Modern Advances in Genetic Testing: Ethical Challenges and Training Implications for Current and Future Psychologists

The ethical implications for psychological practice of genetic testing are largely unexplored. Predictive testing can have a significant impact on health and well-being, and increasing numbers of individuals with knowledge of their risk for various disorders are likely to present for psychotherapy. In addition, more people will struggle with the decision of whether to obtain information regarding their genetic material. Psychologists will need to have the appropriate knowledge and clinical skills to effectively counsel this population. This article highlights the relevant ethical issues surrounding psychological treatment of individuals pursuing or considering undergoing genetic testing. These issues are extended to psychologists working in research, education, and policy domains. Recommendations for graduate training programs to facilitate current and future practitioner competence are also discussed.     

Policy evaluation in a time of fiscal stress: Some reflections from British experience

The debate on the use or nonuse of policy evaluation frequently starts from the normative assumption that is a rational and rewarding activity for governments to pursue. Failure to use evaluation is assumed to indicate political and organizational inefficiencies and weaknesses that can, and should, be corrected. This article argues that this is too simplistic an assumption that abstracts evaluation from the political and social context in which it is developed and utilized. In particular, the way that governments develop and use evaluation is conditioned, first by the macroeconomic climate in which they operate and second, by the ways they choose to respond to this and by the microeconomics of the budgetary process. These issues are explored in the context of recent developments in British central government. here a tight fiscal policy and a concern with administrative costs have led to move from top-down rational systems of evaluation to more pragmatic, bottom-up concerns with performance measures and performance indicators. It is concluded that policy evaluation is unlikely to regain and enhance its credibility unless a reshaping of administrative structures and processes take place. Andrew Gray and Bill Jenkins are respectively senior lecturer in adminiistrative studies and senior lecturer in interdisciplinary studies at the University of Kent at Canterbury, England. They have worked for a number of years on the development of management reforms in the UK government and have recently been involved in a research project on the evolution of the Financial Management Initiative (FMI) in British central government departments. Their publications includeAdministrative Politics in British Govenment (Wheatsheaf Books, 1985) and articles in such journals asFinancial Accountability and Management, Public Administration, andPublic Money and Management.     

Advances in juvenile adjudicative competence: A 10-year update

This article provides a comprehensive review of juvenile adjudicative competence (AC) literature published between 2010 and 2019. Publications included in this article are peer-reviewed and disseminate original research or provide new commentary on forensic evaluation, policy, or theory. The review is organized in the following sequence: (i) factors associated with juvenile AC, (ii) evaluating juvenile AC (assessment tools and techniques, quality of evaluations, evaluation recommendations), (iii) remediation (remediation recommendations), (iv) systemic issues (inconsistency in statutes and court processes, defense attorneys' concerns about AC, age-related issues, developmental immaturity), and (v) special topics (special populations, international research). Systemic processes and variability in statutes have contributed to current concerns regarding reliability of juvenile AC evaluation and remediation. Clear and consistent standards must be developed to address these problems. Continued research is necessary to clarify how to accurately assess juvenile AC and appropriately remediate those adjudicated incompetent. Practice and policy implications as well as future directions for research are discussed.     

What We Know—and Don't Know—About Preventing Child Maltreatment

Abstract

Although child maltreatment is routinely acknowledged as a serious social problem, it remains widespread, raising questions about how prevention efforts can be improved. Following a review of theory and research relevant to prevention programming, the two dominant models of child abuse prevention-child empowerment and parent education-are examined, emphasizing both those factors that appear to contribute to program success (e.g., early intervention, sufficient time commitments, cultural sensitivity) and weaknesses in current efforts (e.g., poor implementation). Although underutilized, broader social and system-level reforms, including social policy and media initiatives, hold promise for prevention. Ways in which to leverage these tools are explored. Additional research is urged to explore assumptions on which programs are based, as well as to conduct more rigorous evaluation of current programs. The article concludes that a sustained commitment to prevention efforts aimed at child abuse and neglect is required.     

