Integrated,Family‐based,Partial Hospital Treatment for Complex Pediatric Illness

This paper describes a unique treatment program for complex pediatric illness. The Hasbro Children's Partial Hospital Program uses a family systems orientation, integrated care, and a partial hospital setting to treat children with a wide range of pediatric illnesses that have failed outpatient and inpatient treatments. We have treated more than 2000 children with at least 80 different ICD‐9 diagnoses. The multidisciplinary treatment team functions as a meta‐family for children and their families who present with illness and family beliefs that impede successful outcomes with standard care. The three features: family systems orientation, integrated care, and partial hospital setting, hopefully interact to create an environment that helps families expand and modify their explanatory models regarding participating in effective medical care. The goal of treatment is for both children and their parents to feel empowered to take control of the illness. Parents completing standardized measures at intake describe their children and families as experiencing significant emotional distress, low levels of general family functioning, and poor quality of life. Although the children are described as having distinct behavioral differences, the families are described as responding to the experience of a seriously ill child in similar ways. A treatment program that addresses the noncategorical aspects of how families respond to illness while addressing the specific diseases of the children can allow children and their families to respond favorably to treatment.     

Meaning making,self‐determination theory,and the question of wisdom in personality

Self‐determination theory (SDT) has advanced the most comprehensive model of motives for human flourishing in the field of personality psychology and beyond. In this article, we evaluate SDT relative to the process of meaning making, particularly from a narrative perspective, showing what SDT can and cannot explain about the construction of self‐identity and its relation to human flourishing. On the one hand, SDT explains how subjective assessments of need fulfillment drive the process of self‐determined living. The internal motives that follow such fulfillment serve as important themes in people's life stories that predict several markers of hedonic and eudaimonic well‐being. On the other hand, SDT's focus on subjective fulfillment limits what SDT can explain about how wisdom, which is a canonical good of both eudaimonia and meaning making, helps people make sense of life's more difficult or unfulfilling events. SDT may facilitate a facet of wisdom that is more subjective and experiential but not the critical facet of wisdom defined by objectively more complex structures of interpretation.     

Why Take Both Boxes?

The crucial premise of the standard argument for two‐boxing in Newcomb's problem, a causal dominance principle, is false. We present some counterexamples. We then offer a metaethical explanation for why the counterexamples arise. Our explanation reveals a new and superior argument for two‐boxing, one that eschews the causal dominance principle in favor of a principle linking rational choice to guidance and actual value maximization.     

What is hope?

According to the standard account, to hope for an outcome is to desire it and to believe that its realization is possible, though not inevitable. This account, however, faces certain difficulties: It cannot explain how people can display differing strengths in hope; it cannot distinguish hope from despair; and it cannot explain substantial hopes. This paper proposes an account of hope that can meet these deficiencies. Briefly, it argues that in addition to possessing the relevant belief–desire structure as allowed in the standard account, a hopeful person must also be able to see a way in which the desired outcome can come about and to see such a way to the outcome as a genuine possibility.     

Psychological impact of colorectal cancer screening.

This article examines the psychological impact of participating in sigmoidoscopy screening for colorectal cancer prevention. The 1st study examined psychological well-being at 3 months, in relation to screening outcome, in 4,153 individuals. The 2nd study used longitudinal data to examine changes in psychological functioning from before to after screening in relation both to screening outcome and baseline indicators of vulnerability. There were few psychological differences between those who had received negative results or had polyps detected. These findings were confirmed in the longitudinal study, which also found no evidence for vulnerability to adverse effects among those who were initially most anxious or who perceived their risk of cancer to be higher. The longitudinal data suggested that screening might produce transient positive effects.