Prevention of post-traumatic stress disorder: Lessons learned from a terminated RCT of prolonged exposure.

The main purpose of the current trial was to test if a brief trauma-focused cognitive-behaviour therapy protocol (prolonged exposure; PE) provided within 72 h after a traumatic event could be effective in decreasing the incidence of post-traumatic stress disorder (PTSD), thus replicating and extending the findings from an earlier trial. After a pilot study (N = 10), which indicated feasible and deliverable study procedures and interventions, we launched an RCT with a target sample size of 352 participants randomised to either three sessions of PE or non-directive support. Due to an unforeseen major reorganisation at the hospital, the RCT was discontinued after 32 included participants. In this paper, we highlight obstacles and lessons learned from our feasibility work that are relevant for preventive psychological interventions for PTSD in emergency settings. One important finding was the high degree of attrition, and only 75% and 34%, respectively, came back for the 2-month and 6-month assessments. There were also difficulties in reaching eligible patients immediately after the event. Based on our experiences, we envisage that alternative models of implementation might overcome these obstacles, for example, with remote delivery of both assessments and interventions via the internet or smartphones combined with multiple recruitment procedures. Lessons learned from this terminated RCT are discussed in depth.

Realidade virtual na prática de mindfulness em psicoterapia: uma revisão narrativa / Realidad virtual en la práctica del mindfulness: una revisión narrativa / Virtual reality in the practice of mindfulness in psychotherapy: a narrative review

RESUMO A associação entre mindfulness (MF) e Realidade Virtual (RV) é recente. O MF vem sendo utilizado na psicoterapia em razão dos efeitos terapêuticos observados. Entretanto, não são todos os pacientes que conseguem obter o benefício desse recurso, sendo a RV uma via para o trabalho com o MF por facilitar o sentido de presença. Este artigo teve como objetivo realizar uma revisão narrativa da literatura sobre a utilização terapêutica da RV na prática de MF. Foram analisados 23 artigos completos, sendo os principais focos de pesquisa: o aprimoramento dos ecossistemas imersivos e dos recursos terapêuticos no contexto do MF em relação à experiência do usuário; o desenvolvimento de recursos tecnológicos econômicos; material de fácil manuseio para facilitar a experiência do usuário. Concluímos que a RV pode ser facilitadora como ferramenta no tratamento de pacientes cujo perfil se enquadra em terapia mediada por MF, embora sejam necessários estudos controlados que permitam compreender as especificidades da RV e as variáveis com valor terapêutico.

RESUMEN La asociación entre mindfulness (MF) y Realidad Virtual (VR) es reciente. MF se ha utilizado en psicoterapia debido a los efectos terapéuticos observados. Sin embargo, no todos los pacientes pueden obtener el beneficio de este recurso, siendo la RV una forma de trabajar con el MF porque facilita el sentido de presencia. Este artículo tuvo como objetivo realizar una revisión narrativa de la literatura sobre el uso terapéutico de la RV en la práctica de MF. Se analizaron 23 artículos completos, siendo los principales focos de investigación: la mejora de ecosistemas inmersivos y recursos terapéuticos en el contexto de MF en relación a la experiencia del usuario; el desarrollo de recursos tecnológicos económicos; material fácil de manejar para facilitar la experiencia del usuario. Concluimos que la RV puede ser un facilitador como herramienta en el tratamiento de pacientes cuyo perfil encaja en la terapia mediada por MF, aunque son necesarios estudios controlados para entender las especificidades de la RV y las variables con valor terapéutico.

ABSTRACT The association between mindfulness (MF) and Virtual Reality (VR) is recent. MF has been used in psychotherapy due to the therapeutic effects reported. However, not all patients are able to obtain the benefits of this resource, and VR becomes a way to work with MF as it facilitates the sense of presence. This paper presents a narrative review of the literature about therapeutic uses of VR in the practice of MF. A total of 23 complete papers were analyzed, being the main research focuses: the improvement of immersive ecosystems and therapeutic resources in the context of MF in relation to the user experience; the development of economic technological resources; easy to handle material to facilitate the user experience. We concluded that VR can be a facilitator as a tool in the treatment of patients who could benefit from MF-informed therapy, although controlled studies are needed to understand the specificities of VR and the variables with therapeutic value.

