Radical presence: Alternatives to the therapeutic state

This article introduces the idea of radical presence as an alternative to the current therapeutic state (or psy-complex) within which we live today. Radical presence challenges us to confront the dominance of psychological discourses which define, control, and limit the ways in which we live. It shifts our attention from diagnosis and treatment of individuals to an exploration of broader relational and institutional contexts, and the ways in which professionals and ordinary people alike can be responsive, present, and open to a multiplicity of life forms.     

Developmental trajectories to heroin dependence: Theoretical and clinical issues

We have built up a great deal of insight into the early developmental trajectories that lead to heroin use. These cluster under five domains: social disadvantage, parental drug use/psychopathology, childhood abuse and neglect, early onset psychopathology and antisocial behaviors, and a developmental sequence of drug onsets. While not all heroin users have these risk factors, the broad clinical picture shows these early correlates to be the predominant presentation. We discuss each of the early psychosocial correlates of heroin dependence, as well as possible early interventions. Given the chronicity of heroin dependence, interventions to prevent heroin use emerging would reduce the considerable burden of disease associated with the disorder.     

Divine omniscience,privacy, and the state

Traditional theism teaches that God engages in a relentless form of observation for every human being. If, as is widely supposed, humans have a right to privacy, then it seems that God constantly violates this right. In this paper we argue that there is both a defensible philosophical excuse and justification for this infringement. We also argue that this defense is extensible to human social and political contexts; it provides the vital elements of a theory of just privacy infringement. This theory is broadly compatible both with major forms of political theory (except anarchistic ones) and with the main conceptions of privacy defended in recent philosophical and jurisprudential literature.     

Existential and religious issues when admitted to hospital in a secular society: Patterns of change

Situated in a secular culture, this study examined the relationship between four dimensions of health and a number of existential, religious, and spiritual/religious practice variables in questionnaires sampled from 480 Danish hospital patients. Illness dimensions were: self-rated health, severity of illness, illness duration, and recent changes in illness. The results indicated the youngest age group (<36 years) to be the most active on all existence/religious/practice variables. Small overall correlations were found between the illness dimensions and existential/religious/practice variables, but results had underlying complex patterns. The dimension of severity of illness showed the most consistent results in the expected direction: the worse the illness, the more existential/religious/practice activity, but very different patterns were found for men and women. Men generally had low levels of existential/religious/practice issues, when illness was not severe, but levels heightened when illness turned worse. The opposite was the case for women who had overall higher levels, when illness was not severe, but unexpectedly lost interest and activity when the illness grew worse, especially regarding the religious faith variables. When illness turned to the better, women (re)gained religious faith. The illness duration of 1–3 months showed to be the most sensitive period for the existential/religious/practice variables involved. The patients’ experience of change in existential/religious/practice issues and the actual measured change pattern did not always follow each other. The findings might contribute to clinical reflection and planning in health care settings in secular societies like in Scandinavia.     

Eight issues in studying organizational constructs: Tackling a complex problem

Much of the industrial/organizational psychology research literature involves abstractions called constructs. Frequently, new constructs are proposed and measures are developed, revised, and evaluated in studies for modeling or predicting organizational criteria. There are many hazards in these studies that lead to incorrect conclusions and decisions. This is especially applicable to the introduction and use of new constructs. We discuss several methodological issues that affect the interpretation of results from theoretical and applied studies and provide examples where construct confusion occurred due to failure to use best practices. A paradigm is proposed to increase the efficacy of studies regardless of which model of constructs has been chosen. Consideration is given to sample characteristics, range restriction, reliability of scores, criterion development, identifying latent sources of variance, content validity, comparing regression equations, and defining the nomological network.     

From the word to the scene: An expanded conceptualization for therapeutic action

The American Journal of Psychoanalysis -     

Media representations of environmental issues: From scientific to political discourse

IntroductionThe media is considered to be a social agent that intervenes in the elaboration of social representations of environmental issues.ObjectiveThis research analyses media representations of environmental issues and how they have been constructed and transformed from the Rio Summit in 1992 to 2006. The authors adopted a constructionist approach based on the theory of social representations (Moscovici, 1961/1976) to describe the generation of information by the mass media.MethodA sample of 1039 news articles from two Spanish newspapers (La Vanguardia and El País) was analysed. The period of study ranged from the Rio Earth Summit to several years after the Johannesburg Summit (1992–2006), and the study analyses both the content and form of the environmental news.ResultsThis longitudinal study shows not only an increase in environmental news during the period of analysis but also an increased variety of themes addressed and represented. The results evidence significant urban problems in recent years. The environment has shifted from being associated with nature to being predominately associated with the urban environment.ConclusionThe results suggest that there has been a movement from scientific to political discourse and a change towards greater reflection and social recognition of the relevance of environmental issues.     

