Psychotherapy as making.

Historically, research and practice of psychotherapy have been conducted within conceptual frameworks defined in terms of theoretical models. These models are in turn guided by meta-theories about the purpose of psychotherapy and its place in society. An image of psychotherapy that underpins much contemporary practice is the idea that therapy operates as an intervention that involves the implementation and application of a pre-existing theoretical model or set of empirically validated procedures. The present paper introduces the idea that it may be valuable to regard psychotherapy not as an intervention but instead as a process of making, in the sense of offering a cultural space for the co-construction of meaningful and satisfying ways of living that draw on shared cultural resources. We offer an overview of what a therapy of making might look like, followed by an account of theoretical perspectives, both within the psychotherapy literature and derived from wider philosophical and social science sources, that we have found valuable in terms of making sense of this way of thinking about practice. Our conclusion is that we need something in addition to theory-specific and protocol-driven therapies, in order to be able to incorporate the unexpected, the not-before-met perspective, event or practice of living, and to be open towards the radically new, the given, and the unknown.

Surface chemical heterogeneous distribution in over-lithiated Li1+xCoO2 electrodes.

In commercial Li-ion batteries, the internal short circuits or over-lithiation often cause structural transformation in electrodes and may lead to safety risks. Herein, we investigate the over-discharged mechanism of LiCoO2/graphite pouch cells, especially spatially resolving the morphological, surface phase, and local electronic structure of LiCoO2 electrode. With synchrotron-based X-ray techniques and Raman mapping, together with spectroscopy simulations, we demonstrate that over-lithiation reaction is a surface effect, accompanied by Co reduction and surface structure transformation to Li2CoO2/Co3O4/CoO/Li2O-like phases. This surface chemical distribution variation is relevant to the depth and exposed crystalline planes of LiCoO2 particles, and the distribution of binder/conductive additives. Theoretical calculations confirm that Li2CoO2-phase has lower electronic/ionic conductivity than LiCoO2-phase, further revealing the critical effect of distribution of conductive additives on the surface chemical heterogeneity evolution. Our findings on such surface phenomena are non-trivial and highlight the capability of synchrotron-based X-ray techniques for studying the spatial chemical phase heterogeneity.

A Pluralistic Perspective on Research in Psychotherapy: Harnessing Passion, Difference and Dialogue to Promote Justice and Relevance.

The adoption of a pluralistic perspective on research design, processes of data collection and analysis and dissemination of findings, has the potential to enable psychotherapy research to make a more effective contribution to building a just society. A review of the key features of the concept of pluralism is followed by a historical analysis of the ways in which research in counselling, psychotherapy and related disciplines has moved in the direction of a pluralistic position around knowledge creation. Core principles of a pluralistic approach to research are identified and explored in the context of a critical case study of contemporary research into psychotherapy for depression, examples of pluralistically oriented research practices, and analysis of a pluralistic conceptualisation of the nature of evidence. Implications of a pluralistic perspective for research training and practice are discussed. Pluralistic inquiry that emphasises dialogue, collaboration, epistemic justice and the co-existence of multiple truths, creates opportunities for individuals, families and communities from a wide range of backgrounds to co-produce knowledge in ways that support their capacities for active citizenship and involvement in open democratic decision-making. To fulfil these possibilities, it is necessary for psychotherapy research to be oriented towards social goals that are sufficiently relevant to both researchers and co-participants to harness their passion and work together for a common good.

Future orientation in successful therapies: Expanding the concept of goal in the working alliance.

OBJECTIVE: To better understand how therapists facilitate client goal attainment in therapy, we analyzed therapists' future-oriented actions in good outcome cases in which clients recorded high ratings on goal items in the Working Alliance Inventory-Short Revised. METHOD: We selected clients who were within the clinical range (OQ-45.2) at pretreatment, demonstrated reliable change at the end of treatment, and recorded high WAI client goals scores early in treatment. Qualitative analyses of transcripts of the initial three sessions and client posttreatment interviews were integrated into a combined analysis to identify themes across the two separate sets of findings. RESULTS: Therapist future-oriented activity included: (1) Picking up explicit and implicit intentions; (2) using linguistic devices, such as meta-communication, action language, and hedging; (3) using evocative interventions; and (4) nudging the client into practicing change. Core finding: Therapists aligned with clients' directionality in a forward-driven, gradually evolving process. CONCLUSION: Conceptual and clinical implications are discussed.

