Behavior-dependent reinforcer-rate changes in concurrent schedules: A further analysis

Six pigeons were trained on concurrent variable-interval schedules in three different procedures. The first procedure was a standard concurrent schedule, and the relative reinforcer frequency for responding was varied. The second was a schedule in which a relative left-key response rate (over a fixed period of time) exceeding .75 produced, in the next identical time period a higher reinforcer rate on the right key. If this criterion was not exceeded, equal reinforcer rates were arranged on the two keys in this period. This was the dependent procedure. In the third (independent) procedure, the periods of higher right-key reinforcer rates occurred with the same probability as in the second procedure, but occurred independently of behavior. In the second and third procedures, the fixed-time period (window) was varied from 5 s to 60 s, and to 240 s in the second procedure only. Performance on the two keys was similar in the concurrent and independent procedures. The procedure used in the dependent conditions generally affected performance when the windows were shorter than about 30 s. Models of performance that assume that subjects do not discriminate changes in local relative reinforcer rates cannot account for the data. Moreover, existing models are inherently unable to account for the effects of contingencies of reinforcement between responding on one alternative and gaining reinforcers on another that are arranged or that emerge as a result of time allocated to alternative schedules. Undermatching on concurrent variable-interval schedules may result from such emergent contingencies.     

Counselor performance in treating anxiety and depressive symptoms in integrated care: A client outcomes study

Depression and anxiety are two of the most common mental disorders treated in Integrated Primary and Behavioral Healthcare programs. We investigated the within and between performance differences of mental health counselors on anxiety and depressive symptomatology in an integrated service with a sample of 1573 clients and 10 licensed professional counselors. The results of growth curves within the framework of Multilevel Modeling showed significant within and between performance differences among counselors treating anxiety and depressive symptoms. Some counselors performed better in treating anxiety symptoms while others did better treating depression. Implications for counselor education, client care, and legislation are provided.     

Saudi therapists' lived experience of self-awareness

Self-awareness and self-reflection in psychotherapeutic processes have been critical components for effective counselling and psychotherapy. However, little qualitative research in Saudi Arabia has been conducted that aims to explore the therapist's subjective experiences of the self in their professional work. Therefore, the purpose of this phenomenological study was to understand the therapist's self-awareness within psychotherapy, by focusing on the therapist's lived experience of self-awareness and exploring how therapists recognise themselves as an integral component of the therapeutic relationship. Semi-structured interviews were conducted with six experienced and accredited psychologists with at least three years of clinical experience, and the qualitative data were analysed using interpretative phenomenological analysis (IPA). Five superordinate themes emerged from the data; that is, development of the professional self, use of self, self-oriented, supervision and experience. This study provides an understanding of the therapist's self in psychotherapy, as it shows that self-awareness is important for therapists to manage their feelings, thoughts and behaviours in meeting with clients and that it is a valuable resource for a therapist to become aware of and reflect upon the process within oneself. This understanding is integrated into the training programmes in counselling psychology, especially in the areas of self-awareness and personal development.     

Psychotherapists’ psychological well-being: The role of epistemic orientation and emotion regulation

Psychotherapists’ mental health has been traditionally associated with the harmful consequences of clinical practice. In contrast to this dominant model, a growing body of research in positive psychology has sparked an interest in therapists’ positive well-being. The main objective of this study was to examine the relations between therapists’ epistemic orientation modes, emotion regulation strategies and psychological well-being (PWB). This was a cross-sectional study in which participants were 674 therapists (78.5% women), with a mean age of 42.02 years (SD = 13.06). Therapists completed an online questionnaire containing self-report measures of all study variables. Structural equation modelling using latent variables was performed to test the study hypotheses. Results revealed no significant direct effects of epistemic orientation on PWB. Up- and downregulation strategies had the most substantial direct effects on total PWB. Furthermore, emotion regulation mediated the association between therapists’ epistemic orientation modes and PWB, accounting for 57% of the variance in the outcome variable. Implications for training, practice and therapist self-care are discussed.     

