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Changes after multicomponent group-based treatment in patients with medically unexplained physical symptoms 医学上无法解释的躯体症状患者多组分分组治疗后的变化
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-11-03 DOI: 10.1080/09515070.2022.2142200
Lucia Polakovská, Michal Čevelíček, J. Roubal, T. Řiháček
ABSTRACT Psychological treatments for patients with medically unexplained physical symptoms (MUPS) reduce somatic symptom severity only moderately. However, patients may profit from changes other than that of symptom reduction. The aim of the present study was to capture the changes that patients with MUPS experience after a multicomponent group-based treatment. Semistructured interviews with 30 patients with MUPS were undertaken after the treatment. Thematic analysis was used to identify the changes the patients reported. The changes included developing a different view of their somatic symptoms, learning how to fulfill their needs, modifying their lifestyle, and becoming open to painful experiences. The patients also noted changes in their somatic symptoms and their quality of life. Multicomponent treatment helps patients with MUPS achieve a variety of changes that reach beyond physical symptoms reduction. Patients’ symptoms often worsen after a return to normal life, which calls for continual care.
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引用次数: 1
The antecedents of gender dysphoria and the associated thoughts, emotions, and ways of coping: a qualitative analysis and clinical implications 性别焦虑症的前因及其相关的思想、情绪和应对方式:定性分析和临床意义
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-11-03 DOI: 10.1080/09515070.2022.2142201
L. Lindley, Lex Pulice-Farrow, Stephanie L. Budge
ABSTRACT Despite recent trans-affirming research centering experiences of gender dysphoria and its relation to psychological outcomes, there is a dearth of research studying the components of experiences of gender dysphoria. This has limited the ability of clinicians to intervene and reduce the distress caused by gender dysphoria. The current study utilized an online qualitative approach based on cognitive-behavioral therapy thought trackers to ask 108 transgender and nonbinary participants four prompts: a) antecedents of gender dysphoria, b) associated thoughts, c) emotions, and e) ways of coping. Analyses of these prompts revealed that gender dysphoria is frequently triggered by body, social, and intrapersonal experiences and is associated with a range of thoughts (e.g. body, gender presentation, medical transition, and self-harm focused) and emotions (e.g. anger, sadness, fear, and suppression) related to experiences of gender dysphoria. Participants noted engaging in both facilitative coping strategies (e.g. mindfulness, gender affirmation, medical transition, social interactions, and cognitive reframes) as well as avoidant strategies (e.g. distraction; suppression; avoid viewing body/self, social interactions, and voice; and identity concealment) to deal with gender dysphoria. Considering the lack of published therapeutic interventions targeting gender dysphoria, the discussion focuses on the ways the current findings can inform clinical practice with TNB individuals.
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引用次数: 1
Social self-efficacy, outcome expectations, and goal progress among American college students: Testing temporal relations by gender and race/ethnicity 美国大学生的社会自我效能、结果期望和目标进展:性别和种族/民族的时间关系测试
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-11-01 DOI: 10.1080/09515070.2022.2142199
Hung-Bin Sheu, M. Dawes, S. Chong
ABSTRACT The transition to college represents an exciting time for adolescents and young adults, but it could also pose a challenge as they adapt to a new environment. According to social cognitive career theory, self-efficacy, outcome expectations and goal progress are key predictors of positive adjustment. While these variables have received considerable empirical attention, they are understudied using longitudinal designs and in the social domain. To fill this gap, the present study adopted the RI-CLPM to examine temporal relations as within-person processes between social self-efficacy, outcome expectations, and goal progress among first-year college students (N = 831) who completed measures of study variables at three time points with a lag of four to five weeks. As hypothesized, results derived from the entire sample identified social self-efficacy as a temporal precursor of social outcome expectations and goal progress. A similar temporal pattern emerged for European American students and students of color. However, while a bidirectional model offered the best fit for male students, no cross-lagged paths were significant for their female counterparts. These findings highlight the importance of self-efficacy and outcome expectations and provide implications for promoting positive social adjustment among college students who have different gender and racial/ethnic backgrounds.
