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Blog mental health psychology research writing

Health blogging – new research about impact of writing style

By Dr Sarah Norgate

 

Ever since blogs arrived on the scene – so, well over two decades ago now – researchers have looked at the extent of benefits of blogging for wellbeing, psychosocial gain and business growth. In the health sector, practitioners and campaigners are increasingly exploring whether health blogging serves as a potential tool for motivating people to make lifestyle changes to prevent onset of health problems.

A new discovery out this year from Carmen Stavrositu (University of Colorado) and Jinhee Kim (Pohang University of Science and Technology)1 shows that the type of narrative used in a blog posting makes a difference to people’s behavioural intentions and perceived vulnerability to health risks.

 

The team set up a blog post called ‘My battle with skin cancer’, and manipulated blog posts to be either ‘transporting narratives’ or ‘non-narratives’. In the transporting version of the blog-post, the reader was immersed in the journey saying what lifestyle changes they would have done differently if they had known better. In the ‘non-narrative’ version the blog remained non-personal and factual. In addition, the researchers also manipulated reader response posts to the blog as being either appreciative for the advice (thanks for the tips, and for sharing) or discounting the advice (have you not heard that….).

After reading the blog, readers of the ‘transported’ narrative were more likely to say they would change their lifestyle – to wear sunscreen regularly or to seek out further information on skin cancer prevention. Compared with before reading the blog, readers perceived themselves as no less vulnerable than others to experiencing negative health outcomes. However, once the reader’s negative/positive comments were taken into account, the picture was more complex. Having the appreciative comments on the blog actually increased the chance that readers thought they were no less vulnerable than others.

The potential role of health blogging interventions raises questions about the reliance on traditional didactic approaches on online information sites.

Onwards then…. towards a new generation of evidence based online health interventions. But in doing this, let’s not forget the voice of the citizen or consumer.

Now then, as this first ever blog has been written more in ‘non-transporting’ mode I decided to make this last sentence more personal. Just to say thanks to other blog writers and social media species who inspired this.

Carmen D. Stavrositu & Jinhee Kim (2015) All Blogs Are Not Created Equal: The Role ofNarrative Formats and User-Generated Comments in Health Prevention, Health Communication, 30:5, 485-495, DOI:

10.1080/10410236.2013.867296

 

 

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@salfordpsych applied psychology brain and behaviour community engaging people Hong Kong media mental health online OUHK political psychology technology

New media and new perspectives on the crisis in Hong Kong

by Stephanie Szeto (@StepSzeto)

Stephanie Szeto

 

 

 

 

 

The high penetration of the new mobile technology and social media enables some Hongkongers, who don’t have much prior knowledge of computer, to access internet media and enjoy spontaneous mobile mass communication, such as Whatsapp, Twitter, Facebook and YouTube.   In past few decades, only few TV media existed in Hong Kong. Television Broadcasts (TVB) is completely monopolising the media market as Asia Television (ATV) produces limited domestic programmes and is facing major financial problem that has to terminate some news broadcasts.  People are now used to read news from wide variety sources for having different perspectives, for example independent press, rather than from the traditional mass media, such as the two existing free-to-air terrestrial television stations, (TVB) and (ATV). Young people are more accessible and develop critical views to various news angles and discover nested interests of different media stakeholders may affect the political stands or economic positions of various commentaries or social media blogs.

 

In last October 2013, tens of thousands of protesters marched to the government headquarters of the Hong Kong SAR claiming the violated Hong Kong’s core values of freedom as the monopolisation of existing TV public media eventually led to rejection from the government in issuing an additional free-to-air TV licence to the Hong Kong Television Networks (HKTV).  The march originated from a social action organised with the help of a Facebook page claiming to gather ten thousand of HKTV supporters and simultaneously gained nearly five hundred thousand LIKES.  Facebook has become a powerful social media to magnify the tearful speeches of HKTV staff and celebrities that were spreading quickly on the web which explained the underlying nested interests of politicians in rejecting the license application.  Protesters claiming that, despite a 85% of respondents in a public survey conducted by The University of Hong Kong indicated more free-to-air TV choices, the government turned down HKTV’s application as a result of politically decision.  Mr. Ricky Wong Wai-kay, the boss of HKTV, presented that he would create a station that will truly belong to Hongkongers by giving alternative choice, such as ‘dark’ comedy and drama, which allows different political satire may capture the popular sentiment.  Therefore, Hongkongers believed that the government was crushing the city’s core values of freedom and vowed to have social movement against the media monopolisation.  Wong questioned whether Hong Kong was still governed by the rule of law and the HKTV, in the end, resorted to broadcast by over-the-top online platform.

