The problem of creating habits: establishing health-protective dental behaviors.

We describe three experiments testing treatments to promote the performance of health-protective dental behaviors. Subjects included 55 women from an introductory psychology course (Experiment 1), 45 men and women (Experiment 2), and 81 older-than-average students identified as at risk for gum disease (Experiment 3). The interventions, derived from social cognitive theory, included health education, skills training, and self-monitoring. In each study, we examined the contribution of additional treatment components, including social support (Experiment 1), intensive contact (Experiment 2), and flexible goal setting (Experiment 3). Across experiments, the behavioral results were remarkably similar: Subjects exhibited excellent adherence while in the study but, at follow-up, reported behavior that differed little from baseline. We discuss parallels between attempts to promote health-protective dental behaviors and other health-promotion programs, and we describe different perspectives from which to address the problem of creating healthy habits.     

MAINTAINING PERFORMANCE OF AUTISTIC CLIENTS IN COMMUNITY SETTINGS WITH DELAYED CONTINGENCIES

To facilitate the classroom and workshop integration of three autistic clients, we examined the feasibility of teaching them to respond appropriately without the continual presence of specially trained treatment providers. Within a multiple baseline design, a 4-step treatment process was implemented to promote durable responsive performance. Results indicated that the therapist could be removed from the treatment environment and that appropriate behavior could be successfully maintained in community settings with only infrequent and delayed contingencies.     

CO-WORKER SOCIAL SUPPORT IN A WORKSITE SMOKING CONTROL PROGRAM

We evaluated the effects of adding a social support component to a worksite controlled smoking treatment program. Twenty-four participants were randomly assigned to either a controlled smoking or a controlled smoking plus partner support condition. Within a multiple baseline across behaviors design, smokers in both conditions made efforts to achieve sequential 50% reductions in: (a) nicotine content of brand smoked, (b) number of cigarettes smoked per day, and (c) percentage of each cigarette smoked. Self-monitoring records, laboratory analyses of spent cigarette butts, and carbon monoxide determinations indicated that both conditions were effective in producing significant reductions in each of the three target behaviors and in carbon monoxide levels. All participants who quit smoking during the program maintained their abstinence at a 6-month follow-up, and those who did not quit were smoking less at follow-up than they had at pretest on all dependent variables. However, few differences were observed between controlled smoking and controlled smoking plus partner support conditions either during treatment or at the 6-month follow-up. Results are discussed with regard to previous worksite studies, future directions for research on social support, and variables that may have mediated treatment outcome.     

“Being human”: A grounded theory approach to exploring how trainers on clinical psychology doctorate programmes decide whether or not to disclose personal experiences of psychological distress to clinical psychology doctorate trainees

Objective

Recent research and guidelines recommend that trainers on clinical psychology doctorate training programmes consider disclosing personal experiences of psychological distress to trainees. Disclosure is thought to promote cultures of openness, validate and normalise trainee distress, encourage trainee disclosure and help-seeking and challenge stigmatising narratives. However, little is known about how trainers decide whether, what or how to disclose. This study aims to address that gap by exploring the processes and factors involved in trainers deciding whether or not to disclose personal experiences of psychological distress to trainees, generating findings of relevance across counselling, psychotherapy and psychology training courses.

Methods

In-depth interviews were conducted with nine trainers on UK clinical psychology doctorate programmes from around the country and analysed in accordance with constructivist grounded theory methods.

Results

Findings indicated that participants valued disclosure personally and professionally but were wary of the dangers of disclosure. Disclosure decisions were made by judging the context against internally held criteria. If criteria were not met, then disclosures were not made. Outcomes, whether positive or negative, served to reinforce the value of disclosure and the importance of managing risks, creating a positive feedback loop.

Conclusions

The findings of this study suggest factors that are important for trainers to consider when deciding whether or not to disclose. The six-factor framework developed may be useful for trainers to consider within reflective practice, supervision or during guided self-reflection in order to make safe, helpful and ethical decisions.     