对于青少年和年轻人来说,进入大学是一个激动人心的时刻,但在适应新环境的过程中,这也可能给他们带来挑战。根据社会认知职业理论,自我效能感、结果期望和目标进展是积极适应的关键预测因子。虽然这些变量已经得到了相当多的实证关注,但它们在纵向设计和社会领域的研究不足。为了填补这一空白,本研究采用RI-CLPM来检验一年级大学生(N = 831)的社会自我效能感、结果期望和目标进展之间的时间关系,作为人内过程,他们在三个时间点完成了研究变量的测量,滞后4至5周。正如假设的那样,来自整个样本的结果将社会自我效能确定为社会结果预期和目标进展的暂时前兆。在欧洲裔美国学生和有色人种学生中也出现了类似的时间模式。然而,尽管双向模型最适合男性学生,但交叉滞后路径对女性学生来说并不显著。这些发现突出了自我效能感和结果期望的重要性,并为促进不同性别和种族/民族背景的大学生积极的社会适应提供了启示。
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引用次数: 0
Psychotherapy failures: to err is human 心理治疗的失败:犯错乃人之常情
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-10-02 DOI: 10.1080/09515070.2022.2142383
N. Gazzola, Shigeru Iwakabe
ABSTRACT Despite the consistent positive outcome findings and psychotherapists’ best intentions in their efforts to help their clients, psychotherapy simply does not work in all cases. There are a variety of reasons why there may be treatment failures in psychotherapy that may be observed at multiple levels: (a) the treatment in question (e.g. the choice of intervention for a given presenting concern), (b) the individuals involved (e.g. therapist and client factors), and (c) the system in which the work of therapists is nested (e.g. the governance of the profession, jurisdictional laws, among others). The field has not fully developed adequate procedures and mechanisms for addressing treatment failures, which is at the core an ethical imperative. Although psychotherapy has made many strides over the last few decades to improve research rigour and to promote evidence-based practices, it is a profession that is continually growing. By embracing the opportunity to learn from therapeutic failures the profession will continue to refine its practices and ultimately better serve clients.
尽管有一致的积极结果发现和心理治疗师在努力帮助他们的客户的最佳意图,心理治疗并不是在所有情况下都有效。心理治疗中可能出现治疗失败的原因有很多,可以在多个层面上观察到:(a)有问题的治疗(例如,针对特定表现问题的干预选择),(b)涉及的个人(例如,治疗师和客户因素),以及(c)治疗师工作的嵌套系统(例如,职业治理,司法法律等)。该领域尚未充分制定适当的程序和机制来解决治疗失败问题,这在核心上是一项道德要求。尽管在过去的几十年里,心理治疗在提高研究的严谨性和促进循证实践方面取得了许多进步,但这是一个不断发展的职业。通过拥抱从治疗失败中学习的机会,这个行业将继续改进其实践,最终更好地为客户服务。
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引用次数: 0
Therapists’ questions to clients about what might be helpful can be supportive without being directive: a conversation analysis 治疗师向客户提出的关于什么可能有用的问题可以在没有指导的情况下提供支持:对话分析
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-10-02 DOI: 10.1080/09515070.2021.1997917
Sarah Cantwell, John P Rae, Jacqueline Hayes, J. Vos, M. Cooper
ABSTRACT Shared decision-making about therapeutic methods has been proposed as a way of conceptualising, and assisting, collaboration in the therapeutic alliance. However, little is known about how psychotherapists actually create concrete, moment-by-moment opportunities for clients to share their ideas about what might be therapeutically helpful. We used conversation analysis to examine psychotherapists’ questions about what might be helpful in audio-recordings of early sessions of a collaborative-integrative therapy. We examined forty-two sessions involving seven dyads and identified 28 cases of questions either inviting clients’ ideas about helpful in-therapy methods or strategies outside the therapy room. Psychotherapists could invite clients’ ideas by using simple questions, however clients could find such questions problematic. Alternatively, psychotherapists could add scaffolding: offering support to the client in terms of how they might respond. However, this could erode clients’ autonomy to respond with their own ideas. We identified a conversational practice, de-specifying, which overcomes this dilemma: asking questions and providing scaffolding whilst also lessening the pressure on the client to go along with that scaffolding. A therapeutic style which includes scaffolding and de-specifying practices creates an opportunity for the client to contribute where clients are empathically supported, but not directed, in responding.
