Models of Psychotherapy: Implications for Pastoral Care Practice

Pastoral care givers are called to provide care and counseling to parishioners that are suffering in many ways. A core question is what does a pastor rely on to provide this care? Pastors usually call on models of psychotherapy to inform their care giving. A framework of theological anthropology, cosmology, soteriology and harmatiology is developed for analyzing the worldviews inherent in models of psychotherapy. The specific models of Adler’s Individual Psychology, Narrative therapy, Horney’s personality theory, and Intersubjective theory are used to demonstrate the application of this framework. Several pastoral care implications are developed following the application of the framework.     

论老年人长期照护机构安全保障义务

老年人长期照护机构安全保障义务纠纷存在法律适用偏差,部分案件以公平责任原则替代过错责任原则、合理限度不清晰、第三人侵权下机构承担责任方式和是否享有追偿权有不同认识。安全保障义务属于法定的危险防免义务。合理限度取决于对危险源的控制能力、因危险源收益大小、避免损失的成本、经营专业性、受害人特殊信赖关系及对危险规避能力等。长期照护安全保障事故诱发因素多、因果关系复杂、当事人举证能力弱、过度关怀的长期照护预期与服务有效供给不足的矛盾突出。长期照护机构应“以人为本”,提高设施环境安全性、服务队伍专业性、安全保障措施有效性。

     

Priority setting in health care: on the relation between reasonable choices on the micro-level and the macro-level

There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order to ensure that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines’ recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients’ claims on health care resources. Moreover, I suggest the basic structure of such a framework.     

Good News for the Logical Autonomy of Ethics

Toomas Karmo claims that his taxonomy of ethical sentences has the result that there does not exist a sound argument with all non-ethical premises and an ethical conclusion. In a recent paper, Mark T. Nelson argues against this claim. Nelson presents a sound argument that he takes to be such that (i) Karmo’s taxonomy classifies that argument’s single premise as non-ethical and (ii) Karmo’s taxonomy classifies that argument’s conclusion as ethical. I attempt to show that Nelson is mistaken about (ii). For any possible world at which the premise of Nelson’s argument is true, Karmo’s taxonomy classifies the conclusion of Nelson’s argument as non-ethical.

Cuban health psychology: A priority is the primary health care system

Cuban health psychology has experienced a great expansion during the last 25 years, both in the number of psychologists and in range of activities in the field. Today, psychologists are integrated at all levels of the national health system, an achievement which is particularly interesting in that Cuba is a developing country. In a position isolated from trends in international psychology, Cuba has developed a role for psychologists within the field of health which is adapted to its situation as a poor and socialistic country. Priority is given to preventive and community-based psychology within primary health care facilities. Psychologists in primary health care serve a composite client-group, with high priority given to pregnant women and to children. The work of these psychologists covers a wide range of health problems—-physical as well as mental—and focuses upon individuals as bio-psycho-social units. Their responsibilities include health promotion, disease prevention, consultation and treatment, rehabilitation, research and education. This report is based on a 2½ month long field study in Cuba, where Cuban health psychology, particularly as it relates to primary health care, was explored.     

The Intensive Mental Health Program: Development and Structure of the Model of Intervention for Children with Serious Emotional Disturbances

In order to meet the challenging needs and behaviors of children with Serious Emotional Disorders (SED), a school and community based Intensive Mental Health Program (IMHP) was developed and evaluated. We describe the conceptual framework, treatment principles, and model for service delivery for psychological and educational interventions under the umbrella of the IMHP. The program illustrates a model of comprehensive services for children with SED.     

Embedding prevention services within systems of care: Strengthening the nexus for children

System-of-care models that offer a continuum of integrated mental health services for children are being widely implemented in local communities. Preventive services, arising from the theoretically grounded prevention sciences, are an important but neglected component of this model. Studies of the use of mental health services by children are reviewed, and an integrative model is proposed to incorporate prevention services as a component of the child mental health service system. Construction of the prevention sciences has followed a linear phase model that has advantages and disadvantages for bridging prevention sciences and services research. As prevention science progresses into broader field tests of its effectiveness, studies of child services can be informative, especially in advancing the applicability and dissemination of research findings. Future directions are outlined to strengthen the nexus between services research and prevention science, and to construct a new genre of prevention services research.     

A role for clinical psychology in health care and policy concerning the physical environment

Some persons adversely react to specific environments, while others are impervious or actually thrive. Medical attention often overlooks such sensitivities to the physical environment. Such sensitivities, including phobias and seasonal affectivity, fall within clinical psychology's purview. A theoretical/clinical approach called the Synchronous Systems Model, which defines and uses individual differences in people and in settings, could serve medical health care and policy. When specific people are matched appropriately with specific treatments within the most propitious settings, cost effectiveness and medical efficacy rise. Such documented accountability could make clinical psychologists central to triage of medical services as well as health care policy in these days of the shrinking health care dollar. The Synchronous Systems Model provides theory, supportive data, and clinical assessment devices to strengthen clinical psychology's role in medical settings.     

