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Carr, Alan
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Carr, Alan
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Carr, Alan
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- PublicationUrban public attitudes to the treatment of psychological problems and depression in general practiceA previous national study of public attitudes to depression indicated that only 17% spontaneously mentioned their general practitioner as someone who could help with depression, in contrast to 79% of respondents being willing to consult their G.P. in a similar U.K. survey. The present study undertook to examine the public perception of an urban sample to the treatment of depression in general practice and the factors associated with expressed unwillingness to consult. A random sample from the electoral register was drawn and 54 (89%) of 61 subjects selected were interviewed. While 85% of respondents were satisfied with their general practice care, only 24% to 52%, depending on the context and wording of the question, said that they would seek help from their general practitioner for depression. Factors associated with an expressed reluctance to consult were being male, dissatisfied with general practitioner care and believing that general practitioners were not qualified to treat depression.
151 - PublicationKarl Tomm's approach to systemic practiceKarl Tomm occupies a pivotal position in the evolution of systemic family therapy. He played an important role in bringing the work of the original Milan systemic family therapy team to the attention of family therapists in North America, the UK and Ireland. He then went on to extend and elaborate their work and also to integrate work from the narrative therapy tradition into systemic family therapy. The account of some aspects of his work presented in this chapter are based on a presentation he made over two days at the Mater Hospital in Dublin in April 1997. The presentation and this account of Karl Tomm’s work clusters around four central themes.
3203 - PublicationMichael White's narrative therapyNarrative approaches to therapy have come to occupy a central position within the field of family therapy in recent years and this is due in large part to the influence of Michael White. Alone and in collaboration with David Eptson, Michael has pioneered the development of this approach to practice. Inspired by this seminal work, other practitioners have begun to write about narrative therapy in clinical practice to debate its place within the wider field of family therapy and to incorporate ideas from narrative therapy into mainstream mental health practices. Narrative therapists works with a wide range of client groups with difficulties which are recognized within mainstream mental-health circles as being among the most difficult to treat including childhood conduct problems; delinquency; bullying; anorexia nervosa; child abuse; marital conflict; grief reactions; adjustment to AIDS; and schizophrenia.
3912 - PublicationOne Perspective on Karl Tomm's Current Approach to Systemic PracticeKarl Tomm occupies a pivotal position in the evolution of systemic family therapy. He played an important role in bringing the work of the original Milan systemic family therapy team to the attention of family therapists in North America, the UK and Ireland (Tomm, 1984a, 1984b). He then went on to extend and elaborate their w ork and also to integrate work from the narrative therapy tradition into systemic family therapy. The account of some aspects of his work presented in this chapter are based on a presentation he made over two days at the Mater Hospital in Dublin in April 1 997. The presentation and this account of Karl Tomm’s work clusters around four central themes.
1073 - PublicationUnderstanding how people cope with cancerThe challenges associated with cancer diagnosis and treatment require a coping response. The nature of the response can be defined according to a number of theoretical models of adjustment. Presented is a review of 3 theoretical models of adjustment applied to the cancer experience (1) The problem solving model of stress and coping (Nezu, Nezu, Houts Friedman & Faddis, 1998); (2) An integrative framework and life events model (Billings and Moos, 1982); and (3) the cognitive model (Moorey and Greer, 2002). While the problem solving model highlights the importance of problem solving processes in mediating the impact of cancer on quality of life, the integrative framework and the life events model defines the relationship between cancer and adjustment as being mediated not only by coping responses but also by the individual’s personal and environmental resources as well as their cognitive appraisal of cancer-related stresses. The appraisal of cancer-related stresses is the central factor in the cognitive model, which proposes that it is patients’ perception of stress which determines the level of adjustment and quality of life. The theoretical frameworks reviewed here suggest that psychosocial interventions that aim to improve the adjustment of cancer patients should enhance problem-solving skills, increase personal and environmental coping resources, and facilitate the development of adaptive appraisals of cancer-related stresses.
