Enhancing sense of recovery and self-reflectivity in people with schizophrenia : a pilot study of Metacognitive Narrative Psychotherapy

Objective This study investigated the effectiveness of an innovative, manualized psychotherapy aimed at enhancing recovery and self-experience in people with schizophrenia, Metacognitive Narrative Psychotherapy. Design Treatment effects were assessed using a mixed methodology. Data were quantitatively assessed using a single sample, pre- and post-therapy design and qualitatively assessed using a case-study methodology. Methods Eleven patients diagnosed with schizophrenia received Metacognitive Narrative Psychotherapy over the course of 11 to 26 months. Therapists were seven supervised postgraduate psychology students. On average patients attended 49 sessions over the course of therapy. Patients completed interview-based and self-report measures for general and treatment-specific outcomes at pre-, mid-, and post-treatment. Results Quantitative analyses showed that patients significantly improved on the general outcome of subjective recovery, as well as the treatment-specific outcome of self-reflectivity, with medium to large effect sizes. Case-study evidence also showed improvements for some patients in symptom severity, and narrative coherence and complexity. Conclusions These results are consistent with previous case-study evidence and suggest that this manualized version of Metacognitive Narrative Psychotherapy produces general and approach-specific improvements for people with schizophrenia. Replication is needed to ascertain its effectiveness with a larger sample size and within a controlled design.

Triumphs and tribulations in the psychotherapy of schizophrenia : reflections on a pilot study of metacognitive narrative psychotherapy

Schizophrenia results in a profound disruption of one’s capacity to make sense of mental states, coherently narrate self-experiences, and meaningfully relate to others. While current treatment options for people with schizophrenia tend to be symptom-focused, experience in designing and implementing a study focusing on enhancing sense of self demonstrates the feasibility of developing and implementing models of treatment that prioritize the subjective distress and self-experience of people with schizophrenia. There is emerging research evidence, based upon dialogical theory of self, that posits the potential of people with deficits of self to engage in meaningful therapeutic relationships and work toward greater integrity of self and degrees of recovery. The challenge is to translate these ideas into a research methodology that can be successfully applied within therapeutic contexts with people who meet the diagnostic criteria for schizophrenia. Based upon dialogical theory, we developed a principle-based manual for metacognitive narrative psychotherapy: a psychological approach to the treatment of people with schizophrenia, which aims to enhance metacognitive capacity and ability to narrate self-experiences. Five phases of treatment were identified: (1) developing a therapeutic relationship, (2) eliciting narratives, (3) enhancing metacognitive capacity, (4) enriching narratives, and (5) living enriched stories. Proscribed practices were also identified. We then implemented the manual within a university clinic context. Six therapists were trained to implement the model and, in turn, provided therapy to 11 patients who completed 12 to 24 months of treatment. Participants were assessed on metacognitive capacity, narrative coherence, narrative richness, self-reported recovery, and symptomatology at three points in time over the course of therapy. Contrary to expectations, participants were highly engaged in the therapeutic process, with minimal dropout. Overall, over 75% of participants evidenced improvement in their level of recovery over the course of therapy. The manualization and outcome findings demonstrate the feasibility of applying such interventions to a broader clinical population.

