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.     

Predictors of Diabetes Fatalism Among Arabs: A Cross-Sectional Study of Lebanese Adults with Type 2 Diabetes

Fatalism is a grounded cultural belief that is common among Arabs and is known to hinder self-care in chronic diseases including diabetes (Nabolsi and Carson in Scand J Caring Sci 25(4):716–724, 2011). The purpose of this study is to identify predictors of diabetes fatalism in this population. Data on 280 Lebanese patients with type 2 diabetes (mean age 58.24 ± 13.48 years; mean HbA1c 7.90 ± 1.90%; 53.76% females) recruited from one hospital in greater Beirut, Lebanon, and from the community using snowballing technique were examined. Multiple linear regression was used to assess the independent association between diabetes fatalism and demographic and patient characteristics. Age (β = ?.14, 95% CI ?.27, ?.002), BMI (β = .35, 95% CI .15; .54), level of education (β = ?3.98, 95% CI ?7.64; ?.32) and number of diabetes problems (β = ?5.03, 95% CI ?9.89; ?.18) were significantly associated with diabetes fatalism in the regression model. The combination of demographic and patient characteristics accounted for 14.5% of the variance in diabetes fatalism scores’ change. Patients with type 2 diabetes who exhibited more fatalistic attitudes were younger, of lower education levels, had higher BMI and had fewer diabetes comorbidities. Such findings are crucial for healthcare practitioners to identify fatalistic patients and to tailor culturally appropriate strategies in diabetes management. Further studies are warranted to explore other potential determinants of diabetes fatalism with larger sample and non-Lebanese Arabic population.     

“Castration Anxiety” Revisited: Especially “Female Castration Anxiety”

ABSTRACT

I find the term castration anxiety a still relevant and important key body fearful fantasy in males, especially expressing fear of the father; as is female castration anxiety an equivalent key fear of the ablation of the sexual and reproductive organs of females, especially by the avenging mother. Freud’s and his followers’ version of the female anxiety, however, has repetitively been shown to be askew since the 1930s, yet it keeps appearing again, as if still worthy of serious argument. To demonstrate its utter blindness to an emotional or imaginative appreciation of female body reproductive functioning, a detailed critique is offered of the once classic paper, “The Body as Phallus” by Bertram Lewin (1933). I recommend that a straightforward sense of female castration is helpful in exploring female body anxieties as a more defined bodily referent than can be encompassed by separation anxieties that are currently more popular.     

Influence of Social Support Received in Online and Offline Contexts on Satisfaction With Social Support and Satisfaction With Life: A Longitudinal Study

People around the globe now regularly interact with family and friends through social network sites (SNSs). In this article, we investigated the differences between social interactions in online and offline contexts as well as users' satisfaction with the social support received in these contexts. It was hypothesized that SNSs are better set up for the task of leveraging informational support but that they are inferior to offline contexts in terms of emotional or instrumental support. We further assumed that users might feel similarly satisfied with how support is rendered online and offline but that only social support transacted in offline contexts would contribute to overall life satisfaction. All hypotheses were supported by longitudinal data (N = 327) that were used to investigate social support over the course of 2 years with 4 points of measurement.     

The sociocultural conceptualisations of schizophrenia and patterns of help seeking in south-east Nigeria

Socioculturally influenced interpretations of mental illness play decisive roles on the time and choice of treatment. These often result in significant delays before patients present at the psychiatric services, with consequent worsening of the prognosis. The aim was to assess the association between sociocultural factors, choice of treatment and treatment delay among patients with schizophrenia. A cross-sectional study of 360 patients with schizophrenia, without previous contact with any statutory psychiatric services, was done. Of this, 75.8% of the participants had visited traditional/faith healers as the first treatment option and have attributed schizophrenia to magico-supernatural causation, despite 70.0% of the participants being educated, while 24.2% of them believed in the natural causation of the illness and presented early to psychiatric hospital. There is a need for community-based psychiatric services that would have mental health education as one of their core mandates; and collaborations with traditional and faith-based healers aimed to reduce delay in their facilities.     

Try it, you'll like it: the influence of expectation, consumption, and revelation on preferences for beer

Patrons of a pub evaluated regular beer and "MIT brew" (regular beer plus a few drops of balsamic vinegar) in one of three conditions. One group tasted the samples blind (the secret ingredient was never disclosed). A second group was informed of the contents before tasting. A third group learned of the secret ingredient immediately after tasting, but prior to indicating their preference. Not surprisingly, preference for the MIT brew was higher in the blind condition than in either of the two disclosure conditions. However, the timing of the information mattered substantially. Disclosure of the secret ingredient significantly reduced preference only when the disclosure preceded tasting, suggesting that disclosure affected preferences by influencing the experience itself, rather than by acting as an independent negative input or by modifying retrospective interpretation of the experience.     

Oppositional defiant disorder toward adults and oppositional defiant disorder toward peers: initial evidence for two separate constructs

Confirmatory factor analysis of 25 items on the Child and Adolescent Disruptive Behavior Inventory (CADBI, Version 2.3; G. L. Burns, T. K. Taylor, & J. C. Rusby, 2001) was conducted on teacher ratings of 824 kindergarten children and replicated on 534 children. Model fit was improved when correcting for 2 method effects: (a) adjacent items and (b) identical behaviors (e.g., argues with adults, argues with peers). The results show that the 25 items loaded on 3 distinct but correlated factors: Hyperactivity, Oppositional to Adults, and Oppositional to Peers. These more refined constructs from the CADBI may be useful for practitioners in identifying children who are at risk and for helping define appropriate contexts in which to intervene. The CADBI and analytic procedures also may contribute to future psychoeducational research on the development of problem behavior.