-version Worn Out scale to be sensitive to aspects of the design and management of work. This study aimed to test its cross-cultural consistency in a Spanish-language workplace context. The data were collected from a sample of 229 workers in Valencia (Spain). Confirmatory Factor Analyses showed the factorial validity, reliability, and concurrent validity of the new Spanish version to be adequate. The sensitivity of the new measure to safety behavior and the reporting of accidents was also assessed and shown to be good. The new questionnaire extends the usefulness of the parent questionnaire to occupational health psychology research in the Spanish language by offering a short assessment tool appropriate for workplace studies.  相似文献   
167.
Understanding the operating characteristics of theory of mind is essential for understanding how beliefs, desires, and other mental states are inferred, and for understanding the role such inferences could play in other cognitive processes. We present the first investigation of the automaticity of belief reasoning. In an incidental false-belief task, adult subjects responded more slowly to unexpected questions concerning another person's belief about an object's location than to questions concerning the object's real location. Results in other conditions showed that responses to belief questions were not necessarily slower than responses to reality questions, as subjects showed no difference in response times to belief and reality questions when they were instructed to track the person's beliefs about the object's location. The results suggest that adults do not ascribe beliefs to agents automatically.  相似文献   
168.
Exposure and response prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD). However, patients often do not adhere fully to EX/RP procedures. Motivational interviewing (MI) has been shown to improve treatment adherence in other disorders. This pilot study used a randomized controlled design to examine whether MI can be successfully added to EX/RP and whether this intervention (EX/RP + MI) could improve patient adherence to between-session EX/RP procedures relative to EX/RP alone. Thirty adults with OCD were randomized to 18 sessions of EX/RP or EX/RP + MI. Therapists rated patient adherence at each exposure session. Independent evaluators assessed change in OCD and depressive symptoms, and patients completed self-report measures of readiness for change and quality of life. The two treatment conditions differed in degree of congruence with MI but not in conduct of EX/RP procedures. Both groups experienced clinically significant improvement in OCD symptoms, without significant group differences in patient adherence. There are several possible reasons why EX/RP + MI had no effect on patient adherence compared to standard EX/RP, each of which has important implications for the design of future MI studies in OCD. We recommend that MI be further evaluated in OCD by exploring alternative modes of delivery and by focusing on patients less ready for change than the current sample.  相似文献   
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Some current models of working memory argue that a passive short-term store is not involved in more dynamic working memory tasks. Other models argue that standard short-term memory and working memory tasks rely on common storage facilities. We examine these issues by exploring two signature effects of passive short-term storage in simple span, complex span, and Brown-Peterson tasks. The finding that all three tasks show word length and phonological similarity effects suggests that common processes or storage mechanisms are involved in all tasks. The implications for models of working memory are discussed.  相似文献   
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