关于治疗方法的共同决策已被提出作为概念化和协助治疗联盟合作的一种方式。然而,对于心理治疗师实际上如何创造具体的、时时刻刻的机会,让客户分享他们关于什么可能对治疗有帮助的想法,人们知之甚少。我们使用对话分析来检查心理治疗师的问题,即在协作-整合治疗的早期阶段录音中可能有什么帮助。我们检查了涉及7对夫妇的42次会议,并确定了28个问题案例,这些问题要么是邀请客户关于有用的治疗方法的想法,要么是在治疗室之外的策略。心理治疗师可以通过简单的问题来激发来访者的想法,然而来访者可能会觉得这些问题很成问题。或者,心理治疗师可以增加脚手架:根据客户的反应提供支持。然而,这可能会削弱客户以自己的想法回应的自主权。我们确定了一种会话练习,去指定,它克服了这个困境:提出问题和提供框架,同时也减轻了客户跟着框架走的压力。包括脚手架和去指定实践的治疗风格为客户创造了一个贡献的机会,在这种情况下,客户得到同情的支持,而不是直接回应。
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引用次数: 3
The mediating role of basic psychological needs satisfaction in the relationship between trait mindfulness and psychological distress in clinical trainees 基本心理需求满足在临床学员特质正念与心理困扰关系中的中介作用
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-09-08 DOI: 10.1080/09515070.2022.2121684
R. Renault, J. Laurin, B. Khoury, C. Spinelli
ABSTRACT Clinical trainees are especially prone to psychological distress. Mindfulness has shown to promote well-being among health care professionals, yet the mechanisms through which it reduces psychological distress are still uncertain. Self-determination theory suggests that mindfulness allows individuals to be more open and receptive to information from their inner and outer worlds, which facilitates satisfaction of their basic psychological needs (BPNS), considered essential to optimal functioning. However, studies investigating whether BPNS is an actual pathway through which mindfulness reduces psychological distress are limited to cross-sectional designs. This longitudinal study tested a mediation model using data collected among 27 clinical trainees at the beginning (T1) and mid-point of the academic year (T2). Results indicated that BPNS (T1) partially mediates the relationship between trait mindfulness (T1) and psychological distress (T2). Both the direct (β = −.36, 95%CI [−.67; −.05]) and indirect (β = −.27, 95%CI [−.58; −.05]) effects were significant. This model explained a large portion of variance for both needs satisfaction (R 2 = .30) and psychological distress (R 2 = .61). Our results not only yield support to the role of basic psychological needs in clinical trainees’ well-being, but also contribute to the understanding of mindfulness and one of its mechanisms of action.
摘要临床实习生特别容易产生心理困扰。正念已被证明能促进医疗保健专业人员的幸福感,但它减少心理困扰的机制仍不确定。自决理论认为,正念使个人能够更开放地接受来自内外世界的信息,这有助于满足他们的基本心理需求(BPNS),这被认为是最佳功能的关键。然而,调查BPNS是否是正念减少心理困扰的实际途径的研究仅限于横断面设计。这项纵向研究使用在学年开始(T1)和中期(T2)在27名临床受训人员中收集的数据测试了中介模型。结果表明,BPNS(T1)部分介导了特质正念(T1)与心理困扰(T2)之间的关系。直接效应(β=−.36,95%置信区间[-.67;−.05])和间接效应(β=−.27,95%可信区间[-.58;−.05])均显著。该模型解释了需求满足(R2=0.30)和心理困扰(R2=0.61)的大部分方差。我们的结果不仅支持了基本心理需求在临床受训者幸福感中的作用,而且有助于理解正念及其作用机制之一。
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引用次数: 0
Counseling psychology and participatory justice: “sharing the university” 咨询心理学与参与式司法:“共享大学”
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-09-01 DOI: 10.1080/09515070.2022.2115459
Laura Smith, Laila Abdel-Salam, Randi Elfrida Scott-Mclaughlin, K. Baranowski, Nyrah Madon, M. Williams
ABSTRACT What is a participatory justice approach to counseling psychology, and what actions would express its inclusive intentions? We propose that a participatory justice framework for counseling psychology practice and training would complement social justice perspectives by emphasizing university-community collaborations and resource-sharing; it also privileges public, community-based knowledge creation as exemplified by participatory action research. In this way, a participatory justice approach offers a counterbalance to current political trends toward private ownership of social assets and resources. This article 1) expands upon these theoretical foundations, and then 2) presents three current practice-related project examples to show how these foundations can tangibly translate to academic and professional activities. Finally, the article 3) relates these activities to the training of students by concluding with suggested curricula by which to prepare graduate students and others for participatory undertakings.
