The MATRIX: A deliberate practice approach for clinical supervision in the public sector.

Clinical supervision is an essential component of psychotherapeutic practice. However, the literature suggests that the provision of supervision in the public sector has been declining significantly over the past two decades, suggesting that many health care professionals are receiving neither the guidance nor support needed to deliver safe and effective care. Identifying the distinct challenges of supervision in the public sector and proposing prospective solutions is, therefore, a burning issue. In this article, we introduce a novel analytical framework for clinical supervision-the MATRIX-striving to address the unique demands of psychotherapy in the public sector. Various applications of this framework are thoroughly presented and further exemplified using a case illustration. We conclude by discussing the contribution of MATRIX-aided supervision to the acquisition of expert performance in psychotherapy, while also addressing its limitations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Topography of vibration frequency responses on the bony tympano-periotic complex of the pilot whale Globicephala macrorhynchus.

In modern Cetacea, the ear bone complex comprises the tympanic and periotic bones forming the tympano-periotic complex (TPC), differing from temporal bone complexes of other mammals in form, construction, position, and possibly function. To elucidate its functioning in sound transmission, we studied the vibration response of 32 pairs of formaldehyde-glutaraldehyde-fixed TPCs of Globicephala macrorhynchus, the short-finned pilot whale (legally obtained in Taiji, Japan). A piezoelectric-crystal-based vibrator was surgically attached to a location on the cochlea near the exit of the acoustic nerve. The crystal delivered vibrational pulses through continuous sweeps from 5 to 50 kHz. The vibration response was measured as a function of frequency by Laser Doppler Vibrometry at five points on the TPC. The aim of the experiment was to clarify how the vibration amplitudes produced by different frequencies are distributed on the TPC. At the lowest frequencies (<12 kHz), no clear differential pattern emerged. At higher frequencies the anterolateral lip of the TP responded most sensitively with the highest displacement amplitudes, and response amplitudes decreased in orderly fashion towards the posterior part of the TPC. We propose that this works as a lever: high-frequency sounds are most sensitively received and cause the largest vibration amplitudes at the anterior part of the TP, driving movements with lower amplitude but greater force near the posteriorly located contact to the ossicular chain, which transmits the movements into the inner ear. Although force (pressure) amplification is not needed for impedance matching in water, it may be useful for driving the stiffly connected ossicles at the high frequencies used in echolocation.

The Impact of 'Being There': Psychiatric Staff Attitudes on the Use of Restraint.

The practice of mechanically restraining psychiatric patients is constantly under debate, and staff attitudes are considered a central factor influencing restraining practices. The aim of this study was to explore associations between psychiatric staff members' presence and participation in incidences of restraint and attitudes towards mechanical restraints. METHODS: Staff members (psychiatrists, nurses, paramedical staff; N = 143 working in a government psychiatric hospital in Israel) completed a questionnaire including personal information, participation in incidents of restraint and attitudes towards mechanical restraints. Items were categorized into the following categories: security and care; humiliation and offending; control; order; education and punishment. RESULTS: Compared to those who were not present during restraint, staff members who were present agreed significantly less with statements indicating that restraints are humiliating and offending and agreed more with statements indicating that restraints are used primarily for security and care (p < .05). Among those present in incidences of restraint, staff members who physically participated in restraint agreed significantly more with statements indicating that restraints are a means for security, care and order, and less with statements indicating restraints are humiliating and offending, compared to those present but not physically participating in restraint (p < .05). CONCLUSIONS: These findings highlight the importance of proximity of staff members to incidences of restraints. This may have implications in understanding the professional and social discourse concerning mechanical restraints.

The link between competitive sports and gambling behaviors among youths.

BACKGROUND AND OBJECTIVES: This study examines the association between physical activities and gambling, making a distinction between two characteristics of the former: intensity level and type (competitive/non-competitive). METHOD: 316 adolescents from four high schools in Israel completed questionnaires. RESULTS: For males, participation in competitive athletic sports was associated with gambling frequency and problem gambling. For females, participation in competitive athletic sports was associated only with gambling frequency. CONCLUSIONS: Both types of physical activity and gender are important when analyzing the association between gambling and sporting activities. SCIENTIFIC SIGNIFICANCE: Youths involved in competitive sports are at greater risk for gambling involvement. (Am J Addict 2015;24:200-202).

The role of ex-POWs' PTSD symptoms and trajectories in wives' secondary traumatization.

Secondary traumatization describes the phenomenon whereby those in proximity to trauma survivors develop psychological symptoms similar to those experienced by the direct survivor. The current study examined secondary trauma (ST) and generalized distress symptoms (general psychiatric symptomatology, functional disability, and self-rated health) in wives of former prisoners of war (ex-POWs). The study compared wives of Israeli ex-POWs from the 1973 Yom Kippur War with wives of a matched control group of non-POW Yom Kippur War combat veterans (CVs). The wives also were divided into groups based on their husbands' current posttraumatic stress disorder (PTSD) status and PTSD trajectory (i.e., chronic, delayed), and their outcomes were compared with resilient CVs. We found that wives of ex-POWs with PTSD reported higher ST and generalized distress than wives of ex-POWs and non-POW CVs without PTSD. Wives of ex-POWs with chronic PTSD reported the highest levels of functional disability. We also found that the relationships between husbands' prior captivity, and wives' ST and general psychiatric symptomatology were fully mediated by the husbands' PTSD symptoms. These findings indicate that it is exposure to a partner with PTSD that leads to overall ST and other distress symptoms, and not simply to a trauma survivor. Furthermore, the more severe their husbands' PTSD, the more wives are at risk for ST and general psychiatric symptomatology. Wives of partners with PTSD should therefore be considered high-risk groups for ST and distress that may require targeted interventions.

