A Complexity Perspective on Narrative Identity Reconstruction in Mental Health Recovery.

The issue of complex nonlinear change processes is one of the least understood aspects of recovery and one of the most difficult to apply in recovery-oriented health care. The purpose of this article is to explore the recovery stories of 17 mental health peer support workers to understand their narrative identity reconstruction in recovery using a complexity perspective. Using the Life Story Model of Identity (LSMI), a narrative thematic analysis of interviews suggests that self-mastery as part of personal agency is an important component of participants' narrative identity reconstruction. Self-mastery is particularly evident in redemptive story turning points (positive outcome follows negative experience). A complexity perspective suggests that participants realized their adaptive capacity in relation to self-mastery as part of recovery and that its use at story turning points critically influenced their recovery journey. Further exploring self-mastery as adaptive growth in narrative identity reconstruction appears to be a fruitful research direction.

Brief Online Training with Standardised Vignettes Reduces Inflated Supervisor Ratings of Trainee Practitioner Competencies.

OBJECTIVE: Supervisor assessments of trainee competence are integral to ensuring that clinical psychology trainees reach competency benchmarks. The commonly used Clinical Psychology Practicum Competencies Rating Scale (CΨPRS) has been shown to elicit inflated ratings of competency. Hence, the aim of this study is to examine whether brief supervisor training reduces ratings by providing objective criteria with which supervisors can assess trainee competency. METHOD: The ratings included were of 124 psychology trainees from nine Australian university clinical programmes. Of 170 supervisors, 32 completed the online training immediately prior to commencing the CΨPRS. Training required supervisors to rate the competency level described in five standardised vignettes (Beginner through to Competent). Vignette ratings, as determined by a panel of expert supervisors, were provided as feedback. A sixth calibration vignette was also rated (no feedback provided). Firstly, CΨPRS ratings from the trained and untrained supervisors were compared. Secondly, the difference between supervisor and expert ratings of the calibration vignettes were compared across trained and untrained groups. RESULTS: Trained supervisors provided lower CΨPRS ratings than untrained supervisors. In addition, trained supervisors (vs untrained supervisors) provided ratings of the calibration vignette that more accurately matched the ratings provided by the expert panel. CONCLUSIONS: Brief online training using standardised vignettes was associated with lower CΨPRS ratings. The standardised vignettes helped calibrate supervisors' ratings and likely attuned supervisors to the skills and competency levels that are expected at particular developmental stages. As a consequence, training appeared to reduce ratings, arguably resulting in more accurate assessments of trainee performance.

The psychological impact of anal cancer screening on HIV-infected men.

BACKGROUND: Anal cancer rates are increasing in HIV-infected men. Screening programmes similar to prostate and cervical cancer have been recommended to reduce morbidity and mortality. Research shows that screening processes have psychological consequences that need to be considered. Limited investigation of the psychological impact of anal cancer screening has been conducted. METHODS: A prospective longitudinal survey of 291 men was conducted at three time points over 14 weeks at a public HIV clinic in Sydney, Australia. Self-report questionnaires measuring worry, distress, depression, anxiety, stress and health-related quality of life (SF-12) were collected. RESULTS: Those who had a biopsy recommended were significantly more worried about anal cancer, rated their anal health worse and were less optimistic about their future health than the control group who needed no further medical investigation. The group receiving high grade histology results remained worried about anal cancer at time 3. We found no evidence that general anxiety, depression or quality of life was significantly affected by the process. CONCLUSIONS: Anal cancer specific worry increases throughout the screening process. Clear communication prior to procedures about the procedure itself, potential adverse events, the recovery process and non-technical explanations of results should be implemented in anal screening programmes.