咨询心理学的参与式正义方法是什么?哪些行动可以表达其包容性意图?我们建议,咨询心理学实践和培训的参与式正义框架将通过强调大学-社区合作和资源共享来补充社会正义观点;它还赋予公共的、以社区为基础的知识创造以参与性行动研究为例。通过这种方式,参与式司法方法为当前私人拥有社会资产和资源的政治趋势提供了平衡。本文1)扩展了这些理论基础,然后2)给出了三个当前与实践相关的项目示例,以展示这些基础如何切实转化为学术和专业活动。最后,第3)条将这些活动与学生培训联系起来,最后提出了建议的课程,为研究生和其他人的参与性事业做好准备。
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引用次数: 0
Implementing routine outcome monitoring in a psychodynamic training clinic: it’s complicated 在心理动力训练诊所实施常规结果监测:这很复杂
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-08-15 DOI: 10.1080/09515070.2022.2110451
K. Aafjes-van Doorn, Jordan Meisel
ABSTRACT The use of routine outcome monitoring (ROM) has been shown to improve treatment outcomes, reduce symptom deterioration and treatment dropout, and is especially relevant for training clinics. However, the use of ROM in a psychodynamic training clinic has remained relatively unexplored. We aimed to instigate an open dialogue about the use and usefulness of ROM within the context of contemporary psychodynamic clinical practice. As a graduate trainee and professor in a psychodynamic training program, we reflect on the seemingly irreconcilable differences between psychoanalytic thinking and ROM, the anxiety around being evaluated as a trainee, whom ROM is for, the pragmatic challenges when trying new tools and technology (especially when not chosen yourself), and the limitations of standardized self-report measures, such as the OQ. Overall, these complexities suggest that although ROM is likely worthwhile for patients, therapists, supervisors, and researchers, it will only come to its fruition if we integrate it into the tri-legged stool of evidence-based practice . We will need to engage in a genuine discussion about the use of ROM and consider the possibility that ROM might even improve our psychodynamic practices. Integrating ROM into psychodynamic didactic courses and supervision in graduate training could be a good starting point.
