Developing psychotherapists’ competence through clinical supervision: protocol for a qualitative study of supervisory dyads.

BACKGROUND: Mental health professionals face unique demands and stressors in their work, resulting in high rates of burnout and distress. Clinical supervision is a widely adopted and valued mechanism of professional support, development, and accountability, despite the very limited evidence of specific impacts on therapist or client outcomes. The current study aims to address this by exploring how psychotherapists develop competence through clinical supervision and what impact this has on the supervisees’ practice and their clients’ outcomes. This paper provides a rationale for the study and describes the protocol for an in-depth qualitative study of supervisory dyads, highlighting how it addresses gaps in the literature. METHODS/DESIGN: The study of 16–20 supervisor-supervisee dyads uses a qualitative mixed method design, with two phases. In phase one, supervisors who are nominated as expert by their peers are interviewed about their supervision practice. In phase two, supervisors record a supervision session with a consenting supervisee; interpersonal process recall interviews are conducted separately with supervisor and supervisee to reflect in depth on the teaching and learning processes occurring. All interviews will be transcribed, coded and analysed to identify the processes that build competence, using a modified form of Consensual Qualitative Research (CQR) strategies. Using a theory-building case study method, data from both phases of the study will be integrated to develop a model describing the processes that build competence and support wellbeing in practising psychotherapists, reflecting the accumulated wisdom of the expert supervisors. DISCUSSION: The study addresses past study limitations by examining expert supervisors and their supervisory interactions, by reflecting on actual supervision sessions, and by using dyadic analysis of the supervisory pairs. The study findings will inform the development of future supervision training and practice and identify fruitful avenues for future research

Older adults' evaluations of the standard and modified pedometer-based Green Prescription

INTRODUCTION: The Green Prescription is a primary care programme designed to increase physical activity in individuals with low activity levels. Older adults tend to engage in insufficient physical activity to obtain health-related gain. AIM: To examine participants’ ratings of the Healthy Steps intervention and to assess how participants rated the use of a pedometer-based Green Prescription in aiding their physical activity. METHODS: In total, 330 community-dwelling older adults who have low levels of activity were randomised to receive either a standard time-based Green Prescription or a modified pedometer-based Green Prescription. Post-intervention, 259 participants completed the participant evaluation questionnaire via postal survey. Data were analysed using descriptive statistics and Chi-squared analyses. RESULTS: The standard components of the Green Prescription (general practitioner consultations and telephone counselling) received similar and higher ratings across both allocation groups than the use of print materials. A pedometer-based Green Prescription was rated as being helpful in aiding physical activity. DISCUSSION: This study supports the importance of general practitioners’ initial role in prescribing physical activity for older adults and of ongoing telephone support for longer-term adherence. Incorporating a pedometer can be effective in helping low-active older adults initiate and maintain regular physical activity

Lay perceptions of mental toughness: Understanding conceptual similarities and differences between lay and sporting contexts

Abstract:  The predominant focus on sporting populations has limited our conceptual understanding of mental toughness in lay contexts. On the basis of its wider benefits beyond sports, we sought to understand the central and peripheral attributes of mental toughness from a layperson’s perspective. To this end, we employed a prototype analysis which consisted of two studies. In Study 1, a list of attributes of mental toughness was generated. In Study 2, these attributes were ranked for their centrality to mental toughness. Study 1 was an open-format questionnaire, where 138 laypeople generated a final list of 75 attributes of mental toughness. The most frequently mentioned attributes were self-belief, determination, perseverance, resilience and focus, which largely supported important attributes identified by athletes in existing mental toughness literature. Study 2 surveyed 136 laypeople, who identified mental strength, overcomes obstacles, achieves/operates under pressure, determination and resilience/recovery as the most central attributes to mental toughness. Although determination and resilience aligned with existing sporting accounts of mental toughness, the remaining attributes reflect differences in perception of mental toughness between sporting and lay contexts. Examination of peripherally-rated attributes provides insights into mental toughness as an enduring form of suffering. Overall, determination and resilience emerged as frequently mentioned, as well as highly central, and, as such, represent the foundation for a universal (i.e., not context-specific) understanding of mental toughness

