出院精神病患者的职业康复

精神病患者出院后的职业康复研究是目前西方精神疾病康复研究的热点。通过帮助出院后症状稳定的精神病患者就业,来帮助患者获得技能,获取收入,增强自信和自我认同,提升生活质量,较好地回归社会。文章从总体上介绍了职业康复的研究现状与进展,并着重阐述了较新的支持性就业、个体支持性就业、工作社交技能训练和综合性支持性就业等方法,旨在为我国的相关研究提供参考     

Elaborate reflections on a simple manifesto

In an earlier article (^{McFall, 1991}), I urged clinical psychologists to work toward the goal of integrating science and practice and proposed the adoption of a principle and two corollaries aimed at achieving this goal. In general, I argued that all aspects of clinical psychology must be guided by the highest scientific and ethical standards, that clinical practice be limited to empirically supported procedures, and that clinical training be devoted to producing clinical scientists. In the present article, I elaborate and defend these points by offering reflections on a number of submitted questions provoked by the earlier article. I address four major issues: the philosophical foundations for a scientific epistemology, the implications of this epistemology for clinical practice, the implications for clinical training, and the likely impact of adopting this epistemology on the field of clinical psychology.     

Coalitional Capacities and Environmental Strategies to Prevent Underage Drinking

Coalitions are the most common platform for implementing community-level environmental strategies (ES), such as media, policy, or enforcement for substance use prevention. The current study examines the associations between two types of coalition capacity (general and innovation-specific) and ES implementation efforts and outputs within 14 intervention communities over a three-year period. Efforts refer to the amount of energy exerted to implement an ES while outputs refer to the materials produced through these efforts. Quantitative measures of capacity were provided by coalition key informants and expert-raters. Additionally, Training and Technical Assistance (TTA) provided proactively to improve the implementation of ES was also examined. Greater general capacity, as rated by a coalition informant, was associated with more ES policy effort. Both expert-rated general and innovation-specific capacity, however, were associated with greater ES outputs. Study results also found that community coalitions that endorsed weaker mobilization, structure and task leadership, (measures of general capacity), utilized more TTA compared to those who perceived their coalition as having greater capacity. Moreover, communities that utilized more TTA resources reported a greater number of successful policy changes. The study supports the need to consider both general and innovation-specific capacity for ES implementation and offers promising preliminary findings regarding the role of TTA for improving coalitions’ capacity to facilitate policy change.     

Controversies and Conflicts in the Institution of "Open" Psychoanalysis: Cases from the History of the Therapeia Foundation

The institution of psychoanalysis has included controversies, dissensions and expulsions at both the theoretical-methodological and personal-organizational levels. There have also been several intra- and intergroup conflicts in the history of psychoanalysis, and in constructing and patterning the future of psychoanalytic knowledge. In the context of Finnish psychoanalysis, the Therapeia Foundation (founded in 1958) met from the start with resistance from official psychiatry and also from the IPA. For example, in the mid-1960s, D. W. Winnicott, as the President of the IPA, supported the orthodox Finnish psychoanalytic study group (later to become the Finnish Psychoanalytical Society), and pronounced that the Therapeia group was too loose and was not strictly able to use the IPA-recognized designation "psychoanalytic." The Therapeia Foundation and its Training Seminar combined classical psychoanalysis and its new versions with existentialphenomenological views, anthropological medicine, research on "social pathology" and even modern theological research. On the basis of their Swiss analytic training, three Finnish psychiatrists, Martti Siirala, Kauko Kaila and Allan Johansson, organized Therapeian training to incorporate sciences and arts, and skills involving the therapeutic "carrying" of burdens. The multifacted nature of open psychoanalysis was seen to find its proper organizational expression when the Training Seminar of the Therapeia Foundation became, in 1974, a Member of the IFPS.     

Psychoanalysis and University in Brazil: Possibilities and Limits of This Articulation

The goal of this article is to clarify some of the aspects concerning the academic teaching and research that is carried out in the field of psychoanalysis in the Brazilian Universities, versus the transmission and training in psychoanalytic institutions. The author describes how psychoanalysis is present in the Brazilian university context, from undergraduate to graduate studies, and also points out perspectives regarding the future of psychoanalysis in Brazil.     

