Psychosocial predictors of intentions to engage in change supportive behaviors in an organizational context

This study utilized the Theory of Planned Behavior (TPB) to understand employee change readiness. The extent to which attitude, subjective norm, and perceived behavioral control predicted employees’ intentions to carry out activities that were supportive of a change event were investigated. The impact of group norm was examined as a further predictor of change-related intentions. The context of the research was a sample of 82 employees in the early stages of a re-brand. Results indicated that direct measures of attitude and subjective norm, as well as group norm, emerged as significant predictors of employees’ intentions to perform re-brand behaviors. To capture the indirect beliefs underlying attitude, subjective norm, and perceived behavioral control, participants also provided an assessment of their behavioral, normative, and control beliefs in regards to the change event, respectively. A series of MANOVAs revealed significant differences between moderate and high intenders on a range of underlying beliefs. Findings are discussed in terms of the application of the TPB for effective change management.

The Melbourne Decision-Making Questionnaire : an instrument for measuring patterns for coping with decisional conflict

A study was conducted to examine the factorial validity of the Flinders Decision Making Questionnaire (Mann, 1982), a 31-item self-report inventory designed to measure tendencies to use three major coping patterns identified in the conflict theory of decision making (Janis and Mann, 1977): vigilance, hypervigilance, and defensive avoidance (procrastination, buck-passing, and rationalization). A sample of 2051 university students, comprising samples from Australia (n=262), New Zealand (n=260), the USA (n=475), Japan (n=359), Hong Kong (n=281) and Taiwan (n=414) was administered the DMQ. Factorial validity of the instrument was tested by confirmatory factor analysis with LISREL. Five different substantive models, representing different structural relationships between the decision-coping patterns had unsatisfactory fit to the data and could not be validated. A shortened instrument, containing 22 items, yielded a revised model comprising four identifiable factors-vigilance, hypervigilance, buck-passing, and procrastination. The revised model had adequate fit with data for each country sample and for the total sample, and was confirmed. It is recommended that the 22-item instrument, named the Melbourne DMQ, replace the Flinders DMQ for measurement of decision-coping patterns.

Learning journals as a counseling strategy

The effects of counseling have been subject to extensive examination including the meta-analyses of Lipsey and Wilson (1993) and Matt and Navarro (1997). The results of these analyses demonstrated the positive effects of counseling interventions but do not indicate how, when, and why these benefits eventuated (Paul, 1967; Shadish & Sweeney, 1991), nor do they consider mediating variables. Much of the research in this area has involved the measurement of quantitative behavioral outcomes and short-term behavioral change (Steenbarger & Smith, 1996). However, there has been a recent move toward more qualitative, process-orientated research (Polkingthorne, 1994). This move addresses the previous methodological myopia but neglects the place of learning in the counseling process. It is suggested that if learning is viewed as underpinning all counseling, then clients should be able to transfer what they have learned from the counseling experience to problematical situations without the need for further counseling.

Current evidence on integrated treatment for serious mental disorder and substance misuse

Substance misuse in people with serious mental disorders is common and has a wideranging negative impact. The multiplicity of problems suggests that this comorbidity is better conceptualized as a type of complex disorder than by ‘dual diagnosis’. Problems with sequential and parallel treatments have led to the development of integrated approaches, with one practitioner or team addressing both the substance use and mental disorder. These treatments are typically characterized by motivation enhancement, minimizing treatment-related stress, emphasizing harm reduction as well as abstinence, and assertive outreach. A review of published randomized trials demonstrates that superior effects to controls are rarely consistent across treatment foci and over time. While motivational interventions assist engagement, more intervention is usually required for integrated treatment programs to improve long-term outcomes more than control conditions. More intensive case management does not consistently improve impact, but extended cognitive-behavioral therapies have promise. Suggestions for maximizing treatment effects and improving research evidence are provided.

