Understanding the Factors That Contribute to Creating a Collaborative Psychological Formulation: A Qualitative Systematic Review.

OBJECTIVES: Creating a formulation is one of the key competencies of a clinical psychologist and is understood to be important for guiding therapeutic input and understanding client distress. However, client experience of formulations can vary, with some reporting it is unhelpful and distressing. This novel review explores the experiences of clinicians and clients when creating a formulation, specifically the barriers and facilitators to collaborating on a formulation. This ultimately aims to improve client experience and engagement in formulation. METHODS: A systematic search of PubMed, Web of Science, PsycINFO and EMBASE was conducted using PRISMA guidelines. The protocol was registered on PROSPERO. This search was conducted using terms related to 'psychological formulation' and 'experience'. Nineteen qualitative papers met inclusion criteria and were appraised using the Critical Appraisal Skills Programme. Findings that pertained to formulation were thematically synthesised. RESULTS: Three analytical themes were identified: toleration of the formulation process-'a necessary evil', which highlights the potential emotional impact of formulation on the client and indicates the importance of responding to client readiness and expectations of formulation; development of the therapeutic relationship-'it's like a two way thing, isn't it?', which suggests that client empowerment, adapting to client needs and clinicians creating a safe and containing environment facilitated the formulation process; systemic factors-'walking a tightrope', which highlights the constraints of resources and team dynamics in therapists' ability to engage in collaborative formulation. CONCLUSION: Facilitators to a collaborative formulation include the following: simple formulations, thorough assessment and preparation for formulation, 'doing with' activities such as timelines and diagrams and working environments that include supportive colleagues and time for reflection and training.

An Exploratory Study on the Conceptualization of Burnout among the Professional Esports Athletes: Focused on League of Legends Champions Korea League.

Research on the stress and burnout experienced by athletes in the esports field remains limited, necessitating an approach that considers the unique environment and circumstances of esports athletes. This study aims to explore the conceptualization of burnout experiences among professional esports athletes. The participants included 88 athletes from the League of Legends Championship Korea (LCK). Among these, in-depth interviews were conducted with 7 athletes who had experience in international tournaments (the World Championship), while an open-ended survey was completed by 81 athletes. Data collected through in-depth interviews and an open-ended survey were digitized and utilized for analysis. Through critical review by another author and inductive categorization, the conceptual components of esports athletes' burnout were derived. Through the analysis of 251 raw datum, it was conceptualized into five conceptual factors: performance, overtraining, interpersonal relationships, physical and psychological exhaustion, and career and motivation. The results of this study confirm that esports athletes, like athletes in other conventional sports, experience burnout during their careers, highlighting issues in their unique environment, particularly in aspects of interpersonal relationships and training and rest conditions. This research can serve as a foundational resource for effective athletes' psychological health management in the esports field and underscores the need for further research on burnout among esports athletes.

The call for an "educational footprint" in conceptualizing mental health and psychosocial support: the case of Norwegian kindergarten teachers.

This article presents an in-depth qualitative case study asking, "How do Norwegian kindergarten teachers conceptualize and negotiate the field of psychosocial support?" This article thoroughly explores how Norwegian kindergarten teachers perceive of the field Mental health and psychosocial support (MHPSS). Recognizing the global imperative to advance mental health and psychosocial support for children, the study highlights the crucial need for interprofessional grounded concepts and logics in developing MHPSS interventions. The study employs a grounded theory approach to actively develop concepts in the MHPSS field in Norway. The six selected Norwegian expert teachers can make up a so-called "unique case", representing a high-income country with a robust welfare system and child-centered pedagogy. Yet, they reveal challenges in embracing the concept of psychosocial support: The analysis shows that the teachers seem to neglect and even reject the concept of psychosocial support, while also expressing inferiority and lack of agency towards other professions. However, the teachers also express the desire for more knowledge, and with proudness they energetically engage in fostering children's agency and functioning by their everyday descriptions of «meeting with the child¼. The study calls for the kindergarten teachers' increased efforts to actively participate in MHPSS interventions, advocating for the further development of an «educational footprint¼ that can empower interprofessional work.

The Operators Model of Psychoanalytic Clinical Reasoning.

