Structural Effects of Poverty on Children

This paper evaluates the perceived benefit to a group of thirty caring professionals of a brief training in Child-centred play therapy. Play therapy enables a child to create fictional worlds and in this way make sense of the real world. By playing in the presence of the therapist, who provides a trusting relationship and at times shares the play, the child is able to obtain relief from the negative effects of distress, sadness, anger or shame. All course participants had adult counsellor qualifications and worked with vulnerable children (n= 25, age range = 56, mean years of experience = 10). The course was delivered in Nairobi, Kenya, East Africa via theory presentations; case presentations; practical skills demonstrations and instruction with tutor feedback and self-development awareness group teaching methods. Questionnaires provided qualitative data for consideration and analysis. Key findings included: pre-training prevalent feelings of inadequacy to meet the therapeutic needs of vulnerable children using adult style counselling; post-training perceived raised awareness of the therapeutic power of play with positive impact on professional and personal lives; perceived increase in therapeutic play skills and increased ease in establishing therapeutic rapport. Training was largely beneficial increasing the confidence, knowledge and skills of the course participants.     

A systematic review of the literature on counselling and psychotherapy for the prevention of suicide: 1. Quantitative outcome and process studies

Scope of review: The paper reports a meta‐review of 15 previous systematic reviews and meta‐analyses of the literature concerning the outcome of counselling and psychotherapy with people at risk of suicide; a meta‐analysis of 67 outcome studies in this area; and a narrative review of 17 studies of the therapeutic process. Publication time span: The literature reviewed was published between 1981 and 2008. Publication origin: The majority of the literature reviewed was by authors from the USA or the UK, but there were also authors from other European countries, Australia, Canada, India, and Sri Lanka. Findings: There is evidence of the effectiveness of dialectical behaviour therapy, cognitive‐behavioural therapy, and problem solving therapy, but also for other forms of therapy. Therapist and client variables, as well as the therapeutic relationship, appear to be related to treatment outcome. Conclusions: People at risk of suicide should have access to psychological interventions, including, but not necessarily limited to, those within the cognitive‐behavioural spectrum. Therapies for which there have been promising findings, but which are under‐researched, should be a research priority.     

Determining Risk in Pediatric Research with No Prospect of Direct Benefit: Time for a National Consensus on the Interpretation of Federal Regulations

United States federal regulations for pediatric research with no prospect of direct benefit restrict institutional review board (IRB) approval to procedures presenting: 1) no more than “minimal risk” (§ 45CFR46.404); or 2) no more than a “minor increase over minimal risk” if the research is commensurate with the subjects' previous or expected experiences and intended to gain vitally important information about the child's disorder or condition (§ 45CFR46.406) (DHHS 2001). During the 25 years since their adoption, these regulations have helped IRBs balance subject protections with the pursuit of scientific knowledge to advance children's welfare. At the same time, inconsistency in IRB application of these regulations to pediatric protocols has been widespread, in part because of the ambiguity of the regulatory language. During the past decade, three federally-charged committees have addressed these ambiguities: 1) the National Human Research Protections Advisory Committee (NHRPAC) (Washington, DC), 2) the Institute of Medicine (IOM) Committee on the Ethical Conduct of Clinical Research Involving Children (Washington, DC); and 3) the United States Department of Health and Human Services Secretary's Advisory Committee for Human Research Protections (SACHRP) (Washington, DC). The committees have reached similar conclusions on interpretation of language within regulations § § 45CFR46.404 and 406; these conclusions are remarkably consistent with recent international recommendations and those of the original National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1977) National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. 1977. Report and recommendations: Research involving children, Washington, DC: U.S. Government Printing Office.  [Google Scholar] report from which current regulations are based. Drawing on the committees' public reports, this article identifies the ethical issues posed by ambiguities in regulatory language, summarizes the committees' deliberations, and calls for a national consensus on recommended criteria.     

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent among adolescents enrolled in behavioral health services but remains undertreated, and the first-line treatment option, stimulant medication, is underutilized. To address this gap, this article introduces the Medication Integration Protocol (MIP): ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about integrating medication interventions into primary care; managing medication priorities for adolescents with multiple diagnoses, including substance use problems; and the compatibility of MIP with everyday practice conditions.     