Psychotherapy in Australia : clinical psychology and its approach to depression

In Australia, clinical psychology training is dominated by cognitive and behavioral treatments (CBTs), although there is exposure to other theoretical orientations. Since 2001, over 20% of general medical practitioners (GPs) have received training in CBT, and psychiatry training increasingly incorporates CBT elements. Psychotherapy by medical practitioners is financially supported by universal health care funding with supplementation by patients and their private health insurance. Federally funded health benefits for up to 12 psychology consultations per year are provided on referral from GPs and psychiatrists, and initial take up has been very strong. Mrs. A would be a typical patient for such a referral. However, she would not fulfil criteria for priority access from state-funded mental health services. Mrs. A would probably consult a GP and receive antidepressants, although she may also access a range of other community support programs. Access to and acceptance of psychotherapy would be greater in urban areas, and if she were of Anglo-Saxon and non- indigenous origin.

An evaluation of brief correspondence programs for problem drinkers

The provision of accessible and cost-effective treatment to a large number of problem drinkers is a significant challenge to health services. Previous data suggest that a correspondence intervention may assist in these efforts. We recruited 277 people with alcohol abuse problems and randomly allocated them to immediate cognitive behavioral treatment by correspondence (ICBT), 2 months in a waiting list (WL2-CBT), self-monitoring (SM2-CBT), or extended self-monitoring (SM6-CBT). Everyone received correspondence CBT after the control period. Over 2 months later, no drop in alcohol intake occurred in the waiting list, and CBT had a greater impact than SM. No further gains from SM were seen after 2 months. Effects of CBT were well maintained and were equivalent, whether it was received immediately or after 2 to 6 months of self-monitoring. Weekly alcohol intake fell 48% from pretreatment to 18.6 alcohol units at 12 months. Our results confirmed that correspondence CBT for alcohol abuse was accessible and effective for people with low physical dependence.

Prediction of adherence and control in diabetes

This study aims to predict adherence to diabetic treatment regimens and sustained diabetic control. During two clinic visits that were 2 months apart, 63 adult outpatients completed measures of diabetic history, current treatment, diabetic control, adherence, and self-efficacy about adherence to treatment. Results showed that self-efficacy was a significant predictor of later adherence to diabetes treatment even after past levels of adherence were taken into account. Posttest levels of adherence in turn were significantly associated with posttest %HbA1c after control for illness severity. A stepwise multiple regression to predict %HbAlc at post entered pretest measures of diabetic control, treatment type, and self-efficacy, which together predicted 50% of the variance. Results are related to self-efficacy theory and implications for practice are discussed.

Mechanisms of improvement in treatment for depression : test of a self-efficacy and performance model

Tested D. J. Kavanagh's (1983) depression model's explanation of response to cognitive-behavioral treatment among 19 20–60 yr old Ss who received treatment and 24 age-matched Ss who were assigned to a waiting list. Measures included the Beck Depression Inventory and self-efficacy (SE) and self-monitoring scales. Rises in SE and self-monitored performance of targeted skills were closely associated with the improved depression scores of treated Ss. Improvements in the depression of waiting list Ss occurred through random, uncontrolled events rather than via a systematic increase in specific skills targeted in treatment. SE regarding assertion also predicted depression scores over a 12-wk follow-up.

Empirically validated interventions for adult disorders

The movement toward evidence-based practice in psychology and medicine should offer few problems in cognitive-behavior therapies because it is consistent with the principles by which they have been developed and disseminated. However, the criteria for assessing empirical status, including the heavy emphasis on manualized treatments, need close examination. A possible outcome of the evidence-based movement would be to focus on the application of manualized treatments in both training and clinical practice; problems with that approach are discussed. Commitment to evidence-based treatment should also include comparisons between psychological and pharmacological interventions, so that rational health care decisions can be made. Psychologists should not be afraid of following the evidence, even when it supports treatments that are not cognitive-behavioral in stated orientation. Such results should be taken as an opportunity for theoretical development and new empirical inquiry rather than be a cause for concern.

Unionization : a necessary strategy to arrest professional decline?

This article examines contemporary social work and why it is under serious threat, ideologically and economically, in a rapidly changing world that no longer highly values its social mandate, methods, and outcomes. Within this hostile environment we investigate the low salaries and high student debt that beginning social workers experience, which might otherwise drive them into unions. Instead, the profession resists unionization, preferring to remain focused on its ideals rather than the disquieting marketplace realities. We then examine the general elements of a hybrid union model that can assist social workers to organize and thus arrest their long-standing professional and fiscal decline.

