Jenny Firth-Cozens

ASSIMILATION OF PROBLEMATIC EXPERIENCES BY CLIENTS IN PSYCHOTHERAPY

DAVID A. SHAPIRO AND GILLIAN HARDYMRC/ESRC Social and Applied Psychology UnitUniversity of SheffieldIn successful psychotherapy,problematic experiences (threatening orpainful thoughts, feelings, memories,etc.) are gradually assimilated intoschemata that are introduced by thetherapist or developed in the therapist-client interaction by modification of oldschemata. As it is assimilated, aproblematic experience passes throughpredictable stages. The client movesfrom being oblivious, to experiencingthe content as acutely painful, then asless distressing, merely puzzling, thenunderstood, and finally as confidentlymastered.

Self-criticism in adulthood and recalled childhood experience.

We investigated in a sample of 75 medical students the hypothesis that higher levels of self-criticism, a major vulnerability factor for depression, are related to retrospective reports of less satisfactory parenting, even when the potentially confounding factors of mood state and social desirability response set are controlled. At each of 2 measurement times, there were significant cross-sectional correlations between parental ratings and both depression and self-criticism, but the associations with self-criticism were no longer significant when depression was controlled. However, even after controlling for the effects of mood state and social desirability, persons with high levels of self-criticism at both measurement points (high trait self-criticism subjects) reported significantly worse relationships with their mothers than did the remaining subjects. They were also more likely to report below average relationships with both parents jointly.

Bullying among doctors in training: cross sectional questionnaire survey.

Workplace bullying is associated with stress, depression, and intention to leave. It is an important issue for the health service because of its potential impact on staff health, retention, and patient care.1 2 In a recent survey of UK doctors in training, 37% said they had been bullied during the past year.3 To understand the problem better, we investigated how commonly doctors in training experienced persistent and serious bullying, who were the sources of this behaviour, and what action was taken to deal with it. We conducted a cross sectional questionnaire survey of doctors in training in London north of the Thames, using electronic survey units followed up by postal questionnaire, as described previously.4 Our sample was defined as all trainees available at the time of the survey in participating trusts. The survey included four questions on bullying. The stem question, derived from one used by Hicks,2 was: …

Source of stress in women junior house officers.

OBJECTIVE--To determine the causes of stress in women doctors and relate these to levels of depression. DESIGN--Questionnaire study. SUBJECTS--Of 92 women doctors who had graduated from the universities of Leeds, Manchester, and Sheffield in 1986 and had been working as junior house officers for eight months 70 (76%) returned completed questionnaires. MAIN RESULTS--Mean score on the general health questionnaire was 13.79 (SD 5.20) and on the symptom checklist for depression was 1.43 (0.83). The scores of 32 subjects (46%) were above the criterion for clinical depression. Overwork was perceived as creating the most strain, followed by effects on personal life, serious failures of treatment, and talking to distressed relatives. Both stress and depression were related to effects on personal life, overwork, relations with consultants, and making decisions. Sex related sources of stress were conflicts between career and personal life, sexual harassment at work, a lack of female role models, and prejudice from patients. In addition to these, discrimination by senior doctors was related to depression. CONCLUSION--Changes are needed in the career paths of women doctors, and could be implemented.

Predicting stress in general practitioners: 10 year follow up postal survey

High levels of stress in general practitioners have been described in numerous cross sectional studies,1 but few have used longitudinal data to explore possible precursors that might allow early prevention or intervention. Such precursors may relate to previous signs of psychological distress or may involve individual differences, such as personality. The importance of a self critical or perfectionist disposition in predicting stress has been noted in preregistration doctors over a two year period,2 and Blatt and Zuroff have investigated its influence on depression.3 I followed up a group of general practitioners from their fourth undergraduate year to investigate the importance of early symptoms of stress and self criticism in predicting stress levels 10 years later. During …

Treatment Order and Thematic Continuity Between Contrasting Psychotherapies: Exploring an Implication of the Assimilation Model

The assimilation model suggests that when problems are poorly formulated, vague, and unfocused, they should respond better to exploratory (e.g., interpersonal/psychodynamic) techniques, whereas when they are well formulated, clear, and focused, they should respond better to prescriptive (e.g., cognitive/behavioral) techniques. Progress on a particular problem is more likely to be steady if exploratory techniques are used first, followed by prescriptive techniques, rather than the reverse. We studied the changes in the intensity of 10 personal problems identified by each of 39 clients who received eight sessions of an interpersonal/psychodynamic therapy and eight sessions of a cognitive/behavioral therapy in counterbalanced order. Consistent with expectations, the change in the rate of change in problem intensity (i.e., the degree of curve in the plot of intensity against time, suggesting discontinuity) was greater when the cognitive/behavioral treatment came first than when the interpersonal/psychodynamic...

Effects of gender on performance in medicine

Men may have higher output than women, but this is possibly offset by litigation and disciplinary action