Examining the Relationship Between the Therapeutic Bond and the Phases of Treatment Outcome

Examined the association between the therapeutic bond—an element of the therapeutic alliance—and treatment effectiveness. 114 psychotherapy clients completed self-report questionnaires at intake and throughout open-ended, psychodynamically oriented psychotherapy. Three bond scales, role investment (RI), empathic resonance (ER), and mutual affirmation (MA), were contrasted to session quality and the three phases of outcome (remoralization, remediation, and rehabilitation). Results indicated that different aspects of the bond predicted session quality and treatment outcome. Clients who felt motivated and invested in therapy (relatively high RI) and who reported that the therapeutic environment was friendly and affirmative (relatively high MA) were likely to rate the session as being helpful and productive. Clients who had a relatively high sense of understanding and of being understood (ER) experienced greater remoralization and remediation (but not rehabilitation). The results are placed within the context of recent research into the therapeutic alliance

Applicants\u27 Experience of Social Support in the Process of Seeking Psychotherapy

Examined informal social support during the process of seeking psychotherapy, conceptualized as four steps: realizing there is a problem; deciding therapy might help; deciding to seek therapy; and contacting the clinic. 315 psychotherapy applicants (aged 18–62 yrs) completed a questionnaire asking them whether they had talked to anyone about the problem prior to seeking therapy, whether they had help at any of the steps, and from whom they had obtained such help. Results indicated that social support was important across the process. Almost three-fourths of all Ss had help with at least 2 of the 4 steps, and almost one-third had help at all 4. Younger applicants had more help. Males more frequently had help from a spouse or romantic partner than females. Medical professionals were used primarily for referral to the clinic, rather than as sources of help at earlier steps

Applicants\u27 Experience of the Process of Seeking Therapy

Assessed the process of seeking psychotherapy, conceptualized as 4 steps: recognizing the problem; deciding therapy might help; deciding to seek therapy; and contacting the mental health system. A process of seeking therapy questionnaire was completed by 275 adult therapy applicants. It ascertained problem duration, alternative coping strategies, difficulty achieving and time needed to achieve the steps, and whether the S had informal help achieving the steps. Results indicated that problems tended to be long-standing; Ss attempted a variety of coping strategies before seeking therapy; and informal help was important throughout the process. Problem recognition was the most difficult, time-consuming step. The least and most distressed Ss reported the most difficulty achieving the first 3 steps

Clinical Psychologists\u27 Perceptions of Persons with Mental Illness

Clinical psychologists have an ethical responsibility to monitor the nature and appropriateness of their attitudes toward persons with mental illness. This article presents the results of a survey of randomly selected clinical psychologists who were asked to rate the effectiveness, understandability, safety, worthiness, desirability, and similarity (to the rater) of persons with moderate depression, borderline features, and schizophrenia. The results show that psychologists perceive these individuals differently with respect to these characteristics. The results also suggest that psychologists disidentify or distance themselves from persons with personality and psychotic conditions. Implications for quality improvement and stigma reduction in the field of professional psychology are discussed

A Naturalistic Study of the Associations between Changes in Alcohol Problems, Spiritual Functioning and Psychiatric Symptoms

The study evaluated how spiritual and religious functioning (SRF), alcohol-related problems, and psychiatric symptoms change over the course of treatment and follow-up. Problem drinkers (n = 55, including 39 males and 16 females) in outpatient treatment were administered questionnaires at pretreatment, posttreatment, and follow up, which assessed two aspects of SRF (religious well-being and existential well-being), two aspects of alcohol misuse (severity and consequences), and two aspects of psychiatric symptoms (depression and anxiety). Significant improvements in SRF, psychiatric symptoms and alcohol misuse were observed from pretreatment to follow-up. Although SRF scores were significantly correlated with psychiatric symptoms at all three time points, improvement in the former did not predict improvement in the latter. When measured at the same time points, SRF scores were not correlated with the measures of alcohol misuse. However, improvement in SRF (specifically in existential well-being) over the course of treatment was predictive of improvement in the alcohol misuse measures at follow-up. These results suggest that the association between SRF, emotional problems, and alcohol misuse is complex. They further suggest that patients who improve spiritual functioning over the course of treatment are more likely to experience improvement in drinking behavior and alcohol-related problems after treatment has ended. (PsycINFO Database Record (c) 2011 APA, all rights reserved

