Equine Facilitated Therapy for Children and Adolescents: A Qualitative Pilot Study

Despite recent growth in the use of equine facilitated therapy (EFT), and its potential to be an effective alternative to traditional therapeutic interventions, the literature has not yet provided a convincing explanatory account of the practices implemented within EFT. In this study, the author investigates consistency of clinical practices within the Equine Assisted Growth and Learning Association (EAGALA) model of EFT. Semi-structured interviews were conducted with mental health professionals and equine specialists (N = 10) from six Australian EFT clinics. Thematic analysis of data revealed: an absence of an underpinning theoretical model; variations between clinical practices; lack of parental involvement in therapy for children/adolescents; and inadequate research into perceived mechanisms of change driving EFT. This article concludes with a set of recommendations directed at EFT practitioners in order to increase the rigor of practice and maximize the potential of this intervention.     

疼痛恐惧的神经机制及其消退

疼痛恐惧是疼痛基础和临床研究中的一个重要课题。个体对疼痛信息产生过度警觉,诱发不恰当的回避行为,扰乱机体的正常功能,加剧疼痛的现象即为疼痛恐惧。疼痛恐惧可影响个体的疼痛感知以及疼痛相关的注意和回避行为,且在慢性疼痛(如慢性肌骨骼疼痛)的发展、维持个体正常生理功能的丧失中起着重要作用。疼痛恐惧的形成与表达涉及杏仁核、海马、背侧前扣带回皮层、和前额叶皮层等脑区的参与。当前的疼痛恐惧消退的心理-行为干预方法可在疼痛恐惧加工的不同阶段(巩固、再巩固和消退)消退个体的疼痛恐惧。然而,由于恐惧记忆形成过程较为复杂并受多种因素影响,疼痛恐惧记忆消退方法效果较不稳定,其基础研究与临床应用之间仍存在较大的鸿沟。将来研究有必要考虑到疼痛恐惧形成环境的差异以及个体人格特质/心理状态的差异,逐步完善相关消退方法并将其引入临床镇痛,以期帮助患者弱化、擦除甚至改写困扰他们的疼痛恐惧,从而缓解甚至消除病患的疼痛。     

The implementation of routine outcome measures in a Tier 3 Psychological Therapies Service: The process of enhancing data quality and reflections of implementation challenges

Background: The Newham Psychological Therapies Service (PTS) has been using the CORE System of evaluation to demonstrate effectiveness since 2004. More recently there has been the national and local drive to improve outcomes as outlined by a number of Department of Health policies and the Improving Access to Psychological Therapies (IAPT) initiative. Aims: This paper describes how, as a secondary care complex mental health service, we have engaged with the process of outcome measurement through complementing the usage of the CORE System with additional measures forming the service pilot minimum dataset. The process of implementation is outlined along with reflections on the challenges which the service faced in introducing outcome measurement. Findings: Engagement with outcome measurement by a service requires attention to be paid to the organisational and professional aspects and personal resonances for clinicians if it is to become established as a meaningful enterprise within secondary care services. Despite success at this task, challenges remain to the further development of this area of work.     

血管介入治疗与自然力再平衡：从扶持到掣肘

自然力是组织维持稳态的自愈能力,完善的内皮及平滑肌功能构成血管自然力基础。损伤力为打破组织稳态的破坏力。自然力弱于损伤力时,负平衡形成,疾病发生发展,需外援医疗干预扶持恢复自然力平衡。经数代技术革新,介入治疗后的血管事件发生率显著下降,但异物引起慢性炎症及再狭窄问题凸显,介入治疗与血管自然力陷入再狭窄-再介入的"对抗平衡",如何避免这种"掣肘"状态成为血管介入治疗后续的核心问题。生物可吸收支架及可回收支架为适度干预介入理念的新生产物,有望在干预成功后恢复血管自然状态,真正意义上实现自然力再平衡。     

Ergonomic Design Improves Cross-Cultural Road Sign Comprehension

BackgroundTraffic sign design can have a substantial impact on road safety and traffic flow. The current study had three objectives: 1) Cross-validate the importance of ergonomic sign design; 2) Evaluate the ability of ergonomics experts to predict sign comprehension by the average driver; 3) Offer improved sign designs for poorly designed road signs. In a previous study (Ben Bassat et al., 2019), human factors and ergonomics experts evaluated several alternative designs for 31 different road signs, based on three ergonomics criteria – familiarity, standardization, and message/symbol compatibility. Some of these signs were tested in the current study and the correlation between the results of the two studies was analyzed.MethodIn this study, 805 licensed drivers from five countries were tested on their comprehension of 24 conventional signs and 32 alternative signs. Signs were individually presented on a screen and as soon as the participant decided on the meaning, the sign disappeared, and an experimenter wrote the stated meaning. The verbal responses were coded as correct (perfectly or partially), wrong, or opposite of the true meaning. Sign identification response time was also recorded.ResultsIn all countries across all signs, more drivers comprehended the alternative ergonomically superior signs, and the identification response times were shorter for these sign designs. Furthermore, the correlation between ergonomics experts' ratings as found in previous study and the percent of comprehension for each sign design was statistically significant and positive with r = 0.61.ConclusionsRoad signs should be designed according to ergonomics-based criteria. Human factors experts' opinions can be a useful tool in improving the design of poorly comprehended signs (or icons) and in designing new signs (or icons).     

See the Triumph Healing Arts Workshops for Survivors of Intimate Partner Violence and Sexual Assault

Existing research demonstrates the potential value of arts-based interventions for survivors of abuse and other forms of trauma. The See the Triumph Healing Arts Workshops were designed to provide survivors of intimate partner violence and sexual assault with an opportunity to express themselves and connect with others through arts-based interventions. When appropriate, using the art developed through the workshops to create an art exhibit can be useful for raising awareness and giving voice to survivors in the local community. The preliminary results of the pilot evaluation suggest that the workshops were well-received and allowed participants to experience emotional expression, connection with others, and greater self-awareness.     

Using Art-Based Strategies in Group-Based Counselor Supervision

In addition to course work and experiential learning experiences, a vital aspect to counselor training is clinical supervision. Supervision acts as a mediator bridging the gap between theory and practice. Using creative interventions has been increasing in clinical work and may be beneficial to be used more in training counseling students. One way to incorporate creative and expressive techniques into a counseling program is to use art-based strategies in clinical group supervision. Research and clinical experiences are discussed.