The Spirituality of Compassion: A Public Health Response to Ageing and End-of-Life Care

SUMMARY

The recent revival of interest in spirituality in later life marks a significant step forward in the person-centred care of ageing people. The benefits will, however, be of limited value if we do not attend to the settings in which spirituality is to be lived. In contemporary society many aged people are located in environments unsympathetic to spiritual belief and practice. Health care settings focus on professionally-assessed physical needs and are dominated by concerns about the cost of services. The national social policies that direct health care services and less directly shape older people's place in contemporary society are strongly influenced by globalised neoliberal economic policies characterised by individualism, competition, and greed. For robust and viable spirituality to develop at the individual level we need compassionate social policies that support interdependence within communities and between nations.     

Restaurant Tipping: Free‐Riding,Social Acceptance,and Gender Differences1

The practice of paying gratuities for services is a worldwide custom. Tipping is found only in some professions, which suggests that it serves to increase the efficiency of specific kinds of exchanges. The literature accepts the view that monitoring of employees by customers appears to be the logical rationale for the practice of tipping. This can be seen in that gratuities are paid at the discretion of consumers after they receive the services for which they are paying. However, it does not explain why, given the voluntary aspect of tipping, rational people would not free‐ride on the tipping of others. We found that both men and women free‐ride in their tipping behavior. Yet, we also found that men are more influenced by social acceptance or approval in their tipping behavior than are women.     

Parent‐selected interventions for infants at‐risk for autism spectrum disorders and their affected siblings

Infants with older siblings having Autism Spectrum Disorders (ASD) are at genetically increased risk for showing characteristics of ASD in the first 2 years of life. Parents, who already have at least one child with ASD, may closely monitor their later born children and implement interventions as soon as the children begin to show what the parents believe is aberrant behavior or development that may be early stages of ASD. To date, no study has examined the number and types of services and interventions these parents access for their at‐risk infants. Using a Service and Intervention Questionnaire developed for this study, we interviewed 23 parents involved in a larger prospective study of genetically at‐risk infants who reported developmental and/or behavior problems in their at‐risk infants. Parents reported utilizing a mean of 1.83 and 7.26 services and/or interventions for their at‐risk infants and older children with ASD, respectively. Two‐thirds of the interventions received by the infants were also given to their older affected siblings. The interventions included empirically validated approaches (e.g., early intensive behavioral intervention), professional services (speech–language therapy, occupational therapy), and non‐validated treatments (e.g., diet and vitamin therapies). Overall, 81 non‐validated and 18 validated interventions were used. On a Likert‐type rating scale, parents reported being involved and satisfied with what they generally thought were effective services. They felt more involved and satisfied with ABA, and felt it was more effective than non‐validated interventions. The findings suggest that parents with infants at‐risk for ASD and an older affected child will access a variety of autism services for both children, but the parents will implement primarily non‐validated interventions. Parent education is recommended to help parents make informed treatment decisions for their children. Copyright © 2009 John Wiley & Sons, Ltd.     

Professional Education and Professional Ethics Right to Die or Duty to Live?

Despite the undeniable ethical dimensions of paid occupations — trades and services — other than the traditional professions, it is still natural to associate courses of professional ethics with medicine, law, nursing or teaching, rather than auto-repair, supermarket assistance or window-cleaning. Indeed, it seems plausible to hold that if there is anything more to the traditional distinction of professions from trades or other services than considerations of social and economic status, it might well reside in the distinctive ethical or moral character and implications of such occupations as medicine, law and education. This paper undertakes to explore, via examination of some of the commonly suggested criteria of professionalism, the nature of such implications and the extent to which they justify continued deployment of a distinctive occupational category of 'profession'. On the assumption that they do, however, the paper is also concerned to examine critically the consequences for education in professional ethics of any such distinctive ethics of profession.     