In this paper, the authors develop a model of psychoanalytic clinical reasoning as the inferential process by which analytic therapists are able to arrive at an understanding of the clinical material. Starting from Bion's theory of functions, the authors propose that a "function" can be thought of as a condition-action sequence that analytic therapists implicitly use to respond to certain configurations of elements in the material by executing conceptual or reflective operations. To investigate the main families of functions that are used by analytic therapists in everyday practice, the authors used an interpersonal process recall procedure based on supervision sessions from a theoretically heterogeneous group of participants. A consensual procedure was developed to identify operations, spell out the underlying functions, and group functions into families. Twelve families of functions were identified that appear to be used by analytic therapists regardless of their schools of thought. The authors call them the "operators" of psychoanalytic clinical reasoning. According to the operators model, the process of psychoanalytic clinical reasoning consists in the chaining together of operations using functions from different families. A specific collection of "clinical reasoning styles" seems to be interwoven in this process. Different avenues open up for research, clinical practice, and training.

Efficiency Conceptualization Model: A Theoretical Method for Predicting the Turnover of Catalysts.

In recent times, the theoretical prediction of catalytic efficiency is of utmost urgency. With the advent of density functional theory (DFT), reliable computations can delineate a quantitative aspect of the study. To this state-of-the-art approach, valuable incorporation would be a tool that can acknowledge the efficiency of a catalyst. In the current work, we developed the efficiency conceptualization model (ECM) that utilizes the quantum mechanical tool to achieve efficiency in terms of turnover frequency (TOF). Twenty-six experimentally designed transition metal (TM) water oxidation catalysts were chosen under similar experimental conditions of temperature, pressure, and pH to execute the same. The computations conclude that the Fe-based [Fe(OTf)2(Me2Pytacn)] (MWOC-17) is a highly active catalyst and, therefore, can endure for more time in the catalytic cycle. Our results conclude that the Ir-based catalysts [Cp*Ir(κ2-N,O)X] with MWOC-23: X=Cl; and MWOC-24: X=NO3 report the highest computed turnover numbers (TONs), τ c o m p u t e d T O N 0 ${\tau _{computed\;TON}^0 }$ of 406 and 490 against the highest experimental TONs, τ e x p e r i m e n t a l T O N ${\tau _{experimental\;TON} }$ of 1200 and 2000 respectively, whereas the Co-based [Co(12-TMC)]2+ (MWOC-19) has the lowest TONs ( τ c o m p u t e d T O N 0 ${\tau _{computed\;TON}^0 }$ =19, τexperimental TON=16) among the chosen catalysts and thereby successful in corroborating the previous experimental results.

Art, Intuition, and Identity in Ramón y Cajal.

In the history of neuroscience, Cajal stands tall. Many figures in the late 19th and early 20th centuries made major contributions to neuroscience-Sherrington, Ferrier, Jackson, Holmes, Adrian, and Békésy, to name a few. But in the public mind, Cajal is unique. His application of the Golgi method, with an array of histologic stains, unlocked a wealth of new knowledge on the structure and function of the brain. Here we argue that Cajal's success should not only be attributed to the importance of his scientific contributions but also to the artistic visual language that he created and to his pioneering self-branding, which exploited methods of the artist, including classical drawing and the new invention of photography. We argue that Cajal created his distinctive visual language and self-branding strategy by interweaving an ostensibly objective research product with an intimately subjective narrative about the brain and himself. His approach is evident in the use of photography, notably self-portraits, which furthered broad engagement initially inspired by his scientific drawings. Through his visual language, Cajal made an impact in art and culture far beyond the bounds of science, which has sustained his scientific legacy.

Women's voices and meanings of empowerment for reproductive decisions: a qualitative study in Mozambique.

BACKGROUND: Women in Mozambique are often disempowered when it comes to making decisions concerning their lives, including their bodies and reproductive options. This study aimed to explore the views of women in Mozambique about key elements of empowerment for reproductive decisions and the meanings they attach to these elements. METHODS: Qualitative in-depth interviews were undertaken with 64 women of reproductive age (18-49 years) in two provinces in Mozambique. Participants were recruited through convenience sampling. Data collection took place between February and March 2020 in Maputo city and Province, and during August 2020 in Nampula Province. A thematic analysis was performed. RESULTS: Women described crucial elements of how power is exerted for reproductive choices. These choices include the ability to plan the number and timing of pregnancies and the ability either to negotiate with sexual partners by voicing choice and influencing decisions, or to exercise their right to make decisions independently. They considered that women with empowerment had characteristics such as independence, active participation and being free. These characteristics are recognized key enablers for the process of women's empowerment. CONCLUSIONS: This study's findings contribute to an expanded conceptualization and operationalization of women's sexual and reproductive empowerment by unveiling key elements that need to be considered in future research and approaches to women's empowerment. Furthermore, it gave women the central role and voice in the research of empowerment's conceptualization and measurement where women's views and meanings are seldom considered.

