Prayer in psychotherapy: a model for its use, ethical considerations, and guidelines for practice

Although few guidelines exist, many therapists use prayer as a part of psychotherapy. The immense variance inherent in prayer behaviors and the paucity of literature on its use beckons the profession to develop a model for its use in therapy, examine the ethical implications for such use, and prepare guidelines for practice. A tripartite model for the conceptualization and localization of prayer in therapy is presented, ethical issues of therapist bias and competence and clients' right to autonomous decision making are considered, and guidelines for employing prayer in psychotherapy are developed.     

Including a Spiritual Dimension in Family Therapy: Ethical Considerations

The inclusion of a spiritual dimension in family therapy theory and clinical practice may well be viewed as an important professional challenge of the nineties. Following a working definition of terms, this paper explores the ethical complexities inherent in operationalizing a spiritual orientation in therapy in light of the following principles adopted from medical ethics: Respect for clients' autonomy, safeguarding clients' welfare, protecting them from harm, and treating them justly and honestly.     

Personal Theories of Hunger and Eating1

Recent research on hunger and eating has shown that (a) among individuals with adlibitum access to food, hunger and eating are not regulated by deviations in the body's energy resources from set-points, and (b) it is healthier for people to consume their daily caloric intake as several small snacks than as 3 large meals. People's beliefs about hunger and eating were assessed in 2 questionnaire studies. In Study 1, a large sample of undergraduates was surveyed; in Study 2, dietetics students, nursing students, medical students, dietitians, nurses, and doctors were surveyed. Both studies revealed that people's personal theories of hunger and eating were inconsistent with research findings in ways that could promote overconsumption. These results suggest that educational programs designed to modify the beliefs about hunger and eating of people suffering from problems of overconsumption and of health professionals who treat problems of overconsumption may increase the effectiveness of current treatment regimens.     

ADVANCING BACKWARDS

The proposal of Friman, Hayes, and Wilson (1998) that the concept of emotion be incorporated into behavior analysis is questioned. Their proposal is undermined by the problem of the verification of private events by others. A focus on private events, as exemplified by the proposal of Friman et al., can lead to a reversion to notions of agency and the autonomous individual. Also, the anchoring of hypothetical constructs to the behavioral data language is ill advised.     

TEACHING MULTIPLICATION FACTS TO STUDENTS WITH LEARNING DISABILITIES

Multiple baseline designs were used to examine the effects of an instructional package on accuracy of performance in solving multiplication facts by 3 students with learning disabilities. The instructional package included the following components: (a) a modified instructional sequence in which multiplication facts were grouped into the zeros, ones, doubles, fives, and nines categories, and those remaining; (b) identification of the category in which each fact belonged; (c) mnemonic strategies associated with solving facts in each category; and (d) steps to be completed for solving facts in each category. Results indicated that the instructional package produced substantial and immediate effects. After receiving instruction, a participant's accuracy was often 100%, and this was maintained throughout the evaluation even as other strategies were introduced. Comparable results occurred across students, demonstrating replication of the effects of the instructional package.     

Empirically defined symptom scales using the DISC 2.3

Empirically defined scales of depressive, attention deficit hyperactivity disorder, oppositional-defiant disorder, and conduct symptoms from the lay-administered National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children (DISC), version 2.3, and evidence of their reliability and validity, are presented. The scales were developed using factor analyses of data obtained from an epidemiologic survey of over 1,200 children drawn from four sites across the U.S. and Puerto Rico (the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders, or MECA Study). Their psychometric properties were tested in a subsample of children reinterviewed by clinicians. The findings support the use of these continuous measures. The scales are strongly related to the diagnostic categories and show good test-retest reliability. The scales can be used to characterize severity in children with diagnoses and to describe problems and symptoms in children without diagnoses. Because these scales can measure gradations in symptomatology, they may be more useful than categorical measures. Like categorical measures, the scales based on the DISC are greatly influenced by the informant, whether child or parent.This research was supported by grant MH-46732 from the National Institute of Mental Health, Bethesda, Maryland.The MECA Program is an epidemiologic methodology study performed by four independent research teams in collaboration with staff of the Division of Clinical Research, which was reorganized in 1992 with components now in the Division of Epidemiology and Services Research and the Division of Clinical and Treatment Research, of the NIMH, Rockville, Maryland. The NIMH Principal Collaborators are Darrel A. Regier, MD, MPH, Ben Z. Locke, MSPH, Peter S. Jensen, MD, William E. Narrow, MD, MPH, and Donald S. Rae, MA; the NIMH Project Officer was William J. Huber. The Principal Investigators and Coinvestigators from the four sites are as follows: Emory University, Atlanta, Georgia, UO1 MH46725: Mina K. Dulcan, MD, Benjamin B. Lahey, PhD, Donna J. Brogan, PhD, Sherryl Goodman, PhD, and Elaine Flagg, PhD; Research Foundation for Mental Hygiene at New York State Psychiatric Institute (Columbia University), New York, New York, UO1 MH46718: Hector R. Bird, MD, David Shaffer, MD, Myrna Weissman, PhD, Patricia Cohen, PhD, Denise Kandel, PhD, Christina Hoven, PhD, Mark Davies, MPH, Madelyn S. Gould, PhD, and Agnes Whitaker, MD; Yale University, New Haven, Connecticut, UO1MH46717: Mary Schwab-Stone, MD, Philip J. Leaf, PhD, Sarah Horwitz, PhD, and Judith H. Lichtman, MPH; University of Puerto Rico, San Juan, Puerto Rico, UO1 MH46732: Glorisa Canino, PhD, Maritza Rubio-Stipec, MA, Milagros Bravo, PhD, Margarita Alegría, PhD, Julio Ribera, PhD, Sarah Huertas, MD, and Michael Woodbury, MD.The authors gratefully acknowledge Zenaida González and José Martínez who performed the data nalayses, as well as Elizabeth Pastrana, and Felícita Laboy, secretaries, for their valuable contributions to this work.     