Pedometer-determined physical activity and active transport in girls

<p>Abstract</p> <p>Background</p> <p>It is well established that the risk of insufficient physical activity is greater in girls than in boys, especially during the adolescent years. The promotion of active transport (AT) to and from school has been posited as a practical and convenient solution for increasing girls' total daily activity. However, there is limited information describing the associations between AT choices and girls' physical activity across a range of age, ethnic, and socioeconomic groups. The objectives of this study were to (1) investigate physical activity patterns in a large multiethnic sample of female children and adolescents, and to (2) estimate the physical activity associated with AT to and from school.</p> <p>Methods</p> <p>A total of 1,513 girls aged 5–16 years wore sealed multiday memory (MDM) pedometers for three weekdays and two weekend days. The ethnic composition of this sample was 637 European (42.1%), 272 Pacific Island (18.0%), 207 East Asian (13.7%), 179 Maori (11.8%), 142 South Asian (9.4%), and 76 from other ethnic groups (5%). Pedometer compliance and school-related AT were assessed by questionnaire.</p> <p>Results</p> <p>Mean weekday step counts (12,597 ± 3,630) were higher and less variable than mean weekend steps (9,528 ± 4,407). A consistent decline in daily step counts was observed with age: after adjustment for ethnicity and SES, girls in school years 9–10 achieved 2,469 (weekday) and 4,011 (weekend) fewer steps than girls in years 1–2. Daily step counts also varied by ethnicity, with Maori girls the most active and South Asian girls the least active. Overall, 44.9% of participants used AT for school-related travel. Girls who used AT to and from school averaged 1,052 more weekday steps than those who did not use AT. However, the increases in steps associated with AT were significant only in older girls (school years 5–10) and in those of Maori or European descent.</p> <p>Conclusion</p> <p>Our data suggest that adolescent-aged girls and girls of Asian descent are priority groups for future physical activity interventions. While the apparent benefits of school-related AT vary among demographic groups, promoting AT in girls appears to be a worthwhile strategy.</p

Measuring flourishing: The impact of operational definitions on the prevalence of high levels of wellbeing

The epidemiology of flourishing is an important research topic prompting international interest in its psychometric assessment. But the need to measure human feelings and functioning at the population level has resulted in the creation of a multitude of different conceptual frameworks of flourishing: a term now commonly used to describe high levels of subjective wellbeing. Not only do different researchers theorise and conceptualise flourishing in different ways, but also the categorical diagnosis of flourishing is dependent upon the various combinations of components, and researcher-determined thresholds, used in each operationalization. The multiplicity of approaches is potentially limiting the usefulness of the resultant epidemiology. This paper comprises two parts: Part 1 identifies four operationalizations of flourishing in the psychology literature and reviews their psychometric properties and utility; Part 2 investigates the impact of operational definition on the prevalence of flourishing using the Sovereign Wellbeing Index survey, a sample of 10,009 adult New Zealanders, and reports substantial variation in prevalence rates according to the four different operationalizations: Huppert and So (24%), Keyes (39%), Diener et al. (41%) and Seligman et al. (47%). Huppert and So’s model was the only one of the four to require endorsement of one particular variable, making it the most stringent criterion for flourishing, while the other three were more flexible in their categorisation. Cross-tabulation analysis indicated strong agreement between our replications of Keyes and Seligman et al.’s models (81%), and between Diener et al. and Seligman et al.’s models (80%). Agreement between Seligman, and Huppert and So’s, operationalizations was moderate (74%). Taken together, and in line with recent OECD recommendations, our findings reinforce the need for greater international collaboration and conceptualisation consensus when measuring flourishing. In the absence of any published empirical research investigating perceptions of flourishing among laypersons, a prototype analysis investigating alignment between lay and academic conceptualisations of flourishing is recommended