Water quality, agricultural policy and science

This paper analyses how agricultural policy and science deal with the problem of increasing exploitation of low quality irrigation water and consequent deterioration of water quality in the States of Punjab and Haryana in India. In these cereal growing tracts the policy objective of food security is translated into production technologies, price protection and subsidies. Deterioration of water quality is countered with technocentric solutions. The paper argues that the response of science to the complexities involved in natural resource problems or in the scientific understanding of farmers partial response to technological solutions recommended to improve degraded resources, is due to the existing “administrative rationalism” of natural resource bureaucracies. This administrative rationalism, “the problem-solving discourse which emphasizes the role of the expert rather than the citizen” allows policy and science to maintain their hierarchy in determining policy goals and technological solutions with scant ecological or democratic concerns. Sustainable use of water demands institutional reform in agricultural policy and the agricultural sciences. With an inter-disciplinary training in the agricultural sciences and economics, her publications address the history of and institutional reform in agricultural science, the evaluation of agricultural research, and the organization and measurement of agricultural research effort. This paper is based on an in-house project on “Ex-post evaluation of soil science technologies,” conducted during 1997–2001, in collaboration with Sunita Sangar (then QHS Fellow, NISTADS) whose Ph.D. thesis on the same topic has been submitted to IIT, Delhi in January 2002. Sunita Sangar has a degree in the life sciences, and is interested in science and technology policy issues related to soil and water resources. The authors are currently working on the NATP sponsored project, on an ecological economics framework for the evaluation of soil science research in India.     

Ethical issues in the research and practice of applied developmental psychology

Within the last decade, applied developmental psychology (ADP) has emerged as a new subspecialization within traditional graduate programs in developmental psychology. Current definitions of ADP range from a primarily research-oriented discipline to a superordinate discipline under which clinical, educational, and school psychology organize applications of the developmental data base. This work draws upon several common themes to arrive at a broad definition of ADP. We outline reasons for developmental psychology's entrance into the “decade of applied research,” the broad spectrum of activities currently characterizing ADP, and training programs proposed to prepare students for these activities. The extension of developmental psychology into applied areas requires attention to the ethical issues encountered across the full spectrum of ADP activities. We present a perspective of ethical issues whose framework is predominantly applied developmental psychology. Our approach focuses on ethical concerns associated with both knowledge generation and knowledge application. In so doing, we raise issues concerning the need for applied developmentalists to address questions concerning the impact of planned methods on development in normal and atypical populations, consultation to institutions and public policy makers, competencies required to conduct developmental education programs, and utilization of developmental assessment techniques.     

Rejecting the Null: Research and Social Justice Means Asking Different Questions

The focus of this article is on the specific ethical issues related to social justice research and the practical implications of engaging in social justice research, including the potential impact of research results on practice, policy, and advocacy at the local and national level. Specific recommendations are offered, including identifying research questions that advance social justice, managing researcher bias and power differentials, improving research methodologies, disseminating research, and giving back and advocating for social justice concerns.     

Insanity defense research and treatment of insanity acquittees

This article is a comprehensive review of issues relevant to the insanity defense and the disposition of insanity acquittees. The characteristics of persons found Not Guilty by Reason of Insanity (NGRI) are described. Although the locus of treatment of the NGRI acquittee varies by jurisdiction, at this time, care and detention of insanity acquittees fall mainly to state mental health agencies. Recent reforms, as they relate to locus of treatment, are reviewed and public policy issues are discussed. The author concludes that more clinical research on the insanity acquittee is necessary for the development of more informed public policy on the insanity defense.     

Location,Location, Location: Applying Spatial Statistics to the Relationship Landscape

The desire to understand relationships is a passion shared by professionals in research, clinical, and educational settings. Questionnaires are frequently used in each of these settings for a multitude of purposes—such as screening, assessment, program evaluation, or establishing therapeutic effectiveness. However, clinical issues arise when a couple's answers on questionnaires do not match clinical judgment or lack clinical utility, while statistical problems arise when data from both partners are put into analyses. This article introduces the use of geospatial statistics to analyze couple data plotted on a two‐dimensional “relational map.” Relationship maps can increase assessment sensitivity, track treatment progress, and remove statistical issues typically associated with couple data. This article briefly introduces core assumptions of spatial models, illustrates the use of spatial models in creating a relational landscape of divorce, offers suggestions for the use of relational maps in a clinical setting, and explores future research ideas.     