La psicología clínica ante la pandemia COVID-19 en España / No disponible

No disponible

La Psicología ante la Pandemia de la COVID-19 en España. La Respuesta de la Organización Colegial / No disponible

No disponible

Evolutionary and genetic insights for clinical psychology.

Recent advances in genetics, and new applications of evolutionary biology, are transforming psychology and psychiatry. The purpose of this article is to review and synthesize the progress in these two areas that is most salient to the practice of clinical psychology. First, I describe how the results of genome-wide studies have elucidated the genetic architectures of psychiatric disorders. These genetic results can be applied to generate polygenic risk scores, identify rare causal mutations, evaluate gene by environment interactions, and help determine the specific causes of psychiatric disorders for each individual, all of which can help to guide therapies and treatments. Second, I explain how evolutionary theory, applied to human development, the human psyche, and mental disorders, leads to novel insights relevant to therapy. Evolutionary thinking for psychiatry and psychology is consilient with contemporary schools of thought in clinical psychology, but also provides novel, non-intuitive, and clinically-useful insights. Effects of the genome in development, and functioning of the adult psyche, are both usefully conceived as dynamical, non-linear systems, regulated by feedbacks, that can become disordered in predictable yet individualistic ways. The merging of genetic, neurological, psychological, and evolutionary approaches is set to transform clinical psychology and psychiatry, but requires increased emphasis on cross-disciplinary thinking and research.

Evolution of clinical neuropsychology: Four challenges.

Quantitative and evidence-based approaches fail to capture "the whole person," neglect the important contributions of nonquantitative variables to understanding behavior, and have limitations when assessing individuals who fall outside traditional normative groups. The emphasis on quantitative and evidence-based practices is one challenge facing the profession. The lack of consensual definitions for various domains of interest is a second challenge, because it hinders research, poses communication challenges, and impedes the accumulation of knowledge about human behavior. A third challenge the profession faces is an overemphasis on the biological basis of behavior. Finally, the forth challenge is the impact of technology on practice. Since the 1970s, there has been a rapid advance in our ability to investigate the brain, resulting in a significant increase of information about brain functioning, making it difficult for clinicians to stay abreast of changes in the field. Advances in technology have resulted in "assessments" being completed by nonpsychologists. To place these and related challenges in context, a brief review of the history of assessment and efforts to investigate brain functioning will be presented. It is suggested that failure to meet these challenges will contribute to the demise of the profession. Suggestions for meeting these challenges are offered.

Introduction to special issue on the history of the future of proactive school psychology: Transcending the past, excelling in the present, and transforming the future.

This Special Issue celebrates the 75th anniversary of the formation of the Division of School Psychology of the American Psychological Association. As part of this milestone celebration, we envisioned a field that could be changed by transcending the past, excelling in the present, and transforming the future. We identified a seminal article written by Conoley and Gutkin (1995) that advocated for the implementation of a systemic, prevention-oriented, ecological framework that would allow school psychology to realize its promise. Conoley, Powers, and Gutkin (2020) provided a synopsis of progress and stagnation in a new paper that served as the nexus from which invited authors were asked to respond, each representing a different aspect of school psychology practice, science, and training. In light of the division anniversary, authors described the historical context of their domain, reflected on the present, and shared recommendations for the future of school psychology. Collectively these contributions discussed school psychology's achievement to date, identify its shortfalls, and offer actionable suggestions for future school psychologists. Transformation is critical now more than ever in light of current health and world concerns and school psychology training and practice issues related to social justice and psychological and educational change. School psychologists are called to become proactive agents of change if we are to help heal our fractured and wounded world. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How is school psychology doing: Why hasn't school psychology realized its promise?