 

With more easy access to online platforms, Hongkongers are now relying less on traditional TV news as they believe it offers more pro-government perspective to the audience.  On the other hand, posts of independent press and internet radio have acquired a higher share of media influence.  This situation is confirmed by the findings of crisis communication research that some people give higher level of credibility to new media than to traditional media in terms of having different perspective of the crisis (Jin, Liu, & Austin, 2014). One would see the new media has become a real battle ground for people to exert their political influence and gaining publicity through the emerging mobile technology.

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career clinical psychology learning mental health psychology research

Polishing your clinical psychology job/course application to a shine

Fleur-Michelle Coiffait is a recently qualified Clinical Psychologist, co-founder & curator for the Early Career Psychologist Network. She tweets @fleurzel, @PMLDresearchand blogs at Fleurzel, Thoughts and Things.  We asked her about getting on in clinical psychology and how to apply for training and assistant posts.  Here’s what she had to say.    

So application season for the clinical psychology doctorate is now open (see here for details of the UK Clearing House in Clinical Psychology, how to apply and the different courses) and ‘tis also the season for applying for voluntary or paid assistant psychologist posts (these can mainly be found on jobs.nhs.uk and jobs.ac.uk/psychology). Here are some tips and pointers that may help you think about and refine your applications* These are based on my own experiences as a former psychology graduate, postgraduate student, and assistant psychologist. I have recently completed my doctorate in clinical psychology and am now a qualified clinical psychologist and have supervised and shortlisted assistant psychologist posts.

First of all, I would suggest taking a little time to think about why exactly you want to do this particular job/course. This is a step that we often overlook, but it is really important to be clear with ourselves about our reasons for pursuing such a goal and it is something you are likely to be asked about in interviews. Many people say ‘I just want to help people’ and there’s nothing wrong with this. Nevertheless, I would spend time really thinking why it is that you want to help people. Who is it that you want to help? What is it you are hoping to help them with? Are you being realistic about the help you can give? Does this post/course actually provide opportunities to help in this way or would another similar career/course be more suitable? Do you have personal experiences that drive this motivation? Why is it important to you to be able to help? In clinical psychology and other helping professions, it is necessary to reflect on these things at all stages so that we can remain aware of our own motivations, as these will influence our actions, reactions and how we make sense of the process. I continue to revisit this question and often return to it in supervision as it is so important to recognise ‘our stuff’ and how this may influence our work.

The next step is to familiarise yourself with what the role actually involves – read through the job description, google the trust/university/organisation and if you happen to know anyone who has a connection to the place – ask them what it’s like and what they do there. Sometimes we see a job or course title pop up and we get ahead of ourselves and quickly see what we want to see, which may not be what it actually is. The reality can be a little different – so you need to fully understand as far as possible (some job/course ads sadly don’t give much detail) what is involved in the ‘day to day’ aspects of the post or course. It can help to phone up the department and ask any questions you may have about this, although only phone if you have genuine questions, it won’t win you any extra points to phone up if you haven’t really got anything to ask/say.

Similarly, you need to study the person specification so you understand exactly what they are looking for. Speaking from personal experience, too many times I applied for something despite not meeting the ‘essential’ criteria because it seemed like my ‘dream job’ and then I failed to get shortlisted. Given that there is often a tight turnaround with deadlines, some NHS assistant psychologist posts even closing following a 24 hour window or when a certain number of applications have been received, you need to focus your efforts or you will end up feeling burnt out, deflated and fed up of the process – trust me. It can seem really unfair and frustrating that such posts close so quickly, but I can say from being on the other side as a clinician and shortlister that we are given minimal time out of clinical and other duties to sift through applications and it really is hard work when there are many more high quality applications than there are posts/course places. If our time is restricted, we unfortunately have to cap applications in some arbitrary way.

This brings me on to how you write and set out your application. Make it easy for whoever is reading your form to tick the boxes that they will inevitably have in front of them that map onto the person specification. There’s a really good explanation of common statements usually contained in the person specification for NHS psychology jobs here that will help you think about exactly what the recruiters are looking for so you can provide evidence of this. If it says, for example, that existing experience of working with people with mental health issues is essential, then this is exactly what you have to have and you must also demonstrate this clearly in your application in order for that box to be ticked. I recommend thinking about the ten core competencies of clinical psychologists and how you may already be developing emerging skills and experience in these areas.