An Assessment of Time Involved in Pre-test Case Review and Counseling for a Whole Genome Sequencing Clinical Research Program

Whole genome sequencing (WGS) is being used for evaluation of individuals with undiagnosed disease of suspected genetic origin. Implementing WGS into clinical practice will place an increased burden upon care teams with regard to pre-test patient education and counseling about results. To quantitate the time needed for appropriate pre-test evaluation of participants in WGS testing, we documented the time spent by our clinical research group on various activities related to program preparation, participant screening, and consent prior to WGS. Participants were children or young adults with autism, intellectual or developmental disability, and/or congenital anomalies, who have remained undiagnosed despite previous evaluation, and their biologic parents. Results showed that significant time was spent in securing allocation of clinical research space to counsel participants and families, and in acquisition and review of participant’s medical records. Pre-enrollment chart review identified two individuals with existing diagnoses resulting in savings of $30,000 for the genome sequencing alone, as well as saving hours of personnel time for genome interpretation and communication of WGS results. New WGS programs should plan for costs associated with additional pre-test administrative planning and patient evaluation time that will be required to provide high quality care.     

Family Therapy Education and Higher Education Administration Policy: Facing New Challenges

Marriage and Family Therapy (MFT) education programs are not immune to the financial pressures associated with providing quality educational programs. In this article, the author discusses the current higher education economic environment, explores contemporary trends in higher education management, and considers their effect on MFT educational programs, an area that is virtually unaddressed in the literature. Finally, the author describes how one MFT training program is responding to the challenges brought forth by the fiscal complexities embedded in the contemporary higher education economic environment. The discussion offers useful and practical administrative policy information to MFT educational programs and their leaders.     

Nuance, Complexity, and Context: Qualitative Methods in Genetic Counseling Research

Because of its potential for capturing complexity and process and its focus on communicating the meaning in human action, qualitative research is rapidly gaining acceptance in a wide variety of disciplines. Various qualitative approaches to research support its potential usefulness in genetic counseling research. Formulation of research questions and selection of appropriate qualitative methods are the first step. Interviewing, narrative analysis, focus groups, ethnography/participant observation, and participatory action research are only some of the most popular techniques that may be suitable in various situations. Processes of evaluation, analysis, and even ethical issues often differ somewhat from quantitative research. This article discusses these issues and the potential value of qualitative methods for research related to genetic counseling.     

Some methodological and training/funding perspectives on the future of personality research

This article provides some methodological and training/funding perspectives on the future of personality research. Traditional correlational approaches to personality data have been useful, but approaches that address the data in new ways (e.g., mean structure, variance structure) permit researchers to ask interesting new research questions, particularly of short- and long-term longitudinal data. Advances and issues in the measurement of personality dimensions, types, situations, and biological markers are considered. Given the shrinkage of training programs in personality, new approaches to training are proposed to take advantage of resources across universities. Finally, some potential unanticipated costs for core personality research of the increased emphasis on grant funding at many universities are considered.     

Navigating Complex Implementation Contexts: Overcoming Barriers and Achieving Outcomes in a National Initiative to Scale Out Housing First in Canada

The scaling out of Housing First (HF) programs was examined in six Canadian communities, in which a multi‐component HF training and technical assistance (TTA) was provided. Three research questions were addressed: (a) What were the outcomes of the TTA in terms of the development of new, sustained, or enhanced programs, and fidelity to the HF model? (b) How did the TTA contribute to implementation and fidelity? and (c) What contextual factors facilitated or challenged implementation and fidelity? A total of 14 new HF programs were created, and nine HF programs were sustained or enhanced. Fidelity assessments for 10 HF programs revealed an average score of 3.3/4, which compares favorably with other HF programs during early implementation. The TTA influenced fidelity by addressing misconceptions about the model, encouraging team‐based practice, and facilitating case‐based dialogue on site specific implementation challenges. The findings were discussed in terms of the importance of TTA for enhancing the capacities of the HF service delivery system—practitioners, teams, and communities—while respecting complex community contexts, including differences in policy climate across sites. Policy climate surrounding accessibility of housing subsidies, and use of Assertive Community Treatment teams (vs. Intensive Case Management) were two key implementation issues.     

Transnational Governance Arrangements: Legitimate Alternatives to Regulating Nanotechnologies?