We take a look back to 1995 when Conoley and Gutkin shared their vision for an adult-focused practice of school psychology with a primary focus on developing health-promoting systems for schoolage children. We then look to the present to what has happened and not happened to substantiate their vision. We found very encouraging developments and continuing challenges in the research targets and practice roles of school psychologists. There is no shortage of evidence-based strategies to improve the school experience of all children. The opportunities offered by, for example, the Multi-Tiered Systems of Support paradigm are promising, but it is unclear whether school psychologists are assuming leadership roles in this work. Furthermore, incorporating postdoctoral specialties is a promising role expansion for school psychologists, but most of the specialties keep the psychologists' focus on individual child assessment and treatment. School psychology is a very large professional tent with room for many approaches to preventing childhood disorders and promoting behavioral and academic success. Graduate education and current practice seem to reflect the traditional test and place roles for psychologists that Conoley and Gutkin hoped to expand beyond 25 years ago. Research efforts and national organization supports are hopeful, however, for a reimagined practice of psychology that makes use of the powerful ecosystems that affect children's well-being. Much work is yet to be done. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

History of the future of proactive school psychology: Historical review at our 75th APA anniversary to transcend the past, excel in the present, and transform the future.

The purpose of this article was to historically review the field of school psychology for the 75th Anniversary of the founding of the Division of School Psychology (DSP) of the APA. Past and present proactive school psychology was evaluated and recommendations for the future were offered in light of historic APA DSP goals. Since its inception, the DSP has worked with APA to protect and expand school psychology as a foundational service area within health service psychology. This article examines the challenges in the field, highlights current issues, and calls for a proactive and transformational future. The article concludes with suggestions from history to adopt current approaches to emulate the transformative vision of proactive school psychology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How the history of American Psychological Association Division 16 can shape the future of school psychology: Demonstrating organizational transformation.

Over the past 75 years, the history of Division 16 (School Psychology) has been integral to the science and practice of school psychology. As a constituent body of the American Psychological Association (APA), the division has advocated for role definitions and professional boundaries within APA and has represented the specialty of school psychology within the larger community of psychology. Since the convening of school psychology's Thayer Conference in 1955, the division has remained steadfastly committed to promoting the well-being of children. Toward this end, Division 16 has negotiated entry level debates between APA and the broad specialty of school psychology, sustained partnerships within and among APA and other organizations representing school mental health, elevated the place of technology in the profession of school psychology, and promoted the central importance of cultural competence and diversity within the discipline. The past contributions of Division 16 shape the future of the profession and the division in ways that are consistent with and add to Conoley, Power, and Gutkin's (2020) recommendations for strengthening school psychology's contributions to psychological health promotion and risk reduction in schools. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

School psychology training within a competency framework: Transcending the past, present, and future.

In this special issue, Conoley et al. (2020) repeat the call for a paradigm shift in school psychology graduate education from the individual level to the system level and from secondary and tertiary intervention to primary prevention and implementation science to optimize environments for children's overall health and success. This article describes how school psychology training, as organized by professional standards of practice and credentialing, has evolved to its current status as a recognized specialty of practice within psychology. A review of the history of the accreditation and approval of school psychology programs, as well as the current status of competencies within these standards and procedures are presented. In addition, school psychology as a distinct specialty; various certifications, credentials, and licensure; professional identities; and recent developments in technology, telehealth, and cross-state credentialing are examined. The article includes a summary of how competencies are reflected in the most recent revisions of American Psychological Association accreditation, National Association of School Psychologists approval standards, and credentialing organizations such as Association of State and Provincial Psychology Boards. Finally, we conclude with the assertion that development and adoption of these standards, competencies and professional recognition certifications, which are informed by the current zeitgeist in both health and education more broadly, might propel school psychology to fulfill the promise not yet achieved as outlined by Conoley and colleagues (2020). (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Retrospect and prospect regarding school psychology scholarship: Reflections of Lightner Witmer award winners.

This article provides reflections on several key elements important for establishing and sustaining successful research trajectories and scholarship within the field. Developed by several Lightner Witmer Award recipients, the article highlights several of Lightner Witmer's experiences and pioneering contributions, including the importance of his own mentors, collaborations with interdisciplinary professionals, and his emphasis on the relevance of scientific research programs and the practical implications for helping children. In an effort to move the field forward, we discuss important elements relevant to developing and sustaining successful research programs in school psychology including the importance of mentorship, collaboration, research methodologies, replicability, extramural funding, and dissemination. Throughout, we emphasize the importance of conducting research within the school context, which is consistent with the important influence of ecological systems articulated by Conoley, Powers, and Gutkin (2020), and reflects the hallmark of school psychology scholarship as an applied science. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Past, present, and future of research in school psychology: The biopsychosocial ecological model as an overarching framework.

