The Core Curriculum on Childhood Trauma: A tool for training a trauma-informed workforce.

Recognition of the nationwide high prevalence of psychological trauma in children and adolescents, combined with increasing awareness of the far-reaching adverse consequences of childhood trauma, have led to calls to develop a trauma-informed mental health workforce. We describe the initial pilot test of the Core Concepts portion of the Core Curriculum on Childhood Trauma, as conducted in a large graduate school of social work. The Core Curriculum uses detailed case vignettes of trauma-exposed youth and families, combined with problem-based learning methods, to promote two primary learning aims: (a) to enhance the development of foundational trauma-related conceptual knowledge, and (b) to accelerate the acquisition of trauma-informed clinical reasoning and clinical judgment. Vignettes are presented in segments to simulate gathering, organizing, drawing meaning from, and making decisions based on information in professional practice. After each segment, the facilitator helps learners to summarize relevant facts, develop hunches and hypotheses, identify learning issues, and plan next steps. The Curriculum was very favorably received by students and was associated with marked increases in self-efficacy in applying the Core Concepts to work with trauma-exposed youth and families. We discuss ways in which the Curriculum can be used, especially as a foundation for training in specific evidence-based treatment protocols, to help prepare a national mental health workforce capable of implementing trauma-informed evidence-based practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Clinical Practice in Corrections: A Conceptual Framework.

Given the rich complexities of clinical practice in corrections, it is surprising that professional psychology lacks a conceptual framework for organizing the knowledge that guides such work. To accommodate the sources of information contributing to this knowledge base, a conceptual framework that informs clinical practice is presented. The framework posits several psychology services, each of which differs in core knowledge and treatment parameters. Implications for training are offered to guide psychologists who contemplate or begin careers in correctional facilities as well as educators and supervisors in training and internship programs who attempt to prepare students for roles as correctional psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Implications of 'Psychological Injuries' for Clinical Psychology Training Programs.

This paper uses the psychological and legal concept of "psychological injury" as an illustration of the evolving market for psychological knowledge and of necessary changes in the graduate and internship training of clinical psychologists. Our current graduate and internship training fails many of our students through neglecting important areas of knowledge and experience. In this paper, I discuss the importance of exposing graduate students to: a) the economics of mental health; b) professional roles involving knowledge dissemination outside traditional academia; c) information needs of direct and indirect consumers of psychological knowledge; and, d) communication skills necessary when interacting with nonpsychologists. Suggestions are made for the improvement of our graduate training programs, including more explicit acknowledgement of the likely career paths of most of our graduates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guidelines for Psychological Practice With Older Adults.

Presents the American Psychological Association Guidelines for psychological practice with older adults. The present document is intended to assist psychologists in evaluating their own readiness for working clinically with older adults and in seeking and using appropriate education and training to increase their knowledge, skills, and experience relevant to this area of practice, when desired and appropriate. The specific goals of these guidelines are to provide practitioners with (a) a frame of reference for engaging in clinical work with older adults and (b) basic information and further references in the areas of attitudes, general aspects of aging, clinical issues, assessment, intervention, consultation, and continuing education and training relative to work with older adults. These guidelines build on, and are intended to be entirely consistent with, the APA's (2002a) "Ethical Principles of Psychologists and Code of Conduct" and other APA policies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Use of Outcome Measures by Psychologists in Clinical Practice.

This survey investigated psychologists' use of outcome measures in clinical practice. Of the respondents, 37% indicated that they used some form of outcome assessment in practice. A wide variety of measures were used that were rated by the client or clinician. Clinicians who assess outcome in practice are more likely to be younger, have a cognitive-behavioral orientation, conduct more hours of therapy per week, provide services for children and adolescents, and work in institutional settings. Clinicians who do not use outcome measures endorse practical (e.g., cost, time) and philosophical (e.g., relevance) barriers to their use. Both users and nonusers of outcome measures were interested in similar types of information, including client progress since entering treatment, current strengths and weaknesses, and determining if there is a need to alter treatment. Implications for practicing clinicians are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bridging the Gap Between Posttraumatic Stress Disorder Research and Clinical Practice: The Example of Exposure Therapy.

There are notable challenges in translating empirically supported psychosocial treatments (ESTs) into general routine clinical practice. However, there may be additional unique dissemination and implementation obstacles for ESTs for trauma-related disorders. For example, despite considerable evidence from randomized clinical trials that attests to the efficacy of exposure therapy for posttraumatic stress disorder, front-line clinicians in real-world settings rarely use this treatment. Perceived and actual barriers that interfere with adoption include clinician misconceptions about what exposure entails and complex cases to which ESTs may not be readily applicable. Specific suggestions for bridging the science-into-service gap in trauma ESTs (in general) and in exposure therapy (in particular) are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Psychological Diagnosis In Clinical Practice.

