Cognitive-Behavioral and Personal Construct Therapies for Depression in Women with Fibromyalgia: A Randomized Controlled Trial

Background/ObjectiveFibromyalgia is a chronic pain syndrome that depressive symptoms can aggravate. The aim of the present study was to test the efficacy of Personal Construct Therapy (PCT), an approach that emphasizes identity features and interpersonal meanings as the focus of the treatment of depressive symptoms, in women with fibromyalgia.MethodWe compared PCT with Cognitive Behavioral Therapy (CBT) in a multicenter parallel randomized trial. Women with fibromyalgia and depressive symptoms (n = 106) were randomly allocated to CBT (n = 55) or PCT (n = 51) in individual and modular formats to adjust to their needs. Analysis was by linear mixed-effects models.ResultsParticipants in both conditions had significantly reduced depressive symptoms, and we found no significant difference when comparing groups both post-treatment (β = -0.47, t = -0.49, p = .63) and at follow-up (β = -1.12, t = -1.09, p = .28). Results were similar between conditions for anxiety, fibromyalgia's impact, and the distribution of clinically significant changes in depressive symptoms and pain.ConclusionsPCT and CBT seem to be equally effective in the treatment of depressive symptoms, making PCT a viable alternative treatment.     

Toward science‐informed supervision of clinical case formulation: A training model and supervision method

Case formulation is a core competency in the practice of clinical psychology and although many component skills can be taught in lectures, supervised clinical practice is a key step in moving from knowledge about case formulation to knowledge of formulation. The present paper outlines a model of science‐informed clinical practice and the ways in which clinical supervision may play a role. In addition, a methodology for assessing and benchmarking skills in case formulation is described to assist clinical psychology training programs to provide supervisees with normative feedback about their skills in case formulation. In so doing, the supervision of case formulation can become more informed by science and responsive to evaluation.     

Predicting complex syntactic structure in real time: Processing of negative sentences in Russian

In Russian negative sentences the verb’s direct object may appear either in the accusative case, which is licensed by the verb (as is common cross-linguistically), or in the genitive case, which is licensed by the negation (Russian-specific “genitive-of-negation” phenomenon). Such sentences were used to investigate whether case marking is employed for anticipating syntactic structure, and whether lexical heads other than the verb can be predicted on the basis of a case-marked noun phrase. Experiment 1, a completion task, confirmed that genitive-of-negation is part of Russian speakers’ active grammatical repertoire. In Experiments 2 and 3, the genitive/accusative case manipulation on the preverbal object led to shorter reading times at the negation and verb in the genitive versus accusative condition. Furthermore, Experiment 3 manipulated linear order of the direct object and the negated verb in order to distinguish whether the abovementioned facilitatory effect was predictive or integrative in nature, and concluded that the parser actively predicts a verb and (otherwise optional) negation on the basis of a preceding genitive-marked object. Similarly to a head-final language, case-marking information on preverbal noun phrases (NPs) is used by the parser to enable incremental structure building in a free-word-order language such as Russian.     

Automatic knowledge learning and case adaptation with a hybrid committee approach

When Case Based Reasoning systems are applied to real-world problems, the retrieved solutions usually require adaptations in order to be used on new contexts. Therefore, case adaptation is a desirable capability. However, case adaptation is still a challenge for this research area. In general, the acquisition of knowledge for case adaptation is harder than the acquisition of cases. This paper explores the automatic learning of adaptation knowledge and explores the use of a hybrid committee approach for automatic case adaptation.     

Ten essential features of European dual career development environments: A multiple case study

