Developing Metacompetence in Low Intensity Cognitive‐Behavioural Therapy (CBT) Interventions: Evaluating a Self‐Practice/Self‐Reflection Programme for Experienced Low Intensity CBT Practitioners

Self‐practice/self‐reflection (SP/SR) is a targeted training and professional development strategy in which clinicians practice cognitive‐behavioural therapy (CBT) techniques and processes on themselves and then working through a structured process of self‐reflection. Previous studies with CBT trainees and experienced mental health practitioners have found that SP/SR or experiencing CBT “from the inside out” has been perceived by participants as increasing competency in a number of important areas and increasing therapist flexibility and artistry. Low intensity (LI) practitioners are identified as a relatively new addition to mental health service delivery in the UK. These workers are differentiated from traditional mental health practitioners by a shorter training period, the delivery of a circumscribed number of CBT interventions, and a very high weekly patient load. This study, the first of its kind, reports outcomes from an SP/SR programme undertaken by seven experienced LI CBT practitioners. Participants used the following measures to track their experience of the programme: time spent on programme, personal‐ and therapy‐related belief rating, goals attained, and perceived skill rated for average and most difficult patients. Results showed a positive change in work‐related skill and behaviour change, particularly when working with the more difficult patients. The findings are consistent with those found in other groups of therapists (e.g., trainee CBT therapists and highly experienced CBT therapists), suggesting that SP/SR may be a valuable addition to LI intensity training and professional development. These findings are discussed in the context of the particular needs of LI practitioners.     

Enhancing Cognitive‐Behavioural Therapy (CBT) Skill Acquisition Through Experiential and Reflective Learning: A Commentary on Studies Examining the Impact of Self‐Practice and Self‐Reflection in CBT

Self‐practice and self‐reflection (SP/SR) is a targeted training tool that is intended to increase CBT competency in therapists. The four articles reviewed in this commentary examine the benefits of SP/SR with various types of therapists, and survey the significant obstacles faced in implementing this tool with clinicians. Collectively, these articles conclude that SP/SR is a valuable tool in improving CBT skill acquisition and preventing burnout, particularly with difficult patients, but that most therapists elect not to use it largely because of the time involved in engaging in it. In this commentary, I suggest that empirical studies with larger samples and controlled designs are needed to build on the wealth of qualitative data collected to date in order to assess the value added by SP/SR compared with other training methods, and in order to determine its impact on a range of therapeutic outcomes. I also suggest that future studies should examine the efficacy of required SP/SR engagement, isolate its critical ingredients, and assess if there are clients and therapists for whom SP/SR is comparably more effective.     

Invited Response to Commentaries: Self‐Practice/Self‐Reflection (SP/SR): Contexts,Challenges and Ways Forward

McGinn (2015) and Fernández‐Álvarez, Castañeiras, and Wyss (2015) make valuable suggestions in their commentaries on the three self‐practice/self‐reflection (SP/SR) articles in this issue of the Australian Psychologist. In our response, we use their commentaries as a springboard to highlight contextual influences and challenges for future SP/SR research, and suggest potential ways forward.     

Participant Reflexivity in Community‐Based Participatory Research: Insights from Reflexive Interview,Dialogical Narrative Analysis,and Video Ethnography

Focusing on researchers, the predominant discourse on reflexivity has seldom considered the contribution that participants could make to research through their self‐reflections. To bring to light the significance of participants' self‐reflection in participatory inquiries, I develop the concept of participant reflexivity, referring to the process in which participants use insights gained through self‐reflection for data analysis and group discussion. My discussion is based on a community‐based participatory research project conducted with a group of adult learners on their educational experiences. I examined the accounts shared by one of the participants by using insights from the theories of reflexive interview, dialogical narrative analysis and video ethnography, and found that her accounts played a pivotal role in evoking group reflections and drawing the conclusion of the project. I argue that participant reflexivity is a useful construct that can do justice to what participants can uniquely offer in participatory inquiries. The concept can also contribute to advancing knowledge of reflexivity by complementing the researcher‐focused predominant discourse on reflexivity. Copyright © 2015 John Wiley & Sons, Ltd.     

Transzendentalpragmatik und Diskursethik. Elemente und Perspektiven der Apelschen Diskursphilosophie

