Statewide Implementation of Cognitive Behavioral Therapy for Psychosis Through a Learning Collaborative Model

Cognitive Behavioral Therapy for Psychosis (CBTp) is an evidence-based psychotherapeutic intervention (EBPI) for adults with schizophrenia spectrum disorders that remains under-implemented in the United States (U.S.). There has been little empirical attention on implementation and dissemination strategies for this EBPI. The Learning Collaborative (LC) model is a method of implementing evidence-based practices across agencies and geographic regions that may facilitate CBTp implementation and dissemination in the US.We applied the LC model in an attempt to enhance the accessibility of CBTp in community mental health settings statewide. Providers (N = 56) from 12 agencies voluntarily participated in an in-person, CBTp workshop followed by 6 months of biweekly phone-based consultation sessions (Phase 1). Twenty-one providers opted to participate in an additional 6-month CBTp LC immediately following completion of the initial CBTp LC (Phase 2). Adoption, penetration, provider-perceived skill development, fidelity, as well as provider-perceived implementation barriers were re-assessed during and 6 months after completion of Phase 2.One year after the completion of the Phase 2 LC, 21% of the original trainee group across 3 of the 12 participating agencies continued to offer CBTp to clients. CBTp trainees were treating between one and two clients each. Self-assessed CBTp skills improved modestly over the Phase 2 consultation period. On average, both clinicians and supervisors reached an acceptable fidelity score on the sessions reviewed. Participating providers identified multiple barriers to CBTp implementation, including features of the training and consultation, the agency, the intervention itself, and psychosocial and clinical challenges associated with the client population.Few CBTp implementation studies have applied a framework to CBTp implementation. The authors adapted the LC model in an attempt to promote adoption of CBTp in community mental health clinics across a large, populous state with poor access to mental health services. Identified challenges and recommendations should be considered in future implementation efforts.     

2D location biases depth-from-disparity judgments but not vice versa

Visual cognition in our 3D world requires understanding how we accurately localize objects in 2D and depth, and what influence both types of location information have on visual processing. Spatial location is known to play a special role in visual processing, but most of these findings have focused on the special role of 2D location. One such phenomena is the spatial congruency bias, where 2D location biases judgments of object features but features do not bias location judgments. This paradigm has recently been used to compare different types of location information in terms of how much they bias different types of features. Here we used this paradigm to ask a related question: whether 2D and depth-from-disparity location bias localization judgments for each other. We found that presenting two objects in the same 2D location biased position-in-depth judgments, but presenting two objects at the same depth (disparity) did not bias 2D location judgments. We conclude that an object’s 2D location may be automatically incorporated into perception of its depth location, but not vice versa, which is consistent with a fundamentally special role for 2D location in visual processing.     

个体特征因素对师徒之间选择倾向的影响

师徒的相互选择过程是师徒关系研究中的一个重要问题。本文采用三个实验探讨了影响师徒相互选择倾向的个体特征因素。实验一和实验二探讨了徒弟选师傅时,师傅的外向性、成就动机水平、管理职务和性别一致性对徒弟选择师傅倾向的影响。实验三探讨了师傅选择徒弟时,徒弟的外向性、成就动机水平和性别一致性对师傅选择徒弟倾向的影响。实验结果表明在徒弟选择师傅时,师傅的外向性、成就动机、管理职务,是影响因素;在师傅选择徒弟时,徒弟的外向性、成就动机水平是影响因素。     

FROM EXTENSION TO REVOLUTIONARY CHANGE IN CLINICAL PSYCHOANALYSIS: THE RADICAL INFLUENCE OF BION AND WINNICOTT

This paper addresses the radical departure of late Bion's and Winnicott's clinical ideas and practices from traditional psychoanalytic work, introducing a revolutionary change in clinical psychoanalysis. The profound significance and implications of their thinking are explored, and in particular Bion's conception of transformation in O and Winnicott's clinical‐technical revision of analytic work, with its emphasis on regression in the treatment of more disturbed patients. The author specifically connects the unknown and unknowable emotional reality‐O with unthinkable breakdown (Winnicott) and catastrophe (Bion). The author suggests that the revolutionary approach introduced by the clinical thinking of late Bion and Winnicott be termed quantum psychoanalysis. She thinks that this approach can coexist with classical psychoanalysis in the same way that classical physics coexists with quantum physics.     

