Sources of Care for Alcohol and Other Drug Problems: The Role of the African American Church

African Americans experience significant disparities in treatment access, retention, and quality of care for alcohol and drug use (AOD) problems. Religious congregations, often the first point of contact for help with AOD problems, can play an integral role in improving access to treatment. However, little is known about the role of African American churches in addressing AOD problems. We administered a survey to a faith-based collaborative of 169 African American churches in Los Angeles to examine how AOD problems are identified in congregations, the types of support provided, barriers to providing treatment referrals, and factors associated with the provision of treatment referrals. Seventy-one percent of churches reported caring often for individuals with AOD problems. AOD problems came to the attention of congregations most commonly via a concerned family member (55%) and less frequently through individuals with AOD problems directly approaching clergy (30%). In addition to providing spiritual support, a substantial proportion of churches reported linking individuals to AOD services through referrals (62%) and consultation with providers (48%). Barriers to providing treatment referrals included lack of affordable programs (50%), stigma (50%), lack of effective treatments (45%), and insufficient resources or staff (45%). The likelihood of providing treatment referrals was greater among mid-sized versus smaller-size congregations (OR 3.43; p < .05) and among congregations with clergy that had attended seminary (OR 3.93; p < .05). Knowing how to effectively coordinate informal sources of care provided by African American churches with the formal service sector could make a significant impact on AOD treatment disparities.     

Understanding Exercise Dependence

Exercise dependence represents a condition in which an individual exercises excessively, often to the detriment of his or her physical and psychological health and wellbeing. Despite substantial investigation of this phenomenon, researchers have only recently developed conceptually sound diagnostic criteria for exercise dependence, and have yet to determine a suitably convincing mechanism or explanation for its onset and development. Likewise, researchers have not assessed whether therapies considered effective for other behavioural dependencies (e.g. internet or gambling addictions) are useful in the treatment of exercise dependence. With these limitations in mind, the present paper seeks to develop a conceptual basis for exercise dependence, critically review a representative portion of the exercise dependence literature, examine theories describing potential mechanisms for its development and onset, and provide recommendations for clinicians regarding the recognition, diagnosis, treatment, and prevention of exercise dependence.     

Advice for fallibilists: put knowledge to work

We begin by asking what fallibilism about knowledge is, distinguishing several conceptions of fallibilism and giving reason to accept what we call strong epistemic fallibilism, the view that one can know that something is the case even if there remains an epistemic chance, for one, that it is not the case. The task of the paper, then, concerns how best to defend this sort of fallibilism from the objection that it is “mad,” that it licenses absurd claims such as “I know that p but there’s a chance that not p” and “p but it there’s a chance that not p.” We argue that the best defense of fallibilism against this objection—a “pragmatist” defense—makes the following claims. First, while knowledge that p is compatible with an epistemic chance that not-p, it is compatible only with an insignificant such chance. Second, the insignificance of the chance that not-p is plausibly understood in terms of the irrelevance of that chance to p’s serving as a ‘justifier’, for action as well as belief. In other words, if you know that p, then any chance for you that not p doesn’t stand in the way of p’s being properly put to work as a basis for action and belief.

Naturalism, Science and the Supernatural

There is overwhelming agreement amongst naturalists that a naturalistic ontology should not allow for the possibility of supernatural entities. I argue, against this prevailing consensus, that naturalists have no proper basis to oppose the existence of supernatural entities. Naturalism is characterized, following Leiter and Rea, as a position which involves a primary commitment to scientific methodology and it is argued that any naturalistic ontological commitments must be compatible with this primary commitment. It is further argued that properly applied scientific method has warranted the acceptance of the existence of supernatural entities in the past and that it is plausible to think that it will do so again in the future. So naturalists should allow for the possibility of supernatural entities.

Looking again at the team dimension in systemic psychotherapy: is attending to group process a critical context for practice?

Team work and group supervision are essential features of the systemic model, yet there is surprisingly little literature on the impact of group process on both group supervision and team-based therapy. Beginning with two vignettes which evoke some aspects of group process and are based on the personal experiences of the authors, this paper will review the literature on working in teams from within a systemic perspective. ¹ Early models of teams and group processes within the literature will be criticized for their over-reliance on technique; more recent models for their over-reliance on collaboration. It will be argued that some systemic approaches to understanding teams can lead to group process issues becoming marginalized and covert, and therefore inevitably more difficult to address. However, viewing supervision groups as 'social constructions' is seen as a position offering more possibilities and, it will be argued, opens a pathway to embracing ideas from within psychoanalytic thinking on group process. Here ideas on group functioning, including the theories of, for example, Foulkes and Bion will be briefly reviewed and their implications for helping both supervisors and teams conceptualize group process discussed.     

Reading Stories Activates Neural Representations of Visual and Motor Experiences

ABSTRACT— To understand and remember stories, readers integrate their knowledge of the world with information in the text. Here we present functional neuroimaging evidence that neural systems track changes in the situation described by a story. Different brain regions track different aspects of a story, such as a character's physical location or current goals. Some of these regions mirror those involved when people perform, imagine, or observe similar real-world activities. These results support the view that readers understand a story by simulating the events in the story world and updating their simulation when features of that world change.     

Professional Ambivalence: Accounts of Ethical Practice in Childhood Genetic Testing

Childhood genetic testing raises complex ethical and moral dilemmas for both families and professionals. In the family sphere, the role of communication is a key aspect in the transmission of ‘genetic responsibility’ between adults and children. In the professional sphere, genetic responsibility is an interactional accomplishment emerging from the sometimes competing views over what constitutes the ‘best interests’ of the child in relation to parental preferences on the one hand, and professional judgements on the other. In the present paper we extend our previous research into parental accounts of childhood genetic testing and explore the ethical accounts of professionals in research interviews. Interviews (n = 20) were conducted with professional practitioners involved in the genetic diagnosis and management of children and their families. We first identify four inter-related themes—juxtaposition of parental rights vis-à-vis child’s autonomy, elicitation of the child’s autonomy, avoidance of parental responsibility and recognition of professional uncertainty. Then, using Rhetorical Discourse Analysis, we examine the range of discourse devices through which ethical accounts are situationally illustrated: contrast, reported speech, constructed dialogue, character and event work. An overarching device in these ethical accounts is the use of extreme case scenarios, which reconstruct dilemmas as justifications of professional conduct. While acknowledging ambivalence, our analysis suggests that professional judgement is not a simple matter of implementing ethical principles but rather of managing the practical conditions and consequences of interactions with parents and children. We conclude that more attention is needed to understand the way professional practitioners formulate judgements about ethical practice.