197 - PublicationHistory of family therapy in Ireland. 2. Profiles of key figuresThis paper presents profiles of individuals who have contributed to the development of family therapy in Ireland. An overview of the history of family therapy in Ireland is given in a companion paper. This paper profiles five of the founders of family therapy in the Republic of Ireland (Nollaig Byrne, Imelda McCarthy, Phil Kearney, Ed McHale and Jim Sheehan); two founders of family therapy in Northern Ireland ( Isobel Reilly, Artie O’Neill , and Arlene Healey) and others who have made distinctive contributions to the Irish family therapy movement (Barbara Kohnstamm, Jo Kennedy, Bernadette O’Sullivan and myself).
615 - PublicationThe effects of actual and potential stressor control on physiological and self-reported stress responsesTwo broad groups of theories offer explanations for the stress modifying effects of stressor control. One group of theories attributes the stress modifying effects of control to the predictive information furnished by the controlling action. The second, regards the effects of stressor control as being independent of predictability. The minimax theory belongs to this second group. It predicts stress reduction in the experimental group when all factors are held constant across experimental and comparison conditions, but where only subjects in the experimental group have stressor control. Two experiments were conducted to test this prediction. Actual control over brief bursts of loud noise was available to subjects in the experimental group of the first experiment. In the second, the effects of potential (but unexercised) control were examined. In both experiments subjects in the comparison group had no control over the stressors. However, they were exposed to the same pattern of stimulation, and had the same amount of predictive information as their experimental group counterparts. Experimental and comparison groups were matched on five organismic variables, viz. age, sex, Neurorticism, Extraversion, Desirability of Control, and coping style. Physiological and self-reported stress responses were recorded during both stressor anticipation and impact periods. Less anticipatory physiological stress was observed in the experimental than in the comparison groups in both experiments. Intergroup differences on the remaining dependent variables were not reliable. The minimax theory was partially supported. Coping style was included as an organismic variable in a number of further analyses. These revealed that while behavioural control led to anticipatory physiological stress reduction, the use of cognitive nonvigilant coping strategies led to a reduction in anticipatory self-reported stress. Interactions between stressor control and coping style were also observed. These interactions suggested that stress reduction may be enhanced by using different coping strategies in different situations. The clinical implications of this congruence model were discussed.
268 - PublicationThe Effectiveness of Psychotherapy. A Review of Research prepared for the Irish Council for PsychotherapyOne in four people suffer from mental health problems, so mental health problems are a major national and international challenge. Psychotherapy is an effective intervention for a wide range of mental health problems in people of all ages. The average success rate for treated cases ranges from 65 to 72%.
7696 - PublicationIrish drug abusers II : Their psychological characteristics.This is the second in a series of three articles based on a study of a cohort of Irish drug abusers. While the social background of the subjects was the subject matter of the first paper (Carr et al., 1980), this article addresses itself to the distribution of certain psychological traits within the cohort. In the final paper a psychosocial typology of drug abusers will be presented.
133 - PublicationThe clinical assessment of young people with sexually abusive behaviourThis chapter outlines some basic ideas that can be used to plan and conduct a clinical assessment for a young person referred for problems with sexually abusive behaviour. It begins by considering key characteristics that reflect a good approach to clinical assessment with this population. It then considers aspects of motivation that are important in planning such assessments. It will outline the main areas usually covered during a clinical assessment and concludes with ideas on formulating information from the assessment, report writing, and contracting for intervention. We use fictional case material to illustrate key points made regarding assessment throughout. The ideas contained in this chapter are drawn from a variety of sources including Beckett (1994), Graham, Richardson and Bhate (1997), Becker, (1998), APA Task Force (1999), Will (1999), and Sheerin and O’ Reilly (2000), and O’ Reilly (2001). Each of these authors provide useful information and ideas on conducting clinical assessments with young people who sexually abuse.
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