Within-person association of volitional factors and physical activity: Insights from an ecological momentary assessment study

ObjectiveCurrent health behavior models of physical activity (PA) suggest that not all PA intentions are translated into actual PA behavior, resulting in a significant intention-behavior gap (IBG) of almost 50%. These models further suggest that higher self-efficacy and specific planning can aid in decreasing this gap. However, as most evidence stems from between-person (trait level), questionnaire-based research, it is unclear how large short-term IBGs are, how self-efficacy and planning covary within-persons across time and whether they similarly predict smaller IBGs. It is likely that day-to-day changes in circumstances and barriers affect these variables thus the applicability of theoretical models is uncertain. Here, within-person prospective analyses of ecological momentary assessment (EMA) data can provide insights.Methods35 healthy participants (aged 23–67) completed four EMA-based questionnaires every day for three weeks. Each prompt assessed PA (retrospectively, “since the last EMA prompt”); PA intentions, planning specificity, self-efficacy, and intrinsic motivation (prospectively, “until the next EMA prompt”) and momentary affect. Generalized logistic mixed-effect modeling was used to test predictors of PA.ResultsAcross the 2341 answered EMA prompts, PA intentions were not enacted in 25% of the episodes (IBG). In episodes with given intentions, PA likelihood increased with higher levels of self-efficacy, planning specificity, and intrinsic motivation. The latter two also positively predicted PA duration and intensity.ConclusionsShort-term intention behavior gaps seem to be smaller than what is known from more long-term studies, most likely as individuals can anticipate the actual circumstances of PA. Further, current health behavior models show validity in explaining within-person dynamics in IBGs across time. Knowing the relevance of planning specificity, self-efficacy and intrinsic motivation for day-to-day variations in PA enactment can inform respective real-time mHealth interventions for facilitating PA.     

Reciprocal Prospective Effects of Momentary Cognitions and Affect in Daily Life and Mood Reactivity Toward Daily Events in Remitted Recurrent Depression

Major depressive disorder is a recurrent condition. Potential risk factors for future episodes are maladaptive cognitions, such as rumination and unfavorable reactivity toward negative daily events. Positive thoughts and positive daily events, in contrast, could act as a buffer against mood deterioration. The aim of the present study is to (a) examine differences in daily affect and cognitions in remitted depressed patients with a history of recurrent episodes (rMDD) and healthy controls, (b) analyze reciprocal prospective effects of momentary cognitions and affect, and (c) investigate effects of daily events on affect and cognitions in both groups. A sample of N = 102 participants underwent an ecological momentary assessment (EMA) phase of 5 consecutive days, where rMDD patients (n = 51) and healthy controls (n = 51) indicated their momentary rumination, positive thoughts, affect, and the occurrence of daily events 10 times per day. Via multilevel lag models, we found higher rumination to predict a decrease of positive affect (PA) in the rMDD group, but no effect of rumination on subsequent negative affect (NA) in either group. Higher positive thoughts predicted an increase in PA and a decrease in NA, similarly strong in both groups. Regarding daily events, rMDD patients reported a stronger increase in NA and rumination following negative daily events compared to controls, whereas an observed subsequent decrease of PA and positive thoughts was not moderated by group. Following positive daily events, rMDD patients showed a stronger increase in PA and positive thoughts and a stronger decrease in NA and rumination than controls. For interventions targeting relapse prevention, our results indicate the implementation of strategies fostering the responsiveness to positive events and the up-regulation of positive affect.     

The Relationship Between Client Emotional Expressions, Therapist Interventions, and the Working Alliance: An Exploration of Eight Emotional Expression Events

The relationship between client emotional expression and therapist interventions was studied in two working alliance conditions. An events-focused methodology was used to examine a total of 8 events taken from a variety of therapeutic orientations. Results indicated that, in the presence of a good client–therapist relationship, therapists showed higher levels of empathy and effectively focused on the immediately expressed feelings; in turn, their clients were engaged in exploration of feelings. In poor-relationship dyads, clients expressed negative feelings toward the therapists. Interventions rated as effective by clinical judges were characterized by accurate therapist understanding of clients' emotional expressions and working with strains in the therapeutic relationship. Ineffective interventions were associated with inaccurate assessments of clients' emotional states. Intensive analysis of these sessions led to three distinct models of in-session emotional expression events. Theoretical and practical implications of these models will be discussed.     