AimDual career development environments (DCDEs) support athletes' effort in combining their competitive sporting careers with education or work. The characteristics of the environments may differ across cultures. The aim was to identify essential features of DCDEs based on a cross-case analysis of seven European DCDEs in Belgium, Denmark, Finland, Slovenia, Spain, Sweden, and the United Kingdom within the Erasmus+ Sport project “Ecology of Dual Career”.DesignThe study was designed as a multiple case study and based on two holistic ecological working models (Henriksen et al., 2020). The cross-case analysis included series of focus group discussions, in which two-three researchers from each partner country and four dual career (DC) support providers compared the findings across seven national cases with a primary focus on similarities rather than differences.ResultsA list of ten essential features of the DCDEs, structured into two overarching themes. (1) Holistic structure with five subthemes: Dedicated DC support team, Integration of efforts across the whole environment, A clear understanding of DC issues and support from across the environment, Role models and mentorship, and Access to expert support. (2) Shared DC philosophy also had five subthemes: A whole-person approach, An empowerment approach, Flexible DC solutions, Care of DC athlete's mental health and wellbeing, and An open and proactive approach to the development of the environment.ConclusionThe features are introduced in the manner of discussions, thus providing detailed information about the DCDEs without losing (too much) contextual information. These features can help researcher-practitioners to understand DCDEs and guide their optimization.     

Theory‐building case studies of counselling and psychotherapy

In addition to their potential for healing, psychotherapy and counselling offer extraordinary opportunities to observe human experience and behaviour. I suggest practitioners have expertise in and daily access to the phenomena that theories of counselling and psychotherapy seek to explain. Practitioners’ clinical experience can be accumulated and shared through theory-building case study research. This article summarizes the logic of theory‐building case studies and offers practical suggestions for conducting case study research.     

A Recursive Frame Qualitative Analysis of MFT Progress Note Tipping Points

Medically oriented psychotherapists typically record progress notes by articulating client symptoms, diagnoses, functional status, progress, and adherence to treatment plans. This orientation can challenge marriage and family therapists working from discursive or post-modern perspectives. Although there are discursive therapy friendly treatment planning guides, no published research on such practice exists. To address this gap the researchers conducted a recursive frame qualitative analysis of 206 de-identified progress notes from 30 completed cases seen by MFT master’s students learning discursive approaches to therapy in a university-based training clinic. Researchers found students noted problem to solution-focused discourse tipping or turning points in 20 cases with positive outcomes and no comparable shifts in 10 cases with negative or unclear outcomes.     

When hoarding is a symptom of OCD: A case series and implications for DSM-V

Hoarding, the excessive collection and failure to discard objects of apparently little value, can represent a serious psychiatric problem and pose a threat to public health. Hoarding has traditionally been considered a symptom (or symptom dimension) of Obsessive-Compulsive Disorder (OCD), but its nosological status has recently been debated. Mounting evidence suggests that, once other primary causes are ruled out, hoarding may be a discrete diagnostic entity, recently named Hoarding Disorder. However, hoarding can sometimes be a genuine OCD symptom. This can be confusing and clinicians may sometimes struggle making the differential diagnosis. To illustrate this, we describe 10 OCD patients with severe hoarding behavior that is better conceptualized as a symptom of OCD. We focus on the motivations for hoarding and the overlapping of hoarding with other obsessive-compulsive symptom dimensions. We estimate that this clinical presentation is relatively rare and accounts for a minority of severe hoarding cases. We discuss the unique characteristics of hoarding as a symptom of OCD and the implications for DSM-V.     

Chickens or eggs? A follow‐up case study exploring links between physical and psychological impact of Tourette's syndrome and sexual abuse

This follow‐up case study highlights the complex relationship when working at the interface between physical and psychological symptoms. The paper draws upon conversations between an ex‐client and myself, held seven years after the end of our six year therapeutic relationship. Conversational interviews, based upon social constructionist beliefs, led to an unexpected exploration of the client's subsequent diagnosis of Tourette's syndrome (given several years after the end of therapy) and evolved into a struggle to reach a shared understanding of how she now makes connection between her problem with eating in public, her neck and facial tics, and childhood sexual abuse. Our research relationship provided both of us with a rare opportunity to reflect upon how she had made meaning of her counselling and its outcomes. The paper draws attention to the impact of counselling and therapy discourses concerning sexual abuse on the work we did at the time and asks how that work might be different today. It also helps us understand the layers of complexity and ambiguity contained within the client's stories. This multi‐layered case study represents the overlap and ‘messiness’ that mirrors the ‘lived experience’ of the persons involved, and provides an example of how co‐constructed research conversations can evoke stories that create meaning as they are told.