FEMALE PARTNERS OF BISEXUAL MEN What They Don't Know Might Hurt Them

Individual interviews with 350 behaviorally bisexual men aged 18–30 revealed that 71% of their female sexual partners and 59% of their steady female sexual partners in the past 6 months had not been aware of their homosexual activity. Rates of nondisclosure were higher for African-American than White men. Compared to nondisclosers, men who disclosed to all their female partners were less self-homophobic and perceived their friends, families, and neighbors as more accepting of their homosexual behavior. Compared to men who had disclosed, the nondisclosers had more female partners and used condoms less consistently with women.     

Correlates of gender role orientation during pregnancy and the postpartum

This study was designed to examine the relationship between gender role orientation and psychological adjustment during pregnancy and the postpartum period in a large sample of French-speaking Caucasian mothers. Gender role was assessed with the Bem Sex Role Inventory, which classifies subjects into four categories: androgynous, masculine, feminine, and undifferentiated. A discriminant analysis showed a relationship between androgyny and the following measures of psychological adaptation: self-esteem, satisfaction with social support, and level of apprehension toward perinatal stressors. The masculine gender role was linked with self-esteem, work involvement, age, and severity of perinatal stress. No relationship was found between gender role and the level of antenatal or postnatal depressive symptomatology. Stress, marital support, and social support were among the predictors of postpartum depression, which underlined the importance of taking these variables into account when studying the well-being of mothers during the postnatal period. Results are discussed in light of previous literature on the association between gender role and motherhood. The limitations of Bem's model and inventory are also considered.     

Influence of the initial projection of the centre of gravity on posturo-kinetic coordination in humans. Application from a horizontal quadrupedal stance during voluntary limb raising

The purpose of the study is to investigate the influence of initial projection of the centre of gravity (CG) on the spatial and temporal organization of the dynamic phenomena accompanying a voluntary movement in humans. From a horizontal quadrupedal stance, ten normal subjects were instructed to raise the right forelimb towards a support target in self paced velocity conditions. Three experimental conditions were tested for which the initial CG projection was either within (C1), at the limits of (C2) or outside the supporting triangle (C3). The results showed that vertical force variations on the four supports always preceded the first vertical displacement of the right wrist (onset of the movement). From C1 to C3, the duration of these anticipatory dynamic phenomena increased enabling an adjustment of the CG position such that equilibrium constraints were fulfilled. For all conditions, the acceleration peak of the CG occurred prior to the onset of movement and from C1 to C3, its magnitude increased in a single direction of the horizontal plane. For each condition, the load transfer was directed to the left forelimb and the right hindlimb (diagonal strategy) and reached a maximal value at the time of lift-off. With respect to this moment, the onset of the movement occurred increasingly early from C1 to C3. These results suggest that contribution of peripheral cues to postural control is more important, when the requirements of horizontal CG displacement increase.     

Validation of a full body 3-D dynamic linked segment model

In studies related to human movement, linked segment models (LSM's) are often used to quantify forces and torques, generated in body joints. Some LSM's represent only a few body segments. Others, for instance used in studies on the control of whole body movements, include all body segments. As a consequence of the complexity of 3-dimensional (3-D) analyses, most LSM's are restricted to one plane of motion. However, in asymmetric movements this may result in a loss of relevant information. The aim of the current study was to develop and validate a 3-D LSM including all body segments. Braces with markers, attached to all body segments, were used to record the body movements. The validation of the model was accomplished by comparing the measured with the estimated ground reaction force and by comparing the torques at the lumbo-sacral joint that resulted from a bottom-up and a top-down mechanical analysis. For both comparisons, reasonable to good agreement was found. Sources of error that could not be analysed this way, were subjected to an additional sensitivity analysis. It was concluded that the internal validity of the current model is quite satisfactory.