Leroy C. Edozien: Self-determination in health care: a property approach to the protection of patients’ rights

Theoretical Medicine and Bioethics -     

The recovery approach to the care of mentally disordered patients. Does it predict treatment engagement and positive social behaviour beyond quality of life?

The main aim of this study was to investigate whether the ‘recovery approach’ to the care of mentally disordered patients is associated with treatment motivation/engagement and positive social interactions on the ward beyond that of perceived quality of life. The participants were 75 service users in a medium secure unit in south-east England, who completed the Recovery Journey Questionnaire (RJQ), The Manchester Short Assessment of Quality of Life (MANSA), The Beck Hopelessness Scale (BHS), and the Patient Motivation and Perception Questionnaires (PMI and PPQ). The patients’ primary nurse independently completed the Disruptive Behaviour and Social Problem Scale (DBSP) for 33 service users. Multiple regressions showed that after controlling for age, ethnicity and diagnosis (severe mental illness vs personality disorder), the RJQ contributed to the variance in treatment motivation, treatment engagement, and positive social interactions on the ward above quality of life with medium to large effect sizes. The strongest effect size was with regard to treatment engagement where the amount of variance explained increased from 22% to 51% after the RJQ was entered into the regression. The results indicate that the recovery approach explains treatment motivation/engagement and positive social interactions above and beyond quality of life.     

Top‐star’ priests and the catholic response to the ‘explosion’ of evangelical protestantism in brazil: The beginning of the end of the ‘walkout'?

Brazil's ‘new’ style of Catholicism, essentially the creation of a group of young, charismatic clergy—'pop‐star priests’ or ‘stars of the altar’, as they have become known—appears to have set in train a reversal, in that Latin American country at least, of the ‘walkout’ to evangelical Protestantism that David Martin analysed in Tongues of Fire: The Explosion of Pentecostalism in Latin America (1990). In that volume Martin described the rapid development of Protestantism in Latin America in the twentieth century and particularly from the 1960s as “... an explosion of conservative evangelical religion, a shift toward Pentecostalism, a rejection of ecumenism, and the manifestation among many of those involved of the evangelical capacity to unite modern technology with political conservatism”; (Martin, 1990: 54). During the past year millions of lapsed Catholics, and former Catholics some of whom were part of that ‘explosion’, have become involved in the ‘new’ Catholicism whose emergence illustrates the indispensable role of the media in religious reform and conversion in contemporary society. The article examines the superstructural elements of the ‘new’ Catholicism and compares its positive ‘cosmology’ and worldview with the emphasis on demonization in the teaching and ritual of the controversial, but highly successful evangelical Protestant Church, the Igreja Universal do Reino de Dens (the Universal Church of the Reign of God). This presentation also considers the various responses to the ‘new’ Catholicism which, although responsible for the return to worship of millions of Catholics, has been strongly criticised by both Liberation Theology and the more theologically and liturgically conservative wing within the Roman Catholic Church in Brazil.     

How to bring the news … peak-end effects in children’s affective responses to peer assessments of their social behavior

The retrospective evaluation of an event tends to be based on how the experience felt during the most intense moment and the last moment. Two experiments tested whether this so-called peak-end effect influences how primary school students are affected by peer assessments. In both experiments, children (ages 7–12) assessed two classmates on their behaviour in school and then received two manipulated assessments. In Experiment 1 (N ?=?30), one assessment consisted of four negative ratings and the other of four negative ratings with an extra moderately negative rating added to the end. In Experiment 2 (N ?=?44), one assessment consisted of four positive ratings, and the other added an extra moderately positive rating to the end. Consistent with the peak-end effect, the extended assessment in Experiment 1 and the short assessment in Experiment 2 were remembered as more pleasant and less difficult to deal with, which shaped children’s peer assessment preferences and prospective choices of which assessment to repeat. These findings indicate that the process of peer assessment can be improved by ending the feedback with the most positive part of the assessment.     

