Reflections on a psychiatric placement

Abstract

During a seminar last year, I was teaching a group of counselling students on the subject of depression. One of the students asked me what I thought of referring a depressed client to a psychiatrist. I replied that in my opinion it was better to keep a person out of the psychiatric services as much as possible. This was an opinion I began to reconsider over the course of a six-month psychiatric placement, undertaken as part of an analytic psychotherapy training.     

美国华人移民的异文化压力:特点、影响因素和中介效应

从美国NLAAS的调查数据中直接抽取美国华人移民样本473份,探讨美国华人移民异文化压力的特点、影响因素及中介效应。结果显示:美国华人移民体验的异文化压力较大,且与多因素存在显著相关,英语熟练度、移民时的年龄、移居美国的年数和种族歧视对压力具有显著预测性;社会地位作为中介变量可以有效缓冲美国华人移民的异文化压力。     

Counsellor conflict in managing the frame: Dilemmas and decisions

An essential feature of psychodynamic counselling is a secure frame for the work that holds boundaries as sacrosanct, both to ensure ethical practice and to provide a vehicle through which unconscious processes can be recognized and understood. Conscious or unconscious attacks on the frame are inevitable in any therapeutic relationship, and provide an opportunity for exploration and insight. However such incidents also have an impact on the therapist who must decide how to respond. In order to understand more about the therapist process when there is an attack on the frame, an investigation was carried out into ways in which psychodynamic counsellors manage the difficulties and dilemmas that arise as they try to hold a secure therapeutic frame. Ten counsellors were interviewed using a semi‐ structured interview format during which they were asked about an instance when the frame was challenged and the process by which it was resolved. The resulting dilemmas were categorized using grounded theory. Three categories of dilemmas emerged a) prior to making a decision about how to deal with it, b) after making a decision, and c), as a result of the outcome of the action taken. The nature of the dilemmas and the process of resolving them are reported and discussed.     

Adherence to Asian Cultural Values and Cultural Fit in Korean American Undergraduates' Help‐Seeking Attitudes

Differences in and relationships of Asian cultural values, cultural congruity, perception of the university environment, and help‐seeking attitudes for 1st‐and 2nd‐generation Korean American undergraduates (N = 228) were examined. Women reported significantly higher cultural congruity and more positive help‐seeking attitudes than did men. Asian values adherence negatively predicted help‐seeking attitudes for women and 2nd‐generation students only. Implications for Korean American undergraduate support services are discussed, and suggestions are presented for future research.     

Immediate source-monitoring, self-focused attention and the positive symptoms of schizophrenia

Previous research suggests that tendencies to misattribute one's own thoughts to an external source, as assessed by an immediate source-monitoring test, are associated with auditory verbal hallucinations (AVHs). However, recent research suggests that such tendencies are associated instead with symptoms of thought interference. The main aim of the present study was to examine whether such tendencies are differentially associated with different types of thought interference, with AVHs, or with both. It has also been suggested that external misattributions are especially likely to occur with emotionally salient material and if the individual's focus is on the self. These suggestions were also tested. The positive psychotic symptoms of 57 individuals with a diagnosis of schizophrenia were assessed and they then completed the Self-Focus Sentence Completion blank. Immediately after completing each sentence they were asked to indicate to what extent the sentence was their own. The number of sentences that were not rated as completely their own served as their externalisation score. Externalisation scores correlated significantly with the severity of three symptoms: voices commenting, delusions of being controlled, and thought insertion. In a logistic regression analysis, all three of these symptoms were significantly and independently related to externalisation. Externalisation was not associated with either a negative or a neutral self-focus. Thus tendencies to misattribute one's own thoughts to an external source are associated with AVHs and some, but not all, symptoms of thought interference. The importance for externalisation of self-focused attention and of the emotional salience of the elicited thoughts was not supported.     

Cultural diversity: Mapping the experiences of students on an international counsellor training programme

This research study explores one part of a diverse counselling training landscape in the shape of an international postgraduate education and training programme for counsellors. The research sample includes participants from Tanzania, the Gambia, Ghana, Nigeria, Indonesia, China, Taiwan, Iceland, Japan, Greece, Portugal, Lebanon and Saudi Arabia. Cultural diversity is examined in relation to the learning and development of international counselling students. Qualitative analysis of interview data is used to identify issues related to student expectations, the process of becoming a counsellor and student learning outcomes. Some issues in counsellor training appear to be shared across all international students, while other issues arise from specific cultural backgrounds of students. The implications of these findings are discussed.     

Maternal speech style with prelinguistic twin infants

The mother–infant communicative speech of a group of mothers of 4‐month‐old first‐born twin infants was compared to the speech of a group of mothers of first‐born singleton infants. Maternal groups were matched on age, education level, mother–infant attachment status and infant gender, and maternal depression was assessed as a control variable. Maternal speech was coded for focus, content, complexity and syntax of mothers' utterances. The findings of earlier studies with toddler age twins, that maternal speech style was more directive and less infant‐focused, were replicated in this prelinguistic period of infancy. Compared to mothers of singletons, mothers of twins used less infant‐focused speech, were less responsive to their infants' cues, and attributed less agency to their infants. Mothers of twins also used fewer questions and requests but did not differ from mothers of singletons in their use of negatives and imperatives. These early differences in the language learning environments of twin and singleton infants may be due to the reduced opportunities that mothers of twins have to establish dyadic communicative routines with their infants and to familiarize themselves with their infants as interactive partners, and may have implications for the early language development of twins. Copyright © 2002 John Wiley & Sons, Ltd.     

The Political Attitudes and Activities of Mainline Protestant Clergy in the Election of 2000: A Study of Six Denominations

This study examines clergy across six mainline Protestant denominations in terms of their social characteristics, their theological positions, and their political attitudes and behavior. The analysis is based on data collected through random surveys of clergy in each denomination conducted in 2001 using the same instrument. The predominant focus of the article is on the nature and level of political activities exhibited by mainline Protestant clergy in the election year of 2000. The analysis revealed that mainline Protestant clergy are indeed relatively active politically, but that, despite their commonality of belonging to the same broad religious tradition, the nature and level of such political activities varies across the six denominations. Variation in the level of political activity is related to a number of different variables. And, while multivariate analysis reduces the number of significant factors that account for such differences, the remaining significant factors are associated with each of the major theoretical approaches that have been advanced to account for differences in participation levels.