Conoley, Powers, and Gutkin (2020) called for an increased emphasis on models of psychological service delivery that are primarily indirect, adult-focused, and geared toward systems-level change in the schools. They asserted that research in school psychology should not focus on the problems of individual children and youth but address the "powerful ecosystems" that surround them. Although school- and system-wide interventions are certainly important and can have a positive impact on student outcomes, we contend that biopsychosocial models of human development that integrate the effects of genetics, personal characteristics and behaviors, environments, and broad social contexts are better frameworks for guiding future research in school psychology. In these models, the role of genetics is mediated by the family environment and broader social contexts to influence variability in cognitive, social-emotional, and behavioral domains of psychological functioning. These individual differences then interact with specific situations, leading to outcomes in educationally relevant behaviors, such as achievement, self-esteem, motivation, and peer relations. The focus of research in school psychology, therefore, should not be on "1 size fits all" school-wide interventions but rather on understanding how and why children and youth differ from one another and on translating research on the effects of genes, the environment, and their interplay into effective educational interventions. Research on bullying and victimization in schools is discussed as an example of the importance of taking a biopsychosocial ecological approach to studying complex behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

From traditional practice to tiered comprehensive services for all: Developing a responsive school culture for the future.

In this article, we reflect on the evolution of school psychology practice from the past to the present, and share some thoughts about the future. Although school psychology programs provide training in consultation, prevention, social emotional development, counseling, and mental health interventions, school psychology practice is still dominated by assessment, and the specialty has yet to live up to its promise to address the multiple needs of an increasingly diverse student population. Today's practitioners need to be skilled in systems-level programing that is informed by cultural awareness, knowledge, and skills necessary to responsibly work toward the best outcomes for students and families from all cultural, ethnic, and racial backgrounds. As the demand for mental health and other services in schools continues to increase, we argue for a wholescale adoption of culturally adapted evidence-based practices to address the expanding role of school-based practice. Finally, we offer considerations from the social psychology literature that will help school psychologists prioritize behavioral health while also reducing disparities in educational attainment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Infusing global and intercultural perspectives to transform school psychology and school psychologists.

School psychology has been criticized for limited attention to and limited evidence-based resources for diverse populations in domestic and international settings, in part because of its foundations on psychological knowledge generated primarily in North America and Western Europe. Moreover, in the past 25 years, the profession has made insufficient progress in changing its focus toward an ecological systems perspective as initially envisioned by Conoley and Gutkin in 1995 and revisited in this issue. In this article, we embrace and expand that vision to include the infusion of global and intercultural perspectives into school psychology research, training, practice, policy, and advocacy as a means to address cultural diversity within local contexts across the globe, with a particular focus on school psychology within the United States. We begin with a discussion of terminology that addresses international and cross-cultural issues related to diversity. We then examine past and present perspectives and approaches to cultural diversity and globalization within school psychology and propose future directions for research, training, practice, policy, and advocacy within a global-intercultural perspective. We conclude with our reflections about transforming school psychology and school psychologists. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Progress will come in the balancing of needs: Professional desires, consumer demand, and why we have to specialize.

Conoley, Powers, and Gutkin (2020) have provided an assessment of the progress and lack thereof of school psychology as a profession toward school reformation, especially as related to their various earlier calls for changes in training and practice. Conoley and Gutkin especially (and I have been colleagues of both) have called for decades for an emphasis on working with teachers, other adults in the school system, and the school system itself to alter the delivery of education. In some earlier work, they have characterized this as adult school psychology. In many ways this is a reconceptualization of earlier mental health consultation models of school psychology practice that were not widely adopted for reasons Conoley et al. (2020) explain. School psychology has a long history of wanting to be seen and to practice differently from in a primary role of test and place, and indeed I would characterize the primary organizations that represent the profession (the National Association of Psychologists and the American Psychological Association's Division of School Psychology) as being in many ways antagonistic toward psychological testing. Yet, it is what most school psychologists are in fact hired to do as their primary role, and training in psychological testing and assessment is one of the key skills that sets us apart and distinguishes us from others in the schools. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Considerations for school psychology to realize its promise: Commentary on the special issue from early career school psychologists.