The Startle Pattern in Infants in Response to Non-Auditory Stimuli

Abstract

Goldstein, K. Human Nature in the Light of Psychopathology. Cambridge: Harvard Univ. Press, 1940. Pp. 258 Reviewed by Frederick Wyatt. Reviewed by Frederick Wyatt

Katona, G. Organizing and Memorizing. New York: Columbia Univ. Press, 1940. Pp. 318. Reviewed by Livingston Welch     

Images of Resistance: A Qualitative Enquiry Into the Meanings of Personal Artwork for Women Living With Cancer

This study explored the meanings, inspirations, and subjective significance of personal artwork created as a leisure activity by women living with cancer. A convenience sample of 12 women aged 23–74 years participated in semistructured interviews. Participants were living in various stages of the cancer trajectory, and engaged in several forms of visual art-making. They submitted examples of their artwork by photograph and explored the meanings of this work in semistructured interviews. The study found that body imagery was extremely rare in participants' array of artwork, unlike the images typically created in art therapy. Few pieces expressed fears about cancer in symbolic terms. Participants described their selected artwork as offering sensuous pleasures, and confirming their ongoing capability, personal continuity, and social connectedness. Participants acknowledged ongoing loss and difficulties related to cancer. However, each piece of art offered a tangible record of resistance against the psychologically and socially disruptive effects of cancer, helping to maintain a familiar noncancer identity. The preinterview photography activity was helpful for empowering participants in the interview, and for stimulating detailed memories.     

The effect of message framing on self-management of chronic pain: A new perspective on intervention?

This study examines framed messages as a novel approach to promote self-management of chronic pain. Primary care patients reporting chronic pain (pain rated?≥?4 on 0–10 NRS-I for ≥3 months) were randomly assigned to receive a gain- or loss-framed message promoting self-management of pain. Impact of the framed message on behavioural self-management (including communicating with providers, relaxation, activity pacing, pleasant activities and healthy lifestyle) was assessed. Post-message, individuals in the loss-frame condition reported significantly greater interest in and more knowledge gained from the information presented in the message (p?≤?0.03). Loss-frame participants were significantly more likely to express confidence that they would practice relaxation (p?≤?0.03). Pain readiness to change, pain self-efficacy and message frame independently influenced motivation to engage in relaxation as a self-management strategy. Across all behaviours assessed, there were no observed interactions between message frame and either pain self-efficacy or pain readiness to change (p?>?0.05). Framing may be useful to promote pain self-management; larger trials are needed to fully evaluate its potential and to further assess the applicability of framed communication to impact a broader range of chronic conditions.     

Decisions to donate bone marrow: The role of attitudes and subjective norms across cultures

Abstract

This paper reports the results of a field investigation of the determinants of decisions to donate bone marrow. Predictions are made on the basis of a modification of the theory of reasoned action wherein attitudes are operational-ized in separate affective and evaluative components. Boundary conditions of the theory of reasoned action are further explored by examining the effects of culture (Hong Kong Chinese, N= 190; American Chinese, N = 107; black Americans, N = 124; and white Americans N = 122) on decisions to donate for each of four targets: Immediate Family Members (TFM), Close Relatives (CR), Ethnic Strangers (ES), and Total Strangers (TS). For this life or death decision, the willingness to give is hypothesized to vary as a function of the so-called fitness value of the recipients (i.e., their capacity to contribute to the donor's inclusive fitness), as modified by cultural differences between group- versus independent-based cultures. Among other results, the following gradient was found in attitudes, subjective norms, and intentions for Chinese: IFM > CR > ES > TS; for Americans the pattern was IFM = CR > ES = TS. American Chinese showed stronger attitudes and felt norms, but not intentions, to give to close relatives than did Hong Kong Chinese, reflecting differential in-group/out-group pressures. Black and White Americans showed stronger attitudes, subjective norms, and intentions to donate to strangers than did Chinese.     

Book reviews

BERNARD RIMLAND:Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behaviour. Methuen. London. 1965. 36/-     

Working memory differences in illusory recollection of critical lures

In the present experiments, we explored the relationship between individual differences in working memory (WM) capacity and susceptibility to false recognitions and their accompanying subjective experiences. Deese/Roediger–McDermott (DRM) associative lists were used to elicit false memories, and remember/know judgments were used to measure the recollective experiences accompanying recognition decisions. We found that WM capacity was related to false recognitions of nonpresented critical lures and to the proportion of remember responses given to critical lures, such that higher WM capacity was associated with lower false-recognition rates and with lower proportions of remember responses. Importantly, these WM differences were only found when participants were forewarned about the nature of the DRM task prior to encoding (Exp. 1). When the forewarning was absent, WM capacity was not related to false recognitions or to the proportion of remember responses given to critical lures (Exp. 2). These results support the controlled-attention view of WM and suggest that subjective experiences of falsely recognized lures fluctuate as a function of WM capacity.