Evaluating a novel MR-compatible foot pedal device for unipedal and bipedal motion: Test-retest reliability of evoked brain activity.

The purpose of this study was to develop and evaluate a new, open-source MR-compatible device capable of assessing unipedal and bipedal lower extremity movement with minimal head motion and high test-retest reliability. To evaluate the prototype, 20 healthy adults participated in two magnetic resonance imaging (MRI) visits, separated by 2-6 months, in which they performed a visually guided dorsiflexion/plantar flexion task with their left foot, right foot, and alternating feet. Dependent measures included: evoked blood oxygen level-dependent (BOLD) signal in the motor network, head movement associated with dorsiflexion/plantar flexion, the test-retest reliability of these measurements. Left and right unipedal movement led to a significant increase in BOLD signal compared to rest in the medial portion of the right and left primary motor cortex (respectively), and the ipsilateral cerebellum (FWE corrected, p < .001). Average head motion was 0.10 ± 0.02 mm. The test-retest reliability was high for the functional MRI data (intraclass correlation coefficients [ICCs]: >0.75) and the angular displacement of the ankle joint (ICC: 0.842). This bipedal device can robustly isolate activity in the motor network during alternating plantarflexion and dorsiflexion with minimal head movement, while providing high test-retest reliability. Ultimately, these data and open-source building instructions will provide a new, economical tool for investigators interested in evaluating brain function resulting from lower extremity movement.

Keeping psychologists in the driver's seat: Four perspectives on quality improvement and clinical data registries.

Performance accountability-also frequently referred to as quality improvement in the fields of medicine and public policy-is under growing scrutiny in mental and behavioral health care. As one high-profile example, psychologists and other mental health providers will be deemed "eligible clinicians" under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act starting in 2019. This will incentivize psychologists to track their Medicare patients' clinical outcomes and report them in data registries, and those who do not will suffer a reimbursement penalty. However, many psychologists are not aware of these developments or prepared for this change. The goal of this article is to provide information to psychologists about quality improvement and clinical data registries from four distinct, though overlapping, vantage points: professional governance, quantitative research, qualitative research, and clinical practice. We review recent regulations and research in this area, with an emphasis on exploring both the potential benefits and challenges of quality improvement. We conclude by providing recommendations for the field of psychology. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

High-Performance Perovskite Light-Emitting Diode with Enhanced Operational Stability Using Lithium Halide Passivation.

Defect passivation has been demonstrated to be effective in improving the radiative recombination of charge carriers in perovskites, and consequently, the device performance of the resultant perovskite light-emitting diodes (LEDs). State-of-the-art useful passivation agents in perovskite LEDs are mostly organic chelating molecules that, however, simultaneously sacrifice the charge-transport properties and thermal stability of the resultant perovskite emissive layers, thereby deteriorating performance, and especially the operational stability of the devices. We demonstrate that lithium halides can efficiently passivate the defects generated by halide vacancies and reduce trap state density, thereby suppressing ion migration in perovskite films. Efficient green perovskite LEDs based on all-inorganic CsPbBr3 perovskite with a peak external quantum efficiency of 16.2 %, as well as a high maximum brightness of 50 270 cd m-2 , are achieved. Moreover, the device shows decent stability even under a brightness of 104  cd m-2 . We highlight the universal applicability of defect passivation using lithium halides, which enabled us to improve the efficiency of blue and red perovskite LEDs.

Investigating the luminescence mechanism of Mn-doped CsPb(Br/Cl)3 nanocrystals.

Inorganic lead halide perovskite CsPbX3 (X = Cl, Br, or I) nanocrystals are promising candidate materials for light-emitting devices and optoelectronics. Mn-Doped CsPbX3 is of particular interest, as the Mn-doping introduces an additional emission band, making this material a promising white-light emitter. In this study, Mn-doped CsPb(Br/Cl)3 nanocrystals are prepared at room-temperature and ambient pressure. The chemical environment of Mn, and the luminescence of these nanocrystals are analyzed in detail using X-ray diffraction (XRD), extended X-ray absorption fine structure (EXAFS), X-ray absorption near-edge structure (XANES) and X-ray excited optical luminescence (XEOL). Although the introduction of Mn does not alter the long-range order of the CsPbX3 crystal, it leads to a local lattice contraction with the bond length of Mn-X much shorter than Pb-X. We also find excitation energy-dependence in both the intensity and wavelength of the perovskite excitonic emission band, while only in intensity of the Mn emission band. Detailed fitting of the XEOL reveals that the perovskite emission band is dual-channel, and it is the excitation energy-dependent intensity variation of these two channels that drives the observed red-shift of the combined emission band. Our findings also confirm that the Mn emission band is driven by exciton-Mn energy transfer and clarify the Mn chemical environment and the luminescence mechanism in Mn-doped CsPb(Br/Cl)3 nanocrystals.