Reviews the book, Psychological Diagnosis In Clinical Practice by Benjamin Pope and Winfield H. Scott (1967). The aim of this book according to the authors, is to demonstrate how the clinical psychologist transforms data obtained from tests into diagnostic formulations. They address the book to a wide audience including student psychologists, teachers, social workers, nurses, counselors, and lawyers. While one might like to see such interest, it is difficult to imagine student nurses ploughing through the intricacies of interpreting Card 4 of the Rorschach. Likewise, while one might feel that law students ought to have a smattering of psychology behind them before being turned loose on the public, it is doubtful if this book provides the best source. While the theoretical portion of this book brings together in a useful fashion some of the more recent findings in the psychometric area, there is very little evidence that the authors have permitted this information to affect their actual practice in the clinical situation. Their approach to diagnostic problems appears virtually unchanged from that which was being advocated a quarter of a century ago. As such they sire unwittingly likely to realize the dual aims of discouraging the "better" more critical student from taking clinical psychology seriously, while at the same time providing further ammunition for those individuals within the discipline who are critical of diagnostic testing in general. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Standing in the Spaces: Essays on Clinical Process, Trauma, and Dissociation.

Review of book: Philip Bromberg. Standing in the Spaces: Essays on Clinical Process, Trauma, and Dissociation. Hillsdale, NJ: Analytic Press, 1998, 365 pp. Reviewed by Peter Kaufmann. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practice Patterns Across the Clinical Life Span: Results From the California Survey of Psychological Practice.

Recent surveys among psychologists and historical accounts of the profession document important practice pattern differences among psychologists on the basis of years of postlicensure experience. Evidence for these differences across 4 groups of psychologists was examined from responses to the 2000 California Survey of Psychological Practice. Psychologists with fewer than 5 years of experience were found to treat on a weekly basis a greater percentage of patients with childhood disorders and substance abuse disorders and to spend a greater percentage of practice time in public health and/or mental health settings than other psychologists. No differences were found in the use of 3 dominant forms of psychotherapy. The implications of these results for practicing psychologists, graduate faculty and students, and representatives of state psychological associations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, Dissociation, and Disorganized Attachment: Three Strands of a Single Braid.

During the past decade, research findings, theoretical reflections, and clinical experiences have woven together the themes of attachment disorganization, dissociative processes, and vulnerability to trauma-related emotional disorders. The resulting unitary perspective is captured in this article by an overview of inquiries on unresolved traumatic memories based on the Adult Attachment Interview (AAI) and of studies on the sequelae of early disorganized attachments. To illustrate the intriguing clinical implications of this unitary perspective, the author considers such topics as vulnerability to complex trauma-related disorders, delayed dissociative responses to past traumatic memories, and the definition of psychological trauma. Some psychotherapeutic implications of the interplay between trauma-related disorders and attachment disorganization are briefly addressed in the concluding section. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

I Bought His Private Practice.

In 1975 I enjoyed a full-time faculty position at the New Jersey Medical School. I held a joint appointment in the Departments of Psychiatry and Obstetrics/Gynecology and was involved in the development of the Human Sexuality Program. In addition to my duties at the Medical School, I conducted a small, part-time private practice, seeing patients in my office at the Medical School and occasionally borrowing a friend's office in a suburban town. This arrangement is probably familiar to many neophyte practitioners. Through my work in the Human Sexuality Program of the New Jersey Medical School, I was in charge of conducting weekend "Sexual Attitude Reassessment Seminars." At the suggestion of a senior psychologist, I invited a well-known New Jersey psychologist and the then-acting Dean of the Organizing Council for the College of Professional Psychology, a forerunner of the Graduate School of Applied and Professional Psychology at Rutgers, as a guest. We felt that his presence would be good publicity for our program. It was during this weekend that I was first approached by him with an offer to buy his practice. At the time of the purchase offer, I knew of no other psychologist who had bought a private practice. For details of the contract and purchase process, see the article by Robert Weitz (see record 2005-09169-002). For the young psychologist genuinely interested in developing a private practice, I would recommend seeking a seller. The choice of the seller, of course, is most important. In my case, it was an excellent choice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The need for inclusion of psychological trauma in the professional curriculum: A call to action.

