Computerised Cognitive Behavioural Therapy in an Adult Mental Health Service: A Pilot Study of Outcomes and Alliance

This pilot study aimed to explore the clinical outcomes and therapeutic relationship for clients of an adult mental health service using Beating the Blues, a computerised cognitive behaviour therapy (CCBT) package. Sixteen participants completed the programme and reported a significant reduction in Beck Depression Inventory scores posttreatment. Participants' mean item ratings on the relationship measure were above the neutral midpoint, but no association was found between the therapeutic relationship and outcome. The results are discussed in terms of the utility of CCBT as part of a stepped-care model and how further research might usefully explore the nature of the relationship formed between clients and CCBT programmes.     

Social Anxiety and Friendship Quality over Time

Abstract

High social anxiety in adults is associated with self-report of impaired friendship quality, but not necessarily with impairment reported by friends. Further, prospective prediction of social anxiety and friendship quality over time has not been tested among adults. We therefore examined friendship quality and social anxiety prospectively in 126 young adults (67 primary participants and 59 friends, aged 17–22 years); the primary participants were screened to be extreme groups to increase power and relevance to clinical samples (i.e., they were recruited based on having very high or very low social interaction anxiety). The prospective relationships between friendship quality and social anxiety were then tested using an Actor–Partner Interdependence Model. Friendship quality prospectively predicted social anxiety over time within each individual in the friendship, such that higher friendship quality at Time 1 predicted lower social anxiety approximately 6 months later at Time 2. Social anxiety did not predict friendship quality. Although the results support the view that social anxiety and friendship quality have an important causal relationship, the results run counter to the assumption that high social anxiety causes poor friendship quality. Interventions to increase friendship quality merit further consideration.     

Gender Differences in the Association of Intimate Partner Violence and Relationship Values among College Students

Although research has indicated that cognitions and situational factors play a role in relationship satisfaction and aggression, few studies have investigated the association between intimate partner violence (IPV) and relationship values. We addressed this gap by measuring college students’ perpetration of and victimization by four types of IPV; namely, physical violence, sexual violence, threats, and psychological aggression over the past year. One-way ANOVAs and multiple regression analyses were used to measure the association between IPV and the endorsement of relationship values. The results suggest that past IPV perpetration and victimization correlated with the current endorsement of relationship values for males more than females. In general, male perpetrators rated relationship values such as security, investment, others’ approval, and daily conflict as less important than non-perpetrators. Although male victimization explained significant variance in security, investment, and others’ approval, the results were somewhat mixed as to whether victimization related to higher or lower ratings of relationship values, with the majority of the results suggesting an inverse correlation between relationship value endorsement and IPV experience. Future research can investigate mediating factors in the relationship between IPV and relationship value endorsement, as well as look at how IPV and relationship values influence decisions concerning relationship maintenance.     

Keep the fire burning: Reciprocal gains of basic need satisfaction,intrinsic motivation and innovative work behaviour

Drawing on insights from self-determination theory, we explored the dynamic relationship between intrinsic motivation and innovative work behaviour (IWB) over time. Specifically, we investigated how basic need satisfaction influences IWB through its effect on intrinsic motivation and how IWB in turn affects basic need satisfaction as measured the next day (i.e., a reciprocal relationship). The current study used a longitudinal design comprising a 6-day period and relied on multi-source data from 76 students in industrial product design and electronic engineering who participated in an innovation boot camp. In general, results provided support for the mediating role of intrinsic motivation in the relationship between basic need satisfaction and IWB, as well as the reciprocal relationship between basic need satisfaction and IWB.     

The integrative attitude–a personal journey

The origins of clinical psychotherapy date from the beginning of last century and the development of broadly four foundational schools–psychoanalytic, cognitive-behavioural, humanistic and transpersonal psychologies. The imperative to integrate these schools, however, is relatively recent and in the last 25 years a professional integration movement has developed, exemplified by the formation of SEPI and the UKAPI, and ‘integrative psychotherapist’ is now the most popular nomenclature used in the profession. This article gives a brief history of the integration movement, reviews some issues raised by developments so far, and discusses the personal dilemma that integration evokes in the would-be integrative practitioner. Using my own journey I espouse an integrative attitude that is based on the nature of integration as an evolving personal process rather than an ideal, fixed, profession-wide position. I describe three interweaving modalities of integration I call constructive, complicit and contiguous integration, which form a developmental framework that aims to encourage the individual activity of questioning, inventing, researching and interrogating the discipline within its philosophical, professional and social context. In concluding, this article exhorts the profession to see integration as a personal journey, as a way of being that is constantly becoming and unfolding in relation with the therapist's training, experience and interaction with peers and clients. The result is indefinable and unnameable, and perhaps represents the soul of integrative psychotherapy.     