College Students' Perceptions of the Relationship Between Fee and Counseling

Fee as a variable that could have an impact on college students' perceptions of counseling was explored because of the authentic concerns about college counseling centers needing to charge direct fees for their services. Participants (N = 350) represented a cross-section of potential consumers of psychological services, not just individuals currently receiving services. On an overt level, fees seemed to be less influential in counseling considerations, but were taken into account on a more covert level. This study supports the psychological literature, which suggests that fee is not the most important factor in clients' decisions to seek counseling. Implications for counselors, administrators, researchers, and program planners are discussed.     

Psychoanalytische Intervalltherapie

The history of focal therapy clearly reveals it to be closely linked with short-term therapy. This fact can often lead us to take a rather limited view of the focal therapeutic approach, since in reality it can also be a useful concept for long-term treatment. Experiences with therapy performed on an interval basis show that development happens in stages and that a new step forward – a “quantum leap in development”– can only be achieved when the time is right. This step frequently requires that the patient have their own experiences, undergo their own suffering and develop an Ego-dystonic reaction towards their characteristic behavioral conditions which can often only be achieved outside the therapeutic environment. In this context, it becomes even more significant that we understand and take into consideration the “self-analytical function of the Ego”. If these preconditions are met, then it may even be possible to achieve profound structural changes in a longer-term therapeutic process, assuming that this therapy is performed in focal stages rather than continuously.     

Foster mother state of mind and treatment use: Different challenges for different people

On the basis of our research findings from the last 10 years, we have developed a training program for foster parents that targets three critical needs for infants in foster care. This treatment program has now been manualized to allow dissemination to other sites. With our intervention as well as any other, we see it as critical to tailor services to the needs of individual clients rather than adhering in doctrinaire fashion to the manual. In particular, we suggest that attending to foster parents' state of mind with regard to attachment is vital to providing an effective treatment. In this article, we present examples of foster parents with different states of mind and describe how treatment is tailored to meet their individual needs.     

Can Consent be Presumed?

Opt‐out systems of postmortal organ procurement are often referred to as ‘presumed consent’ systems. A presumption directs us, in a case in which no compelling evidence is available to hold that P, nevertheless to proceed as if P were true, unless there is sufficient evidence that it is false. It is recommended to presume consent in this case, because, in the absence of registered objections of the deceased, it is held to be more probable that she consented than that she did not. Whether this suggestion makes sense, however, turns out to depend on the proper interpretation of the concept of ‘consent’. On a mental state conception of consent we are allowed to presume it if we have reason to suppose the deceased to have been in favour of donation. However, we should rather understand consent to be a public action of authorisation. On that view consent cannot be presumed, and the opt‐out systems as we presently know them on the European continent and elsewhere do not satisfy the requirement that the deceased should have consented to the removal of his organs.     

The meaning of money: A psychiatric-psychological evaluation

Summary In summary, we have reviewed some psychoanalytic formulations about the symbolic meanings of money, such as its equation with feces, semen, life, and love. Money becomes a sublimated interest so that we may avoid more primitive desires. Nevertheless, it also is an interest upon which is focused guilty feelings for more basic wishes from the past, so that seeking money is both pleasurable and anxiety-provoking. The helper of suffering humanity who demands money for his services is in a particularly conflicted position. As a result, he finds it necessary to develop a rationalization system that concludes that his demand for money is good for the sufferer. While this is true in some circumstances, it is better to face one's basic selfishness and realistic needs for money. The pastoral counselor experiences a different conflict, faced as he is with his need to be altruistic, and his lack of a good system of rationalization as possessed by the psychiatrist.     

