A Transtheoretical Approach to Case Formulation

In answer to the need for a comprehensive, systematic, yet flexible case formulation method, the present article describes the Causal Analysis and Synthesis of Events (CASE) system, a transtheoretical case formulation method. This method of functional case formulation is useful in terms of explicating the problem and identifying potential areas for intervention when dealing with clinical problems of both an intrapersonal and interpersonal nature. Further, this formulation method may improve communication between the therapist and the client during case conceptualization and facilitate dialogue between therapists of different theoretical orientations. This paper describes the case formulation method and includes an example incorporating this case formulation technique for a young man with social phobia.     

A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes.     

A Sociocultural Approach to Narcissism: The Case of Modern China

Using large Internet samples, we examined the possible influence of sociodemographic factors on the Chinese self‐concept and in particular, on the level of narcissism. We found that (i) younger persons are more narcissistic than older ones; (ii) persons from higher socioeconomic classes are more narcissistic than those from lower socioeconomic classes; (iii) persons from only‐child families are more narcissistic than those from families with multiple children; (iv) persons from urban areas are more narcissistic than those from rural areas; and (v) individualistic values are predictive of individual differences in narcissism. The findings suggest that sociocultural changes contribute to the rise of narcissism in China. Copyright © 2011 John Wiley & Sons, Ltd.     

Case Report: A Systems Approach to Genetic Counseling for Albinism

A systems approach to family therapy assumes that a person and his/her problems do not operate in a social vacuum but instead are imbedded in a social context. This context includes fairly small social systems such as a nuclear family and larger social systems such as school systems and cultural beliefs. A case of a girl with albinism born to a couple from India will be used to discuss how a systems approach might be useful in a genetic counseling setting.     

A Case for Standards of Counseling Practice

A mature counseling profession has entered the decade of the 1990s. Several factors including professionalism, accountability, health care consumerism, credentialism, and public demands for quality mental health care indicate a need for more definitive statements on standards of practice in counseling. In response to this need, an 8-point proposal for standards of practice in mental health counseling is offered.     

A Communities of Practice Approach to the Synoptic Problem

Although the study of the Synoptic Problem has been the focus of scholarly attention for over two hundred years, the social learning theory known as Communities of Practice is a relatively recent phenomenon. This article describes a communities of practice approach to the study of the Synoptic Problem in an upper‐division undergraduate course at a private, liberal arts college. Students with little or no prior knowledge of the Synoptic Problem were introduced to the salient issues of the Synoptic Problem as well as a theoretical framework in which to interpret them. Data were collected using a variety of mixed methods, including pre‐ and post‐treatment tests, written survey questions, interviews, field notes, and focus group sessions. The results of this study suggest that a communities of practice approach can enhance students' knowledge of the Synoptic Problem and also foster an awareness of scholarly and personal presuppositions that influence the interpretation of the gospels.     

A Case Study and Balance Sheet Approach to Unemployment

The authors describe positive and negative aspects of employment and unemployment in a balance sheet framework. They also discuss the value of the balance sheet approach in understanding individual differences in reactions to unemployment.     

Natural Selection: A Case for the Counterfactual Approach

This paper investigates the conception of causation required in order to make sense of natural selection as a causal explanation of changes in traits or allele frequencies. It claims that under a counterfactual account of causation, natural selection is constituted by the causal relevance of traits and alleles to the variation in traits and alleles frequencies. The “statisticalist” view of selection (Walsh, Matthen, Ariew, Lewens) has shown that natural selection is not a cause superadded to the causal interactions between individual organisms. It also claimed that the only causation at work is those aggregated individual interactions, natural selection being only predictive and explanatory, but it is implicitly committed to a process-view of causation. I formulate a counterfactual construal of the causal statements underlying selectionist explanations, and show that they hold because of the reference they make to ecological reliable factors. Considering case studies, I argue that this counterfactual view of causal relevance proper to natural selection captures more salient features of evolutionary explanations than the statisticalist view, and especially makes sense of the difference between selection and drift. I eventually establish equivalence between causal relevance of traits and natural selection itself as a cause.     

Child Sexual Abuse: A Multidisciplinary Approach to Case Management

Treatment for child victims of sexual abuse is a complex and sometimes lengthy process involving members of numerous social service agencies. Coordination of services can be accomplished through the use of a multidisciplinary team approach to case management. The author provides information about the roles of various team members as well as suggestions for organizing a child sexual abuse multidisciplinary team.     

Making Meaning: The Constructive-Developmental Approach to Persons and Practice

The constructive (in the sense of construing) and developmental (but throughout the lifespan) framework, whose conceptual roots lie in the work of Piaget, outlines the holistic personality process of systems of making meaning, systems that organize human thought, feeling, and action. In this article Kegan discusses and then applies the model—to a worker in a CETA program and to a psychiatric ward patient—elucidating the perspectives—on mental health and employability—it can open for practitioners.     

A MIMIC Model Approach to Research in Geriatric Neuropsychology: The Case of Vascular Dementia

The goal of the current study is to demonstrate a new methodology that can be used in neuropsychological research concerning differential diagnosis research. The multiple indicators, multiple causes (MIMIC) model is a latent variable methodology which can examine group differences on individual tests while controlling group differences in global cognitive impairment. As a demonstration, neuropsychological data from 217 dementia patients were incorporated into a MIMIC model to examine the influence of cerebrovascular disease (CVD) upon (1) dimensions of global cognitive impairment and (2) upon individual tests after controlling for global impairment. The presence of CVD in dementia (i.e., vascular dementia [VaD]) was not significantly related to dimensions of global impairment. In addition, the presence of CVD within dementia did not significantly contribute to impairment on 9 out of 10 neuropsychological tests/subscales examined after controlling global cognitive impairment. These results are discussed in the context of current vascular dementia research, and are focused primarily upon the MIMIC model methodology and suggestions for its use in future research.     

Dimensions of Stressful Situations: A Comparison Between a Response Analytical and a Stimulus Analytical Approach

The congruence between two different approaches for the isolation of situational dimensions was studied. For each of the two approaches, data were obtained from an inventory consisting of 24 stressful situations. In the first study (the response analytical approach), 77 youn male Ss rated the unpleasantness of each of the stressful situations. A principal components analysis was employed for the isolation of the situational factors. In the second study (the stimulus analytical approach), another 24 young male Ss rated the degree of experienced similarity of the same situations. A multidimensional scaling method was employed for the isolation of the situational dimensions. The factorial congruence between the two approaches was considerable.     

A Case for an Expanded Framework of Ethics in Practice

Using a case vignette as an illustration, an expanded framework for examining ethical issues in human service practice is proposed. The article argues that the helping relationship is multiply constructed through discursive fields, rather than being a given, and that the lens of ethics must be widened to understand both the highly contradictory nature of practice, with its accompanying paradoxes, and the broader structures that constrain and influence practitioners. The article draws on the centrality of the concept of ethical trespass to recognize the inevitability of some level of harm in the application of human service work, despite intention or skill. At the same time, investigating workers' uses of resistance to the dominant discourses is suggested as a means to edge toward the reduction of trespass.