Mirror mirror on the ward: who is the unfairest of them all? Reflections on reflective practice groups in acute psychiatric settings

Consultant psychiatrists in medical psychotherapy, adult psychotherapists, child and adolescent psychotherapists and clinical psychologists increasingly complement their direct therapeutic activity with applications of their psychotherapeutic thinking in acute mental health work through facilitating reflective practice groups for staff working in mental health teams. The authors offer their reflections on facilitating National Health Service reflective practice groups using the metaphor of a mirrored dialogue between patient and professional, and professional and institution as a basis for informing the development of reflective practice for colleagues. Their reflections are based on working on three acute in-patient wards, in a crisis resolution team and in community mental health teams. They describe the practicalities of setting up and facilitating reflective practice groups, and offer insights into some of the issues that arise in reflective practice groups. They conclude that these groups are mutually beneficial in forging links between psychotherapy professionals and professionals working in other disciplines and areas of mental health. Facilitating these groups often requires a challenging adaptation of technique, which will not suit all psychotherapists, as well as a wider understanding of organisational dynamics and the interplay between clinicians and management.     

What you see is what will change: Evaluative conditioning effects depend on a focus on valence

This study investigated whether evaluative conditioning (EC) effects depend on an evaluative focus during the learning phase. An EC effect is a valence change of an originally neutral stimulus (conditioned stimulus or CS) that is due to the former pairing with a positive or negative stimulus (unconditioned stimulus or US). In three experiments, the task focus during the conditioning phase was manipulated. Participants judged CS–US pairings either with respect to their valence or with respect to another stimulus dimension. EC effects on explicit and implicit measures were found when valence was task relevant but not when the non-valent stimulus dimension was task relevant. Two accounts for the valence focus effect are proposed: (1) An additional direct learning of the relation of CS and evaluative responses in the valence focus condition, or (2) a stronger activation of US valence in the valence focus condition compared to the non-valent focus condition.     

The influence of motivational and mood states on visual attention: A quantification of systematic differences and casual changes in subjects' focus of attention

A great number of studies have shown that different motivational and mood states can influence human attentional processes in a variety of ways. Yet, none of these studies have reliably quantified the exact changes of the attentional focus in order to be able to compare attentional performances based on different motivational and mood influences and, beyond that, to evaluate their effectivity. In two studies, we explored subjects' differences in the breadth and distribution of attention as a function of motivational and mood manipulations. In Study 1, motivational orientation was classified in terms of regulatory focus (promotion vs. prevention) and in Study 2, mood was classified in terms of valence (positive vs. negative). Study 1 found a 10% wider distribution of the visual attention in promotion-oriented subjects compared to prevention-oriented ones. The results in Study 2 reveal a widening of the subjects' visual attentional breadth when listening to happy music by 22% and a narrowing by 36% when listening to melancholic music. In total, the findings show that systematic differences and casual changes in the shape and scope of focused attention may be associated with different motivational and mood states.     

Connected to the wellspring: ecclesiological capabilities of small groups of adolescents

The relationship between adolescents and institutional manifestations of church is often problematic. Nevertheless, adolescents still have a need to talk about and to experience faith together with other adolescents. When institutional activities are not available or do not satisfy the needs of the adolescents they sometimes create their own small groups and (informal) meetings to affirm their faith integrated in their (social) lives. Sociological studies also show the tendency to create their own small groups (tribes) besides existing groups of institutional organisations. In this article the question posed is how this more tribal way of being together can be seen as church. Is a (new) form of ecclesiology possible in a world of small groups, networks, social media? This article describes ecclesiological capabilities in a complex sociological environment for adolescents.     

Suitability and context for brief therapy

Abstract

The main point of this paper is that a client's suitability for brief or time-limited therapy is determined by various factors, including context. There is still agreement on the validity of Malan's selection criteria, which included ‘mild illness, recent onset, high motivation and response to trial interpretation’, yet many additional issues have since emerged and need to be considered. For instance, the counsellor's suitability, training and work experience, the counsellor's assessment skills and ability to establish a dynamic focus, the clients' capacity for self-reflection, their ego strength and their response to a trial therapy in the first session. Then there is the importance of the various contexts in which nowadays much brief counselling is offered free to clients, whether in education, at the workplace, in primary healthcare settings or by charitable organizations. This means that issues of money and markets have come to the fore and an initial differential assessment needs to be carried out in order to decide which method or model of therapy is best for the client. Matching the counsellor's personality to the needs and to the pathology of the client, and matching the treatment to the client's developmental stage or life stage crises are other aspects of the work, which determine the issue of suitability. In the end as always there is much that remains unknown about what works for whom and how the client's decision to take up help is made.     

Art from the Heart

Abstract

This article describes art therapy techniques grounded in a relational-cultural approach used in a middle school group for girls. Art from the Heart is an interactive preventive intervention designed to facilitate increased connections among group members. It is intended to bring together multiethnic groups of urban girls with complex relational histories to learn about growth-fostering relationships, without relying on sophisticated verbal abilities. Specific techniques encourage the expression of “feeling thoughts” and other interpersonal dynamics that do not lend themselves well to words. The interactive nature of the art projects creates a context where interpersonal disconnections can be explored and understood, and connections can be celebrated, both by talking and by making art.     

Focusing on Educational Outcomes

National education goals, content standards, and national tests are the hot topics of the day in educational reform. Special services personnel eventually will be faced with these issues, and can either be part of the discussion from the beginning, or wait and have to deal with someone else's decisions. In this article, we highlight some recent national and state educational reform activities and their probable implications for students with disabilities. We explain in brief the impetus behind the thrust toward an outcomesbased approach to education, and summarize the response of the National Center on Educational Outcomes for Students with Disabilities to this push. Possible ways in which special service providers can act to influence the focus on outcomes are described.     

The memory drum theory after twenty years

The difference between the Henry “memory-drum” theory and our version is that ours includes an additional assumption that, after programming has occurred, the resultant representation can be stored in short-term memory. Otherwise, the essential ideas are the same in the two theories. Implications of the presently available data for the distinction between the theories are discussed. Regardless of how one evaluates our added assumption, it is clear that the essential insight of the Henry theory has fared very well in the 20 yr since the theory first appeared in print.     

Unconscious Semantic Priming Influences Performance of Visuomotor Tasks Differently but the Effects are Similar in Young and Older Adults

We examined the effects of semantic priming of attention on two sequentially presented visuomotor tasks, traffic judgments and saccadic adaptation. Priming was accomplished with the scrambled sentence task: participants formed meaningful sentences from a list of words where a word denoting wide attention focus was involved. The results showed that semantic priming influenced positively saccade adaptation (its’ benefit increased) while it attenuated visuomotor performance in the traffic task (RT of hand movements increased). We found the effects of priming on both tasks’ performance to be comparable in young and older participants. It was suggested that semantic priming effect on visuomotor tasks depended on the cognitive resources which were needful as for the priming as for the primed task.