The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence—favorably evaluated in the West—for Chinese HIV-positive patients. The adaptation process was theory-driven and covered several key issues of cultural adaptation. We considered the importance of interpersonal relationships and family in China and cultural notions of health. Using an evidence-based treatment protocol originally designed for Western HIV-positive patients, we developed an 11-step Chinese Life-Steps program with an additional culture-specific intervention option. We describe in detail how the cultural elements were incorporated into the intervention and put into practice at each stage. Clinical considerations are also outlined and followed by two case examples that are provided to illustrate our application of the intervention. Finally, we discuss practical and research issues and limitations emerging from our field experiments in a HIV clinic in Beijing. The intervention was tailored to address both universal and culturally specific barriers to adherence and is readily applicable to generalized clinical settings. This evidence-based intervention provides a case example of the process of adapting behavioral interventions to culturally diverse communities with limited resources.     

Attachment in Adult Child-Older Parent Relationships: Research,Theory, and Practice

Greater longevity has increased the years that adult children share with their older parents, yet it creates the potential for family stress situations that may be amenable to counseling intervention. In this article, the authors examined an attachment theory perspective for conceptualizing adult child—older parent issues by introducing the basic constructs of attachment theory and by demonstrating how the theory and its related research can be applied to adult children's struggles with older parental issues.     

Silence and Memories of War: An Autoethnographic Exploration of Family Secrecy

A personal journey and a scientific challenge, this is an autoethnographic study about my own family's secrecy. I knew my grandfather had been a German prisoner of war during World War II. We all knew. But nobody talked about it. Then one day I decided I wanted to do systematic research on the issue of family secrecy around my grandfather's war experiences. Researching one's own family can be called autoethnography. It could be said that autoethnography is an approach to research that aims to describe and systemically analyze (graphy) personal experience (auto) to understand social and cultural phenomena (ethno). This scientific approach is quite new in the field of family therapy. This study has been an important personal quest, but it also led to important reflections on silences in families, on my own professional development, and on methodological issues concerning autoethnographical research. For one thing, it highlights some of the positive aspects of family secrecy and silences, and invites us—when confronted with family secrecy in clinical practice—to carefully consider the potential destructive and life‐giving aspects of the silence.     

Location,Location, Location: Applying Spatial Statistics to the Relationship Landscape

The desire to understand relationships is a passion shared by professionals in research, clinical, and educational settings. Questionnaires are frequently used in each of these settings for a multitude of purposes—such as screening, assessment, program evaluation, or establishing therapeutic effectiveness. However, clinical issues arise when a couple's answers on questionnaires do not match clinical judgment or lack clinical utility, while statistical problems arise when data from both partners are put into analyses. This article introduces the use of geospatial statistics to analyze couple data plotted on a two‐dimensional “relational map.” Relationship maps can increase assessment sensitivity, track treatment progress, and remove statistical issues typically associated with couple data. This article briefly introduces core assumptions of spatial models, illustrates the use of spatial models in creating a relational landscape of divorce, offers suggestions for the use of relational maps in a clinical setting, and explores future research ideas.     

Ethical Challenges in a Complex World: Highlights of the 2005 ACA Code of Ethics

Being an effective counselor includes having knowledge of and the ability to integrate a code of ethics into one's professional practice. This article addresses some of the highlights of the changes in the 2005 ACA [American Counseling Association] Code of Ethics such as end‐of‐life issues, boundaries and relationships, and multicultural and diversity considerations. It is critical for counselors to demonstrate cultural sensitivity during the ethical decision‐making process throughout their counseling, supervision, teaching, and research practice.     

Application of Child Protective Services in Korea

Abstract

Because childrearing is a very culturally oriented practice, cultural sensitivity in Child Protective Services (CPS) is a very important factor for effective services. Korea has recently begun social intervention in cases of child abuse, but faces many difficulties resulting from cultural dilemmas. In particular, Korean society has the value of corporal punishment and negative attitudes toward social intervention into family issues. These cultural characteristics result in strong resistance to intervention by CPS. In the future, the success of child abuse intervention in Korean society will depend on how these cultural dilemmas are resolved. The development of a CPS model based on Korean culture can be an alternative to reduce conflicts in the application of CPS.     

Imaging or Imagining? A Neuroethics Challenge Informed by Genetics

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point—even a backbone—for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.     

