Understanding,respecting and integrating difference in therapeutic practice

The purpose of this paper is to promote thought and discussion around how and why we treat patients in chosen ways. In the present climate practitioners are required to treat patients following NICE guidelines in which cognitive behavioural therapy (CBT) is the treatment of choice in the majority of diagnoses. This paper raises concerns that this may lead to an homogenization of treatment, loss of invaluable skills and understanding from other treatment approaches, and loss to the patient who may be best cared for by a combination of treatments and approaches, most notably patients presenting with complex pathology. This paper aims to present this as a general principle, and by way of example, will focus on coupling two specific treatment orientations, cognitive behavioural therapy with psychodynamic psychotherapy, with the specific diagnosis of obsessive compulsive disorder (OCD).

Methods: Clinical material is drawn from case studies from practice in secondary adult mental health care services within the NHS. All patients were referred to the psychological services for treatment for OCD and provided with 1:1 therapy with UKCP‐registered therapists. Details have been anonymized by describing fictitious cases re‐constructed from clinical material. A theoretical understanding is included which provides both an overview for integrating treatment for the specific example of OCD and is intended by extension to other diagnoses.

Results: Working with the commonalities of therapeutic approaches, and integrating specific skills of CBT and psychodynamic psychotherapy, appears to offer a viable mode of treatment for cases resistant to single‐orientation therapies.

Conclusions: Coupling the skills of different therapies can be effective in treating complex patients that are referred to the secondary mental health services. Conversely, restricting practice to single orientation therapies can lead to an impoverished care for patients and diminution of invaluable therapeutic skills which may become underused, undervalued and lost in the practice of mental health care within the NHS. Acknowledgement of the skills of others, valuing these and learning from each other can help to avoid the defensive reactions of practitioners, where each may defensively retreat to their corners of specialism. Respecting and sharing skills from different orientations, and acknowledging this in the NICE guidelines, is good for both mental health services and patient care and addresses the concerns raised by practitioners exemplified by Bateman (2000 Bateman, A. 2000. Integration in psychotherapy: An evolving reality in personality disorder.. British Journal of Psychotherapy, 17(2): 147–156.  [Google Scholar], p. 147) that ‘psychotherapy continues to be bedeviled by ideological schisms with practitioners apparently ignoring alternative conceptualizations and potentially superior interventions’.     

Separating the confident from the correct: Leveraging member knowledge in groups to improve decision making and performance

Groups often struggle to distinguish expert members from others who stand out for various reasons but may not be particularly knowledgeable (Littlepage & Mueller, 1997). We examined an intervention designed to improve group decision making and performance through instructing group members to search for information they already possessed that was relevant to a problem. Participants estimated values and expressed their confidence in their estimates individually and then a second time either individually or in a group. This was done with or without the intervention. Results indicated that: (1) groups were more confident than, and out-performed, individuals, (2) group decision making was best captured by models predicting more influence for more accurate members when the intervention was used and more influence for more confident members in its absence, and (3) groups that received the intervention out-performed groups that did not.     

Do you see what I see? The effect of members’ cognitive styles on team processes and errors in task execution

This research investigates the effect of members’ cognitive styles on team processes that affect errors in execution tasks. In two laboratory studies, we investigated how a team’s composition (members’ cognitive styles related to object and spatial visualization) affects the team’s strategic focus and strategic consensus, and how those affect the team’s commission of errors. Study 1, conducted with 70 dyads performing a navigation and identification task, established that teams high in spatial visualization are more process-focused than teams high in object visualization. Process focus, which pertains to a team’s attention to the details of conducting a task, is associated with fewer errors. Study 2, conducted with 64 teams performing a building task, established that heterogeneity in cognitive style is negatively associated with the formation of a strategic consensus, which has a direct and mediating relationship with errors.     

