Serendipity is not serendipitous.

Serendipitous events have been shown to affect the careers of prominent counseling psychologists. Why should this seem surprising? Unplanned events affect everyone's career. The surprise is due to the widespread but unfounded assumption that career decisions should be the logical outcome of a "true reasoning" process. Counseling psychologists need to (a) broaden their view so that the reluctance to make an occupational commitment in the face of unpredictable future events can be celebrated as open-mindedness, not denigrated as indecisiveness, (b) teach clients that unplanned events are a normal and expected part of the career development process, and (c) teach clients how to generate unplanned events that contribute to a more satisfying life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Family Stories and the Life Course: Across Time and Generations.

In this review of "Family Stories and the Life Course: Across Time and Generations" (see record 2004-13618-000), the reviewer states that many psychologists will want to read this book from cover to cover because it is excellent. It will create excitement for developmental psychologists who are open to extending their perspectives on individual functioning to include more of a focus on whole family systems. It will also challenge family psychologists to deepen their understanding of how the functioning of each family member at different stages of the life span is related to interactions and meaning-making in the group. Clinical psychologists will glean new ideas about the accounts of family life they hear from their clients and the transformative power of having family members jointly engage in reconstructing problematic family stories. The range of topics and the overall quality of the research and theorizing are truly impressive. This book draws together in one volume conceptual development and recent research findings about family narratives. The reader will gain an understanding of how family stories and story telling are related to acquisition of language, regulation of affect, attachment processes and socialization of children, development of identity in adolescents, cognitive functioning in older persons, and interactions between children, parents, and grandparents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Narrative psychology and psychotherapy integration.

Bruner (1986) and Sarbin (1986) have argued that people make sense of living by actively constructing stories containing characters moving toward goals through time. Both content and structure in these narratives are understood as promoting either flexible, adaptive functioning or psychological distress. Theories of psychotherapy can also be seen as stories about human function and dysfunction that incorporate many of the same ideas about reality, human nature and change that are found in clients' personal narratives. This narrative perspective, then, suggests that the therapeutic alliance might be improved and an integrative use of different theories might be made by selecting therapeutic approaches and interventions based on the degree of similarity between the nature of the client's life story and the story of human functioning incorporated in the theory. A classification of theories, examples of classification of client stories and some issues of implementation of this integrative proposal are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Who are we, but for the stories we tell: Family stories and healing.

Storytelling is a notable part of family life. Families share stories that illuminate and combine their separate experiences into a meaningful whole. Families narrate both their best and worst life experiences and in this way pass down a heritage of remembrances from one generation to the next. Clinicians working with families who have been impacted by trauma can use family storytelling to aid healing. This article reviews the functions of family storytelling and the skills used by family members in the act of storying to illustrate how therapists can facilitate families' use of their storytelling skills in the healing process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How to use psychotherapy on, for, and by oneself.

Discusses how psychotherapists can use psychotherapy on, for, and by oneself. The author suggests that in order to feel better, and want to accomplish some of the wonderful things that psychotherapy can help bring about, one needs to have regular psychotherapy sessions, preferably experiential sessions, on, for, and by oneself. There are several questions that the author addresses: What personal life circumstances invited me to search for some way of undergoing self-care? What can a practitioner do to have deep-seated sessions by oneself? How can a psychotherapy be created for one's own self-sessions? What does one do in an experiential session on, for, and by oneself? If you trust what you do with clients, why not do it with yourself? If you trust what you do with yourself, why not do it with clients? (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiskilling: a survey of occupational therapy practitioners' attitudes

OBJECTIVE: Multiskilling has been identified as one means of reducing she cost of health care. This study examined occupational therapy practitioners' knowledge of multiskilling, how it is affecting service delivery and quality of care, and how therapists believe the addition of skills should occur. METHOD: A questionnaire was constructed for the survey and mailed to a random sample of 200 occupational therapists and occupational therapy assistants, all of whom were members of the American Occupational Therapy Association. RESULTS: The 117 respondents had a moderate understanding of multiskilling. They responded that multiskilling is beneficial to both the occupational therapy profession and the clients it serves, but they were also aware of its potential risks or disadvantages. According to respondents, multiskilling occurs formally through defined protocol and; more commonly, informally, driven by necessity and the desire to treat the client most effectively. CONCLUSION: The results indicate a need for the occupational therapy profession to define multiskilling and cross training; develop ways of serving clients that respond to administrative needs and constraints while preserving the uniqueness of occupational therapy; and monitor treatment outcomes of all service delivery methods to provide information regarding efficiency, effectiveness, and client satisfaction.     

Sharing wisdom: Ethnic minority supervisor perspectives.

