Psychologists in Academic Health Centers: Reflections on Traditions and Innovations in Education,Science, and Practice

In 2007, the Association of Psychologists in Academic Health Centers (APAHC), formerly known as Association of Medical School Psychologists (AMSP), held its first national conference since 1997. At the latter conference, the author of this article [Sheridan (1999) Journal of Clinical Psychology in Medical Settings, 6, 211–218] was asked to present some of the issues that would be important to health care psychologists in the next decade. These issues included the role of psychology in academic health centers, interventions psychologists offer, reimbursements for such treatments, education and training models, and research. This article examines those observations, offers new data, and explores the current challenges and opportunities for psychologists in academic health centers. The presentation also addresses aspirations of psychologists as well as resistances within the profession. Parts of this paper were delivered at the 3rd Conference of the Association of Academic Health Center Psychologists in Minneapolis, Minnesota in 2007.     

Training the Parents of Juvenile Offenders: State of the Art and Recommendations for Service Delivery

Parent training is consistently highlighted as one of the most effective means of preventing delinquency and treating young children with conduct problems, and it has proven to be one of the most cost-effective interventions for doing so. There is, however, far less evidence supporting the efficacy of parent-training programs with adolescents and juvenile offenders. Nonetheless, it still seems to be one of the more promising methods for treating the behavior problems of adolescent delinquents, especially when used in conjunction with other carefully selected program components. We begin with an overview of parent training, highlighting the key components of successful programs. Research on the efficacy of parent training in the treatment of behavior problems among children and adolescents is discussed, particularly the differential impact of parental-training programs with specific groups of youths and families. We then discuss the ways in which parent training has been combined with other interventions in the treatment of delinquency. We conclude with a discussion of the problems encountered in implementing parent training, including recommendations for meeting the unique challenges of effective program implementation. The findings and conclusions of the research reported here are those of the authors and do not reflect the official positions or policies of the National Institute of Justice, The Office of Justice Programs, or the U.S. Department of Justice.     

Implementation of Effective Treatments of Preschool Behavior Problems in a Clinic Setting

Epidemiological data indicate that nearly 20% of preschool aged children have significant behavioral problems. Parents typically consult their child’s primary care provider, who frequently refers to child psychologists for treatment regarding these difficulties. Psychologists skilled in providing effective services for young children are in short supply, limiting accessibility, and parents often are reluctant to follow up with a mental health specialist, suggesting low acceptability. The Behavior Consultation Clinic is a structured clinic for preschool children designed to address these issues of effectiveness, accessibility and acceptability. A retrospective review of 550 patients seen over a 5-year period found that half were seen for one therapy session. Review of the remaining patients found that slightly more than half showed improvement (32% successful discharge with improvement, 24% premature discharge with improvement) with a typical range of two to seven half-hour sessions, about a quarter did not improve, and the remaining patients were referred to a higher level of service. These data indicate that a structured, brief clinic that focuses on the needs of preschool children utilizing evidence-based approaches can be effective, acceptable, and accessible. The Behavior Consultation Clinic also serves as a training clinic for psychology interns and pediatric medical residents.     

Emotion-regulation skills as a treatment target in psychotherapy

Background

Deficits in emotion-regulation skills have been shown to be integral to the development and maintenance of a wide range of mental disorders.

Aim

To evaluate the importance of these skills as a treatment target in psychotherapeutic interventions.

Method

Nine specific emotion-regulation skills were assessed in a sample of 289 inpatients before and after cognitive-behavioural treatment. Self-reports of success in pretreatment skills application were first compared to those of 246 non-clinical controls. Pretreatment skills application and change in skills application during therapy were then related to a variety of outcome measures. Finally, the effects of integrating a brief training of general emotion-regulation skills into the CBT-based treatment were evaluated in a controlled trial.

Results

Uni- and multivariate analyses identified the skills of acceptance, tolerance, and active modification of negative emotions as particularly important for current mental health and treatment outcome. Replacing parts of the standard CBT treatment with the emotion-regulation training enhanced the effects of the CBT treatment on skills application and on other measures of mental health.

Conclusion

Incorporating interventions that directly target general emotion-regulation skills may improve the effectiveness of psychotherapeutic interventions.     