孝意识的时间分析

The reason for the emergence of consciousness of filial piety is that parental care could activate reciprocal filial piety. Parental care and filial piety are two supplementary phenomena caused by the same time consciousness. Phenomenology neglects consciousness of filial piety because it lacks the thinking that sees the fundamental “meaning of time” in the intersection of “past” and “future”. The consciousness of filial piety can only be really constituted by a human being’s personal experience. “Frustrations in personal life” and “breeding of children for oneself” are two occasions for an adult to fight against the separating effect of individualized consciousness and regain awareness of filial piety. Translated by Huang Deyuan from Beijing Daxue Xuebao 北京大学学报 (Journal of Peking University), 2006, (1): 14–24     

New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.     

Counselling in primary care: A study of the psychological impact and cost benefits for four chronic conditions

Primary care counselling services have expanded rapidly over the last twenty years. Their principal focus has been to manage the demands placed on general practitioners by high service users, such as frequent attenders and patients with mental health problems. To date, very little research has been conducted to ascertain the impact of counselling for other patient groups in terms either of psychological outcomes or of cost-benefits. This study looked at the effect of short-term counselling on both the uptake of health services and the psychological states of four patient groups – frequent attenders and patients with diabetes, hypertension and asthma. All patients on the chronic disease register for these conditions and all patients who had made at least eight GP appointments over the previous twelve months were invited to take part in the study. The participants received eight 90-minute small-group counselling sessions, conducted by trained counsellors. The counselling followed a cognitive behavioural therapy (CBT) approach, with an emphasis on developing personal responsibility. Psychological outcomes were assessed using three proprietary measures (SF 36, HADS and CORE) immediately following counselling and at six months post-intervention. Health service uptake was assessed for each group over the twelve months post-intervention, using number of GP consultations, home visits, hospital referrals and test/investigations requested as outcome indicators. These data were compared with those for comparable control groups for each condition. The results suggested that, overall, all patient groups showed a significant improvement in psychological well-being, and that these gains were maintained for the six-month study period. The intervention groups also significantly reduced their uptake of primary and secondary care services, by comparison with their comparable control groups. The results suggest that the psychological and fiscal benefits of counselling provision within a primary care setting can extend to other patient categories.     

It is not all about the Benjamins: Understanding preferences for mates with resources

We contend that preferences for mates with resources or money might be calibrated on where a potential mate gets her/his money. In three studies (N = 668) we examined the nature of individuals’ preferences for mates who have resources or money. Both sexes preferred a long-term mate who has earned her/his money over other sources. In particular, women preferred mates who earned their money over other potential means of getting resources (i.e., inheritance, embezzlement, and windfall). Women maintained a high level of interest in mates who earned their money regardless of duration of the mateship whereas men became less interested in a mate who earned her money in the context of short-term relationships. Overall, the sexes preferred a mate who earned their money more strongly in the long-term than the short-term context. Results are discussed from evolutionary and sociocultural models of mate preferences.     

Provider quality and barriers to care for transgender people: An analysis of data from the Wisconsin transgender community health assessment

Background: Transgender people in the United States often lack access to high-quality health care.

Methods: A group of researchers and transgender people came together in a community-based participatory research process to survey transgender Wisconsinites about their health care experiences. A multiple regression analysis of survey data was used to evaluate the association between barriers to health care, gender identity, and quality of medical and mental health care provider.

Results: Seventy-seven respondents were included in this analysis. Transmasculine respondents were more likely than transfeminine respondents to report barriers to high-quality health care, but having a high-quality medical or mental health care provider was associated with reporting fewer barriers to care across the entire sample.

Discussion: This community-based study suggests that health care providers play a key role in facilitating access to care for transgender Wisconsinites in the USA.     

Because difficulty is not the same for everyone: the impact of complexity in working memory is associated with cannabinoid 1 receptor genetic variation in young adults

Individual differences in working memory ability are mainly revealed when a demanding challenge is imposed. Here, we have associated cannabinoid 1 (CB1) receptor genetic variation rs2180619 (AA, AG, GG), which is located in a potential CNR1 regulatory sequence, with performance in working memory. Two-hundred and nine Mexican-mestizo healthy young participants (89 women, 120 men, mean age: 23.26 years, SD?=?2.85) were challenged to solve a medium (2-back) vs. a high (3-back) difficulty N-back tasks. All subjects responded as expected, performance was better with the medium than the high demand task version, but no differences were found among genotypes while performing each working memory (WM) task. However, the cost of the level of complexity in N-back paradigm was double for GG subjects than for AA subjects. It is noteworthy that an additive-dosage allele relation was found for G allele in terms of cost of level of complexity. These genetic variation results support that the endocannabinoid system, evaluated by rs2180619 polymorphism, is involved in WM ability in humans.