State regulation of managed care: fragments of reform

State legislatures consider numerous bills to regulate managed care organizations. After identifying the legal, political, and economic barriers to state reform efforts, the paper assesses recent types of state regulation, particularly mandated benefits and disclosure requirements. Two prerequisites to future reform, coalition building and the diffusion of information about managed care, are analyzed.     

BEHAVIORAL THERAPY DEVELOPMENT AND PSYCHOLOGICAL SCIENCE:

Abstract— An abundance of research from diverse areas of psychological science is potentially relevant to behavioral therapy development research. The National Institute on Drug Abuse of the National Institutes of Health convened a workshop to reinforce the connection between basic behavioral and therapy development research. The articles in this Special Section are the product of this workshop. Several lines of basic behavioral research are described, and implications for the development of behavioral therapies are discussed. This Special Section highlights the notion that strengthening the bond between behavioral therapy development research and basic behavioral science will accelerate the advancement of knowledge about behavior, behavioral change and therapeutic interventions.     

A general linear model for estimating effect size in the presence of publication bias

When the process of publication favors studies with smallp-values, and hence large effect estimates, combined estimates from many studies may be biased. This paper describes a model for estimation of effect size when there is selection based on one-tailedp-values. The model employs the method of maximum likelihood in the context of a mixed (fixed and random) effects general linear model for effect sizes. It offers a test for the presence of publication bias, and corrected estimates of the parameters of the linear model for effect magnitude. The model is illustrated using a well-known data set on the benefits of psychotherapy.Authors' note: The contributions of the authors are considered equal, and the order of authorship was chosen to be reverse-alphabetical.     

“mother is not holding competely respect”: Making social sense of schizophrenic writing

This paper provides a phenomenological account of the writing of a young woman diagnosed with schizophrenia. The method of interpretation is to put ourselves in the place of the author drawing upon a combination of sympathy, reason, common-sense, experience, and “an intersubjective world, common to us all” (Schutz, 1945: 536). The result is the recognition of the person as also capable of putting herself in the place of others so as to understand their behavior. This “role-taking success” identifies the limits of the current sociological understanding of insanity's significance in social interaction as an instance of “role-taking failure” (Rosenberg, 1992). The very appearance of a piece of writing often permits one to recognize the presence of schizophrenia. The use of space may be quite bizarre. The varying margins betray the writer's changing mood. The letter may start at the bottom or side of the paper or very close to the top .... Capital letters and all letters are employed without any apparent rules, the former even in the middle of a word. (Bleuler, 1950: 159) What we want to understand is not something hidden behind the text, but something disclosed in front of it. (Ricoeur, 1971: 557) Why do we need an art of guessing? Why do we have to “construe” the meaning? Not only — as I tried to say a few years ago — because language is metaphorical and because the double meaning of metaphorical language requires an art of deciphering which tends to unfold the several layers of meaning.... [But also] because [a text] is not a mere sequence of sentences, all on an equal footing and separately understandable. A text is a whole, a totality. (Ricoeur, 1971: 548)     

A DEVELOPMENTAL DEFICIT IN LOCALIZING OBJECTS FROM VISION

Abstract— We describe a college student, A. H., with a developmental deficit in determining the location of objects from vision. The deficit is selective in that (a) localization from auditory or tactile information is intact, (b) A H reports the identity of mislocalized objects accurately, (c) visual localization errors preserve certain parameters of the target location, and (d) visual localization is severely impaired under certain stimulus conditions, but nearly intact under other conditions. These results bear on the representation and processing of location information in the visual system, and also have implications for understanding developmental dyslexia.     

Direct comparisons between residential and community students on school performance measures in a public school setting

The purpose of the current study was to evaluate the school performance of residential youth who attended a public school setting. Direct comparisons were made between the residential youth and students in the community on a number of school measures. Results from a multivariate analysis of covariance indicated that the residential students had significantly lower grades, participated in significantly fewer extracurricular activities, and exhibited more problematic behaviors such as tardies and absences. These findings were consistent with previous research which found that many residential youth have a number of behavioral, social, and academic difficulties that interfere with school functioning. A number of recommendations were made regarding educational placement for residential youth.     

Client Cognitive Responses as a Function of Quality of Counselor Verbal Responses

This study examined the relationship between high and low quality counselor responses in four response modes and client cognitions. Twenty-one university students participated in two sessions of brief counseling that included high and low quality counselor responses in paraphrasing, questioning, reflection of feeling, and self-disclosure. After each counseling session, participants used Kagan's (1975) interpersonal process recall method to report their cognitions in response to these counselor responses. Results indicated that the participants had more favorable cognitions toward the counselor associated with high quality counselor paraphrasing and reflection of feeling responses. Participants' cognitions directed toward themselves did not differ in response to any of the four high and low quality counselor responses. Implications of the results are discussed.     

On Alan Turing's anticipation of connectionism

It is not widely realised that Turing was probably the first person to consider building computing machines out of simple, neuron-like elements connected together into networks in a largely random manner. Turing called his networks unorganised machines. By the application of what he described as appropriate interference, mimicking education an unorganised machine can be trained to perform any task that a Turing machine can carry out, provided the number of neurons is sufficient. Turing proposed simulating both the behaviour of the network and the training process by means of a computer program. We outline Turing's connectionist project of 1948.In Memory of Robin Gandy