From health beliefs to self-regulation: Theoretical advances in the psychology of action control

Abstract

The paper reviews the theoretical concepts included in a range of social cognitive models which have identified psychological antecedents of individual motivation and behaviour. Areas of correspondence are noted and core constructs (derived primarily from the theory of planned behaviour and social cognitive theory) are identified. The role of intention formation, self-efficacy beliefs, attitudes, normative beliefs and self-representations are highlighted and it is argued that these constructs provide a useful framework for modelling the psychological prerequisites of health behaviour. Acknowledging that intentions do not translate into action automatically, recent advances in our understanding of the ways in which prior planning and rehearsal can enhance individual control of action and facilitate the routinisation of behaviour are considered. The importance of engaging in preparatory behaviours for the achievement of many health goals is discussed and the processes by which goals are prioritised, including their links to self-representations, are explored. The implications of social cognitive and self-regulatory theories for the cognitive assessment of individual readiness for action and for intervention design in health-related settings are highlighted.     

From regulation to projection: Reliance on regulatory mode in predictions about others

Past research showed that people project their goals onto unknown others. The present research investigates whether they also rely on their motivational orientation in terms of regulatory mode (locomotion vs. assessment). In line with work on self-judgments, a stronger chronic personal focus on locomotion over assessment decreased predictions of others' experiences of nostalgia (Study 1) and increased predictions of others' preference for, motivation by, and evaluation of a transformational over a transactional leader (Study 2). Furthermore, an experimentally induced locomotion mode compared to an assessment mode increased peoples' predictions of others' motivation to reconcile after interpersonal conflict (Study 3). We examined process evidence via the Testing-Process-by-Interaction-Strategy: As predicted, effects only emerged under time pressure (vs. ample deliberation; Study 2) and for ingroup (vs. outgroup) members (Study 3). These findings suggest that people's regulatory mode is a basis for predicting others' reactions and preferences. We discuss implications and future research directions.     

Adolescent sexuality in a therapeutic community: staff countertransference issues

Issues connected with sexuality such as heterosexual relationships, homosexuality, sexual identity, and seductiveness, create conflict and countertransference dilemmas for staff who work with psychiatric patients in a therapeutic community. When the therapeutic community is composed of adolescents, these issues are exacerbated since sexual identity and sexual development are major concerns. The staff reacts strongly to the issue of self-determination and violation/infringement on a basic human need. These philosophical differences have their roots in countertransference feelings. Staff sometimes find it difficult to confront adolescents on emotionally charged issues that have a sexual coloring. A system is proposed for articulating and working through these feelings. A unique solution is posited for solving this conflictual attitude (based on object relations theory), whereby the residential treatment center serves as the analog of the home in order to allow adolescents to develop a sense of self before they can move on to the halfway house where heterosexual behavior is allowed (as part of the therapeutic process). This facilitates the meeting of the "self" with the "other." This procedure is explored in light of Sullivan's concept of intimacy.     

From scapegoating to thinking and finding a home: delivering therapeutic work in schools

This paper discusses how the child psychotherapist's core skills can be usefully applied in a school setting. It outlines some of the important policy changes that have necessitated a move towards delivering therapeutic work in community settings such as schools. It is argued that the role of the child psychotherapist in schools has much in common with the role played by the psychotherapist in a therapeutic community. The paper suggests that therapy in schools is in many ways less simple than therapy in clinic settings, and in particular it is often unclear who exactly the client is and at what level to intervene when a referral is made. The referred patient is not necessarily the ‘problem’, so that the child psychotherapist must be prepared to tackle issues in the system to ensure that splitting and projection are reduced, and systems around children can become more containing. Clinical vignettes and one main clinical illustration are used to try to illustrate these points.     

Parent-adolescent health conversations as action: Theoretical and methodological issues

Abstract

A qualitative research method based on action theory is proposed and illustrated for use in health psychology and health promotion research. Action refers to the goal-directed and intentional behaviors of individual and groups. Action theory has the advantage of using the perspectives provided by manifest behavior, internal processes, and social meaning in the analysis of action. In this article, the actions under consideration are the health-related conversations of parents and their adolescent children. The approach is premised on an understanding of health promotion as a family task constructed through actions such as conversations between family members. Health conversations in two parent-adolescent dyads are used to illustrate the method. The analysis includes the identification of goals, functional steps, and elements and their relation to the family health promotion project. Specific attention is paid to data gathering and analysis issues and their implications for health promotion research.     

Processes of patient decision making: Theoretical and methodological issues

Abstract

There is a paucity of research studying patients' decision making processes. Traditional normative approaches investigating human decision have presented rational, analytic processing as a ‘gold standard’ for decision making with decision aids developed to facilitate such thinking. This paradigm has been challenged by the recent emergence of naturalistic decision making. Naturalistic approaches argue for techniques modelled closer to how decisions are actually made in ‘real life’. Early work in this evolving field suggests the importance of more automatic, intuitive processing such as the use of heuristic short-cuts. This paper discusses the contribution of naturalistic decision theory and assesses its usefulness as an alternative to classical decision approaches in investigating patient decision making. Approaches for measuring underlying cognitive processes are also critically discussed.