I hear you (not): sharers’ expressions and listeners’ inferences of the need for support in response to negative emotions

When in emotional distress, people often turn to others for support. Paradoxically, even when people perceive social support to be beneficial, it often does not result in emotional recovery. This paradox may be explained by the fact that the sharing process disproportionately centres on support that is not helpful in the long run. A distinction has been made between two types of support that are differentially effective: Whereas socio-affective support alleviates momentary emotional distress, cognitive support fosters long-term recovery. But can listeners tell what support the sharer needs? The present study examines the hypothesis that sharers communicate their support goals by sharing in such a way that it allows listeners to infer the sharer’s needs. In Experiment 1, we manipulated participants’ support goals, and showed that socio-affective support goals led participants to express more emotions, whereas cognitive support goals resulted in greater use of appraisals. In Experiments 2 and 3, we tested whether these differential expressions would affect the support goals that listeners inferred. We found no evidence for such an effect: Listeners consistently perceived the sharer to predominantly want socio-affective support. These findings help explain why many social sharing instances revolve around socio-affective support, leading to subjectively experienced benefits, but not to genuine recovery.     

A response to Nguyen’s article, ‘Identification: A qualitative study of the experiences of bilingual therapists with their monolinguals and bilingual clients’

Noticing a certain lack of reflections directly related to language per se, I emphasise and discuss the importance of language issues in any bilingual or multilingual therapy. I try to illustrate this both with some of the existing literature on the subject and by offering my own take on some of the comments made by the interviewees.     

‘How the other half lives’?: Taking a critical approach to the social psychology of economic inequality and extreme wealth

The negative impact of economic inequality on social issues and wellbeing is of importance to social psychology that historically has an interest in social justice. Social Identity Theory is explored as an approach that acknowledges the wider context of social issues. The use of experiments encounters challenges in categorizing wealth and how individuals account for extreme wealth. Mainstream research agendas in psychology are not neutral and draw upon current ideology (such as neoliberalism) that can often maintain inequality. These difficulties are addressed by Critical Social Psychology driven by a social justice agenda that challenges the acceptance of neoliberal values. The application of Critical Social Psychology to wealth inequality is demonstrated with research using UK media data. Critical feminist psychology is discussed to explore the role of class and how to challenge the stigmatization of working-class people. Finally, this paper outlines how Discursive Psychology addresses how extreme wealth and the practices of the super-rich are warranted. A discursive approach questions the acceptance of wealth inequality as an everyday assumption and demonstrates how dominant discourse draws upon individualism. Furthermore, Discursive Psychology has examined how accountability for problematic practices, such as tax avoidance that maintain inequality, are managed in media broadcasts.     

Facing Down the Representation of An Impossibility: Indigenous Responses to a ‘Universal’ Problem in the Repatriation Context

This paper explores the ways Native Americans and Native Hawiians have responded to what Ernesto Laclau has called ‘the representation of an impossibility’—the discursive crisis faced by non-dominant groups who seek to advance rights claims in ways that are culturally rooted but universally audible to ideologically dominant audiences. Taking the NAGPRA law of 1990 as its case study, this paper asserts the need for a re-theorisation of indigenous religious discourse in order to illuminate the ways native peoples build rather than concede agency through self-representations in the current political moment. Pursuing this argument, the paper charts an analytical course specifying the relationship of rights claims to discourse, hegemony, articulation, tradition, and religion. The paper then focuses upon specific examples of religious claims in the context of the Native American Graves Protection and Repatriation Act to demonstrate the ways Native Americans have faced down an ‘impossibility’.     

Motivated to be socially mindful: Explaining age differences in the effect of employees’ contact quality with coworkers on their coworker support

In this research, we examine how high-quality contact can facilitate employees’ coworker support and explain why the benefits of high-quality contact are contingent upon age. First, we employ a social mindfulness lens to decipher the motivational mechanisms of high-quality contact with coworkers on providing coworker support via coworker-oriented perspective taking and empathic concern. Second, we utilize socioemotional selectivity theory to overcome the current age-blind view on workplace interactions and examine the indirect moderating effect of age via future time perspective on the link between contact quality, social mindfulness, and coworker support. We tested our hypotheses based on data from a sample of 575 employees collected in three waves. Results showed that both coworker-oriented perspective taking and empathic concern mediated the positive effects of contact quality on coworker support. The effect of contact quality on coworker-oriented empathic concern was stronger for older employees with a more constrained future time perspective as compared to younger employees with a more extensive future time perspective. Overall, we extend research on aging, workplace interactions, and support behavior by linking the literature on these topics using a social mindfulness lens and by adding employee age and age-related mechanisms as important boundary conditions that qualify the outcomes of positive workplace contact.     