The incidence of injuries traveling to and from school by travel mode

Objective. To assess the absolute and relative risks of youth school-related travel using the New Zealand's no fault accident liability scheme and Census at School datasets. Methods. Injury risk associated with traveling to and from school was assessed by combining census data from the Accident Compensation Commission database, New Zealand's no fault liability accident scheme database and the Census at School survey. Population injury and cost was assessed for incidents during a 2-year period (1 July 2003 to 30 June 2005) and during normal school travel hours (7.30 a.m.–9.00 a.m., 3.00 p.m.–4.30 p.m., weekdays) for youth 5–17 years of age. Results. Overall, 7573 cases were identified as being school travel-related, representing 1.6% of total, and 11.4% school travel period injuries. Walking (30.7%), cycling (30.3%), and motor vehicles (27.7%) provided the majority of injuries. Risk of injury per million trips was highest for cycling (46.1), walking (10.3), and motor vehicle travel (6.1). Conclusion. These data provide the first comprehensive examination of absolute risk of travel to and from school and by transport mode, showing that school-related travel is a relatively safe activity contributing to a minority of all injuries sustained by youth

The green prescription and older adults:What do general practitioners see as barriers?

Introduction: Limited research exists that has examined the barriers that older adults (those aged 65 years and older) can encounter when given a Green Prescription (GRx)). This study aimed to identify what general practitioners (GPs) perceived their older-aged patients' barriers were with regard to carrying out a GRx. This study also identified the strategies that GPs used to assist their older-aged patients in overcoming barriers to physical activity engagement. Methods: Fifteen GPs from the Auckland region of New Zealand were interviewed individually. An inductive thematic approach was used to analyse data. Findings: GPs identified chronic health conditions, fear of injury, transportation contraints, set routines and lack of confidence as being barriers that some of their older-aged patients have encountered when considering whether to become more physically active and, also, when engaging in actual physical activity. Conclusion: Physical activity interventions, such as the GRx programme, can have an important role in helping confer health-related gain for low-active older adults. To ensure that such interventions are successful on a long-term basis, practitioners need to be aware of the barriers that their older-aged patients can encounter when given a prescription for physical activity

Social support for youth physical activity: Importance of siblings, parents, friends and school support across a segmented school day

<p>Abstract</p> <p>Background</p> <p>Whilst evidence exists for the influence of encouragement on physical activity participation, the diversity of support sources and the type of physical activity examined previously is limited. This study examined the importance of perceived encouragement from parents, siblings/cousins, friends, and schools on participation levels across three time-specific activity opportunities that are available during a school day (after-school physical activities, lunchtime activity, and active transportation to and from school).</p> <p>Methods</p> <p>A cross-sectional sample of 12–18 year old high school students (n = 3,471) were recruited from low SES schools within South Auckland, New Zealand and categorised as either Junior (Years 9–11) or Senior (Years 12 & 13) students. Participants reported their physical activity levels and quantity of encouragement received from their parent(s), friend(s), sibling(s)/cousin(s), and school to be active. For each physical activity variable participants were dichotomized as being either "active" or "less active". For each social support source, participants were grouped into either receiving "high" or "low" levels of support. Binary logistic regression analyzes were conducted to calculate odd ratios and 95% confidence intervals.</p> <p>Results</p> <p>Low parental support (Juniors, OR: 0.47, 95% CI: 0.38–0.58; Seniors, OR: 0.41, 95% CI: 0.29–0.60) and low peer support (Juniors, OR: 0.61, 95% CI: 0.51–0.74; Seniors, OR: 0.49, 95% CI: 0.35–0.69) were associated with reduced odds of being regularly active after school. For lunchtime activity, low peer support (Juniors, OR: 0.39, 95% CI: 0.32–0.48; Seniors, OR: 0.41, 95% CI: 0.29–0.57) was associated with reduced odds of being categorized as active. While no variables were significantly related to active transportation among senior students, low peer support was associated with reduced odds of actively commuting for Junior students (OR: 0.78, 95% CI: 0.66–0.92). Irrespective of the activity examined, no significant difference was noted for students receiving high support from two parents than students reporting high support from their sole parent in a single parent family.</p> <p>Conclusion</p> <p>The importance of encouragement from parents, siblings, friends, and schools on physical activity is dependant on the time-specific activity examined. It is clear that proximal social networks need to be considered during the development of physical activity promotion strategies.</p