We offer this special issue in an effort to fill the gap in the literature regarding ethnic minority supervisor processes. We dedicate this issue to the ethnic minority psychologist pioneers who have brought tremendous life experience to their work as supervisors, who can reflect on their strategies, lessons learned, You will find three types of articles in this issue. The narratives speak to the personal journeys of psychologists and how their stories inform the practice of supervision. The theoretical offerings highlight the need to think creatively and with an integrative mind when applying extant literature to supervision involving supervisors of color. Finally, one qualitative research article demonstrates that although there are more people of color supervisors in the field, there is still a need to educate them on cultural competency in supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pursuing an evidence-based culture through contextualized feedback: Aligning youth outcomes and practices.

How can contextualized feedback on therapy practices and youth outcomes promote an evidence-based culture for adolescent mental health? Relative to other quality improvement tools, feedback and progress monitoring systems are generally underutilized. This article describes a feedback system collaboratively developed by the Hawai'i Department of Health Child and Adolescent Mental Health Division and private agency staff contracted to provide mental health services to youth. Feedback reports allow providers to monitor progress of their youth clients, compare their progress with youth receiving similar services, examine the extent they are using practices derived from evidence-based protocols, and compare these practice profiles to what other youth are receiving. Providers gather to discuss reports, share success stories, and offer suggestions to improve practices and outcomes based on data from the reports. The provider feedback system in Hawai'i has emphasized youth outcomes and has promoted an “evidence-based culture.” This article encourages direct providers and supervisors to consider how such a system might fit in their current practice and whether contextualized feedback might be one way to enhance services and outcomes for youth with mental health needs. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Perspectives of probabilistic inferences: Reinforcement learning and an adaptive network compared.

The assumption that people possess a strategy repertoire for inferences has been raised repeatedly. The strategy selection learning theory specifies how people select strategies from this repertoire. The theory assumes that individuals select strategies proportional to their subjective expectations of how well the strategies solve particular problems; such expectations are assumed to be updated by reinforcement learning. The theory is compared with an adaptive network model that assumes people make inferences by integrating information according to a connectionist network. The network's weights are modified by error correction learning. The theories were tested against each other in 2 experimental studies. Study 1 showed that people substantially improved their inferences through feedback, which was appropriately predicted by the strategy selection learning theory. Study 2 examined a dynamic environment in which the strategies' performances changed. In this situation a quick adaptation to the new situation was not observed; rather, individuals got stuck on the strategy they had successfully applied previously. This "inertia effect" was most strongly predicted by the strategy selection learning theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethics and multiculturalism: Advancing cultural and clinical responsiveness.

The provision of ethical and responsive treatment to clients of diverse cultural backgrounds is expected of all practicing psychologists. While this is mandated by the American Psychological Association’s ethics code and is widely agreed upon as a laudable goal, achieving this mandate is often more challenging than it may seem. Integrating culturally responsive practices with more traditional models of psychotherapy into every practitioner’s repertoire is of paramount importance when considering the rapidly diversifying population we serve. Psychologists are challenged to reconsider their conceptualizations of culture and of culturally responsive practice, to grapple with inherent conflicts in traditional training models that may promote treatments that are not culturally responsive, and to consider the ethical implications of their current practices. Invited expert commentaries address how conflicts may arise between efforts to meet ethical standards and being culturally responsive, how the application of outdated theoretical constructs may result in harm to diverse clients, and how we must develop more culturally responsive views of client needs, of boundaries and multiple relationships, and of treatment interventions. This article provides additional considerations for practicing psychologists as they attempt to navigate dimensions of culture and culturally responsive practice in psychology, while negotiating the ethical challenges presented in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of standardized assessment in occupational therapy: the BaFPE-R as an example

Before 1970, most assessments administered by occupational therapists were informal and nonstandardized. Since the 1970s, the use of scientifically sound instruments has increased. One such standardized assessment, the Bay Area Functional Performance Evaluation (BaFPE), was developed to measure the functional performance of psychiatric clients. This study was designed to explore the use of a revised version of BaFPE as an example of standardized assessment in occupational therapy. The BaFPE was selected as an example of an assessment extensively used in psychiatric occupational therapy practice. A qualitative study that used in-depth semistructured interviews was conducted with a convenience sample of occupational therapists. The occupational therapists who were interviewed described and explained making several adaptations and modifications to the recommended administration and scoring of the BaFPE. An analysis of the interview data suggested that standardized assessments are valued as indicators of professional status. However, the interview responses also suggested that the demands of test standardization were incongruent with the values that guide occupational therapy practice. The findings of this study suggest that the future development and use of standardized instruments should be consistent with the values of the profession. In particular, assessments that recognize the diverse nature and needs of individual clients are required.     

