Research on embedded counselling: An emerging topic of potential importance for the future of counselling psychology

A significant proportion of the counselling that people receive takes place within informal, situated encounters between service users and practitioners in fields such as nursing, medicine, teaching and social work. However, almost all of the research that has been carried out into the process and outcomes of counselling consists of studies of formal, contracted counselling and psychotherapy based in therapy clinics and offices. The competent and effective delivery of counselling that is embedded in a primary professional role, such as that of nurse, teacher or social worker, presents considerable challenges for practitioners. Research evidence around the process and outcomes of embedded counselling represents a valuable resource that has the potential to enhance the quality of counselling conversations enacted by practitioners in health, education, social work and other professions. An overview is provided of different types of research that has been carried out into informal and embedded counselling, and of the main themes that have emerged from these studies. Suggestions are made for the further development of this field.     

“I would have lost the respect of my friends and family if they knew I had bent the road rules”: Parents,peers, and the perilous behaviour of young drivers

Young novice drivers are at considerable risk of injury on the road. Their behaviour appears vulnerable to the social influence of their parents and friends. The nature and mechanisms of parent and peer influence on young novice driver (16–25 years) behaviour was explored via small group interviews (n = 21) and two surveys (n1 = 1170, n2 = 390) to inform more effective young driver countermeasures. Parental and peer influence occurred in pre-Licence, Learner, and Provisional (intermediate) periods. Pre-Licence and unsupervised Learner drivers reported their parents were less likely to punish risky driving (e.g., speeding). These drivers were more likely to imitate their parents and reported their parents were also risky drivers. Young novice drivers who experienced or expected social punishments from peers, including ‘being told off’ for risky driving, reported less riskiness. Conversely drivers who experienced or expected social rewards such as being ‘cheered on’ by friends – who were also more risky drivers – reported more risky driving including crashes and offences. Interventions enhancing positive influence and curtailing negative influence may improve road safety outcomes not only for young novice drivers, but for all persons who share the road with them. Parent-specific interventions warrant further development and evaluation including: modelling safe driving behaviour by parents; active monitoring of driving during novice licensure; and sharing the family vehicle during the intermediate phase. Peer-targeted interventions including modelling of safe driving behaviour and attitudes; minimisation of social reinforcement and promotion of social sanctions for risky driving also need further development and evaluation.     

THE IMPACT OF DEPRESSION ON MATERNAL RESPONSES TO INFANT FACES IN PREGNANCY

Research has suggested that prenatal depression may be associated with disrupted maternal responses to infant stimuli, with depressed pregnant women not showing the bias toward distressed infants as that observed in nondepressed pregnant women. The current study examined the effects of depression on self‐ reported responses to infant stimuli, in early pregnancy. Women with clinical depression (n = 38), and nondepressed women (n = 67) were recruited from a wider cognitive behavioral therapy trial. They completed Maternal Response Scales in which they were presented with images of distressed, neutral, and happy infant faces, with no time limit. The women rated their responses to these images along three dimensions—wanting to comfort, wanting to turn away, and feelings of anxiety—using Likert scales via a computerized task. There was evidence that women with depression in pregnancy showed different responses than did women without depression. Women with depression were substantially more likely to be in the highest quartile for ratings of wanting to turn away, odds (OR) ratio = 4.15, 95% confidence intervals (CIs) = 1.63–10.5, p = .003, and also were substantially less likely to be in the highest quartile for wanting to comfort a distressed infant face, OR = 0.22, 95% CIs = 0.09–0.54, p < .001. Findings are consistent with there being both a heightened avoidant and a reduced comforting response toward distressed infants in depressed pregnant women, providing some support that depression disrupts maternal preparations at a conscious level.     

涉疫人员隐私保护的现实困境与法治路径

涉疫人员的隐私权利能够体现其独立人格与个体尊严,蕴藏人文价值,对于防疫工作促进和公共健康保护具有积极意义。新型冠状病毒肺炎疫情与大数据发展的双重背景之下,涉疫人员隐私保护存在知情同意困难、信息泄露和持续监控的新型难点。因此,分析其背后公民知情权与个人隐私权之冲突原因,在立法完善、执法优化、司法救济和守法普及四个维度为优化涉疫人员个人隐私保护的法律规范提供建议,帮助缓和权利冲突,为后续规范疫情常态化防控提供依据。

     

COVID-19防控的责任伦理考量

在积极应对疫情防控引发的法律及现实问题的同时,应该更加关注其责任伦理问题。如个人自由与公共责任冲突的问题,特殊从业者与职业责任冲突的问题,政府公权力的行使主体与个人知情同意的冲突问题。针对上述问题,基于责任伦理原则,提出培养个人责任伦理意识,形成群体认知共识、制定特殊人员免责条款,约束集体无意识的责任迷失、政府明确社会组织主体行使公权力的权利及限度等具体对策完善COVID-19防控机制,以保护人民的生命健康权益,促进当前及未来社会的稳定发展。

     

诊断技术增强与癌症恐慌考量

癌症危及生命,人们寄希望于“三早”战略能带来福音。随着诊断技术增强,癌症发病率急剧飙升,但人群中癌症死亡率却没有明显降低,而由此引发的癌症恐慌趋势日益加剧。当今对癌症二级预防战略仍存在很多争议,尤其是引发的过度诊断和过度治疗更是备受关注。“三早”问题的关键并非是其本身问题,而是在于如何解释和应用“三早”原则。肿瘤可以早发现,但绝不能早恐慌;癌症应该早治疗,但权衡利弊很重要。人们应该以自然的心态应对恐慌,以整合的理念解决现代肿瘤问题。     

确定的不确定性与不确定的确定性——治疗疾病决策与控制传染病决策之差异

新型冠状病毒肺炎疫情给人类带来了一场严重的公共卫生危机。人们需要制定抗击疫情的对策。系统地比较了治疗疾病决策与疫情防控决策的制定过程与方式,讨论了这二者在影响决策的因素、决策的内容以及决策的目标上的差别。治疗疾病决策主要是一种事实判断,其确定性与不确定性都是建立在还原论的基础之上;而控制传染病决策基本上是一种价值判断。尽管传染病本身是客观的生物学和医学问题,但是控制传染病方案的制定却不可避免地涉及到许多主观因素。     

谈疫情防控的社会防控学科化建设

公共性是疫情的本质特征,社会防控和医学干预是疫情防控的两条基本路径。现代社会因高度分工而相互依赖,疫情的公共性本质特征更加突出。改革开放前我国的疫情防控遵循社会防控和医学干预并重原则,改革开放后逐渐演变为过度倚重医学干预。通过比较这两个时期的疫情防控措施及效果,证明只有依靠社会防控和医学干预的共同作用,才能有效地应对疫情。因此,建议推进公共卫生社会防控的学科化建设,保证其能够进行长期深入的研究,以便有效服务于疫情防控工作。