Injury narrative text classification : a preliminary study

Description of a patient's injuries is recorded in narrative text form by hospital emergency departments. For statistical reporting, this text data needs to be mapped to pre-defined codes. Existing research in this field uses the Naïve Bayes probabilistic method to build classifiers for mapping. In this paper, we focus on providing guidance on the selection of a classification method. We build a number of classifiers belonging to different classification families such as decision tree, probabilistic, neural networks, and instance-based, ensemble-based and kernel-based linear classifiers. An extensive pre-processing is carried out to ensure the quality of data and, in hence, the quality classification outcome. The records with a null entry in injury description are removed. The misspelling correction process is carried out by finding and replacing the misspelt word with a soundlike word. Meaningful phrases have been identified and kept, instead of removing the part of phrase as a stop word. The abbreviations appearing in many forms of entry are manually identified and only one form of abbreviations is used. Clustering is utilised to discriminate between non-frequent and frequent terms. This process reduced the number of text features dramatically from about 28,000 to 5000. The medical narrative text injury dataset, under consideration, is composed of many short documents. The data can be characterized as high-dimensional and sparse, i.e., few features are irrelevant but features are correlated with one another. Therefore, Matrix factorization techniques such as Singular Value Decomposition (SVD) and Non Negative Matrix Factorization (NNMF) have been used to map the processed feature space to a lower-dimensional feature space. Classifiers with these reduced feature space have been built. In experiments, a set of tests are conducted to reflect which classification method is best for the medical text classification. The Non Negative Matrix Factorization with Support Vector Machine method can achieve 93% precision which is higher than all the tested traditional classifiers. We also found that TF/IDF weighting which works well for long text classification is inferior to binary weighting in short document classification. Another finding is that the Top-n terms should be removed in consultation with medical experts, as it affects the classification performance.

Narrative and multimodality in English language arts curricula : a tale of two nations

In this policy column within this special edition on "The Arts in Language Arts", we critique the current place of multimodality and narratives in research and curriculum policy. This is a vital issue of significance for literacy educators, researchers, and policy makers because the narrative texts that circulate in our everyday lives are multimodal, tied to the ever-broadening range of narratives forms in digital sites of display. Here, we critically evaluate the place of multimodality and narratives in the language arts or English curriculum policies of two nations, the USA and Australia. In particular, we highlight the silence on multimodality within the Common Core State Standards, USA, and the contrasting centrality of multimodality in the National Curriculum: English, Australia.

Trashtopia by Maison Briz Vegas

Description of the Work Trashtopia was a fashion exhibition at Craft Queensland’s Artisan gallery showcasing outfits made entirely from rubbish materials. The exhibition was part of an on-going series by the Queensland Fashion Archives, called Remember or Revive. Maison Briz Vegas designers, Carla Binotto and Carla van Lunn created a dystopian beach holiday tableau referencing mid-century Californian and Gold Coast beach culture and style, and today’s plastic pollution of the world’s oceans. The display engaged a popular audience with ideas about environmental destruction and climate change while bringing twentieth and twenty-first century consumer and leisure culture into question. The medium of fashion was used as a means of amusement and provocation. The fashion objects and installation questioned current mores about the material value of rubbish and the installation was also a work of environmental activism. Statement of the Research Component The work was framed by critical reflections of contemporary consumer culture and research fields questioning value in waste materials and fashion objects. The work is situated in the context of conceptual and experimental fashion design practice and fashion presentation. The exhibited work transgressed the conventional production methods and material choice of designer fashion garments, for example, discarded plastic shopping bags were painstakingly shredded to mimic ostrich feathers. The viewer was prompted to reflect on the materiality of rubbish and its potential for transformation. The exhibition also sits in the context of culture jamming and contemporary activist practice. The work references and subverts twentieth century beach holiday culture, contrasting resort wear with a contemporary picture of plastic pollution of the oceans and climate change. Hawaiian style prints contained a playful and dark narrative of dying marine-life and the viewer was invited to take a “Greetings from Trashtopia” postcard depicting fashion models floating in oceans of plastic rubbish. This reflective creative practice sought to address the question of whether fashion made from recycled rubbish materials can critically and emotionally engage viewers with questions about contemporary consumer culture and material value. This work presents an innovative model of fashion design practice in which rubbish materials are transformed into designer garments and rubbish is placed centre stage in the public presentation of the designs. In overturning the traditional model of fashion presentation, the viewer is also given a deeper connection to the recycling process and complex ideas of waste and value. In 2015 two outfits from the exhibition were selected, along with works from three leading Australian fashion labels, and four leading New Zealand labels, for a commemorative ANZAC fashion collection shown at iD Dunedin Fashion Week. The show titled, “Together Alone, revisited” reprised an Australian and New Zealand fashion exhibition first held at the National Gallery of Victoria in 2009.

