“Part of me feels like there must be something missing”: a phenomenological exploration of practising psychotherapy as a clinical psychologist

The experience of practising psychotherapy as a clinical psychologist was explored through a small number of in-depth interviews. Using Interpretative Phenomenological Analysis, three main themes were identified: “Feeling there’s something missing”, “Being able to get in there emotionally” and “Needing somewhere to go for support”. This study suggests that training for psychotherapy work can be experienced as piecemeal and fragmented, contributing to professional self-doubt, with clinical psychologists seeking more structured, cohesive training in this area. It also suggests that engagement in personal therapy can contribute to greater emotional capacity as a psychotherapy practitioner, although clinical psychologists can fear engaging in something that is unfamiliar. In addition, the psychologists highlighted the felt necessity of safe and satisfying supervision for resilient practice.     

IMPLEMENTATION OF AN EVIDENCED‐BASED PARENTING PROGRAM IN A COMMUNITY MENTAL HEALTH SETTING

The process of mental health intervention implementation with vulnerable populations is not well‐described in the literature. The authors worked as a community‐partnered team to adapt and pilot an empirically supported intervention program for mothers of infants and toddlers in an outpatient mental health clinic that primarily serves a low‐income community. We used qualitative ethnographic methods to document the adaption of an evidence‐based intervention, Mothering from the Inside Out, and the pilot implementation in a community mental health clinic. Seventeen mothers and their identified 0‐ to 84‐month‐old children were enrolled in the study. Key lessons from this implementation include (a) the importance of formative work to build community relationships and effectively adapt the intervention to meet the needs of the therapists and their clients, (b) the importance of designing plans for training and reflective supervision that fit within the flow of the clinic and can tolerate disruptions, and (c) that use of an interdisciplinary approach is feasible with the development of a plan for communication and the support of a trained reflective clinical supervisor. These key lessons advance the scientific knowledge available to healthcare managers and researchers who are looking to adapt mental health clinical interventions previously tested in clinical trials to implementation in community settings.     

Introducing Spirituality into Psychiatric Care

Spirituality is important to many psychiatric patients, and these patients may be moved toward recovery more effectively if their spiritual needs are addressed in treatment. This, however, is rarely given expression in the psychiatric services of teaching hospitals. In order to develop this potential area of improved care, we (1) evaluated the differential attitudes of patients and psychiatric trainees toward the value of spirituality in the recovery process, (2) established a program of group meetings conducted by psychiatric residents and staff where patients can discuss how to draw on their spirituality in coping with their problems, and (3) established related training experiences for psychiatric residents. The results and implications of these three initiatives are presented.     

Risky Behavior in Affluent Youth: Examining the Co-occurrence and Consequences of Multiple Problem Behaviors

Children of affluent parents are often excluded in psychological research as they are considered to be at “low risk”; however, research is beginning to suggest that this previously under-studied population may be at risk for developing multiple problem behaviors, including substance use and externalizing problems. The current study aimed to extend the application of Problem Behavior Theory (PBT) to a sample of affluent adolescents by examining the extent to which these behaviors co-occurred and were associated with negative outcomes. Data were collected from 1,147 high school students living in an affluent community via anonymous questionnaires regarding their engagement in various problem behaviors. PBT was supported in this sample, and youth who engaged in multiple problem behaviors reported experiencing more negative outcomes than youth who did not engage in these behaviors. The findings of this study support the generalizability of PBT and also highlight the importance of continuing to study affluent youth in addition to traditionally high-risk populations.     

Natural Mentoring,Academic Motivation,and Values Toward Education Among Latinx Adolescents

We examined the roles of relational and instrumental relationship quality with natural mentors and academic intrinsic motivation on Latinx adolescents’ perceived economic values of education. Participants were 256 Latinx youth (M = 15.07 years old; 116 boys, 140 girls) who completed surveys in 9th and 10th grades. Path analyses indicated significant cross‐sectional effects in 9th grade such that instrumental quality was associated with more perceived benefits of education, and relational quality was associated with fewer perceived limitations of education. Neither instrumental nor relational quality in 9th grade was associated with either benefits or limitations of education in 10th grade. Instrumental relationship quality in 9th grade, however, did have an indirect effect on perceived benefits of education in 10th grade through intrinsic motivation. Implications for research on natural mentoring with Latinx adolescents are discussed.     

Brain activity during the encoding, retention, and retrieval of stimulus representations

Studies of delayed nonmatching-to-sample (DNMS) performance following lesions of the monkey cortex have revealed a critical circuit of brain regions involved in forming memories and retaining and retrieving stimulus representations. Using event-related functional magnetic resonance imaging (fMRI), we measured brain activity in 10 healthy human participants during performance of a trial-unique visual DNMS task using novel barcode stimuli. The event-related design enabled the identification of activity during the different phases of the task (encoding, retention, and retrieval). Several brain regions identified by monkey studies as being important for successful DNMS performance showed selective activity during the different phases, including the mediodorsal thalamic nucleus (encoding), ventrolateral prefrontal cortex (retention), and perirhinal cortex (retrieval). Regions showing sustained activity within trials included the ventromedial and dorsal prefrontal cortices and occipital cortex. The present study shows the utility of investigating performance on tasks derived from animal models to assist in the identification of brain regions involved in human recognition memory.     

Working memory consolidation is abnormally slow in schizophrenia

This study reports evidence that patients with schizophrenia demonstrate a slowing of working memory (WM) consolidation, which is the process of transforming transient perceptual representations into durable WM representations. Sixteen schizophrenia patients and 16 healthy control participants performed a task measuring the visual WM consolidation rate in a change-detection paradigm. A target display containing 3 colored squares was followed by a variable delay of 17-483 ms, a pattern mask, and then a test stimulus. This pattern mask does not interfere with perception but disrupts WM consolidation. Control participants reached no-mask performance by 250 ms, indicating completed WM consolidation, whereas patients failed to reach no-mask performance by 483 ms. Slowed consolidation may play an important and largely unrecognized role in schizophrenia.     

Impaired control of visual attention in schizophrenia

To investigate attentional impairment in schizophrenia, the authors examined the performance of 22 patients with schizophrenia and 16 healthy control subjects in 4 visual search tasks that varied in perceptual requirements and in the need for precise attentional control. The rate of search was slowed in the patients in all tasks. However, the degree of slowing was largest in tasks requiring precise attentional control and smallest in tasks that were perceptually difficult but required less attentional control. This pattern of results indicates that the primary impairment of attention in schizophrenia lies in the control of attention and not in the selection processes that operate once attention has been directed to an object.