三维空间中不同视野深度位置上的返回抑制

通过虚拟现实构建虚拟三维场景,将二维平面视觉空间返回抑制范式应用到三维空间,通过两个实验操纵了目标深度、线索有效性以及视野位置三个变量,考察注意在三维空间不同视野深度位置上进行定向/重定向产生的返回抑制效应。结果发现,(1)二次线索化位于固定的中央视野时,不论目标出现在近处空间还是出现在远处空间,外周视野条件下的返回抑制大于中央视野条件下的返回抑制;(2)二次线索化位于非固定的中央视野时,近处空间和远处空间的返回抑制存在分离,表现为当目标出现在远处空间时,外周视野条件下的返回抑制效应减小。研究表明,三维空间中外周视野深度位置上的返回抑制与中央视野深度位置上的返回抑制存在差异。     

The big carrot: High‐stakes incentives revisited

Using an international dataset of about 35 000 subjects, this paper provides an empirical example of high‐stakes incentives in relation to religious practice. First, we show that incentives (based on absolute belief) play a salient role in religious performance. Second, we find that when both positive (heaven) and negative (hell) incentives are available the former are more effective than the latter. Specifically, it is shown that beliefs in heaven are much more relevant than beliefs in hell when estimating the production of religious commodities (church‐attendance and praying equations). Copyright © 2009 John Wiley & Sons, Ltd.     

Debunking Antipsychiatry: Laing,Law, and Largactil

The term “psychiatry” refers to two radically different ideas and practices: curing–healing “souls” and coercing–controlling persons. It is important that critics of psychiatry clarify whether they object to the former or the latter or both, and why. Because I believe coerced psychiatric relations are like coerced labor relations called “slavery,” and like coerced sexual relations called “rape,” I spent the better part of my professional life criticizing involuntary-institutional psychiatry and the insanity defense. In 1967, my effort to undermine the medical-political legitimacy of the term “mental illness” and the moral-legal legitimacy of depriving individuals of liberty by means of psychiatric rationalizations suffered a serious blow: the creation of the antipsychiatry movement. Despite their claims, “antipsychiatrists” rejected neither the idea of mental illness nor coercion practiced in the name of “treating” mental illness. Sensational claims about managing “schizophrenia” and pretentious pseudophilosophical pronouncements diverted attention from the crucial role of the psychiatrist as an agent of the state and as an adversary of the denominated patient. The legacy of the antipsychiatry movement is the creation of a catchall term used to delegitimize and dismiss critics of psychiatric fraud and force by labeling them “antipsychiatrists.”

Loss aversion and perceptual risk aversion

We prove that, in cumulative prospect theory, the weak loss aversion for S-shaped value functions is equivalent to a notion of risk aversion that we define from the perceptual point of view. No additional assumption or condition on the probability distortion is needed. It is demonstrated that a power S-shaped value function does not satisfy weak loss aversion, i.e., a decision maker is risk seeking with respect to some mixed sign lotteries.     

On the Fulfillment of Moral Obligation

This paper considers three general views about the nature of moral obligation and three particular answers (with which these views are typically associated) concerning the following question: if on Monday you lend me a book that I promise to return to you by Friday, what precisely is my obligation to you and what constitutes its fulfillment? The example is borrowed from W.D. Ross, who in The Right and the Good proposed what he called the Objective View of obligation, from which he inferred what is here called the First Answer to the question. In Foundations of Ethics Ross repudiated the Objective View in favor of the Subjective View, from which he inferred a Second Answer. In this paper each of the Objective and Subjective Views and the First and Second Answers are rejected in favor of the Prospective View and a Third Answer. The implications of the Prospective View for another question closely related to the original question are then investigated: what precisely is your right regarding my returning the book and what constitutes its satisfaction?