Using Scaling to Facilitate Ethical Decision-Making in Family Therapy

Ethical decision-making in family therapy is inherently complex, as it requires therapists to balance competing needs of multiple individuals and subsystems. Scaling offers a potential means of helping facilitate such decision-making, by encouraging attendance to the likely impact of various courses of action on individuals and subsystems as related to each of the core ethical principles underlying psychotherapeutic practice. This article explores the potential use of scaling in family therapists’ ethical decision-making through case examples. Benefits and risks of such an approach are reviewed.     

Determinants of assessing efficiency within auditory attention networks

The attention network test (ANT) assesses efficiency across alerting, orienting, and executive components of visual attention. This study examined approaches to assessing auditory attention networks, and performance was compared to the visual ANT. Results showed (1) alerting was sufficiently elicited in a pitch discrimination and sound localization task, although these effects were unrelated, (2) weak orienting of attention was elicited through pitch discrimination, which varied based on ISI and conflict level, but robust orienting of attention was found through sound localization, and (3) executive control was sufficiently assessed in both pitch discrimination and sound localization tasks, but these effects were unrelated. Correlation analysis suggested that, unlike alerting and orienting, sound localization auditory executive control functions tap a shared attention network system. Overall, the results suggest that auditory ANT measures are largely task and modality specific, with sound localization offering potential to assess all three attention networks in a single task.     

Decreasing influence of arbitrarily applicable verbal relations of recreational gamblers: A randomized controlled trial

Twenty‐one recreational gamblers were randomly assigned to two groups; one group was exposed to a conditional discrimination relational training task to bias choice allocation to a black machine presented concurrently with a red machine, and the other group underwent the same relational training task immediately followed by a defusion procedure, designed to expand upon the relations developed in the initial relational task. Both groups completed a simulated slot‐machine task before and after the relational training task, with or without the defusion procedure. Results showed that 9 of 11 participants in the relational training only group showed an increased bias toward the black machine, compared to only 4 of 10 in the relational training plus defusion group; this latter group also showed greater matched responding. Results suggest that expanding verbal–relational networks may reduce the influence of any single verbal relation on gambling choice behavior.     

Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: The children of Superstorm Sandy

This study examined the effects of in utero exposure to maternal depression and Superstorm Sandy, a hurricane that hit metropolitan New York in 2012, on infant temperament at 6 months. Temperament was assessed using the Infant Behavior Questionnaire-Revised. Maternal depression was measured by the Edinburgh Postnatal Depression Scale. The main effects and the interaction of maternal depression and Sandy exposure on infant temperament were examined using a multivariable generalized linear model. Results show that prenatal maternal depression was associated with lower emotion regulation and greater distress. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in utero Sandy exposure. This study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy while also identifying high-risk families who may have suffered from disaster-related traumas to provide necessary services. As the frequency of natural disasters may increase due to climate change, it is important to understand the consequences of in utero stress on child development and to formulate plans for early identification.     

Developing an informational tool for ethical engagement in medical tourism

Background

Medical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism.

Methods

The methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists’ decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists.

Results

The final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service.

     

Relationships,Human Nature,and the Four “Words” of Inspector Gamache1

The Inspector Gamache mysteries by Louise Penny are very popular, in no small part because of the appeal of the main character, Chief Inspector Armand Gamache. However, another main draw of the series is the small set of recurring main characters. In this article, I delve deeply into their lives and relationships, using as a lens the four sayings of Gamache as a means of illuminating both the brokenness and grace that characterize human relationality.     

IMPACT OF JOINT ATTENTION ON SOCIAL‐COMMUNICATION SKILLS IN INTERNATIONALLY ADOPTED CHILDREN

Internationally adopted (IA) children have often experienced early adversity and are at risk for long‐term deficiencies in multiple developmental domains. This study examined the association between IA children's joint attention (JA) soon after arrival and later cognitive, communicative, and socioemotional competency 6 months’ postadoption. We expected a child's initial JA would positively predict later cognitive, communication, and social ability. IA children (n = 63) adopted from Eastern Europe were seen soon after their arrival into the United States to assess their JA. Their socioemotional competency, social communication, and cognitive abilities were measured at a follow‐up session 6 months’ postadoption. We found that higher order JA was positively associated with measures of social relatedness. Furthermore, individual hierarchical regressions of each measure of JA (higher order JA, initiating JA, responding to JA, and initiating behavior requests [BR]) considered with age‐at‐adoption showed that each measure was an independent and positive predictor of Mullen outcomes in the receptive and expressive language domains. These results suggest that JA may be a sensitive predictor of subsequent functioning in the social, communicative, and cognitive domains. Thus, assessing JA soon after arrival has the potential to identify at‐risk IA children, and interventions targeting JA may support those children in overcoming the negative impacts of early adversity.