Reasonable Hope: Construct, Clinical Applications, and Supports

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full-text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ).
Hope may be the most laden shorthand term of all time. Everyone wants it; few know how to articulate what it is. Although family therapists frequently work to restore hope with hopeless families, they have contributed little to the abundant literature on hope. I present a new conceptualization of hope—reasonable hope—that reflects how family therapists think and practice. By subscribing to reasonable hope, clinicians enhance their ability to offer accompaniment and bear witness to clients. I describe clinical practices that, informed by reasonable hope, also facilitate its cocreation. Finally, I suggest supports for clinicians who practice reasonable hope.     

Deception,Catholicism, and Hope: Understanding Problems in the Communication of Unfavorable Prognoses in Traditionally-Catholic Countries

The doctor's use of deception in appropriate circumstances has commonly been considered a necessity of the medical art. Resistance to full and frank communication is typical of many traditionally Catholic countries, and particularly of Italy, a western country where Catholicism remains particularly influential. The Catholic teaching on truth and lies, and the problem of telling the truth to a severely ill patient is discussed. It is suggested that the contemporary Catholic model of gradually telling a terminal patient the truth, which looks reasonable and feasible in theory, is rarely followed in practice, as in the majority of cases the truth is not told tout court. Problems stem from the way in which medicine is currently practiced in Italy; from the synergism between Catholicism and the medical tradition's grounded paternalism; and from the ambiguity of the term ‘hope’. Catholic ethics in fact recommends that the truth must be told without destroying hope, but the Catholic meaning of ‘hope’ is very different from its meaning in current language.     

Translating Research for Professional Development and Effective Clinical Practice With Older Adults

This paper offers a commentary on the articles in the special series on cognitive behavior therapy with older adults (Carmin, 2012-this issue), noting the commonalities found across discussions of diagnostic interviewing and cognitive-behavioral assessment and treatment for late-life insomnia, depression and suicide risk, PTSD, and OCD. These case studies demonstrate best practices in the application of cognitive-behavioral strategies for assessment and intervention with a diverse range of older adults. Clinicians can improve the effectiveness of their work with aging clients by expanding their skills in assessment and managing interprofessional relationships in integrated health-care settings. Reflected by the papers in this series, ongoing professional development and research attention are both essential as clinicians from the mental health disciplines increase provision of CBT with older adults. Treatments for specific disorders and problems will also benefit from the growing literature on successful aging, and the application of positive psychology in our future collaborations with older adults and their care partners.     

Developmental Therapy: Integrating Developmental Processes into the Clinical Practice

The facilitation of development may be considered the primary goal of counseling and therapy. Developmental theory, however, remains relatively divorced from direct clinical work. Developmental therapy is oriented toward identifying how to use basic developmental theory in clinical consultation. Developmental therapy differs from life span developmental psychology in emphasizing specific processes of change, growth, and development rather than outcomes and life stages. Thus, developmental therapy supplements life span theory and provides specific suggestions for clinical-counseling interventions that may be used to assess the developmental level of a client on a specific task, select counseling skills and theory to match client cognitive-developmental level, and obtain feedback on the effectiveness of the intervention that will enable one to change counseling style to meet client needs. Basic to developmental therapy is a modern adaptatio of Platonic and Piagetian constructs that allows the systematic integration of counseling and therapy theory. Implications of the model for training and practice are discussed.     

Translating experimental paradigms into individual-differences research: Contributions,challenges, and practical recommendations

Psychological science has long been cleaved by a fundamental divide between researchers who experimentally manipulate variables and those who measure existing individual-differences. Increasingly, however, researchers are appreciating the value of integrating these approaches. Here, we used visual attention research as a case-in-point for how this gap can be bridged. Traditionally, researchers have predominately adopted experimental approaches to investigating visual attention. Increasingly, however, researchers are integrating individual-differences approaches with experimental approaches to answer novel and innovative research questions. However, individual differences research challenges some of the core assumptions and practices of experimental research. The purpose of this review, therefore, is to provide a timely summary and discussion of the key issues. While these are contextualised in the field of visual attention, the discussion of these issues has implications for psychological research more broadly. In doing so, we provide eight practical recommendations for proposed solutions and novel avenues for research moving forward.     

Translating Evidence to Practice: Two Stories from the Field

Translating research evidence into daily practice is a challenging process at the organizational level. Conceptual models about this process point to the importance of resources for change and environmental influences as two key factors that need to be addressed in translation efforts. Two organizational case studies focused on improving care for adults with depression are described that illustrate lessons about translating evidence to practice that may be helpful to others.     