常规结果监测(ROM)的使用已被证明可以改善治疗结果,减少症状恶化和治疗中途退出,并且与培训诊所特别相关。然而,ROM在心理动力训练诊所的应用仍然相对未被探索。我们的目的是在当代心理动力学临床实践的背景下,激发关于ROM的使用和有用性的公开对话。作为一名心理动力学培训项目的研究生实习生和教授,我们反思了精神分析思维和ROM之间看似不可调和的差异,作为实习生被评估时的焦虑,ROM是为谁服务的,在尝试新工具和技术时的务实挑战(尤其是当你自己没有选择的时候),以及标准化自我报告测量的局限性,比如OQ。总的来说,这些复杂性表明,尽管ROM对患者、治疗师、主管和研究人员来说可能是值得的,但只有当我们将其整合到循证实践的三脚凳中,它才能取得成果。我们需要对ROM的使用进行真正的讨论,并考虑ROM甚至可以改善我们的心理动力学练习的可能性。将ROM纳入心理动力学教学课程和研究生培训的监督可能是一个很好的起点。
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引用次数: 4
The influence of enculturation and shifting in predicting marianismo beliefs among Latinx women 文化适应和转变对预测拉丁女性的玛丽亚主义信仰的影响
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-08-11 DOI: 10.1080/09515070.2022.2110450
Sara Garcia, G. Gamst, L. Meyers, Leticia Arellano-Morales, Jerry L. Kernes
ABSTRACT The present study examined shifting, or the altering of one’s self-presentation in response to perceived environmental cultural cues, as a mediator of the predictive effects of Latinx women’s enculturation on their marianismo beliefs. Understanding how Latinx women’s perceptions of traditional cultural values and beliefs regarding gender, such as marianismo (i.e. gendered Latinx family cultural values), are influenced by their enculturation and shifting coping strategies, may provide investigators and practitioners more nuanced ways of viewing these women. These predictive relationships were examined with measures of Latinx enculturation, shifting, and marianismo within a structural model. These quantitative relationships were examined with a sample of 548 Latinx women. Results of a structural equation model indicated full mediation: Latinx women who were less enculturated tended to use shifting to a greater extent, and subsequently were more likely to endorse marianismo beliefs. Enculturation did not directly predict marianismo in the full mediation model. These findings suggest that some Latinx women may navigate perceived hostile social environments through the use of the shifting coping mechanism which in turn results in a stronger endorsement of marianismo beliefs. Implications for clinical work and future research with Latinx populations are discussed.
本研究考察了一个人的自我表现在响应感知到的环境文化线索时的转变或改变,作为拉丁女性文化适应对其玛丽亚主义信仰的预测作用的中介。了解拉丁裔妇女对传统文化价值观和关于性别的信仰,如marianismo(即性别化的拉丁裔家庭文化价值观)的看法是如何受到她们的文化适应和不断变化的应对策略的影响的,可以为调查人员和从业人员提供更细致入微的方式来看待这些妇女。这些预测关系通过结构模型中的拉丁文化、迁移和marianismo的测量来检验。对548名拉丁女性的样本进行了这些定量关系的检验。结构方程模型的结果显示了充分的中介作用:适应程度较低的拉丁裔妇女倾向于在更大程度上使用转移,随后更有可能支持marianismo信仰。在完整的中介模型中,文化适应并不能直接预测marianmo。这些发现表明,一些拉丁女性可能会通过使用变化的应对机制来应对感知到的敌对社会环境,这反过来又导致了对marianismo信仰的更强烈支持。讨论了拉丁裔人群临床工作和未来研究的意义。
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引用次数: 1
Individuals’ accounts and explanations of continued engagement in non-suicidal self-injury: a qualitative study 个体对持续参与非自杀性自伤的描述和解释:一项定性研究
IF 3 Q3 PSYCHOLOGY, APPLIED Pub Date : 2022-08-10 DOI: 10.1080/09515070.2022.2108762
Heather Pearce, Olga Smoliak, Stephen P. Lewis
ABSTRACT Non-suicidal self-injury (NSSI) is the deliberate damage of bodily tissue which occurs without suicidal intent. NSSI is a common behavior among young people and a frequent focus in clinical practice. Many models of the aetiology and maintenance of NSSI are focused on emotion regulation. The role that cognition plays in the behavior is less well understood. We used thematic analysis to explore how individuals explain or attribute their engagement in NSSI. The study identified several ways of thinking that may be play a role in why people engage in NSSI. Specifically, five themes were generated: Limited Controllability, Benefits, Limited Resources, Stability, and Changing Meaning and Significance. Implications for research and practice are discussed.
非自杀性自伤(non - suicide self injury,简称NSSI)是指在没有自杀意图的情况下故意伤害身体组织的行为。自伤是青少年中常见的行为,也是临床实践中经常关注的焦点。许多自伤的病因和维持模型都集中在情绪调节上。认知在行为中扮演的角色还不太清楚。我们使用主题分析来探讨个体如何解释或归因于他们参与自伤。该研究确定了几种可能在人们从事自伤的原因中发挥作用的思维方式。具体而言,产生了五个主题:有限可控性,利益,有限资源,稳定性和变化的意义和意义。讨论了对研究和实践的启示。
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引用次数: 1
期刊
Counselling Psychology Quarterly
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