Investigating the relationship between competence and patient outcome with CBT

Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government’s Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed.

Exploring the source of differences and similarities in L1 attrition and heritage speaker competence: evidence from pronominal resolution

Several studies of different bilingual groups including L2 learners, child bilinguals, heritage speakers and L1 attriters reveal similar performance on syntax-discourse interface properties such as anaphora resolution (Sorace, 2011 and references therein). Specifically, bilinguals seem to allow more optionality in the interpretation of overt subject pronouns in null subject languages, such as Greek, Italian and Spanish while the interpretation of null subject pronouns is indistinguishable from monolingual natives. Nevertheless, there is some evidence pointing to bilingualism effects on the interpretation of null subject pronouns too in heritage speakers’ grammars (Montrul, 2004) due to some form of ‘arrested’ development in this group of bilinguals. The present study seeks to investigate similarities and differences between two Greek–Swedish bilingual groups, heritage speakers and L1 attriters, in anaphora resolution of null and overt subject pronouns in Greek using a self-paced listening with a sentence-picture matching decision task at the end of each sentence. The two groups differ in crucial ways: heritage speakers were simultaneous or early bilinguals while the L1 attriters were adult learners of the second language, Swedish. Our findings reveal differences from monolingual preferences in the interpretation of the overt pronoun for both heritage and attrited speakers while the differences attested between the two groups in the interpretation of null subject pronouns affect only response times with heritage being faster than attrited speakers. We argue that our results do not support an age of onset or differential input effects on bilingual performance in pronoun resolution.

'You show me yours, I'll show you mine': the negotiation of shifts from textual to visual modes in computer-mediated interaction among gay men

This article explores the way users of an online gay chat room negotiate the exchange of photographs and the conduct of video conferencing sessions and how this negotiation changes the way participants manage their interactions and claim and impute social identities. Different modes of communication provide users with different resources for the control of information, affecting not just what users are able to reveal, but also what they are able to conceal. Thus, the shift from a purely textual mode for interacting to one involving visual images fundamentally changes the kinds of identities and relationships available to users. At the same time, the strategies users employ to negotiate these shifts of mode can alter the resources available in different modes. The kinds of social actions made possible through different modes, it is argued, are not just a matter of the modes themselves but also of how modes are introduced into the ongoing flow of interaction.