The Democratization of Art: A Contextual Approach

ABSTRACT

Publicly funded museums and art galleries have been called upon to demonstrate their worth as nodes of social inclusion and facilitators of social change. Flagship galleries have been constructed to foster urban regeneration in part aimed at social inclusivity and transformation. A new museology has emerged that is perceived to be intrinsically more democratic for visitors. This focus on the democratization of art in academia and cultural policy is not matched by a focus on robust empirical research. There are few studies that demonstrate successful democratization and little work that considers methodological issues. This article responds to critiques leveled at three conceptions of the democratization of art to develop a fourth conception—the contextual approach. I argue that collecting visitor sociodemographic data is meaningful only in the context of an institution's social construction and the role of art in the everyday lives of visitors and nonvisitors. Understanding that a good life is possible without engagement with high culture must be part of a democratization agenda.     

Cultural Training Based on a Theory of Relational Ideology

This article describes the development of a theory-based cross-cultural training intervention, named relational ideology training, and reports a field experiment testing its effectiveness in facilitating intercultural collaborations. The intervention was based on our Protestant relational ideology (PRI) theory and cross-cultural research derived from this theory. An experiment compared the effectiveness of this novel intervention with the well established cultural assimilator training. Results show that compared to cultural assimilator training, relational ideology training is more effective in improving managers' task performance and affective adjustment in cross-cultural ventures. Important practical and theoretical benefits can be gained from integrating theoretical advances in cultural psychology into cross-cultural training. We discuss the implications of RI training as an empirically validated intervention for Americans living locally yet working globally.     

“It takes a village to heal a child”: Necessary spectrum of expertise and benevolence by therapists,Non-Governmental Organizations,and the United Nations in managing war-zone stress in children traumatized by political violence

This article highlights the post-traumatic stress responses in some war-zone children who were exposed to political violence—witnessing unspeakable horror, maimings, brutal beatings, torture, and murders. Children inducted into rebel military units to serve as child-soldiers further traumatized self and others by raping and killing children and adults. Additionally, some children go without food, shelter, and adult protection, while finding themselves as refugees in a foreign country. This article advances some conceptual, technical, and practical issues in intervention with these children and provides a model of intervention that seeks to integrate established international policies of the United Nations (UN) and Non-Governmental Organizations (NGOs) along with cognitive, behavioral, and psychodynamic clinical approaches in the context of cultural/racial sensitivity and indigenous folk medicine. The child's adaptational strengths are discussed, and the recognition and management of transference and countertransference are not ignored in the treatment of traumatized children. Basically, the author's point of view is that Western models of interventions are very useful, but that the personal, cultural, social, spiritual, and economic resources of the child's homeland or village probably constitute the best system for healing and integration after brief or continuous exposure to political violence.     

Which preventive interventions effectively enhance depressed mothers' sensitivity? A meta‐analysis

Improving depressed mothers' sensitivity is assumed to be a key element in preventing adverse outcomes for children of such mothers. This meta‐analysis examines the short‐term effectiveness of preventive interventions in terms of enhancing depressed mothers' sensitivity toward their child and investigates what type of intervention is most effective. Thirteen interventions, reported in 10 controlled outcome studies, met the inclusion criteria (N = 918). Meta‐analytic results showed a small to medium, significant mean effect size (g = 0.32) with large variation in individual effect sizes (?0.56–1.76). Interventions including baby massage were highly effective in improving maternal sensitivity (g = 0.85). In contrast, individual therapy for the mother proved ineffective in terms of improving maternal sensitivity (g = ?0.00). Two other significant predictors of greater effect sizes were the inclusion of a support group and the use of a higher number of intervention methods; however, the significance of these results was largely accounted for by one single study. Our meta‐analysis confirms that depressed mothers' sensitivity can be improved by preventive intervention and suggests that baby massage may be an effective intervention method to evoke short‐term changes in maternal sensitivity. It is unclear whether these changes are maintained over time.     

The soul of psychoanalysis in the modern world reflections on the work of Christopher Bollas

The paper begins with the claim that psychoanalysis faces a dilemma in locating itself in a contemporary world that devalues experiences of interiority, depth, and embeddedness in personal history. Psychoanalysis's coming to terms with this modern world—reflected in contemporary relational paradigms and emphases on interaction, authority, and epistemology—is essential yet tends to replace an outdated conformity with an updated one, in which what is offered to analysands may become limited and the soul of psychoanalysis lost.

Bollas's work attempts to reinspire psychoanalysis. This paper explores his contributions and the tensions within them and develops several points about how psychoanalysis can maintain a worthwhile self—for itself and for its analysands—in the modern world. Among the issues discussed are the sense in which an endogenous motivational core associated with an emphasis on interiority may be compatible with a relational paradigm and how the notion of personal idiom is a rich and fruitful one, but that the cultural field deserves a more fundamental place than it is given by Bollas. The problem of authority and exploitation, within and outside the consulting room, is also taken up, and it is argued that psychoanalysis should be conceived as a moral discourse in which the analyst's self‐subverting (but not diminished) authority is essential.     

