Addressing multiple relationships between clients and therapists in lesbian, gay, bisexual, transgender communities

Therapists working in lesbian, gay, bisexual, and transgender (LGBT) communities are likely to experience the potential to engage in multiple relationships with their clients. Currently, the American Psychological Association's (2002) ethics code and the related literature base offer minimal direct guidance to therapists practicing in LGBT communities. In this article, the authors review current literature regarding multiple relationships in psychotherapy, considering how this literature addresses issues specific to practitioners working within LGBT communities, present a case study highlighting the negotiation of a multiple relationship between a client and therapist who both identify as lesbian, and offer recommendations for practitioners working within LGBT communities.     

Sensory processing sensitivity and its relation to parental bonding, anxiety, and depression

Sensory processing sensitivity is a recently proposed construct referring to a tendency to process a variety of information more strongly and deeply than others. Although some research has found links between sensory processing sensitivity and psychological difficulties, highly sensitive people may not necessarily be predisposed to negative affect, but may be more sensitive to poor parenting. Two hundred thirteen college students were given a measure of sensory processing sensitivity (the HSPS), the parental bonding scale (measuring parental care and over-protection), the trait anxiety scale, and the Beck depression inventory. Sensory processing sensitivity predicted both anxiety and depression above and beyond parental factors, indicating that it may be an independent risk factor. An interaction was found between sensory processing sensitivity and parental care when measuring depression. Highly sensitive people may be particularly sensitive to uncaring parents. Results indicate that sensory processing sensitivity may be a temperamental disposition that interacts meaningfully with environmental factors.     

Disseminating a smokeless tobacco cessation intervention model to dental hygienists: a randomized comparison of personalized instruction and self-study methods.

This study evaluated 2 methods of disseminating an empirically validated smokeless tobacco intervention delivered during routine dental care. Twenty cities within 12 states were stratified and then randomized to 1 of 3 groups: personalized instruction (PI), self-study (SS), or delayed training (DT) control. Dental hygienists in the SS condition were sent a manual and video. Those in the PI condition were recruited to attend a workshop. Thirty-seven percent of eligible hygienists agreed to participate. At 12 months postenrollment, hygienists in the SS and PI conditions significantly increased their "Assist" behaviors (discuss cessation techniques, help patient set a quit date, and provide cessation materials) and reported fewer perceived barriers to delivering the intervention as compared with hygienists in DT. An economic analysis suggests that SS is more cost-effective than PI.     

Attentional flexibility and perseveration: developmental aspects in young children.

Whereas a growing interest in the development of attentional flexibility (AF) and in perseverative behavior, being one marker of this component, exists in neuropsychological studies and in the domain of developmental psychopathology (e.g., PKU, infantile schizophrenia, autism and Parkinson's disease) (Pennington & Ozonoff, 1996; Stahl & Pry, 2002), only a few studies have concerned themselves with this subject in normal children. It is thus of interest to add more empirical data to the existing literature in this domain. Therefore, the aim of our study was to explore the development of AF and of perseverative errors in young preschool children with normal development, aged 1.5 to 6 years. Using set-shifting tasks of increasing difficulty level, three age groups were compared with respect to their AF skills.Results show a developmental factor underlying AF, with different levels of this form becoming more and more complex with age, ranging from a rudimentary visual form to a complex representational form of flexibility. Overall, few perseverative errors occurred and they decreased with age. Results are discussed from a developmental and neuropsychological perspective.     

Socioeconomic status, resources, psychological experiences, and emotional responses: a test of the reserve capacity model

The current study used ecological momentary assessment to test several tenets of the reserve capacity model (L.C. Gallo & K. A. Matthews, 2003). Women (N = 108) with varying socioeconomic status (SES) monitored positive and negative psychosocial experiences and emotions across 2 days. Measures of intrapsychic and social resources were aggregated to represent the reserve capacity available to manage stress. Lower SES was associated with less perceived control and positive affect and more social strain. Control and strain contributed to the association between SES and positive affect. Lower SES elicited greater positive but not negative emotional reactivity to psychosocial experiences. Women with low SES had fewer resources relative to those with higher SES, and resources contributed to the association between SES and daily experiences.     

Assessment of the Use and Feasibility of Video to Supplement the Genetic Counseling Process: A Cancer Genetic Counseling Perspective

Cancer genetic counselors use a variety of teaching modalities for patient education. This survey of cancer genetic counselors assessed their use of educational videos and their recommendations for content of future videos. Thirty percent of respondents use videos for patient education. Cited benefits included reinforcement of information for clients and increased counselor efficiency. Of the 70% who do not use videos, predominant barriers included the perceived lack of an appropriate video, lack of space and/or equipment, and concern that videos are impersonal. Most respondents desired a video that is representative of the genetic counseling session, but emphasized the importance of using broad information. Content considered critical included the pros and cons of genetic testing, associated psychosocial implications, and genetic discrimination. The results of this exploratory study provide data relevant for the development of a cancer genetics video for patient education, and suggestions are made based on aspects of information processing and communication theories.     

Distilling Common History and Practice Elements to Inform Dissemination: Hanf-Model BPT Programs as an Example

There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically supported interventions in general and the core components of specific approaches in particular. The evidence base for behavioral parent training (BPT) and the standard of care for early-onset disruptive behavior disorders (oppositional defiant disorder and conduct disorder), which frequently co-occur with attention deficit hyperactivity disorder, are well established, yet an ahistorical, program-specific lens tells little regarding how leaders, University of Oregon Medical School, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; (Cunningham et al. in J Child Psychol Psychiatry 36:1141–1159, 1995; Cunningham et al. in COPE, the community parent education program: large group community-based workshops for parents of 3- to 18-year-olds, COPE Works, Hamilton, 2009), Defiant Children (DC; (Barkley in Defiant children: a clinician’s manual for assessment and parent training, Guilford Press, New York, 1987; Barkley in Defiant children: a clinician’s manual for assessment and parent training, Guilford Press, New York, 2013), Helping the Noncompliant Child (HNC; Forehand and McMahon in Helping the noncompliant child: a clinician’s guide to parent training, Guilford Press, New York, 1981; McMahon and Forehand in Helping the noncompliant child: family-based treatment for oppositional behavior, 2nd ed., Guilford Press, New York, 2003), Parent–child interaction therapy (PCIT; Eyberg and Robinson in J Clin Child Adolesc Psychol 11:130–137, 1982. doi:10.1080/15374418209533076; Eyberg in Child Fam Behav Ther 10:33–46, 1988; Eyberg and Funderburk in Parent–child interaction therapy protocol, PCIT International, Gainesville, 2011), and the Incredible Years (IY; (Webster-Stratton in Behav Ther 12:634–642, 1981. doi:10.1016/S0005-7894(81)80135-9; Webster-Stratton in J Pediatr Psychol 7:279–294, 1982. doi:10.1093/jpepsy/7.3.279; Webster-Stratton in The incredible years: parents and children series. Leader’s guide: preschool version of BASIC (ages 3–6 years, The Incredible Years, Seattle, 2008). Our goal is not to provide an exhaustive review of the evidence base for the Hanf-Model programs, rather our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed.