Supervision in Community Mental Health: Understanding Intensity of EBT Focus

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the supervisor level and implementation climate was the only significant factor associated with EBT supervision intensity. While individual clinician and supervisor factors may play a role in EBT coverage in supervision, our results suggest that an implementation climate that supports EBT may be the most critical factor for improving intensity of EBT coverage. Thus, implementation efforts that address the extent to which EBTs are expected, rewarded, and supported within an organization may be needed to support greater coverage of EBT during workplace-based supervision.     

The Effect of Locus of Control on University Students' Mental Health: Possible Mediation through Self-Esteem and Coping

The purpose of this study was to examine the effect of locus of control on university students' mental health and to examine possible mediational roles of self-esteem and coping. A total of 418 university students completed Rotters I-E Scale, Self-liking/self-competence Scale, Endlers Coping with Stressful Situations Scale and Depression, Anxiety and Stress Scale. The results showed that external locus of control, lower self-liking and self-competence, as well as less problem-focused and more emotion-focused coping predict more symptoms of depression, anxiety, and stress in university students. However, mediational analysis revealed that the effect of locus of control was fully mediated by self-esteem and coping, with self-liking and emotion-focused coping being the strongest mediators. Results suggest that beliefs about control affect beliefs about one's self-worth and coping strategies, which in turn can affect one's mental health.     

HANDBOOK OF ATTACHMENT,THIRD EDITION: THEORY,RESEARCH, AND CLINICAL APPLICATIONS JudeCassidy and Phillip R.Shaver (Eds.), New York: Guilford Press, 2016, 1,068 pp., ISBN 978‐1‐4625‐2529‐4

Jude Cassidy and Phillip R. Shaver's third edition of the Handbook of Attachment has emerged and set a new bar for formative texts on pivotal issues related to the field of attachment. This state‐of‐the‐science reference on attachment eloquently intertwines attachment theory, research, and clinical applications, giving us innovative conceptualizations and perspectives on both implications for clinical advancement and directions for future research. This handbook moves basic research findings quickly into the realm of clinical and community applications, providing the field with new information about intervention procedures and outcomes while setting the stage for theoretical advancement. New chapters reflect the way we think about the interweaving of attachment, development, and infant mental health research and application. From the authors’ opening “Overview of Attachment” to the summary overview and evaluation of the field, “The Place of Attachment in Development” by attachment‐research pioneer L. Alan Sroufe, this third edition broadly delivers the most significant and important information that the field has on attachment. Researchers, clinicians, and professionals will benefit from this handbook as it presents with the most up‐to‐date, innovative, and thorough presentation of attachment theory.     

Psychosocial aspects of successful ageing and resilience: critique,integration and implications / Aspectos psicológicos del envejecimiento exitoso y la resiliencia: crítica,integración e implicaciones

Abstract

As the number of older adults increases worldwide, it is becoming increasingly important to find effective ways of fostering better ageing trajectories. The models used to shape this process inform research, policy and practice and impact older adults themselves. Two important ageing models are successful ageing (SA) and resilience (RES). Aligning the conceptual framework in research contexts with those of older adults’ perspectives is an integral component of driving forward the research agenda in a manner that has the greatest potential to benefit older adults. Studies conducted with laypersons indicate that psychosocial components are important components of successful ageing models; therefore, it is imperative that these non-biomedical components are incorporated. There are many similarities between SA and RES models, but an important distinguishing feature is the incorporation of adversity into conceptualizations of resilience. SA models suggest high levels of functioning as a requirement for ageing successfully, regardless of the circumstances the individual experiences; resilience models take into account the level of adversity being experienced by the individual. Individuals can demonstrate RES by having a more positive outcome than would be expected given their level of adversity. The incorporation of psychosocial constructs into SA models and the integration of SA and RES paradigms has important implications for research and for older adults themselves. Through the promotion of models of ageing that include psychosocial components and elements of adversity, greater generalizability to a broader population is possible with enhanced potential for research derived from these efforts to more positively influence individuals’ trajectories of ageing.     

Legacies of War: Asian American Women and War Trauma

ABSTRACT

Although Asian Americans are diverse in many ways, such as language, culture, ethnicity, religion, generational status, and more, many share a common experience: that of having experienced war first hand or being progeny of war survivors. World War II, the Korean War, the Vietnam War, the Cambodian genocide, along with centuries of oppressive and authoritarian rule, have brought experiences of trauma, directly and historically, to the lives of many Asians. Subsequent experiences of migration and resettlement, as well as life in the United States as an ethnic minority, have also compounded the layers of oppression for many Asian Americans. Sexism in our cultures of origin, as well as sexism in the U.S., represents additional realities and traumas faced by Asian American women. In this article, we explore the experiences of war and subsequent traumas in the lives of Asian American women. We present a brief review of the current state of mental health as it relates to the experiences of war trauma, with the goal of providing a crucial contextual backdrop for our review of the best practices in mental health services to Asian American women. We review some of the best practices and conclude with a narrative reflection based on our own involvement in a small professional women’s group that yielded insights, discoveries, healing, and empowerment from the legacy of war trauma.     

