Making a difference for young people with learning disabilities: A model for inclusive counselling practice

The prevalence of mental health problems in young people with learning disabilities and the disability rights movement provide the background to this paper. The aims are to investigate the inclusivity of counselling; gain insight into inclusive practices; and put forward a model for inclusive counselling practice. Mixed methodology provides quantitative and qualitative data through a survey of counsellors (n = 396) and a series of semi‐structured interviews (n = 15). The results produce six indicators of inclusive counselling, which are used to build a model for inclusive counselling practice: proactive approach to inclusion; focus on building relationships; operationalising equal opportunities policies; inclusive initial assessments; adopting flexible and creative approaches to counselling; and training and awareness raising. The implications for research and practice are to acknowledge the exclusive nature of the profession and address the issue of inclusion through training, professional development and further research in the field. The model for inclusive counselling practice is put forward as a tool for auditing existing counselling provision and as guidance for counsellors and policy makers in increasing inclustion of young people with learning disabilities in mainstream counselling.     

The effectiveness of counselling with older people: Results of a systematic review

In 2003 the British Association for Counselling and Psychotherapy (BACP) commissioned a systematic review of the research evidence relating to counselling older people. This paper reports on some of the findings of this review, particularly those which address the effectiveness of counselling with this population. Electronic searches of the research literature spanned six databases and were supplemented by hand‐searches of reference lists and key journals, along with an extensive search of the “grey” literature. The location of papers testing interventions which fall within a definition of counselling set out by the BACP, with samples aged 50 years of age or above resulted in the inclusion of 47 relevant studies. Studies investigated a variety of mental health problems in older people, particularly depression, anxiety, dementia and the psychological impact of physical conditions such as chronic obstructive pulmonary disease. Of the 47 studies, eight tested counselling as a generic treatment, 15 tested cognitive behavioural therapy, 13 tested reminiscence therapy, and 11 tested various other specific approaches. The review concluded that counselling is efficacious with older people, particularly in the treatment of anxiety and depression and outcomes are consistent with those found in younger populations. Evidence as to the efficacy of counselling interventions in the treatment of dementia is weak.     

虚拟现实技术在心理治疗中的应用

虚拟现实系统具有良好的沉浸性、互动性和构想性而被广泛应用于军事、工业、建筑、教育等诸多领域。近年来,国外一些研究者将虚拟现实技术用于恐惧症、社交焦虑症、创伤后应激性障碍和厌食症等心理疾病的治疗,并取得了良好效果。本文简要介绍了国外在方面开展的主要工作,并对未来的研究趋势进行了展望。     

Ethical Care for Vulnerable Populations Receiving Psychotropic Treatment

The increasing use of pharmacotherapy raises specific ethical concerns for psychologists working with vulnerable populations. Due to a shortage of trained specialists, professionals without training in mental health, such as primary care providers, are increasingly prescribing and monitoring psychotropic medications. Vulnerable populations (e.g., older adults, people currently low in social status, immigrants, and racial/ethnic minorities) face additional barriers to mental health treatment and are at heightened risk when these factors intersect. Hence, these patients experience unique barriers to receiving optimal psychopharmacological care and are differentially vulnerable to deleterious outcomes associated with misdiagnosis and overmedication. Taken together, these factors fuel inequities in the access, quality, and utilization of mental health care. Psychologists working with these patients are ethically mandated to protect patients from harm and ensure equitable care across patient populations. Specifically, psychologists must respond to the dilemma of how to effectively treat patients within these vulnerable populations who have been misdiagnosed or poorly medicated while remaining within the bounds of their competence. This article recommends pathways to address these dilemmas through education, training, research, and advocacy.     

Clinical Approaches to Conflicts Between Religious Values and Same‐Sex Attractions: Contrasting Gay‐Affirmative,Sexual Identity,and Change‐Oriented Models of Therapy

The literature germane to the care of clients presenting for psychotherapy with conflicts between their sexual orientation and religious values typically addresses the topic from within a particular therapeutic approach. This article addresses the issue from a broader perspective that takes into account 3 different paradigms: gay‐affirmative therapy, sexual identity therapy, and change‐oriented therapy. The authors describe the 3 approaches, compare and contrast them across several different key dimensions of theory and practice, and identify some strengths and potential limitations of each approach for assisting clients who are attempting to navigate the resolution of their conflict.     

Self-Healing Aspects of EMDR: The Therapeutic Change Process and Perspectives of Integrated Psychotherapies

Eye Movement Desensitization and Reprocessing (EMDR) (Shapiro 1989a, 1989b, 1995) is an innovative, comprehensive approach to psychotherapy. While EMDR's use of eye movements has attracted a great deal of attention, the efficacy of the EMDR method can be explained parsimoniously in terms of many different types of therapy. Lang's (1985) information processing networks provide a way to understand the Accelerated Information Processing model proposed by Shapiro to explain EMDR. A representative EMDR session is presented to illustrate the integrative components of EMDR's procedural elements and the range of clinical effects. Therapeutic changes seen as a result of self-healing using EMDR are discussed from the perspectives of other psychotherapeutic approaches in order to understand the contribution of EMDR to the psychotherapy integration movement.     

国外自杀心理学研究与理论评介

以自杀致病理论、自杀评估理论、自杀治疗理论为线索,回顾与总结了国外近十年来的自杀心理学理论与研究概况,同时重点介绍了致病理论中的应激—易感模型、逃避自我理论、杀死自我理论;自杀评估理论中的SSF评估、四阶段过程模式;自杀治疗理论中的SATIR理论和荣格艺术治疗理论等,并做了简短评论     

A randomized clinical trial comparing affect regulation and social problem-solving psychotherapies for mothers with victimization-related PTSD

Addressing affect dysregulation may provide a complementary alternative or adjunctive approach to the empirically supported trauma memory processing models of cognitive behavior therapy (CBT) for posttraumatic stress disorder (PTSD). A CBT designed to enhance affect regulation without trauma memory processing—trauma affect regulation: guide for education and therapy (TARGET)—was compared to present centered therapy (PCT) and wait-list (WL) conditions in a randomized clinical trial with 146 primarily low-income and ethnoracial minority mothers with PTSD. TARGET achieved statistically and clinically significant improvement on PTSD and affect regulation measures compared to WL, with more consistent and sustained (over a 6-month follow-up period) evidence of improvement than PCT. Drop-out rates (~ 25%) were comparable in TARGET and PCT, similar to those previously reported for trauma memory processing CBTs. Symptom worsening was rare (2–8%) and transient. Affect regulation-based CBT without trauma memory processing warrants further research as a potentially efficacious therapy for victimization-related PTSD.