Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic

In response to the COVID-19 pandemic and consequential shutdown measures, many mental health professionals started providing therapy to patients exclusively via telehealth. Our research center, which specializes in studying and treating obsessive-compulsive disorder (OCD), historically has provided in-person exposure and response prevention (ERP) to adults with OCD, but shifted to telehealth during the pandemic. Unlike in other modes of talk therapy, ERP’s emphasis on therapist-supervised exposures presented unique opportunities and challenges to delivering treatment entirely via a virtual platform. This paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021 and offers recommendations for future study and practice. Though we observed a number of drawbacks to fully remote ERP, we also discovered advantages to delivering ERP this way, meriting additional research attention.     

Systematic review of interruption and redirection procedures for autistic individuals

Interruption and redirection (IR) procedures involve systematically disrupting an undesirable behavior and prompting an individual to engage in an alternative behavior. These procedures have been frequently assessed for reducing repetitive behaviors for autistic individuals. The primary purpose of this review was to assess IR interventions to determine whether outcomes vary according to intervention characteristics, dependent variable types, design quality, or publication status. A secondary purpose was to assess the extent to which generalization and maintenance outcomes were measured and whether characteristics of these conditions were related to outcomes. IR interventions were moderately successful for reducing repetitive behaviors but less effective for improving corollary variables such as appropriate vocalizations and functional engagement. Generalization and maintenance outcomes, when measured, were poor. Results indicate the need for alternative or augmentative procedures that focus on engagement in meaningful interactions and activities.     

L’approche existentielle dans l’accompagnement de personnes au chômage en perte de repères : les processus de construction du sens de la vie et du travail (études de cas)

The guidance design for unemployed people in changing career must increasingly take into account their existential concerns about career meaning. The literature about life and work meaning has highlighted the multifactorial complexity of meaning definition and determinants of meaning. This fact does not facilitate their use in counselling design. Bernaud et al. (2020) “Guidance for life and work meaning” device takes into account this problem; it offers many thinking prospects that organize meaning questioning in order to help people who loosed professional and personal markers. By analyzing an application of this device with the multiple cases method, our article examines how a meaning guidance helps unemployed people in giving a new direction of their career. The study of five cases with chronologic analysis unities shows how various meaning dimensions help people to clarify, to enrich and to transform their initial problematic during accompaniment and how they progress with different rhythms to major personal and vocational decisions.     

Does authenticity always breed mental health? A cross-cultural comparison between the United States and China

Numerous studies on Western cultures have suggested a strong linkage between authenticity and mental health. However, little is known about whether such an association can be generalized to Eastern cultures. This study aimed to conduct a cross-cultural comparison on the association between three dimensions of authenticity (authentic living, self-alienation, and accepting external influence) and two factors of mental health (negative and positive) across Western and Eastern cultures. Measurement invariance tests were carried out and multigroup structural regression models developed on two college samples from the US (n = 392) and China (n = 281). Results suggested that the associations between authenticity and the negative factor of mental health were consistent across cultures, where both self-alienation and accepting external influence were positively associated with anxiety. However, the associations between authenticity and the positive factor of mental health were different in the US and Chinese samples. Specifically, both authentic living and accepting external influence were significantly associated with life satisfaction in the US sample but not in the Chinese sample. Findings stress that having a nondistorted perception of the true self is critically related to lower levels of anxiety across cultures and highlighted the need to identify culture-specific promotive factors for life satisfaction.     

“It's wrong to relax,you have to be on the go,go, go,all the time”: Emotional transformation in a case of emotion-focused therapy for generalised anxiety disorder

Generalised anxiety disorder (GAD) is a highly prevalent, chronic and impairing disorder. The aim of this study was to qualitatively describe the transformation in emotional processing across 16 sessions of a successful emotion-focused therapy (EFT) treatment for GAD. A theoretical framework derived from the EFT model of in-session emotional transformation proposed by Pascual-Leone and Greenberg was used as the basis for qualitative analysis. Additionally, the Classification of Affective Meaning States, the Client-Expressed Arousal Scale-III and the Client Emotional Productivity Scale-Revised were utilised by observer–raters to classify moment-by-moment shifts in client affective-meaning states, emotional arousal and emotional productivity. Results supported the emotion transformation model. The client presented in a state of poorly differentiated but highly aroused distress provoked by identifiable interpersonal and intrapersonal triggers. Emotional and behavioural avoidance provoked by fear of pain was evident. Accessing core pain and responding to attendant needs with compassion and protective anger was shown to facilitate the higher order emotional processing states of grief, relief and agency. Implications are proposed, including that addressing core emotional vulnerability may be a critical intervention in the successful treatment of GAD.     

Examining Safety Behavior Subtypes Across Distinct Social Contexts in Social Anxiety Disorder and Major Depression

People with social anxiety disorder (SAD) use different types of safety behaviors that have been classified as avoidance vs. impression management. The current study investigated differences in safety behavior subtype use in 132 individuals with principal diagnoses of social anxiety disorder (SAD, n = 69), major depressive disorder (MDD, n = 30), and nonpatient controls (n = 33) across two social contexts: an interpersonal relationship-building task (social affiliation) and a speech task (social performance). We examined whether diagnostic groups differed in safety behavior subtype use and whether group differences varied by social context. We also explored relationships between avoidance and impression management safety behaviors, respectively, and positive and negative valence affective and behavioral outcomes within the social affiliation and social performance contexts. Safety behavior use varied by diagnosis (SAD > MDD > nonpatient controls). The effect of diagnosis on impression management safety behavior use depended on social context: use was comparable for the principal SAD and MDD groups in the social performance context, whereas the SAD group used more impression management safety behaviors than the MDD group in the social affiliation context. Greater use of avoidance safety behaviors related to higher negative affect and anxious behaviors, and lower positive affect and approach behaviors across contexts. Impression management safety behaviors were most strongly associated with higher positive affect and approach behaviors within the social performance context. These findings underscore the potential value of assessing safety behavior subtypes across different contexts and within major depression, in addition to SAD.     

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...