The Controversial Discussions: Edward Glover and the Origins of "Double-Barrelled Training"

I attempt to rehabilitate Edward Glover's historical reputation, based on unpublished interviews as well as recently found documentary material. This should make one of the defining moments in the history of British psychoanalysis more plausible. Glover was an eloquent heresy-hunter - against Jung, Rank, Klein, Alexander, and others - yet the polemical side of him represents only one aspect of his career. During the Controversial Discussions Glover was taking some of the burden for the way his leader Jones had run the British Society. In moving against Klein, Glover felt he was fulfilling Freud's own wishes, and that he was allied with the recently arrived Viennese contingent. After Glover's resignation in 1944, Jones split the opposition by appointing Anna Freud as Glover's successor as IPA Secretary. Subsequently Adrian Stephen and Donald Winnicott opposed Glover's even being allowed to speak at a psychoanalytic conference in Amsterdam; Anna Freud defended Glover's presence then. Glover's long struggle to be accepted as a member of the Swiss Society only went through in 1949, when Jones ceased being President of the IPA. Glover and Anna Freud regularly corresponded about setting up of the distinction between the "B" and "A" groups within the British Society. Meanwhile Glover, who had since the early 1930s been the de facto founder of the Institute for the Study and Treatment of Delinquency, used his administrative talents there. He successfully founded The British Journal of Delinquency with Miller and Mannheim. Unlike what happened at the British Society, Glover cooperated without problem at the ISTD and the Portman Clinic. Glover was not only an important and successful clinical analyst but also a pioneer in forensic psychiatry. In 1947 he was unofficially approached and asked to take over the Directorship of the New York Psychoanalytic Training Institute. When the proceedings of the Controversial Discussions were published in 1991, various myths had been established about what had happened. That Glover found himself caught in the middle was not only a personal tragedy but also a part of a much larger story.     

Effects of test anxiety,ego stress,and attentional skills training on arithmetic reasoning: An experimental evaluation of a brief counseling strategy

Abstract

Two hundred forty high school students (120 male and 120 female) in India performed a moderately difficult multiple choice Arithmetic Reasoning task after undergoing short-term (40 minutes) cognitive treatment in the form of Attentional Skills Training. A 2 × 2 × 2 (Test Anxiety x Attentional Skills Training x Stress) design with separate analysis for boys and girls indicated these results: with intervention the high anxiety subjects under ego stress conditions, compared to their high-anxious control, low-anxious ego stress, or low-anxious control counterparts, reported the maximum significant improvement in performance on the Arithmetic Reasoning test. The low-anxiety subjects performed consistently well with or without treatment or stress conditions. The findings shed new light on the attentional theory of test anxiety, and it was reasoned that long-term effects of cognitive treatment be studied by using varied performance tasks (difficulty level controlled) on different gender and age groups across cultures.     

Form and forming a focus: In brief dynamic therapy

This paper describes a model of training for individual work which treats as essential the consideration of group and institutional dynamics, as contrasted with the ‘prevailing model’ in which such issues are not overtly attended to. The author outlines key elements of such a ‘group-aware’ model and endeavours to show the value of it in terms of the students’ self-development, their fuller use of the training experience and in relation to their clients. She suggests that such a model has key advantages over the ‘prevailing model' for all counselling and psychotherapy students, but places emphasis on its particular relevance and value for those training to work with children, adolescents and young people.     

Ripples in the pond: A qualitative study of graduates' perceptions of the impact of counselling training upon their work within the core professions

A small-scale qualitative study was conducted in order to examine the value of counselling training when incorporated into a person's established professional role. Questionnaires were sent to graduates from an MA/diploma in counselling course in order to identify those who had continued working within their core profession. This was followed by in-depth exploration of the issues through a focus group and interviews. Twelve respondents, from a variety of work settings, took part in this second stage. Results indicated that counselling training had impacted on all aspects of their work role and that there can be a benefit of such training in the workplace. Participants developed a tripartite understanding with regard to the self, clients and the organization, and change was experienced in each of these three dimensions. A larger-scale study, among graduates from a number of courses and also among employers, is indicated.