Shooting for the Moon: How Academicians Could Make Management Research <Emphasis Type="Italic">Even Less</Emphasis> Irrelevant

By publishing a special issue on “The State of Practice,” JBP takes an important step to bridge the science/practice gap, but it is only a step and will not alone span this gap. On the academic side, currently dominant cultures and incentive systems all but guarantee the irrelevance of most scholarly work to anyone except other scholars. On the practice side, managers rarely frame their dilemmas and decisions in ways that lend themselves to scholarly inquiry, find little reason to subject their own research to the peer review process, and rarely look to academia for practical insights. The present article focuses on why this gap persists, and the kinds of fundamental shifts that would be required to address it. It begins by framing the structural nature of the current science/practice gap in business psychology, and then promoting the study of this gap as critical in its own right. From there a framework of research questions is provided that can inform efforts to bridge the science-practice gap.     

Therapeutic practice in multi-racial Britain

Service planners and providers of mental health services (including therapy and counselling) claim that their services are being restructured so as to become more sensitive to the needs of users—irrespective of race and cultural background. This paper is one step towards that goal. It aims to (i)challenge assumptions and beliefs held by mainly white, mainstream therapists and counsellors; (ii) question the therapeutic practice which is based on white, middle-class ideology; (iii) raise awareness of a ‘black’ perspective in therapy and counselling and (iv) provide some practical guidelines for transcultural counselling.     

Consciousness and inference to the best explanation: Compiling empirical evidence supporting the access-phenomenal distinction and the overflow hypothesis

A tacit assumption in the field of consciousness studies is that the more empirical evidence a theory can explain, the better it fares when weighed against competitors. If one wants to take seriously the potential for empirical evidence to move forward debates in consciousness studies, there is a need to gather, organize, validate, and compare evidence. We present an inference to the best explanation (IBE) process on the basis of empirical support that is applicable in debates between competing theories of consciousness. Our proposed IBE process consists in four steps: Assimilate, Compile, Validate, and Compare. Until now, the vast majority of the work in the field has consisted in gathering empirical evidence for theories i.e., the assimilation step. To illustrate the feasibility of our proposed IBE process, and what it may look like when applied in practice, we deliver a complete collection (the compilation step) of empirical support for the distinction between A-Consciousness and P-Consciousness and the overflow hypothesis. Finally, we offer an example of the validation step, by scrutinizing the interpretation of aphantasics’ performance on retro-cue paradigms offered in the literature in support of the overflow hypothesis. The compilation we deliver here is the first effort in the IBE process, the end result of which — hopefully — will be the ability of the research community to carry out side-by-side comparisons of theories and the empirical phenomena they claim to explain, i.e., the comparison step.     

小学生代数运算规则的样例学习

采用完整或不完整样例,对180名六年级小学生用样例学习两种代数运算规则进行了实验研究。结果显示：多数被试难以学会“平方差”运算规则,只有少数被试学会了“完全平方和”运算规则;反馈对不完整样例的学习效果有促进作用;用不完整样例学习难度不同的规则,其效果不同;在无反馈条件下,完整样例的学习效果都好于不完整样例;在有反馈的情况下,只有删除一步运算步骤样例的学习效果比完整样例的学习效果好     

From autonomy to heteronomy (and back): The enaction of social life

The term “social cognition” can be construed in different ways. On the one hand, it can refer to the cognitive faculties involved in social activities, defined simply as situations where two or more individuals interact. On this view, social systems would consist of interactions between autonomous individuals; these interactions form higher-level autonomous domains not reducible to individual actions. A contrasting, alternative view is based on a much stronger theoretical definition of a truly social domain, which is always defined by a set of structural norms; moreover, these social structures are not only a set of constraints, but actually constitute the possibility of enacting worlds that would just not exist without them. This view emphasises the heteronomy of individuals who abide by norms that are impersonal, culturally inherited and to a large extent independent of the individuals. Human beings are socialised through and through; consequently, all human cognition is social cognition. The article argues for this second position. Finally, it appears that fully blown autonomy actually requires heteronomy. It is the acceptance of the constraints of social structures that enables individuals to enter new realms of common meaningfulness. The emergence of social life marks a crucial step in the evolution of cognition; so that at some evolutionary point human cognition cannot but be social cognition.     

