Does Motivational Interviewing (MI) Work With Nonaddicted Clients? A Controlled Study Measuring the Effects of a Brief Training in MI on Client Outcomes

This study investigated the relationships between motivational interviewing (MI) and client symptoms, attendance, and satisfaction. Seventy‐nine clients attending a university‐based counseling center were purposefully assigned to treatment or control conditions. Statistical analyses revealed client symptoms in both groups improved. However, clients assigned to treatment conditions attended more sessions and missed fewer sessions than clients in the control group. Implications for using MI and suggestions for additional research are explored within the study.     

To be in touch

This study examined the constellation of interaction structures – repetitive patterns of interactions between patient and therapist over the course of treatment – that emerged in the psychodynamic therapy (PDT) of a child diagnosed with borderline personality disorder and treated by two doctoral student therapists. Identification of these interaction structures can inform therapists of what might be expected from patients with particular symptom or behaviour patterns and how interactions change over time. This study also examined each session’s adherence to three session prototypes: PDT, cognitive-behavioural therapy (CBT) and reflective functioning (RF) process. The Child Psychotherapy Q-Set (CPQ) is a 100-item instrument that assesses the processes within a single psychotherapy session. Items reflect a wide range of therapist attitudes and behaviours, patient attitudes and behaviours and interactions between therapist and patient. Experts used the CPQ to define PDT, CBT and RF process session prototypes. The results suggested that four distinct interaction structures could be identified and that their constellations differed between the two therapists and also differed over time within each treatment. Therapists were more structured and accommodating early on in their treatments and more interpretive later. Prototypical PDT process was more prominent in the sessions than RF process, which in turn was more prominent than CBT process. Unique therapeutic processes are at work in every dyad, despite holding the patient and theoretical orientation constant. An effective treatment in one dyad might not work in another due to therapist-specific and dyad-specific effects.     

Avoiding unbearable pain

This presentation describes the way in which defence mechanisms and resistance manifested themselves in the analysis of a man with a narcissistic personality disorder. In the course of the analysis, there were changes in the forms taken by the defence and the resistance, signalling important genetic and dynamic conditions in his life. Both represented desperate attempts to avoid the unbearably painful feelings and affects which he had experienced in his childhood, and bore witness to early and primitive defence mechanisms such as denial, splitting and projective identification. The defence can also be seen as an expression of an unconscious fear of being re-traumatised. The idealisation of the analyst in the first years of the analysis can therefore be understood as a precondition for entering into this kind of process. It also represented a defence against aggressive and homosexual feelings in the transference which first became clear during the final phase of the analysis and could then be worked through. At this point, the analyst's reactions to his own unconscious countertransference were of help in understanding what was actually going on. This analysis may also suggest that defects and trauma in the earliest years may be conducive to alexithymia, deficient contact between feelings and words, linked to the risk of developing serious psychosomatic illnesses. This may be a consequence of the fact that the child's feelings and affects were neither accepted, understood nor affirmed in words, or they may even have been met with rejection or ridicule. A connection between narcissistic personality disorders and alexithymia can possibly be seen here.     

Family and Cultural Predictors of Depression Among Samoan American Middle and High School Students

This study investigated family intergenerational conflict and collective self‐esteem as predictors of depression in a sample of 128 Samoan middle and high school students. Simultaneous regression analyses revealed that each independent variable significantly contributed to an overall model that accounted for 13% of the variance in depression. Implications for counseling research and practice are discussed in terms of how schools may consider ways to promote these youth's cultural worth and positive family dynamics. Este estudio investigó el conflicto familiar intergeneracional y la autoestima colectiva como predictores de depresión en una muestra de 128 estudiantes samoanos de enseñanza media y secundaria. Los análisis simultáneos de regresión revelaron que cada variable independiente contribuyó de forma significativa a un modelo general que explicó un 13% de la varianza en depresión. Se discuten las implicaciones para la investigación y práctica de la consejería, en términos de cómo las escuelas pueden considerar formas de promover el valor cultural de estos jóvenes y una dinámica familiar positiva.     

Social cognitions measured in 4 to 6 year olds are predictive of objectively measured physical activity

Objective: This study tested whether social cognitions from the reasoned action approach (RAA) can be reliably measured in a sample of primary school children (aged 4–6 years) and whether these RAA measures are predictive of physical activity.

Design: Longitudinal observational study with repeated measures over six months.

Measures: RAA variables were measured using a novel choice paradigm between physically active and sedentary pastimes. Relative reinforcing value, covariates (sex, age, deprivation and BMI) and physical activity by accelerometry (primary outcome) were also measured.