Performance in occupational therapy as a predictor of successful prevocational training

Scores on three subtests of the Minnesota Follow-up Scale (MFS) were related to client outcomes in a prevocational training program in a study of 26 clients who were referred from an adult psychiatric day treatment unit. The results of the study agreed with a prediction that successful performance in occupational therapy in the day treatment unit, as measured by subtest 1, would be significantly related to successful client outcomes. the results regarding predictions for two other subtests were less conclusive because clients received high scores. Age and sex distributions showed that the younger male clients were most likely to be referred for prevocational training. The staff of the prevocational training program accepted the results of the study and also agreed that performance in occupational therapy (in the day treatment unit) should receive greater recognition by staff members as an important indicator of work potential when evaluating clients for referral to a vocational training program. It is planned to continue the use of the MFS in the day treatment unit as an aid for evaluating clients for referral purposes. Scores will continue to be related to client outcomes in the prevocational training program. Further study is also planned concerning the relationship of age and sex and sources to which clients are discharged or referred from the day treatment unit.     

Developing as a therapist: Stress-related growth through parenting a child in crisis.

Stress-related growth following a variety of highly stressful experiences is receiving increased attention. However, one area that has not yet been addressed is the growth that therapists may experience in their own personal life through encounters with trauma and personal struggles and how this growth might carry forward to the work that they do with their clients in the practice of psychotherapy. In the present article, the authors describe stress-related growth and use it as a framework to examine the stressful experience and ultimate growth of a therapist dealing with a family member's emotional crises. Three areas of her growth as a therapist are examined: strengthened understanding of the therapeutic process from the client's viewpoint, additional strategies for approaching the change process, and increased empathy for parents and clients. The article concludes with recommendations for therapists experiencing personal struggles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An examination of age and cognitive test performance across job complexity and occupational types.

In this study, job complexity and occupational type were examined as potential moderators of the relationship between age and cognitive ability. Data include general, verbal, and numerical ability scores for 21,646 individuals in the General Aptitude Test Battery (GATB) data base. These individuals comprised 102 unique samples and 10 major occupational groups. Differences in the relationship between age and cognitive ability test scores were observed across occupational types but not for different levels of job complexity. Findings were discussed in terms of a need for research that examines specific life and work experiences and how such experiences may influence an individual's cognitive abilities across the life span. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prostate cancer: clinical perspectives

1. When obtaining a screening history for prostate cancer, important risk factors include age, family history, and ethnicity. The digital rectal examination remains the "gold standard" physical examination screening technique. 2. If prostate cancer is detected at an early stage, it is potentially curable. It is incumbent upon occupational health care providers to afford those constituents who fall into a high risk category, or who are > or = 40 years of age, every opportunity for prostate cancer screening. 3. Education is the "sine-qua-non" of complete health care provision for prostate cancer clients. The occupational health care provider can play a pivotal role in allaying a client's fear and misconception of this disease. 4. Providing appropriate assessment and advocacy for clients returning to the workplace following diagnosis and treatment of prostate cancer is crucial.     

Comparing motor and process ability of persons with suspected dementia in home and clinic settings

OBJECTIVES: Evaluating functional level of persons with diagnosed or suspected dementia is an important part of occupational therapy. The importance of the environment is often highlighted. We investigated the ability of clients with suspected dementia to perform instrumental activities of daily living (IADLs) in the clinic versus in their homes. METHOD: We used the Assessment of Motor and Process Skills (AMPS) to measure the motor and process skill ability of 19 clients with suspected dementia. RESULTS: Using two-tailed paired t-tests, we found no overall difference in IADL motor or process performance between the clinic and home setting. However, of the 19 clients, 6 had motor ability measures, whereas 5 had process ability measures that differed significantly between the two settings. CONCLUSION: The results suggest that if we want to know how a person with suspected dementia performs in IADLs in a specific environment we should test him or her in that environment.     

Implications of payment of fees for psychotherapy.

Considers the question of how the payment of fees by clients for psychotherapy and related psychological services influences therapeutic outcomes. Psychoanalytic theory and cognitive dissonance theory suggest that clients who pay for psychotherapy will benefit more than those who pay nothing. This question and related issues are discussed with reference to observations and experimental studies that have explored how fees influence psychotherapy. Presently, sufficient evidence does not exist either to support or refute most of the hypotheses that have been generated, including the one that clients who pay a fee benefit more than those who pay nothing. Explanations for this void in the research literature and suggestions for expanding the understanding of this domain are provided. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Keeping our instruments finely tuned: An existential–humanistic perspective.

Discusses psychologist self-care from an existential-humanistic point of view. The authors use the metaphor of a musician fine-tuning her instrument to illustrate that psychotherapists should, like the musician, seek to be in communion with their own aliveness—with their personal life force that is the instrument. It is stated that if one neglects to maintain this connection, burn out is possible. Listed are ways in which psychotherapists can avoid a disconnection from this aliveness and seek this communion, in turn allowing psychotherapists to have a grounded conception of their own responsibilities and those of their clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)