Finding focus in a difficult landscape: Therapists’ experiences with challenging video guidance processes for parent–infant dyads

Marte Meo video guidance uses filmed interaction of the actual parent–infant dyad in the guidance of caregivers. Exploring the challenges that therapists meet in the guidance of parent–infant dyads may illuminate important aspects of the method itself as well as the therapists’ role and requirements. This could lead to method development and improved practice, but is hitherto little addressed. In this paper, we explore how skilled therapists experience and handle challenging or failing guidance processes with parent–infant dyads. We analyzed interviews with 13 Marte Meo therapists/supervisors using team-based reflexive thematic analysis. Four main themes were identified: promoting relational growth in a coercive context, building an alliance that feels safe for the parents, looking at positive moments in difficult lives, and handling intense feelings as a therapist. Our findings show that therapists experience specific therapeutic and ethical challenges with a vulnerable subgroup of parent–infant dyads where child protective issues arise, where caregivers’ insecurities impede the therapeutic relationship, and where caregivers have unsolved relational or mental health problems. The therapists’ role becomes pivotal and demanding with regard to the therapeutic alliance, the therapeutic interventions in the guidance process, and their own need for regulation, supervision, and structure. Identification of these vulnerable dyads early in the process could facilitate a better adaptation and practice of video guidance. Our findings suggest a need for supporting structures, clinical supervision, and training that address these challenges.     

Within-day time-varying associations between motivation and movement-related behaviors in older adults

ObjectivesEmerging evidence suggests both motivation and movement-related behaviors vary within and across days. Yet common data analytic approaches assume static or consistent relationships between motivation and behavior across time. Just as motivation and behavior change across time, so too might associations between motivation and behavior. This study will apply time-varying effect modeling to Ecological Momentary Assessment (EMA) data to examine time of day differences in how motivational constructs predict older adults’ subsequent movement-related behavior over the next 2 h.DesignOlder adults (n = 104) completed a 10-day EMA protocol.MethodParticipants answered up to 6 EMA prompts/day to assess momentary intentions and self-efficacy to stand or move as well as intentions and self-efficacy to limit sedentary time over the next 2 h. Participants wore an activPAL accelerometer continuously to measure time spent being upright (i.e., standing or moving) and time spent sitting.ResultsOn weekdays, intentions and self-efficacy were generally predictive of subsequent behavior in the expected direction over the majority of the day whereas these constructs predicted subsequent behavior in the expected directions over a smaller range of times on weekend days.ConclusionsThis study adds to emerging evidence that associations between motivational constructs and subsequent behavior change over the course of the day, but these time-varying associations may be different depending on the day of week. This work has implications for intervention design and the timing of intervention content delivery in approaches like just-in-time adaptive interventions.     

The facilitative interpersonal skills method: Difficult psychotherapy moments and appropriate therapist responsiveness

The Facilitative Interpersonal Skills (FIS) task is a performance test of therapists’ use of common relational skills (e.g. empathy, building expectations). The FIS method includes (a) materials that simulate difficult client moments on video, which are used to collect therapists’ responses to these situations; and (b) independent ratings of these responses. Many of the FIS items are informed by psychotherapy processes that have been linked to outcome and facilitative conditions that have been reframed as individual therapist skills (e.g. alliance bond capacity). Overall, the FIS has predicted psychotherapy outcome. A single study is described in which FIS predicted the therapist effect using multilevel modelling of a large sample of clients who were nested within therapists. We also summarise two additional outcome studies that used experimental designs. One future direction is to better understand how therapists form responses to these difficult moments. We conclude that forming an optimal therapeutic response during challenging, emergent in‐session situations involves responsiveness (Stiles et al., 1998), or finding a response that fits the clients’ needs within any moment.