Science-Based Neurorehabilitation: Recommendations for Neurorehabilitation From Basic Science

ABSTRACT

Neuroscience has fundamentally changed the understanding of learning and memory within recent years. Here, the authors discuss a number of specific areas where they believe new understanding of the CNS from basic science is having a fundamental impact on neurorehabilitation and is leading to new therapeutic approaches. These areas have constituted a basis for development of some basic principles for neurorehabilitation: Optimal rehabilitation should involve (a) active (patient) participation in the training, (b) training that does not only involve many repetitions, but also continues to challenge the skill of the training person, (c) motivation and reward, (d) intensive training and practice over a long time, (e) careful organization of the training in relation to other activities, and (f) incorporation of other potentially beneficial parameters such as sleep and diet. It should in this relation also be pointed out that albeit neurorehabilitation may be predicted to have the most optimal effect early in life and as soon after injury as possible, there is no reason to believe that beneficial effects of training may not be obtained late in life or several years after injury.     

External focus and autonomy support: Two important factors in motor learning have additive benefits

We examined whether the combination of two factors that have consistently been found to enhance motor learning – an external focus (EF) of attention and autonomy support (AS) – would produce additive benefits. Participants practiced throwing with their non-dominant arm. In a 2 × 2 design, they were or were not asked to focus externally (i.e., on the target), and were or were not given a choice (autonomy support). The latter involved choosing 2 5-trials blocks during practice on which they used their dominant arm. All four groups – EF/AS, EF, AS, and C (control) – completed a practice phase consisting of 60 trials. The distance to the target (bull’s eye) was 7.5 m. One day later, participants performed retention (same target distance) and transfer tests (8.5 m). Both external focus instructions and autonomy support enhanced retention and transfer performance. Importantly, the combination of these factors resulted in additive learning advantages. The EF/AS group showed the greatest throwing accuracy, and the EF and AS groups outperformed the C group. In addition, self-efficacy measured after practice and before retention and transfer was increased by both factors. Thus, promoting an external focus of attention and supporting learners’ need for autonomy seem to independently influence learning.     

Using client feedback in training of future counseling psychologists: An evidence-based and social justice practice

Training in counseling psychology has evolved to emphasize both evidence-based practice (EBP) and social justice, though these two dimensions have often seemed disconnected, or even at odds in the practice of psychotherapy. The Partners for Change Outcome Management System (PCOMS), an EBP that monitors treatment outcomes and the therapeutic alliance across treatment (often called “client feedback”), may offer a means to connect evidence-based and socially just practices. The purpose of this article was to outline how the use of PCOMS in psychotherapy and supervision can serve as a useful training tool that is a form of EBP and also promotes a socially just paradigm in psychotherapy. We also offer an implementation example from a counseling psychology doctoral program to demonstrate how PCOMS can be used with clients in psychotherapy and included within the supervisory process.     

Religious competence and individuality: three studies in the Roman Empire

Abstract

The theme of individuality and individualisation in religious contexts in the fairly remote past is perhaps best viewed as a heuristic device whose main value, at least in the context of Graeco-Roman history, is to question the excessive dominance of a model of religious action as essentially collective, which is perhaps proximately Durkheimian but in the Classical field goes back ultimately to early scholarship on ancient Judaism. Terminology is a basic problem in this context. Religious individuality can be defined as the construction of personal religious achievement or the practice of mastery defined by sui generis rules. In the case of the Roman Empire, five types of such achievement have been suggested: pragmatic; moral; competitive; representative; or exemplary/ reflexive. All these distinguishable types of individuality are linked, at least indirectly, to the complex and highly differentiated social, political, economic and moral structures of the Empire. Specifically religious individuation emerges only with the development of religion as a distinctive field of (social) action and thus the possibility of specifically religious distinction. If sustained over the long term, any such achievement is to be seen as individualisation under ancient conditions. This article briefly explores three types of religious distinction based on a conviction and lived practice of such individualised competence: the figure of the Weberian mystagogue in his Mediterranean forms; the figure of the practitioner skilled in Graeco-Egyptian ‘magic’; and the idealised figure of Pythagoras as projected by Iamblichus’ On the Pythagorean life (c.300 CE).     

