Type a behaviour pattern as a risk factor after myocardial infarction: A review

Abstract

This paper is a response to Eiser's (1996) call for a unifying theoretical perspective that would bridge the gap between 'individualistic and ‘social’ approaches to studying human social behaviour in general, and health behaviour in particular. While agreeing with Eiser's premise that it makes no sense to study cognition, affect, and behaviour independently of social context, the present paper takes issue with certain features of his argument that a connectionist approach provides the needed unifying theoretical framework. It is suggested that if connectionism can describe the psychological processes underlying social behavior better than non-connectionist theories, this would provide more compelling evidence of its value than claims that it affords new theoretical insights.     

The impact of assuming the primary caregiver role following traumatic spinal cord injury: An interpretative phenomenological analysis of the spouse's experience

This study aimed to explore the lived experience of assuming the primary caregiver role in a group of spouses of individuals living with a traumatic spinal cord injury (SCI) (injuries ranged from paraplegia to quadriplegia). Individual in-depth interviews were conducted with 11 participants who were both the spouse and primary caregiver of an individual with a SCI; of these, 10 were female and 1 was male. All interviews were transcribed verbatim and were subjected to interpretative phenomenological analysis (IPA). Here we present three inter-related master themes: ‘The emotional impact of SCI’; ‘Post-injury shift in relationship dynamics’ and ‘Impact of caregiving on identity’. Regarding the emotional impact of spinal injury, participants reported an almost instantaneous sense of loss, emptiness and grief during the injured person's rehabilitative period and feelings of anxiety were reported in anticipation of their return to the family home. A distinct change in role from spouse and lover to care provider was reported and this ultimately contributed to relationship change and a loss of former identity. The findings are discussed in relation to extant caregiver literature and recommendations for future caregiver support are highlighted.     

An exploration of the therapeutic process while using computerised cognitive behaviour therapy

Background: Modern technologies that offer an alternative to face‐to‐face therapy have gained ground in the NHS. Critics have argued that some of the important elements of the therapeutic change process necessarily require a human therapist. Yet, the traditional understanding of the change process in psychotherapy is challenged by evidence that some computerised cognitive behaviour therapy (cCBT) programs may be as effective as face‐to‐face therapy, suggesting that in certain cases the interaction between user and a cCBT product satisfies sufficient criteria for personal change without the need for actual human contact. Aim: This study used the cCBT package Blues Begone as a means of investigating the process by which a computer‐mediated program helped adults with mild depression help themselves. Method: Seven qualitative interviews were conducted with mildly depressed users who had completed Blues Begone in their own homes without any additional human help or support. Findings: Interpretive phenomenological analysis (IPA) was performed with four main themes emerging. These were: the meaningful relationship; shape from confusion; stimulation and empowerment. This study illustrates some of the ways that some depressed users make use of cCBT self help.     

Supervision of supervision: Specialism or new profession?

Abstract

Consecutive BAC Codes of Ethics and Practice of the Supervision of Counsellors have emphasised the importance of supervisory consultations for supervisors, and the need of evaluating and monitoring supervision work. Supervision of supervision work has also been an integral part of the training of supervisors, in order for them to learn supervision by actually supervising and receiving feedback on their work. The paper attempts to define and conceptualise the task of the supervisor of supervision in comparison with and by contrast to ordinary supervision and covers such areas as function, format, focus, presentation.     

Supporting Transgender and Sex Reassignment Issues

SUMMARY

For the care provider unfamiliar with supporting transsexual and transgender persons, as well as their partners, it becomes an imperative to be able to identify this population's unique needs, transition concerns and relationship dynamics. New challenges arise as transgender clients become more prevalent within the GLBT community and contact community clinical resources. These include distinguishing between sexual orientation and the complexities of gender identity; differentiating actual transgender issues and ordinary relationship concerns; and recognizing characteristics of strong relationships versus those doomed to fail when one or both partner's needs can no longer get met.