Alternative Type Two-Dimensional-Three-Dimensional Lead Halide Perovskite with Inorganic Sodium Ions as a Spacer for High-Performance Light-Emitting Diodes.

Two-dimensional (2D) lead halide perovskites with long-chain ammonium halides display high photoluminescence quantum yields (PLQYs), because of their size and dielectric confinement, which hold promise for a high-efficiency and low-cost light-emitting diode (LED). However, the presence of an insulating organic long-chain spacer cation (L) dramatically deteriorates the charge transport properties along the out-of-plane nanoplatelet direction or adjacent nanocrystals, which would limit the device performance of the LED. To overcome this issue, we successfully incorporate small alkaline ions such as sodium (Na+) to replace the long organic molecule. Grazing incidence X-ray diffraction measurements verify 2D layer formation with a preferred crystallite orientation. In addition, the incorporated sodium salt also generates amorphous sodium lead bromide (NaPbBr3) in perovskite as spacers to form a nanocrystal-like halide perovskite film. The PLQY is dramatically improved in the sodium-incorporated film because of its enhanced photoluminescence lifetime. Upon incorporation of a low concentration of an organic additive, this two-dimensional-three-dimensional (2D-3D) perovskite can achieve a compact and uniform film. Therefore, a 2D-3D perovskite achieves a high external quantum efficiency of 15.9% with good operational stability. We develop a type of 2D-3D halide perovskite with various inorganic ions as spacers for promising high-performance optoelectronic devices.

"It's both a strength and a drawback." How therapists' personal qualities are experienced in their professional work.

Objective: The aim of this study was to gain knowledge about how the integration of personal and professional experiences affects therapeutic work. Method: Therapists (N = 14) who had been recommended by their leaders at their individual workplaces were interviewed twice with semi-structured qualitative interviews, which were then subjected to thematic and Interpretative Phenomenological Analysis. Results: All the therapists in the sample described their personal qualities as an experienced tension between their personal strengths and vulnerabilities in the therapeutic setting. This tension came to expression through four subordinate themes: (a) The tension between perceiving oneself as a helper while dealing with one's own needs for attention and care; (b) The tension between the ability for embodied listening to the patient while tuning into oneself; (c) The tension between staying present while handling aggression and rejection from clients; and (d) The tension in striving for a constructive balance between closeness and distance. Conclusion: The results point to ways in which the personal selves of the therapists may affect their professional role performance. Drawing upon previous research and literature on the topic, the paper discusses how therapists' personal qualities are experienced as affecting their work and suggests several implications for psychotherapy training and practice.

Photocatalytic Polymerization from Amino Acid to Protein by Carbon Dots at Room Temperature.

The chemical origins of life have been widely accepted at the present stage. However, the idea that amino acids further react to produce peptides and proteins remains an unsatisfactory explanation, because producing polypeptides via spontaneous reaction of amino acids in solution is extremely difficult. It is also necessary to further answer whether amino acids can form longer peptide chains as well as specific chiral structures and so on under this same reaction mechanism. Carbon dots (CDs) have been intensively researched over the past years due to their unique chemical and physical properties. Here, we demonstrate the photocatalytic polymerization of amino acids into polypeptides and proteins using CDs as a photocatalyst, in which the synthetic conditions required are only room temperature (or as low as -20 °C) and aqueous conditions along with light irradiation, which are very mild and easy to satisfy. We even obtain a protein with tertiary structures, namely an artificial insulin with the biological function to reduce the blood sugar of the laboratory mice. The innovation of using CDs to initiate amino acids to condense into polypeptides is based on strong adsorption (e.g., hydrogen bonding), the acidity of the -OH surface functional groups, and the photogenerated protons/holes, which are the fundamental factors for polypeptide or even ternary structure protein formation by means of capturing and condensing the amino acids as well as forming the S-S bonds.

Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach.