Fusion of worlds : consumers’ self-narrative in a hybrid physical/digital world

As the Internet becomes deeply embedded into consumers’ daily life, the digital virtual world brings significant influence to consumers’ self and narrative. Prior studies look at consumer self from either from a certain online space or comparing consumers’ physical and digital virtual selves but not the integration of the physical/digital world. This paper aims to explore the meanings of the digital virtual space on consumers’ narrative as a whole (their interests, dreams, or subjectivity). We utilise a postmodern concept of the cyborg to understand the cultural complexity, subjective meanings of, and the extent to which the digital virtual space plays a role in consumers’ self-narrative. We conducted in-depth interviews and gathered three consumer narratives. Our findings indicate that consumers’ narrative contains important fragments from both physical and digital virtual worlds and their physical and digital virtual selves form a feedback loop that strengthen their overall narrative.

Using personal construct theory and narrative methods to facilitate reflexive constructions of teaching physical education

This paper reports on two lengthy studies in Physical education teacher education (PETE) conducted independently but which are epistemologically and methodologically linked. The paper describes how personal construct theory (PCT) and its associated methods provided a means for PETE students to reflexively construct their ideas about teaching physical education over an extended period. Data are drawn from each study in the form of a story of a single participant to indicate how this came about. Furthermore we suggest that PCT might be both a useful research strategy and an effective approach to facilitate professional development in a teacher education setting.

‘Hiring a Nashville sensation’ : using narrative learning to develop the problem solving skills of contract law students

This article discusses the design of interactive online activities that introduce problem solving skills to first year law students. They are structured around the narrative framework of ‘Ruby’s Music Festival’ where a young business entrepreneur encounters various issues when organising a music festival and students use a generic problem solving method to provide legal solutions. These online activities offer students the opportunity to obtain early formative feedback on their legal problem solving abilities prior to undertaking a later summative assessment task. The design of the activities around the Ruby narrative framework and the benefits of providing students with early formative feedback will be discussed.

The timing of solid introduction in an ‘obesogenic’ environment : a narrative review of the evidence and methodological issues.

Objective To evaluate the evidence for association between obesity risk outcomes >12 months of age and timing of solid introduction in healthy term infants in developed countries, the large majority of whom are not exclusively breastfed to 6 months of age. Methods Studies included were published 1990-March 2013. Results Twenty-six papers with weight status or obesity prevalence outcomes were identified. Studies were predominantly cohort design, most with important methodological limitations. Ten studies reported a positive association. Of these only two were large good quality studies and both examined the outcome of early (<4 months) solid introduction. None of the four good quality studies that directly evaluated current guidelines provided evidence of any clinically relevant protective effect of solid introduction from 4-5 versus ≥ 6 months of age. Conclusion Overall the introduction of solids prior to 4 months may result in increased risk of childhood obesity but there is little evidence of adverse weight status outcomes associated with introducing solids at 4-6 rather than at 6 months. Implications More and better quality evidence is required to inform guidelines on the ‘when, what and how’ of complementary feeding.

In search of Nirvana : why Nirvana : the True Story could never be "true"

In my book Nirvana: The True Story (2006), I undertake an autoethnographical approach to biography, attempting to impart an understanding of my chosen subject - the rock band Nirvana - via discussion of my own experiences. On numerous occasions, I veer off into tangential asides, frequently using extensive footnotes to explain obscure musical references. Personal anecdotes are juxtaposed with "insider" information; at crucial points in the story (notable concerts, the first meeting of singer Kurt Cobain with his future wife Courtney Love, the news of Cobain's suicide), the linear thread of the narrative spills over into a multi-faceted approach, with several different (and sometimes opposing) voices given equal prominence. Despite my firsthand experience of the band, however, Nirvana: The True Story is not considered authoritative, even within its own field. This article considers the reasons why this may be the case.In my book Nirvana: The True Story (2006), I undertake an autoethnographical approach to biography, attempting to impart an understanding of my chosen subject - the rock band Nirvana - via discussion of my own experiences. On numerous occasions, I veer off into tangential asides, frequently using extensive footnotes to explain obscure musical references. Personal anecdotes are juxtaposed with "insider" information; at crucial points in the story (notable concerts, the first meeting of singer Kurt Cobain with his future wife Courtney Love, the news of Cobain's suicide), the linear thread of the narrative spills over into a multi-faceted approach, with several different (and sometimes opposing) voices given equal prominence. Despite my firsthand experience of the band, however, Nirvana: The True Story is not considered authoritative, even within its own field. This article considers the reasons why this may be the case.

