Transition,transformation and the art of losing: Some uses of poetry in hospice care for the terminally ill

What lessons for psychotherapy can be drawn from the enjoyment and sustenance we find in the use of literature? This paper looks back on a recent creative writing project undertaken with patients in a hospice day centre, and suggested reasons why the patients found this activity not only enjoyable but also therapeutic. Both the hospice as an institution and the poetic form are defined in terms of a transitional space. The article shows how the act of reading and writing poetry places a value for patients on not knowing at a time when the plain hard facts of terminal illness loom large. The author describes a practical way of engaging with poetry in this context, and uses clinical material to describe how the literary arts can provide a transformational object, and a point of inspiration, that may help patients to negotiate the changes brought about by their illness.     

Relative Efficacy of Cognitive-Behavioral Therapy Administered by Videoconference for Posttraumatic Stress Disorder: A Six-Month Follow-Up

Until recently, only one study was published on cognitive-behavioral therapy (CBT) of posttraumatic stress disorder (PTSD) in individual therapy via videoconference (Germain, Marchand, Bouchard, Drouin, & Guay, 2009 Germain, V., Marchand, A., Bouchard, S., Drouin, M. S. and Guay, S. 2009. Effectiveness of cognitive behavioural therapy administered by videoconference for posttraumatic stress disorder. Cognitive Behaviour Therapy, 38: 42–53. [Taylor & Francis Online] , [Google Scholar]); however, it only assessed the posttreatment effect. This study presents the follow-up of Germain et al.'s (2009 Germain, V., Marchand, A., Bouchard, S., Drouin, M. S. and Guay, S. 2009. Effectiveness of cognitive behavioural therapy administered by videoconference for posttraumatic stress disorder. Cognitive Behaviour Therapy, 38: 42–53. [Taylor & Francis Online] , [Google Scholar]) study. The main goal was to compare the effectiveness after six months of CBT for PTSD either face-to-face (n = 24) or by videoconference (n = 12). Each participant received CBT for 16 to 25 weeks and completed various questionnaires before and after treatment and at a six-month follow-up. The two treatments had equivalent levels of symptom reduction (Modified PTSD Symptom Scale: η² < 0.01, p > .05) and proportion of patients with a clinically significant change in symptoms (42% for face-to-face vs. 38% for videoconferencing, p > .05). Thus, CBT for PTSD via videoconference seems to be a viable alternative when adequate face-to-face treatments are less available.     

Functionalism about possible worlds

Various writers have proposed that the notion of a possible world is a functional concept, yet very little has been done to develop that proposal. This paper explores a particular functionalist account of possible worlds, according to which pluralities of possible worlds are the bases for structures which provide occupants for the roles which analyse our ordinary modal concepts. It argues that the resulting position meets some of the stringent constraints which philosophers have placed upon accounts of possible worlds, while also trivializing the question what possible worlds are. The paper then discusses a range of problems facing the functionalist position.     

Evolutionary Biology and Classical Teleological Arguments for God's Existence

Much has been made of how Darwinian thinking destroyed proofs for the existence of God from ‘design’ in the universe. I challenge that prevailing view by looking closely at classical ‘teleological’ arguments for the existence of God. One version championed by Aristotle and Thomas Aquinas stems from how chance is not a sufficient kind of ultimate explanation of the universe. In the course of constructing this argument, I argue that the classical understanding of teleology is no less necessary in modern Darwinian biology than it was in Aristotle's time. In fact, modern biology strengthens the claims that teleological arguments make by vindicating many of their key features. As a consequence, I show how Aristotle and Aquinas' teleological argument for an intelligent First Cause remains valid.     

Iconicity in the speech of children and adults

Iconicity – the correspondence between form and meaning – may help young children learn to use new words. Early‐learned words are higher in iconicity than later learned words. However, it remains unclear what role iconicity may play in actual language use. Here, we ask whether iconicity relates not just to the age at which words are acquired, but also to how frequently children and adults use the words in their speech. If iconicity serves to bootstrap word learning, then we would expect that children should say highly iconic words more frequently than less iconic words, especially early in development. We would also expect adults to use iconic words more often when speaking to children than to other adults. We examined the relationship between frequency and iconicity for approximately 2000 English words. Replicating previous findings, we found that more iconic words are learned earlier. Moreover, we found that more iconic words tend to be used more by younger children, and adults use more iconic words when speaking to children than to other adults. Together, our results show that young children not only learn words rated high in iconicity earlier than words low in iconicity, but they also produce these words more frequently in conversation – a pattern that is reciprocated by adults when speaking with children. Thus, the earliest conversations of children are relatively higher in iconicity, suggesting that this iconicity scaffolds the production and comprehension of spoken language during early development.     

