Special Psychology Research Articles

An updated meta-analysis to assess the effectiveness of psychological interventions delivered by psychological specialists and generalist clinicians on glycaemic control and on psychological status

Objective To update a meta-analysis and determine the effectiveness of psychological interventions on glycaemic control measured by HbA 1c and psychological status in type 2 diabetes and to compare effects when interventions are delivered by generalist clinicians compared to psychological specialists. Methods We used the original review protocol and searched the Cochrane central register of controlled trials, Medline, Embase, PsychLIT, and Google Scholar from February 2003 (end of previous review) to March 2007. We extracted data on the participants, interventions, delivery methods, comparison groups and outcome measures. Results 35 trials were reviewed and meta-analysis of 19 trials ( n = 1431), reporting HbA 1c found a reduction in HbA 1c by 0.54% (−0.32; 95% CI: −0.47 to −0.16). In nine trials ( n = 832) interventions were delivered by diabetes or general clinicians reducing HbA 1c by 0.51% (−0.27; 95% CI: −0.50 to 0.04). In nine trials, interventions ( n = 561) were delivered by psychological specialists reducing HbA 1c by 0.57% (−0.36; 95% CI: −0.61 to 0.12). Meta-analysis of 13 trials reporting psychological status found psychological status to be lower in the intervention groups −0.56 (95% CI: 1.00 to −0.13). Trial quality for the majority of studies remained poor. Conclusion Our findings suggest that psychological and general clinicians are similarly effective in delivering psychological interventions, however, effect sizes for all clinicians have reduced since the earlier review. Practice implications Psychological training opportunities for generalist clinicians could lead to wider availability of effective psychological care.

Learning to resolve real cases using computing tools for learning and collaboration. Experimental study in the context of university education

Technology can act as a dynamic factor in the process of learning and of communication, generating a context in which people with different training and interests can work together to deal with real problems of major complexity, often badly structured and in different domains of knowledge. The expectations of improving the ability of users of information and communications technologies (ICT) are highly related with the way the full set of computing tools is used within the process of shared construction of knowledge. In this article we propose a model to demonstrate that the use of computing as a tool for the mind is capable of optimising the individual and group potential to reach expert knowledge. That is to say, ICT can affect our ability, at different levels of intensity, in the processes of learning to learn, learning to generate knowledge, learning by collaboration, if the conditions are those based on the principles of the theory of cognitive flexibility, transformational learning, and collaborative learning. The results are presented of research with 63 university students, speech therapists, and specialists in psychology and pedagogy who, using computing tools, had to solve eleven real cases of non-vocal children and adults who aimed to introduce improvements in their systems of augmentative communication. Two learning contexts are compared in the achievement of expert knowledge elaborated in a WebQuest format which uses resources on the Internet, one rigid, based on traditional tools which use protocols, and the other flexible, using "mindtools". Differences in the full use of the programmes between elementary and advanced students are demonstrated, in favour of the latter, who use databases and conceptual maps which are supported by the theory of cognitive flexibility. We discuss the need to make available computing tools for communication which allow students and professionals to create shared work spaces to deal with particularly complex real cases.

The European Network of Young Specialists in Sport Psychology

The European Network of Young Specialists in Sport Psychology

The relevance of trauma to general clinical practice.

