“Being human”: A grounded theory approach to exploring how trainers on clinical psychology doctorate programmes decide whether or not to disclose personal experiences of psychological distress to clinical psychology doctorate trainees

Objective

Recent research and guidelines recommend that trainers on clinical psychology doctorate training programmes consider disclosing personal experiences of psychological distress to trainees. Disclosure is thought to promote cultures of openness, validate and normalise trainee distress, encourage trainee disclosure and help-seeking and challenge stigmatising narratives. However, little is known about how trainers decide whether, what or how to disclose. This study aims to address that gap by exploring the processes and factors involved in trainers deciding whether or not to disclose personal experiences of psychological distress to trainees, generating findings of relevance across counselling, psychotherapy and psychology training courses.

Methods

In-depth interviews were conducted with nine trainers on UK clinical psychology doctorate programmes from around the country and analysed in accordance with constructivist grounded theory methods.

Results

Findings indicated that participants valued disclosure personally and professionally but were wary of the dangers of disclosure. Disclosure decisions were made by judging the context against internally held criteria. If criteria were not met, then disclosures were not made. Outcomes, whether positive or negative, served to reinforce the value of disclosure and the importance of managing risks, creating a positive feedback loop.

Conclusions

The findings of this study suggest factors that are important for trainers to consider when deciding whether or not to disclose. The six-factor framework developed may be useful for trainers to consider within reflective practice, supervision or during guided self-reflection in order to make safe, helpful and ethical decisions.     

Drawing conclusions: Instructing witnesses to draw what happened to them

We reviewed the child and the adult literature on the impact of witnesses drawing what happened on the number of details recalled and the accuracy of the reported details. Most experiments reported a beneficial effect of drawing what happened (or drawing the scene) on the number of details reported primarily in free recall and sometimes also in cued recall. The consensus across studies was that drawing protocols did not negatively impact the accuracy of reported details (when accuracy was attainable) unless suggestive details were drawn. These results were largely consistent regardless of interviewer expertise or protocol used. Draw-and-tell instructions should be considered by forensic investigators for the following reasons: (1) the beneficial effect on number of details recalled with no detriment to accuracy, (2) the added benefit for children who need additional interviewer support, and (3) the ease at which the instruction can be implemented with minimal expertise or training. However, more ecologically valid research is needed to establish the efficacy of drawing (1) in forensic interviews, (2) in the presence of misinformation, (3) across instances of repeated event memory, and (4) across sequential interviews.     

Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders,Co-Occurring ADHD,and Psychosocial Impairment

Our objective was to evaluate the feasibility and acceptability, and preliminary efficacy of a modified comprehensive behavioral intervention for tics (MCBIT) therapy for youth with chronic tic disorders (CTDs), co-occurring attention-deficit hyperactivity disorder (ADHD), and associated psychosocial impairment. Seventeen youth ages 10–17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n = 9) or to a control group where they received traditional comprehensive behavioral intervention for tics (CBIT) therapy (n = 8). Both groups received ten 55-minute weekly treatment sessions, and two 55-minute biweekly relapse prevention sessions. Sixteen of the 17 participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in tic severity, ADHD symptom severity, and tic-related impairment. Group differences were not significant. The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and is similarly well tolerated relative to traditional CBIT. Results were not sufficiently superior to recommend MCBIT over CBIT for this population. However, given the demonstrated benefit of behavioral treatments that target co-occurring conditions concurrently, continuing to examine novel behavioral approaches that can target tics and related conditions simultaneously and successfully is recommended.     

Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD,Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial

This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires.One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128, p = .001; d = .519, 95% CI = .142–.895), depression (F[1,118.29] = 9.978, p = .002; d = .519, 95% CI = .141–.898) insomnia (F[1,117.60] = 4.574, p = .035; d = .512, 95% CI = .132–.892), and anxiety (F[1,119.64] = 5.465, p = .021; d = .421, 95% CI = .044–.797) symptom severity and disability (F[1,111.55] = 7.015, p = .009; d = .582, 95% CI = .200–.963). Larger effect sizes (d = 0.823–1.075) were observed in participants who completed at least half of the treatment. The RESILIENT online treatment platform was successful to provide access to specialized evidence-based mental health care after a disaster.     