Vigilant Self‐regulation and Costly Punishment in Public Goods Situations

Applying regulatory focus theory to the context of social dilemma situations, the present research demonstrates that individual differences in vigilant, prevention‐focused self‐regulation predict the tendency to invest private resources to punish uncooperative interaction partners (costly punishment), a behaviour that typically has strong positive effects on the collective level of cooperation. Analyses further support the distinctiveness of the vigilance system proposed in regulatory focus theory (prevention focus) in comparison with general defensive inhibitory tendencies (measured with Carver and White's Behavioral Inhibition System scale). Results document that individual differences in prevention‐focused self‐regulation but not differences in general defensive inhibitory tendencies are positively related to costly punishment. In sum, the findings indicate that vigilant, prevention‐focused self‐regulation plays a crucial role in the context of sanctions that enforce cooperation. Copyright © 2013 John Wiley & Sons, Ltd.     

公交行业一线员工人格特质对工作绩效影响的实证分析--以工作态度作为调节变量

通过问卷调查法,探讨在工作态度调节下大五人格特质与工作绩效的关联。对1277名公交行业一线员工的研究结果表明：(1)人格特质与工作绩效有显著的相关,工作态度在这一关系中起到调节作用。在高工作态度中,人格特质与任务绩效联系较为紧密,工作绩效的良好预测指标是尽责性和外向性;在低工作态度中,人格特质与关系绩效联系较为紧密,工作绩效的良好预测指标是宜人性和外向性。(2)在高工作态度的环境中,人们更看重工作的完成;在低工作态度的环境中,人们更看重关系的协调。工作态度调节着人格特质对工作绩效的影响。     

An Exploratory Assessment of Sales Culture Variables: Strategic Implications Within the Banking Industry

Growing, or even simply sustaining, profitability in today's rapidly changing environment is a daunting task. Today's firm must contend with increasing competition, changing customer requirements, and unprecedented technological change. Further, changing government regulations, such as the recent wave of deregulation, have dramatically changed the way business has traditionally been done in certain industries. In such a turbulent environment many firms have discovered that a total organizational sales effort is necessary. For many firms, this means a paradigm shift that involves strengthening their sales culture.

The purpose of this study is to empirically examine the sales culture (SC) concept and discuss its importance in contemporary business strategy. First, we will discuss market orientation from a corporate culture perspective. Second, the sales culture component of a market orientation will be defined and examined. Third, an exploratory investigation of constructs associated with sales culture will be investigated using an example taken from an industry that is experiencing rapid change, the banking industry. Finally, strategic implications, limitations and suggestions for future research will be shared.     

Examining direct and indirect pathways to health behaviour: The influence of cognitive and affective probability beliefs

This study aimed to extricate the influence of rational (e.g. ‘I think …’) and intuitive (e.g. ‘I feel …’) probability beliefs in the behavioural decision-making process regarding skin cancer prevention practices. Structural equation modelling was used in two longitudinal surveys (sun protection during winter sports [N?=?491]; sun protection during summer [N?=?277]) to examine direct and indirect behavioural effects of affective and cognitive likelihood (i.e. unmediated or mediated by intention), controlled for attitude, social influence and self-efficacy. Affective likelihood was directly related to sun protection in both studies, whereas no direct effects were found for cognitive likelihood. After accounting for past sun protective behaviour, affective likelihood was only directly related to sun protection in Study 1. No support was found for the indirect effects of affective and cognitive likelihood through intention. The findings underscore the importance of feelings of (cancer) risk in the decision-making process and should be acknowledged by health behaviour theories and risk communication practices. Suggestions for future research are discussed.     

Individual differences in susceptibility to infection and illness following respiratory virus challenge

Abstract

The aim of the present research was to investigate whether susceptibility to experimentally-induced respiratory virus infections and illness is related to measures of personality, physiological state, performance efficiency, and subjective ratings of alertness and motivation obtained prior to virus challenge. Two studies, using different viruses, showed that volunteers who subsequently developed colds had higher temperatures prior to virus challenge than those who remained free from illness. Similarly, those who later had colds were worse than other volunteers on certain performance tests given in the pre-challenge period. The results also showed that task-related motivation was related to subsequent infection. Personality scores were poor predictors of infection and illness, the only exception being introversion, which, in one study, was related to the likelihood of developing a sub-clinical infection.