File review consultation in the adjudication of mental health and chronic pain disability claims.

The role of the psychological file review consultant in assisting disability insurance carriers to adjudicate chronic pain and mental health claims is discussed. The authors advocate an empirical basis for the practice and outline the relevant professional issues and procedural steps to be taken in this consulting role. They examine the role of the consultant in evaluating the quality of assessment, whether empirically evaluated treatments have been applied, and what factors can be used in estimating return to work dates. Specific problems that a file review consultant might encounter and suggested solutions are described as are potential biases and ethical dilemmas that may occur when psychologists take on this emerging consulting role. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consequences of revealing personal secrets.

In this article, the authors review the theories and empirical findings concerning the consequences of revealing personal secrets (i.e., ones that directly involve the secret keeper). Most of the literature has suggested that revealing personal secrets is advantageous to the secret keeper. However, choosing to reveal secrets is a complex decision that can have disturbing consequences, such as being rejected by and alienated from the listener. Such rejection may lead the revealer to construct a negative self-image. The authors contend that (a) there are many circumstances when the secret keeper is better off not revealing a personal secret and (b) the real or perceived feedback from the confidant plays a critical role in determining whether the secret keeper will benefit from the revealing. They recommend when one should reveal one's secrets to others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consultation and training with school-based crisis teams.

Schools often bring outside mental health consultants to provide postcrisis counseling after a suicide or another tragedy. This article describes a different role for consultants who specialize in this type of work: training school personnel to provide this valuable service themselves. It is argued that training school-based personnel to provide postcrisis counseling results in greater value to a school system than does direct service provision by an outside consultant. The author's experience as mental health consultant to a large urban/suburban school district's crisis team is used to illustrate various training techniques that can be used and benefits that can be derived from this type of consultation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of consultants in the provision of psychological services to the university community.

Attempted to justify the provision of psychological services within the university community by consultation. In this context, 4 main issues are discussed. The recommendations of the Kirk Committee concerning the provision of consulting services to the university community are summarized. 5 views of the consultant task and consultant role models are presented. 2 role models for the university consultant, emphasizing the consultant as a facilitator of social integration and/or the consultant as a facilitator of appropriate action toward distressed individuals are recommended. (French summary) (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived competence in supervisory roles: A social cognitive analysis.

Using Bandura's (1997) model of competency development, we evaluated the level and sources of supervisory self-efficacy among experienced Canadian psychology supervisors (N = 155) employed in academic and clinical settings. Multiple-regression analyses showed that a set of 7 measures representing training, experience, context, and aptitude accounted for substantial variance in self-efficacy in the roles of teacher, counselor, and consultant. Unique contributors included directive aptitude (all roles), nurturant aptitude (counselor and consultant roles), and perceived workplace support (teacher role). Implications for supervisory practice and training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the relationship between ethics committees and the wound care clinician

Ethics Committees have gained increasing popularity since the mid-1970s. This is likely due to the recognized need to more openly discuss the legal and ethical issues of clinicians and their patients. Wound care clinicians play an important role in the interdisciplinary care of the patient. The typical framework of a hospital-based Ethics Committee is described, Ethics Committees as a resource to the wound care clinician is presented, and the role of the wound care clinician as a consultant to the Ethics Committee, from an interdisciplinary perspective, is illustrated.     

In the Eye of the CEO!

Consultants need to seek more client advice and counsel. This article shares an interview with a chief executive officer (CEO) regarding the need for consulting services, expectations, able and less able consultants, and the issue of consultant training and experience from the client's perspective. The CEO's views might provide a platform for thinking about the education and continuing growth and development of the consultant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between quality of care and financial performance in dialysis: "doing well by doing good"

Reconstruction of posterior lamellar eyelid defects requires a tissue substitute that is either identical to the tissue lost (ex. surrounding or nearby tarsus) or donor tissue from another site that serves the same supportive role. Irradiated homologous tarsal plate and irradiated homologous aorta are potential posterior lamellar substitutes. Each provides a structural framework for the surrounding lid tissues to grow upon and are incorporated into the normal eyelid anatomy. Both the tarsal plate and aorta can be harvested, irradiated and stored in a refrigerator, ready to be utilized in those selected cases with severe tissue loss. They may also be utilized as a donor material in more routine lid reconstruction as an alternative. We discuss our experience with these materials.     

