Ending With Options

No matter what has come before, if the ending of the analytic relationship is not managed sensitively, much good may be undone. Analytic endings are emotionally challenging for analysts as well as patients. What was missing from the classical approach, at least as interpreted by Freud's American disciples, was appreciation of the personal relationship (Flank, 2006 Frank, K. A. 2006. Toward conceptualizing the personal relationship in therapeutic action: Beyond the “real” relationship.. Psychoanal. Perspectives, 3: 6–43.  [Google Scholar]). In a relational view, the ending must be considered uniquely and mutually negotiated as part of a relationship that is both technical and personal. Accordingly, both permanent separation and separation with possible return are seen as just two of many possibilities for ending that the pair may co-create. Other options must also be considered.     

Optimizing Contingency Management With Methamphetamine-Using Men Who Have Sex With Men

Among men who have sex with men (MSM), methamphetamine use is associated with multiple, overlapping syndemic conditions including increased risk for HIV seroconversion and onward HIV transmission. Contingency management (CM) is an evidence-based behavioral intervention implemented to curb methamphetamine use and optimize HIV/AIDS prevention among MSM in San Francisco since 2003. We conducted a program evaluation to document the evolution of this 12-week CM program to include delivery of brief, individual counseling incorporating motivational interviewing and behavioral skills. A drop-in group delivered concurrently with CM urine-screening visits also provides peer support as well as referrals for other social and medical services. From December 2011–October 2013, a total of 131 clients enrolled in the CM program and provided a median of 22 urine samples (Interquartile Range = 10–34) that were nonreactive for methamphetamine. Findings support the feasibility and acceptability of integrating individual and group counseling with community-based CM for methamphetamine-using MSM.     

A Relational Cultural Approach to Working With Clients With Eating Disorders

The authors examine eating disorders through the conceptual framework of relational cultural theory (RCT). Taking into account the importance of relationships and connection, it is suggested that RCT may be a useful lens for conceptualizing and working with people who are experiencing eating disorders. Ways that RCT can be applied to enhance prevention efforts and recommendations for combining relationally focused counseling with evidence‐based individual eating disorder treatment are presented.     

Problems With John Earman's Attempt To Reconcile Theism With General Relativity

Discussions of the intersection of general relativity and thephilosophy of religion rarely take place on the technical levelthat involves the details of the mathematical physics of generalrelativity. John Earman's discussion of theism and generalrelativity in his recent book on spacetime singularities is anexception to this tendency. By virtue of his technical expertise,Earman is able to introduce novel arguments into the debatebetween theists and atheists. In this paper, I state and examineEarman's arguments that it is rationally acceptable to believethat theism and general relativity form a mutually consistent oreven mutually supportive pair. I conclude that each of hisarguments is unsound.     

Depressive Symptomatology Mediates Associations With Community Reintegration in Veterans With TBI

Community reintegration (CR) is a challenge for military veterans with traumatic brain injury (TBI). Posttraumatic stress disorder (PTSD), depression, bodily pain, and limitations in physical functioning—common comorbidities with TBI in veterans—have all been associated with problems in CR, but their interrelationships are unclear. The role of depression as a possible mediator of effects on CR has not been examined. We tested depressive symptoms as a possible mediator of CR’s associations with physical limitations, PTSD, and bodily pain. This cross-sectional study used baseline data from a larger randomized controlled trial that evaluated the impact of an in-home intervention for veterans with TBI and their families. Eighty-three military veterans with TBI recruited from a medical rehabilitation service at an urban U.S. Department of Veterans Affairs medical center participated in the study. Interview instruments measured CR, depressive symptoms, physical limitations (limitations in physical functioning), bodily pain, quality of the relationship with key family members, and sociodemographic characteristics. PTSD was determined through review of the electronic medical record. Interview data were collected in veterans’ homes. Depressive symptoms totally mediated the association between physical limitations and CR and the association between PTSD and CR. The bodily pain–CR association was not significant after quality of relationship had been entered into the regression models. Findings suggest that interventions to increase CR of veterans with TBI should address depression, a treatable condition. Replication of our mediation findings in larger veteran and civilian samples with TBI is needed.     

Career Counseling With Couples

As an outgrowth of the developmental and systemic trends characterizing career counseling in recent years, the role of the family has been highlighted. Nonetheless, inadequate attention has been given to incorporating family members in the career counseling setting with adult clients. This article explores a career counseling paradigm that takes into account the couple dynamics active in the adult's career choice process. Unique elements of the conjoint model, such as couple career assessment, along with directions for further study, are offered.     

开拓创新 与时俱进——关于五台山研究会发展壮大的思考

自然科学与社会科学是社会向前发展的两大动力,但在不同的历史时期,两门科学研究的发展却有失衡的现象,建设社会主义市场经济的初期,重商不重学的现象也是自然的。于是,淡漠对于社会科学的研究,相应的研究人员纷纷下海,蔚然成风。但是,随着市场经济建设的深入,社会科学研究在社会中越来越受到重视。今年8月7号江泽民总书记在北戴河接见科学研究工作者,并作了“八七讲话”。讲话中提出了社会科学和自然科学研究的四个同等重要,明确提出社会科学的研究水平也是我们国家综合国力的重要标志。讲话还明确地给社会科学研究的同志提出,要加强全局性、战略性、前沿性课题的研究。同时,特别强调对社会科学研究人才的培养。     

With and Without End

Ways and words about infinity have frequently hidden a continuing paradox inspired by Zeno. The basic puzzle is the tortoise's – Mr T's – Extension Challenge, the challenge being how any extension, be it in time or space or both, moving or still, can yet be of an endless number of extensions. We identify a similarity with Mr T's Deduction Challenge, reported by Lewis Carroll, to the claim that a conclusion can be validly reached in finite steps. Rejecting common solutions to both challenges, we use a Wittgensteinian approach for dissolution, noting also that other paradoxes, such as the Surprise Examination and Yablo's, trap us inconsistently into similar endlessnesses. In so doing, we encounter a hopping flea, generate a proportionality paradox and consider the knight's move in chess.     

Family Therapy With Irish-Americans

This paper presents a paradigm for understanding the cultural values and family patterns of Irish-American families and offers suggestions for clinical intervention. Families' correspondence to the model described will depend upon their level of acculturation, socioeconomic status, and other contextual factors. The paradigm suggests a number of issues that may create difficulties for the therapist and for the family in therapy. In general, behavioral techniques, Bowen systems therapy, and strategic interventions may be more useful than techniques emphasizing expression of emotions in therapy or direct attempts to alter communication or family behavior in therapy sessions, as used in structural therapy.