Research findings on the prevalence in general clinical settings of trauma histories, trauma-related disorders and various other psychological disorders associated with trauma exposure, and physical health problems related to trauma are surveyed. It is argued, on the basis of diverse comorbid conditions associated with trauma exposure, that generalists with varied experience who obtain specialized trauma training are especially well equipped to develop competency in trauma practice. There are many subjects that have the potential to be useful and relevant facets of the psychology practitioner’s repertoire of knowledge and skills. Why should clinicians, who already have such a wide-ranging compendium of material to master in order to maintain competency in general practice, expend the time and effort to master yet another content area? It is this question that the remainder of this article aims to address. Appreciation of the relevance of trauma to understanding psychological difficulties played a central role in the very first pioneering stages of the development of psychotherapeutic practice (Herman, 1992b). The sustained, systematic empirical study of trauma, however, is much more recent. The legitimization of psychological trauma as an issue worthy of study can be traced back roughly a quarter century to the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–III; American Psychiatric Association, 1980). This event marked the official recognition of posttraumatic stress disorder (PTSD) as a diagnostic syndrome. In the intervening period between 1980 and the present, the study of trauma has evolved rapidly, generating a vast body of empirical, clinical, and theoretical literature (Gold & Faust, 2002). The systematic study of the impact of trauma on psychological functioning is so recent that even the most elementary aspects of the identification, assessment, and treatment of psychological trauma have not been incorporated into the standard curriculum for training professional psychologists (Courtois, 2002). The vast majority of psychologists currently practicing, therefore, are not familiar with this knowledge base. The overwhelming majority of contemporary psychological trauma specialists were of necessity self-taught, since their graduate training occurred in an era predating the existence of their field of specialization. They developed their expertise in trauma studies on their own initiative by reading and attending workshops

Psychological performance from player point of view of fighting,individual and team games

This study aims at: - identifying deference in psychological performance between theoretical means of scales and response sample on scales. - identifying deference in psychological performance scale between basketball, swimmers, tai kwan do players. The sample of the study was consisted of (29) players who play in Talafer,AL-mousl,AL- ftwoa clubs in games of basketball, swimming and taikwando,the data collected through psychological performance inventory was adapted from( James E. loehrs). The study revealed the following results: - the sample of study was suffer weakness in-self confidence, Negative energy, mental Imagery, positive energy, and situation control . - the sample of study was distinguished by acceptable level motivation and attention control . The researchers recommended the following: - Emphasizing the coaches to participatein training programming to important psychological side when training programming preparations. - Emphasizing the importance of psychological preparations with the use of modern methods under supervision of specialist in the field sport psychology .

Treatment of erectile dysfunction: defyning the optimal response

Prevalence of erectile dysfunction (ED) has been estimated at 13% to 28% of men aged 40 to 80 years worldwide. The availability of oral treatments has enhanced awareness of the impact of ED on emotional well being and on sexual satisfaction (i.e., satisfaction with sexual intercourse, sex life, and sexual relationship). However, it is crucial for patients with ED non only to improve erectile symptoms but to optimize response to the treatment proposed. This allows to improve sexual function, patient satisfaction and overall couple relationship. In this context a novel patient assessment consisting of erection hardness evaluation has been proposed. Erection hardness is a physiologic response which can be easily graded subjectively with the Erection Hardness Grading Scale (EHGS). The importance of the ability to achieve a hard erection has been recently recognized by an International Consensus Advisory Panel of urology, psychology, and reproductive health specialists with experience in assessing and treating ED. This panel defined ED treatment efficacy as “…the ability of a pharmacologic agent to promote achievement and maintenance of firm or adequate erections” and described a complete response as “…consistent achievement and maintenance of full erection”. Several prospective double-blind trials have indeed demonstrated how erection hardness positively correlated with successful sexual intercourse rate, patient satisfaction, and satisfaction with overall couple relationship. Therefore, achievement of hard erections may be considered a unifying factor that defines response in ED treatment. Completely hard and fully rigid erections should be thus recognized as the optimal goal of an ED therapy.

The changing role of the subject specialist

As we all know, libraries are these years rapidly undergoing change on unparalleled scale. Evidently, this applies to librarians, too, and not the least to that important category of library staff, the subject specialist. As recruiting and education of library workers differ from country to country it is difficult to give a detailed, generally valid description of the subject librarian in libraries, but I believe that you can describe an ideal model of subject librarianship as follows: Within each of the major subject disciplines covered by the library, the library should have a subject specialist preferably with a master degree or at least a bachelor degree in the particular subject discipline. The role of the subject specialist is to perform four basic functions where extensive subject knowledge is considered to be necessary: selecting and classifying books, assisting users with advanced subject inquiries, giving subject-specific courses in information retrieval, and maintaining liaison with relevant academic departments and centres. Personally, I know this system very well since I got employment in the Royal Library in Copenhagen as a subject specialist in psychology in the very month I finished my degree in psychology from the University of Copenhagen, back in 1973. The subject librarian system at the Royal Library in Copenhagen was patterned on the ideal model, as I just described it, and it was closely paralleled in the other academic libraries in Denmark, also the new university libraries which were founded in the seventies.