Injury narrative text classification using factorization model

Narrative text is a useful way of identifying injury circumstances from the routine emergency department data collections. Automatically classifying narratives based on machine learning techniques is a promising technique, which can consequently reduce the tedious manual classification process. Existing works focus on using Naive Bayes which does not always offer the best performance. This paper proposes the Matrix Factorization approaches along with a learning enhancement process for this task. The results are compared with the performance of various other classification approaches. The impact on the classification results from the parameters setting during the classification of a medical text dataset is discussed. With the selection of right dimension k, Non Negative Matrix Factorization-model method achieves 10 CV accuracy of 0.93.

Bricolage and storied selves: Young people's assemblages of narrative and identity in an Australian life storytelling project

Narrating is simultaneously self-interpretation and self-construction. People make sense of their lives and create their identities through an active process of assembling and applying meaning to memories, experiences, thoughts, actions and passions. Such a process can usefully be described as a bricolage: life narratives are created as an assemblage of scattered experiences and events. Through the particular way in which they are arranged, the storyteller constructs what Paul Ricoeur (1992) calls a “narrative identity”; that is, an identity which is organised through and specific to the story told. Applying this notion of narrative as bricolage to ‘Heywire’ – an Australian youth life storytelling project – this paper discusses the unique affordances that the process of storytelling offers in terms of identity and the way new, digital technologies and the internet augment the features of life narratives. It argues that narrative, in addition to new media, offers important tools through which young people who participate in the Heywire project make sense of personal experiences and craft their own identities in powerful and purposeful ways.

Reflections on a novel coach education program: A narrative analysis

This paper reports on a collaborative research project between the Faculty of Health Sciences at the University of Ottawa, Triathlon Canada, and the Coaching Association of Canada (CAC). It was designed around a lifelong learner perspective and the Organization for Economic Cooperation and Development’s (OECD) qualifications system. In this paper, we first review the coach learning literature as it pertains to the CAC. We then highlight the background and perspective of a high performance director’s experience in designing and attempting to implement a novel coach education training program. In doing so we uncover the frustrations and tensions in trying to balance innovation with prescribed process and policy. We conclude by making suggestions for further research specifically focused on the background of the key agents involved with the design, implementation and administration of coach education training programs in the competition-development context of the NCCP.

Comparative exploration of narrative processes for better and poorer outcomes for depression

Background Contemporary psychotherapy research demonstrates that whilst most clients respond positively to psychological interventions, a small, but significant proportion of clients fail to experience the expected benefits of therapy. Although methodologies exist that enable the identification of successful and unsuccessful therapy, we have a limited understanding of the processes associated with these outcomes. Aim The current study sought to examine the relationship between therapeutic outcome and therapeutic language. Methodology: The therapeutic outcomes of 42 trainee-therapists who provided psychotherapy to 173 clients were tracked with the OQ-45.2 over a 5 year period with the view of identifying the client/ trainee-therapist dyads with the best and poorest outcomes. The 6 best outcome and 6 poorest outcome client/ trainee-therapist dyads were identified in order to examine the characteristics of therapeutic conversations associated with better and poorer therapy outcomes. Therapeutic conversations were analysed with the Narrative Process Coding System. Findings The best outcome client/ trainee-therapist dyads demonstrated significant increases in reflexive conversation over the course of psychotherapy. Implications Examining the practices of the best and poorest outcome client/ trainee-therapist dyads with objective measures of therapy outcome provides an important first step in understanding how therapeutic language may contribute to the greatest therapeutic improvement or deterioration.