The Counselor and Student Discipline: Suggested Roles

The problem of role definition for counselors relative to discipline problems has been persistent. Difficulties in defining and adopting appropriate roles in discipline have been exacerbated by conflicting expectations between and among administrators, counselors, and faculty. This article provides a short summary and analysis of the literature on the counselor's role in school discipline; possible counselor roles are grouped into six categories: mediator, ombudsman, consultant, psychological educator, special program developer, and counselor. From the variety of roles defined and discussed, counselors may find one or a combination of several roles that both satisfy the needs of their students and are appropriate to their own personalities and/or skill levels.     

The effect of behavioral skills training on shot performance in field hockey

Behavior analysis procedures have been used to improve sports performance and enhance player safety across a wide variety of sports. The current study evaluated the effects of behavioral skills training on three common field hockey shots, a slap shot, drive, and sweep for young field hockey players. The procedures were evaluated in a multiple baseline across behaviors for three players. Results showed increases in each type of shot once intervention was implemented.     

Conflict of interest: the importance of potential

The UK Medical Research Council (MRC) takes the issue of conflict of interest very seriously. The overall aim is to preserve a climate in which personal and organisational innovation can flourish while ensuring that potential conflicts are disclosed and identified and conflicts are either avoided or managed with integrity. The approach needs to encompass the MRC’s various responsibilities and the levels at which conflicts might arise: MRC staff (scientists and administrators); the governing Council; research Boards and committees; external peer-reviewers; and applicants for funding. To achieve its goals, the MRC has issued practical guidance on various aspects of conflict of interest. For the future, the MRC has identified the continuing commercialisation of science and the increasing involvement of lay people in scientific decision-making as special challenges in this area. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Time Course of Treatment Effect of OROS(R) Methylphenidate in Children With ADHD

Objective: The authors evaluated the time course of the treatment effect of Osmotic-Release Oral System methylphenidate (OROS(?) MPH) HCl (Concerta(?), Raritan, NJ) CII in children with ADHD. Method: Data were combined from two double-blind, randomized, placebo-controlled, cross-over, analog classroom studies in children (9-12 years) with ADHD. Participants received an individualized dose of placebo or OROS(?) MPH on two laboratory school days. Permanent Product Math Test and Swanson, Kotkin, Agler, M-Flynn, and Pelham scores were evaluated 0.5 hr before dosing and 1, 2, 4, 10, 11, and 12.5 hr post dose. Analysis used a repeated-measures mixed model. Results: Treatment effects were present at all postdose assessment points (p < .0001 for all comparisons, n = 139). Adverse events were similar to previous reports for OROS(?) MPH. Conclusion: A robust treatment effect occurred with OROS(?) MPH; onset was at 1 hr and persisted for at least 12.5 hr after dosing.     

The countertransference impact of autistic defence in an otherwise neurotic patient

This paper investigates the question of why, in the psychoanalytic psychotherapy of a patient with encapsulated autistic pathology, the steady maintenance of a therapeutically neutral stance can be especially difficult. Transference and countertransference vicissitudes are examined. The author notices that the patient's intolerance of ‘opposites’ (cf. Tustin, 1986), combined with extreme antipathy to having that intolerance noticed, can elicit corresponding, and potentially destabilizing, countertransference reactions. These reactions comprise an unstable tension between co‐existing pressures towards fusion with, or expulsion of, the patient, their co‐existence under further pressure to remain unnoticed. Until perceived, this state of affairs risks collusion with the pressure either to merge with or to expel the patient, and compromises the capacity to notice the detail of the transference process and even to notice co‐existent positive and negative transference images. Detailed clinical illustration is given, including a session where it was difficult to notice the patient's experience of a couple as a combined object. The author finds these observations of bipolar countertransference tensions illuminated by Green's concepts of positive and negative narcissism and of the disobjectalizing function, and specifically accounted for by Ribas's theory of autism as radical drive defusion.