The Role of Theory and Research in the Practice of Cognitive-Behavioral Couple Therapy: If You Build It,They Will Come

Cognitive-behavioral couple therapy (CBCT), while empirically validated and highly efficacious, does not always have positive results for couples. One factor that may limit the efficacy of this intervention is the way in which therapists are trained to provide this type of therapy. More specifically, there is a need for therapists to gain a solid foundation in CBCT theory in order to maximize treatment results. This paper presents an argument for why an understanding of theory is necessary for therapists in treating couples. Then, this paper presents our training model and how we integrate theory into our training of both graduate student therapists and more experienced clinicians. We take the stance that “if you build it, they will come.”     

Predicting Psychologists' Intentions to Integrate Complementary and Alternative Therapies Into Their Practice

Drawing on an extended Theory of Planned Behaviour (TPB) framework, we employed a cross‐sectional design study to investigate psychologists' intentions to integrate complementary and alternative therapies (CAT) into their practice via recommending CAT to clients or referring clients to CAT practitioners. Participants were registered practicing psychologists from a range of therapeutic orientations (e.g., narrative, cognitive behavioural, psychodynamic). The psychologists were either recruited by phone, following a search of the Internet, or were contacted through their place of employment (hospitals, university counselling service). Those who agreed to participate (N = 122; n = 88 females, n = 34 males) completed a questionnaire that included standard TPB items of attitude, subjective norm, and perceived behavioural control, along with items measuring perceived risk, past behaviour, CAT knowledge, and gender. The outcome variables of interest were (a) intention to recommend CAT to clients and (b) intention to refer clients to CAT practitioners. Structural equation modelling revealed that the extended model was a good fit, explaining 69% (recommending CAT) and 51% (referring to CAT practitioners) of the variance in intentions. For both behaviours, direct paths from attitude and subjective norm to intentions were observed, with perceived risk and past behaviour influencing the TPB predictors of attitudes, subjective norm, and perceived behavioural control. The findings illustrate the role that cognitive and risk factors have on psychologists' decisions to integrate CAT into their practice. Understanding psychologists' cognitions and decisions about CAT integration forms an important basis on which to consider future changes in policy or practice.     

Mental health among people with psoriasis undergoing patient education in climate therapy

This study investigated the mental health of people with psoriasis undergoing patient education in climate therapy. A prospective design included a baseline assessment and two follow‐ups after a 3‐week patient education program. Participants were 254 adults. Positive mental health was measured by the mental health continuum short form (0–70), and negative mental health by the emotional distress subscale (1–4) of the health education impact questionnaire. Paired‐samples t‐tests were used to evaluate changes in mental health from baseline to follow‐up. Multiple linear regression was used to analyse the ability of socio‐demographic and clinical variables and emotional distress to predict changes in positive mental health. To predict change in negative mental health we repeated the same analysis but with a change in negative mental health as a dependent variable and positive mental health as an independent variable. The results show that positive mental health and health‐related emotional distress improved significantly from before to after the intervention by 7.1 points, p < 0.001 and 0.21 points, p < 0.001) respectively. At the second follow‐up, health‐related emotional distress remained significantly improved compared with baseline levels by 0.11 points, p = 0.004. The longer participants had lived with psoriasis ( β = 146, p = 0.027), and the presence of co‐morbid health problems (β  =  111, p = 0.051) the greater the improvement in the positive mental health immediately after the intervention. No predictors were identified for negative mental health. This study indicates that the promotion of positive mental health needs to be integrated into the climate therapy program, and sustained in their home context.     

Children,words and symptomatic acts

Referring to communicative material from an autistic and a psychotic child, the author argues for the primary importance of understanding children's words and actions in terms of their conscious or intended meaning before seeking a latent, symbolic meaning for them and attempting to convey this to the child in therapy. In furtherance of the argument the author introduces and develops a distinction between the signification and the significance of expressive utterances, and explains its relevance to the development of children's concepts by means of clinical material.     

Recovery of affect and structural conflict

This paper deals with fragmented or dispersed affects states with special reference to deep depression. The clinical material presented consists of two patients; a seriously depressive man, and a female patient with a schizoaffective psychosis which has been treated and followed up by the author since the end of the 60s. The hypothesis is that, in a serious depression, as well as in traumatic states in general, the genuine affect tends to be dissected into its two constituents: a diffuse bodily excitation and dismantled drive-instinctual urges devoid of affective meaning. The author arrives at the conclusion that the analytic situation represents a metaphorical frame where the recovery of affect becomes possible when the disruptive experiences of the past are dealt with in the transference. The integration of affect signifies a major structural achievement, making the perception of reality possible without sacrificing affective experience and genuine interest in life. The author deals with the foundations of the structural theory and proposes that the early frame of primary identification comes to play a crucial rôle in the advanced psychic organisation. On the one hand, it carries the capacity of psychic representation and metaphorical thinking. On the other hand, as projected onto the future, it defines the frame of the ego-ideal and forms the basis for metaphorical interpretation of the superego demand.     

Powerful Occupational Therapists: A Community of Professionals, 1950–1980

A powerful community of therapists changed occupational therapy in the United States between 1950 until 1980. These innovators, primarily women, strategically positioned themselves to market the emerging profession. These therapists, categorized as theorists and futurists, political movers and new and old guard sustainers, determined occupational therapy's direction. Participating in the 1950s rehabilitation, the 1960s equal rights, and the 1970s women's movements, the community of therapists separated from the male-dominated medical model to gain professional and scientific authority. An internal tension arouse between those therapists embracing an objective, and arguably male, science and those supporting a characteristically feminine caring philosophical base.     

Effect of Training on Sensory Room and Cart Usage

In this study, the authors assess the effectiveness of education on the consistency of use of sensory rooms within a large mental health facility. Eleven staff and thirty-six clients received additional multimodal education in sensory strategies, the use of the sensory rooms on their assigned units, and the link between the rooms and clients' personal crisis intervention plans. Staff knowledge and room usage rates were analyzed pre- and post-training. The authors found statistically significant increases in staff knowledge post-training and increases in the use of the sensory rooms by study participants. The results support the effectiveness of training which uses hands-on, population-specific strategies.     

An Activities Approach to the Treatment of Mentally Retarded Clients in an Acute Care Psychiatric Hospital

This article describes therapeutic activities offered in an occupational therapy treatment program for mentally retarded patients in an acute-care hospital facility. Implications of therapeutic activities for the building of ego strengths are discussed.     

A Guide to Women in Management

The majority of occupational therapists are female clinicians who tend to be motivated by human service. They do not tend to be motivated by administrative or managerial responsibilities beyond those essential to local disciplines functions. More occupational therapists may become interested in management once they are aware of sociocultural assumptions and prejudices as well as the specific qualifications and competencies involved. Sex role stereotyping and some roles are reviewed. Assertiveness training and basic management competencies are listed as pertinent skill acquisitions.     

One Parent-Child Activity Group

Abstract

The framework that the author developed for parent-child activity groups is described. This is followed by “snapshots” of a group session to enhance the readers' understanding of the framework. Excerpts of the author's logs from her participant observation of the parent-child activity group that she studied are organized sequentially to provide examples of each part of a parent-child activity group session.