A pluralistic framework for counselling and psychotherapy: Implications for research

Historically, training, research and practice in counselling and psychotherapy have been dominated by unitary theoretical models. Although integrative and eclectic positions have been developed as alternatives, these have not been successful in generating research and have resulted in a further proliferation of competing models. In this paper we introduce a ‘pluralistic’ framework for counselling and psychotherapy and discuss the implications of this framework for research. The basic principle of this pluralistic framework is that psychological difficulties may have multiple causes and that there is unlikely to be one, ‘right’ therapeutic method that will be appropriate in all situations—different people are helped by different processes at different times. This pluralistic framework operates as a meta‐theory within which it is possible to utilise concepts, strategies and specific interventions from a range of therapeutic orientations. The framework is structured around three domains—goals, task and methods—by which therapeutic processes can be conceptualised, critically examined and empirically investigated. These domains, and the relationships between them, are outlined and the collaborative relationship at the heart of the pluralistic framework is discussed. The pluralistic framework provides a means for empirical research directly to inform practice and potential lines of empirical inquiry are outlined, along with findings from a recent study of counselling in schools.     

On causality, responsibility, and self-blame: a theoretical note

Examples from the literature on "self-blame" for illness (Tennen, Affleck, & Gershman, 1986) and criminal victimization (Janoff-Bulman, 1979) illustrate insufficient attention to construct validity in the measurement of causality, responsibility, and blameworthiness. Distinctions among these terms have been drawn in detail in a recent theory of the attribution of blame (Shaver, 1985), and these are briefly described. We argue that in future research and theory in the attribution of responsibility and blame, especially self-blame, investigators should attend more carefully to such conceptual distinctions.     

Personal responsibility and middle knowledge: a challenge for the Molinist

In this paper, I develop and discuss an argument intended to demonstrate that the Molinist notion of middle knowledge, and in particular the concept of counterfactuals of freedom, is incompatible with the notion of personal responsibility (for created creatures). In Sect. 1, I discuss the Molinist concepts of middle knowledge and counterfactuals of freedom. In Sect. 2, I develop an argument (henceforth, the Transfer of Negative Responsibility Argument, or TNRA) to the effect that, due to their construal of the concepts of middle knowledge and counterfactuals of freedom, Molinists are not entitled to the notion that individuals are personally responsible—even for those actions that they freely perform. I then discuss the only two promising strategies for rejecting the argument in Sects. 3 and 4. Finally, in Sect. 5, I contend that, although TNRA may be unsuccessful as an internal argument against the Molinist, either of the possible strategies for rejecting TNRA poses a difficulty for the Molinist. Both response strategies force the Molinist into adopting a popular compatibilist strategy for rejecting a common negative argument against compatibilism. Thus, if Molinism represents a libertarian—i.e., incompatibilist—account of human freedom (as, e.g., Flint claims in his recent Divine Providence: The Molinist Account, noting that libertarianism is one of the “twin bases of Molinism”), then the discussion of TNRA poses, if not a dilemma, at the very least a serious challenge for the Molinist.     

Spirituality and Subjective Well-Being: Evidences for a New Domain in the Personal Well-Being Index

Subjective well-being explores the evaluations, both positive and negative, of how people experience their lives. Research in the field inquires how people perceive their well-being in different settings, including different cultures, regions and cities. A large number of different measures have been designed to capture subjective well-being. One of the most used SWB measure is the Personal Well-being Index (PWI), an evaluation of life developed by Cummins et al [(2003). Social Indicators Research, 64, 159–190] which proposes that satisfaction with life consists of seven different life-domains. Theoretical considerations of the contribution of spirituality and religiosity to life satisfaction, from a eudaimonic (from the Greek, it consists of the word "eu" (good or well-being) and the word “daemon” (spirit)) point of view, led to test the contribution of this new domain in the prediction of the Personal Well-being Index (PWI) in Bogotá, Colombia. Empirical results confirm the construct validity and reliability of the scale. The contribution of the new domain—satisfaction with spirituality and religiosity—to PWI was found significant. Based on these results the paper explores conceptually the role of spirituality contributing to satisfaction with life. The finding stresses the importance of interpreting satisfaction with life as a whole from the Aristotelian concept of eudaimonia. New questions for research in this important area are proposed     

Psychological distance,stated values and values in use: An approach to considering interactions for counselling within organizations

The work of Argyris (Reasoning, Learning and Action: Individual and Organisational: San Francisco Jossey-Bass, 1982) demonstrated the gaps that we tend tio have between our stated values and those that we actually use in practice. That of Micholt (Transactional Analysis Journal, 22, 228–233, 1992) illustrated the concept of psychological distance as applied tio facilitating groups in an organizational setting. These are both important works which can be very useful in conceptualizing the organizational context of counselling and also the client's problem situation. By combining these two approaches, it is possible to demonstrate a more detailed picture of the psychological distance and some of the potential problems inherent in interactions among three (or more) parties. For counselling, the combined approach emphasizes the importance of the counsellor remaining aware that the client's story is likely to reveal their stated values and that only by gaining a values-in-action perspective (i. e. behaviour) about the client's life can the counsellor adequately assess the client's situation. The examples given in this paper relate to counselling in an organisational context, but the approach may be applied tio facilitation, geneal management or consltancy.     