Exploring teenagers' adaptive and maladaptive thinking in relation to the threat of hiv infection

Abstract

Teenagers' HIV-preventive cognitions were explored within a protection motivation theory framework. Five hundred and seven adolescent men and women from two cohorts (sixteen and eighteen) completed a confidential postal questionnaire. The effect of demographic variables, previous sexual experience and appraisal of threat and coping resources upon HIV-relevant cognitions was investigated using path analysis. Cognitions promoting (adaptive) and inhibiting (maladaptive) preventive behaviour were considered. Anticipated condom use, intention to limit number of sexual partners and willingness to consider an HIV antibody test were included as adaptive HIV-preventive cognitions. Coping appraisal measures were strongly associated with anticipated condom use but threat appraisal measures were not. Gender, previous sexual experience, coping appraisal measures and denial accounted for 33% of the variance in anticipated condom use. Overall the results provided qualified support for Protection Motivation Theory. Implications for health education are highlighted.     

A Tale of Two Cities: Predicting Homeless People's Uptake of Outreach Programs in London and New York

Two studies involved structured interviews with 203 homeless people to examine the impact of sociodemographic variables, prior behavior, and the theory of planned behavior (TPB) variables, attitudes, subjective norms, perceived behavioral control, and intention, on uptake of outreach services. Study 1 was conducted in London, and Study 2 involved a comparable sample in New York. In line with previous research, the psychological variables accounted for more variance than the sociodemographic variables, and there was no evidence that the effects of TPB variables were moderated by sociodemographics. In London intentions and behavior were most affected by perceived control and subjective norms. In New York they were most affected by perceived control and attitude. These differences may be attributable to different institutional structures and opportunities for service uptake in the two cities. Sensitivity of the TPB to social context and implications for intervention strategies are discussed in light of these differences.     

Designated as Dangerous: Characteristics of Sex Offenders Subject to Post‐Sentence Orders in Australia

The earliest characterisation of Australian sex offenders subjected to post‐sentence legislation is presented. Demographic, developmental, clinical, and criminal characteristics were obtained for sex offenders under post‐sentence orders in Western Australia, New South Wales, and Victoria. Data on 50 offenders were recorded from psychological and psychiatric risk assessment reports statutorily required at the initiation of post‐sentence legal proceedings. The findings describe a group of demonstrably dangerous men who exhibited an early onset of sexual offending, high rates of mental disorder, sexual deviance, and antisociality. Their developmental histories are characterised by early deprivation, disadvantage, abuse, early exposure to substance abuse, and social and psychological dislocation. These offenders present a conundrum to criminal justice agencies. They are an objectively unfortunate group and have engaged in significantly harmful behaviours. However, the early onset of their offending suggests that early intervention services, such as those offered by mental health professionals, have a critically important role to play in any effort to alter offending trajectories such as those exhibited in this sample. A paradigm shift in public policy from a post hoc model to a well‐resourced preventative and public health approach to the problem of sexual violence is proposed. Broad treatment implications are also considered.     

Indirect goal priming is more powerful than explicit instruction in children

This study examined the relative efficacy of explicit instruction and indirect priming on young children's behavior in a task that required a series of choices between a small immediate reward and a larger delayed reward. One hundread and six 4-year-old children were randomly assigned to one of four conditions involving one of two goals (maximize rewards or obtain immediate rewards) and one of two types of instruction (indirect priming using stories or explicit verbal instructions). Children were more likely to make goal-congruent choices as a result of indirect priming, but there was no effect of explicit instruction, suggesting that indirect approaches to changing young children's behavior may be more effective than direct approaches under some circumstances. These results have implications for understanding the dynamic interplay between bottom-up and top-down influences on self-regulation early in development.