Family therapy ‘lite’? How family counsellors conceptualise their primary care family work

A number of current developments in the field potentially provide opportunities for preventative relationship and family interventions to be integrated into primary care. In this context, it is important to understand what family counselling is and how it might differ from family therapy. Thus, this paper investigates how the service of one low-intensity family counselling provider, Relate, is conceptualised and practised by counsellors on the ground. Questions about practice were posed to five focus groups of family counsellors and these were analysed using thematic analysis. The findings suggest that Relate family counselling is seen as ‘family therapy lite’, with a flexible, eclectic and integrative use of concepts and techniques within a systemic framework. Implications of this conceptualisation of family counselling for training, practice and research are discussed.     

未来情景思考对目标达成的双刃作用及其机制

未来情景思考指个体想象并预先感受某个可能在未来发生的自我相关情景事件的心理加工,它对目标达成可产生双刃影响:一些思考方式会妨碍目标达成,如想象理想的结果或过程;而另一些思考方式则会促进目标达成,如过程模拟和想象较为消极的目标相关场景。对于未来情景思考是促进还是妨碍目标达成,动机水平的高低和执行意向的清晰程度可能是关键调节因素,相应的干预策略可通过增强这两者而将未来情景思考对目标达成的妨碍作用转化为促进作用。进一步的研究需系统探讨不同方式的未来情景思考影响目标达成的认知神经机制,并对目标特征和人格特点如何调节未来情景思考对目标达成的影响进行探讨。     

Integrating Sex Therapy Interventions with Couple Therapy

This conceptual/clinical paper presents a couple, integrative, psychobiosocial model of assessment, treatment, and relapse prevention for common sexual dysfunctions. The goal is to encourage couple therapists to integrate sexual permission-giving, scientifically and clinically relevant sexual information and guidelines, and specific sexual suggestions/interventions into their couple work. The artificial barriers between couple and sex therapy is to the detriment of couples who need to address intimacy and sexuality problems.     

结直肠癌多学科专家组诊疗模式

结直肠癌多学科专家组诊疗模式(colorectal cancer multidisciplinary team,CRC-MDT),最早始于英国,它以病人为中心,多个学科共同参与诊治过程,制定出最适合病情的多模式相结合的科学合理的诊疗方案。此后,结直肠癌多学科专家组诊疗模式逐渐在德国、法国、意大利、美国等医疗中心相对集中的国家得到推广和完善。北京大学人民医院胃肠外科于2002年成立了包括内科、外科,病理科、影像科等8个学科专家组成的胃肠MDT。越来越多的临床实践证实,结直肠癌多学科专家组的诊疗方案,更具有科学性和合理性,明显改善结直肠癌病人预后,增加了患者的临床获益。目前,结直肠癌多学科专家组诊疗模式在世界范围内已经成为现代医院医疗体系的重要组成部分。结直肠癌MDT模式不只是对患者进行多学科会诊,而是对整个医疗过程全程指导,促进学科间的交流,增进学科间了解。在欧美CRC-MDT发展完善的地区,人们的目光不仅关注MDT在结直肠癌诊治中的应用,而且注意到了MDT作为一套宏观的医疗管理模式,在结直肠癌诊治流程运作中的社会效益、经济学价值的推动作用。     

Adding “Circle of Security – Parenting” to treatment as usual in three Swedish infant mental health clinics. Effects on parents’ internal representations and quality of parent‐infant interaction

This study presents effects of adding Circle of Security‐Parenting (COS ‐P) to an already established comprehensive therapeutic model for early parent‐child intervention in three Swedish infant mental health (IMH ) clinics. Parents’ internal representations and quality of parent‐infant interaction were studied in a clinical sample comprised of 52 parent‐infant dyads randomly allocated to two comparable groups. One group consisted of 28 dyads receiving treatment as usual (TAU ) supplemented with COS ‐P in a small group format, and another group of 24 dyads receiving TAU only. Assessments were made at baseline (T1), 6 months after inclusion (T2) and 12 months after inclusion (T3). Changes over time were explored in 42 dyads. In the COS ‐P group, the proportion of balanced representations, as assessed with Working Model of the Child Interview (WMCI ), significantly increased between T1 and T3. Further, the proportion of emotionally available interactions, as assessed with Emotional Availability scales (EA ), significantly increased over time in the COS ‐P group. Improvements in the TAU ‐group were close to significant. Limitations of the study are mainly related to the small sample size. Strength is the real world character of the study, where COS ‐P was implemented in a clinical context not otherwise adapted to research. We conclude by discussing the value of supplementing TAU with COS ‐P in IMH treatment.     

