An assessment of accountability areas by psychiatrists, psychologists, and social workers

Sixty-nine psychiatrists, psychologists, and social workers rated the usefulness of fifteen studies representing seven broad areas of accountability. Although respondents differed in experience, training, and position in the hospital hierarchy, their ratings were highly similar. Results suggest that, in the hospital under study, members of the three professions respond as members of a single profession--clinician.     

Examining the multifaceted notion of isomorphism in marriage and family therapy supervision: a quest for conceptual clarity

The notion of isomorphism has been recommended as a conceptual framework to guide the practice of marriage and family therapy (MFT) supervision. The term is frequently cited in the MFT training literature but is often used in different ways. A panel of MFT supervisors rated the importance and relevance to both therapy and supervision of a large pool of variables. The majority of variables were found to be equally relevant or isomorphic to the domains of MFT and MFT supervision. A qualitative interview with a small subset of the panelists suggested that the concept, to varying degrees, has influenced their work as supervisors. The implications of the results for theory development, research and supervisory practice are discussed.     

Effect of music therapy on mood and social interaction among individuals with acute traumatic brain injury and stroke.

Objective: To investigate the efficacy of music therapy techniques as an aid in improving mood and social interaction after traumatic brain injury or stroke. Design: Eighteen individuals with traumatic brain injury or stroke were assigned either standard rehabilitation alone or standard rehabilitation along with music therapy (3 treatments per week for up to 10 treatments). Measures: Pretreatment and posttreatment assessments of participant self-rating of mood, family ratings of mood and social interaction, and therapist rating of mood and participation in therapy. Results: There was a significant improvement in family members' assessment of participants' social interaction in the music therapy group relative to the control group. The staff rated participants in the music therapy group as more actively involved and cooperative in therapy than those in the control group. There was a trend suggesting that self-ratings and family ratings of mood showed greater improvement in the music group than in the control group. Conclusions: Results lend preliminary support to the efficacy of music therapy as a complementary therapy for social functioning and participation in rehabilitation with a trend toward improvement in mood during acute rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Detection of two loci involved in (1-->3)-beta-glucan (curdlan) biosynthesis by Agrobacterium sp. ATCC31749, and comparative sequence analysis of the putative curdlan synthase gene

A 28-item questionnaire was returned by 291 psychiatrists who had completed training between 1962 and 1992. There were positive correlations between the amount of couple and family therapy training (CFTT) they received and the following: the extent to which graduate psychiatrists practice CFT; their involvement as supervisors, teachers, teaching program directors, or researchers; the extent to which they seek continuing education in CFT; their positive attitude toward CFT; and the extent to which they feel that their attitude to and interest in CFT has had a positive effect on the milieu in which they practice and on their personal lives.     

The malleability of age-related positive gaze preferences: Training to change gaze and mood.

Older adults show positive gaze preferences, but to what extent are these preferences malleable? Examining the plasticity of age-related gaze preferences may provide a window into their origins. We therefore designed an attentional training procedure to assess the degree to which we could shift gaze and gaze-related mood in both younger and older adults. Participants completed either a positive or negative dot-probe training. Before and after the attentional training, we obtained measures of fixations to negatively valenced images along with concurrent mood ratings. We found differential malleability of gaze and mood by age: for young adults, negative training resulted in fewer posttraining fixations to the most negative areas of the images, whereas positive training appeared more successful in changing older adults' fixation patterns. Young adults did not differ in their moods as a function of training, whereas older adults in the train negative group had the worst moods after training. Implications for the etiology of age-related positive gaze preferences are considered. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Roles, functions, and training in clinical psychology: A survey of academic clinicians.

Describes a questionnaire sent to 239 academic clinical psychologists in American Psychological Association (APA)-approved clinical training programs to obtain their attitudes towards a number of critical issues in clinical psychology. 75% returned the questionnaire. A PhD degree in psychology, with equal emphasis on scientific and applied training, was endorsed by most respondents, as was the training of MA and MS clinicians. Other doctoral programs for training clinicians, including PsyD degrees, did not receive strong endorsement. Activity areas of clinical psychologist were rated from 6 reference points ranging from adequacy of present training to training emphasis expected in 7 yr. Results indicate that: (a) therapy and research were rated high by most respondents; (b) many respondents believed that consulting and teaching should be emphasized more and that their clinical training programs did not adequately train in these areas; (c) the emphasis on diagnosis was expected to decline in training and future usefulness; (d) in addition to research, respondents believed that APA should support other interest areas; and (e) clinical psychology should be more attuned to social problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of gender in family evaluations: A comparison of trained and untrained observer perceptions of matriarchal and patriarchal family interviews.

