How Managed Care Can Help Couples Cope

ABSTRACT

This article traces how managed care became a quick fix to curb out-of-control healthcare costs rather than a real effective approach to managing care. To date, the impact has been not only a negative experience, but impediment to treating couples facing relationship and related problems. The author is optimistic about how managed care will evolve to recognize the importance of couples and family treatment as we enter the future with integrated systems of healthcare. ? The future will also require significant shifts in the thinking and practice patterns of providers and an emphasis on quality and outcomes.     

How School Counselors Can Help Prevent Online Victimization

Although the Internet is a beneficial tool, some youth are at risk for being victimized by Internet predators. School counselors are in a unique position to assist in efforts to prevent online victimizations because of their continual interaction with students, parents, and other school faculty. This article provides school counselors with information about youth Internet use; risk factors associated with online victimizations; and recommendations to assist youth, parents, and families in improving Internet safety practices.     

How Frameworks Can Help Operationalize Sustainable Development Indicators

After nearly three decades of discussion about sustainable development are we any nearer to achieving it? And do we even know what a sustainable world will look like for future generations? Early definitions of sustainable development were so broad as to allow a range of interpretations based largely on individual interests and anthropocentric needs. We are measuring the performance of countless indicators of sustainable development, but is this more an exercise in applying data than meaningful progress? This article explores the ultimate goals of sustainable development and the most important means of achieving this by analyzing and comparing two frameworks designed to direct attention to the fundamental means and the ends of sustainable development.     

生命末期患者及家属对“善终”看法的Meta整合

研究采用Meta整合方法,对生命终末期患者及家属善终认知的质性研究结果进行整合,形成四个整合结果:不恐惧,从心理上接受死亡,做好死亡的准备;没有痛苦和不适,不延长死亡过程,以自己期望的方式离开;不是他人的负担,能感受到来自亲人和专业人员的支持;维持做人的尊严,找到生命的价值和意义,灵性需求得到满足。揭示了生命末期患者及家属的潜在需求,要求医务人员需要根据生命末期患者、家属的不同需求,评估不同的个体对善终的偏好,提供针对性的服务,最终达到善终的目的。     

Logotherapy in the Care of the Terminally Ill

SUMMARY

Logotherapy is very useful in dealing with a person with a terminal illness in that such a person often feels that life is meaningless. Viktor Frankl asserts that each person's life has a unique meaning even when the person is confronted with a terminal condition over which he/she seemingly has little control. It is the role of the logotherapist to help the person to discover that unique meaning within himself/herself. The logotherapist does not provide the meaning, but rather assists the person in discovering his/her own meaning. This article explores the various ways by which meaning may be discovered through the methods of logotherapy.     

大学生对临终者的内隐与外显态度

目的:考查大学生对临终污名者的内隐、外显态度。方法:使用内隐联想测验(IAT)和相应的外显测验,对安徽师大在校本科生、研究生共60名进行实验研究。结果:大学生在临终者内隐态度上,不相容任务反应时(1185.53±278.95)ms长于相容任务反应时(765.62±199.10)ms;大学生对临终者外显态度均表现出消极态度,但对于临终关怀的态度表现出积极(1.54±0.52);被试的性别以及被试是否接触过临终者并不能改变内隐以及外显态度。结论:大学生对临终者具有负面刻板印象以及污名效应,临终关怀以及对临终者的偏见应该引起重视。     

How Chaos and Complexity Theory Can Help Counselors to Be More Effective

Chaos and complexity theory can help counselors to assist clients in new and unique ways. Chaos and complexity theory do not need to replace other counseling theories but can provide an alternative view. Using chaos theory in counseling requires, however, a revaluation of counselors' assumptions about the world, particularly about linearity, prediction, and control. This article uses a case study to illustrate how counselors can use chaos and complexity theory in their work with clients. This theory can offer an alternative framework to assist counselors in conceptualizing their clients and their practice.     

Using Implementation Intentions in Shopping Situations: How Arousal Can Help Shield Consumers Against Temptation

Previous research has suggested that individuals who repeatedly experience self‐regulatory failure in purchasing behaviour have trouble shielding themselves against temptations. Because shopping is often accompanied by increased arousal, we examined whether attending to affective arousal could help people keep their attention focused. Before participants completed a visual distraction task embedded in a shopping context, we (i) instructed them to formulate an implementation intention with affective arousal as the eliciting cue and concentrating on the task as the intention; (ii) instructed them to formulate the goal intention of concentrating on the task without mentioning an eliciting cue; or (iii) gave them no further instructions. During the task, we recorded eye movements to measure the time they looked at the target products. The findings suggest that implementation intentions with affective arousal as an eliciting cue enable consumers who repeatedly perceive self‐regulatory failure to focus their attention on their initial shopping goal. Copyright © 2016 John Wiley & Sons, Ltd.     

A Burden to Others: A Common Source of Distress for the Terminally Ill

Recent research into the desire for death among people with terminal illness has begun to recognize the importance of “feeling oneself a burden to others” as a factor in suicidal behaviour. In this study, 69 patients with advanced cancer underwent semi‐structured interviews. The sense of self‐perceived burden was found to be a common experience, reported by 39.1% of participants as a minimal or mild concern and by 38% as a moderate to extreme concern. The sense of burden showed a low correlation with physical symptoms (r = 0.02–0.24) and higher correlations with psychological problems (r = 0.35–0.39) and existential issues (r = 0.45–0.49). Comparisons of participants with high or low levels of self‐perceived burden showed the importance of this factor for overall quality of life. In summary, self‐perceived burden is an important but underestimated dimension of social cognition in the medically ill.     

