Knowledge of and interest in geropsychology among psychology trainees.

Given the increasing number of older people in the U.S. population, how well prepared are graduate students to deliver services to older adults? Do graduate students want to see older adults in clinical practice? Ninety-four psychology externs and interns were surveyed about their knowledge of and attitudes toward older people. Although trainees evidenced gaps in knowledge, they indicated interest in expanding that knowledge. They also reported favorable attitudes toward the aged and interest in practice with them. This article summarizes geropsychology resources for graduate program directors, students, and practitioners who want to expand practice to include older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical psychologists' judgments of older adult patients with character pathology: Implications for practice.

The most rapidly growing segment of the U.S. population is elderly, and an increasing number of older adults are expected to seek psychological services. Concerns have previously been expressed about the impact of psychologists' attitudes toward elderly patients on their clinical practice. This exploratory study examined the diagnostic, treatment, and attitudinal responses of 186 psychologists toward a patient portrayed in a clinical vignette that varied by age (46, 66, 86 years) and pathology (depression vs. depression with borderline personality disorder). Psychologists with specialized gerontological training were more likely to make age-related diagnostic decisions and treatment recommendations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statewide adoption and initial implementation of contingency management for substance-abusing adolescents.

Four hundred thirty-two public sector therapists attended a workshop in contingency management (CM) and were interviewed monthly for the following 6 months to assess their adoption and initial implementation of CM to treat substance-abusing adolescent clients. Results showed that 58% (n = 131) of the practitioners with at least one substance-abusing adolescent client (n = 225) adopted CM. Rates of adoption varied with therapist service sector (mental health vs. substance abuse), educational background, professional experience, and attitudes toward treatment manuals and evidence-based practices. Competing clinical priorities and client resistance were most often reported as barriers to adopting CM, whereas unfavorable attitudes toward and difficulty in implementing CM were rarely cited as barriers. The fidelity of initial CM implementation among adopters was predicted by organizational characteristics as well as by several demographic, professional experience, attitudinal, and service sector characteristics. Overall, the findings support the amenability of public sector practitioners to adopt evidence-based practices and suggest that the predictors of adoption and initial implementation are complex and multifaceted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical judgment of major depression in AIDS patients: The effects of clinician complexity and stereotyping.

This clinical judgment study found an overshadowing bias that existed in the treatment of major depression in AIDS patients. Two clinician individual differences—cognitive complexity about AIDS issues and attitudes toward AIDS victims—were investigated for possible moderating effects of the treatment overshadowing bias. Cognitive complexity about AIDS issues had a significant moderating effect, as more complex clinical and counseling psychologists were more likely to recommend antidepressant medication. Attitudes toward AIDS victims, measured by the Attitudes Towards AIDS Victims scale (Larsen, Serra, & Long, 1990), did not moderate clinician's treatment judgments. Results from a second set of exploratory analyses suggest that the diagnostic overshadowing occurred, but as a function of the presence of a terminal illness (AIDS or cancer) and not as a bias unique to AIDS issues. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Willingness to perform euthanasia. A survey of physician attitudes

BACKGROUND: In the United States, few studies have examined important variables in physician attitudes toward the practice of euthanasia, such as the patient's underlying disease, mental capacity, and age, and the physician's specialty and religion. We administered a case-based survey to analyze the impact of such specific variables on physician attitudes toward the practice. METHODS: A four-section survey solicited (1) physician responses to three hypothetical cases in which patients requested euthanasia; (2) physicians' general opinions about euthanasia and how its legalization might affect them personally and professionally; and (3) demographic information. Analysis focused on physicians' characteristics as they related to their responses to the various aspects of euthanasia elicited in the survey. Univariate and multivariate analyses, using logistic regression, were performed. RESULTS: Completed and analyzable surveys were returned by 740 physicians. We found that physicians felt more comfortable with euthanasia requests from nondecisional, nonterminal patients who had left advance directives than they did with requests from decisional patients suffering from grave illnesses or injuries, or from decisional patients who had early signs of a progressive but nonlethal neurologic disease. We also found that physicians' specialties and religions correlated with their responses to the hypothetical cases and with their generalized attitudes toward euthanasia. CONCLUSIONS: Given the disparity in responding physicians' attitudes toward euthanasia, along with the fact that values based on religious affiliation or profession may underlie many physicians' opposition to the practice, we conclude that if euthanasia is to be legalized, safeguards protective of patients and physicians must be incorporated.     

