Ethical Challenges in the Treatment of Individuals With Intellectual Disabilities

The effective provision of psychotherapy services to individuals with intellectual disability requires consideration of ethical issues related to clinical competence, access to services, obligations to multiple parties, guardianship, and appropriate assessment practices. This article provides an overview of major ethical considerations with guidance for clarifying and resolving common ethical concerns. Psychologists are encouraged to expand access to psychotherapy services for this population while maintaining awareness of potential modifications, training needs, and boundaries of professional competence. The authors provide recommendations and resources for effective and ethical treatment of psychotherapy clients with intellectual disabilities.     

Books Received

Abstract

Social identity theory was applied in group therapy for adults with mild mental retardation. Social identity theory suggests that social group membership, also called collective identity, has an impact on self-esteem. Individuals will try to maintain self-esteem by viewing their social groups positively. This may not be possible for individuals who are members of a stigmatized group. However, it may be possible to enhance self-esteem by broadening one’s awareness of collective identity. Furthermore, being able to positively view other individuals who are co-members of one’s own stigmatized group can also have positive consequences for self-esteem. A clinical vignette demonstrates this process in group therapy. Results are discussed as being applicable to members of various stigmatized groups.     

Effects of Electromyostimulation on Knee Extensors and Flexors Strength and Steadiness in Older Adults

It is known that electromyostimulation (EMS) alone or superimposed over voluntary contraction (EV) can effectively improve muscle strength. However, the effect of this type of training on the ability to control force production at submaximal levels is unknown. The authors examined the effects of EV training on steadiness in force production of knee extensors and flexors in older adults. Forty participants, including 20 men and 20 women, 60–77 years of age, were randomly allocated into a control group (CG) and an electromyostimulation superimposed over voluntary contraction (EVG) group. The EVG performed 30 bilateral isometric knee extension and flexion contractions per session, 3 training sessions per week, for 6 weeks. The variations in force production, expressed in absolute (standard deviation [SD]) and relative (coefficient of variation [CV]) terms, were assessed in isometric contractions at 5%, 15% and 25% maximal voluntary contraction (MVC) levels. Results indicated that MVC increased in knee extension and flexion in EVG (p < .05) after the training; steadiness CV also improved at 15% MVC in knee flexion (p < .05) but no significant changes were found in knee extension and steadiness SD. The training-induced changes in MVC were not correlated to steadiness CV that might indicate different mechanisms underlying these adaptations.     

APP conference summary

This is an account of the extended assessment of a 22-year-old man who was initially sent for a court report, having been accused of setting fires. He had a history both of delinquency and, importantly, of childhood asthma. Although he proved unable to engage in psychotherapy, some management was provided, such as Winnicott advocates in cases of delinquency. This paper explores the symbolic meanings and functions of the patient's delinquent acts, drawing upon theoretical concepts from Freud, Aichhorn, and Deutsch. Of particular importance is the link between this patient's delinquency, his asthma, and the unresolved mourning for his dead mother which he carried not simply for himself but for his whole family.     

Philosophical intervention and cross-disciplinary science: the story of the Toolbox Project

In this article we argue that philosophy can facilitate improvement in cross-disciplinary science. In particular, we discuss in detail the Toolbox Project, an effort in applied epistemology that deploys philosophical analysis for the purpose of enhancing collaborative, cross-disciplinary scientific research through improvements in cross-disciplinary communication. We begin by sketching the scientific context within which the Toolbox Project operates, a context that features a growing interest in and commitment to cross-disciplinary research (CDR). We then develop an argument for the leading idea behind this effort, namely, that philosophical dialogue can improve cross-disciplinary science by effecting epistemic changes that lead to better group communication. On the heels of this argument, we describe our approach and its output; in particular, we emphasize the Toolbox instrument that generates philosophical dialogue and the Toolbox workshop in which that dialogue takes place. Together, these constitute a philosophical intervention into the life of CDR teams. We conclude by considering the philosophical implications of this intervention.     

