Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

价值观的稳定性与可变性

价值观是人们区分好坏、善恶、美丑、损益、是非的信念系统,通常是充满情感的。价值观具有稳定性与可变性的特点。价值观的稳定性表现为:基本价值观具有跨时间的稳定性和跨情境的一致性; 特别是保护性价值观和人生价值观具有较强的稳定性。个人的发展、经历重大事件以及实验干预可导致价值观的改变,可变性主要表现为价值观的重要性发生变化。从我国的实际出发,探讨个人的核心价值观问题、以及价值观研究中国化、价值观研究对价值观教育的启示,乃是我们今后研究的关注点。     

Penser les temporalités à l’accueil des urgences psychiatriques : paroles d’intervenants de la crise

ObjectiveTo explore the relation to times in crisis units and psychiatric emergencies by crisis stakeholders.MethodIt is in a qualitative logic that the collection and analysis of data are discussed. 9 crisis stakeholders participated in the study. The data were collected using semi-structured interviews and analyzed using the Grounded Theory.ResultsThe Grounded Theory shows significant phenomena resulting the experience of temporality in psychiatric emergencies: plural human temporalities (1), impacts of multiple temporalities (2), reorganizing temporalities of the relationship (3), and appropriation of temporality (4). The manner of appropriating time depends essentially on the emotional control and the reflexivity of the therapeutic actions.ConclusionCrisis stakeholders are in temporality of immediacy, speed and subjective urgency and suggest us thinking in less quickly and better. Team exchanges are so many suspended moments that contribute to the resumption of a thought process and avoid acting too quickly. Participants would like the relational component to be privileged with patients.     

Research in counselling and psychotherapy Post‐COVID‐19

The COVID‐19 pandemic brings to light many areas the field of counselling and psychotherapy may need to address in future research. We outline several issues stemming from or exacerbated by the pandemic and offer suggestions for future research to address the mental health needs of those impacted. Our suggestions focus on five domains: (a) the health and well‐being of helping professionals, (b) the infodemic, (c) discrimination and minority stress, (d) spiritual and existential dynamics in mental health and (e) couple and family stress and resilience. We aim to provide a multi‐systemic perspective of mental health and well‐being in the time of COVID‐19, as well as encourage current and future studies to incorporate these suggestions to advance the health and well‐being of our communities through evidence‐based treatment approaches.     

Gerontological Counseling Trends in Adultspan Journal: 1999–2019

Using quantitative content analysis, we categorized 76 out of 154 articles (49.35%) published in Adultspan Journal from 1999 to 2019 as focused on gerontological counseling. This study explored publication trends for these articles and compared results with a larger study (Fullen et al., 2019) on publication trends for gerontological counseling across all counseling‐related journals.     

正式反馈的发展与临床应用

摘要:正式反馈通过系统收集当事人的效果反馈来追踪其治疗进展,进而识别缺乏治疗进展的个案,并通过促进治疗策略的调整来阻止治疗失败。正式反馈是近20年来发展出的一种循证治疗手段,其目的为进一步提高当事人的咨询效果。正式反馈的发展大致经历了临床有效性检验和实用性发展两个阶段。正式反馈可用于促进个体、夫妻和团体咨询的效果,也可用于评估临床督导效果、确定督导个案和指导临床督导。未来研究可探讨咨询师对待正式反馈的态度,拓展正式反馈的使用价值,建立正式反馈系统的本土化常模。     

A systematic review of the effectiveness of machine learning for predicting psychosocial outcomes in acquired brain injury: Which algorithms are used and why?

Clinicians working in the field of acquired brain injury (ABI, an injury to the brain sustained after birth) are challenged to develop suitable care pathways for an individual client’s needs. Being able to predict psychosocial outcomes after ABI would enable clinicians and service providers to make advance decisions and better tailor care plans. Machine learning (ML, a predictive method from the field of artificial intelligence) is increasingly used for predicting ABI outcomes. This review aimed to examine the efficacy of using ML to make psychosocial predictions in ABI, evaluate the methodological quality of studies, and understand researchers’ rationale for their choice of ML algorithms. Nine studies were reviewed from five databases, predicting a range of psychosocial outcomes from stroke, traumatic brain injury, and concussion. Eleven types of ML were employed with a total of 75 ML models. Every model was evaluated as having high risk of bias, unable to provide adequate evidence for predictive performance due to poor methodological quality. Overall, there was limited rationale for the choice of ML algorithms and poor evaluation of the methodological limitations by study authors. Considerations for overcoming methodological shortcomings are discussed, along with suggestions for assessing the suitability of data and suitability of ML algorithms for different ABI research questions.     

The Nature of Client Agency Prior to Therapy: A Qualitative Study on Clients’ Narratives

Client agency is considered a crucial contributor to good treatment outcome. Recent studies, however, differ strongly in how they conceptualise and investigate agency. The current study explores the nature of client agency in ten clients’ pre-treatment interviews. Applying Consensual Qualitative Research, we constructed three overarching categories, subdivided into 14 sub-categories capturing both between- and within-person differences in agency before therapy. We found that all participants oscillated between the experience of a lack of grip on problems on the one hand and noticing their involvement in the problem and taking action on the other. These results present a dynamic conceptualisation of client agency. This allows us to ask pertinent questions for both future research and clinical practice.