BACKGROUND: The management of people with multiple chronic conditions challenges health-care systems designed around single conditions. There is international consensus that care for multimorbidity should be patient-centred, focus on quality of life, and promote self-management towards agreed goals. However, there is little evidence about the effectiveness of this approach. Our hypothesis was that the patient-centred, so-called 3D approach (based on dimensions of health, depression, and drugs) for patients with multimorbidity would improve their health-related quality of life, which is the ultimate aim of the 3D intervention. METHODS: We did this pragmatic cluster-randomised trial in general practices in England and Scotland. Practices were randomly allocated to continue usual care (17 practices) or to provide 6-monthly comprehensive 3D reviews, incorporating patient-centred strategies that reflected international consensus on best care (16 practices). Randomisation was computer-generated, stratified by area, and minimised by practice deprivation and list size. Adults with three or more chronic conditions were recruited. The primary outcome was quality of life (assessed with EQ-5D-5L) after 15 months' follow-up. Participants were not masked to group assignment, but analysis of outcomes was blinded. We analysed the primary outcome in the intention-to-treat population, with missing data being multiply imputed. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN06180958. FINDINGS: Between May 20, 2015, and Dec 31, 2015, we recruited 1546 patients from 33 practices and randomly assigned them to receive the intervention (n=797) or usual care (n=749). In our intention-to-treat analysis, there was no difference between trial groups in the primary outcome of quality of life (adjusted difference in mean EQ-5D-5L 0·00, 95% CI -0·02 to 0·02; p=0·93). 78 patients died, and the deaths were not considered as related to the intervention. INTERPRETATION: To our knowledge, this trial is the largest investigation of the international consensus about optimal management of multimorbidity. The 3D intervention did not improve patients' quality of life. FUNDING: National Institute for Health Research.

Influence of Eu-substitution on luminescent CH3NH3PbBr3 quantum dots.

We report a series of Eu-substituted methylammonium lead tribromide quantum dots (MAPb1-xEuxBr3 QDs). The crystallinity of these QDs increases with increasing Eu content, while there is only a small change in the lattice constant, and the morphology of the MAPb1-xEuxBr3 QDs is unaffected by the Eu content. This demonstrates that Eu is a suitable element for substituting Pb while retaining the original crystal structure. We observe blue photoluminescence (PL) consistent with Eu2+, which, at high Eu content (x = 0.3), contributes luminescence intensity equal to the green PL of unsubstituted MAPbBr3 QDs. As Eu is a less toxic substitute for Pb, that also provides blue luminescence, MAPb1-xEuxBr3 QDs may prove to be a valuable optoelectronic material.

Prospects for Mitigating Intrinsic Organic Decomposition in Methylammonium Lead Triiodide Perovskite.

Organometallic lead halide perovskites seem to be on the threshold of becoming viable commercial photovoltaics; however, further improvements to the stability of these materials must be made before they can compete with existing photovoltaic technologies. Of the organometallic lead halide perovskites used in photovoltaics, methylammonium lead triiodide perovskite (MAPI) is perhaps the most studied, and understanding how MAPI degrades is crucial for developing strategies to improve stability. We discuss the experimental evidence behind several possible routes for MAPI to degrade into PbI2 and various organics, and how the decomposition path of MAPI may strongly depend on substrate, precursors, intrinsic organic defects, and morphology. Exploring the conditions required for MAPI to degrade according to a particular pathway is important not only from a fundamental materials chemistry perspective, but also for understanding intrinsic instability in MAPI-based photovoltaics and to develop strategies to improve stability.

Wisdom in professional knowledge: Why it can be valuable to listen to the voices of senior psychotherapists.

OBJECTIVE: To explore the nature of professional wisdom, through learning from the experiences of a group of highly experienced senior therapists. METHOD: Twelve senior psychotherapists took part in qualitative in-depth interviews about their professional role and their views around a range of aspects of therapy theory and practice. Interview transcripts were subjected to thematic analysis. RESULTS: The analysis yielded nine wisdom themes, clustered within three domains. Each domain represented efforts to resolve dilemmas arising from the experience of being a therapist, around the use of theory in psychotherapy practice, the type of therapeutic relationship that is most helpful for clients, and the experience of therapeutic failure. CONCLUSIONS: Therapist wisdom can be viewed as a form of contextualized knowledge, which functions as a source of emergent insights that arise as responses to the limitations of prevailing ways of thinking. Research into the nature of therapist wisdom draws attention to sources of knowledge within philosophy and the humanities that have the potential to enhance therapy practice and contribute to our understanding of therapist expertise.