Women who are empowered seem to make better health decisions for themselves. Nevertheless, women's views about and understanding of empowerment are seldom considered in the study of empowerment and its definitions. In this study we explore how women in Mozambique view, understand and experience empowerment, i.e., gaining power and control in the household, and specifically around decision-making processes concerning their reproductive lives. A total of 64 adult women were interviewed in rural and urban areas within two provinces of Mozambique. Through the data analysis, we identified key characteristics of the empowerment process that Mozambican women perceived to be of relevance in their context. Women who have power were perceived as financially and socially independent, free to choose their own pathway, and be active participants in the household decision-making process. In reproductive decisions, women show power through the ability to negotiate with their partner, or by making sole decisions and by planning the number of pregnancies and the size of the family. The elements identified provide important information for improving the definition and the measurement of empowerment in Mozambique, as well as for the support of women in their pathways to empowerment within this context.

A Comparative Study on Mental Disorder Conceptualization: A Cross-Disciplinary Analysis.

The conceptualization of mental disorders varies among professionals, impacting diagnosis, treatment, and research. This cross-disciplinary study aimed to understand how various professionals, including psychiatrists, psychologists, medical students, philosophers, and social sciences experts, perceive mental disorders, their attitudes towards the disease status of certain mental states, and their emphasis on biological versus social explanatory attributions. A survey of 371 participants assessed their agreement on a variety of conceptual statements and the relative influence of biological or social explanatory attribution for different mental states. Our findings revealed a consensus on the need for multiple explanatory perspectives in understanding psychiatric conditions and the influence of social, cultural, moral, and political values on diagnosis and classification. Psychiatrists demonstrated balanced bio-social explanatory attributions for various mental conditions, indicating a potential shift from the biological attribution predominantly observed among medical students and residents in psychiatry. Further research into factors influencing these differing perspectives is necessary.

Conceptualisation of violence and discipline among students, teachers, and parents in Nyarugusu Refugee Camp, Tanzania.

BACKGROUND: Little academic research has been conducted on how people conceptualise 'violence' and 'discipline', especially in humanitarian settings. This may limit the transferability of violence prevention interventions. This paper examines the understanding of violence and discipline concepts among students, teachers, and parents in the Nyarugusu Refugee Camp in Tanzania. METHODS: A qualitative study was undertaken as part of the larger trial testing the effectiveness of the EmpaTeach intervention to prevent physical violence from teachers to students implemented in 27 schools in Nyarugusu Refugee Camp. Data from baseline and midline surveys in control schools that did not receive the intervention informed this paper where a total of 14 in-depth interviews (eight with students and six teachers) and six focus group discussions (two with teachers and four with parents from the Parent Teacher Association) were analyzed. Both audio recordings from in-depth interviews and focus group discussions were transcribed verbatim, and translated from Kiswahili to English (Congolese) and Kirundi to English (Burundian). Translated data were verified and coded using thematic analysis based on the views of students, teachers, and parents. RESULTS: Participants revealed that the same behavioural acts could be differentially classified as violence or discipline. Violence was understood in relation to the consequences of acts, which could include physical or psychological harm, or other harms which were seen as detrimental to children's futures and life chances, particularly adolescent pregnancy. Sexual acts without consent were also seen as violence. In contrast, discipline was understood according to intent, and perceived acts done towards students to correct bad behaviour. CONCLUSION: Results imply that education about the harmful consequences of behavioural acts intended as discipline, may be important for violence prevention interventions and that framing interventions in terms of positive child development could help change discipline strategies in schools.

Examining the Interrelationships Between Social Isolation and Loneliness and Their Correlates Among Older British Adults Before and During the COVID-19 Lockdown: Evidence From Four British Longitudinal Studies.

Background and Objectives: Unprecedented social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have provided a new lens for considering the interrelationship between social isolation and loneliness in later life. We present these interrelationships before and during the COVID-19 restrictions and investigate to what extent demographic, socioeconomic, and health factors associated with such experiences differed during the pandemic. Research Design and Methods: We used data from four British longitudinal population-based studies (1946 NSHD, 1958 NCDS, 1970 BCS, and ELSA, N = 12,129). Rates, co-occurrences, and correlates of social isolation and loneliness are presented prior to and during the early stage of the COVID-19 pandemic and the interrelationships between these experiences are elucidated in both periods. Results: Across the Four studies, prepandemic proportions reporting social isolation ranged from 15% to 54%, with higher rates in older ages (e.g., 32% of individuals aged 70-79 years and 54% of those more than 80). During the pandemic, the percentage of older people reporting both social isolation and loneliness and isolation only slightly increased. The interrelationship between social isolation and loneliness did not change. Associations between sociodemographic and health characteristics and social isolation and loneliness also remained consistent, with greater burden among those with higher economic precarity (females, nonhomeowners, unemployed, illness, and greater financial stress). Discussion and Implications: There were already large inequalities in experiences of social isolation and loneliness and the pandemic had a small impact on worsening extent and inequalities in these. The concepts of loneliness and social isolation are not interchangeable, and clarity is needed in how they are conceptualized, operationalized, and interpreted. Given many older adults experience high levels of social isolation, there should be greater emphasis on reducing social isolation and the inequalities observed in who experiences greater isolation and loneliness.