Examined how training and experience, family roles, and gender of observed family leadership affect ratings of both family and individual parent functioning. Seventy experienced therapists and 70 clinically naive individuals rated 2 videotaped family interviews. One interview demonstrated a matriarchal style of family interaction and the other demonstrated a patriarchal style. Ratings from the 2 groups of observers were compared to determine the effects of training and experience. The effects of leader gender were determined by comparing ratings of the 2 family interviews. Ratings of the mother and the father from the 2 interviews were compared to determine the effects of family roles. Results suggest that experienced observers in assessments of family functioning are vulnerable to biased views of mother-led families. In assessments of parent functioning, results suggest that although training and experience may promote more critical ratings, vulnerability to biased views of women as family leaders is not significantly affected. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How do psychiatric patients experience interactions with their relatives?

Numerous studies have established the prognostic validity of family attitudes and interactional behaviors in psychiatric disorders. However, most have relied on observer-rated rather than patient-rated measures of the family context. Bipolar patients (N?=?31) rated their relatives' verbal behaviors in problem-solving discussions using the Patient's Experiences of a Relative's Affective Style (PERAS) scale. The PERAS had acceptable reliability and internal consistency. Patients' PERAS judgments of the frequencies of harsh and benign criticisms in relatives correlated positively with an observer's affective style (AS) ratings of these same behaviors in relatives. However, patients' ratings of intrusiveness and support in relatives were unrelated to the observer's AS ratings. The PERAS is a promising measure of how patients experience their family interactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists in geriatric medicine: Results of a national survey.

51 physician directors of geriatric medicine fellowship programs were surveyed on their current and desired involvement with psychologists, perceived areas of expertise of psychologists, comparisons of psychologists with overlapping health care professions, and factors limiting involvement of psychologists in geriatric medicine. Results indicate that psychologists are quite involved in most geriatric medicine training programs and that directors of these programs welcome their greater involvement. Significantly, psychologists and psychiatrists are rated as similar in expertise in most areas of clinical practice. Neuropsychological assessment and family therapy are areas of psychologist expertise that are seen as especially valuable. Factors that may increase psychologist involvement in geriatric medical settings and the special importance of medical settings for the care of older patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of New Zealand psychiatrists' clinical experience with the Mental Health (Compulsory Assessment and Treatment) Act of 1992

AIMS: This study examines the clinical experience of New Zealand psychiatrists with the Mental Health (and Compulsory Assessment and Treatment) Act of 1992. METHODS: A survey was distributed to all psychiatric specialists residing in New Zealand who were registered with the Medical Council of New Zealand (n = 232). The survey examined the extent of practitioners' use of the Mental Health Act, perceived strengths and weaknesses of the Mental Health Act, and experiences with the family court system. RESULTS: Psychiatrists estimated that almost half (46.4%) of patients retained under the Mental Health Act were released within 3 weeks. Inpatient consultants reported dedicating 18.6% of their working time to Mental Health Act related activities. A majority of respondents indicated that: the Mental Health Act requires major revision (55.6%), the Mental Health Act results in the inappropriate release of some psychiatric patients into the community (70.9%), and that compulsory treatment orders are a useful tool for promoting community treatment of the mentally ill (69.2%). While a majority (81.5%) indicate that individual judges are consistent in their interpretation of the Mental Health Act across cases, only 26.5% of respondents agree that the law is interpreted uniformly by different judges. CONCLUSIONS: The Mental Health Act is perceived as time-consuming and cumbersome to administer. However, compulsory treatment orders do facilitate community treatment, an explicit goal of the Mental Health Act. Proposed areas for refinement of the Mental Health Act are discussed. Further examination of the interface between psychiatrists and the family court system would be useful.     

The effects of sex composition on cohesiveness and interpersonal learning in short-term personal growth groups.

