Computer-Assisted Therapies: Examination of Therapist-Level Barriers to Their Use

Despite enthusiasm in the field for their potential ease of dissemination, little work has examined whether practicing clinicians are willing and able to use computer-assisted therapies (i.e., computerized treatments designed to be administered with therapist support). For therapists to use these tools, they require access to computer equipment, the skills needed to use the equipment, and willingness to adopt the technology in treatment. This study examined these three factors using survey data from a national sample of mental health clinicians (N = 1,067). Respondents reported on their access to technology and computer fluency, in addition to completing the Computer-Assisted Therapy Attitudes Scale (CATAS), a measure of therapist attitudes designed for this study. Overall, the majority of therapists (90.7%) reported access to at least one computer at work and self-reported computer fluency levels were high. On average, therapists held positive attitudes towards computer-assisted therapies, although expressed concern that these technologies might damage rapport and did not feel that these technologies would improve treatment outcomes. Predictors of positive attitudes included greater general openness toward new treatments, greater comfort with computers, and easier access to technology at work (all ps < .01). Results suggested that, on the whole, therapists may be likely to integrate computer-assisted therapies into their clinical practice. However, therapists vary both in their ability and willingness to use these tools. Implications for the dissemination of computer-assisted therapies are discussed.     

Voices of African Traditional Healers: Cultural Context and Implications for the Practice of Counselling in Sub-Saharan Africa

The healing paradigm implicit in many sub-Saharan African cultures is embedded in African cosmology, and thus the recognition of this is essential for understanding Traditional African Healing practices and implementing collaborative counselling practices. To this end, this article focuses on the cultural importance, or voice, of traditional healers in sub-Saharan Africa. The current article uses an ethnographic approach to analyse systematically the cultural context of indigenous healing practices in sub-Saharan Africa. The anthropological importance of Traditional Healing practitioners, the context of healing, and the changing legal and ethical status of Traditional Healers are addressed as pivotal in furthering the development of this crucial, yet under utilized resource. The authors propose that such cultural understanding is highly relevant to the work of professional counselors.     

Learning and teaching (briefly)

This paper was given as the Annual Ellen Noonan Counselling Lecture on July 2012 and retains some of the spoken style of the lecture. It uses examples of Ellen Noonan’s work to examine aspects of the process of teaching and learning psychodynamic practice. The difficulties of how to embed theoretical knowledge with its clinical application are discussed and the question of what are the key skills of the self-reflective practitioner is raised with reference to whether, and how, they can be taught or learnt. It is suggested that part of this process consists in helping students, and their teachers, to be more comfortable with not knowing, a concept that is both counter intuitive and counter cultural. From this aspects of contemporary therapeutic practice, with specific reference to psychodynamic short-term therapy, are addressed. The paper looks at the ambivalence felt by many psychodynamic clinicians towards working within a short-term paradigm in current workplace settings and how this might be addressed. The paper discusses the intrinsic qualities of a psychodynamic short-term approach and its relation to contemporary therapeutic modalities. It is suggested that the increasing managerial culture, leading to the ascendance of protocol driven, manualised and structured therapies, represents an attack on the relational and must be challenged.     

‘I download my prayer schedule’: exploring the technological mediation of Islamic religious practice at work

The practice of daily prayers in Islam and how observances such as Ramadan fall each year follow specific solar or lunar calendars different from the Gregorian calendar of UK work places. Identifying the time for daily prayers and finding a place to practise is a skilled activity requiring ways to ascertain the correct (and changing) time and a place in which prayer can take place. In the absence of traditional mediation such as the call to prayer broadcast from a local mosque, new, often technologically innovative, approaches are being adopted. This paper reports on a study of how Muslims practise and negotiate the difficulties of performing daily prayers in a UK university. Though technological mediation is a significant aspect of daily prayers, it is but one part of a complex practice which often involves multiple technologies and multiple ways of working.     

ADHD Assessment

Abstract

This study examined effects of negative versus positive symptom formats on the assessment and subsequent classification of ADHD in children in public schools. Symptoms associated with the disorder based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) were presented to parents and teachers of referred children according to both types of formats. Informants were then asked to indicate whether the symptoms described the child's behavior over the last six months. Overall, the negatively phrased symptoms appeared to generate response bias which resulted in an increased percentage of children meeting the DSM-IV criteria for ADHD. Additionally, the decision reliability or classification agreement between the two formats was low, suggesting the possibility of confirmation bias in the assessment process. Implications for practice and future research are discussed.     