As early career scholars, we have benefitted from the recommendations made by Conoley and Gutkin nearly 25 years ago. Our training and applied experiences were closely aligned with Conoley and Gutkin's view of school psychology practice. Namely, the content of our courses and our practice of psychology in practicum and internship were reflective of an applied ecological orientation within a prevention framework rather than focused solely on individual level services. As we reflected on the articles in the special issue, and the state of the field moving forward, we identified 2 broad recommendations we believe are integral to realizing the promise of school psychology, the applied use of an implementation science lens and the explicit centering of equity and social justice in school psychology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Academic journals can and should contribute to the future of school psychology.

In this Perspective, Rich Gilman and Robin Codding (the current and outgoing editors of School Psychology) respond to Conoley, Power, and Gutkin's views of the role of academic journals to advance professional paradigm shifts. Based on both historical trends and current readership data, the authors provide several reasons that academic journals have and will continue to be a primary forum for discourse on how school psychology should evolve as a discipline. Nonetheless, academic journals have inherent limitations that hinder this discourse. The paper concludes with several recommendations that could enhance the contributions of academic journals to these discussions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psicologia em tempos sombrios e o despertar da bela adormecida: estudos em subjetividade e clínica / Psychology in dark times: the awakening of the sleeping beauty / Psicología en tiempos oscuros y el despertar de la bella durmiente: estudios en subjetividad y clínica

O texto suscita o debate acerca da constituição da psicologia no Brasil, apontando para suas bases importadas de países com realidades bastante diversas daquelas aqui encontradas, tanto nos aspectos sociais e econômicos, quanto naqueles históricos, culturais e raciais. A psicologia, desde 1962, vem se pautando em modelos que raramente levam em conta o contexto no qual se encontra: um país que assenta seus alicerces sobre a escravidão, o preconceito, a violência, os 20 anos de uma truculenta ditadura militar, a exclusão, o encarceramento em massa e o extermínio de populações indígenas e negras, assassinatos de homossexuais e transsexuais. No cenário atual, que intensifica aspectos desde sempre aqui presentes e desmonta as estratégias do seu enfrentamento, torna-se urgente repensar as práticas e saberes psicológicos produtores e reprodutores de subjetividades coloniais, em tempos que, parafraseando Hannah Arendt, se anunciam como sombrios, mas que, ao mesmo tempo, desafiam a psicologia, sobretudo clínica, a despertar de seu sono e sonhos encantados.

The text raises the debate about the constitution of psychology in Brazil, pointing to its bases imported from countries with realities quite different from those found here, in social and economic as well as historical, cultural and racial aspects. Psychology since 1962 has been based on models that rarely take into account the context in which it finds itself: a country that lays its foundations on slavery, prejudice, violence, the 20 years of a truculent military dictatorship, exclusion, mass incarceration and the extermination of indigenous and black populations, murders of homosexuals and transsexuals. In the current scenario, which intensifies aspects always present here and dismantles the strategies of their confrontation, it is urgent to rethink the practices and psychological knowledge producers and breeders of colonial subjectivities, in times that, paraphrasing Hannah Arendt, announce themselves as dark, but at the same time challenge psychology, especially clinical, to awaken from their sleep and enchanted dreams.

El texto plantea el debate sobre la constitución de la psicología en Brasil, señalando sus bases importadas de países con realidades bastante diferentes a las aquí encontradas, tanto en los aspectos sociales y económicos, como en los aspectos históricos, culturales y raciales. La psicología desde 1962 se ha guiado por modelos que pocas veces tienen en cuenta el contexto en el que se encuentra: un país que cimenta la esclavitud, el prejuicio, la violencia, los 20 años de una dictadura militar truculenta, la exclusión, el encarcelamiento masivo y exterminio de poblaciones indígenas y negras, asesinatos de homosexuales y transexuales. En el escenario actual, que intensifica aspectos que siempre han estado presentes aquí y desmantela las estrategias para enfrentarlos, es urgente repensar las prácticas y saberes psicológicos que producen y reproducen subjetividades coloniales, en tiempos que, parafraseando a Hannah Arendt, se anuncian como oscuros, pero que, al mismo tiempo, desafían a la psicología, especialmente a la clínica, a despertar de su torpor y sus sueños encantados.