Some thoughts and responses to The Francis Report

This response to the report by lawyer Robert Francis into the failure of National Health Service (NHS) care in Mid-Staffordshire is fairly positive about its conclusions but points out that without consideration of personal, psychosocial factors in care, on the ward, in the institution things are unlikely to improve, the report leaves much unconsidered. Francis emphasises that patient care is at the very centre of the NHS, this is obvious but so often forgotten. He comments that the unhelpful blame culture still exists. Missing from Francis’ analysis is a psychological perspective – the systemic factors he mentions are administrative not relational. This response is an attempt to redress the balance in thinking about the improvement of care for patients and of the working lives of staff.     

Cancer fear and the interpretation of ambiguous information related to cancer

We tested the hypothesis that people with a high fear of cancer would be more likely to interpret ambiguous information about cancer in a negative manner compared with people low on cancer fear. Adults (n=47) aged 50–70, who scored either high (n=16) or low (n=31) on cancer fear, took part in a laboratory-based ambiguous sentences task. Participants were presented with ambiguous cancer and social threat scenarios mixed with unambiguous neutral scenarios. Interpretations were assessed in a recognition task, by asking participants to rate disambiguated sentences in terms of how similar in meaning they were to the originals. People high on cancer fear were more likely to endorse negative interpretations of the original ambiguous cancer scenarios than were people low on cancer fear. This negative interpretation bias was specific to cancer scenarios and was not observed for the social threat scenarios.     

When death thoughts lead to death fears: Mortality salience increases death anxiety for individuals who lack meaning in life

Research derived from terror management theory demonstrates that subtle reminders of mortality increase strivings for meaning. It is argued that such strivings reflect efforts to prevent the anxiety that death reminders may otherwise cause. However, no research has directly tested the assertions that subtle mortality primes increase death anxiety and perceptions of meaning in life moderate this effect. The current study examined these predictions. Meaning in life was measured, death cognition primed, and death anxiety assessed. A mortality prime increased death anxiety, but only for individuals who lack perceptions of meaning in life. Theoretical and applied implications are discussed.     

CACREP Accreditation: A Solution to License Portability and Counselor Identity Problems

A confluence of forces addressing counselor identity occurred with the 20/20: A Vision for the Future of Counseling initiative, the 2009 Standards of the Council for Accreditation of Counseling and Related Education Programs (CACREP), and the quest by the American Association of State Counseling Boards to establish license portability. This article provides a historical context for the profession's struggles with these issues, 1 state's experience, TRICARE's impact, and the role CACREP standards can play in their resolution.     

Modeling Interactions Between Latent Variables in Research on Type D Personality: A Monte Carlo Simulation and Clinical Study of Depression and Anxiety

Several approaches exist to model interactions between latent variables. However, it is unclear how these perform when item scores are skewed and ordinal. Research on Type D personality serves as a good case study for that matter. In Study 1, we fitted a multivariate interaction model to predict depression and anxiety with Type D personality, operationalized as an interaction between its two subcomponents negative affectivity (NA) and social inhibition (SI). We constructed this interaction according to four approaches: (1) sum score product; (2) single product indicator; (3) matched product indicators; and (4) latent moderated structural equations (LMS). In Study 2, we compared these interaction models in a simulation study by assessing for each method the bias and precision of the estimated interaction effect under varying conditions. In Study 1, all methods showed a significant Type D effect on both depression and anxiety, although this effect diminished after including the NA and SI quadratic effects. Study 2 showed that the LMS approach performed best with respect to minimizing bias and maximizing power, even when item scores were ordinal and skewed. However, when latent traits were skewed LMS resulted in more false-positive conclusions, while the Matched PI approach adequately controlled the false-positive rate.     

Ritual without myth: The use of legal materials for the study of religions

This essay explores the role that Buddhist narrative literature plays in fostering the cultivation of ethically valorised emotions. The essay focuses on astonishment, as it figures in ārya ?ūra's Jātakamālā, a collection of Sanskrit narratives. The essay examines how and why ārya ?ura valorises astonishment and what this valorisation reveals about the significance of emotions in Buddhist ethical life. The key distinction implicit in ārya ?ura's work between natural and cultivated emotions is worked out.     

Methodological concerns in the psychology of religion: Continuities,losses and transforming perspectives

This article seeks solutions to what has recently been called the ‘crisis' in the psychology of religion by returning to the programs of its founding fathers. It explores some of the methodological debates that followed the translation of William James' The Varieties of Religious Experience into German. More was at stake than the commonly drawn distinction between empirical and hermeneutical approaches to religion, or between quantitative and qualitative methods. What was at stake was the need for another kind of psychology in general. This article pays special attention to Wilhelm Wundt's fundamental criticism of James and of others in the psychology of religion. Despite the problems inherent in both James' and Wundt's aborted general psychology programs, each nonetheless contains approaches that may yet serve as an impetus to contemporary research on religion. Contemporary developments in cultural psychology in particular complement current research in the psychology of religion.     

Author biographies

This paper describes how an application of psychodynamic principles and techniques in a school setting can open up perspectives and insights into aspects of loss and mourning, which result in the personal and professional growth of individuals. It discusses applied psychoanalytic work in relation to its clinical base in the consulting room, in particular family work, and exemplifies this with a variety of cases.     

‘I don't want to be the mother of a paedophile’: the perspectives of mothers whose adolescent sons with learning disabilities sexually offend

The subject of sexual abuse is a major focus of professional and public concern. Sexual abuse of (and by) people with learning disabilities evokes even greater disquieting emotions, and makes severe demands on the social services, and the criminal justice system. The aims of the project were: 1) to determine whether group psychotherapy produced effective outcomes for adolescent boys with learning disabilities who exhibit sexually abusive behaviour, 2) to explore the perspectives of parents and other care-givers, and 3) to document the nature and extent of service support to families. This paper focuses solely on the mothers' perspectives. This was a three-year project with six boys (under 16) receiving group psychotherapy, using both quantitative and qualitative methods. Clinical measures were used to track changes throughout the course of psychotherapy. Semi-structured interviews (taped and transcribed) were held (separately) with the boys, their parents, paid care-givers and the therapists. The mothers tried hard to make sense of, and come to terms with, what was happening to their sons and to themselves, they struggled to reconcile their own confused and often conflicting emotions, and to maintain their own sense of identity. They felt almost totally unsupported by the services, both in the past and present, and could see little hope for the future. There is an urgent need for development of effective and sympathetic services for the parents of boys with learning disabilities who have been abused, and who are now showing abusive behaviour.