An appreciable disparity exists between the need for services by professionals with expertise in psychological trauma and the availability of these services. Despite the establishment of a solid base of scientific literature on trauma and the growing attunement of society and the media to the adverse psychological impact of traumatic events, this area has yet to be decisively incorporated into the core curriculum of graduate training in psychology and other professions. This paper provides an overview of the prevalence, scope, and impact of trauma in the general population and the current lack of adequate resources to address the psychological difficulties engendered by traumatic experiences. Existing models of trauma training are discussed, and strategies for expanding the availability of trauma training are recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

I Sold My Private Psychological Practice.

In 1971, following 31 years of private practice in clinical psychology, including 26 years on a full-time basis, I decided that it was time to think about closing out this phase of my career in favor of semiretirement. Five years later my plan became a reality, see article by R. M. Samuels (see record 2005-09169-003). Here is the story of how it was done. It is my opinion that most psychological practices have a sale value and that with adequate planning, a qualified purchaser will be found and an effective transfer of the practice can be realized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma exposure and posttraumatic stress disorder in psychosis: Findings from a first-admission cohort.

This study examined the lifetime prevalence of trauma exposure and posttraumatic stress disorder (PTSD) and their demographic, diagnostic, and trauma-related correlates in a clinical cohort of 426 patients with a first psychiatric admission for psychosis. The prevalence of trauma exposure was 68.5%. Female gender and substance abuse were risk factors for trauma exposure. The prevalence of PTSD was 14.3% in the full sample and 26.5% in those with trauma exposure. PTSD was less prevalent in patients with bipolar disorder and schizophrenia and was twice as common in women. Other significant risk factors were younger age and trauma exposure that was repeated and ongoing or that involved childhood victimization. The findings highlight the importance of systematically ascertaining trauma histories in patients with psychotic disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice.

Reviews the book, Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice by Raymond A. Levy and J. Stuart Ablon (see record 2008-14828-000). This book presents a lucid and timely review of research advances assessing the efficacy and effectiveness of psychodynamic psychotherapies in treating many psychological disorders. From research on broad-based meta-analyses of the effectiveness of psychodynamic psychotherapy to close process analysis of therapist and patient interactions, the invited contributors of this volume translate complex research findings into clinically relevant information for clinicians working in the field. The volume is organized to lead the reader from broad-based reviews of psychodynamic psychotherapy outcome studies to examining in-session processes of patient– therapist interactions that affect the patient’s well-being, improvement, and personality change. In all, it lives up to its title and should be added to any clinician’s library. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do Psychologists Adhere to the Clinical Practice Guidelines for Tobacco Cessation? A Survey of Practitioners.

Practicing psychologists are well positioned to provide at least minimal interventions for tobacco dependence among their clients. Because smoking covaries with psychopathology, a substantial proportion of psychologists' clients are likely to be smokers. Psychologists have expertise in motivating behavior change, and they have greater contact and stronger relationships with their patients than do most other health providers. Despite these advantages, the current study found that psychologists were less likely to intervene for tobacco use than for other client behaviors, such as alcohol or illicit drug abuse. Psychologists do not regularly ask their clients whether they smoke, advise them to quit, assess their willingness to quit, assist them with quitting, or arrange follow-up. Recommendations for additional training are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Impact of the Sibling in Clinical Practice: Transference and Countertransference Dynamics.

For many years, the impact of sibling relationships on psychological development has been neglected in the literature, overshadowed by the role of the parent-child relationship. As a result, attention to sibling dynamics and sibling transference as valuable information for case formulation and treatment interventions has not been used to its maximum potential. The authors demonstrate how deliberate consideration of sibling dynamics as well as the transferences and countertransferences associated with those dynamics can facilitate treatment. Several important sibling dynamics are discussed, including siblings' influences on identity development; sibling rivalry, jealousy, envy, guilt, and resentment; and sibling attachment. The impact of sibling dynamics on adult love relationships is discussed, as are potential effects of sibling abuse and sibling bereavement. Examples of how these dynamics can manifest themselves in transference and countertransference reactions and suggestions for working with those dynamics are illustrated with clinical examples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inventory of Problematic Internet Experiences Encountered in Clinical Practice.

People are bringing a variety of Internet-related problems into consultation with mental health professionals. This exploratory study used a systematic sample of mental health professionals and obtained both structured and open-ended information from 1,504 practitioners who reported having at least 1 client with an Internet-related problem. This article proposes an inventory of 11 types of problematic Internet experiences reported by youth and adult clients: (a) overuse; (b) pornography; (c) infidelity; (d) sexual exploitation and abuse; (e) gaming, gambling, and role-playing; (f) harassment; (g) isolative-avoidant use; (h) fraud, stealing, and deception; (i) failed online relationships; (j) harmful influence websites; and (k) risky or inappropriate use, not otherwise specified. The authors discuss the spectrum of cases within each category and implications for clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)