察觉、辨析、体验，让医学伦理遍布临床

临床医学伦理有两条进路:外部渗入与内部自生。前者因有伦理规范和相关法律约束,已初步得到落实,后者则是常寓于医疗实践中的常态,难有规范约束,且有背离初衷之事例发生。诸如诊疗方案、新技术的应用、手术、急诊救治、护理等临床实践中的伦理问题,需要通过察觉、辨析、体验的进路才能得以彰显和重视。而坚持医生临床、构建医患间的权力平衡、重视非技术因素在医疗中的作用,启动医师美德的动力机制,则是保证医学伦理遍布临床的重要支撑条件。     

Using a Mindfulness-Based Procedure in the Community: Translating Research to Practice

Maladaptive behaviors, such as aggressive and disruptive behaviors, are a significant risk factor for maintaining community placement by individuals with intellectual disabilities. When experienced researchers provide training to individuals with intellectual disabilities on a mindfulness-based strategy, Meditation on the Soles of the Feet, the individuals are able to effectively self-manage their maladaptive behaviors. We investigated whether similar effectiveness would be found if community-based therapists provided the training to similar individuals living in the community. Three adults with mild intellectual disabilities and mental illness living in the community were taught by a community-based therapist to use this strategy to control maladaptive behaviors that included verbal aggression, disruptive behavior and physical aggression. They were taught to shift the focus of their attention from the negative emotions that triggered their maladaptive behavior to a neutral stimulus, the soles of their feet. All three individuals were able to reduce their maladaptive behaviors to near-zero levels and maintain their community placement that they had been at risk for losing, due to their maladaptive behavior. Subjective measures of various psychological symptoms showed a reduction in two of the individuals. Our study suggests that the demonstrated effectiveness of Meditation on the Soles of the Feet can be achieved by a community-based therapist.     

Fantasy,defense, and the representational world

This paper discusses the manipulation of mental representations, particularly in relation to the psychoanalytic concepts of conscious or unconscious fantasy. A distinction is made between the unconscious phenomenal (experiential) aspect of representations and the nonexperiential, quasi-structural aspect. The concept of the representational world is described and elaborated, and its development is seen as a consequence of the infant's interaction with itself and the external world. Processes such as identification and projection can be seen in terms of changes in self and object representations, and the same is true for all the mechanisms of defense. The content of unconscious wishes is transformed, by use of such mechanisms, into representations that are acceptable to consciousness. Major transformations of unconscious representational content occur in the process of creating unconscious (preconscious) fantasy, and further transformations are frequently needed before such (preconscious) fantasies are permitted access to consciousness. The concept of projective identification is considered in the light of the ideas put forward in the paper.     

Fantasy and mourning: heterogeneity, alterity, and discontinuity in the pastoral encounter

In exploring why the topic of fantasy has been absent from current pastoral care articles, the author draws from the work of Peter Homans and Eric Santner to inscribe the social dimensions of fantasy in the pastoral encounter, arguing that fantasy closes us off from radical change, difference, strangeness, and loss (discontinuity, heterogeneity, alterity, and mourning) while, paradoxically, opening us up to these excesses of life. Understanding the unconscious interpsychic role of fantasy makes these ever-widening dilemmas more psychologically transparent and even theologically transformational. Without this perspective, what often remains is a disappointing, unreflective, rationalized fiction of a stranger.     

ICU的核心内容及临床思维要点

危重症患者存在急性的、全身性的、动态发展的病理生理改变（临床综合征）。ICU主要任务是：准确地识别和有效地调整患者的这种病理生理学状态／过程,促使其稳定。对危重病患者病情分析判断的原则是：在综合分析的基础上,要动态观察各种指标的变化,包括对治疗的反应性;在整体晓念的指导下、要注意个体化的特殊性。诊疗原则是：抓住最主要的...     

ICU的核心内容及临床思维要点

危重症患者存在急性的、全身性的、动态发展的病理生理改变(临床综合征).ICU主要任务是:准确地识别和有效地调整患者的这种病理生理学状态/过程,促使其稳定.对危重病患者病情分析判断的原则是:在综合分析的基础上,要动态观察各种指标的变化,包括对治疗的反应性;在整体观念的指导下、要注意个体化的特殊性.诊疗原则是:抓住最主要的病理生理学状态、找到该患者的平衡点,保持相对的稳定状态;同时积极治疗原发病.     

Pointing Unknowingly: Fantasy, Nonsense and 'Religious Understanding'

Lewis, Charles M. (ed.), Relativity and Religion
Tessin, Timothy and von der Ruhr, Mario (eds), Philosophy and the Grammar of Religious Belief     

Translating cognition into action: the role of visual guidance in observational learning

This experiment examined the role of two forms of visual guidance in facilitating the translation of cognitive representations into action. Subjects matched a modeled action pattern either concurrently with the model or after the modeled display. They then either did or did not visually monitor their actions during tests of production accuracy in the model's absence. Acquisition of the cognitive representation was assessed periodically. Concurrent matching of modeled actions or visual monitoring of productions both increased the level of observational learning. The more accurate the cognitive representation, the more skilled were subsequent reproductions of the modeled actions. After acquiring proficiency in converting cognition to action, subjects maintained their level of performance accuracy even though modeled and visual-monitoring guidance were withdrawn. These results are in accordance with the theory that cognitive representation mediates response production and that corrective adjustments through visual guidance aid in the translation of conception into action.