The way I structure my own applications is to go through the person specification, grouping similar skills/experiences together. I then describe how I meet each one, evidencing this with examples from my experience to demonstrate this and any reflections I have on that particular skill/experience to show that I understand it and have thought about it. What I mean by reflections is going one step further than simply describing ‘I have done x, y, z.’ What exactly did you learn from that experience? What insight did it give you into the importance of that skill/field? What insight did it give you into the practice of clinical psychologists or academics in that field? Did it make you realise anything about the work? How does it relate to topical issues in the news or on the current political agenda? And so on… Show that you don’t just do things to simply tick the boxes – demonstrate that you think about, learn from, and develop in response to your experiences. It’s not about ‘collecting’ experiences from your CV – it’s the quality of them (and by that I mean what you take from them), rather than the quantity. There are a number of different models of reflective practice that you can use as a framework to start you off if you’re not sure, including Gibbs’ reflective cycle Johns’ structured reflective promptsand Rolfe’s three key questions.   For further discussion on reflective practice, see here.   

Something else that I realised from feedback on one of my assistant psychologist applications many moons ago was that it is good to be confident, but don’t be arrogant or overstate your skills. If your application states that you are already trained in 10 therapies and have been chairing multi-disciplinary meetings for years and have a caseload of 50 patients – why the chuff aren’t you employed as a Professor / Consultant already and why should they bother wasting their money training you if you already know it all?! In all seriousness, it is good to be aware of and realistic about your limitations (another common interview question is about your strengths and weaknesses) and this is an important skill as both a practitioner and a researcher. It means that you won’t do things that you aren’t capable of that are potentially risky if they are outside your skills and experience and also means you know when to seek help and advice where appropriate. Counterintuitively, these attributes are actually valued and respected in the psychology profession – you don’t have to know everything and you never will, so it’s probably a good lesson to learn now 🙂 On the other side of that, be confident in what you do know!

Along these lines, I think that the best candidate for any position is probably the person who shows that they understand the role and what is required, meets the essential requirements, and shows evidence of potential and a readiness and openness to learn and develop. Other key things that employers and admissions staff look for in this field is enthusiasm and warmth. Now these two are pretty hard to convey in a standard application form, especially if you’ve followed all of the other advice above. The way I tackled this one was to not use other people’s forms as a template or formula (this usually freaked me out, led me to compare my experience to theirs and ultimately morph my application into something similar) and to just focus on what I’d done and write what I really thought about things. So, for example, I would mention in application forms that I loved the challenge of every day being different when you work with children. Or that I am passionate about involving carers in research as I feel they often get overlooked. Be real, be you, as at the end of the day it’s a person they want, not a robot who ticks all the boxes. As for warmth, this is really tricky to demonstrate in an application – but once you get to the interview stage – my top tip is simply to smile, try and relax and be friendly and yourself!

Other simple things that really will enhance your application and increase your chances of being shortlisted include checking and double checking your application for typos and spelling mistakes and getting someone else to check it if you have time, just in case you’ve missed any. I realise that spelling isn’t some people’s strong point and we all make typos, but if a busy, tired shortlister who has to read through 30 applications in their lunch break has to read through one littered with mistakes, the reality is that it will probably put them off and risk you being seen as sloppy and unprofessional and possibly mean your application gets put into the no pile. If your application is full of spelling mistakes – what are your reports going to be like? Unfortunately, these sort of judgements will be made based on your form, so polish it up to be the best it can be! Another pet hate of mine is when people don’t capitalise the letter ‘I’ (when referring to oneself). I also dislike the use of acronyms without the phrase initially being used in full, because we may not be familiar with whatever it is you are talking about.

Another tip that helps make your shortlister’s life easier is to make your application as clear, succinct and visually easy to read as you can make it. That means not cramming in as much information as you possibly can in size 8 point font with no paragraphs. Now, I know people are divided on whether you should use headings or not (so that’s your call), but the use of proper paragraphs is recommended, ideally with a line break in between them. With regard to the use of bullet points, again people are divided on this one. I prefer complete sentences, but I think it is ok to use a bulleted list if for example, you’re giving a brief summary of duties involved in a particular position when you have to list your previous employment. List your qualifications and jobs in date order, starting with the most recent, this makes it easier for the person reading your form to have an overview of your experience in their mind. Again, repeat and pay attention to this mantra – make their job easy!

Include any publications you are an author or co-author on (including internal reports or things that have been submitted but not yet published), as well as conference presentations or posters, and reference these correctly using APA or BPS format. As an aside, the BPS Editorial Style Guide is an invaluable freely downloadable resource for all sorts of things, from how to reference a website to whether or not you should write numbers greater than ten out in full in the text (the answer to that is no). Use control+F (or command+F if you’re on a Mac) with the document open to search for the exact thing you’re looking for.