Context,voice and choice: A curricular framework for the medical humanities

Although the humanities' place in the medical school curriculum has been established, how we can best approach our teaching remains unanswered. A curricular framework which addresses process, as well as subject matter and structure is needed. A process-oriented framework demands that we enhance our student's ability to contextualize experience through multiple realms of meaning; encourage our students in the struggle to find a voice; and once a voice is found, to endow our students with the courage to let it be heard.     

A theoretical framework for understanding self-report and observational measures of pain: a communications model

Self-report and observational measures of pain are examined from the perspective of a model of human communication. This model examines the experience of pain as affected by intrapersonal and contextual factors, the process whereby it is encoded into expressive behaviour, and the process of decoding by observers prior to their engaging in action. Self-report measures primarily capture expressive pain behaviour that is under the control of higher mental processes, whereas observational measures capture behaviour that is less subject to voluntary control and more automatic. Automatic expressive behaviours are subject to less purposeful distortion than are behaviours dependent upon higher mental processes. Consequently, observational measures can be used and have clinical utility as indices of pain when self-report is not available, for example, in infants, young children, people with intellectual disabilities or brain damage, and seniors with dementia. These measures are also useful when the credibility of self-report is questioned and even when credible self-report is available. However, automatic behaviours may be more difficult for observers to decode. The model outlined herein takes into account the role of various human developmental stages in pain experience and expression and in understanding the utility of self-report and observational measures. We conclude that both observational and self-report measures are essential in the assessment of pain because of the unique information that each type contributes.     

I move, therefore I am: a new theoretical framework to investigate agency and ownership

The neurocognitive structure of the acting self has recently been widely studied, yet is still perplexing and remains an often confounded issue in cognitive neuroscience, psychopathology and philosophy. We provide a new systematic account of two of its main features, the sense of agency and the sense of ownership, demonstrating that although both features appear as phenomenally uniform, they each in fact are complex crossmodal phenomena of largely heterogeneous functional and (self-)representational levels. These levels can be arranged within a gradually evolving, onto- and phylogenetically plausible framework which proceeds from basic non-conceptual sensorimotor processes to more complex conceptual and meta-representational processes of agency and ownership, respectively. In particular, three fundamental levels of agency and ownership processing have to be distinguished: The level of feeling, thinking and social interaction. This naturalistic account will not only allow to “ground the self in action”, but also provide an empirically testable taxonomy for cognitive neuroscience and a new tool for disentangling agency and ownership disturbances in psychopathology (e.g. alien hand, anarchic hand, anosognosia for one’s own hemiparesis).     

Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study

Discrepancies often exist among different informants' (e.g., parents, children, teachers) ratings of child psychopathology. Informant discrepancies have an impact on the assessment, classification, and treatment of childhood psychopathology. Empirical work has identified informant characteristics that may influence informant discrepancies. Limitations of previous work include inconsistent measurement of informant discrepancies and, perhaps most importantly, the absence of a theoretical framework to guide research. In this article, the authors present a theoretical framework (the Attribution Bias Context Model) to guide research and theory examining informant discrepancies in the clinic setting. Needed directions for future research and theory include theoretically driven attention to conceptualizing informant discrepancies across informant pairs (e.g., parent-teacher, mother-father, parent-child, teacher-child) as well as developing experimental approaches to decrease informant discrepancies in the clinic setting.     

Control by action representation and input selection (CARIS): a theoretical framework for task switching

Control by action representation and input selection (CARIS) is a modeling framework for task-switching experiments, which considers action-related effects as critical constraints. It assumes that control operates by choosing control parameter values, representing input selection and action representation. Competing CARIS models differ in whether (a) control parameters are determined by current instructions or represent a perseveration, (b) current instructions apply to the input selection and/or to action representation. According to the chosen model (a) task execution results in a default bias in favor of the executed task thus creating perseverative tendencies; (b) control counteracts these tendencies by applying a transient momentary bias whose locus (input selection or action representation) changes as a function of task preparation time; (c) this happens because the task-cue (e.g., SHAPE) initially attracts attention to the immediately available cue-information (e.g., target shape) and then attracts it to inferred or retrieved information (e.g., "circle" is related to the right key press).     