Beliefs in the end of the world,justice, religiosity and system preservation: a psychological study of how the ‘end of the world’ could match common belief systems

While historical research has shown that Beliefs in the End of the World (BEW) are present in human culture, no psychological study has yet explored why people endorse one BEW rather than another. The aim of this study is to understand how the BEWs are linked to other beliefs. Three BEWs were studied: Human Deserved End of the World (HDEW) (ecological view of the end of the world); AOW (an external and total end of the world); and Religious End of the World (RSEW) (end of the world caused by a God). Several common beliefs were hypothetically linked to them: Immanent and Ultimate Justice (two dimensions of the Belief in a Just World [BJW]); System Justification (SJ); and Religiosity. Eight hundred and eighty-one participants answered our questionnaires on general Internet forums. Results showed that: (1) HDEW is explained positively by Immanent Justice and negatively by SJs; (2) Annihilation of the World (AOW) is explained negatively by Ultimate Justice and Religiosity, and positively by SJ; and (3) RSEW is explained positively by Religiosity and Ultimate Justice. Justice, Religiosity and preservation of one’s way of life (SJ) seem to be ways to cope with the symbolic threat that is represented by the End of the World. Some perspectives for a psychological study of BEWs are presented.     

Putting the ‘app’ in Happiness: A Randomised Controlled Trial of a Smartphone-Based Mindfulness Intervention to Enhance Wellbeing

Smartphones are revolutionizing approaches to wellbeing investment. Those seeking greater happiness can engage with thousands of downloadable self-help applications instantly, yet their effectiveness remains largely unknown. This investigation explored the viability of delivering a positive psychological intervention in application format to authentic happiness seekers. A smartphone-based randomized-controlled trial was conducted with a diverse self-selecting pool, randomly assigned to engage with an empirically supported mindfulness intervention (n = 57) or a control intervention (n = 64) for 10 days. The study explored smartphone methodology, the importance of empirically based content for wellbeing enhancement and the extent to which user experience related to wellbeing gains. Results of repeated measures ANOVAs showed statistically significant increases in positive affect with a medium effect size and reduced depressive symptoms with a small effect size, although no statistically significant differences in satisfaction with life, flourishing or negative affect were found. No statistically significant gains were observed in the control condition. Ratings of task enjoyment were positively correlated (Pearson’s r) with positive affect increase. Findings support the viability of smartphone-based interventions to significantly enhance elements of wellbeing, underscoring the importance of application content and the role of person-activity fit. This investigation presents implications for happiness seeking strategies in the real world whilst showcasing a dynamic method of intervention delivery that can benefit future research and practice. If the greatest mission of positive psychology is to enhance global flourishing, the potential of smartphone-based interventions may play a vital role.     

How are recent changes to primary care mental health provision within the NHS affecting psychodynamic counsellors’ construction and management of their professional identities? A Foucauldian perspective

The research used Foucauldian techniques to explore how counsellors currently working for the NHS construct and manage their professional identities in the face of changes imposed on them by the institution. Semi-structured interviews were carried out with four counsellors and one doctoral student, all with substantial experience working for the NHS. A Foucauldian Discourse Analysis revealed four main subjectivities that were made available; feeling like part of a process at times; the NHS imposes limitations on their practice; feeling able to retain their professional standards despite the limitations and lack of influence; feeling proud of, and satisfied with the work they do. Places in which the participants explored ways of constructing a professional identity were also explored.     