Reflections on a specialist groupwork placement

This article is a first person account of a clinical psychology specialist groupwork placement undertaken in 2005–6 by a trainee clinical psychologist.

The suicide epidemic in Japan and strategies of depression screening for its prevention

Introduction Suicide is among the most tragic outcomes of all mental disorders. WHO estimates that, worldwide, there are approximately one million deaths from suicide each year, and 20 times this number of people attempt suicide. Although the Japanese population leads the world in longevity, it has a high rate of suicide that is globally ranked ninth. From 1995 to 2004, the incidence of reported suicides rose dramatically from 17.5 to 25.1 per 100 000. Some studies have reported that this increase is closely related to the economic depression that occurred in Japan over the same period. While a reduction in suicide rates may depend on an economic recovery, public health practitioners must try to help potentially suicidal individuals, regardless of outside influences such as the economy. Depression plays an important role in the etiology of suicide. Over 60% of the individuals who commit suicide were identified as depressive. Reducing the number of suicide attempts requires, therefore, an initial identification of people with potential depression. When the University of Iowa's psychiatric department hosted clinics on the National Depression Screening Day in the USA in 1996, 65% of the 927 participants required further evaluation, of whom 83% subsequently received treatment for depression. (1) Efforts made in the USA indicate that tactics instituted to identify depression can work well to reduce suicide rates at the national level. In 2000, the Japanese Government declared its goal to reduce the annual incidence of suicide by 30% until 2010. The National Committee published proposals for suicide prevention in 2002, emphasizing the importance of pre-intervention (assessment of factors affecting suicide), intervention (identification of high-risk persons to prevent suicide) and post-intervention (social support for bereaved family and friends). They also published two guidelines for managing depression: one for health-care professionals and one for public servants. The guidelines recommend a screening test for depression in the workplace and the community, using a method based on the full criteria of the Statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR), including eight or nine items for assessment. A simpler method is required to promote screening for depression nationwide. Fulfilment of the national goal within the next five years will require identification of target groups and extensive intervention for high-risk persons in these groups. Identification of target groups Depression is one of the most rapidly spreading mental disorders in Western countries and in Japan. According to the National Survey in Japan, the number of individuals diagnosed with depression increased from 83.1 to 340.0 per 100 000 during the period 1984-98. Although depression is generally more common in women than in men, the most dramatic increase has involved middle-aged men (40-60 years); this tendency also applies to the percentage of the population who commit suicide. In Japan, most middle-aged men function as the family breadwinner and may be too busy with work to visit a clinic, even when they feel mental distress. Because it is mandatory for all workers in Japan to undergo health check-ups every year at the expense of their employers, targeting middle-aged men in the workplace is a good strategy for identifying potentially depressive persons. Simple screening methods to detect depression The most commonly used standard for the diagnosis of major depressive disorder (MDD) is a structured interview by a specialist, such as a psychiatrist, according to the DSM-IV-TR criteria. Essential MDD symptoms are depressive mood and a loss of interest lasting at least two weeks; diagnosis also requires three additional concurrent symptoms (e.g. appetite loss, fatigue and insomnia). With the possible exceptions of psychiatrists and psychological specialists, diagnosing depression is not an easy task: interviews are somewhat complex and are time consuming. …

Achieving Risk Reduction, Effectively

This paper makes the case that to achieve risk reduction effectively: the first steps are to identify and evaluate the hazards and assess the risks deriving from them; then, a logically supported, feasible, hierarchical series of control measures should be undertaken to reduce risks; and the risk reduction measures should be encompassed within a sound problem solving technique. The combination of the hierarchy of controls and the problem solving technique is called The Safety Decision Hierarchy. Outcomes to be achieved through the application of The Safety Decision Hierarchy are given, as well as the logic of taking risk reduction steps in the order set forth. Comments are made on cases in which engineering measures did not achieve expected results because of psychosocial work situations and how specialists in occupational psychology and organizational psychology can help to resolve circumstances of that sort.