Personal standards and evaluative concerns dimensions of "clinical" perfectionism: a reply to Shafran et al. (2002, 2003) and Hewitt et al. (2003)

Shafran, Cooper, and Fairburn (2002, 2003) provided a cognitive-behavioral analysis of "clinical" perfectionism, a construct they considered to involve both the determined pursuit of self-imposed standards and extremely vulnerable self-evaluation. They argued against a multidimensional perspective to studying perfectionism. We respond to Shafran et al. (2002, 2003) and Hewitt, Flett, Besser, Sherry, and McGee's (2003) reply to Shafran et al. (2002) by considering the theoretical, empirical, and clinical implications of findings identifying two higher-order dimensions of perfectionism reflecting personal standards (PS) and self-critical evaluative concerns. Analyses of data from two diverse study groups, a college student sample (N = 527) and a clinical sample of patients with binge eating disorder (N = 236), revealed that self-criticism accounts for the relation between perfectionism measures and depressive, anxious, and eating disorder symptoms. We conclude that possessing high PS is not by itself maladaptive. Rather, self-critical evaluative tendencies are more relevant than PS to the critical processes Shafran et al. (2002) suggested contribute to the maintenance of clinical perfectionism.     

Transcultural discussion in bioethics drawn from research experience in China: building up a theoretical and methodological framework for further research cooperation

My article discusses bioethics in transcultural context and builds on an experience of conducting research in China in partnership with Chinese scholars and institutions. Key points are about the creation of ethical committees and their prerogatives, the regulation of experimenting in human and animal, and of donating and transplanting organs. Ethical issues are approached according to an anthropological reading. Three transversal lines for further research are suggested: global/local ethical governance applied to research ethics; implications of transnationalizing and delocalizing research practices with regards to governance; theoretical positioning--conceptual pluralism versus pragmatic pluralism--following actual confrontation to transcultural variations in research ethics. Moreover, this work claims for conceptualizing and implementing an ethics in context while assessing intangible (non-relative) principles based on knowledge production and a global patrimony.     

The scholar as activist: Postcolonial feminist film practice as a tool for social development,empowerment and resistance

This article explores the concept of the “scholar as activist” in the context of postcolonial feminist film practice, and the successes and shortcomings of a research design conceptualised to explore the potential that self-reflexive filmmaking offers to articulate the narratives of South African Hindu women (and other suppressed groups). My point of departure was a strong sense of the misrecognition of my own identity as a South African Hindu woman of Indian descent, in stereotypical representations of Hindu women in mainstream film. South African Hindu women, and suppressed groups by extension, have stories that need to be told. The question emerged of how such stories could be told through the medium of film. Could the interface between the medium of self-reflexive film, the academic filmmaker and the narratives of South African Hindu women translate into meaningful social action that would offer a platform for resistance to mainstream (mis)representations? A critical reflection on my initial filmmaking process, and an analysis of the film text itself, illustrated that as an academic with various platforms of expression at my disposal, I had assumed a superficial similarity to and yet privileged position over those whose story I attempted to tell. How then could women use self-reflexive filmmaking to tell their own stories that resist limited mainstream gendered representations and reclaim their own identities? In a play between an academic register and an overtly self-reflexive narrative style, I thus explicate the organic process of developing a revised methodological approach for the postcolonial “scholar as activist”.     

Personal, practical, and professional issues in providing managed mental health care: a discussion for new psychotherapists

Written by a former corporate manager pursuing counseling as a 2nd career, this article offers pointed views on managed mental health. Values of practitioners that are a mismatch for managed care are noted, and more specific disadvantages and advantages are examined. Loss of client confidentiality is addressed and procedures and technologies for its reclamation are noted. Negative effects on therapy are acknowledged and potential for better accountability and research are pointed out. Economic disadvantages of a small provider's practice as well as opportunities for creating new value and additional income are reviewed. The relatively sudden emergence of managed care is credited with a natural time lag preceding regulatory responses. Acknowledging that most new practitioners have little choice about the clients they serve, the article concludes that it would be shortsighted to rule managed care out of one's practice.     

Psychological effects of a suicide prevention unit on adolescents' levels of stress,anxiety and hopelessness: Implications for counselling psychologists

This study examined the effects of a senior high school suicide prevention unit on students' levels of stress, anxiety, and hopelessness. An experimental group that received instruction in suicide prevention, and that demonstrated special needs, i.e. low social support, high stress, high anxiety, and/or high degrees of hopelessness, was compared with an experimental group that did not demonstrate special needs, and with two control groups that received no instruction, one with, and one without, special needs. Results indicated that both the experimental group with special needs and the experimental group without special needs showed significant increases in factual knowledge; the experimental group with special needs showed significant change on psychological variables, while the control group with special needs did not. No significant differential changes were noted between the experimental group with special needs and the control group with special needs. Implications for counselling psychologists are considered.