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.     

Built to last: Interactive effects of perceived overqualification and proactive personality on new employee adjustment

We integrate relative deprivation and broaden and build theories to develop a process-based model of perceived overqualification and its relationship with new employee adjustment via “broaden and build” mechanisms (i.e., reciprocal relationships between initial status and change trajectories in work-related positive affect and perceived job autonomy). Additionally, we examine how new employee proactive personality may influence this process. Analyses of weekly survey responses from 331 new employees of a large financial institution throughout their first 90 days of employment revealed that those who felt overqualified generally experienced less work-related positive affect and perceived less job autonomy when beginning their jobs (assessed the first week of employment) than their more qualified counterparts. Moreover, initial levels of perceived job autonomy were positively associated with adjustment outcomes (assessed at 90 days of employment) via linear change in positive affect over time (assessed weekly, up to 8 weeks of employment). These findings suggest that perceived overqualification may negatively influence newcomer adjustment by stunting broaden and build processes. However, proactive personality attenuated this effect. Theoretical and practical implications are discussed.     

Sleep deprivation in Air National Guard medical personnel responding to simulated disaster-training exercises

National Guard personnel remain largely unstudied within the sleep research community, despite their unique and important role. In response, the purpose of this study was to investigate the extent of sleep deprivation in National Guard medical personnel from two separate Air Force Bases (AFBs) responding to simulated disaster-training exercises. National Guard medical personnel (N = 77) were fitted with wrist activity monitors (actigraphy) to objectively measure their sleep for 4 days of their civilian time (baseline), followed by a 4-day transition period from civilian to military duty, and a 3–5-day disaster-training exercise. Differences in sleep quantity, quality, and “cognitive effectiveness” were analyzed using generalized linear mixed models. Participants’ sleep quantity was significantly reduced from civilian to disaster-training periods, and their cognitive effectiveness also dropped significantly. National Guard medical personnel were sleep-deprived during a simulated disaster-training exercise, which, although a valid proxy for real-world disasters, is likely to be a conservative approximation of the stress and fatigue National Guard personnel experience during crisis response. As such, the need for targeted fatigue-related interventions to safeguard our service members during these critical times is clear.     

A client‐generated psychometric instrument: The development of ‘PSYCHLOPS’

PSYCHLOPS (Psychological Outcome Profiles) is a recently developed, client‐generated, psychometric instrument that can be used as an outcome measure. Based on a similar instrument developed primarily for use in physical illnesses (MYMOP — ‘Measure Your Medical Outcome Profile’), it seeks the client's perspective on their psychological distress. It asks them to describe and then score the problem that troubles them the most at the start of counselling. We describe the development of PSYCHLOPS, including the involvement of the Plain English Campaign and two national mental health organisations: the mental health charity and support group, Depression Alliance (DA) and Primary Care Mental Health Education (PRIMHE). We review the literature and suggest that PSYCHLOPS, by focusing on the problems of greatest priority to the client, might prove a sensitive measure of improvement after counselling.     

Medicine as Enlightenment cure: Benedetto Frizzi, physician to eighteenth-century Italian Jewish society

This article examines modern Jewish doctors and the Enlightenment in action through its analysis of Dr. Benedetto Frizzi (1756–1844) as an Enlightenment Jewish physician and public intellectual in Habsburg northern Italy. Frizzi sought to spread the new Enlightenment gospel of polizia medica—public health policy or social medicine—that he learned from its pioneering exponent, Dr. Johann Peter Frank, his teacher at the University of Pavia. Frizzi dispensed Enlightenment medicine for the benefit of the state and society in general, as well as Jewish society and culture in particular, for he saw himself as both public health crusader and doctor-priest ministering to his own people. His commitments to Enlightenment science and rationalism led him to criticize Jewish social practices harshly even as he creatively reinterpreted classic Jewish texts; accordingly, Frizzi was regarded in some quarters as subversive, while in others as an apologetic defender of Jews and Judaism. Situating Frizzi within the traditions of Jewish as well as European Enlightenment physicians, this article raises broader questions about religion and secularism in the modern discourse of medicalized Judaism.     

Student welfare and guidance: The pastoral role of the academic

Problems relating to the role of academic staff in the pastoral care of students in institutions of higher education are discussed, and the arrangements made in one university for the provision of such pastoral care are considered. The operation of this 'supervisory system' is shown to vary between the different departments, and the views of the heads of departments are seen to be far from unanimous. The responsibilities attributed by heads of departments to supervisors are numerous and diverse. Perhaps, with the influx of professional student counsellors into institutions of higher education, the time is ripe for a re-assessment of the part academic staff can play in the pastoral care of their students.