Do primary care psychological therapists ‘think family’? Challenges and opportunities for couple and family therapy in the context of ‘Improving Access to Psychological Therapies’ (IAPT) services

Very little couple or family work takes place in primary care despite the advantages offered by the context. This pilot study investigated the experiences of primary care adult therapists regarding the place of families in their clinical work. Semi‐structured interviews with seven therapists were analysed using interpretative phenomenological analysis. The findings tentatively suggest that primary care psychological therapists ‘think family’ primarily from the perspective of their main therapeutic model when offering individual therapy. Some study participants questioned the appropriateness of their family/context focus. Family members were extremely rarely seen together. Facilitating factors included supervision and training. Barriers to family work were both external (the work setting) and internal (beliefs about it). The impact of the current dominance of cognitive behavioural therapy in National Health Service adult psychological therapy services and the development of Improving Access to Psychological Therapies (IAPT) services on the provision of couple and family therapy are discussed. Some challenges and opportunities presented by IAPT for couple and family therapy are explored.     

The Experience of Former Women Officials and the Impact on the Sporting Community

In an effort to explore the shortage of female sport officials, the authors examined the experience of eight former female basketball officials from five geographically diverse states in the U.S. who voluntarily left the role. Specifically, the authors asked former female basketball officials to describe their workplace experiences. Utilizing a phenomenological approach and workplace incivility framework, the results indicated that the felt social inequity for female officials detracted from the participants experiencing a sense of community in the workplace, which ultimately led to their discontinuation in the role. Results indicate four key factors that created this uncivil work environment. An examination of the data revealed four major themes. Specifically the female basketball officials reported experiencing a Lack of Mutual Respect from male counterparts; Perceived Inequity of Policies; a Lack of Role Modeling and Mentoring for and from female officials; and experiencing more Gendered Abuse than did their male counterparts. The combination of these four factors exacerbated the female officials’ inability to connect to the officiating community and led to their withdrawal from the role. The results further indicate that women officials likely threatened the hegemonic characteristics of a sport setting. Although females have made great strides in terms of sport participation, the practical implications of this research suggest that understanding females in workplace roles, such as officiating, is vital if social equity is to be achieved in the sporting community.     

The effects of co-witness discussion on confidence and precision in eyewitness memory reports

We examined the influence of co-witness discussion on the metacognitive regulation of memory reports. Participants (N?=?92) watched a crime video. Later, a confederate confidently agreed with (gave confirming feedback), disagreed with (gave disconfirming feedback), or gave no feedback (control) regarding participants’ answers to questions about the video. Participants who received disconfirming feedback reported fewer fine-grain details than participants in the confirming and control conditions on a subsequent, individual recall test for a different question set. Unexpectedly, this decrease in fine-grain reporting was not accompanied by a decrease in participants’ confidence in the accuracy of their fine-grain responses. These results indicate that receiving social comparative feedback about one’s memory performance can affect rememberers’ metamemorial control decisions, and potentially decrease the level of detail they volunteer in later memory reports. Further research is needed to assess whether these results replicate under different experimental conditions, and to explore the effects of social influences on metamemory.     

Cognitive outcomes of pediatric stroke

A limited number of longitudinal studies have investigated long-term neuropsychological development in the pediatric stroke population. This study retrospectively examines cognitive outcomes in 41 children with a history of stroke, with reference to age at stroke, laterality, region and mechanism of stroke. In the course of recovery, neuropsychological measures of intellectual functioning and memory were administered at two time points, whilst executive functioning, attention and academic skills were administered at one time point. As predicted, children with stroke performed significantly worse compared to normative expectations on all neuropsychological measures. Up to two thirds of children scored in the borderline impaired and impaired ranges on at least one domain of cognition. Performance on intellectual and memory assessment remained relatively stable over time. Younger age at stroke was found to be associated with poorer intellectual functioning. No effects of laterality of stroke on neuropsychological performance over time were found. Children with subcortical stroke demonstrated a greater improvement in immediate memory over time than children with cortical stroke. These findings reveal that children with stroke display long-term cognitive difficulties that typically remain stable over time. Attention and academic skills are particularly vulnerable to impairment. Further evidence that age at stroke is a significant factor in terms of cognitive outcome is provided, in support of the “early vulnerability” position.     

