Crisis counseling: A right and a necessity for members of the underclass

Crisis counseling, short-term, directive psychotherapeutic intervention, is an appropriate form of therapy for the low socioeconomics status (SES) individuals. Poverty, racism, and cultural alienation contribute to making crises a prominent feature of life among poor people. Members of the underclass frequently do not have the time or cultural affinity for many forms of long-term therapy. Oriented toward the solution of practical problems and toward quickly re-establishing emotional equilibrium, crisis counseling does not require the client's long-standing commitment to personal growth. Because it is relatively free of the social biases of most treatment modalities, crisis counseling is a way of introducing many low SES individuals to psychotherapy. For many underclass individuals, crisis counseling can lead them in the direction of overcoming other situations that keep them at a disadvantage.     

Obligations In Medical Crises: Treatment and Protocols

This article adduces several lines of argument to try to analyze the need for certain sorts of interventions in medical crises. The recent Ebola crisis is taken as exemplary, and other similarly serious medical situations requiring intervention, such as the endemic presence of Valley fever in parts of California, are alluded to. The overall contention is that our duties in medical crises may be somewhat stronger than previously constructed by analysts. The work of Kuhse and Singer is cited, and the article concludes that there are special moral obligations to respond to international medical emergencies when they arise.     

Ethics and public health emergencies: encouraging responsibility

The three primary ethical challenges in preparing for public health emergencies - addressing questions of rationing, restrictions and responsibilities - all entail confronting uncertainty. But the third, considering whether people and institutions will live up to their responsibilities in a crisis, is perhaps the hardest to predict and therefore plan for. The quintessential example of a responsibility during a public health emergency is that of health care professionals' obligation to continue caring for patients during epidemics. Historically, this 'duty to treat' has sometimes gone unrecognized or ignored, but it has also famously been adhered to, including during the recent SARS epidemic. And non-crisis examples of health professionals working in the face of personal risk are very common. The duty to treat should be circumscribed by several considerations, including the levels or risk and benefit at issue, the degree of public reliance on health professional action, and the nature of the individual health professional's acceptance of greater than usual risk. Examining the professional duty to treat and the legitimate questions it raises can provide insight into other actors' responsibilities. Public health ethics as well as professional ethics can help frame answers to some key questions: How strong are ethical responsibilities during crises? To whom do they apply? Should they be more explicit - and hence more circumscribed - or less explicit and hence largely aspirational? And how can public health policies encourage responsible actions?     

Borderline Personality Disorder,Divorce and Family Therapy: The Need for Family Crisis Intervention Strategies

Recent literature reviews, point out the lack of crisis intervention and crisis prevention programs that are in existence to address crises experienced by first-degree and divorced family members of Borderline Personality Disorder (BPD) probands. The focus of such intervention programs should be to facilitate the improved ability of the first-degree and divorced family members to manage and transcend the unstable family environment. Correlations between personal instability and frequency of psychosocial crises have been examined, as well as the ripple effect of frequent individual crises on family environments. Reviews of current therapeutic interventions, as well as a synthesis of practical family therapy interventions focusing on breaking the cycle of dysfunctional multi-generational family environments are also examined.     

Some Diagnostic Observations of Post-September 11, 2001 Crisis Groups

Crisis groups following the September 11 attack in New York were an opportunity to learn about people in crisis. The many groups that were formed to assist individuals' return to work, school, and home offered opportunities to observe how people managed their personal crises. While diagnoses such as Post-traumatic Stress Disorder were used, they offer no help in understanding group dynamics and individual behavior in groups. In this paper a psychoanalytic group orientation is offered to help learn about the impact of such terrible crises on individuals and the use of psychoanalytically oriented groups to aid in their path to recovery.     

Spiritual and Ethical Orality in Children: Educating an oral self

Infants and children learn through organizing their experience into generalizable forms. One aim for teaching is to help children learn to organize personal, social, ethical and spiritual experience so they can pick out common human themes among people as well as identify particular authentic differences between people. The dominant modern educational strategies for organizing experience have been based on literacy. This essay suggests that literacy needs to reconnect with orality and oral learning strategies in order to accommodate shifts in the constitution of personal and public identity that children face due to technological and social change. Under the current technological and social conditions, the citizens we educate for the future need to be both oral and literate as they construct a sustainable identity, so as to ground their personal freedom and public commitments on a willingness and ability to be 'near and different'.     

