Guided Recovery: An Interpretative Phenomenological Analysis of Service Users’ Experiences of Guided Self-Help for Bulimic and Binge Eating Disorders

The efficacy of Cognitive Behavioral Therapy–based Guided Self-Help for mild to moderate bulimia and binge eating disorders has been well supported. However, limited research has explored in-depth individual experiences of this treatment approach. In-depth semi-structured interviews were conducted with 4 individuals who had completed Cognitive Behavioral Therapy–based Guided Self-Help (CBT-GSH) for bulimic or binge eating disorders. The interviews were transcribed verbatim and subsequently analyzed using Interpretative Phenomenological Analysis (IPA). Three superordinate themes emerged: Autonomy and volition; A dynamic relationship: the guided and the guide; and The unwanted friend. The reciprocal nature of the guide/guided relationship was identified as integral to the success of the therapeutic approach. However, participants expressed initial uncertainty towards the therapeutic process, and experienced an uncomfortable dissonance between a lack of volition in therapy seeking and the need to continually self-prescribe CBT-GSH. The findings affirm the central role of the guide in promoting motivation to engage with therapy and highlight the potential benefits of in-session weighing. However, it may be necessary to provide additional support on commencing CBT-GSH to address concerns about the therapeutic approach in this group.     

Early Eye Movement Desensitisation and Reprocessing (EMDR) intervention in a disaster mental health care context

‘Early psychological intervention’ is defined as commencing treatment within three months of the traumatic event, with the aim to prevent or treat posttraumatic stress disorder, ongoing distress or acute stress disorder. In natural disaster situations, specific issues may limit the amount of time available for treatment and the possibility of interventions. Eye Movement Desensitisation and Reprocessing (EMDR) can be used without regard to these limits. The aim of the study is to evaluate the effects of EMDR, Recent Traumatic Episode Protocol (R-TEP) provided within three months of the traumatic event to a large sample of individuals exposed to the earthquake that hit Emilia Romagna Region (Northern Italy) in 2012. This study is based on a retrospective review of medical records collected during the activities of psychological and psychosocial unit in the immediate aftermath of earthquake. In total, 529 participants completed the Impact of Event Scale Revised (IES-R) (pre e post treatment). In order to provide a comparison similar to a waitlist-like control group, a method of cohort analysis was applied. In addition, possible time dependent effect was tested. ET (early-treated sample, participants treated within one month after the earthquake) and LT (late-treated sample, participants treated after the first month from the earthquake) reported at post-treatment an improvement to a level below the IES-R cutoff (65.8% of the ET sample and 64.02% of the LT sample). Control group analogue and time-outcome correlation suggest that positive changes in symptoms were likely due to the treatment provided and not merely to the time lapse from the traumatic event. The results of this study suggest that EMDR is a viable treatment option in response to a disaster crisis and in reducing psychological distress of acutely traumatized individuals within the context of a natural disaster.     

Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity

Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention’s impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation.     

Safe and unsafe school spaces: Comparing elementary school student perceptions to common ecological interventions and operationalizations

There is a burgeoning literature on school safety in the United States. Often, researchers determine the problem and intervention. Few studies, however, examine how students understand school safety. In this study, elementary school students in the United States (n = 225) marked safe and unsafe school places; this was correlated with other commonly used school safety measures. Results indicate that children have different perceptions of safety based on school location. Additionally, for older children, unsafe places correlated with injury data, adult absence and low levels of territoriality. For younger children, unsafe places were associated with adult absence and referrals. Safe places were places that were more likely to have an adult. Results bring into question some common safety interventions. Implications include working with children to determine what is meant by ‘safe’ and interventions. Copyright © 2010 John Wiley & Sons, Ltd.     

Gender differences in the person-activity fit for positive psychology interventions

Research on positive psychology interventions (PPIs) has established the value of activities such as acts of kindness, gratitude, and savoring life’s joys, for increasing individuals’ sense of well-being. Critical to the efficacy of PPIs is person-activity fit – the degree activities stem from intrinsic motivation. Although person-activity fit effects are well documented, gaps remain in our understanding of how sociodemographic variables, particularly age and gender, play a role. We investigated how gender may affect self-reported person-activity fit across three PPIs: A gratitude journal; Acts of Kindness; and Savoring life’s joys. Age was explored since the subject sample ranged widely, from 18 to 51?years. Twenty-eight men and 82 women completed person-activity fit questionnaires. A multiple analysis of variance resulted in a main effect for gender, with women showing greater person-activity fit for all three PPIs. Among women only, age correlated significantly with person-activity fit for all three PPIs, suggesting greater maturational variability among men.     

An Ecosystemic Approach to Improving Mother-Infant Attachment in a Caribbean Matrifocal Society

Within an ecosystemic framework integrating a cultural-family approach and Bowlby's attachment theory, this paper describes a mother-infant therapeutic program focusing on a high-risk population of infants from dysfunctional extended matrifocal families in the French Caribbean island of Martinique. Some of the factors involved in the disturbed mother-child attachment relationships were identified, and a multisystemic approach for remodeling both internal family processes and interactions between the family and the larger social system were described. The authors stress the importance of using a combination of specialized and non-specialized services which draw upon, and remain embedded in, the family's ecological context and argue for a conceptualization of extended matrifocal family organizations as being resourceful and resilient systems.     

The Future of Psychology in Academic Health Care Centers

A promising opportunity exists to continue psychology's move beyond its traditional mental health emphasis into a general health care discipline. Abundant empirical evidence supports that psychologists treat a wide array of physical disorders as well as psychological components of medical problems. The immediate issues confronting psychology's full emergence into the health care world are discussed and recommendations are offered to assure the success of this initiative. Office of the Senior Vice President and Provost     

Mandated Interventions with Drug-Dependent, Pregnant Women

Increased concern about the influence of pregnant women's substance use on fetal health has prompted a variety of actions, including calls for legal interventions against some pregnant women with chronic substance abuse problems. In this paper I examine the legal and social science arguments used to support and oppose these interventions. Several assumptions about the behaviors of pregnant women that are used to support the arguments are described. The types of social science research that could inform the ongoing debate about interventions with pregnant women are explored.     

Behavioral Family Interventions for Improving Child-rearing: A Review of the Literature for Clinicians and Policy Makers

This paper reviews evidence that behavioral family interventions are effective at improving child-rearing in distressed families and families with children exhibiting disruptive behavior. Essential therapeutic strategies offered within a collaborative therapeutic process are identified. Exemplary materials for parents and clinicians are identified. Differences between behavioral family interventions and two popular press parenting approaches are highlighted, including the lack of empirical support for these widely used programs and the advice they offer which runs counter to behavioral approaches. Recommendations are offered for combining behavioral family interventions with other empirically supported approaches, promoting more widespread use of empirically supported treatments, such as behavioral family interventions, and the need for a public health perspective on family functioning, involving collaboration among clinicians, policy makers, and researchers.