Single payers and multiple lists: must everyone get the same coverage in a universal health plan?

In spite of recent political setbacks for the movement toward universal health insurance, considerable support remains for the idea. Among those supporting such plans, most assume that a universal insurance system, especially if it is a single-payer system, would offer a single list of basic covered services. This paper challenges that assumption and argues for the availability of multiple lists of services in a universal insurance system. The claim is made that multiple lists will be both more efficient and more fair. Any single list will fund some services that are quite attractive to some people, but only marginally attractive to others. Thus any single-list plan will fund some services that produce only marginal benefit for the resources used. Moreover, since some people will hold values quite compatible with the single list and others will hold values leading to preferences for unfunded services, some people will get much more benefit from any single list than other people will. Fairness and efficiency require providing an entitlement to universal access to health insurance that could be purchased by typical consumers for a fixed price of perhaps $3500. By permitting everyone to pick their preferred list of services available at that price, each person will efficiently use his or her entitlement while getting more equal opportunity for benefits.     

What is (Dis)Agreement?

When do we agree? The answer might once have seemed simple and obvious; we agree that p when we each believe that p. But from a formal epistemological perspective, where degrees of belief are more fundamental than beliefs, this answer is unsatisfactory. On the one hand, there is reason to suppose that it is false; degrees of belief about p might differ when beliefs simpliciter on p do not. On the other hand, even if it is true, it is too vague; for what it is to believe simpliciter ought to be explained in terms of degrees of belief. This paper presents several possible notions of agreement, and corresponding notions of disagreement. It indicates how the findings are fruitful for the epistemology of disagreement, with special reference to the notion of epistemic peerhood.     

Integrating remotely accessible information services into psychology instruction and research

Wide-area computer networks provide a wealth of information services that have the potential to alter the approach toward scholarship taken by both students and researchers. Although it can be argued that the translation of information from hard copy to a publicly accessible electronic form has developed slowly, the total volume of text-based information that has been digitized is already staggering. Two major challenges facing psychologists wishing to develop their skills in network use are to identify and locate pertinent information that is accessible, and to find an easy way to retrieve it. This paper is an attempt to provide an overview of network resources and services that may be of particular interest to psychologists and psychology students. Its focus is on how to learn more about the available information services, as well as how to make access as user friendly as possible.     

Attrition among families of divorce: Patterns in an outpatient psychiatric population

The accelerated divorce rate has greatly increased the number of children of divorce. In addition, the children and families of divorce are proportionately overrepresented in populations seeking child guidance and psychiatric services. However, the patterns in the use of such services by these families has been unexamined. In our study we find no differences in the use of outpatient psychiatric services between families where both biological parents are present and families of divorce. A closer look at the divorced families reveals that recently divorced mother-headed families more frequently interrupt both the evaluation and treatment phases of clinic contact. Several clinical patterns are described which help explain the finding and it is suggested that the traditional child guidance model may not be the most suitable intervention modality in working with these families.     

Lessons from the Transition to Relational Teletherapy During COVID-19

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship-based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context’s constraints and exploiting its strengths is key to providing high-quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add-on to a face-to-face practice.     

The significance of occupations in work careers: An empirical and theoretical review

The central position of occupations in work careers has been a widely accepted position in the study of careers. Furthermore, it has also been commonly believed that most work careers follow the temporal sequence of occupational choice, occupational preparation and training, and occupational entry and retention. An analysis of research findings, however, shows that most individuals do not make stable occupational choices as the first step in their work careers, nor do they show a strong commitment to a particular occupation during their work careers. On the contrary, occupational mobility is far more characteristic of most work careers than occupational stability. One possible explanation of the high rates of occupational mobility is that individuals are responding to opportunities that develop during the course of their careers. As opportunities unfold during work careers, individuals use those opportunities to make future career and occupational choices. Thus, careers may be more accurately considered as a series of responses to a succession of opportunity situations than the effort to realize a predetermined occupational goal.