Organizational culture and climate and mental health provider attitudes toward evidence-based practice.

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Connecting the research and nursing processes: making a difference in baccalaureate students' attitudes and abilities

Student nurses are often intimidated by the research process. They also frequently have negative attitudes about working with the elderly, especially in long-term care settings. This article describes a clinical project designed to help students improve their attitudes, knowledge, and skills toward research and care of the elderly by connecting the research process and the nursing process. Students implement research-based clinical practice in a long-term care setting. Student evaluations indicate that project goals are achieved. Nursing staff evaluation data indicate that they find student projects interesting and useful in updating resident care plans.     

The "war" for boys: Hearing "real boys'" voices, healing their pain.

Boys are in a crisis--boys in treatment and boys next door. Practitioners need to know more about research that helps to elucidate this crisis of boyhood as well as new clinical insights, derived from a modern rethinking of boyhood. The results of the Listening to Boys' Voices project (see W. S. Pollack, 1999) are reviewed as a springboard for pragmatic suggestions for changes in clinical attitudes toward, and treatment of, boys and young men. Practitioners are also urged to help society stem the tide of pain that today's boys must face in the midst of changing attitudes toward the normative journey toward masculinity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practicing psychologists’ reflections on evidence-based practice in psychology.

An American Psychological Association (APA) policy definition of evidence-based practice in psychology (EBPP) states that practice based on evidence must consider the best available research, use clinical expertise, and consider client contextual variables (APA Presidential Task Force, 2006). The researchers qualitatively examined clinical and counseling psychologists’ attitudes toward EBPP using grounded theory. The study explored the extent to which the official view of EBPP reflects current psychological practice as well as whether EBPP is an idealistic definition to work toward. An examination of themes from this research yielded evidence that the framework for EBPP is in place, although many participants initially confused EBPP with research. Psychologists will benefit from an open-minded review of the official APA policy definition and from considering how the policy may affect their practice and interactions with managed care providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work activities of academic clinical psychologists: Do they practice what they teach?

Do PhD-level clinical psychologists who work in academic settings engage in both research and clinical practice, as the Boulder model recommends? Clinical psychology faculty members in 3 types of psychology departments were surveyed regarding their actual and preferred work activities and their attitudes toward clinical practice. Respondents indicated that they spent more than twice as much time in research as in clinical activity, with many (44%) reporting no involvement in clinical practice. Implications of declining practice among clinical faculty include potentially ineffective instruction in clinical course work, less informed clinical research, and the devaluing of clinical practice in traditional academic settings. Recommendations for facilitating practice among clinical faculty who wish to do so are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managers' attitudes toward how their pay is and should be determined.

Investigated, by questionnaire, the perceptions of 563 managers toward how their pay is determined and their attitudes toward how it should be determined. The results show that in general the managers' perceptions of how their pay was determined reflected the way in which it was determined. However, the way their pay was determined did not appear to influence strongly their attitudes toward how it should be determined, although there was general agreement that merit should be the most important determinant. However, attitudes toward what factors should be important in determining pay were shown to be related to the managers' perception of their relative standing on the various factors. There was a positive correlation between how well the managers felt they compared with other managers on each factor and how important they felt the factor should be. The data also showed that there was a tendency for lack of congruence between a manager's attitudes toward how his pay should be determined and how it is determined to be associated with high dissatisfaction with pay. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Male role and gender role conflict: Relations to help seeking in men.

Tested theory that adherence to the traditional male gender role and help-seeking attitudes and behaviors are related. Ss were 401 undergraduate men who completed measures of help-seeking attitudes and behaviors, attitudes toward the stereotypic male role, and gender role conflict factors (i.e., success/power/competition, restrictive emotionality, and restrictive affectionate behavior between men). Canonical analysis and regression indicated that traditional attitudes about the male role, concern about expressing emotions, and concern about expressing affection toward other men were each significantly related to negative attitudes toward seeking professional psychological assistance. Restrictive emotionality also significantly predicted decreased past help-seeking behavior and decreased likelihood of future help seeking. The implications of these results for theory, research, and counseling practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward integrating feminist psychotherapy and feminist philosophy.