THE PHYSICALIZED MIND AND THE GUT‐BRAIN AXIS: TAKING MENTAL HEALTH OUT OF OUR HEADS

As it becomes increasingly plausible that the mind–brain is explicable in naturalistic terms, science‐and‐religion scholars have the opportunity to engage creatively and proactively with facets of brain‐related research that better inform our understanding of human well‐being. That is, once mental health is recognized as being a whole‐body phenomenon, exciting theological conversations can take place. One fascinating area of research involves the “gut–brain axis,” or the interactive relationship between the microbiome in the gastrointestinal tract (i.e., gut bacteria), the central nervous system, and mental health. A growing body of literature explores the immensely significant interactions between the gut microbiome and mental health issues involving depression, anxiety, gene expression, and stress responses. One's mental health does not occur in a disembodied state, but in a complex physical environment that is strongly influenced by environmental factors, many of which we can control. This article argues that science‐and‐religion can welcome scientific research in this area, creatively incorporating such insights into a theology of mental health and physical well‐being.     

An experimental test to reveal negative side-effects of high treatability information on preventative health behaviour

Objectives: When the course of a disease can be positively changed by health professionals the disease can be indicated as ‘highly treatable’. This ‘high treatability information’ (HTI) may have negative side-effects on people’s preventative motivation. This study examined the effects of HTI regarding skin cancer on preventative motivation.

Design: This study employed a 2 (high treatability (HTI) versus low treatability (LTI)) × 2 (high versus low susceptibility)?experiment with a hanging control group. (family) History and self-efficacy were assessed as moderators. Participants (N = 309) were randomly assigned to one of the five conditions.

Main outcome measures: The main outcome was intention to engage in preventative actions regarding skin cancer.

Results: HTI significantly lowered the intention compared to LTI, under the condition of high susceptibility in people with low self-efficacy. In addition, in people with a (family) history of skin cancer, HTI significantly lowered the intention compared to the no-information group.

Conclusion: HTI regarding skin cancer can cause a drop in the preventative motivation. The effects can be conceptualised as negative side-effects of HTI. As substantial proportions of the general population have a (family) history of skin cancer or low self-efficacy, the side-effects may be widespread, possibly increasing the incidence of skin cancer.     

Emotional processes in risky and multiattribute health decisions

Objective: Here, we develop an integrative account of the roles of emotion in decision-making. In Part I, we illustrate how emotional inputs into decisions may rely on physiological signals from emotions experienced while making the decision, and we review evidence suggesting that the failure to represent the emotional meaning of options can often reduce decision quality. We propose that health-related decrements in the ability to generate emotional reactions lead people to inaccurately represent emotional responses and compromise decisions, particularly about risk. Part II explores complex decisions in which choice options involve trade-offs between positive and negative attributes. We first review evidence showing that difficult trade-off decisions generate negative affect and physiological arousal. Next, we propose that medical decision-making will be linked to short- and long-term stress and health outcomes.

Conclusion: In sum, this article proposes and reviews initial evidence supporting the effective use and management of emotional inputs as important to both clinical and non-clinical populations. Our approach will contribute to the understanding of patient-centred emotional decision-making and will inform medical decision aids.     

Understanding the prevalence and correlates of implicit theories of weight in the United States: Insights from a nationally representative sample

Objectives: The primary aim of this research is to understand how mindsets about weight controllability in the United States relate to population health. We examined the distribution of people’s implicit theories of weight, from an incremental (controllable) to an entity (not controllable) mindset, in a nationally representative sample, as well as their relation to: sociodemographic factors, beliefs about behaviour and genetics as causes of obesity and engagement in weight management-relevant behaviours.

Methods: We report data from the National Cancer Institute’s Health Information National Trends Survey 4.

Results: A majority of respondents endorsed an incremental mindset of body weight, but endorsement of this mindset was stronger among younger, white respondents, and those with a higher income and more educational attainment. A stronger incremental mindset was related to stronger behaviour and weaker genetic causal beliefs about obesity, as well as a tendency to report increased engagement in weight management-relevant behaviours.

Conclusions: Our research provides evidence that although incremental mindsets are more common overall and associated with engagement in health behaviours that can contribute to or detract from population health, incremental mindsets are less common among individuals from more marginalised groups.