An intervention for substance abuse in schizophrenia

Describes a cognitive-behavioral intervention for alcohol and cannabis abuse with schizophrenic patients. The intervention integrates substance abuse treatment with other aspects of psychosis management, including assessment, use of anti-psychotic medication, and training in coping skills.

Issues in multidisciplinary training of cognitive-behavioural interventions

Argues that if brief workshop training is used as the primary method of disseminating behavior therapy skills across professions, it will provide an inadequate preparation, especially for higher levels of behavioral practice. In some circumstances, brief training may lead to an overestimation of behavioral skills by the trainees. These issues are discussed in the context of current moves toward providing health professionals with multiple skills. Examples are provided of situations in which generic health professionals received brief workshop training in behavior therapy and attempted to make use of that training in their jobs. There is no substitute for ongoing training and consultation by senior clinical psychologists who are expert in behavior therapy.

Application of cognitive-behavioural family intervention for schizophrenia in multidisciplinary teams : what can the matter be?

Surveyed 45 therapists who had participated in a family intervention for schizophrenia training program to examine the difficulties they had encountered, their recall of the intervention strategies, and the extent that they thought the approach had become integrated in their everyday work. Between 6 mo and 3 yrs after the family training, Ss reported the number of families they had systematically treated, and the difficulties they had encountered. Allowance of time to undertake the intervention, afterhours scheduling, and illness or holidays presented particular difficulties. Only 4% reported that their knowledge of behavioral techniques was a problem, but in a written test most therapists did not display minimum recall of the material of cognitive therapy, social skills training, or behavioral strategies. The study demonstrated significant problems in disseminating cognitive-behavioral approaches to multidisciplinary settings.

Role of self-efficacy in predicting outcomes from a programme for controlled drinking

Predicted the outcomes of 40 men and 20 women who attended a controlled drinking program in a general hospital. Measures included a behavioral interview, the Alcohol Dependence Scale (ADS), the Severity of Alcohol Dependence Questionnaire (SADQ) described by T. Stockwell et al (1979), and a problem drinking self-efficacy scale (PDSES). Substantial reductions in drinking appeared after the program and appeared to be sustained over a 6-mo follow-up. Intake dropped from 11.3 drinks per day to 2.2 drinks during follow-up. Drinking history and alcohol dependence (as measured by the SADQ, but not the ADS) were significant predictors of alcohol consumption during follow-up. Predictive utility of the PDSES was confirmed. PDSES administered at the end of the program significantly predicted alcohol consumption over the next 6 mo.

Age-related differences in exercise and quality of life among breast cancer survivors

Purpose: Physical activity has become a focus of cancer recovery research as it has the potential to reduce treatment-related burden and optimize health-related quality of life (HRQoL). However, the potential for physical activity to influence recovery may be age-dependent. This paper describes physical activity levels and HRQoL among younger and older women after surgery for breast cancer and explores the correlates of physical inactivity. Methods: A population-based sample of breast cancer patients diagnosed in South-East Queensland, Australia, (n=287) were assessed once every three months, from 6 to 18 months post-surgery. The Functional Assessment of Cancer Therapy-Breast questionnaire (FACTB+4) and items from the Behavioral Risk Factor Surveillance System (BRFSS) questionnaire were used to measure HRQoL and physical activity, respectively. Physical activity was assigned metabolic equivalent task (MET) values, and categorized as < 3, 3 to 17.9 and 18+ MET-hours/weeks. Descriptive statistics, generalized linear models with age stratification (<50 years versus 50+ years), and logistic regression were used for analyses (p=0.05, two-tailed). Results: Younger women who engaged in 3 or more MET-hours/week of physical activity reported a higher HRQoL at 18 months compared to their more sedentary counterparts (p<0.05). Older women reported similar HRQoL irrespective of activity level and consistently reported clinically higher HRQoL than younger women. Increasing age, being overweight or obese, and restricting use of the treated side at six months post-surgery increased the likelihood of sedentary behavior (OR>3, p<0.05). Conclusions: Age influences the potential to observe HRQoL benefits related to physical activity participation. These results also provide relevant information for the design of exercise interventions for breast cancer survivors and highlights that some groups of women are at greater risk of long-term sedentary behavior.