Substance Abuse Counselors in Recovery: Implications for the Ethical Issue of Dual Relationships

The issue of dual relationships is a significant ethical challenge for all counselors. For the counselor recovering from an addiction to substances, this issue can be even more problematic. Existing codes of ethics offer insufficient guidance to the recovering counselor. Following an overview of dual relationships, the author reviews the ethical codes of the American Counseling Association and the National Association of Alcoholism and Drug Abuse Counselors, with particular attention paid to their applicability to the recovering counselor. Potentially difficult situations are considered, and recommendations are offered both for the recovering counselor and for the counseling field in general to minimize the incidence of unethical behavior due to dual relationship issues.     

Teaching chained skills in a non-school setting using a divided half instructional format

This investigation evaluated the use of dyadic instructional arrangements in teaching chained skills to four students with moderate mental retardation. Each instructional dyad consisted of two students. Each of the three cooking skills was divided into two equal parts, and each student in a dyad received direct instruction on one part of the task analysis during each instructional session. During the following session, the two parts were reversed and a student received instruction on the second part. A constant time delay procedure was used to teach the targeted skills in an off-campus setting. A multiple probe design across skills and replicated across students evaluated the effectiveness of the instructional procedure and teaching arrangement. Results indicate that each of the four students learned the three cooking skills. Implications for future research are discussed.     

Effects of presenting incidental information in consequent events on future learning

The effects of presenting future target stimuli in the consequent event following correct responses to current target stimuli were examined in two experiments teaching eight students with moderate handicaps to name photographs. In Experiment I, progressive time delay was used to teach two sets of photographs. During instruction, correct responses to one set of stimuli resulted in praise and presentation of the printed word for the person in the photograph (future condition). In the second set, a correct response was followed by praise alone (non-future condition). After establishing criterion level performance on both sets of photographs, students were taught to read the printed word from each of the two sets. Experiment II was a systematic replication of Experiment I. Four students from a different classroom also were taught to name two sets of photographs. An adapted alternating treatments design was used in each experiment. The results indicated that (a) all students learned to name the photographs; (b) presentation of future target stimuli (words) in consequent events resulted in seven of the eight students learning to read some of the words; and (c) the total number of sessions, trials, errors, and percentage of errors     

The Rapid Establishment of Low-Rate Fixed Interval Responding by Humans in a Single Experimental Session

Subjects responding to receive monetary reinforcement on a fixed interval schedule were read instructions containing varying amounts of information regarding the schedule contingencies prior to their participation in the experiment. In addition, some subjects were exposed to an additional response cost contingency for early responding. The results indicate that reliable low-rate fixed interval responding can be rapidly generated in a single 45-minute experimental session when subjects are provided with explicit instructions together with the response cost contingency.

     

The preservation of amplitude information in burst phenomena in physiological recordings

This paper describes an inexpensive and simple electronic circuit that rectifies and smooths high-frequency burst data and holds the peak value of the burst for predetermined time intervals.     

Evaluating the validity of anger regulation problems, interpersonal style, and disturbed mental state for predicting inpatient violence

Research has been conducted to try to identify risk factors to help predict which patients will be violent during psychiatric hospitalization. Despite the relatively large amount of research conducted, it is difficult to draw any firm conclusions, as the studies vary considerably in study design, methods used, and choice of outcome measures. Studies also tend to focus on risk prediction, even though risk management is the primary aim of clinical practice in mental health services and few studies have focused on a theoretical basis for understanding violence. This study assessed the predictive validity of brief assessment scales in a sample of 94 forensic inpatients who had been inpatient for a median of 521 days, to test the hypotheses that anger regulation problems, interpersonal style, and disturbed mental state would be linked to increased violence risk in a forensic hospital during a hospital stay. The outcome variables for this study were physical violence against another and/or clear threats of physical violence. The results of this study provide support for the hypotheses, and this remained the case after controlling for age, gender, length of stay, and presence of major mental disorder. The findings should not only assist clinicians with assessment and management of risk but also support the reconceptualizing of risk prediction research to reflect the task of clinical risk management.     

Genetic Evaluation and Counseling of Couples with Recurrent Miscarriage: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic evaluation and counseling of couples with recurrent miscarriage (RM). The recommendations are the opinions of the multidisciplinary Inherited Pregnancy Loss Working Group (IPLWG), with expertise in genetic counseling, medical genetics, maternal fetal medicine, internal medicine, infectious disease, cytogenetics, and coagulation disorders. The IPLWG defines RM as three or more clinically recognized consecutive or non-consecutive pregnancy losses occurring prior to fetal viability (<24 weeks gestation). These recommendations are provided to assist genetic counselors and other health care providers in clinical decision-making, as well as to promote consistency of patient care, guide the allocation of medical resources, and increase awareness of the psychosocial and cultural issues experienced by couples with RM. The IPLWG was convened with support from the March of Dimes Western Washington State Chapter and the University of Washington Division of Medical Genetics. The recommendations are U.S. Preventive Task Force Class III, and are based on clinical experiences, review of pertinent English-language published articles, and reports of expert committees. This document reviews the suspected causes of RM, provides indications for genetic evaluation and testing, addresses psychosocial and cultural considerations, and provides professional and patient resources. These recommendations should not be construed as dictating an exclusive course of medical management, nor does the use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the circumstances of a specific case, should always supersede these recommendations.     

FACILITATING GENERALIZED REQUESTING BEHAVIOR IN BROCA'S APHASIA: AN EXPERIMENTAL ANALYSIS OF A GENERALIZATION TRAINING PROCEDURE

The effects of a generalization training procedure on requesting by 4 subjects with chronic Broca's aphasia were examined using a multiple baseline design across behaviors and subjects. Subjects were trained to request information on three topics sequentially. Generalization across topics and persons was assessed in weekly probe sessions consisting of 5-min conversational interactions with trainers and unfamiliar volunteers in a nontreatment setting. Results revealed generalization effects were greatest when trainers, as opposed to unfamiliar volunteers, served as conversational participants. Nevertheless, subjects' requests increased with all conversational participants to a level comparable to a normal comparison group assessed under conditions identical to the experimental probes. Social validation of treatment effects using a subjective evaluation procedure revealed significant improvement on the parameters of talkativeness, inquisitiveness, and conversational success.     

Further experiments on the perception of growth in three dimensions

Mark and Todd (1983) reported an experiment in which the cardioidal strain transformation was extended to three dimensions and applied to a three-dimensional (3-D) representation of the head of a 15-year-old girl in a direction that made the transformed head appear younger to the vast majority of their subjects. The experiments reported here extend this research in order to examine whether subjects are indeed detecting cardioidal strain in three dimensions, rather than detecting changes in head slant or making 2-D comparisons of the shape of the occluding contour. Three-dimensional surfaces were obtained by measuring a real head manually (Experiment 1) and with a laser scanner (Experiment 2), and transformed to different age levels using the 3-D strain transformation described by Mark and Todd (1983). There were no statistically significant differences in the accuracy with which relative age judgments could be made in response to pairs of profiles, pairs of 3/4 views, or pairs of mixed views (profile plus 3/4 view), suggesting that subjects can indeed extract the cardioidal strain level of the head in three dimensions. However, an additional effect that emerged in these studies was that judgments were crucially affected by the instructions given to subjects, which suggests that factors other than cardioidal strain are important in making judgments about rich data structures.