Transcendental Pragmatics and Discourse Ethics. Elements and Perspectives of Apel's Discourse-Philosophy. The author follows Apel's intellectual biography and shows the conception of a critique of meaning qua ‘reflection upon the discourse within the discourse’ to be the centre of Apel's language-pragmatic ‘Transformation of Philosophy’ (Frankfurt a.M. 1973). Beginning with an explication of the situation of a speaker/thinker, especially of the situation of a philosophising speaker/thinker, Apel reconstructs a two fold apriori of communication: Every thought is situated within the context of a particular, historically evolved, community of language and interaction. At the same time, however, the validity-claims of thoughts transcend the context of their origin towards an unlimited community of argumentation. On the basis of the first apriori Apel criticises the methodical solipsism as well as the objectivism of modern philosophy and theory of science. Drawing upon the second apriori he develops a universalist critique of meaning of relativism and contextualism. In the sixties and seventies Apel worked out a differentiated theory of the – more or less – communicatively cognizing humanities and set it apart from the theory of the causal-explanatory natural sciences, thus challenging the objectivism of a Theory of Unified Science. Building upon this work Transcendental Pragmatics, as developed by Apel and others, sets philosophy primarily two tasks: firstly, a (fallible) internal reconstruction of argumentative discourse as the (logical) situation of speech and thought which seeks to elucidate the conditions of the meaningfulness, i. e. the presuppositions, of discourse. These presuppositions comprise, thus Apel with Habermas, the four validity-claims to intelligibility, sincerety/credibility, truth and normative rightness/legitimacy. Their moral content consists, thus Apel, not only in the recognition of the equality of all beings capable of discursive reasoning but also in their recognition of a co-responsibility for the realizability of discourses and of responsibility. The author argues that the existence of a co-responsibility of this kind is indisputable because the discursive claims to validity are intertwined with a set of ‘primordial promises of dialogue’. Only with the elucidation and explication of these promises can the reconstruction of the internal conditions of discourse be completed.The second task of a pragmatics of argumentation isthe strict resp. actual reflection of the thinker upon the presuppositions of the discourse in which he currently engages. This reflection has a Socratic character and can only be done in the form of discussion and debate (‘Auseinandersetzungen’, Apel, Frankfurt a.M. 1998) with critics of the reconstruction. In this context, the author proposes a method of Socratic reflection upon the presuppositions of dialogue which suspends the usual, theoretically oriented, attitude of the scientist and the philosopher in favour of an actual reflective attitude. Within a dialogue with a sceptic who doubts one of the results of the internal reconstruction of dialogical presuppositions, say X, it is tested whether his doubt as to the unrestricted validity of X can be understood as a sincere contribution to the current dialogue or whether this particular sceptical thesis does not make sense, because it is incompatible with the role of a sincere participant of argumentation which, after all, the sceptic cannot refuse to claim for himself.Finally the author explains Apel's characterization of the tension between “Discourse and Responsibility” (Frankfurt a.M. 1988). In the course of discussions with Max Weber, Lawrence Kohlberg, Hans Jonas et al., Apel formulates and justifies an ethics of responsibility and gives an affirmative answer to the crucial question of whether the fulfilment of the moral obligations connected with the recognition of co-responsibility can be demanded within the non-dialogical circumstances of social reality. Apel's answer employs the idea of counter-strategies which are morally legitimate in virtue of their being worthy of argumentative consensus. This revised version was published online in August 2006 with corrections to the Cover Date.     

美学"心理距离说"的哲学认识论联想

本文从审美与认识的异中求同,提出了认识过程中“距离”的存在可以缩小认识成果与真理之间距离的基本观点,多角度地分析了时空距离和心理距离在认识过程中的作用,论述了研究认识过程中距离效应的重要价值。     

明见性:相即感知与自我--再论胡塞尔的"直观"理论

在《逻辑研究》中具有本源性奠基意义的胡塞尔意义上的内感知,实际上是一个歧义两可的概念：作为对真理、本质的相即感知,它实现了直观的明见性理想,但其对象性感知的自然意识特征使其无法作为现象学考察的根基,而实际上它又并不具有对象性感知的意向构造性;只有作为“自身给予”（明见性）意义上的自身意识：才可以在起源的意义上真正实现现象学反思以至本质直观的切实意蕴。而这种意识一体验的时间性本性又使得明见性坐落于作为其根源的“自我”的问题域中。由此,自身意识与反思的含义、关系及其发展脉络才能真实呈现,明见性从相应性向绝然性的逐步过渡才能被理解。     

On the Counterfactual Nature of Gambling Near‐misses: An Experimental Study

Research on gambling near‐misses has shown that objectively equivalent outcomes can yield divergent emotional and motivational responses. The subjective processing of gambling outcomes is affected substantially by close but non‐obtained outcomes (i.e. counterfactuals). In the current paper, we investigate how different types of near‐misses influence self‐perceived luck and subsequent betting behavior in a wheel‐of‐fortune task. We investigate the counterfactual mechanism of these effects by testing the relationship with a second task measuring regret/relief processing. Across two experiments (Experiment 1, n = 51; Experiment 2, n = 104), we demonstrate that near‐wins (neutral outcomes that are close to a jackpot) decreased self‐perceived luck, whereas near‐losses (neutral outcomes that are close to a major penalty) increased luck ratings. The effects of near‐misses varied by near‐miss position (i.e. whether the spinner stopped just short of, or passed through, the counterfactual outcome), consistent with established distinctions between upward versus downward, and additive versus subtractive, counterfactual thinking. In Experiment 1, individuals who showed stronger counterfactual processing on the regret/relief task were more responsive to near‐wins and near‐losses on the wheel‐of‐fortune task. The effect of near‐miss position was attenuated when the anticipatory phase (i.e. the spin and deceleration) was removed in Experiment 2. Further differences were observed within the objective gains and losses, between “clear” and “narrow” outcomes. Taken together, these results help substantiate the counterfactual mechanism of near‐misses. © 2017 The Authors Journal of Behavioral Decision Making Published by John Wiley & Sons Ltd.     

精神疾病时代心理治疗的哲学反思

在精神疾病时代,心理治疗家应增强心理治疗的文化敏感性,关注心理治疗对象的个体性,将目标和价值作为关注焦点的同时重视哲学引导在心理治疗中的作用.     

临床均势原则辨析——对临床科研方法的伦理思考

随机对照试验作为一种评价新疗法的可靠设计方法,开始逐渐被世界范围内的临床医生所广泛接受和采用,成为目前最重要的试验方法之一。RCT的运用应该遵循一定的伦理准则,即临床均势原则。围绕临床均势原则这一主题,对随机对照试验的方法论进行较为深入的伦理学思考。并对临床均势的内涵、伦理意义,以及这一伦理要求在实践中所引发的各种伦理争论加以探讨。