A chlorine-free protocol for processing germanium.

Replacing molecular chlorine and hydrochloric acid with less energy- and risk-intensive reagents would markedly improve the environmental impact of metal manufacturing at a time when demand for metals is rapidly increasing. We describe a recyclable quinone/catechol redox platform that provides an innovative replacement for elemental chlorine and hydrochloric acid in the conversion of either germanium metal or germanium dioxide to a germanium tetrachloride substitute. Germanium is classified as a "critical" element based on its high dispersion in the environment, growing demand, and lack of suitable substitutes. Our approach replaces the oxidizing capacity of chlorine with molecular oxygen and replaces germanium tetrachloride with an air- and moisture-stable Ge(IV)-catecholate that is kinetically competent for conversion to high-purity germanes.

Beyond Oxidation States: Distinguishing Chemical States of Gallium in Compounds with Multiple Gallium Centers.

The electronic structures of a series of gallium complexes are examined using X-ray absorption spectroscopy (XAS) in combination with ab initio calculations. The chemical states of Ga are strongly affected by the ligands and the bonding environment. For complexes containing multiple gallium sites, we demonstrate that XAS can identify the chemical state of each unique gallium center. A reliable understanding of the chemical nature of the core element in a coordination complex with strong core-ligand interaction can be obtained only when both experimental and theoretical approaches are combined.

Structural evolution of reduced GeOx nanoparticles.

GeOx nanoparticles (NPs) are of growing interest in lithium storage and optoelectronics. GeOx NPs prepared by chemical reduction, exposed to air or retained under N2, then annealed under H2 at various temperatures are studied herein using soft X-ray spectroscopy. We find that fresh and air-exposed GeOx NPs evolve rather differently under annealing. The fresh GeOx NPs start as a very amorphous heterogeneous mixture of GeOx and Ge, and during annealing both the valence band and conduction band edges evolve. In contrast, the air-exposed GeOx NPs initially contain quartz-phase GeO2, and during annealing only the conduction band edge evolves due to increased oxygen vacancies forming unoccupied defect states (the valence band does not change until annealing at high temperture, at which point almost all of the GeO2 is removed). These findings suggest a preparation and annealing strategy that could be used to tailor GeOx NPs for their intended use in lithium storage or optoelectronic applications.

Iodomethane-Mediated Organometal Halide Perovskite with Record Photoluminescence Lifetime.

Organometallic lead halide perovskites are excellent light harvesters for high-efficiency photovoltaic devices. However, as the key component in these devices, a perovskite thin film with good morphology and minimal trap states is still difficult to obtain. Herein we show that by incorporating a low boiling point alkyl halide such as iodomethane (CH3I) into the precursor solution, a perovskite (CH3NH3PbI3-xClx) film with improved grain size and orientation can be easily achieved. More importantly, these films exhibit a significantly reduced amount of trap states. Record photoluminescence lifetimes of more than 4 µs are achieved; these lifetimes are significantly longer than that of pristine CH3NH3PbI3-xClx films. Planar heterojunction solar cells incorporating these CH3I-mediated perovskites have demonstrated a dramatically increased power conversion efficiency compared to the ones using pristine CH3NH3PbI3-xClx. Photoluminescence, transient absorption, and microwave detected photoconductivity measurements all provide consistent evidence that CH3I addition increases the number of excitons generated and their diffusion length, both of which assist efficient carrier transport in the photovoltaic device. The simple incorporation of alkyl halide to enhance perovskite surface passivation introduces an important direction for future progress on high efficiency perovskite optoelectronic devices.

Dissociation of Methylammonium Cations in Hybrid Organic-Inorganic Perovskite Solar Cells.

Organic-inorganic lead perovskites have shown great promise as photovoltaic materials, and within this class of materials (CH3NH3)PbI3-xClx is of particular interest. Herein we use soft X-ray spectroscopy and density functional theory calculations to demonstrate that the methylammonium cations in a typical photovoltaic layer may dissociate into a metastable arrangement of CH3I-Pb2 defects and trapped NH3. The possibility that other metastable configurations of the organic components in (CH3NH3)PbI3-xClx is rarely considered but adds an entirely new dimension in understanding the charge trapping, ionic transport, and structural degradation mechanisms in these materials. Understanding the influence of these other configurations is of critical importance for further improving the performance of these photovoltaics.