The Measurement of Positive Attitudes: The Glass is Half Full

Positive thoughts play a significant role in the experience and recovery from depression. The Coping Attitudes Scale (CAS) is a rationally derived measure of positive cognitions. The CAS contains statements reflective of coping attitudes along five domains: life perspective, personal accomplishment, positive future, self-worth, and coping with problems. The current study examined the CAS in psychiatric outpatients and college students. Measures of depression, hopelessness, suicidal ideation and positive attitudes were administered to 82 adult psychiatric outpatients and 156 college students. Depression and hopelessness were strongly, negatively, partially correlated with each of the CAS factors, after controlling for age. Relationships among individual CAS factors and suicidal ideation demonstrated weak to moderate partial associations, after controlling for age. Depression was significantly associated with the coping with problems subscale (R ² = .530). Hopelessness was significantly related to the positive future subscale (R ² = .696). Further, the CAS demonstrated a significant relationship with depression and hopelessness, even after accounting for the Automatic Thoughts Questionnaire-Revised, Positive subscale. The CAS may be an improved measure of positive attitudes that could be useful in establishing a patient’s baseline of positive thinking, determining targets for therapy, and in monitoring progress in treatment.     

Technology-Assisted Psychotherapy (TAP): Adapting Computerized Treatments into Traditional Psychotherapy for Depression

Technology may be changing the process of psychotherapy. Unfortunately, some therapists lack the computer skills or financial resources needed for the newest technology. The literature is reviewed for journal articles on the treatment of depression published during the past 7 years in which treatments have been guided by technology. Six findings are summarized that may be helpful when therapists lack skills or resources for advanced technology. (1) The assessment of depression can be facilitated by technology, whether using standardized questionnaires or simple ratings of mood submitted each day. (2) Technology tools can be used to send daily reminders to help clients develop more adaptive habits in thoughts or actions. (3) Clients can confront their problems through therapeutic dialogue, whether conducted in person, over the telephone, or via videoconference. (4) Depressed clients can confront their negative attitudes, often triggered by some form of loss, failure, or rejection, whether real, imagined, or anticipated. (5) Clients can use writing assignments to identify, label, explore and express their thoughts and feelings. These writing assignments can be conducted via email, or internet forms. (6) Clients value rapport with a therapist, and this bond seems important to ensure participation and adherence with treatment. Therapists can strengthen the treatment of depression using basic technology tools to extend, or supplement traditional sessions. However, it is important to protect the rapport needed for sustained participation in psychotherapy sessions.     

Emotional Reliance and Social Loss: Effects on Depressive Symptomatology

A reactive form of dependence has been proposed to occur when a person is undergoing a period of substantial stress and change. The present study assessed 114 psychiatric inpatients categorized according to the presence or absence of social loss and their level of emotional reliance on others. Both emotional reliance and social loss were related to a variety of depressive symptoms. A significant interaction was observed between emotional reliance and social loss on depression severity as measured by the Beck Depression Inventory (BDI). In general, subjects high in emotional reliance but experiencing no social loss displayed higher levels of depression than emotionally reliant subjects who had undergone a social loss. Patients reporting high emotional reliance on others, in the aftermath of a social loss, may be reacting to the loss and suffer from less-severe and less-chronic pathology. Subjects reporting excessive emotional reliance in the absence of any precipitating exit event may be displaying more of a trait-like pathology. Personality disorder pathology should occur with such frequency and intensity so it can be observed even when obvious eliciting stimuli are absent.     

Cognitive-Behavioral Treatment of Depression with Comorbid Borderline Personality Traits

Personality dysfunction can influence the onset and maintenance of depressive symptoms. When both depression and personality dysfunction are present, it is important to develop an integrated treatment plan that addresses both conditions. A case example is used to illustrate how features of borderline personality disorder can influence the assessment and treatment of major depression. Specific challenges encountered by the therapist include: 1) differentiating borderline personality from depressive symptoms, 2) maintaining the therapeutic alliance, 3) managing impulsivity and self-destructive tendencies, 4) staying focused on long-term therapeutic goals, and 5) coping with noncompliance. Over the course of 27 sessions, the client was able to make positive changes in mood, self-image, and impulsive tendencies. Although the client's borderline personality traits complicated the course of treatment for depression, neglecting these personality problems would have left the client vulnerable to depressive relapse.     

Contemporary Psychotherapy: Gold Mines and Land Mines

Psychotherapy has a rich past and great potential. However, psychotherapists should be aware of several areas of strength as well as some problem areas. Strengths include the benefits of a strong therapeutic alliance, a diverse range of theories, and quality research that documents the effectiveness of psychotherapy. Weaknesses include conflicting theories, financial matters, and misunderstandings between clinicians and researchers. Hopefully, mental health professionals can focus on mining the gold from the gold mines while also working to understand and disarm the land mines.     

The 5th Annual psyche awards: celebrating excellence in scholarship

The Psyche Awards were developed to recognize the best journal articles published during the previous year. Each award confronts a specific topic within the field of mental health care, identifying articles that integrate the science and practice of psychology. For the current awards, 161 journals were screened, and 223 relevant articles were identified. The papers were then narrowed down to 46 papers distributed across 11 award categories. A panel of four expert judges read each article and rated all papers for their contribution to the field. The current award categories highlight some of the best articles published during 2021, capturing important information about psychological assessment, treatment of depression, working with suicidal clients, technology-assisted psychotherapy, the impact of Covid-19 on mental health, lessons from a review of history, recent innovations in the field, and strategies to expand the integration of science and practice.

     

Ten Criteria to Qualify As a Scientist-Practitioner in Clinical Psychology: An Immodest Proposal for Objective Standards

The term ‘scientist-practitioner’ has never been defined in clear or objective terminology. Detailed criteria may help to guide new generations of clinical psychologists to live by the ideals of the Boulder model. Ten criteria are proposed for evaluating the scientist-practitioner in clinical psychology across three domains: scholarship, clinical practice, and the integration of science and practice in psychology. The scientist-practitioner remains active in scholarly works, making regular contributions to the field. These contributions are visible at a national level of impact, and they extend beyond teaching. The scientist-practitioner remains active in the clinical practice of psychology, conducting face-to-face work with clients on regular basis, even if it involves a rather modest time commitment. The clinical services reflect standard clinical practices and extend beyond the supervision of others. The scientist-practitioner strives to integrate the science and practice of psychology. This integration centers around evidence-based practice, and can be seen when scholarship examines issues relevant to mental illness and its treatment.     

You’ve Got to Believe: Core Beliefs that Underlie Effective Psychotherapy

A mixture of core beliefs may lay the foundation for effective psychotherapy. Sincere trust in these beliefs may help to promote therapeutic change. The therapist must have faith in the power of words to promote change. Clients usually change in a gradual manner, and the initial plan for therapy can be simplified by focusing on strategies for changing actions and attitudes. Also, therapy can help to improve various aspects of clients’ intimate relationships. However, before attempting to promote therapeutic change, it is important for the therapist to begin by understanding the client’s life situation, current distress, and natural tendencies. Clients benefit from emotional tolerance of stressors by recognizing that many negative life events turn out better than initially expected. A tendency to dwell on past events can perpetuate problems, while it can be more helpful to accept and grow from negative events. Therapists are encouraged to view a client’s emotions as natural reactions, not deviant dysfunctions that need to be blocked or suppressed through medications. In a similar manner, most labels, including many psychiatric diagnoses, pose a danger through societal discrimination and self-stigma. When therapists adopt these core beliefs, they can more effectively help clients move forward, making adaptive psychological changes.