Telehealth issues in consulting psychology practice.

Consulting psychologists have recognized the importance of providing comprehensive consultation and clinical services for consumers with special needs. Often because of distance and access to consultation services, remote and underserved populations may not have the necessary access to consultant specialists in psychology and other disciplines. Such services are now available through an innovative model of telehealth. Telehealth technology and services have gained the attention of scientists, clinicians, consultants, and health educators in a variety of settings. Examined are consultation case scenarios using telehealth qualitative observations of consultants who have used telehealth and liability issues consultants may face using this technology. A model release of liability is provided for consulting psychologists who may consider its use in their consultation practice. Case examples using telehealth applications are discussed, as are special applications for health care delivery to undeserved rural populations using telehealth technology.

Programa de formación en Psico-Oncología para residentes de Psiquiatría y Psicología Clínica: modelo de interconsulta

Training in Psycho-Oncology, as its principal objective, seeks to endow the resident in Clinical Psychology and Psychiatry with the theoretical-practical knowledge and the clinical-care skills necessary for the psychological evaluation, diagnosis and treatment of emotional reactions and the psychopathological traumas presented by the cancer patient and family members. This implies the acquisition of skills and knowledge necessary to develop programs of investigation in the field of Psycho-Oncology. We start with a model of training that encompasses not only didactic-theory but also clinical-care skills using structured clinical supervision. The final objective is to guaranty an appropriate clinical ability to provide care for the cancer patient. However, this training program does not convert the resident into a specialist in Psycho-Oncology but merely into a specialist in Clinical Psychology or Psychiatry with a specific insight and ability in Psycho-Oncology.

Classification and examination of halitosis

In this paper, the classification of halitosis and the examination procedures used in diagnosing halitosis are outlined. Halitosis is classified into categories of genuine halitosis, pseudo-halitosis and halitophobia. Genuine halitosis is subclassified into physiologic halitosis and pathologic halitosis. Pathologic halitosis itself is subdivided into oral and extraoral halitosis. Patients diagnosed with pseudo-halitosis and halitophobia usually complain about having oral malodour that does not really exist. Pseudohalitosis can be treated by dental practitioners, but halitophobic patients must be referred to psychological specialists. Oral malodour can be measured using an organoleptic measurement or a gas chromatography analysis. The organoleptic measurement is the most practical procedure with which one can evaluate oral malodour. Gas chromatography (GC) analysis using a flame photometric detector has been shown to be the gold standard for measuring oral malodour, owing its reputation to its objectivity and reproducibility. Moreover, GC is specific for volatile sulphur compounds (VSC), which are the main causes of oral malodour. It has been demonstrated that there is a high correlation between the intensity of oral malodour and the VSC concentration as measured by GC.

Patients' need for information before surgery

Frequently, prior to surgery, patients are provided with information in order to meet legal and hospital requirements, but without taking their psychological needs into consideration. In order to learn how to improve this situation, the present study was performed. By means of a semi-structured interview including a newly constructed card system, that avoids giving patients undemanded and possibly harmful implicit information, the need for information of 60 patients before hip- or knee-replacement surgery were investigated in great detail. The results show that 83.3% of the patients want to be prepared by the surgeon, preferably by means of an oral communication (75.0%). Most frequently the day when decision for surgery is made and the day of hospitalization were preferred as point of time for preparation (30% each). Patients were more interested in information about the operation and recovery (43.3% each) than about risks (33.3%). Only 11.7% wanted to get psychological preparation prior to surgery. We conclude that coming into contact and establishing a trustful relationship with the surgeon who does the operation is the most crucial need of surgical patients. He should give presurgical information according to the patient's needs, which often do not focus on the risks, as legal regulations do. By providing psychological preparation for the small number of patients in need, psychological specialists may contribute to improve satisfaction and outcome of surgical patients.