This article reviews an abundance of stereotypes adversely affecting transgender individuals, relationships and which can taint the treatment environment. At a core level, there exists the need for care providers to recognize when having a transgender identity stops being a disorder, such as when the client is no longer gender dysphoric, and where the care provider needs to advocate the individual's right of self-determination. This includes recognizing when situational depression or anxiety and social discrimination are the actual root of ongoing individual and relationship concerns. With basic transgender knowledge, effectively supporting transgender persons and their relationships is possible for cross-specialty providers, and is recommended.     

Logotherapy and Pastoral Counseling

SUMMARY

An intensive study of Frankl's logotherapy reveals its timely relevance for pastoral counseling. The paradigm of logotherapy recognizes the spiritual dimension as the inclusive and encompassing dimension for comprehending and integrating human phenomena. Its hermeneutical phenomenological analysis introduces an understanding of personhood which affirms one's capacity to find meaning in life, indeed, even in suffering and dying. It is this unique spiritual capacity which conveys a renewed awareness of self worth and human dignity and assists persons in understanding themselves as fashioned in the image of God. Logotherapy provides a helpful counseling theory for pastors and laity engaged in older adult ministry.     

Computerised Cognitive Behavioural Therapy in an Adult Mental Health Service: A Pilot Study of Outcomes and Alliance

This pilot study aimed to explore the clinical outcomes and therapeutic relationship for clients of an adult mental health service using Beating the Blues, a computerised cognitive behaviour therapy (CCBT) package. Sixteen participants completed the programme and reported a significant reduction in Beck Depression Inventory scores posttreatment. Participants' mean item ratings on the relationship measure were above the neutral midpoint, but no association was found between the therapeutic relationship and outcome. The results are discussed in terms of the utility of CCBT as part of a stepped-care model and how further research might usefully explore the nature of the relationship formed between clients and CCBT programmes.     

Social Anxiety and Friendship Quality over Time

Abstract

High social anxiety in adults is associated with self-report of impaired friendship quality, but not necessarily with impairment reported by friends. Further, prospective prediction of social anxiety and friendship quality over time has not been tested among adults. We therefore examined friendship quality and social anxiety prospectively in 126 young adults (67 primary participants and 59 friends, aged 17–22 years); the primary participants were screened to be extreme groups to increase power and relevance to clinical samples (i.e., they were recruited based on having very high or very low social interaction anxiety). The prospective relationships between friendship quality and social anxiety were then tested using an Actor–Partner Interdependence Model. Friendship quality prospectively predicted social anxiety over time within each individual in the friendship, such that higher friendship quality at Time 1 predicted lower social anxiety approximately 6 months later at Time 2. Social anxiety did not predict friendship quality. Although the results support the view that social anxiety and friendship quality have an important causal relationship, the results run counter to the assumption that high social anxiety causes poor friendship quality. Interventions to increase friendship quality merit further consideration.     

Gender Differences in the Association of Intimate Partner Violence and Relationship Values among College Students

Although research has indicated that cognitions and situational factors play a role in relationship satisfaction and aggression, few studies have investigated the association between intimate partner violence (IPV) and relationship values. We addressed this gap by measuring college students’ perpetration of and victimization by four types of IPV; namely, physical violence, sexual violence, threats, and psychological aggression over the past year. One-way ANOVAs and multiple regression analyses were used to measure the association between IPV and the endorsement of relationship values. The results suggest that past IPV perpetration and victimization correlated with the current endorsement of relationship values for males more than females. In general, male perpetrators rated relationship values such as security, investment, others’ approval, and daily conflict as less important than non-perpetrators. Although male victimization explained significant variance in security, investment, and others’ approval, the results were somewhat mixed as to whether victimization related to higher or lower ratings of relationship values, with the majority of the results suggesting an inverse correlation between relationship value endorsement and IPV experience. Future research can investigate mediating factors in the relationship between IPV and relationship value endorsement, as well as look at how IPV and relationship values influence decisions concerning relationship maintenance.