In recent years, the development and the use of engineered nanomaterials have generated many debates on whether these materials should be part of the new or existing regulatory frameworks. The uncertainty, lack of scientific knowledge and rapid expansion of products containing nanomaterials have added even more to the regulatory dilemma with policy makers and public/private actors contenting periods of both under and over regulation. Responding to these regulatory challenges, as well as to the global reach of nanotechnology research and industrial needs, governance arrangements beyond the state have addressed the challenge head-on. This article focuses on the governance arrangements of the International Organization for Standardization (ISO), which has led to the development of numerous “horizontal anticipatory standards” with an important role in setting the foundation for science, technology and market development. During the course of its operation ISO has broadened its scope to address not only technical issues related to the concept and the size of nanomaterials but also broader aspects of the technology, including health, environment and safety issues. The increasing relevance of the ISO to regulate economic relations and achieve certain public policy goals has given rise to many concerns about its legitimacy. The important questions are whether these governance arrangements may be deemed as being legitimate and where this legitimacy is derived from? What are the main sources of legitimacy at the transnational level and how we can apply them to analyse nanotechnology standardization? This article provides concise answers to these questions. It focuses at the normative concepts of democratic and scientific legitimacy and explores the institutional structures and processes by which nanotechnology standards are established.     

Beyond non-utilization of evaluations: An institutional perspective

Evaluations are spreading over a number of policy areas and are being integrated into administrative routines on many levels in organizations. Yet, a central finding in evaluation research is that the utilization of evaluations is limited. As an alternative to conventional rational and political approaches the paper explores how an institutionalist perspective explains this paradox. This article argues that the institutionalist perspective is useful in showing how evaluation procedures are symbolically appropriate in our age of “reflexive modernization”; explaining a number of empirical findings about the actual (non-)utilization of evaluations; and suggesting an alternative horizon of effects of evaluations. His recent interests include the application of cultural and institutional perspectives on evaluation.     

Assessment and treatment of obsessional harassment

Obsessional harassment and stalking have become increasingly recognized as significant social problems, often with dramatic negative repercussions on the lives of victims. As the public awareness of this problematic behavior has grown, the amount of clinical attention and empirical research focused on understanding the perpetrators of harassment has increased accordingly. Nevertheless, relatively little research has addressed the numerous issues involved in the assessment and treatment of obsessional harassment offenders. This article reviews the existing research on obsessional harassment/stalking, and offers a diagnostic typology of these offenders based on the nature of the relationship with the victim and the motivation of the offender. Treatment modalities are then discussed with regard to each of the primary diagnoses that occur among obsessional harassment offenders. Finally, strategies for initiating treatment for unmotivated or unwilling offenders are discussed, along with clinical issues that arise in the evaluation and treatment process.     

Psychology and Medical Rehabilitation: Moving Toward a Consumer-Driven Health Care System

Changes in health care will provide both opportunities and threats for rehabilitation psychologists. We must demonstrate the relevance of our clinical services to important outcomes or risk being excluded as treatment providers. With shifts to nonhospital settings, we can provide increasing clinical and administrative leadership. However, we must redefine models of treatment to include home care and telepsychology, practice guidelines and critical paths, involvement of paraprofessionals, case management, injury prevention, and health promotion. We should be involved when datasets are established to define disability-related health policies and reimbursement and be proactive in Medicare, Medicaid, and managed care reform to develop treatment packages to decrease long-term handicap. Collaboration with consumers is critical. We must frame research questions to address current policy issues. Our skills can help improve the effectiveness of human behavior, whether it be patients with illness, consumers with disability, health care providers, health systems managers, or legislators.     

Entwicklungsbezogene Pr?vention von Gewalt und Kriminalit?t

This article provides an overview of concepts and empirical evaluations of developmental prevention of delinquency, violence and other forms of antisocial behavior in childhood and youth. At first basic terms and arguments are discussed; then a selection of family, child school and community-oriented programs are briefly presented. There follows an integrative evaluation of the field that is mainly based on systematic reviews and meta-analyses. An integrative model shows that preventive effects depend on many characteristics of the programs, contexts, participants and evaluation methods. In total effect sizes are positive and small but show practical relevance. There is a strong need for more well controlled outcome evaluations with long-term follow-up and more process evaluations of implementation and quality assurance. Future research and practice should be integrated within a long-term and cross-departmental prevention policy.