“We don't Talk about that Around Here”: religion,Spirituality and Mental Health in Northern Ireland

Since the early 1970s, Northern Ireland has experienced violent conflict, the boundaries of which are shaped by religious identification. Although the violence has significantly decreased since the late 1990s, its legacy remains. Research evidences a complex relationship between religious and spiritual beliefs and mental well-being, there is a lack of research about how political conflict, in which religion plays a dominant role, may shape how beliefs may shape the impact of faith on mental health. This article draws upon the views and experiences of mental health service users’ from a qualitative study about religion, spirituality, mental health and social work practice. Participants’ accounts state that while the role of religion and spirituality within mental health was recognised, its exploration was marked with questions of legitimacy. This article proposes that support is needed for service users to both acknowledge this aspect of their mental well-being and promote their having choice about its inclusion in their mental health care.     

Attachment to God,adult attachment,and spiritual pathology: mediator and moderator effects

In this exploratory study, we examined moderated mediation models grounded in psychoanalytic and attachment theory regarding the correspondence between adult attachment and Divine–human relating in a sample of graduate students in the USA. Results supported the correspondence hypothesis as positive correlations between adult attachment dimensions and attachment to God dimensions were observed. An interaction effect was observed as spiritual grandiosity moderated the indirect effect between insecure adult attachment and insecure God attachment dimensions through spiritual instability. Results therefore provided support for the theoretical notion that spiritual dysregulation can function as a mechanism of the attachment correspondence that varies as a function of spiritual grandiosity. Findings are discussed in the context of advancing existing theory on implicit models of attachment correspondence and the nature of the association between spiritual insecurity and spiritual grandiosity.     

Distinct episodic contexts enhance retrieval-based learning

Spaced retrieval practice results in better long-term retention than massed retrieval practice. The episodic context account of this effect suggests that updated representations of the more distinct temporal contexts associated with spaced retrievals facilitate later recall. We examined whether environmental context, in addition to temporal context, may also play a role in retrieval-based learning. Participants studied and then attempted to retrieve the English translations of Swahili words during four acquisition blocks of trials. They were then randomly assigned to practice retrieving items three more times in one of the following conditions: massed practice with the same environmental context scene; massed practice with different environmental context scenes; spaced practice with the same environmental context scene; or spaced practice with different environmental context scenes. After a one-week delay, measures of recall, forgetting, and the joint probabilities between study session recall and final recall performance all indicated enhanced retention for both the spaced and different environmental context conditions. Indeed, after retrieving items in the study session, forgetting them during final recall was 371% more likely in the same context than in the different context conditions. These findings redefine and refine previous accounts of the episodic context model of retrieval-based learning.     

Immigrant students’ educational expectations: the role of religious affiliation and practice

A body of scholarly work has emerged on educational expectations. More recently, the relationship between educational expectations and immigrant background in Western Europe has been investigated. Although the results of this type of inquiry show that students with an immigrant background tend to have higher educational expectations, potential explanations of this relationship remain unarticulated. In this article, we investigate whether religious affiliation and practice help explain the relationship between immigrant background and educational expectations. We use the Flemish survey data from the 2009 wave of the International Civic and Citizenship Education Study (ICCS). In comparison with students who claimed to have no religious affiliation, students with a Muslim and other religious affiliation were more likely to have these expectations. This relation does not hold for the students with a Christian religious affiliation. However, the effect of religious affiliation disappears when the effects of religious participation were included. We also found that the more religiously active, the higher the educational expectations are for the students. This effect diminished when we controlled for talking with parents about political or social issues. The relationship between immigrant background and educational expectations is partially explained by the level of religious practice and religious affiliation of students.