Social Media in Disaster Risk Reduction and Crisis Management

This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.     

Commentary on Becoming a Daughter: Trauma is a Powerful Teacher

Personal life crises profoundly impact genetic counselor practice. In this commentary, themes from Matloff’s (in press) article, Becoming a Daughter are highlighted and expanded upon. These themes include: personal impact of a life crisis, and professional impact vis a vis empathy countertransference, self-disclosure, nondirectiveness, and self-confidence. Strategies that help genetic counselors manage personal life crises within their clinical practice and also promote their professional development are emphasized, including normalization of life crises, self-reflection, boundary-setting, and use of peer supervision and consultation.     

The role of developmental features,environmental crises,and personal resources (self-control and social support) in adolescents' aggressive behavior

Aggression among adolescents is a social problem that has sharply escalated in recent years, instigating research into related factors. This article outlines the characteristics of adolescents' aggressive behavior in line with Buss and Perry's (1992) theory linking it to the tendency to develop hostile thoughts and angry emotions. Aggressive behavior may be described as a possible outcome of normal development on the one hand, and as a result of exposure to crisis and trauma on the other. Thus, developmental characteristics highlight the role of age and sex in adolescents' aggressive behavior. In addition, possible external crises and distress (e.g., war, divorce) may contribute to adolescents' aggression. This article also identifies two possible resources that may contribute to a reduction in aggressive behavior under normal and crisis conditions: social support as an environmental resource, and self-control as a personal resource. We conclude with suggestions for reducing aggression through a unified intervention setting that integrates developmental features, environmental and family components, as well as personal components.     

Spontaneous Self‐Practice of Cognitive Behavioural Therapy (CBT) by Aboriginal Counsellors During and Following CBT Training: A Retrospective Analysis of Facilitating Conditions and Impact

Previous cognitive behavioural therapy (CBT) training studies have suggested that therapists who practice CBT strategies on themselves during training may experience professional and personal benefits. However, it has also been reported that some CBT trainees are reluctant to engage in self‐practice. The present study reports an incidental finding from a CBT training study with Aboriginal counsellors: all five counsellors reported that they practiced CBT techniques on themselves without specific encouragement by the trainers to do so. This paper therefore posed three questions: (a) Why—in contrast to some other trainees—did this group choose to apply CBT to themselves? (b) How did they apply it—with what purpose, in what contexts, and which skills? (c) What was the impact of CBT self‐practice? Data from the group's reflections were qualitatively analysed by two of the researchers, and “member checked” by the remainder. Results indicated that the counsellors were motivated to practice CBT on themselves for two principal reasons: the value they placed on CBT, and their personal need resulting from the high number of crises experienced while living and working in their communities. The counsellors reported practicing CBT in a wide variety of contexts as part of their learning. As in previous studies, the impact of CBT self‐practice was that it increased their confidence and competence as therapists. It also appeared to be a valuable burnout prevention strategy. If the results are generalisable, they suggest that self‐experiential training in CBT may be a culturally responsive and adaptive way for Aboriginal counsellors to enhance their learning of CBT skills.     

A Genetic Counselor’s Journey from Provider to Patient: A Mother’s Story

As genetic counselors, we frequently offer support and information while shielding ourselves emotionally from the heartbreaking situations faced by our patients. To experience such circumstances firsthand changes our perspective on the world, ourselves, our relationships, and, inevitably, our role as genetic counselors. No one asks to be in the position of having to make a decision about one’s pregnancy, but such experiences may help us, as a profession, reflect on and improve our counseling. It is my hope that this personal account will provide other counselors with a real-life example they may draw upon when supporting patients in crisis. Here is my story.     

Person and consciousness.

My interlocuter is Locke with his reduction of person to personal consciousness. This reduction is a main reason preventing people from acknowledging the personhood of the earliest human embryo, which lacks all personal consciousness. I show that Catholic Christians who live the sacramental life of the Church have reason to think that they are, as persons, vastly more than what they experience themselves to be, for they believe that the sacraments work effects in them as persons that can only be believed but that cannot be experienced within themselves in this life. I also show that Christians and non-Christians alike have an experience of moral good and evil in themselves that implies that they are, as moral persons, far more than they find in their conscious self-presence. It is, therefore, natural to think that if my being a person so far exceeds my consciousness, I may well have once existed as person even before the awakening of consciousness.     