Determinants of observed confidant support for divorced mothers

Marital separation can be a time of extreme stress and can significantly disrupt support networks and support processes when they are needed most. The purpose of this investigation was to test mechanisms of support erosion in a multimethod study of 138 divorced mothers and their confidants. Previous work was extended by using observational measures of confidant support in a process model including (a) maternal characteristics over time, (b) support person characteristics, and (c) relationship characteristics (intimacy and confidant relationship type). A hypothesized mechanism of erosion was supported in which ongoing maternal distress was positively associated with levels of confidant negativity, which in turn was related to lower levels of observed support. Having a partner was related to more intimacy than was having family and friends. Contrary to expectation, however, having a partner was related to lower levels of support, and intimacy was not related to observed support.     

Indications for psychological examination in diagnosis, certification and prevention of occupational diseases

The work is based on the author's clinical experience gained due to her responsibilities as a consultant in the Department of Occupational Diseases, Nofer Institute of Occupational Medicine, Lodz, as well as on the literature dealing with the effect of some chemical and physical occupational hazards on the central nervous system. The author points out that psychological examinations play a significant role in diagnosis and prevention of occupational disease. She suggests that workers should be subjected to periodical psychological examinations during the whole period of employment. Particular indications for these examinations are also discussed.     

Anticipating the school consultant role: Changes in personal constructs following training.

Investigated developmental changes in novices' personal theories of consulting. A variation of G. Kelly's (1955) role repertory grid technique was used to explore changes in school psychology students' cognitive representations of the consultant role following a 9-mo consultation practicum experience. Nine graduate students in school psychology were interviewed prior to and following a program of consultation training. Results document subtle and interesting changes in how these beginning consultants construed their role. Ss applied slightly more varied constructs to the hypothetical consultation situations. Although they continued to primarily focus on the child, Ss demonstrated a shift in the way they approached problems, following the training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support as a mediator of optimism and distress in breast cancer survivors.

Breast cancer patients can experience emotional distress as a result of diagnosis and treatment. Higher levels of optimism and social support are associated with less emotional distress in cancer patients. This 12-month prospective study followed 69 women who had completed treatment for Stages 0-11 breast cancer. At 3-month intervals, participants completed measures of mood disturbance, optimism, and social support. As hypothesized, affective social support mediated the relationship between optimism and distress in early-stage breast cancer survivors at baseline and 6 months but not at 1 year. In contrast, confidant social support did not mediate the optimism-distress relationship at any time point. Clinical and research implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The quest for executive effectiveness: Consultants bridge the gap between psychological research and organizational application.

However we picture success for ourselves as consulting psychologists or for the executives and clients with whom we work, the role as pathfinder and mapmaker identifies those who "make a diference." Effectiveness for both consultant and executive calls for competencies in dealing with individual, group, and organizational-level issues. Critical competencies are discussed under the headings vision, motivation, and action. The ability to conceptualize, or to envision, relies on updated mental processes and stagnates without motivational astuteness. Key to motivation is emotional wisdom, the management of vital sign emotions: curiosity, anxiety, and anger. Finally, the invitational leadership approach (ILA) is presented as a synthesis of leadership research to assist a consultant or an executive in execution of the action competencies that get an organization moving in a coordinated, constructive direction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group consultation: Key variables that effect change.

Discusses 2 hypothesized key variables of the effective consultation process, and presents 7 categories of consultant manipulations designed to promote the facilitation of improved consultee information processing behaviors: (a) focusing attention on alternative aspects of the informational field (theme interference reduction), (b) didactic provision of mental health information, (c) intercommunication of perceptions of options for intervention, (d) modeling alternative behaviors, (e) positive reinforcement of the consultee's engaging in information processing behaviors, (f) promoting a group experience of expressing feelings and attitudes, and (g) relinquishing previous intervention behaviors as the group becomes self-assessing. Four stages in the progress of the consultation alliance are delineated: (1) relationship development stage, (2) working stage, (3) group autonomy stage, and (4) consultee–consultant stage. In conclusion, a piece of a theoretical framework for consultation is developed that should facilitate the design of systematic research. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity of an expanded-issue (Modified General Question) polygraph technique in a simulated distributed-crime-roles context.