108 undergraduates were divided into 6 all-male 6-person groups, 6 all-female 6-person groups, and 6 mixed-sex 6-person groups that convened for 5 hrs, during which time Ss completed 5 exercises designed to promote group cohesiveness, personal exploration, and interpersonal learning. Ss completed a group cohesiveness and a projected group learning scale and self-report measures rating Ss' enjoyment of the exercise, value and usefulness of the exercise for them, and their own level of participation in the exercise. Observational ratings were made on the groups for 5 variables, including task orientation, group mood, group interaction, self-disclosure, and exercise length. Findings indicate that members of the all-female and mixed sex-groups rated themselves significantly higher on cohesiveness than did members of the all-male groups. The mixed-sex groups also rated themselves as participating more and their groups as being more valuable and useful than did the all-male groups. The all-male and the mixed-sex groups were rated as significantly more task oriented than the all-female groups; however, the all-female groups were rated as having a significantly brighter mood than the all-male groups. Results suggest that sexually heterogeneous groups possess significant advantages for both sexes over all-male or all-female groups. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of carbamazepine compared with other agents: a clinical practice survey

BACKGROUND: To gain an impression of the experience with and efficacy of carbamazepine relative to other agents and relative to its use in treating psychiatric and neurologic disorders in general clinical practice, a survey was distributed in 1988 to psychiatrists practicing in the United States. METHOD: The survey was mailed to 9030 members of the American Psychiatric Association (APA) who had expressed an interest in the study and treatment of affective disorders in a 1982 APA survey. The survey sampled clinicians' experience of the efficacy and side effects of carbamazepine in a number of psychiatric and neurologic conditions. Each clinician also provided global impression ratings of the efficacy of a variety of traditional and novel treatments. RESULTS: Completed surveys were returned by 2543 (28%) physicians. Carbamazepine was reported to be moderately to markedly effective in the following percentage of patients: partial complex seizures, 85.2%; generalized seizures, 82.9%; trigeminal neuralgia, 81.5%; mania prophylaxis, 72.9%; acute bipolar depression, 67.5%; intermittent explosive disorder, 65.2%; acute mania, 62.2%; schizoaffective disorder, 58.8%; other pain syndromes, 51.2%; posttraumatic stress disorder, 48.1%; borderline personality disorder, 43.0%; unipolar depression, 32.2%; schizophrenia, 25.7%; and alcohol withdrawal, 15.9%. About 4.4% of the patients reported were withdrawn from carbamazepine because of side effects. CONCLUSION: Carbamazepine was widely used to treat a variety of psychiatric conditions in 1988 and found to be of use in the acute and long-term treatment of bipolar illness. It was rated slightly less effective than lithium, electroconvulsive therapy, or neuroleptics, but more effective than several other agents. The results of the survey highlight many areas in need of further systematic investigation.     

Skills that Iowa family physicians desire in a new physician partner

BACKGROUND AND OBJECTIVES: The importance of specific skills in primary care continues to be debated. As a result, there is not consensus on which skills need to be stressed during residency training. Our project asked community-based family physicians to rate the importance of specific skills in a new family physician partner. METHODS: Data were collected through a cross-sectional survey of all active members of the Iowa Academy of Family Physicians. Participants were surveyed by mail, using a list of 83 skills pertinent to primary care. Physicians were asked to rate the importance of a new member of their practice having the individual skills on this list. RESULTS: A total of 546 family physicians (67%) completed questionnaires. Fourteen skills (seven cognitive and seven psychomotor) were reported to be "essential" or "very important" by at least 80% of the physicians. A total of 43 skills were rated as "essential" or "very important" by at least 50% of responding family physicians. Many of the hospital-based procedural skills, particularly those used in an intensive care setting, were rated as less important. The importance ratings of many skills were associated with the physicians' ages, size of their primary hospitals, and availability of other medical specialties. CONCLUSIONS: Family physicians tended to rate office-based procedural skills, counseling skills, and management skills as "essential or very important" to their practices. These rating might be used to guide residency training in family practice.     

Belief in the existence of multiple personality disorder among psychologists and psychiatrists

The present study surveyed the attitudes of psychiatrists and psychologists with regard to the existence of dissociative and multiple personality disorders. Questionnaires were sent to psychiatrists and psychologists in all VA Medical Centers. A total of 1,120 VA psychologists and psychiatrists completed the surveys. More than 97% of respondents indicated that they believed in dissociative disorders, while 80% reported a belief in multiple personality disorder. Belief in multiple personality disorder was related significantly to profession, age, and years of experience.     