I also think it is really crucial to include some indication that you have a work life balance – i.e. you do not spend every waking hour, 24/7 doing psychology. That is not healthy and anyone who does fill up their spare time with psychology as well as working in or studying it really needs to take a step back to think about their priorities. Self-care is paramount in this profession and it is important that we practice what we preach. You are going to be no use to anyone (or not for any significant period of time) if you do not ensure you have a life outside of psychology where you pursue other interests, socialise, unwind and look after yourself. Indeed, evidence of hobbies and self-care, or at least recognition of the importance of self-care and work life balance, are something I look out for when shortlisting. Someone without this is at risk of burning out, so take heed!

Finally, once you’ve done all that, think about what makes you stand out. What makes you you. Have you done something particularly unusual or interesting that is worth mentioning? Do you have experiences from outside of psychology that are relevant? Think about how you can convey this in your form and weave it in somewhere, obviously within reason and within the boundaries of taste, relevance and appropriateness to the application.

If after submitting your form you are unsuccessful, read through your form and think about why and what you could possibly improve. Ask for feedback on your form from the shortlisters (although this is not always given at the application stage) and take this on board and do something to address it. It can be disheartening and upsetting to not get a job or place on a course, but it is an opportunity to learn and refine your application, so dust yourself off and go back to it when you’re feeling a little better and have had some space to reflect. If you know anyone who is in the field – ask them to read over your form and share their thoughts (also take them with a pinch of salt, as like this blog post, it is just their opinion). It may be that they just had too many applicants who were all really reallly good and they had to just find a way to cut the cloth and you lost out on something that you can’t change. In that case, you just have to keep your head up, learn from it, and keep going.

As they say in the Hunger Games, may the odds be ever in your favour….

*disclaimer: sadly, following this advice does not guarantee you a place/post and is my personal opinion based on my own experiences 🙂

Categories
applied psychology depression mental health postgraduate

Ten Years On: Improving Access to Psychological Therapies; The Case of Depression

lizBy Dr Liz Smith

Over ten years ago, after finishing my degree in Psychology, I secured funding from the Medical Research Council (MRC) to do a PhD investigating why clinical guidelines (which at the time had become an increasingly familiar component of health care) were not always implemented.  I knew that there was a massive gap between evidence and practice and that this was particularly true for depression.  At this time antidepressant prescribing had increased for all age and sex groups over the previous 20 years.  GPs regularly handed out anti-depressant drugs but very rarely referred patients for therapy even though this may have been the preferred treatment. So my PhD focused on how clinicians used clinical guidelines in depression.

prescription

The first couple of quantitative studies I carried out confirmed that (1) a gap existed between clinical guidelines and practice; (2) the GPs in my study tended to overprescribe relative to recommendations and (3) prescribing no drugs at all was extremely rare.  This led me to the question of why.  The next study I undertook  was one of the most enjoyable research studies I have ever carried out.  It was a qualitative study using in-depth interviews with a purposive sample of GPs.  Here I aimed to elicit GPs’ views about the depression guidelines, how they used them in their practice and any barriers they thought there were that prevented them from implementing them.  The GPs who took part in the study were from general practices across the Scottish Grampian region and North East England.

The main findings were that (1) the GPs did not always agree with recommendations of the depression guidelines current at that time; (2) they thought the guidelines were insufficiently flexible to use with the variety of patients they see; and (3) lack of resources, particularly mental health professionals for referrals, were seen as the main barriers to guideline use.

For these GPs lack of resources emerged as a major barrier to following guideline recommendations. They had problems in referring patients to mental health specialists.  They reported having no specialist to refer them to, patients being misled about specialists’ qualifications, and problems with patient confidentiality issues. Several GPs reported that they had tried their best to follow the guidelines and refer patients for some form of talking therapy but by the time patients received appointments from mental health specialists, the patients reported that their depression problems had disappeared and they no longer wanted appointments. Waiting times reported were between 2 to 26 weeks for psychiatrists or community psychiatric nurses and 9 to 12 months for psychologists. These delays partially explained GPs’ tendency to over prescribe relative to recommendations.  In sum, these GPs saw the lack of mental health professionals as a main barrier to following depression guidelines.  When this study was published we recommended that those involved in guideline production should be demonstrating the case for more mental health professionals.

Since this time I have not given the issue much thought as I changed my career track and worked on research within a business school for 8 years.  However, last year I returned back to the realms of psychology, here at the University of Salford.  On checking out the courses which ran from here I discovered that there is a postgraduate course in Applied Psychology (Therapies).  The University advertises these courses as providing great opportunities for students to prepare to undertake a role in therapeutic interventions and Cognitive Behaviour Therapy (CBT) which is high on the government agenda “Improving Access to Psychological Therapies” (IAPT).