浅谈妇外科医生手术操作的四个层次

手术是处理妇科疾病的主要手段之一。本文从作者的经历和感触出发,就妇外科医师的成长过程中的共性规律进行总结。对于住院医师,熟悉解剖结构、练习基本操作是主要目标;对于主治医师,归纳手术套路、学会独立操作是主要任务;对于主任医师,承担常规工作的同时,条件和能力许可应有所创新。只有将手术从工作变为创作,将技术升华为艺术时,才能完成从“手术匠”到“大师”的飞跃。     

Interdisciplinary research and interprofessional collaborative care in a memory clinic for rural and northern residents of western Canada: Unique training ground for clinical psychology graduate students

Abstract: In Canada, interprofessional education (IPE) and interdisciplinary health research initiatives are beginning to transform the academic health sciences, including graduate training programs for clinical psychologists. In response to mandates and directives from national health policy and research funding bodies, academic training programs are re‐structuring course offerings, practicum training experiences, and research activities to better prepare students for their future roles within interdisciplinary research groups and collaborative patient‐centred clinical teams. As an example of this transformative movement in IPE, described herein are the recent training initiatives in the Graduate Program in Clinical Psychology at the University of Saskatchewan, and the role of clinical neuropsychology in an innovative interprofessional rural and remote memory clinic.     

Opinions of Australian Psychological Society College Chairs about process and content in supervision training: Preliminary investigation in Queensland

Few psychologists in Australia have been trained to provide supervision to probationary psychologists. The current preliminary study investigated whether a supervision training workshop could, in the view of representative psychologists, provide effective training across a range of psychological specialties, or whether separate training was needed for different specialties. The nine Queensland Chairs of the Australian Psychological Society specialisation colleges were given a semi‐structured interview to investigate the goals, content and processes of supervision within their specialty, and perceived relationships with other specialties. Results indicated considerable agreement regarding the content and process of supervision across specialties, suggesting that supervision has much in common regardless of specialty.     

Toward science‐informed supervision of clinical case formulation: A training model and supervision method

Case formulation is a core competency in the practice of clinical psychology and although many component skills can be taught in lectures, supervised clinical practice is a key step in moving from knowledge about case formulation to knowledge of formulation. The present paper outlines a model of science‐informed clinical practice and the ways in which clinical supervision may play a role. In addition, a methodology for assessing and benchmarking skills in case formulation is described to assist clinical psychology training programs to provide supervisees with normative feedback about their skills in case formulation. In so doing, the supervision of case formulation can become more informed by science and responsive to evaluation.     

Toward the science‐informed practice of clinical supervision: The Australian context

Although supervision of clinical practice is mandatory for trainee psychologists, surprisingly little is known about the key ingredients of effective supervision and the relationship between supervision and patient outcomes. The purpose of this paper was to review current regulations that shape supervision in Australia and explore the links between these regulations and the components of effective supervision. Although recent developments including supervisor training and other quality control programs are an indication of progress, there are several empirical and conceptual issues in the supervision literature that require resolution. The second part of this paper identifies the gaps in the supervision literature and suggests steps to advance the development of a mature science of clinical supervision. The main areas requiring attention include the identification of the mechanisms by which supervision produces change in supervisees and their patients, the refinement of measurement methods and instrumentation, and the need to pursue collaborative research that maximises the generalisability of research findings.     

An evaluation of intraverbal training and listener training for teaching categorization skills

The effects of vocal intraverbal training and listener training on the emergence of untrained categorization skills were evaluated. Five typically developing preschool children initially learned to name a number of previously unfamiliar visual stimuli. Each child then received one of two types of training. Intraverbal training involved reinforcing vocally emitted category names by the child in the presence of a spoken exemplar name. Listener training involved reinforcing the selection of visual stimuli by the child in the presence of a spoken category name. A multiple baseline design was used to evaluate the effects of training on each child's intraverbal category naming and stimulus selection. Pre- and posttests were used to assess additional emergent relations. Four of 5 participants did not demonstrate the emergence of any untrained relations. The current findings suggest that additional research is needed to determine the optimal sequencing of conditions in programs designed to teach categorization skills.