Profession Differences in Family Focused Practice in the Adult Mental Health System

There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross‐sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices.     

The sandwich model: The ‘music and dance’ of therapeutic action

My premise is that a ‘layered’ approach is necessary to understand the process of exchanges that result in therapeutic change. I imagine these processes occurring in three layers – although the number of domains in which change is taking place is actually infinite – such as in a sandwich. The top layer, or top slice of bread of the sandwich, represents a broad view of the change process; it is non‐linear and includes the feature of uncertainty, a general principle of dynamic systems theory. The middle layer, or the meat of the sandwich, is explained by theories that are immediately and clinically useful to a therapist, such as psychoanalytic theories. These are primarily linear theories and use language and symbols to ‘tell a story of what happened’. The bottom layer, or bottom slice of bread of the sandwich, is the micro‐process; this layer includes the moment‐to‐moment patterns of coordinated rhythms that both communicate meaning and provide the essential scaffold for all higher‐level change processes. The micro‐process also requires a non‐linear theory to make sense of its variability and emergent properties. Taking a bite out of the sandwich will include a ‘polysemic bundle of communicative behaviors’ (Harrison and Tronick, 2011). I will illustrate the ‘sandwich model’ with the clinical case of the analytic treatment of a 5 year‐old boy.     

ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

Coping strategies: A prospective study of patterns,stability, and relationships with psychological distress

The aims of this article are: (1) to explore patterns (clusters) of coping strategies; (2) to examine the stability of individual coping strategies and patterns of coping over time; and (3) to establish long term associations between coping and psychological distress. Coping strategies were assessed with the Brief Cope questionnaire, whereas psychological distress was measured with the ten‐item version of the Hopkins Symptom Checklist, in a two‐year prospective sample comprising 3,738 employees. Based on TwoStep cluster analysis of the Brief Cope, three different coping patterns were identified: low coping, engagement coping, and disengagement coping. Analyses of long‐term stability indicated malleable properties for the individual coping strategies as well as the three clusters. Disengagement coping strategies in the form of self‐blame and self‐distraction were most strongly associated with distress at follow‐up, whereas baseline distress was related to increased use of these strategies two years later. Coping patterns at baseline had no main effects on later levels of distress, but levels of distress at baseline predicted subsequent use of engagement and disengagement coping patterns. The finding that specific coping strategies are malleable suggests that it is possible to modify and develop dysfunctional strategies. The associations between disengagement coping strategies and distress indicate that this kind of coping is especially problematic with regard to mental health problems. A main contribution of this study is that it establishes cluster analytic techniques as beneficial in the assessment of coping.     

Meaningfulness in Day Centers for People With Psychiatric Disabilities: Gender and Empowerment Aspects

This study investigated the experience of meaningfulness in occupations at day centers among people with psychiatric disabilities from an empowerment and gender perspective. One hundred eight participants, from eight day centers in Sweden, completed instruments measuring experienced meaning, empowerment, psychosocial functioning, and socio-demographic factors. Mixed methods were used, combining statistical analyses and content analysis. Gender differences were found concerning principal occupations performed. These confirmed traditional gender roles. The experience of meaning in day center occupations, particularly the domain of meaning pertaining to personal development, was significantly associated with empowerment. These results may be used in the future development of day centers.     

The Goal Circuit Model: A Hierarchical Multi‐Route Model of the Acquisition and Control of Routine Sequential Action in Humans

Human control of action in routine situations involves a flexible interplay between (a) task‐dependent serial ordering constraints; (b) top‐down, or intentional, control processes; and (c) bottom‐up, or environmentally triggered, affordances. In addition, the interaction between these influences is modulated by learning mechanisms that, over time, appear to reduce the need for top‐down control processes while still allowing those processes to intervene at any point if necessary or if desired. We present a model of the acquisition and control of goal‐directed action that goes beyond existing models by operationalizing an interface between two putative systems—a routine and a non‐routine system—thereby demonstrating how explicitly represented goals can interact with the emergent task representations that develop through learning in the routine system. The gradual emergence of task representations offers an explanation for the transfer of control with experience from the non‐routine goal‐based system to the routine system. At the same time it allows action selection to be sensitive both to environmental triggers and to biasing from multiple levels within the goal system.     

MIRACLES AND TWO ACCOUNTS OF SCIENTIFIC LAWS

Since early modernity, it has often been assumed that miracles are incompatible with the existence of the natural laws utilized in the sciences. This paper argues that this assumption is largely an artifact of empiricist accounts of laws that should be rejected for reasons internal to philosophy of science, and that no such incompatibility arises on the most important alternative interpretations, which treat laws as expressions of forces, dispositions, or causal powers.     

On the Role of Specific Emotions in Autonomous and Controlled Motivated Behaviour

In the present study, we study the effect of four specific emotions (i.e. happiness, relaxation, depression, and anxiety) on autonomous and controlled motivated behaviour. Drawing on the componential approach to emotions, we argue that because different emotions have a different action readiness—the readiness to engage with the environment—they also have a different impact on autonomous and controlled motivated behaviour. To test this hypothesis, we performed two studies. In the first one, 50 participants took part in an experience sampling study in which they reported their emotions (happiness, relaxation, depression, and anxiety) and autonomous and controlled motivated behaviour 10 times a day for 7 consecutive days. In the second study, 217 students participated in a lab experiment in which we studied the effect of induced anxiety, depression, happiness, and relaxation on autonomous motivated behaviour. The results showed how specific emotions predict autonomous motivated behaviour and that the relationship between the different emotions and autonomous motivated behaviour depends on the emotion under study. By doing so, we demonstrated the important role of emotions in the elicitation of autonomous motivated behaviour. Copyright © 2014 European Association of Personality Psychology     

An internet survey of emotional health,treatment seeking and barriers to accessing mental health treatment among Chinese-speaking international students in Australia

The present internet survey examined the demographic characteristics of Chinese-speaking international students in Australia, psychological distress levels as measured by the Kessler-10 (K-10) Item scale, help-seeking history and preferences, as well as treatment barriers. Of the 144 respondents, 54% reported high psychological distress (mean K-10 score?=?23.96; SD?=?9.03). However, only 9% of those who were highly distressed reported they had sought mental health services in the past year. While the majority preferred help from informal social networks, they tended to favour mental health services over traditional culture-specific forms of help. Common barriers to accessing mental health services reported by respondents with high psychological distress included costs or transportation concerns, limited knowledge of available services, time constraints, the perception that symptoms were not severe enough to warrant treatment, language difficulties and lack of knowledge of symptoms of psychological distress. Although the majority preferred face-to-face treatments over internet treatments, a considerable percentage of respondents were willing to try either treatment modality. Chinese-speaking international students are a high risk group for developing psychological distress, yet they tend to underuse mental health services. Education about the effectiveness of face-to-face and online treatments may increase treatment seeking by this population.     

心理学的想象力与行动力

本文由心理学与内卷化问题切入讨论,提出心理学应该具备想象力与行动力.想象力的培养可以借助人类学、历史学、哲学等学科的视野.行动力则需要树立相应的观念,面向社区、生活与人民群众.知行合一或许是可能的选择.