The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

James and Carnap on philosophical systems and the role of temperaments

The relationship between American pragmatism and logical empiricism is complicated at best. The received view is that by around the late 1930s or early 1940s pragmatism had been replaced, supplanted, or eclipsed by the younger and more logic-oriented form of empiricism developed in interwar Vienna. Recently, however, this picture has been challenged, and this paper offers further reasons for thinking that the received view is inadequate. Through a critical examination of William James's Pragmatism and “The Sentiment of Rationality” and Rudolf Carnap's “Elimination of Metaphysics Through Logical Analysis of Language” and other works, the paper builds a case for the existence of a rather striking correspondence between the work of one of pragmatism's most vaunted figures and the thought of logical empiricism's most famous advocate. Not only were both philosophers interested in what might be called metaphilosophy or the psychology of philosophy, both held very similar deflationary views.     

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.     

自闭症谱系障碍社交动机理论：机制及干预探索

自闭症谱系障碍(Autism Spectrum Disorder, ASD)表现为社会交往困难以及重复刻板兴趣或行为。社交动机理论提出ASD个体是由于社交动机缺乏导致的社交障碍。目前该理论缺乏理论元素及结构关系的系统论证, 及基于此理论的低龄ASD儿童群体的研究证据。本研究拟采用心理实验法、眼动及近红外脑成像技术, 探索低龄ASD儿童早期社交奖赏、社交定向异常眼动标记及眶额叶脑区活动的神经机制。此外, 通过音乐奖赏强化学习的干预方式改善该理论的核心元素(社交奖赏), 观测能否改善ASD儿童的社交动机。本研究的开展有望对该理论进行系统验证, 并形成改善社交行为的潜在干预方案。     

Ten principles of counselling: Grounded theory in a mixed methods research project

This grounded theory (GT) study is part of an extensive mixed methods research project to develop general principles for counselling. Nine hundred counselling protocols were examined. The material is characterised by a quantitative amount of data with a qualitative character. The research is based on the systemic-constructivist research paradigm. The variety of perspectives is an important aspect of the work. Therefore, it is important that the entire research process with GT takes place in exchange with other research settings in order to minimise the limitations caused by the perspective of the researchers. During the research process, there was an intensive examination of GT in order to adapt it to the research project. By using the GT to analyse the extensive qualitative material, the actions of the counsellors were observed and 10 counselling principles were developed. This article presents the research process and the findings.     

“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.     

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.