The long‐term effects of counselling: The process and mechanisms that contribute to ongoing change from a user perspective

Aims: This qualitative study aimed to expand the limited evidence base about the long‐term effects of psychological therapies.Method: We conducted in‐depth interviews with 15 people, 1–3 years after primary care counselling, to investigate whether they could identify enduring benefits and the mechanisms that brought about and maintained them. From their narratives, we developed a model of the change process of counselling and mechanisms that were perceived as essential to produce lasting benefit. The model conceptualised movement through distinct phases: engagement; exploration of internal and external worlds; consolidation and negotiated ending. Results: Mechanisms integral to sustained impact were: the active engagement of people during and between sessions to work toward their own solutions; and acquisition through the change process of skills which could be further built on after the counselling ended. These enabled ongoing, dynamic change in the way people conducted their lives and relationships. Conclusion: A key concept in securing long‐term benefit was co‐production, both during counselling and in taking ownership of and using the ‘box of skills’ acquired. Support of the model was reinforced through comparison with the experience of three interviewees who reported no long‐term benefit.     

Impact of Co-Therapy Teams on Client Outcomes and Therapist Training in Marriage and Family Therapy

This study of 33 student therapists, 402 client systems, and three supervisors tested the efficacy of using student co-therapy teams as an aspect of clinical training in a marriage and family therapy program. This study utilizes both quantitative and qualitative methodology. Two research questions were addressed: “Do different pairings of co-therapists affect client outcomes?” and “Is co-therapy a viable option for a training program?” The results indicate that client outcomes using co-therapy are at least as effective as treatment using one therapist and in some circumstances produce more positive outcomes for both clients and student therapists.     

工作反刍及其“双刃剑”效应

工作反刍指在没有要求其出现的情境下, 有意识的、重复发生的工作方面的相关想法, 分为工作相关情感反刍与工作相关问题解决沉思两个维度。工作反刍对个体健康、工作及幸福感的影响有“双刃剑”效应。持续性认知理论、压力认知激活模型与认知资源视角理论, 可以解释该效应的内在机制。未来研究应分析影响双刃剑效应的边界条件, 寻求减少消极效应、增加积极效应的途径, 拓展其双刃剑效应心理机制的分析视角和该效应的作用层面。     

正式反馈的发展与临床应用

摘要:正式反馈通过系统收集当事人的效果反馈来追踪其治疗进展,进而识别缺乏治疗进展的个案,并通过促进治疗策略的调整来阻止治疗失败。正式反馈是近20年来发展出的一种循证治疗手段,其目的为进一步提高当事人的咨询效果。正式反馈的发展大致经历了临床有效性检验和实用性发展两个阶段。正式反馈可用于促进个体、夫妻和团体咨询的效果,也可用于评估临床督导效果、确定督导个案和指导临床督导。未来研究可探讨咨询师对待正式反馈的态度,拓展正式反馈的使用价值,建立正式反馈系统的本土化常模。     

多时点结果跨期选择的决策效应及其心理机制

多时点结果跨期选择涉及两个及两个以上多个时点结果的权衡, 正日益成为跨期选择的研究重点。现有研究主要从两时点结果和序列结果两方面深入探讨了多时点结果跨期选择中的诸多决策效应, 包括：隐藏的零效应、象征效应、额外金额效应、前端金额效应以及序列效应, 并运用序列模型和权衡模型对上述决策效应进行阐释。未来还应深入探索同时涉及损益结果混合的多时点结果跨期选择, 运用决策过程追踪技术揭示决策效应的过程机制。     

Family therapy and outcome: Relationships between therapist and family styles

This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided.     

The Influence of Posttreatment Mutual Help Group Participation on the Friendship Networks of Substance Abuse Patients

The effect of 12-step mutual help groups (e.g., Narcotics Anonymous) on members' friendship networks has received little attention. This 1-year longitudinal study examined such effects in a sample of 2,337 male substance abuse inpatients, 57.7% of whom became significantly involved in 12-step activities (e.g., reading program literature, attending meetings) after treatment. An a priori model of the interplay of 12-step involvement and friendship networks was tested using structural equation modeling, and found to have excellent fit to the data. Twelve-step group involvement after treatment predicted better general friendship characteristics (e.g., number of close friends) and substance abuse-specific friendship characteristics (e.g., proportion of friends who abstain from drugs and alcohol) at follow-up. Results are discussed in terms of how mutual help group involvement benefits patients and how the self-help group evaluation paradigm should be broadened.     

The relations among cry characteristics, demographic variables, and developmental test scores in infants prenatally exposed to methadone

This study examined the relations among developmental test scores, infants' demographic characteristics, and cry features. Cry features were strongly related to developmental test scores at all ages, suggesting that use of the infants' cry characteristics can help to identify those infants at greatest risk for later developmental problems.     

矛盾态度对决策后自我评价的影响：有中介的双阶段调节作用

矛盾态度不仅影响信息搜索、态度形成和决策行为, 而且影响决策后自我评价。本研究构建了一个基于不确定性的中介作用、决策困难水平和结果效价的双调节作用的矛盾态度与决策后自我评价关系模型, 3个实验通过设计冲突情境对矛盾态度进行操纵, 冲突情境包括选择一所大学和就业企业, 运用SPSS 20.0软件对数据进行分析, 发现矛盾态度对决策后自我评价存在积极影响, 矛盾态度通过不确定性影响决策后自我评价的中介过程受到决策困难水平和结果效价的调节。矛盾态度和决策困难水平对不确定性产生影响, 不确定性和结果效价对决策后自我评价产生影响, 由于不确定性的分离效应, 使矛盾态度和决策困难水平对决策后自我评价产生相互冲突的双重作用结果。当获得负面结果时, 相较于低决策困难水平, 高决策困难水平的个体, 矛盾态度通过不确定性对决策后自我评价产生积极影响; 当获得正面结果时, 相较于高决策困难水平, 低决策困难水平的个体, 矛盾态度通过不确定性对决策后自我评价产生积极影响。     

Research on embedded counselling: An emerging topic of potential importance for the future of counselling psychology

A significant proportion of the counselling that people receive takes place within informal, situated encounters between service users and practitioners in fields such as nursing, medicine, teaching and social work. However, almost all of the research that has been carried out into the process and outcomes of counselling consists of studies of formal, contracted counselling and psychotherapy based in therapy clinics and offices. The competent and effective delivery of counselling that is embedded in a primary professional role, such as that of nurse, teacher or social worker, presents considerable challenges for practitioners. Research evidence around the process and outcomes of embedded counselling represents a valuable resource that has the potential to enhance the quality of counselling conversations enacted by practitioners in health, education, social work and other professions. An overview is provided of different types of research that has been carried out into informal and embedded counselling, and of the main themes that have emerged from these studies. Suggestions are made for the further development of this field.