Developing psychoanalytic case conceptualization skills through didactic teaching: A randomized controlled trial.

OBJECTIVE: Time-limited didactic interventions have been shown to be effective in developing "generic" case conceptualization skills. The objective of this study is to test whether similar interventions can be used to develop case conceptualization skills that are "specific" to a treatment modality. METHOD: University psychology students were randomized to a target (n = 62) or a control group (n = 62). The target group received a training on psychoanalytic case conceptualization skills based on the newly-developed operators model. The control group received a training on generic case conceptualization skills based on the well-established 5 Ps model. RESULTS: The students' self-efficacy for case conceptualization significantly increased in both groups. However, students in the target group reported a significantly greater increase in psychoanalytic case conceptualization skills and in their ability to make clinical inferences. The teaching method, as well as the case conceptualization models, were acceptable to students. However, the 5 Ps model was significantly more acceptable to students than the operators model. CONCLUSIONS: This is the first RCT to provide evidence that psychoanalytic case conceptualization skills can be developed through didactic teaching and that they constitute a specific set of skills that are not developed by learning generic case conceptualization skills.

Consensus definition of advance care planning in dementia: A 33-country Delphi study.

INTRODUCTION: Existing advance care planning (ACP) definitional frameworks apply to individuals with decision-making capacity. We aimed to conceptualize ACP for dementia in terms of its definition and issues that deserve particular attention. METHODS: Delphi study with phases: (A) adaptation of a generic ACP framework by a task force of the European Association for Palliative Care (EAPC); (B) four online surveys by 107 experts from 33 countries, September 2021 to June 2022; (C) approval by the EAPC board. RESULTS: ACP in dementia was defined as a communication process adapted to the person's capacity, which includes, and is continued with, family if available. We identified pragmatic boundaries regarding participation and time (i.e., current or end-of-life care). Three interrelated issues that deserve particular attention were capacity, family, and engagement and communication. DISCUSSION: A communication and relationship-centered definitional framework of ACP in dementia evolved through international consensus supporting inclusiveness of persons with dementia and their family. HIGHLIGHTS: This article offers a consensus definitional framework of advance care planning in dementia. The definition covers all stages of capacity and includes family caregivers. Particularly important are (1) capacity, (2) family, (3) engagement, and communication. Fluctuating capacity was visualized in relation to roles and engaging stakeholders.

Toward Socially Meaningful Case Conceptualization: The Risk-Driven Approach.

The Behavior Analysis Certification Board (BACB) Ethics Code states that "behavior analysts should put compliance with the law and clients' interests first by actively working to maximize desired outcomes and minimize risk" (emphasis added; BACB, 2020, p. 5). In turn, board certified practitioners must approach the case conceptualization process in applied behavior analysis (ABA) with respect to minimizing risks to an improved quality of life (QoL). As such, ABA services must be based on an understanding of risk-risk to ensuring desired outcomes. The purpose of the current article is two-fold (1) revisit social validity and propose features of socially meaningful case conceptualization, and (2) introduce a corresponding structured risk-driven approach to ABA service delivery. A primary aim is to equip all stakeholders with readily accessible practice-related supports-ensuring clients' rights to effective services towards an improved QoL.

Clinical diagnosis and case formulation in the psychotherapy of personality disorders.

Purpose: The article aimed to present a case conceptualization in two stages of therapy for PD patients qualifying for a specific therapy modality and diagnosis, including the conceptualization and monitoring of the process and mechanism of changes under the influence of specific therapeutic interventions. The problem is significant as there is a high level of treatment dropout among patients with various personality disorders. Views: The article discusses the current state of knowledge and Kazdin's methodology of scientific research on the processes and mechanisms of change in patients under the influence of therapeutic interventions. Using the assumptions of this model, the author describes the six steps of a therapeutic procedure which aims at describing and monitoring the process and mechanism of therapeutic interventions, with a special emphasis on the significance of a mediator in the form of the therapeutic alliance. The therapeutic alliance is a significant mediator of changes leading to positive and/or negative therapy outcome and some of its components should be considered as moderators that may significantly modify the influence of the mediator on the strength of the links between a given therapy modality and its effectiveness. Conclusions: Kazdin's model and diagnostic principles seem very useful and promising in clinical practice. At our current stage of knowledge and research, the diagnosing and monitoring of the process and mechanism of change in patients, resulting from specific therapeutic interventions, constitutes a considerable challenge for psychotherapists and clinicians.