Board certification (Diplomate) in behavioral psychology.

This article describes the American Board of Behavioral Psychology (ABBP) and how it can assist you in maximizing your potential as a behaviorally-oriented professional psychologist. The mission of the board is to grant board certification in Behavioral Psychology to qualified behavioral psychologists after a competency-based examination. As a board certified psychologist (Diplomate), you will be on a par with board certified physicians and other similar professionals. Furthermore, possession of the diploma makes it easier for psychologists to be licensed in many other states. Some managed care companies increasingly look for the possession of credentials such as board certification and other employers recognize such specialty credentialing as well. In some employment settings, increased pay schedules may be possible for board certified psychologists. Finally, possession of the diploma informs the professional community that the holder is a recognized specialist in behavioral psychology as demonstrated through a competency-based examination presented by peers. Because of this competency-based assessment, a diploma from ABBP is recognized as the gold standard of professional practice in this specialty. ********** In order to provide behaviorally-oriented psychologists with the opportunity to demonstrate their specialty competencies, the American Board of Behavioral Psychology was formed in 1987 and incorporated shortly thereafter. After an initial phase of negotiation with and monitoring by the American Board of Professional Psychology (ABPP), ABBP was incorporated into ABPP as a specialty member board in 1992. ABPP has been certifying psychological specialists since 1948. I was the first Behavioral Psychology representative to ABPP's Board of Trustees, serving from 1993 through 1996. Dick Suinn, former AABT President and Past President of APA, was the Behavioral Psychology representative from 1997 through 2000. Christine Nezu began her term this year as the third Behavioral Psychology representative. The General Eligibility Criteria for the Diplomate in Behavioral Psychology are as follows: 1. Psychologists must be of good moral character, scientific integrity, and professional standing. Their conduct must be in accordance with the prevailing ethical principles of the American Psychological Association or the Canadian Psychological Association, as appropriate to the location of their practice. 2. An earned doctorate in psychology is required that is APA accredited or met equivalent standards at the time the degree was awarded. 3. State or regional licensure or certification at the level of independent practice is required in the state in which the psychologist practices. 4. Three years of experience in one or more aspects of behavioral psychology; one of which may be pre-doctoral, as well as appropriate supervision in behavioral psychology is required. The board recognizes that not all of a candidate's experience may be in behavioral psychology. 5. Membership and participation in professional organizations which have identifiable purposes that are congruent with those of ABBP. The process of acquiring board certification in Behavioral Psychology consists of three phases. In Phase One (Application Phase), the candidate obtains the ABBP application packet from the ABPP Central Office, completes it, and submits it with copies of the following documents: * Current psychology license * Current curriculum vita * Official school transcripts * Supervisor rating forms from two former supervisors * Colleague rating forms from two or three current or past colleagues/peers * Candidates who are members of the National Register of Health Service Providers in Professional Psychology are presumed to have met the General Eligibility Criteria. In Phase Two (Work Sample Phase), candidates are invited to submit four copies of at least one work sample of his/her typical practice as a behavioral psychologist. …

An Anthropological Approach to the Study of Organizational Change: The Move to Self-Managed Work Teams

Anthropology plays a useful role in understanding work life in complex organizations. As a practicing anthropologist who works in business organizations along with specialists from other disciplines, I find that there is a particular set of skills and way of knowing that I contribute to understanding human behavior in these complex settings. In this article I plan to concentrate on three of the contributions anthropologists make: our qualitative methods, our holistic perspective and our understanding of organizational culture change. I plan to illustrate these contributions through a description of my recent work studying self-managed work teams of knowledge workers in six organizations. This work is from a three-year study conducted by a team which included specialists in anthropology, psychology, management, computer science, and engineering.

Introduction to the Special Section on Psychological and Behavioral Approaches to Occupational Health.

