Fonctionnements et dysfonctionnements des psychothérapies : synthèse de la littérature et présentation de deux méthodologies associées aux meilleurs résultats

IntroductionPsychological difficulties are part of higher stakes health issues. What are the real effects and the difficulties to generate results of psychotherapies?Literature resultsPsychotherapy is efficient for multiple psychological disorders, as well in controlled as in naturalistic studies, and participate in reduction of health expenditure. However, all patients do not get real benefits from care, patients can deteriorate or drop-out treatment, and persistent side effects can occur; clinicians overestimate their efficiency and their performances decline during their career. Two promising methodologies seems to be associated with better outcomes: Routine Outcome Monitoring (ROM) and a specific form of training clinician expertise named “Deliberate Practice”.DiscussionUsing client feedback allows to implement ROM and “Deliberate Practice” in routine care.ConclusionImplementation of Routine Outcome Monitoring should be encouraged in French Speaking countries to produce evidence-informed practice for the delivering, the improvement and the payment for psychotherapy expenditure.     

Relative effects of breastfeeding intention and practice on maternal responsiveness

Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother–infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months’ postpartum. The outcome was maternal responsiveness assessed at 12 months’ postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.     

Complementary teaching practices: Ignatian pedagogy and Buddhist‐inspired compassion meditation

While scholarly discussions on Jesuit education are plentiful, inquiries related to Ignatian pedagogy are rare. This article examines the applications of Ignatian pedagogy by juxtaposing it with the analysis of a Buddhist‐inspired and interdisciplinary contemplation program, Cognitively‐Based Compassion Training® (CBCT®). Drawing from the author's experience in teaching CBCT® at a Jesuit University, this article explores how CBCT® aligns with the Ignatian Pedagogical Paradigm's five elements: context, experience, reflection, action, and evaluation. This study uses psychometrical measurements, such as the Compassionate Love for Humanity Scale, to document how my interdisciplinary approach may enhance participants' emotional well‐being and widen their ethical concerns. As these outcomes are inherently cross‐disciplinary and include intellectual and affective dimensions, they cannot be achieved through a single field. Building a bridge between the Ignatian Pedagogical Paradigm and CBCT® provides a successful strategy for the educational objectives of developing the whole person and forming a compassionate character.     

Relating Coalition Capacity to the Adoption of Science-Based Prevention in Communities: Evidence from a Randomized Trial of Communities That Care

Coalition‐based efforts that use a science‐based approach to prevention can improve the wellbeing of community youth. This study measured several coalition capacities that are hypothesized to facilitate the adoption of a science‐based approach to prevention in communities. Using data from 12 coalitions participating in a community‐randomized trial of the prevention strategy Communities That Care (CTC), this paper describes select measurement properties of five salient coalition capacities (member substantive knowledge of prevention, member acquisition of new skills, member attitudes toward CTC, organizational linkages, and influence on organizations), as reported by coalition members, and examines the degree to which these capacities facilitated the community leader reports of the community‐wide adoption of a science‐based approach to prevention. Findings indicated that the five coalition capacities could be reliably measured using coalition member reports. Meta‐regression analyses found that CTC had a greater impact on the adoption of a science‐based prevention approach in 12 matched pairs of control and CTC communities where the CTC coalition had greater member (new skill acquisition) and organizational capacities (organizational linkages).     

Commentary on Three Articles on Self‐practice/Self‐reflection in Cognitive‐Behavioural Therapy

The commentary embraces three valuable contributions to the development of professional practice: (a) engagement with self‐practice/self‐reflection as a professional self‐development: the role of therapist beliefs; (b) spontaneous self‐practice of cognitive‐behavioural therapy (CBT) by aboriginal counsellors during and following CBT training: a retrospective analysis of the facilitating conditions and impact; (c) developing metacompetence in low intensity CBT interventions: evaluating a self‐practice/self‐reflection programme for experienced low intensity CBT practitioners. Each article provides different perspectives of the self‐practice and self‐reflection benefits for efficient therapy and their use as powerful resources in therapeutic training skills in general and CBT in particular. Conclusions of their contributions close the commentary.     

医学生对医学人文临床践行情况认知的调查分析

为了解医学生对目前临床医疗实践中医学人文的认知情况, 调查了924名正在临床实习的七年制学生和五年制学生以及已有临床实习经历的在读研究生。调查结果显示, 虽然大多数被调查者对目前医生的医学人文素养持肯定态度, 但也存在医学人文精神欠缺的问题;目前医师在临床实践中践行医学人文, 是“被动”需要而非“主动”提供;医院转变以营利为目标的经营理念是医学人文精神建设的前提;患者应成为临床工作医学人文关怀行为监督的主体。     

A failure of dialogue? a critical reflection on a discussion between a teacher trainer and a pre-service second-language teacher

Reflective practice in teacher education often involves dialogic communication between teacher educators and teachers. This essay asks what constitutes authentic dialogic engagement in discussions between a pre-service second-language (SL) teacher and her university supervisor. Written as a self-critical reflection, the paper first describes the author’s thoughts and feelings about a post-teaching session he conducted with one of his supervisees and identifies possible disconnections existing between them. Drawing on Mikhail Bakhtin’s concept of dialogism and Hans-Georg Gadamer’s of genuine dialogue, this paper reflects on the dispositions that foster a dialogic relationship between teacher educators and pre-service and in-service teachers.     

Not just for special occasions: supporting the professional learning of teachers through critical reflection with audio-visual information

Despite increased use of professional learning communities in the teacher education field, they do not necessarily guarantee change in teachers’ daily practice. This study is a multiple case study of three school leaders in Vietnam to connect their teachers’ learning and practice by utilising visual records. In the cases studied, we see a progression of models of joint reflection based on visual information, from only occasional reflection to daily critical reflection, the latter of which the authors call ‘vide-flection’ referring to a process for people to consider their actions, thoughts, or experiences by utilising video-recorded images. For joint vide-flection, school leaders visit every classroom for several minutes every day to observe the wellbeing and learning of pupils and video-record struggles or breakthroughs in children’s learning; they share those images with teachers to jointly reflect on the situations. Through this vide-flection, teachers develop more detailed awareness of pupils needs.