The IAPT programme has its own website where it claims to support the frontline NHS in implementing National Institute for Health and Clinical Excellence (NICE) guidelines for people suffering from depression and anxiety.  The website states that the initiative was developed with the aim of offering patients realistic and routine first-line treatment, combined where appropriate with medication which they say was traditionally the only treatment available. It is amazing that something I found out to be true in my early research days has been addressed by the government and the institute where I carry out my current research actually trains people to prepare them for the IAPT programme.  In chatting with the leader of the course, Dr Simon Cassidy, he tells me that a substantial number of students graduating from the Applied Psychology (Therapies) course go on to work in this initiative.

It’s really great to see that someone somewhere has recognized the need for psychological therapies in the treatment of depression.  It would be marvelous to obtain funding for a follow up study to investigate how clinicians use clinical guidelines in depression today and to see if the gap has closed between evidence and practice.

Contact Details: Dr Liz Smith, Email: e.smith1@salford.ac.uk

Image courtesy of Jaypeg on Flickr, Creative Commons Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0)

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learning Level 6 mental health PGCap psychosis reflection schizophrenia teaching

Labels Hurt!

This post is from Dr Linda Dubrow-Marshall, a Lecturer in Psychology at Salford.  Linda is a clinical and counselling psychologist (HCPC Registered) and a BACP Accredited Counsellor/Psychotherapist.  Below she reflects on teaching Level 6 (Year 3) undergraduates who are taking a module called The Psychology of Mental Health.  The session was on Psychosis and Schizophrenia.  If you participated in the session, Linda would really like your feedback.

“My goal in contributing to the teaching of The Psychology of Mental Health is to help students to develop a personal framework to understand serious mental illness that is humanistic and compassionate. I had previously taught a lecture on “Mood Disorders” where I showed a DVD in which Stephen Fry interviewed several well-known people with mood disorders.  The students seemed to appreciate the DVD as it extended their understanding of the facts about mood disorders to a more personal appreciation of what it is like for someone to live with a mood disorder. I took that feedback on board in planning my lecture on ”Psychosis and Schizophrenia”, and decided that even better than a DVD would be to bring in a service user and carer for part of the session, which I did.

Also, as part of my participation in the PGCAP (Postgraduate Certificate in Academic Practice) programme, I participated in a mixed-reality game with the other PGCap students to explore teaching and learning directly linked to our practice.  The goal was to come up with innovative ideas to enhance a specific teaching and learning situation. I worked with a partner, Robert Purvis, who really helped me to develop my idea of using plasters to have people experience the painful experience of having a sticky label.  Robert gave me the idea to write specific diagnoses on the plasters. Robert and I won the prize for the best collaborative ideas – the web page about the competition is available here.  

On the 5th of November, I piloted this idea by trying it at the beginning of my lecture on “Psychosis and “Schizophrenia”. I noticed that the class had already been divided into learning sets, so I asked them to try an experiential learning exercise in these groups. I asked them to pick a plaster from the envelope and put it on their wrist, read the diagnosis, and reflect on what their life might be like if they had been given that diagnosis.  They could consider it from the viewpoint that it was a new diagnosis that they just found out about and didn’t even understand, or something that they had for awhile. They were then to introduce themselves to their learning set as follows: “Hi, my name is  ____, I am a ____, and let me tell you a little bit about my life…” I asked them to reflect on the experience, share with each other, and have a representative give a brief report to the larger group, leading to a group reflection.  One of the things which I found interesting was that the learning sets had been communicating with each other via email and did not necessarily even know what the people in their learning set looked like.  I enjoyed everyone’s participation and feedback.  One person put the label on their clothing because it would hurt to put it on their skin – part of my point about labels hurting. People felt confused by their diagnoses and did not know what they meant.  Some people felt very shy because they suddenly had this label and did not want to talk about it.  The paranoid people did not feel they trusted the group in order to talk about it, demonstrating that they were really getting into the role.

I would very much appreciate feedback from students in general about the plaster exercise, and especially from those students who participated.  I would also be grateful for feedback about incorporating service users and carers into the lecture.  My PGCAP tutor recorded part of this exercise, and if students want to give their permission for their recordings to be put on the blog, please email l.dubrow-marshall@salford.ac.uk to give permission for this.”

You can also listen to Linda and Robert pitch their collaborative ideas for teaching and learning below.

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