The ECLW Collaborative Study: III. Training and reliability of ICD-10 psychiatric diagnoses in the general hospital setting--an investigation of 220 consultants from 14 European countries. European Consultation Liaison Workgroup

A comprehensive training program for reliable use of the ICD/10 in Consultation-Liaison (C-L) psychiatry was conducted with 220 psychiatrists and psychologists from 14 European countries. The training included rating of written test cases and development of a coding manual to avoid diagnostic pitfalls not addressed in the ICD-10 manual. Following this training, all consultants rated 13 written case histories. One hundred sixty-seven consultants (76%) had a kappa (kappa) of at least 0.70. Only 13 (6%) had a kappa 0.40. The percentage of high reliability raters was evenly distributed among the different countries. Consultants had some problems in the differentiation between adjustment disorders and depressive disorders, and in the classification of disorders where ICD-10 differs from the DSM-III-R system. National biases in diagnostic practice were found with regard to the "case" concept and the role of alcohol in confusional states. Finnish consultants coded "no psychiatric disorder" significantly more often, whereas German and Italian consultants attributed delirious state more often to alcohol than consultants from other European countries. The study demonstrates that it is possible to achieve acceptable interrater reliability in applying the ICD-10 guidelines, through training programs designed for C-L psychiatrists and psychologists. Nevertheless, this first cross-national study shows the importance of addressing differences in national diagnostic practice.     

Family therapy training opportunities in psychology and counselor education.

Investigated the nature and scope of course work and practica training available within all 108 American Psychological Association-approved clinical and counseling psychology programs and 125 departments of counselor education granting the doctorate. Findings indicate that at least two-thirds of all faculty and students believe that there is departmental support for marriage and family therapy (MFT) training. 66% of clinical and counseling psychology departments and 33% of counselor education departments were offering some MFT course work. Few new MFT faculty additions were being planned or anticipated, and in most departments offering MFT, few new course offerings were being considered. Thus, there was a discrepancy between the strong support generated for MFT training and the actual courses available to students. Strategies are suggested for increasing MFT training in these settings. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assigning new meanings to traditional literature: illustrations for HIV educators

PURPOSE: To evaluate training in general preventive medicine and public health, determining which experiences and institutional sponsors best prepare residents for practice and where improvements are most needed. METHOD: A 1991 survey of the 1,070 graduates of preventive medicine residencies from 1979 through 1989 asked the graduates to measure the adequacy of their training in preventive medicine topic areas by using a Likert-type scale of 1 (poor) to 4 (excellent). Adequacy was analyzed for variation against practice emphasis during training, training program sponsor, and other variables. The statistical methods included Student's t-test, analysis of variance and linear regression. RESULTS: A total of 797 graduates (74.5%) responded. The overall mean ratings of adequacy of training were 3.1 (SD, 0.9) for epidemiology, 2.5 (SD, 1.0) for clinical preventive medicine, 2.4 (SD, 0.9) for environmental health, 2.3 (SD, 0.9) for health administration, 2.3 (SD, 0.9) for health education and behavioral sciences, and 2.2 (SD, 0.9) for occupational medicine. Training was rated highest for topics emphasized during practice experiences. Adequacy varied by type of institution sponsoring the residency. Women rated their training as being less adequate than did men in all areas except clinical preventive medicine. The graduates tended ultimately to practice in topic areas emphasized during training. CONCLUSION: The graduates' ratings suggest that improvements are most needed in health administration, environment health, health education, and occupational medicine. Potential improvement strategies include highly focused practice experiences and increased emphasis on training in actual practice settings and community sites.     

Impact of task experience and individual factors on training-emphasis ratings.

This study included 2 sets of analyses examining the impact of task experience and individual factors on task ratings of training emphasis. Aerospace ground equipment mechanics in the US Air Force completed surveys 8 and 12 mo after formal training. Mechanics rated how much formal training they would recommend for a sample of tasks. In the cross-sectional analyses, with tenure constant at 12 mo, an individual's breadth of experience (number of tasks performed) and level of self-efficacy were found to have significant effects on training-emphasis ratings. The change analyses examined factors influencing changes in ratings of training emphasis from 8 to 12 mo on the job. Results indicate that mechanics whose breadth of experience or self-efficacy perceptions increased over time tended to increase their ratings of training emphasis. Implications for understanding the task analysis rating process are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)