The validity of an expanded-issue control-question technique that is commonly used in investigations was tested with simulations of thief, accomplice, confidant, and innocent crime roles. Field numerical scores and objective measures discriminated between the guilty and innocent groups. Excluding inconclusives (guilty?=?18.1%, innocent?=?20.8%), decisions based on total numerical scores were 84.7% correct for the guilty group and 94.7% correct for the innocent group. There was relatively weaker, but significant, discrimination between the thief group and the other guilty groups and no significant discrimination between the accomplice group and confidant group. Skin conductance, respiration, heart rate, and cardiograph measures contributed most strongly to discrimination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group therapy and the somatoform patient: An integration.

Recent reports and literature reviews suggest that psychotherapeutic interventions with somatoform patients have efficacy. From their clinical experience with somatoform patients, the authors identify helplessness as the central psychotherapeutic issue for these patients. They propose that effective group therapy interventions have their impact through the addressing and working through of this affect. They discuss paradigmatic stages in the group therapeutic process of addressing helplessness in somatoform patients. Technical issues regarding membership selection and leadership style with this intervention are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When are cookbooks useful?

The clinical psychologist as tester in the diagnostic triad (patient, referring person, and tester) may have the role of a technician or consultant. As a technician, he is concerned with comparing the patient with others (diagnostic categorization); as a consultant, he attempts to understand the patient—to develop and evaluate hypotheses on the basis of the patient's behavior (rather than in getting test responses from him). "The important differences between these two roles arise from the differences in the position or orientation of the psychologists in them… . Theoretically the kinds of activity in which the clinician cannot be replaced by the cookbook represent the limits of computing machines, of which the cookbook is a special case." It is the role of technician "that requires the use of cookbooks." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychologist as front-line mental health consultant in a general hospital.

Describes the experiences and diverse functions of a psychologist who acts as an independent mental health consultant in a general hospital. Particular attention is paid to problems that arise when psyche and soma interface, because these problems require knowledge of biology as well as of psychology. The appropriateness of this role for the psychologist and its acceptability to referring physicians are examined. The particular strengths of the psychologist as a behavioral scientist and the need for continuing education in differential diagnosis when psychological and physiological factors interact are also explored. Professional boundaries and role relations between psychology and related professions are reviewed. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and survival among women with breast cancer

BACKGROUND: Two recently reported randomized trials, one among patients with advanced breast cancer and the other among patients with early stage melanoma, suggested that social support may affect survival favorably. This study assesses relationships of social support indicators with 7-year survival among women diagnosed with localized or regional stage breast cancer. METHODS: All newly diagnosed patients with surgically treated localized or regional disease in seven Quebec City hospitals in 1984 were considered for this analysis. Among 235 eligible patients, 224 (95%) participated in a home interview 3 months after surgery. This interview provided information on the use of confidants in the 3 months after surgery. Data on disease and treatment characteristics were abstracted from patients' medical records. RESULTS: Compared with women who used no confidant in the 3 months after surgery, the hazard ratio for the 7-year period was 0.61 (95% confidence interval [CI], 0.33-1.12) among those who had used at least one confidant, 0.54 (95% CI, 0.28-1.06) in women who used two or more types of confidant, and 0.51 (95% CI, 0.22-1.18) among those whose confidants included either physician or nurse. These results were adjusted for age, presence of invaded axillary lymph nodes, adjuvant radiotherapy, and adjuvant systemic therapy (hormone or chemotherapy). CONCLUSION: These results support the view that social support may be associated with longer survival among women with localized or regional stage breast cancer.     

Representation of space in blind persons: Vision as a spatial sense?

Some researchers of studies of the incidence of early visual experience on spatial abilities have demonstrated profound spatial deficits in early blind participants, whereas others have not found evidence of deleterious effects of early visual deprivation. The aims of this article are to (a) consider the theoretical background of these studies, (b) take stock of the divergent data, and (c) propose new means of investigation. The authors examine the reasons why vision plays a critical role in spatial cognition. They review the literature data. They also review the factors that could account for the discrepant data and the effects of the lack of early visual experience on brain functioning. They propose that the study of strategies is a valuable option to obtain insight into early blind persons' spatial impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)