Results: RAA cognitions could be measured with acceptable retest reliability and discriminant validity and social norms regarding parents and teachers (but not friends) were correlated with physical activity and change in physical activity when relative reinforcing value and other covariates were controlled for.

Conclusions: RAA cognitions can be reliably measured in primary school children aged 4–6 and RRA measures appear useful in understanding children’s activity choices and may potentially inform future interventions.     

Predictors of reading fluency in Italian orthography: Evidence from a cross-sectional study of primary school students

This study investigates the role of linguistic and visuospatial attentional processes in predicting reading fluency in typical Italian readers attending primary school. Tasks were administered to 651 children with reading fluency z scores > ?1.5 standard deviation to evaluate their phonological awareness, rapid automatized naming (RAN), verbal short-term memory, vocabulary, visual search skills, verbal-visual recall, and visual-spatial attention. Hybrid models combining confirmatory factor analysis and path analysis were used to evaluate the data obtained from younger (first and second grade) and older (third–fifth grade) children, respectively. The results showed that phonological awareness and RAN played a significant role among younger children, while also vocabulary, verbal short-term memory, and visuospatial attention were significant factors among older children.     

The role of perfectionism in cognitive behaviour therapy outcomes for clinically anxious children

The main aim of this study was to determine whether pre-treatment levels of child perfectionism impacted on anxiety treatment outcomes for school-aged children. In addition, it was investigated whether child perfectionism decreased following treatment for anxiety. Participants were sixty-seven clinically anxious children aged 6–13 years (female = 34; majority Caucasian) who were enrolled in a group-based cognitive behaviour therapy program, and their parents. They completed self-report questionnaires on anxiety and depressive symptoms and were administered a diagnostic interview to determine the type and clinician rated severity of anxiety and related disorders pre- and post-treatment and at 6-month follow-up. Self- and parent-rated perfectionism were also measured pre-treatment, while a subset of children completed perfectionism measures post-treatment as well. Self-Oriented Perfectionism, but not Socially Prescribed Perfectionism, predicted poorer self-reported treatment outcome (higher levels of anxiety symptoms) immediately following treatment and at 6-month follow-up when using a multi-informant approach. Additionally, both Self-Oriented and Socially Prescribed child perfectionism significantly reduced immediately following treatment. Despite reductions in child perfectionism following anxiety treatment, higher Self-Oriented Perfectionism may impact negatively on child anxiety treatment outcome.     

Emotional Intelligence and the Identity Negotiation of a Racial Minority Group in a Majority School Context

This article describes the possible impact of emotional intelligence on identity negotiation of a racial minority group in a majority school context. The study investigated the adjustment and functioning of racial minority groups in majority school contexts, as well as the identity negotiation associated with it, and determined whether there is a correlation between the former and the Emotional Intelligence (EI) of the participants. Participants were 16 black and 21 white learners attending two schools where they were in the minority (mean age = 16.23 years; SD = 1.49 years). The learners attended Grades 9–12. Data were first organised, after which themes and patterns were identified, and the data appraised and categorised (Creswell, 2007), after which a comparison was drawn between the identified categories of existing knowledge. Findings suggest that racial integration in both high schools actually occurred in name only; most participants chose to mingle within their own racial groups and the black participants in particular were exposed to racism, discrimination and prejudice on a regular basis. Despite the necessary steps taken and implemented by government in order to oppose racism in the country and promote racial integration in schools, it seems that the consequences of apartheid remain for the foreseeable future.     

Therapeutic outcomes in the Welsh Government's school‐based counselling strategy: An evaluation

Aims: The purpose of this study was to evaluate the outcomes of school‐based counselling, as delivered in the Welsh Government's School‐based Counselling Strategy, for reducing psychological distress in young people aged 11–18. Method: The study used a quantitative cohort design, comparing levels of distress on either the Young Person's CORE (YP‐CORE) or the Strengths and Difficulties Questionnaire (SDQ) from baseline to endpoint. Data were available on 3613 episodes of counselling, across 42 datasets. Meta‐analytical procedures were used to identify the mean effect size and predictors of outcomes. Results: Within each dataset, counselling was associated with significant reductions in psychological distress, with a mean effect size (d) of 0.93(95% CI = 0.89–0.97) using a fixed effects model and 1.09 (95% CI = 0.97–1.22) using a random effects model. Datasets using the YP‐CORE had larger effect sizes than those using the SDQ, and datasets with more complete response rates had lower outcomes than those with poorer response rates. Conclusion: The results confirm that school‐based counselling, as delivered in the UK, is associated with significant reductions in psychological distress, comparable to adult counselling and psychotherapy services.     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.