Post-inpatient Attrition from Care “As Usual” in Veterans with Multiple Psychiatric Admissions

Disengagement from outpatient care following psychiatric hospitalization is common in high-utilizing psychiatric patients and contributes to intensive care utilization. To investigate variables related to treatment attrition, a range of demographic, diagnostic, cognitive, social, and behavioral variables were collected from 233 veterans receiving inpatient psychiatric services who were then monitored over the following 2 years. During the follow-up period, 88.0 % (n = 202) of patients disengaged from post-inpatient care. Attrition was associated with male gender, younger age, increased expectations of stigma, less short-term participation in group therapy, and poorer medication adherence. Of those who left care, earlier attrition was predicted by fewer prior-year inpatient psychiatric days, fewer lifetime psychiatric hospitalizations, increased perceived treatment support from family, and less short-term attendance at psychiatrist appointments. Survival analyses were used to analyze the rate of attrition of the entire sample as well as the sample split by short-term group therapy attendance. Implications are discussed

Measuring the Discrepancy Between Current and Ideal Spiritual and Religious Functioning in Problem Drinkers

The idea that spiritual and religious functioning (SRF) is associated with alcohol misuse is generally supported, but problems with typical research methods limit the utility of findings. Problems in SRF were conceptualized as discrepancies between current and ideal SRF. Two separate studies were conducted to develop and evaluate a scale to measure the subjective importance and adequacy of aspects of SRF that seem to be associated with alcohol problems. The 1st study suggested that a questionnaire developed to evaluate self-reported ratings of current and ideal SRF is both internally consistent and temporally stable. In the 2nd study, the questionnaire was administered to persons seeking treatment for alcohol problems and persons who indicated that they had never sought treatment for an alcohol problem. Results indicate that those with a drinking problem were more likely to report substantial discrepancies between current and ideal SRF, supporting the validity of the measure as an indicator of problems in SRF. The usefulness of this method for treatment and research is discussed

SLIDES: Climate Change and Public Lands: Examples from National Parks

Presenter: Stephen Saunders, President, The Rocky Mountain Climate Organization (Denver, CO) 40 slide

Exploring the Possibilities of a Cellular Automata in Minecraft

Complex systems are not always generated by complex individuals. Simple, cell-like individuals can produce sophisticated outcomes. Structures implementing this nature are called cellular automaton. In this paper, we discuss the difficulties associated with the creation of one such automaton in a pre-existing environment, in this case the game MineCraft. A subsequent study of the behavior of this automaton is presented, using an objective information measure called set complexity

Psychology Doctoral Students’ Perspectives on Addressing Spirituality and Religion with Clients: Associations with Personal Preferences and Training

Students (n = 543) in doctoral clinical and counseling psychology programs were surveyed about training experiences with regard to addressing the spiritual and religious beliefs and practices (SRBP) of their patients. About one fourth of the respondents indicated they had received no training related to patients’ SRBP. Another half had only read material on their own or discussed such issues with a supervisor. Nonetheless, respondents almost universally endorsed the idea that patients should be asked about spirituality and religiousness. Participants also rated the appropriateness of spiritual and religious queries that might be asked of patients. As expected, queries about the relevance of SRBP were rated as the most appropriate, whereas queries that implied a disrespectful or challenging tone were rated as the least appropriate. Participants’ personal SRBP and training that was specific to patients’ SRBP were weakly but significantly associated with appropriateness ratings. The results suggest that students are formulating ideas about how to ask patients about their spiritual and religious issues despite potentially inadequate formal instruction