Defining and Measuring Mechanisms of Change in Psychological Therapies: The Path Not Taken

Metcalf and Dimidjian (this issue) have provided an important review of the current evidence base for mindfulness‐based cognitive therapy (MBCT) and presented a helpful summary of the proposed mechanisms of change. It is necessary to engage in a continuous dialogue regarding the evidence base for change mechanisms, and the article by Metcalf and Dimidjian highlights an important barrier of concern to the field of treatment outcome research. The present commentary aims to expand the discussion regarding the definition, measurement, and evaluation of “mechanisms of change.” Using MBCT as an example, this commentary addresses the ambiguity surrounding the definition and operationalisation of these mechanisms in research on psychological therapies and how the method of measurement may impact the results obtained in clinical trials. It is argued that a potentially fruitful avenue of future research would involve investigation of techniques, important client‐therapeutic processes, and mechanisms in a single study in order to comprehensively evaluate how change occurs.     

A Qualitative Exploration of Sun Safety Beliefs Among Australian Adults

Informed broadly by the theory of planned behaviour, this study used qualitative methodology to understand Australian adults' sun‐protective decisions. Forty‐two adults participated in focus groups where they discussed behavioural (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs, as well as potential social influences and images of tanned and non‐tanned people. Responses were analysed using the consensual qualitative research approach to determine the dominant themes. Themes of fashion and comfort were prominent, the important role of friends and family in sun safe decision‐making was highlighted, as was the availability of sun‐protective measures (e.g., in an accessible place or in the environment). Additional themes included the need to model sound sun‐protective behaviours to (current and future) children, the emphasis on personal choice and personal responsibility to be sun safe, and the influence of Australian identity and culture on tanning and socially acceptable forms of sun protection. These beliefs can be used to inform interventions and public health campaigns targeting sun safety among Australians, a population with the highest skin cancer incidence in the world.     

Psychoanalytic training experience and postgraduate professional development: A survey of six decades of graduate analysts

This exploratory study explored the training and post‐training experience of graduates of the Chicago Institute for Psychoanalysis. All living graduates of the past six decades were invited to complete a survey that addressed their training analysis, classroom work, supervision and other training experiences as well as their degree of post‐graduation involvement in teaching, supervising, study groups and other professional endeavors. They were also asked to rate their sense of themselves as psychoanalysts and their satisfaction with their analytic career. Further, they were encouraged to provide spontaneous narrative data. Our findings contribute to the current understanding of the careers of psychoanalysts – including that there is a difference in generational cohorts regarding professional satisfaction, identification as an analyst, and experience of training. We also found that there are no real differences between analysts who do and do not have analytic patients on some important variables: supporting analysis as a treatment method, identifying oneself professionally with psychoanalysis, and disillusionment with psychoanalysis – which is consistent with other studies. Also discovered were differences between male and female analysts' perception of certain aspects of their training.     

The Prevalence and Prevention of Crosstalk: A Multi-Institutional Study

It is a common problem in psychology subject pools for past study participants to inform future participants of key experimental details (also known as crosstalk). Previous research (Edlund, Sagarin, Skowronski, Johnson, & Kutter, 2009) demonstrated that a combined classroom and laboratory treatment could significantly reduce crosstalk. The present investigation tested a laboratory-only treatment for the prevention of crosstalk at five universities, along with institutional-level moderators of crosstalk. Results indicated the presence of crosstalk at all universities and that the laboratory-based treatment was effective in reducing crosstalk. Importantly, crosstalk rates were higher (but successfully neutralized) in research pools with higher research credit requirements. Therefore, this research provides valuable guidance regarding crosstalk prevalence and its minimization by researchers.     

The Self’s Symbolic Role in Implicit Approach/Avoidance: Movement Time Evidence

Theories of self-regulation emphasize the special role that the symbolic self may play in approach and avoidance movements, but experimental evidence is lacking. In two experiments (total N = 157), participants moved either a self-relevant (e.g., “me”) or non-self (e.g., “not me”) agent to one of two locations, one occupied by a positive word and the other occupied by a negative word. In both experiments, the movement agent interacted with the destination valence such that it was only the symbolic self that moved more quickly to positive rather than negative locations. These results established a role for the symbolic self in approach/avoidance that had been questioned, thereby supporting both classic and contemporary self-related theories of approach and avoidance.     

Effects of Group Activity Play Therapy on Problem Behaviors of Preadolescent Ugandan Orphans

This randomized controlled study examined the effectiveness of group activity play therapy (GAPT) with 60 displaced Ugandan orphans, ages 10 to 12 years, exhibiting clinical levels of behavior problems. Teachers and housemothers reported that experimental group children demonstrated statistically significant reductions (p < .025) in behavior problems compared with children in the active control condition and that GAPT demonstrated moderate to large treatment effects. Results support GAPT as an effective intervention for troubled Ugandan orphans.     

A Protective Factors Model for Alcohol Abuse and Suicide Prevention Among Alaska Native Youth

This study provides an empirical test of a culturally grounded theoretical model for prevention of alcohol abuse and suicide risk with Alaska Native youth, using a promising set of culturally appropriate measures for the study of the process of change and outcome. This model is derived from qualitative work that generated an heuristic model of protective factors from alcohol (Allen et al. in J Prev Interv Commun 32:41–59, 2006; Mohatt et al. in Am J Commun Psychol 33:263–273, 2004a; Harm Reduct 1, 2004b). Participants included 413 rural Alaska Native youth ages 12–18 who assisted in testing a predictive model of Reasons for Life and Reflective Processes about alcohol abuse consequences as co-occurring outcomes. Specific individual, family, peer, and community level protective factor variables predicted these outcomes. Results suggest prominent roles for these predictor variables as intermediate prevention strategy target variables in a theoretical model for a multilevel intervention. The model guides understanding of underlying change processes in an intervention to increase the ultimate outcome variables of Reasons for Life and Reflective Processes regarding the consequences of alcohol abuse.     

Motivos de los ciudadanos para realizar ejercicio físico: un estudio desde la teoría de la autodeterminación

Based on self-determination theory, the objective of this study was to analyze the relationship between the reasons for exercise and its reported weekly frequency in a representative sample of an adult urban population. A total of 918 inhabitants, aged between 16 and 89, participated in this study answering the Spanish version of the Exercise Motivations Inventory-2 (EMI-2) and reporting on their exercise frequency. Controlling for the influence of age and gender, multivariate analysis of covariance (MANCOVA) showed that participants who reported the highest exercise frequency had the highest score on both self-determined and controlling exercise motives, except the ill-health avoidance motive. The results support propositions of self-determination theory, and suggest that citizens may internalize exercise behaviour as they become more physically active. However, the results also suggest that some controlling motives are pertinent to exercise. Decision makers of the local sport policy should look into suitable ways of combining both controlling motives and more internalized motives in order to produce long lasting exercise adherence in citizens.