Sleeping patterns of Afghan unaccompanied asylum-seeking adolescents: a large observational study.

Unaccompanied asylum-seeking children (UASC) have experienced multiple traumas and are a high-risk group for posttraumatic stress disorder (PTSD). The effects of trauma are known to be associated with sleep problems; indeed sleeping problems are core features of PTSD. However, there has been no systematic research examining the sleep of this high risk group of children. This study presents the first evidence on the sleeping patterns of Afghan UASC living in the UK. A total of 222 male Afghan children, aged 13-18, were interviewed using validated self-report questionnaires measuring sleeping patterns and PTSD. Overall, UASC patterns for bed time and rise time appear acculturated to the country of asylum. Mean UASC sleep onset latency scores were approximately 20 minutes greater compared with normative scores, which may be a reflection of UASC pre-migration and post-migration experiences. As expected, UASC who screened above the clinical cut-off for PTSD reported significantly greater sleep onset latency, increased nightmares, and less total sleep time compared to the non-PTSD group. The results may be of particular interest to clinicians given that, compared to screening for PTSD, screening for sleep problems may be a less culturally disputed form of initial assessment indicating distress in UASC. Similarly, the field of UASC and refugee child interventions is largely focused on trauma, yet sleep may provide a novel avenue for equally or more effective treatment.

Emotional and behavioural problems amongst Afghan unaccompanied asylum-seeking children: results from a large-scale cross-sectional study.

Unaccompanied asylum-seeking children (UASC) are considered at high risk for mental health problems, yet few studies focus on single ethnic populations. This study presents results from the largest Afghan UASC mental health survey in the U.K. Specifically, the study aims to estimate the prevalence of emotional and behavioural problems and to investigate the associations of these problems with demographic variables, cumulative traumatic events, and care and migration variables. A census sample of 222 Afghan UASC was interviewed using validated self-report screening measures. Emotional and behavioural problems were screened using the Hopkins Symptoms Checklist 37A (HSCL-37A). Pre-migration stressful life events were screened using the Stressful Life Events Questionnaire. Administrative data on care and asylum were provided by the local authority social services and the UK Border Agency. Approximately one-third (31.4%) scored above cut-offs for emotional and behavioural problems, 34.6% for anxiety and 23.4% for depression. Ordinary least squares regression indicated a significant dose-response relationship between total pre-migration traumatic events and distress as well as between increased time in the country and greater behavioural problems. Compound traumatic events in the pre-migration stages of forced migration have a deleterious association with UASC well-being. Increased time in country suggests a possible peer effect for these children. Consistent with other studies on refugee children, it should be stressed that the majority of UASC scored below suggested cut-offs, thus displaying a marked resilience despite the experience of adverse events.

PTSD in asylum-seeking male adolescents from Afghanistan.

This study concerned the mental health of Afghan unaccompanied asylum-seeking children in the United Kingdom (UK). Afghans are the largest group of children seeking asylum in the UK, yet evidence concerning their mental health is limited. This study presents an estimate of probable posttraumatic stress disorder (PTSD) within this group and describes its associations with the cumulative effect of premigration traumatic events, immigration/asylum status, and social care living arrangements. Male adolescents (N = 222) aged 13-18 years completed validated self-report screening measures for traumatic experiences and likely PTSD. One-third (34.3%) scored above a selected cutoff, suggesting that they are likely to have PTSD. A higher incidence of premigration traumatic events was associated with greater PTSD symptomatology. Children living in semi-independent care arrangements were more likely to report increased PTSD symptoms when compared to their peers in foster care. A substantial majority in this study did not score above the cutoff, raising the possibility of notable levels of resilience. Future research should consider approaching mental health issues from a resilience perspective to further the understanding of protective mechanisms for this at-risk population.

Psychological distress in refugee children: a systematic review.

Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style review was conducted searching nine major databases, bibliographies, and grey literature from 2003 to 2008. Included studies had to meet the reporting standards of STROBE and investigate mental health in non-clinical samples of asylum seeking and refugee children residing in OECD countries. A total of twenty-two studies were identified of 4,807 retrieved citations, covering 3,003 children from over 40 countries. Studies varied in definition and measurement of problems, which included levels of post-traumatic stress disorder from 19 to 54%, depression from 3 to 30%, and varying degrees of emotional and behavioral problems. Significant factors influencing levels of distress appear to include demographic variables, cumulative traumatic pre-migration experiences, and post-migration stressors. Importantly, the research base demands greater contextual and methodological refining such that future research would have greater generalizability and clinical implications.