Using public feedback to increase contributions to a multipurpose senior center

Multipurpose senior centers are expanding their services to meet the demands of a growing population. Unfortunately, federal agencies have not matched this expansion with monetary support. Many senior centers hold fund-raisers to supplement their budgets, but the impact of these projects is rarely evaluated. This study assessed the effectiveness of a public posting strategy designed to increase donations to an ongoing fund-raiser for a multipurpose senior center. The fund-raiser, "Coupons for Caring," consisted of senior volunteers clipping grocery coupons from newspapers, sorting them, and attaching them to their respective products in local grocery stores. Grocery store customers were given the option of donating the coupons to the senior center or redeeming them when they purchased the products to which the coupons were attached. In the experimental condition, signs were posted that included visual and written instructions, feedback on the value of coupons donated by customers the previous week, and feedback on the overall amount of money donated to the senior center. The signs were posted near each cashier stand and at the front entrances of the grocery stores in a multiple baseline across grocery stores. The percentage of coupons donated to the senior center increased at each store after the signs were posted.     

Challenges in Defining and Developing the Field of Rural Mental Disorder Preventive Intervention Research

An overview of selected issues and challenges in defining and developing the field of rural preventive intervention research is presented. One fundamental challenge is to clarify the distinguishing characteristics of prevention science in rural contexts. Other challenges are evident in the need to address: the lack of consensus on conceptual and methodological approaches to this field, limited empirical study to date, the tremendous diversity of rural populations, and inconsistencies in the usage of the term rural. This article suggests the organization of a work group to formulate and implement a clear research agenda. In addition, several general questions are discussed that, if addressed, might serve to better define and further develop the field. These questions concern the implications of multiple approaches to prevention science in rural contexts, the classification of rural populations, the functional relevance of rural residence in the etiology of specific disorders, the application of extant etiological models to interventions designed specifically for rural populations, the conduct of rural area prevention needs assessments, the development of models for collaboration between intervention researchers and rural community stakeholders, and strategies to engage rural residents in preventive interventions.     

Issues in group work with older lesbians

This article outlines considerations in group interventions with older lesbians. It is intended for mental health professionals who work—as leaders, supervisors, and consultants—with various kinds of groups in their professional practice, including therapy, psychoeducational, support, growth, recreational, and self-help groups. First, unique issues in the life circumstances of older lesbians are addressed. Next, five case examples are presented that illustrate the usefulness of group interventions with this population. The article concludes with recommendations for effective practice.     

Goal-setting in diabetes self-management: A systematic review and meta-analysis examining content and effectiveness of goal-setting interventions

Background: Goal-setting is recommended and widely used within diabetes self-management programmes. However, empirical evidence around its effectiveness lacks clarity. This review aims to evaluate the effectiveness of goal-setting interventions on diabetes outcomes and to determine which behaviour change techniques (BCTs) are frequently used within these interventions.

Methods: A systematic search identified 14 studies, describing 12 interventions targeting diabetic-control which incorporated goal-setting as the main intervention strategy. Study characteristics, outcome measures and effect sizes of the included studies were extracted and checked by two authors. The BCT taxonomy v1 was used to identify intervention content. Meta-analyses were conducted to assess intervention effects on the primary outcome of average blood glucose levels (HbA1c) and on body-weight. Psycho-social and behavioural outcomes were summarised in narrative syntheses.

Results: Significant post-intervention improvements in HbA1C were found (?.22, 95% CI, ?.40, ?.04) across studies. No other main effects were identified. The BCT ‘goal-setting (behaviour)’ was most frequently implemented and was identified in 84% of the interventions.

Conclusions: Goal-setting interventions appear to be associated with reduced HbA1C levels. However, the low numbers of studies identified and the risk biases across studies suggest more research is needed to further explore goal-setting BCTs in diabetes self-management.