Intraclass Correlation Associated with Therapists: Estimates and Applications in Planning Psychotherapy Research

It is essential that outcome research permit clear conclusions to be drawn about the efficacy of interventions. The common practice of nesting therapists within conditions can pose important methodological challenges that affect interpretation, particularly if the study is not powered to account for the nested design. An obstacle to the optimal design of these studies is the lack of data about the intraclass correlation coefficient (ICC), which measures the statistical dependencies introduced by nesting. To begin the development of a public database of ICC estimates, the authors investigated ICCs for a variety outcomes reported in 20 psychotherapy outcome studies. The magnitude of the 495 ICC estimates varied widely across measures and studies. The authors provide recommendations regarding how to select and aggregate ICC estimates for power calculations and show how researchers can use ICC estimates to choose the number of patients and therapists that will optimize power. Attention to these recommendations will strengthen the validity of inferences drawn from psychotherapy studies that nest therapists within conditions.     

Therapist Awareness of Client Resistance in Cognitive-Behavioral Therapy for Generalized Anxiety Disorder

Clients' resistance relates negatively to their retention and outcomes in psychotherapy; thus, it has been increasingly identified as a key process marker in both research and practice. This study compared therapists' postsession ratings of resistance with those of trained observers in the context of 40 therapist–client dyads receiving 15 sessions of cognitive-behavioral therapy for generalized anxiety disorder. Therapist and observer ratings were then examined as correlates of proximal (therapeutic alliance quality and homework compliance) and distal (posttreatment worry severity) outcomes. Although there was reasonable concordance between rater perspectives, observer ratings were highly and consistently related to both proximal and distal outcomes, while therapist ratings were not. These findings underscore the need to enhance therapists' proficiency in identifying important and often covert in-session clinical phenomena such as the cues reflecting resistance and noncollaboration.     

Social Workers and Battered Women: The Need to Study Client Violence in the Domestic Violence Field

Domestic violence is a significant issue for the United States and internationally. Although many social workers may desire to work in the domestic violence field, such work is far more difficult and challenging than many social workers would expect. In fact, many domestic violence workers are abused by their clients or their clients' family members in the course of their work. The purpose of this article is to clarify why examining client violence toward workers in the domestic violence field is critically important, describe the current state of the research, and discuss recommendations for future research in this area.     

The prevalence,risk factors and outcomes of workplace bullying among junior doctors: a systematic review

ABSTRACT

Junior doctors’ exposure to bullying may impact their training and compromise quality healthcare, yet little is known in relation to its predictors and effects. The aim of this paper is to assess the prevalence, factors and outcomes of workplace bullying among junior doctors. Literature search was performed to identify all primary studies examining workplace bullying among junior doctors using the following electronic databases: Medline, Scopus, Web of Science, PsycINFO and Cochrane Library. A total of 18 articles were included, reporting on a total of 9,597 junior doctors. The quality of evidence can be rated as moderate according to the Newcastle Ottawa Scale. From the review, a wide range (30–95%) of bullying prevalence, significant differences in bullying rates according to gender, age, height, ethnicity and subspecialty, and significant associations between bullying and mental strain, job dissatisfaction, burnout, and increased accidents at work were observed. Concurrently, heterogeneity in the terms and methodologies used to examine workplace bullying as well as definitional issues in relation to the persistency of negative interactions were noted. Evidence suggests that workplace bullying is a serious occupational hazard for junior doctors, and more research is warranted to better understand this phenomenon and address its definitional and methodological issues.     

教师工作压力与职业枯竭的关系：职业承诺的调节效应

应用工作压力、职业枯竭和职业承诺问卷对中小学教师2114人进行调查,主要探讨职业承诺对工作压力与职业枯竭关系的调节效应。结果发现：工作压力与职业枯竭的情绪衰竭、非人性化、认知枯竭具有显著正相关,情感承诺、规范承诺与职业枯竭具有显著负相关;教师职业承诺以及所包括的情感承诺、留职承诺、规范承诺对工作压力与职业枯竭关系具有负向调节效应;不同教龄段教师在职业枯竭不同方面存在差异。     

The Use of Self of the Therapist

This article explores how the Satir model facilitates the development of the self of the therapist, which Virginia Satir strongly advocated. Discovering and developing creative ways to externalize the internal hidden processes of people, she invited therapists to work on their own unresolved issues in their training through various methods such as: family of origin, family reconstruction, ingredients of an interaction, and parts party. Her goal was to increase self-esteem, foster better choice making, increase responsibility, and facilitate personal congruence through a therapeutic process. Although very relevant in the training and professional development of therapists, there has been little exploration or research of this topic.     

Social Support, Job Stress, Health, and Job Satisfaction Among Nurses in the United Kingdom

Recruitment and retention of nurses is a major concern in healthcare provision in several countries. This study explored the relationship between perceived social support, job stress, health, and job satisfaction among nurses from 4 organizations in northwest England. A total of 350 usable questionnaires measuring stressors, perceived support, health, and job satisfaction, was obtained from a sample of 1,162 nurses drawn from 4 healthcare organizations. A follow-up study was conducted after 6 months. Results indicate that perceived organizational support is related to nurses' health and job satisfaction. Current interventions to increase support, which typically operate at individual or group level, may be limited in their effectiveness unless nurses' perceptions of organizational support are taken into account.     

Is how it is said important? The association between quality of therapist interventions and client processing

This study examined the association between the quality of therapist interventions and client in‐session processing using the York Therapist Process Measure (YTPM; Toukmanian and Armstrong, 1998). The instrument's three dimensions — attunement, tentativeness and meaning exploration — were tested separately for their impact on clients' manner of processing and depth of experiencing. For each of the 20 mild‐moderately depressed clients, treated in short‐term experiential therapy, a high and a low client‐process segment was isolated from a session that was judged by an experienced therapist to manifest the greatest amount of “good therapy moments”. Therapist interventions within these segments were then rated on the YTPM. Results revealed significant differences in the quality of therapist interventions between high and low segments. Attunement and tentativeness were associated significantly with greater complexity in manner of processing, and meaning exploration with greater depth in experiencing. The implications of these findings for psychotherapy research and practice are discussed.     

工作压力的研究现状与方向

工作压力的研究在西方已经进行了多年,并受到越来越多的注意,但在我国研究还较少。本文从工作压力的定义、对于工作压力的测量、影响工作压力产生的因素、工作压力的后果、以及应对这几个方面介绍这一领域目前的研究现状并提出作者认为这一领域现存的问题和今后的研究方向。     

Creative Occupational Therapist: It's About the Client Using Focus Groups to Explore Creativity in Occupational Therapy

Although creativity is an important aspect of occupational therapy theory and practice, there have been few studies that would explore this concept in the context of the occupational therapy process. This was the first qualitative study of creativity in occupational therapy in Slovenia. It was conducted as part of a larger mixed-methods study and included 22 experienced occupational therapists who participated in four focus groups. The focus of the study was on the exploration of different factors that could contribute to creativity and creative strategies in occupational therapy, in either a positive or a negative way. Since occupational therapy promotes a client-centered therapy approach, the role of the client as the motivating factor was of particular interest to our study. Six factors that can influence the creativity of occupational therapists emerged from the qualitative analysis (Strauss & Corbin, 1990). While the client was identified as the key factor, the potential of other factors was also recognized. This qualitative study increased the understanding of the concept of creativity and creative behavior in occupational therapy, and also provided empirical material that formed the basis for the development of a questionnaire on creativity in occupational therapy.