EMERGENCE AND NON‐PERSONAL THEOLOGY

In response to recent theories of emergence which attempt to examine system dynamics and the evolution of complexity from physics to biology and consciousness, a number of theologians have attempted to distill religious insights from a philosophical concept of emergence. Recent work by Terrence Deacon, however, which emphasizes constraint and a process understanding of complexity, undercuts significant features in emergent theologies, namely the privileging of certain loci within emergent complexity, an emphasis on efficient causation, and, theologically, an agential and personal God. The final section of this article, using the example of Navaho religious thought, argues that other religious insights which centralize norm‐ativity, global features of complexity, and are depersonalized, have greater traction with current scientific theories of emergence.     

“We Always Spend Time Together on Sundays”: How Grandparents and Their Grandchildren Think About and Use Informal Learning Spaces

ABSTRACT

Self-reflection is critical for visitors to make sense of an exhibit collection in which they are the subject of investigation and may play an important role in any informal learning context. This study examines this construct by listening for self-reflective talk at Mind, an exhibit collection focused on helping visitors explore aspects of themselves rather than external objects or phenomena. It addresses 3 questions: (a) What does self-reflective talk sound like in such a collection? (b) What categories of self-reflective talk are prevalent? (c) What types of exhibits engender what categories of self-reflective talk? Findings indicate that self-reflective talk comes in various forms. Self-monitoring talk, including self-assessments about how visitors are feeling and doing and what they know, is more prevalent than self-connecting talk, comments about visitors’ own lives, values, and their sense of self. Comparisons among different types of exhibits suggest that exhibits designed for multiple users prompt high frequencies of self-connecting talk and self-monitoring talk, whereas interactive exhibits and exhibits that pose a challenge elicit high frequencies of self-monitoring but not self-connecting talk. Additional work is needed to better understand self-reflection, its role in informal learning, and effective means of fostering self-reflection in science museums.     

Convergent and divergent thinking in verbal analogy

Individual differences in convergent and divergent thinking may uniquely explain variation in analogical reasoning ability. Across two studies we investigated the relative influences of divergent and convergent thinking as predictors of verbal analogy performance. Performance on both convergent thinking (i.e., Remote Associates Test) and divergent thinking (i.e., Alternative Uses Task) uniquely predicted performance on both analogy selection (Studies 1 and 2) and analogical generation tasks (Study 2). Moreover, convergent and divergent thinking were predictive above and beyond creative behaviours in Study 1 and a composite measure of crystallised intelligence in Study 2. Verbal analogies in Study 2 also varied in semantic distance, with results demonstrating divergent thinking as a stronger predictor of analogy generation for semantically far than for semantically near analogies. Results thus further illuminate the link between analogical reasoning and creative cognition by demonstrating convergent and divergent thinking as predictors of verbal analogy.     

Play it again: neural responses to reunion with excluders predicted by attachment patterns

Reunion behavior following stressful separations from caregivers is often considered the single most sensitive clue to infant attachment patterns. Extending these ideas to middle childhood/early adolescence, we examined participants' neural responses to reunion with peers who had previously excluded them. We recorded event‐related potentials among nineteen 11‐ to 15‐year‐old youth previously classified on attachment interviews (11 secure and 8 insecure‐dismissing) while they played a virtual ball‐toss game (Cyberball) with peers that involved fair play, exclusion and reunion phases. Compared to secure participants, dismissing participants displayed a greater increment in the N2 during reunion relative to fair play, a neural marker commonly linked to expectancy violation. These data suggest a greater tendency toward continued expectations of rejection among dismissing children, even after cessation of social exclusion. In turn, the link between self‐reported ostracism distress and neural signs of negative expectancy at reunion was moderated by attachment, such that self‐reports were discordant with the neural index of expectancy violation for dismissing, but not for secure children. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=qzoRel5c-4s .     

Psychological Hardiness and Adjustment to Life Events in Adulthood

Data were collected from 88 persons who had lost their jobs and 227 persons whose youngest child had left home to explore the impact of psychological hardiness on personal distress, adjustment, and coping strategies. Analyses controlling for numerous sociodemographic factors as well as NEO Neuroticism and Extroversion suggested that the interaction between overall hardiness and the experience of differential life events influenced the use of planful problem solving and positive reappraisal as coping mechanisms, as well as influencing levels of positive affect. In addition, a main effect for overall hardiness on several coping strategies, positive affect, and life satisfaction was obtained. Findings also suggested that job loss was a more stressful experience for adults in this study than was the empty nest. These data indicate that hardiness may mediate responses to life events that differ in terms of their predictability and anticipatory nature.