‘But everyone else is doing it’: a closer look at the occupational taxpaying culture of one business sector

When individuals embark on their careers they not only become acculturated into their occupational sectors' day‐to‐day norms and practices, but also their taxpaying ones. Although the research on taxpaying cultures is still in its infancy, understanding more about taxpaying cultures could improve our understanding of the processes underlying tax compliance. To this end, this study aimed to build a detailed picture of the taxpaying culture (i.e. the norms and values) of one business sector—the hairdressing/beauty industry. Nineteen small business and self‐employed hairdressers/beauticians were interviewed and a variant of Grounded theory was used to uncover the main themes that ran through the interviews as a whole. The main themes that emerged—which appear to characterize this sector's culture—include a reliance on accountants/tax advisors, the notion of an acceptable level of cash‐in‐hand payments, and the use of different mental accounts for different types of income. Although some of these themes have already arisen in the small business literature they have often been couched in individualistic terms. We build a case that these issues are more cultural than individual—they are tied to occupational group membership as they are socially constructed within occupational groups and are a key component of the group's taxpaying culture. Implications and directions for future research are discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

The Educational Psychology of Self-Regulation: A Conceptual and Critical Analysis

The multiplicity of definitions and conceptions of self-regulation that typifies contemporary research on self-regulation in psychology and educational psychology is examined. This examination is followed by critical analyses of theory and research in educational psychology that reveal not only conceptual confusions, but misunderstandings of conceptual versus empirical issues, individualistic biases to the detriment of an adequate consideration of social and cultural contexts, and a tendency to reify psychological states and processes as ontologically foundational to self-regulation. The essay concludes with a consideration of educational research and intervention in the area of students’ self-regulated learning in terms of the scientific and professional interests of psychologists and educators, and the disguised manipulation of student self-surveillance in the service of the institutional mandates of schools.     

PHILOSOPHICAL QUESTIONS AND BIOLOGICAL FINDINGS,PART I: HUMAN COOPERATIVITY,COMPETITION, AND AGGRESSION

This Part II of a two-part article illustrates how research in evolutionary biology, anthropology, archeology, and psychology illuminates questions arising in philosophy—specifically questions about René Girard's theory of aggression. Part I looked at: (i) how old the systemic practice of severe aggression is; (ii) how much of it results from humanity's mimetic/social and competitive nature and how much from ecological, resource, and cultural conditions; and (iii) if ecological, resource, and cultural conditions are important, might we adapt this information toward greater cooperativity today? Part II investigates Girard's theory of ritual sacrifice—especially human sacrifice—as a societal steam valve for the systemic aggression explored in Part I. It draws on theories of play, theater, and art to examine the role and function of such ritual sacrifice.     

Ethical and social dilemmas in community-based controlled trials in situations of poverty: a view from a South African project

All psychological and social research presents ethical dilemmas, many of which centre around the difficulties which flow from the power imbalances between those conducting the research and the research respondents or participants. Issues of power are magnified in research undertaken in contexts of poverty, and there is a burgeoning literature on ethical issues in research in developing countries. In this article, we augment the existing literature by focusing on the experiences of an assessor working in a controlled trial of a mother-infant intervention in a poor South African community. We consider issues of community expectations, the presentation to our project of physical health problems, the issue of HIV/AIDS, cultural beliefs which impact on the research, child protection issues, and the tensions between research assessment and ubuntu--a cultural norm which requires helpful engagement with others. We suggest that our experiences may assist with the development of further research.     

Filial Therapy and Hispanic Values: Common Ground for Culturally Sensitive Helping

Hispanics are the largest and fastest growing minority group in the United States, and numerous and varied interested constituencies stress that preventive intervention with Hispanic families is imperative. Filial therapy as an intervention and prevention counseling approach shows promise as an effective way to help these families. This article explores some of the constructs of filial therapy, specifically regarding ways they interface with important social and cultural values of Hispanic families.     

The Qualitative Revolution and Psychology: Science,Politics, and Ethics

Growing interest in qualitative research methods and methodological pluralism in psychology since the 1990s is placed in the historical contexts of long-standing philosophical and scientific rationales and the more recent “qualitative revolution” in other social sciences that began in the 1970s. An examination of areas in which qualitative methods have become most strongly established—applied, feminist, and multicultural psychologies—suggests practical and social motivations as primary and as energizing renewed expression of previously ignored ontological, epistemological, and scientific reasoning in the turn to qualitative methods. Methodological diversification in the arenas of human suffering, women's issues, and cultural politics is traced to psychologists' deeply rooted ethical obligations. The existential philosophy of Emmanuel Levinas articulates an implicit ethics at the heart psychology's increasing acceptance of qualitative methods and provides an understanding of how the emerging methodological diversity can contribute to social justice and human liberation as well as to an enhancement of rigorous scientific knowledge.