Family crisis intervention in social services

This article advocates the use of family therapy in crisis intervention. It relies upon the literature on crisis intervention, on family therapy literature, and on ten years experience of working in a social services area office, in which social workers are often required to respond alone to many different kinds of crises. Two typical referrals demanding crisis intervention and the responses to them are described.     

To change our thinking: Philosophical practice for difficult times

If a time of crisis calls for a new mode of thinking, philosophical practice offers the means to answer that call. Contemporary philosophical practice revitalises the ancient Greek understanding of philosophy as a way of life that cultivates personal transformation and new ways of seeing the world. This article describes the development of the author’s philosophical counselling practice as a practice of emancipation, in concert with the writings of Emmanuel Levinas and Jacques Rancière. It considers the significance of personal engagement and companionship for the cultivation of practical wisdom, and suggests that the intransigence of our global social and economic crises ultimately indicates an incorrect view of human nature and an ossified or unbalanced relationship between practical and theoretical ways of knowing and wisdom.     

Ethical Considerations in Crisis and Humanitarian Interventions

The need for professionals to volunteer their time in crisis situations and to reach across time and culture in the service of humanitarian interventions will likely not abate in the near future. This article provides readers with multiple venues for considering the ethical dimensions present in crisis and humanitarian interventions. Core ethical concerns common to helping situations are magnified in crisis work. In addition, issues unique to the nature of volunteer and crisis work must also be considered. Using hypothetical case examples, bioethical principles, and ethical decision-making models, helping professionals are encouraged to go beyond their particular ethical codes in contemplating ethically and clinically sensitive volunteering.     

“Not Being Counted”: Women's Place and Religious Space in Jewish Orthodox Communities During the COVID-19 Crisis

This article draws on the anthropology of crisis to analyze ways in which communal-religious responses to crisis situations can reveal engrained social and cultural structures, and especially their gendered aspects. We focus on two alternative forms of Jewish communal prayer service that emerged in Orthodox communities in Israel during the first year of the COVID-19 pandemic: street and balcony minyans. Based on interviews and texts, we explore Orthodox women's experiences of these new religious spaces that entailed the rearrangement of traditional gender and spatial boundaries. We show that while these spaces opened room for new religious experiences for women, they ultimately accentuated their experiences of exclusion. We argue that the destabilization of the physical religious space in these alternative communal prayers reinforced symbolic gender boundaries. Thus, our study not only demonstrates how crises can uncover the deep social grammar of a community, but also how they unearth processes that defy and challenge that grammar.     

Is Personal Identity Evaluative?

Abstract

Martha Nussbaum subscribes to the view that our identity is an evaluative question determined by our common, deeply held beliefs about what is worthwhile in human life. In so doing, she asserts that for an account of ethics to have “philosophical power” it needs to be grounded in an account of human nature that is both evaluative and internal.

I focus on Nussbaum’s claim that personal identity has to include the necessary features of practical rationality and sociability. Although Nussbaum puts forward self-validating arguments to prove that we cannot - on pain of pragmatic inconsistency - dispute that practical rationality and sociability are necessary features of human life, it is my claim that her account is flawed. The nature of the relationship between ethics and human nature is the broader context to such debates. This paper raises questions regarding on the one hand, whether it is possible to found ethics in human nature and, on the other, what we are to make of accounts that turn on the assumption that identity is ethical, not metaphysical.     

Medical crisis counseling: A new service delivery model

The diagnosis or exacerbation of a chronic illness, the aftermath of a serious accident, or worries about future in the context of illness or debilitating injury are all examples of medical crises that pose significant coping challenges. Too often, traditional approaches to psychotherapy have been unable to respond the most urgent needs of people confronting such crises. Medical crisis counseling is a specialized approach to addressing the needs of individuals and families confronted by the difficulties of coping with losses or changes, as well as the challenge of living with long-term illness. This paper describes the medical crisis counseling model in contrast with other more traditional intervention approaches.     

Two kinds of identity crisis

In order to outline a model of identity crisis, it is necessary to distinguish two types. In an identity deficit ("motivation crisis"), the individual experiences a lack of guiding commitments but struggles to establish personal goals and values. In an identity conflict ("legitimation crisis"), the person has several commitments which prescribe conflicting behavioral imperatives in some situations, such that at least one commitment may have to be betrayed. The literature on identity crisis is reviewed in connection with this distinction, and an attempt is made to delineate the causes, the subjective experiences, behavioral consequences, and modes of resolution of each type of crisis.