What does neuroscience offer us in understanding cognitive therapy and person-centred therapy for depression? A realist synthesis review

A need for increased access to effective therapies for depression has been identified in the United Kingdom. There has been significant investment in Cognitive Therapy but a perceived lack of funding for alternatives. This study takes a pluralistic perspective in enquiring into what neuroscience offers us in understanding Cognitive Therapy and Person-Centred Therapy for Depression. This realist synthesis review provides a background of the theories, mapped for commonality in causality and therapy for depression. It examines neuroscience theory of depression and fMRI evidence of the effects of Cognitive Therapy and Person-Centred therapeutic concepts on the brain. This review highlights some of the limitations of scanning technology and the way that research within ‘schools’ interprets evidence from the perspective of a particular theory. This has led to evidence being presented for the case of cognitive control of emotion. The alternate hypothesis for emotional regulation was not tested in the studies reviewed despite being observed as the mechanism of change in drug therapy for depression. Since all disciplines and theories reviewed suggest the involvement of both cognitive and affective processes further research is suggested to clarify their interaction

Not All Managers Are Managerial: A Self-Evaluation of Women Middle-Managers' Experiences in a UK University

The focus of this small-scale self-evaluation is the implementation of a new middle-management role in a post-92 UK university. A realist appreciative inquiry was undertaken with five women who had been promoted to a middle-management role 18 months prior to the inquiry. This evaluation for knowledge offered an opportunity to reflect on experiences in practice and sought to understand the experiences of the women in this role and how they cope with the challenges middle-management brings. Particular challenges (instability-generating) accorded with existing literature and included: lack of role clarity, lack of pre-preparation for management role, colleagues’ views of management, including perceptions of women in management roles and malicious intent of managed academics in rare cases. Supportive factors (provisional-stability-generating) included: personal resilience, informal peer support, external support and reflection. The co-evaluators offered reflections for the future from this co-evaluation. These suggest that training may contribute to provisional-stability in role and should be considered for new entrants to middle-management. The alternative construct of humanistic management is proposed as a way of understanding these women’s values-based decision-making practices in complex situations