Anxiety,depression, and the suicidal spectrum: a latent class analysis of overlapping and distinctive features

ABSTRACT

Anxiety and depression diagnoses are associated with suicidal thoughts and behaviours. However, a categorical understanding of these associations limits insight into identifying dimensional mechanisms of suicide risk. This study investigated anxious and depressive features through a lens of suicide risk, independent of diagnosis. Latent class analysis of 97 depression, anxiety, and suicidality-related items among 616 psychiatric outpatients indicated a 3-class solution, specifically: (1) a higher suicide-risk class uniquely differentiated from both other classes by high reported levels of depression and anxious arousal; (2) a lower suicide-risk class that reported levels of anxiety sensitivity and generalised worry comparable to Class 1, but lower levels of depression and anxious arousal; and (3) a low to non-suicidal class that reported relatively low levels across all depression and anxiety measures. Discriminants of the higher suicide-risk class included borderline personality disorder; report of worthlessness, crying, and sadness; higher levels of anxious arousal and negative affect; and lower levels of positive affect. Depression and anxiety diagnoses were not discriminant between higher and lower suicide risk classes. This transdiagnostic and dimensional approach to understanding the suicidal spectrum contrasts with treating it as a depressive symptom, and illustrates the advantages of a tripartite model for conceptualising suicide risk.     

Strategies to Engage Underrepresented Parents in Child Intervention Services: A Review of Effectiveness and Co-occurring Use

The purpose of this review was to estimate the impact of parent engagement strategies tested with underrepresented families of young children with social, emotional, or behavioral disorders, and describe the combinations in which these strategies are commonly used together. We conducted a systematic review using the PracticeWise Engagement Coding System to identify which strategies had the strongest empirical support for engaging underrepresented (i.e., minority race or ethnicity, or low income) families receiving psychosocial services for their children. Social network analyses were used to identify the frequency of strategy use and how strategies were combined to engage underrepresented families. Linear regression was used to estimate the impact of each strategy on parent engagement, using attrition as a proxy for non-engagement. Thirty-five studies met inclusion criteria. Parent attrition was predicted by larger sample sizes, lower maternal education, interventions that were more community or home-based, less therapist monitoring, positive reinforcement from therapists, and more pairing families with peers. Social network analyses suggested that more effective strategies were more frequently implemented alone and less effective strategies were commonly combined with each other. Our findings suggest that researchers and practitioners require guidance in selecting engagement strategies to reduce attrition of underrepresented families in treatment. Although we identified promising strategies for improving parent engagement in treatment for underrepresented children with social, emotional, or behavioral disorders, the frequent combining of engagement strategies in research means that there is little data on the independent effects of interventions to increase parent engagement for this population.     

Sources of Disagreement in Object Naming

Two experiments examined the processing of objects with low name agreement. Experiment I compared naming latencies for objects with three different types of name disagreement to those for matched control objects with very high name agreement. Objects with low name agreement due to abbreviations (e.g. phone) were named no more slowly than were control objects. Objects with multiple names (e.g. couch, sofa, settee) and objects often given incorrect names (e.g. spider for ant) took longer to name correctly than did matched controls. These results were confirmed in a second naming experiment using a revised set of high-name-agreement control stimuli. In Experiment 2, subjects carried out an object decision task using the revised stimulus set. Subjects could recognize objects with multiple names as quickly as those with high name agreement. Objects often given incorrect names were recognized by subjects more slowly than were high-agreement matched stimuli. The pattern of data suggests that the delay in naming latency due to the availability of more than one correct name arises after structural recognition. In contrast, the slowed naming of objects often misnamed would seem to originate from difficulties encountered at or before the structural stage of recognition.     

Challenging gender stereotypes: Theory of mind and peer group dynamics

To investigate the social cognitive skills related to challenging gender stereotypes, children (N = 61, 3–6 years) evaluated a peer who challenged gender stereotypic norms held by the peer's group. Participants with false belief theory of mind (FB ToM) competence were more likely than participants who did not have FB ToM to expect a peer to challenge the group's stereotypes and propose that the group engage in a non‐stereotypic activity. Further, participants with FB ToM rated challenging the peer group more positively. Participants without FB ToM did not differentiate between their own and the group's evaluation of challenges to the group's stereotypic norms, but those with ToM competence asserted that they would be more supportive of challenging the group norm than would the peer group. Results reveal the importance of social‐cognitive competencies for recognizing the legitimacy of challenging stereotypes, and for understanding one's own and other group perspectives.     

The role of perception, language, and preference in the developmental acquisition of basic color terms

When learning basic color vocabulary, young children show a selective delay in the acquisition of brown and gray relative to other basic color terms. In this study, we first establish the robustness of this finding and then investigate the extent to which perception, language, and color preference may influence color conceptualization. Experimental tasks were designed to measure different aspects of perceptual color processing (discrimination and saliency), color preference and objective counts of color term frequency in preschool-directed language (books and mothers' speech) were used to compare the acquisition of three groups of colors: primary colors, secondary colors (orange, pink, and purple) that appear at the same time as the primary colors, and secondary colors (brown and gray) that appear late. Although our results suggest that perception does not directly shape young children's color term acquisition, we found that children prefer brown and gray significantly less than basic colors and that these color terms appear significantly less often in child-directed speech, suggesting that color preference, linguistic input, and developing color cognition may be linked.