Between the street and the consulting room: The role of therapeutic frame in working with homeless clients

This paper explores the context of psychotherapy with people who are homeless and the kinds of dynamics and challenges that typically arise in this work. The paper specifically considers the process of therapy as it takes place with clients who have been recurrently homeless and who have difficulties with sustaining shelter that has its roots in deficits in early containment. Clinical case material from psychotherapy conducted with two homeless men is presented and the implications of the approach adopted are explored both in relation to policies around the provision of services for homeless people and the more specific issue of psychotherapy intervention.

It is argued that a clear, well-articulated set of expectations has to be developed around this work in order to protect it and to provide it with the greatest opportunity for providing the kind of safety that is required for the development of this work. It is argued that the most important issue here relates to the provision of a consistent therapeutic framework and a care around the development of the specific psychotherapeutic frame within, and in relation to, the other frames present in the person's life.     

Issues in using interpreters in therapeutic work with refugees. What is not being expressed?

‘Interpreting’ could be thought about as a legal equal opportunities or human rights issue. Whereas interpreters are likely to focus on the linguistic issues, and will be aware of the technical complexities of their work. Clinicians may worry about the impact on the therapeutic relationship of the interpreter's presence, how this will be managed and how it may depend on the match or mismatch of such factors as the client's gender, age and first or other language. This paper considers the issue on each of these levels to reveal the complexities and dilemmas of effective clinical work with interpreters, but also what can be achieved: the multiple layers of meaning concerning the client's experience and communication which can be elicited through effective working between interpreter and clinician.     

Integrating different types of knowledge in supervision

The present article examines ways to integrate two, often contradictory, types of knowledge in supervision, which are sometimes represented either by supervisors or supervisees, and sometimes by different parts in the supervisee. These types of knowledge are in a dialectic relationship: they may define each other and at the same time influence and shape each other, yet remain two separate sources for understanding the therapeutic experience. One type is the primary, vague, and intuitive knowledge about patients and therapist–patient interactions, derived from actual participation in the therapeutic relationship. The other type is knowledge derived from theory, experience acquired mainly outside of the specific therapy, and dialog with colleagues.     

Community Engagement as Liberal Performance,as Critical Intellectualism and as Praxis

This article aims to illustrate that engagement is a dynamic and evolutionary process, moulded by contesting ideological, social actor and contextual forces. For purposes of illustration, I draw on a university-affiliated, participatory enactment of community engagement as a case example. The case illustrates that community engagement may assume a form of action, critical intellectualism and praxis. As action, community engagement is oriented towards performance of liberal democracy. Community engagement, as shaped by the critical intellectualism of the Black Consciousness philosophy, reflects community self-affirmation, autonomy and intellectual independence. Community engagement as praxis may be characterised by reflexivity, vision-making and the building of interpersonal relationships. Community engagement is marked by a dynamic interplay between race, power and counter-hegemonic ideology.     

From prematurity to parenting stress: The mediating role of perinatal post-traumatic stress disorder

Preterm delivery may lead to the emergence of symptoms of Post-Traumatic Stress disorder (PTSD), which may, in turn, affect the quality of the mother-child relationship. The aim of this study is to shed light on the development of parenting stress in mothers of preterm and full-term children. It is hypothesized that PTSD symptoms mediate the relationship between preterm/full-term birth and the levels of parenting stress. Perinatal PTSD, parenting stress and social support were assessed in 156 mothers of full-term children and 87 mothers of preterm children. Mothers of preterm children experienced more post-traumatic stress and parenting stress than mothers of full-term children. However, the relationship between preterm delivery and subsequent levels of parenting stress was mediated by PTSD symptoms. These findings suggest that the maternal perception of childbirth as a traumatic experience and the subsequent development of PTSD symptoms are pivotal in the emergence of parenting stress.