Group Psychotherapy as a Specialty: An Inconvenient Truth.

Group psychology and group psychotherapy (GPGP) are distinctive, effective practices that meet an important need. In 2018, the American Psychological Association recognized GPGP as a specialty, thus setting standards for education and training in the field. Although there is a need for high-quality group psychotherapy, practitioners often lack standardized training, thus posing a risk to patients. Adoption of these standards by practice settings and training programs is essential for expanding the availability of quality group therapy. An understanding of how the specialty became recognized and of the specific criteria for its practice (i.e., public need, diversity, distinctiveness, advanced scientific and theoretical preparation, structures and models of education and training, effectiveness, quality improvement, guidelines for delivery, and provider identification and evaluation) are essential for expanding the availability of high-quality group psychotherapy. Such understanding also informs how training programs can align with standards. This article provides a foundation of understanding and details implications of group psychotherapy's establishment as a specialty. The benefits of high-quality group psychotherapy are far-reaching, whereas the risks of inadequate practice loom large.

A Training Model for Addressing Microaggressions in Group Psychotherapy.

Culturally responsive group psychotherapists have an ethical obligation to respond to microaggressions; therefore, training in therapeutic approaches to microaggressions is necessary. This article describes the complex factors present when microaggressions occur in group psychotherapy and provides a training model that addresses barriers to microaggression responsiveness and facilitates complex skill building. The training model consists of didactic training, role-play and modeling, and an experiential fishbowl-style group exercise. It provides the rationale, parameters, and descriptions of each component to promote the training model. The model was well received at conferences of the American Group Psychotherapy Association, but more research is needed to establish its effectiveness.

A University-Based Transdisciplinary Approach to Mental Health Workforce Shortages.

The purpose of this paper is to describe the development, actions, and evaluation of a university-based, transdisciplinary coalition so that the model may be replicated in other university or multidisciplinary systems. The University of Nevada Las Vegas (UNLV) Mental and Behavioral Health Coalition addresses Nevada's workforce shortages through multi-disciplinary faculty collaboration among seven training programs at UNLV that produce mental health professionals. The coalition's collaborative approach to solution-generating work has served as a catalyst for professional integration in the community as a whole.

What Determines the Surgical Patient Experience? Exploring the Patient, Clinical Staff, and Administration Perspectives.

Hospitals are increasingly concerned with enhancing surgical patient experience given that Medicare reimbursements are now tied in part to patient satisfaction. Surgical patients' experience may be influenced by several factors (e.g., integration of care, technical aspects of care), which are ranked differently in importance by clinicians and patients. Strategies designed to improve patient experience can be informed by our research, which examines the determinants of the surgical patient experience from the perspective of multiple healthcare team members. We conducted 12 focus groups with surgical patients, family members, physicians, nurses, and hospital administrators at one acute care, for-profit hospital in a western state and analyzed the content for determinants of the overall surgical patient experience. Specifically, we analyzed the content of the conversations to determine how frequently participants discussed the determinants of the surgical patient experience and how positive, negative, or neutral the comments were. The study's findings suggest that surgical patients and members of the healthcare team have similar views regarding the most important factors in the patient experience-namely, interdisciplinary relationships, technical infrastructure, and staffing. The study results will be used to improve care in this facility and can inform the development of initiatives aimed at improving the surgical patient experience elsewhere. Our study could serve as a model for how other facilities can analyze the surgical patient experience from the perspectives of different stakeholders and improve their performance on the basis of data directly relevant to their organization.

Toward a phenomenology of feelings.

Our understanding of emotion cannot be complete without an understanding of feelings, the experiential aspect of emotion. Despite their importance, little effort has been devoted to the careful apprehension of feelings. Based on our apprehension of many randomly selected moments of pristine inner experience, we present a preliminary phenomenology of feelings. We begin by observing that often feelings occur as directly experienced phenomena of awareness; however, often no feelings are present in experience, or if they are present, they are too faint to be observed by a process intended to observe them. Feelings range from vague to distinct and sometimes do, but other times do not, include bodily sensations. When bodily sensations are present, there is a wide range of clarity and location of these sensations. Sometimes people experience multiple distinct feelings and sometimes people experience one feeling that is a mix or blend of different feelings. We also discuss what feelings are not, including instances when feelings do not appear to be present, despite evidence suggesting the presence of underlying emotional processes (e.g., behavioral evidence of emotion). These instances of emotion but not feeling lead us to speculate that experiencing feelings is a skill developed over time through an interaction of interpersonal and intrapersonal events.

Improving session attendance in mental health and substance abuse settings: a review of controlled studies.

Patient nonattendance to scheduled sessions results in excessive costs to mental health and substance abuse providers and compromises the care of clients. This paper presents a comprehensive review of interventions that have been shown to increase session attendance rates in these settings. Unique to other review papers, reliability estimates were performed in the selection and evaluation of obtained studies. Reliability of article selection and evaluation strategies was excellent (.80 to .88). Study results indicate several attendance improvement methods appear to be particularly promising, such as scheduling appointments promptly, reminder letters and telephone calls, soliciting patient commitment, and helping to resolve obstacles to attending the session. The specific manner in which these interventions are implemented appears to influence session attendance rates. Moreover, some attendance improvement interventions are clearly effective in some settings, but not others. Specific recommendations are provided in light of the study findings.

The semistructured interview for consideration of ethnic culture in therapy scale: initial psychometric and outcome support.

There has been recent pressure for practitioners to consider cultural variables when implementing evidence-based interventions. Therefore, the Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale (SSICECTS) was empirically developed to address this issue. First, psychometric properties of a 6-item scale were evaluated in 279 individuals of various ethnicities. Results indicated two factors accounting for 71% of the variance (ethnic cultural importance and ethnic cultural problems). Internal consistency and convergent validity were satisfactory. Ethnic minority participants demonstrated significantly higher scores than did Caucasians, suggesting this scale may be particularly applicable in ethnic minority populations. In a second study, a controlled trial was conducted to examine clinical utility of the semistructured interview component in a subsample of 151 participants. Participant interviewees were queried about their basic demographic information and were subsequently instructed to evaluate the interviewers' performance. Interviewees were then randomly assigned to receive the SSICECTS or a parallel semistructured interview regarding exercise. After participants completed their respective semistructured interviews, they were again instructed to evaluate the interviewers. Results indicated both semistructured interviews enhanced evaluations. However, interviewers who administered the SSICECTS were perceived as having greater knowledge and respect of participants' ethnic culture.

Examination of ethnicity in controlled treatment outcome studies involving adolescent substance abusers: a comprehensive literature review.

The extent to which adolescent drug treatment outcome studies address ethnicity was systematically examined. Reliability coefficients were calculated for both the search methodology used to obtain these outcome studies and the extent to which ethnicity was addressed along several dimensions. The resulting coefficients were highly reliable. Findings indicated that although investigators of 94% of the outcome studies considered ethnicity to some extent, only 28% of these studies incorporated ethnicity into their design, and only 6% of studies involved statistical analyses to examine differential response to treatment or moderating effects of ethnicity with a sufficient number of ethnic minority participants. Overall, results indicated that there is much work to do regarding the examination of ethnicity in controlled treatment outcome studies involving adolescent substance abusers. Indeed, modifications were rarely made to the treatment components to accommodate ethnicity-related variables. Future recommendations are presented in light of these findings.