Reflections on a psychiatric placement

Abstract

During a seminar last year, I was teaching a group of counselling students on the subject of depression. One of the students asked me what I thought of referring a depressed client to a psychiatrist. I replied that in my opinion it was better to keep a person out of the psychiatric services as much as possible. This was an opinion I began to reconsider over the course of a six-month psychiatric placement, undertaken as part of an analytic psychotherapy training.     

Gains without pains? Growth after positive events

While past research suggests that people experience positive psychological changes after adverse events, little is known about psychological changes that happen after positive events. Adult participants (N?=?605) went online to complete a new self-report instrument measuring positive psychological changes linked to positive events, changes that I provisionally call post-ecstatic growth. Factor analysis indicated that this growth happens in four domains: deeper spirituality, increased meaning and purpose in life, improved relationships, and greater self-esteem. Participants were particularly likely to report growth after events that evoked feelings of inspiration and meaning, and events that led them to see new opportunities.     

Adverse childhood experiences,religious/spiritual struggles,and mental health symptoms: examination of mediation models

Emerging research has documented greater risk for posttraumatic stress disorder (PTSD) and depression among young adults with prior adverse childhood experiences (ACEs). Building upon prior findings, we hypothesised that religious/spiritual (R/S) struggles may serve as an intervening pathway through which accumulation of ACEs impacts mental health symptom severity in this population. Young adults (N?=?458) were recruited from a southeastern university to complete an online self-report survey that assessed for ACEs, lifetime trauma exposure, R/S struggles, PTSD and depressive symptomatology. Bivariate correlations yielded significant positive relationships between ACEs and all six types of R/S struggles, depression, and PTSD. Additionally, when accounting for non-childhood trauma exposure, the mediational analyses indicated an indirect effect of struggles with ultimate meaning on the well-establish association between ACEs and mental health symptoms. Clinical implications (such as the importance of fostering meaning making), study limitations, and future research directions are discussed.     

Adverse developmental experiences and risky health behaviours among black South African university students

This study examined the relationship between adverse developmental experiences (ADEs) and risky health behaviours among a cross-sectional sample of black South African students (n = 393; females = 58%, M_age = 20.5 years, SD = 2.9). Binary logistic regression was used to model the association between categories of ADEs and risky health behaviours. Findings suggest individual ADEs to significantly predict risky health behaviours. The highest singular ADEs reported were being treated like a child (62%), parents being overprotective (59%), and being driven to be perfectionistic (58%). There was no indication of a general trend of ordered associations between the number of ADEs and risky health behaviours.     

The Counseling Experiences of Transgender and Gender Nonconforming Clients

The counseling experiences of 13 transgender and gender nonconforming (TGNC) individuals were examined via semistructured, in‐depth interviews. Using multiple standards of trustworthiness (e.g., member checking, negative case analysis), the authors analyzed each interview from an interpretative phenomenological analytic framework. Four main themes were identified: mental health professional selection process, transaffirmative approach, transnegative approach, and support systems beyond counseling. Implications for implementing culturally responsive TGNC affirmative counseling, TGNC sensitive counselor training, and social justice–oriented research are discussed.     

心理治疗的会谈间体验对治疗效果的影响——来自追踪研究的证据

采用多层线性分析方法,在短程心理咨询的连续会谈中检验来访者的会谈间体验对咨询效果的影响。以36名个案、151次会谈为样本,结果发现,来访者的症状总体呈线性下降趋势;不同来访者症状变化的速率存在个体差异,会谈间体验的情绪因子能解释症状变化速率总变异的40.79%。结论：在短程心理咨询中,来访者想起咨询会谈或/和咨询师时的情绪体验能显著预测咨询效果。     

Subjective relational experiences and employee innovative behaviors in the workplace

This paper presents two studies that explore the implications of subjective relational experiences (positive regard, mutuality and vitality) on employee engagement in innovative behaviors at work. Data collected at two points in time were used to test two mediation models that link subjective relational experiences and innovative behaviors. The results of Study 1 indicate that subjective relational experiences directly and indirectly, through affective commitment, are associated with employee engagement in innovative behaviors. The results of Study 2 indicate that subjective relational experiences are positively related to psychological availability, creative self-efficacy, and engagement in innovative behaviors. In addition, the findings of Study 2 indicate that creative self-efficacy fully mediates the relationship between psychological availability and engagement in innovative behaviors, and partially mediates the link between subjective relational experiences and employee engagement in innovative behaviors. The findings of both studies provide further support to the theoretical distinction between psychological state engagement and behavioral engagement at work.     

Consciousness lost and found: subjective experiences in an unresponsive state

Anesthetic-induced changes in the neural activity of the brain have been recently utilized as a research model to investigate the neural mechanisms of phenomenal consciousness. However, the anesthesiologic definition of consciousness as “responsiveness to the environment” seems to sidestep the possibility that an unresponsive individual may have subjective experiences. The aim of the present study was to analyze subjective reports in sessions where sedation and the loss of responsiveness were induced by dexmedetomidine, propofol, sevoflurane or xenon in a nonsurgical experimental setting. After regaining responsiveness, participants recalled subjective experiences in almost 60% of sessions. During dexmedetomidine sessions, subjective experiences were associated with shallower “depth of sedation” as measured by an electroencephalography-derived anesthesia depth monitor. Results confirm that subjective experiences may occur during clinically defined unresponsiveness, and that studies aiming to investigate phenomenal consciousness under sedative and anesthetic effects should control the subjective state of unresponsive participants with post-recovery interviews.