Conceptualizing healthy cognitive aging: the role of time and variability.

The interest in healthy cognitive aging (HCA) has increased substantially over the past decade. Researchers are interested in exploring how health can be promoted and cognitive decline mitigated when pathology is not present. Identifying the necessary strategies is crucial as the gradual accumulation of small declines can lead to negative effects on quality of life over time. However, the conceptualization of HCA is not agreed upon. In fact, authors often turn to the use of traditional pathology screeners in the context of HCA because of their clear threshold results and their wide use in the different fields. This leads to the assumption that individuals are either cognitively unhealthy and therefore may have some form of dementia or are dementia-free and cognitively healthy. We believe that this view is an overly simplistic approach to the understanding of the aging process. In this work, we explore how HCA has been defined and conceptualized within the different fields. We further discuss how time and variability are key concepts that are often missing when studying HCA and propose a definition that aims to unify the findings from the multidisciplinary research that studies HCA and simplify the translation of knowledge. Incorporating these two novel dimensions to the study of HCA has already been proposed methodologically but has yet been discussed at the conceptual level. We believe that the proposed new approach will allow the identification of individual factors that cause changes in cognitive health and will help build new cognitive health strategies and mitigate further declines.

"What It Means to be a Digital Citizen": Using concept mapping and an educational game to explore children's conceptualization of digital citizenship.

Digital citizenship (DC) education is key to a bright future for children in the digital age. Despite its attention in K-12 settings, little is known about how children conceptualize DC, which diminishes the effectiveness of associated lessons. This study introduced the conceptual content cognitive mapping (3CM) approach to investigate children's conceptualization of DC and its changes after digital game-based learning with MinecraftEDU. Results showed that children tended to conceptualize DC superficially as personal responsibility and generally ignored the role of active online engagement. The game's mechanism had weak influence on how children conceptualized this idea, mainly reflected in the change of importance they perceived during the game. These changes were related to their perceptions of emotion, game design, and value commitments. Children jointly showed their interest in the game and exhibited diverse behaviors and learning reflections during the game. Implications for teaching DC and using educational games are discussed to promote DC localization in China.

Analyzing Chinese parents' and teachers' perception of play, children's emotional needs and therapy: implications for seeking help.

Introduction: Before going through play therapy with children, parents' consent is usually needed. Thus, Parents' perception of play therapy can be a very important variable that influences the extent to which children are exposed to play therapy. Previous research has demonstrated the significant influence of social-cultural factors on people's perceptions of play therapy. This may in turn influence parents' decision about whether their children will participate in play therapy. This study explores the factors that influence Chinese parents' decisions on their children's engagement in play therapy from a social-cultural perspective. Methods: This small-scale research includes the following: a questionnaire with 16 parents; three one-to-one semi-structured interviews with three parents; and one focus group with 3 teachers. Results: The results showed that Chinese parents' perceptions of therapy are mostly negative, which may reduce the desire of parents to let their children become involved with play therapy. The children's academic stress and the parents' economic pressures indicate a barrier for families to commit time and money to play therapy. Parents' confidence in their ability to recognize children's emotions, their lack of knowledge about play therapy, and the process of obtaining help from mental health services for children could be another barriers preventing engagement with play therapy. Discussions: Even though the research is conducted with a very limited sample size and the results cannot represent the wider population, this research provides some insights into this issue that can be explored in detail in future research, to re-evaluate the results and form a more concrete theory within a wider population in China.

Participants' Bias in Disability Research on Family Quality of Life during the 0-6 Years Stage.

BACKGROUND: Over the past two decades, various research teams have designed and applied instruments to measure the quality of life of families with a member who has a disability. A recent systematic review on the state of the Family Quality of Life in early care identified that many of these studies collected data only from the mothers. The present study aimed to investigate whether there is a bias in participant selection in these types of studies. METHOD: A systematic review of the scientific literature was conducted in three databases-Scopus, Web of Science, Eric-from 2000 to 2022. A total of 72 empirical studies were identified. RESULTS: The findings indicate that most studies examining the Family Quality of Life were based on the information of a single informant per family unit. The profiles of participants according to the research objective are quite similar. In one-third of studies, the authors reported that family members who participate cannot be represented by only mothers or one participant per household. CONCLUSIONS: Given the dynamic and collective nature of the construct, the application of a systemic approach is necessary.