末期癌症患者的临终关怀

临终关怀与末期癌症关系密切,末期癌症患者是临终关怀的主要对象,这也是姑息医学的主要内容。作为发展中的学科,本文对临终关怀的发展、目的、内容及其在末期癌症患者中的实施作一综述。     

Growing Pains: How Psychologists Can Help to Meet the Clinical Needs of Clients With Autism Spectrum Disorders

The pervasiveness and the prevalence of the autism spectrum disorders (ASD) are now much more recognized than in years past. The treatment needs of higher functioning people with ASD unfortunately often go unmet, and there is tremendous potential for psychologists to help meet these needs. The four articles in this special series provide current, best practice reviews and recommendations for practicing psychologists who work in this area. They highlight commonalities that cut across ASD and other clinical populations, and offer considerations that are unique to working with clients who have ASD. This commentary emphasizes the need for clinicians and applied psychological scientists to consider some of these issues in their own work.     

An Oral Proof in a Geometry Class: How Linguistic Tools Can Help Map the Content of a Proof

Recommendations that teachers promote argument and discourse in their mathematics classrooms anticipate researchers' needs for methods for examining and analyzing such talk. One form of discourse is oral arguments, including proofs. We ask: How can we track the development of an oral argument by a teacher and her/his students? We illustrate a method that combines Systemic Functional Linguistics (SFL) and Toulmin's argumentation scheme to examine how speakers logically connect different parts of an argument. We suggest that conjunction analysis can aid a researcher to map the content of a proof that has been constructed in class discussion. Using data from a discussion of a geometry proof, we show that different types of conjunctions enabled the teacher and the students to connect various components of an argument and, also, different arguments. The article illustrates how conjunction analysis can support and deepen what Toulmin's scheme for arguments can reveal about oral discussions.     

危重患者的院内转运

危重患者的转运分为院内转运及院间转运,院内转运由医院内的医务人员来完成.危重患者的转运存在风险有可能增加病死率与伤残率.本文对危重患者院内转运的转运前风险评估、转运前准备、转运中监护和生命支持、特殊情况转运和转运后交接方面做一综述,目的是降低危重患者的转运风险、安全转运.     

危重患者的院内转运

危重患者的转运分为院内转运及院间转运,院内转运由医院内的医务人员来完成。危重患者的转运存在风险有可能增加病死率与伤残率。本文对危重患者院内转运的转运前风险评估、转运前准备、转运中监护和生命支持、特殊情况转运和转运后交接方面做一综述,目的是降低危重患者的转运风险、安全转运。     

How Can I Help You? Dimensional versus Categorical Distinctions in the Assessment for Child Analysis and Child Psychotherapy

ABSTRACT

This paper describes the process of a psychoanalytically-informed or a psychodynamic diagnostic assessment with children, contrasting it with a DSM-like diagnostic process. The importance of understanding and sensitively addressing the experience of parents when they bring their child to a professional for help is highlighted. The promotion of a psychoanalytic atmosphere, the unique contribution of a child analyst or psychodynamic clinician to the general mental health field, is an approach which promotes the development of a therapeutic alliance. This allows both parents and children to express their underlying issues as openly as possible. In addition to the basic assumptions of psychoanalysis (the ubiquity of unconscious mental activity and the impact of the past on the present/the developmental perspective), several factors are crucial to bear in mind: the importance of understanding the nature of the child’s (and the parent’s) emotions, emotion regulation, development of mental representations of self and other, and their conflicts and defense mechanisms. Potential therapeutic approaches are highlighted, including stressing the need to empirically study how decisions are made by a mental health provider when moving from assessment to treatment recommendation.     

The Possibilities and Pitfalls of Talking about Conception with Donor Egg: Why Parents Struggle and How Clinicians Can Help

It can be challenging for parents to talk with their children about gamete donation. Many mothers who chose donor egg, following failed fertility treatments and/or advanced maternal age, do not talk about it with their children. Research has found significant parental anxiety, increasing with time after conception, in parents who have not told their children about their donor origins. A set of common reasons given for a reluctance to talk will be considered, along with its impact on the psychic functioning of parents and children. Talking about donor conception is not a one-time conversation but a process that will evolve over the child’s lifetime. Psychological adjustment to the choice of egg donation that can foster disclosure will be discussed, including how couples (1) accept that a donor is required; (2) imagine the donor, who is often anonymous; and (3) incorporate the choice of donor conception into daily family life. There is growing research and psychoanalytic literature on the development of children conceived with gamete donation; however, fewer families of heterosexual parents are included in these follow-up studies because of the prevalence of nondisclosure. This article considers why talking about conception with donor egg is so hard for many families and offers lines of inquiry that may be helpful to these families and the clinicians that will support them.     

Anger Can Help: Clinical Representation of Three Pathways of Anger

Anger is a powerful emotion prevalent in therapy. An integrative model situating varied manifestations of anger within a purposive context of healing and repair following relationship trauma is needed. A first paper (Butler, Meloy-Miller, Seedall, & Dicus, 2017) approached anger as a psychological and relational construction of diffuse physiological arousal and provided a conceptual model of how the experience of offense interacts with a person's view of self in relation to other (VSIRO) in the formation of anger. Three resulting trajectories and pathways of anger were outlined. Here we provide clinical representations of these pathways—two pathways of hostile anger arising from pathogenic VSIROs (inflated, with accompanying externalizing anger, and collapsed, with accompanying internalizing anger), and a third pathway of benevolent anger, arising from a balanced VSIRO. Clinical application of the model through several vignettes illuminates its use in discriminating helpful from harmful pathways of anger and developing interventions for reshaping pathogenic anger to beneficent anger.