Attitudes of clinical psychologists towards clients with personality disorders

Previous studies have found that a variety of mental health professionals hold negative attitudes towards clients diagnosed with a personality disorder. These negative attitudes may lead to clients receiving a lower quality of service. Specialist training has been found to improve attitudes towards personality disorders but no empirical studies in Australia have examined this among clinical psychologists. In this study, the attitudes of 81 clinical psychologists towards clients with personality disorders were examined. We were specifically interested in investigating the relationship between recency of specialist training and clinician's attitudes as well as the influence of percentage of personality disorder clients on the clinician's caseload. Results demonstrated that both recency of specialist training and percentage of clients seen were associated with more positive attitudes; however, a higher caseload of clients with personality disorders was the most important predictor of positive attitudes. The implication is that recent participation in specialist training for personality disorders appears to be valuable in improving clinician's attitudes but that more positive attitudes are associated with seeing a greater number of individuals with personality disorders.     

Issues in Professional Training to Implement Evidence‐based Parenting Programs: The Preferences of Indigenous Practitioners

Indigenous children have elevated risk for poor health, behavioural, emotional, and social outcomes. Significant evidence exists that parenting programs can reduce family risk factors and improve outcomes for children and families; however, mainstream programs have had slower uptake in Indigenous communities than other communities. Culturally sensitive delivery of evidence‐based programs can enhance engagement of parents, yet the development of a workforce to deliver programs to Indigenous parents faces many obstacles. This project seeks to identify professional training processes that enhance Indigenous practitioners’ skills and confidence in delivering an evidence‐based parenting program. A survey of trained parenting practitioners via an online practitioner network assessed their views of the training and post‐training support processes they had experienced. Respondents were 57 Indigenous and 720 non‐Indigenous practitioners from 15 countries. Most training processes were rated equally helpful by Indigenous and non‐Indigenous practitioners. However, several training processes were identified as important for the delivery of culturally competent training, such as tailoring the pace of training and simplifying the language in teaching resources. Practitioners with higher ratings of the helpfulness of peer support following training reported higher program uptake and implementation. Qualitative themes also focused on the helpfulness of program resources, and having a peer support network and mentoring. Increasing access to appropriate, flexibly delivered training and post‐training support for Indigenous professionals will support the development of a skilled workforce with local knowledge and connections, and further increase the reach of evidence‐based services in Indigenous communities.     

Improving arithmetic performance with number sense training: An investigation of underlying mechanism

A nonverbal primitive number sense allows approximate estimation and mental manipulations on numerical quantities without the use of numerical symbols. In a recent randomized controlled intervention study in adults, we demonstrated that repeated training on a non-symbolic approximate arithmetic task resulted in improved exact symbolic arithmetic performance, suggesting a causal relationship between the primitive number sense and arithmetic competence. Here, we investigate the potential mechanisms underlying this causal relationship. We constructed multiple training conditions designed to isolate distinct cognitive components of the approximate arithmetic task. We then assessed the effectiveness of these training conditions in improving exact symbolic arithmetic in adults. We found that training on approximate arithmetic, but not on numerical comparison, numerical matching, or visuo-spatial short-term memory, improves symbolic arithmetic performance. In addition, a second experiment revealed that our approximate arithmetic task does not require verbal encoding of number, ruling out an alternative explanation that participants use exact symbolic strategies during approximate arithmetic training. Based on these results, we propose that nonverbal numerical quantity manipulation is one key factor that drives the link between the primitive number sense and symbolic arithmetic competence. Future work should investigate whether training young children on approximate arithmetic tasks even before they solidify their symbolic number understanding is fruitful for improving readiness for math education.     

Selecting a patient or initiating a psychoanalytic process?

The defences provoked in the analyst by the anxieties associated with the difficult tasks of ‘assessment’ and ‘selection’ for psychoanalysis can result in a tendency to think in terms of ‘hurdles to be cleared’ by potential psychoanalytic patients, rather than ‘opening the gates’. This can result in a diminution of the analyst's capacity to enlist and sustain a psychoanalytic stance. Only within a psychoanalytic frame can a meaningful psychoanalytic process unfold, at all stages of a potential patient's movement from their first contact through to, possibly, entering into an analysis. The author illustrates the value of this thinking by describing the work of the London Clinic of Psychoanalysis where there has been a shift of emphasis in psychoanalytic consultation towards working with individuals on their potential to initiate a psychoanalytic process, and away from the sole aim of ‘selection of a suitable patient’. In this paper, the author notes that when institutional culture and practice supports psychoanalytic identity, this makes it more possible to recognize and articulate the anxieties provoked by the ‘emotional storm’ inevitable in psychoanalytic consultation, and the draw towards unhelpful enactment that may otherwise obscure the initiation of a psychoanalytic process that may or may not result in analytic treatment. Illustrative case material from the Clinic is presented.     

BECOMING RELATED: THE EDUCATION OF A PSYCHOANALYST

The author uses a “professional memoir,” a story about his first experiences in clinical work, to illustrate what he believes to be certain fundamental aspects of an analytic attitude. Taking place in a psychiatric hospital, it is meant to highlight the central place of intuition, emotional receptivity, empathy, relatedness—and their inherent dangers—in engaging therapeutically with patients' emotional disturbances. The author postulates that these and related aspects of clinical psychoanalysis are not sufficiently emphasized in psychoanalytic training and are often eclipsed by idealizations of psychoanalytic theories and their derivative techniques, third‐party demands for evidence‐based data, preoccupations with neurobiological correlates of experience, etc. Despite the clinical fact that psychoanalysis can be extraordinarily helpful to patients, he questions whether clinical psychoanalysis is rightly regarded as a “treatment.”