Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Eco-restrictive experiences forming extraordinary consumer experiences

This article contributes to different research traditions when proposes to reflect on theoretical fields, such as consumer culture and contemporary marketing. The study in a tourist and ecological conservation project revealed eco-restricted extraordinary experiences. We found a group of volunteers that build meanings and practices connected with new actions and habits that offer, not only ecological and sustainable benefits, but new value consumption relations. In contextualizing our findings, we highlight experiences and curiosities that are glossed over in academic and practical accounts that celebrate the extraordinary experience. It was observed, by analyzing data from various qualitative techniques, that the findings cross borders of mundane ingrained practices and bring an emerging domain, where both, consumption and anti-consumption experiences, offer insights into to a diversity of areas of knowledge.     

The effect of the two-chair dialogue intervention on self-compassion - adding an emotional evocative component to a basic Rogerian condition

Objective

How people relate to themselves when facing distress or failure influences general psychological well-being and vulnerability to psychological disorders. The aim of the present study was to explore the effect of an emotionally evocative intervention on self-compassion.

Methods

The data were retrieved from a larger study of Emotion-Focused Therapy (EFT) utilising a multiple baseline design comparing two treatment phases. The baseline phase consisted of 5, 7 or 9 therapy sessions where the therapist solely adhered to Rogerian relational conditions, as prescribed in EFT. A two-chair dialogue intervention was then added for five sessions. The sample consisted of 18 self-critical clients with clinically significant symptoms of depression and/or anxiety. The “Self-Compassion Scale” (SCS) was administered pre, mid and post therapy.

Results

The baseline phase did not lead to significant changes in self-compassion. However, the addition of the two-chair dialogue was associated with a significant increase in self-compassion. This increase was due to reductions in the negative subscales, especially the isolation subscale.

Conclusion

The emotionally evocative two-chair dialogue was associated with a significant change in self-to-self relating, compared to relational conditions alone. The two-chair dialogue, thus, seems to be a promising intervention for promoting healthier self-to-self relating.     

Encoding and memory for verbal and pictorial stimuli

Memory for visually presented verbal and pictorial material was compared using stimuli chosen to minimize non-essential differences between the two types of material. Experiment I required retention of a short list; verbal and pictorial stimuli were remembered equally well. Experiment II required recall of single items after 30 s of backwards counting; recall was much superior for pictorial stimuli. The type of task appeared to affect encoding, with verbal encoding reported to be predominant in Experiment I and visual encoding, or imagery, common in Experiment II.     

Murder in the family: An analysis of two Poe short stories

Learning to be possessed has been described elsewhere by the writer as a form of pathogenic relating begun when children are taught by adults that they will receive a lesser penalty for misbehavior if they can show they were not responsible, such as if it were caused by an evil agent or the Devil. It was suggested that learning to be possessed can be an underlying cause of psychopathology, the delusion of persecution in particular. Two short stories by the distinguished American writer Edgar Allan Poe are examined to develop the formulation of learning to be possessed, especially when it has passed to a delusion of persecution. Two propositions are offered: (1) Where it appears that a family member is murdered by a delusional assailant by accident, it is not an accident; and (2) the delusion of persecution entails a memory loss so that the murderer not only can claim lack of personal responsibility for the act, but also spares himself the guilt of having broken a fundamental taboo. Further comparison is made between learning to be possessed as a cause of delusion, and the psychoanalytic theory in which the defense mechanism of projection is central. In the latter theory, interpretation of the delusion is critical; whereas in the former, interpretation is counterproductive because it merely reinforces the delusion.Probably a note of appreciation is due the writer's daughter Cary, who at age 14 is an expert at badgering her father for help with homework assignments. For several weeks the writer was alternatively pestered and cajoled to help Cary with her Poe Project for high school English which required an essay analyzing the work of a great American writer denigrated by the author as weird by his recollection formed decades earlier. Cary's persistence required the author to consider Poe anew, to recognize his unwarranted earlier prejudice, and to recognize that Poe offered him a gift of understanding regarding a topic about which the author had been thinking for several years, namely that form of pathogenic relating named learning to be possessed.     

Improvisational therapy: Evolving one's own clinical style

This article offers an invitation to develop one's own unique clinical style, relying less on institutionalized schools of therapy and more on the therapist's own natural resources. An emphasis is placed upon understanding therapy as art, trusting one's imagination, and maintaining a healthy irreverence for professional politics.     

Arousal and paired-associate learning

Walker and Tarte (1963) postulate that at short retention intervals high arousal paired-associates are reproduced more poorly than low arousal items. Walker and colleagues believe that this hypothesis is confirmed by their paired-associate learning studies. However, results of these paired-associate learning studies are position confounded artifacts. Better recall of low arousal items at short-term retention is caused by the coincidence of the recency effect and low arousal at the end of the trial. When these position effects are controlled there is no action decrement for the high arousal paired-associates. To test this assumption, the Kleinsmith and Kaplan study (1963) was replicated and two other variations were conducted. In these three studies with 76 subjects, which were tested at two minutes or 1 week, the action decrement occurs only when the two position effects coincide.     

Family coping strategies and the rural Appalachian working poor

Naturalistic research methods were used in this study to collect the voices, ideas, and opinions of rural, working poor, Appalachian families from Southeast Ohio about the stress of poverty in family life and family coping in the face of poverty. This data should be of interest to the professional family therapist who practices with the working poor.