Examining Influences on Problem Recognition and Help-Seeking for Child Externalizing Behaviors Among African American Mothers

Childhood behavior problems are one of the most common clinical referrals. If left untreated, these behaviors can result in detrimental consequences to the child’s development (Wehmeier et al., 2010; Scholtens et al., 2012). Behavior parent training has been identified as first-line treatment for oppositional behavior; however, many racial minority families fail to enroll in behavior parent training. The current study examines maternal help-seeking for children displaying oppositional behavior in hopes to delineate variables that might influence parent training enrollment among African American families. Participants were 112 African American mothers who were provided child behavior vignettes and completed measures assessing factors related to problem recognition, parental attributions, child rearing values, mental health stigmatization, racial identity, and treatment utilization. Results found that when presented with a child displaying clinically significant externalizing child behaviors, slightly more than half of African American mothers recognized clinically significant child behavior problems. Mothers were more likely to engage in behavioral parent training if problematic behavior was recognized. Additionally, mothers’ attributions of child behavior, cultural values, and mental health stigmatization were influential to help seeking. This study supports the importance of considering cultural variables that impact problem recognition and subsequent treatment utilization among African American families.     

跨期选择的变易程度正向预测中华文化圈国民的自评扛疫成效：亚非欧美大洋洲18国跨国研究

跨期选择是对不同时间点的得失的权衡与选择。伊索寓言《蚂蚁和蚱蜢》假借群居型昆虫的跨期选择偏爱暗喻投资未来的慢策略比只顾眼前的快策略更利于生存。用跨期选择领域通用的语言解读这一寓言便是：选择大而迟选项的蚂蚁比选择小而早选项的蚱蜢更可能扛过严冬而生存下来。为了探索何种跨期选择策略更有助于我们扛过疫情,本研究调查了亚非欧美大洋洲这5大洲18个国家共计26355名受测者对混合得失双结果的跨期选择偏爱,测量了人们平时和疫时跨期选择偏爱的变易程度(2类变易的程度指标),以及人们自评的扛疫成效。跨文化比较结果的主要发现是：不同通货的选择变易程度(指标1)和不同时期的选择变易程度(指标2)能联合预测中国/新加坡文化圈国民的自评扛疫成效;不同时期的选择变易程度(指标2)也可以单独预测印度/马来西亚/菲律宾/尼日利亚文化圈国民的自评扛疫成效;这2类选择偏爱变易的程度指标不能预测其他文化圈国民的自评扛疫成效(或者预测方向和假设相反)。基于易经“穷则变,变则通”的要旨和跨国比较的发现,我们认为：面临历史危机时善于变通的特长抑或成就了中华民族特有的竞争优势;在应对危机时,与中国文化距离越相近的国家或民族抑或也能...     

依恋对象回应方式对不同依恋类型幼儿支持提供预期修正的影响

依恋对象的敏感性回应是儿童安全依恋发展的重要前因。研究采用改编版依恋预期范式考察实时互动情境中依恋对象确定性和概率性回应对幼儿支持提供预期及预期修正的影响。结果发现：相对不安全型依恋幼儿,初始预期中安全型幼儿更多预期依恋对象会向依恋者提供支持;幼儿能够基于依恋对象的确定性和概率性回应一致地修正对该对象是否提供支持的预期。同时,低水平回应对幼儿预期修正的影响高于高水平回应。研究表明5岁左右幼儿能够基于实时互动中依恋对象的回应信息修正其对该依恋对象的预期,这对理解幼儿依恋表征的发展具有重要启示。     

亲子依恋与儿童抑郁症状的关系：儿童对环境的生物敏感性的作用及父母差异

不良的亲子依恋是导致儿童抑郁症状的风险因素,但其对儿童的影响会因儿童对环境的生物敏感性不同而存在差异。为探究家庭中母子、父子依恋对儿童抑郁症状的影响及儿童生物敏感性(本文中采用迷走神经抑制作为指标)在其中的作用,本研究结合行为任务、问卷报告、生理测量等多种研究手段,招募150名学龄儿童(平均年龄8.64岁,63名女孩)参与研究。结果表明：(1)学龄儿童的母子依恋水平高于父子依恋水平。(2)高水平的母子依恋与父子依恋会同等程度地降低儿童的抑郁症状。(3)儿童对环境的生物敏感性对母子依恋影响儿童抑郁症状路径的调节作用显著,生理上对环境更敏感(高迷走神经抑制)的儿童更易得益于高母子依恋,表现出较低的抑郁水平;但同时,这类儿童在母子依恋较低时也更易表现出较高的抑郁水平。(4)儿童的生物敏感性对父子依恋影响儿童抑郁症状路径的调节作用不显著,高父子依恋对生物敏感性水平不同的儿童均存在有利影响。(5)在不同情境中测量的迷走神经抑制对亲子依恋影响儿童抑郁症状的调节作用模式相似,表现出跨情境一致的特点。本研究率先揭示儿童迷走神经抑制与亲子依恋对儿童抑郁症状的联合作用机制及父母角色差异。