Clinical Supervision and Professional Development Using Clients from Literature,Popular Fiction,and Entertainment Media

Abstract

The use of clinical supervision is central to mental health work. In this article, the authors propose using practice cases drawn from characters found in literature, popular fiction, biographies, television, and movies as one method for clinical supervision and professional development in the mental health skill areas of client assessment, case conceptualization, diagnosis, and treatment planning. The method is illustrated with clinical formulations pertaining to four practice clients: Scarlett O'Hara; Maya Angelou's Marguerite Johnson; the fairytale character, Hansel; and the Wicked Queen of Disney's Snow White and the Seven Dwarfs. Applications and limitations of the method are discussed.     

Materials used to support cognitive behavioural therapy for depression: a survey of therapists’ clinical practice and views

ABSTRACT

Use of supporting materials in cognitive behavioural therapy (CBT) is widely advocated, and homework increases effectiveness. The study aimed to identify materials most frequently used by CBT therapists to support CBT for depression, and those perceived clinically most effective. Questionnaires were sent to 3665 accredited CBT therapists asking about their use of resources commonly described in CBT manuals, and their views on effectiveness. Of 3665 approached by post/email, 994 (27%) responded. Another 33 completed the questionnaire via the study website. 818/1027 (80%) of respondents were accredited practitioners who deliver one-to-one therapy. Symptom measures, lists of problems/goals, activity schedules, behavioural activation diaries/plans, and case formulation worksheets were used “frequently” or “very frequently” by over 85% of respondents. Sleep diaries and computerised CBT were used least. Most resources were used within and between sessions. Activity schedules, behavioural activation diaries/plans, case formulation worksheets, thought records, and resources to support the identification of conditional beliefs were regarded as most effective. Symptom measures, sleep diaries, and computerised/online materials were considered only moderately effective. Therapists use a wide range of materials to support individual CBT. For delivering CBT, technology-enabled approaches should incorporate a range of materials to enable therapists to tailor treatment effectively.     

Sole Expression: A Trauma-Informed Dance Intervention

The primary treatment for individuals who have encountered violence and/or abuse is trauma-focused cognitive and behavioral modalities. However, these therapeutic approaches are not always effective for youth who have encountered this type of trauma. Trauma is often communicated through the body via physical ailments, particularly when words are insufficient to capture an individual’s experience or when adequate processing of the trauma is not possible due to profound stress. Dance offers an alternative form of therapy that can address “where” the trauma is held, relieve tension, and restore a sense of ownership with one’s body and mind. In this article, we discuss the development of Sole Expression, a trauma-informed hip-hop dance program for youth who have experienced abuse and/or exposure to violence. We provide an overview of establishing the team, securing funding, trauma training, program curriculum, and the related research. We conclude with recommendations for best practices that benefit both practitioners and the young people served.     

I am happy in my faith: the influence of religious affiliation,saliency, and practice on depressive symptoms and treatment preference

Religion is thought to significantly impact numerous areas of mental health, including depression. Using a 63-item questionnaire, the influence of religious affiliation, saliency, and practice on levels of depressive symptoms and treatment preference in a non-clinical sample of Christians, Muslims, Atheists, and Agnostics (N = 471) was investigated. No significant differences in depressive symptoms were found between affiliations. Saliency and frequency of practice had a weak negative correlation with depressive symptoms for Christians, but were not significant for Muslim participants. No significant differences of preference were found between affiliations for social, cognitive, and medical treatments. Treatment preference of religious-based treatments differed significantly between affiliations. Findings suggest that affiliation is not significantly related to depressive symptoms or treatment preference, and the influence of saliency and practice differs between religions. Limitations and implications of the current study are discussed, and directions for further research are identified.     

Physio Kundalini syndrome and mental health

The increasing practice of traditional eastern philosophies within the modern society has highlighted the difficulties of assimilation of these traditions within Western culture. This invariably results in difficulties on the part of the practitioners to integrate these practices into their daily lifestyle. The reasons for these are often complex. One of the contributing factors could be insufficient understanding or acquisition of a superficial interpretation of the eastern tradition or philosophies. The Kundalini concept comes from the yogic philosophy of ancient India and refers to mothering intelligence behind yogic awakening and spiritual maturation. We describe a case of a young male who presented with functional deterioration experiencing psychotic symptoms, which he describes as his Kundalini awakening.