The history of the International Commission on Occupational Health is deeply bound to that of the 20th century. First and only international scientific society of such an importance, it was founded in 1906 to bring solutions to the problems caused by a great number of occupational injuries and diseases due to the developing of industry. With the passing years, from a small medical group it has become a multidisciplinary society, present in 90 countries, where researchers, government authorities, and practitioners are coexisting in a permanent exchange between practice and research. It is composed of international scientific committees, which organize regular conferences and meet every 3 years on the occasion of the great International Congress in Occupational Health. Owing to the changes due to the new technologies of work and to the globalization of economy, the orientation of its activities is in progress: larger opening toward developing countries and the phenomenon of development in general, emphasis on prevention in occupational health, and opening of a new field of research on the psychosocial factors and work organization. At the first conference on this theme, held in Copenhagen in August 1998, occupational health and occupational psychology specialists met. Indeed, new approaches are needed, like the setting up of adapted tools to face the consequences of these factors on health and the construction of a new paradigm of occupational health. Today, both the transcultural approach of the problems of occupational health and the ethical thought on fundamental values are necessary.

Introduction to the special section on psychological and behavioral approaches to occupational health.

The history of the International Commission on Occupational Health is deeply bound to that of the 20th century. First and only international scientific society of such an importance, it was founded in 1906 to bring solutions to the problems caused by a great number of occupational injuries and diseases due to the developing of industry. With the passing years, from a small medical group it has become a multidisciplinary society, present in 90 countries, where researchers, government authorities, and practitioners are coexisting in a permanent exchange between practice and research. It is composed of international scientific committees, which organize regular conferences and meet every 3 years on the occasion of the great International Congress in Occupational Health. Owing to the changes due to the new technologies of work and to the globalization of economy, the orientation of its activities is in progress: larger opening toward developing countries and the phenomenon of development in general, emphasis on prevention in occupational health, and opening of a new field of research on the psychosocial factors and work organization. At the first conference on this theme, held in Copenhagen in August 1998, occupational health and occupational psychology specialists met. Indeed, new approaches are needed, like the setting up of adapted tools to face the consequences of these factors on health and the construction of a new paradigm of occupational health. Today, both the transcultural approach of the problems of occupational health and the ethical thought on fundamental values are necessary.

Psychological services utilization: relationship to severity of behaviour problems in intellectual disability services.

Using the Developmental Disabilities Profile, a population service registry, the present study gives an analysis of the relationship between the rated frequency of contact with psychology specialists and a composite rating of 13 behaviour problems in intellectual disability services. An analysis of information on 45,810 adults with intellectual disability indicated that, when the population was divided into quintile groups based on behaviour severity, distinctively different distributions of rated contacts with psychologists were discernible. The people rated in the highest quintile for severity of maladaptive behaviour constituted especially high utilizers of psychology services. About 37% of participants had had no contact with psychologists during the past year, whereas 26% had such contact weekly or more frequently. The findings are introduced and discussed in the context of psychological practice in intellectual disability services and trends toward managed health and behavioural health care in the USA.

THE CHILD WHO HAS SEVERE NEUROLOGIC IMPAIRMENT

The formulation of a diagnosis in a child who has neurologic impairment should not (except in extreme circumstances) be made on the basis of a single finding. For example, the presence of delayed milestones, primitive or exaggerated reflexes, abnormal muscle tone, abnormal posture, abnormal neurologic examination, and temporal course should all be used to make the diagnosis of cerebral palsy. Furthermore, because each condition has a spectrum of disabilities from mild to severe involvement, determination of the child's abilities and impairments should be part of the diagnostic process. Because the child lives in a number of different environments, assessment of the child's functional abilities and evaluation of the environments should be made. Finally, evaluations by specialists in physical therapy, occupational therapy, speech therapy, psychology, special education, and nutrition may be necessary to complete the child's diagnosis. The ability to examine the child over a period of time (i.e., continuity of care) allows the practitioner to provide a more accurate prognosis for future development. It also enables easier diagnosis of the child when he or she is acutely ill. This also allows a more trusting relationship to develop with the parent and enhances the ability to influence the psychosocial conditions that affect outcomes. Finally, all these children should have care coordination (case management) (i.e., someone who can ensure that they receive the care they need, without duplication) across all settings, including home, school, hospitals, and ambulatory facilities.