Understanding bike-sharing acceptability and expected usage patterns in the context of a small city novel to the concept: A story of ‘Greek Drama’

Developing initiatives that allow societies to embrace more sustainable travel behaviour patterns is a prerequisite for creating more livable urban futures. Bike-sharing, a measure designed to inspire modal shift from short car-trips, despite its recent exponential growth, is still understudied. This paper discusses a quantitative survey of 640 responses examining road users' attitudes towards bike-sharing and its possible introduction to Drama, a small Greek city resembling many others in terms of size, transport culture and socio-economic characteristics, which has never been exposed to a similar intervention. Most of the respondents recognised that bike-sharing is a mode with pro-environmental, cost-effective and health-improving qualities and the potential to promote a greener identity for the city. Evidence is provided that people would support a bike-sharing investment even in cases where the frequency of their current bicycle use and the regularity with which they intend to use an eventual scheme is low. Age, gender, the primary factor for modal choice, its perceived effectiveness in reducing traffic congestion and their usage expectations were all factors influencing the respondents’ acceptability of such an introduction. The lack of cycling infrastructure and road safety concerns were identified as possible usage barriers but the pro-social potential of bike-sharing combined with policy efforts to create a more pro-cycling culture could outweigh them. The present analysis suggests that bike-sharing can go beyond, what is typically regarded as its primary function, that of a last-mile solution for metropolitan areas, and be a publicly acceptable investment for smaller cities.     

Problems in Measuring Diachronic Religious Behavior,or Using Indicators to ‘Make a Virtue of Necessity’: the Case of the Netherlands (1975–2005)

The aim of this study is to show the different advantages and drawbacks of the main quantitative indicators used in research on diachronic religious behavior. We will demonstrate that religious affiliation has to be used in long-term studies; although it is extremely imprecise, it is often available over long periods of time. Instead, the best solution for medium-term studies is to use frequency of attendance at religious services. This indicator is more accurate than religious affiliation, but is only widely available from the 1960s–1970s onwards. Finally, the most suitable indicator for short-term analysis is obtained from diary-based time-use studies. It is the most precise of the three indicators, but the source is less readily available as these surveys have only been conducted in most countries in the last 30 years. This study is based on data from Time Use Surveys conducted in the Netherlands every 5 years from 1975 to 2005.     

The effects of a ‘pretend play-based training’ designed to promote the development of emotion comprehension,emotion regulation,and prosocial behaviour in 5- to 6-year-old Swiss children

The objective of this study was to evaluate the effects of a pretend play-based training designed to promote the development of socio-emotional competences. 79 children aged 5 to 6 years were evaluated before and after a pretend play-based training. The experimental group (39 children) received this programme on emotion comprehension, negative emotion regulation, and prosocial behaviour one hour a week for eleven weeks during class hours, while the control group (40 children) received no specific intervention. The programme was implemented by 5 teachers. The results show improvements in the ability to understand emotions in children who benefited from the training. These findings are discussed in the broader context of using this form of play as a privileged pedagogical tool to allow children to develop these competences.     

‘… you kind of frantically go from one thing to the next and there isn’t any time for thinking any more’: a reflection on the impact of organisational change on relatedness in multidisciplinary teams

This paper reflects on the relational impact on Clinical Psychologists of NHS organisational change in the context of cuts and reorganisation. The reflections illustrate one theme drawn from a study of eight Clinical Psychologists working within adult Community Mental Health Multi-Disciplinary Teams. The paper considers the impact of competition and change in healthcare on the ability to engage in reflective practice potentially affecting client care due to reduced joint-working, consistency and creativity. The paper considers how acts of kindness (compassion) within organisational contexts at all levels can facilitate relatedness, reflection and more human care. It concludes by considering how shifting from short-term planning evaluating efficiencies based on perceived financial value, to thinking more widely and long-term about relational value may be of benefit to clinicians, clients and the system as a whole.     

‘If that's what I need,it could be what someone else needs.’ Exploring the role of attachment and reflective function in counselling psychologists' accounts of how they use personal therapy in clinical practice: a mixed methods study

Empirical evidence supporting the inclusion of mandatory training therapy for therapists is sparse. We present results from a mixed methods study designed to interrogate how counselling psychologists' attachment status and levels of reflective function (RF) intersect with how they experience, recall and describe using personal therapy in clinical practice. Results suggest that securely-attached, or earned secure participants with ordinary or marked levels of RF used their therapy to manage feelings evoked by difficult or challenging clients. Insecurely-attached participants with lower levels of RF found therapy valuable in terms of behavioural modelling, but not in managing complex process issues. Negative case analysis found that high levels of RF may not be uniformly advantageous for therapists. The study concludes with a brief discussion of issues relating to epistemology, validity and reflexivity.