The practice of psychology in rural communities: potential ethical dilemmas

The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas.     

Psychological Defense Mechanisms: A New Perspective

Approaching psychological defense mechanisms from the perspective of an evolved strategy, it is proposed that there are two basic templates-dissociation and cognitive distortions. Frequently conceived of as pathological, these psychological phenomena actually constitute overlapping spectrums with milder manifestations being common and highly functional, and more severe variants less common and typically dysfunctional. Dissociation provides the capacity to adaptively detach from disturbing emotional states, and cognitive distortions place a positive ego-enhancing spin on experience. Most of the classical defense mechanisms described in the psychoanalytic literature represent a form of cognitive distortion with some containing strong elements of dissociation.     

Humanistic psychology and religion: Steps toward reconciliation

Disagreements have surfaced recently among rank- and-file mental health practitioners regarding the relationship between psychology and religion. To mediate these differences and misunderstandings, a study is presented here of the basic concepts of humanistic psychology vis-á-vis major elements of Judeo-Christian biblical theology. An assumption is posited that all forms of knowledge share a fundamental language basis and symbolic system regarding the ultimate questions and meanings of existence. From this presupposition similarities and congruities among specific elements of humanistic psychology and biblical theology are discussed, providing a basis for more intensive empathic dialogue and cooperative research. A bridge is established to enable therapists to understand better their clients' religious conflicts and/or emotional stresses caused by religious factors.     

Sport psychology service delivery: staying ethical while keeping loose

Although the parent discipline of sport psychology is psychology, the delivery of sport psychology services has its main roots in physical education and sports science (motor learning and control, skill acquisition). Thus, sport psychologists may look more like coaches than they look like clinicians or counselors. In this article, the authors trace the evolution of sport psychology services and contrast the temporal, spatial, and delivery issues of applied sport psychology with more mainstream counseling and clinical psychology. The looser boundaries of sport psychologist practice have both benefits and dangers, and the authors offer some examples to professional psychologists who are thinking of expanding their delivery of service to athletes and coaches.     

Self-assessment in clinical health psychology: a model for ethical expansion of practice

Society expects autonomous professions to ensure the competency of it practitioners, and professions should facilitate the continuing education and training of its members. Given the shift from psychology as a mental health profession to that of a health profession, the authors propose a self-assessment model for the individual practitioner to gauge his or her readiness to provide professional service in expanded areas of practice. This model could also be useful to the American Psychological Association, state psychological associations, and other purveyors of continuing education programs in systematically developing postgraduate experiences. A template for self-assessment that reflects well-accepted core domains of knowledge and skills is presented.     

Maximal care considerations when treating patients with end-stage heart failure: ethical and procedural quandaries in management of the very sick

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy. These criteria for subsequent listing are based on clinical outcome data but also reflect the reality of organ shortage. Lack of compliance and non-adherence to lifestyle changes represent relative contraindications to heart transplant candidacy. Mechanical circulatory support therapy using ventricular assist devices is becoming a more prominent therapeutic option for patients with end-stage heart failure who are not candidates for transplantation, which also requires strict criteria to enable beneficial outcome for the patient. Physicians need to critically reflect that in many cases, the patient’s best interest might not always mean pursuing maximal technological options available. This article reflects on the multitude of critical issues that health care providers have to face while caring for patients with end-stage heart failure.     

Psychohistory before Hitler: early military analyses of German national psychology

As part of a grandiose post-World War I psychological project to predict the behavior of nations, the U.S. Military Intelligence Division (MID) utilized racial and social psychological theories to explain an alleged problematic German national character. Though unsuccessful, this project has major significance in the history of psychohistory. For the newly discovered MID files reveal that ideas, attitudes, and biases many psychohistorians subsequently identified as manifestations of a peculiar German national character had previously been held by American officers and reputable psychologists. What American analysts would, in 1940, view as symptoms of a maladjusted German mind, their predecessors had, in 1920, considered valid scientific concepts.     

Megatrends in personality assessment: toward a human science professional psychology

Societal megatrends have assessment counterparts--superempiricism, biopsychosocial perspective, person-centering, population-specificity, self-assessment--which are used to examine the contemporary status of professional psychology. A human science approach to research, training, and practice can exemplify a profession that acknowledges these megatrends. The nurture of competent professional psychologists requires a reinvestment in Boulder Model ideology, a human science that is shared with consumers on the basis of values which communicate caring and understanding.     

Contributions to the history of psychology: CXVII. Who's who in American psychology: a citation study of introductory psychology textbooks

The author indexes of 15 introductory psychology textbooks were surveyed to identify the authorities cited most frequently. The five names cited most often in descending order were Freud, Bandura, Skinner, Piaget, and James. Differences from earlier comparable citation studies are discussed.