Describes liberal, cultural, radical, and socialist feminist philosophies and proposes that psychologists' orientations toward feminist political and philosophical theory will have an impact on their practice of feminist psychotherapy with regard to their preferences for group or individual modalities, therapeutic interventions, diagnostic practices, and organizational affiliations. Psychologists' philosophical positions may also influence their attitudes about research, epistemology, and the role of men and women as clients and therapists. Specific connections between feminist philosophy and psychological theories and other aspects of practice are discussed. It is proposed that all psychologists who work with gender-related issues can benefit from contemplating how their therapeutic practices intersect with feminist philosophy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV knowledge and stigmatization of persons with AIDS: Implications for the development of HIV education for young adults.

A group of 660 undergraduates and 596 clinical and counseling psychologists completed a battery of questionnaires about AIDS. Both groups knew moderate amounts of AIDS general information and prevention information and reported moderately positive attitudes toward AIDS patients. Also, both groups felt fairly invulnerable to HIV infection; neither group had much direct experience with HIV-infected patients. For both samples, degree of homophobia was the best predictor of stigmatizing attitudes toward persons with AIDS. Implications for program development and professional practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of treatment manuals to train psychotherapists: Observations and recommendations.

The author's experience using treatment manuals for various forms of psychotherapy in several situations provides the basis for this discussion of their value in graduate-level clinical training programs and psychiatric residencies. Use of manuals is recommended, particularly for novice psychotherapists. Commonly accepted goals of clinical training are enumerated. Based on the goals, features of manuals that distinguish those likely to be most useful for early training are identified. Limitations of available manuals for meeting the goals of training are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Manual-guided cognitive-behavioral therapy training: A promising method for disseminating empirically supported substance abuse treatments to the practice community.

A gap exists between empirically supported substance abuse treatments and those used in community settings. This study examined the feasibility of training substance abuse counselors to deliver cognitive-behavioral treatment (CBT) using treatment manuals. Participants were 29 counselors. Counselors were randomly assigned to receive CBT training or to a control group. Counselor attitudes were assessed pre- and posttraining. In addition, CBT therapy sessions were videotaped and rated for adherence and skillfulness. CBT counselors reported high levels of satisfaction with the training , intention to use CBT interventions, and confidence in their ability to do so. Ratings indicated that 90% of counselors were judged as having attained at least adequate levels of CBT skillfulness. Findings demonstrate the feasibility of using psychotherapy technology tools as a means of disseminating science-based treatments to the substance abuse practice community. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of computers on professional practice: A survey of current practices and attitudes.

Surveyed 227 practicing psychologists to explore the impact of computers on the everyday practice of psychology and practitioners' attitudes toward specific uses of computers. Whereas more than half of the respondents reported using computers in their practices, most restricted their use to clerical applications. Few practitioners used their computer for more clinical applications. Reasons most frequently reported for not using computers related to lacking the necessary skills and experience and to financial considerations. Overall, practitioners had positive attitudes toward a variety of specific applications of computers. Implications of these findings for facilitating the appropriate use of computers by practitioners are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health service utilization among African American and Caucasian mothers and fathers.

Mental health services have been routinely underutilized. This study investigated the influence of parents' gender, race, and psychopathology on perceived barriers and attitudes toward mental health utilization for themselves and for their children. A unique contribution of this study is the examination of father, mother, and child factors influencing service utilization from the parents' perspective. A total of 194 African American and Caucasian parents were recruited from the community to participate. Parents completed measures on barriers and attitudes toward treatment for themselves and for their children, history of mental health service utilization for themselves and for their children, and their own current psychological symptoms. Results indicated that 36.3% and 19.4% of parents and children, respectively, had used mental health services during their lifetime. Parents perceived fewer barriers and had more positive attitudes toward seeking services for their children than for themselves. Race and gender differences were found in parents' perceptions of barriers and attitudes toward treatment. Furthermore, barriers, attitudes, and psychopathology predicted parents' plans for future utilization of mental health services. The clinical implications of this study and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)