Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Social status and friendship in peer victimization trajectories

Background/Objective: Most studies have evaluated victimization at a single time point, making it difficult to determine the impact of the time during which an individual is victimized. This longitudinal study aims to examine the differences in the levels of social status (social preference and perceived popularity) and friendship in peer victimization trajectories, and to analyse if there were changes over time in the levels of social status and friendship in each trajectory. Method: The final sample was composed of 1,239 students (49% girls) with ages between 9 and 18 (M = 12.23, SD = 1.73), from 22 schools in southern Spain. Peer nominations were collected. Results: The General Linear Model results associated the highest levels of social preference, perceived popularity and friendship with the sporadic victimization profile and the lowest levels of these dimensions with the stable profile. Conclusions:The results are discussed based on important personal aspects of stable victimization that confirms social rejection, unpopularity, and the low social support that victimization causes. This contribution is discussed in terms of health and social welfare in adolescence.     

The Knowledge Argument and Objectivity

In this paper I argue that Frank Jackson’s Knowledge Argument is better considered not as an argument against physicalism, but as an argument that objective theories must be incomplete. I argue that despite the apparent diversity of responses to the knowledge argument, they all boil down to a response according to which genuine epistemic gains are made when an individual has an experience. I call this the acquaintance response. I then argue that this response violates an intuitive stricture on the objectivity of theories. Therefore, the knowledge argument does show that objective theories cannot provide a complete understanding of the world. The result, however, is that both objective dualism and objective physicalism are refuted by the argument. In the end it is suggested that the notion of “subjective physicalism” is one that should be pursued.     

How Wittgenstein Defeated Russell’s Multiple Relation Theory of Judgment

In 1913 Wittgenstein raised an objection to Russell’s multiple relation theory of judgment that eventually led Russell to abandon his theory. As he put it in the Tractatus, the objection was that “the correct explanation of the form of the proposition, ‘A makes the judgement p’, must show that it is impossible for a judgement to be a piece of nonsense. (Russell’s theory does not satisfy this requirement,” (5.5422). This objection has been widely interpreted to concern type restrictions on the constituents of judgment. I argue that this interpretation is mistaken and that Wittgenstein’s objection is in fact a form of the problem of the unity of the proposition.     

THE USE OF REBT PRINCIPLES AND PRACTICES IN LEADERSHIP TRAINING AND DEVELOPMENT

Training, coaching, and consulting with people in leadership roles can be a primary consulting function for clinicians. In this paper, the authors describe their model of leadership, and what they believe to be the central personality or character components of leadership necessary for producing extraordinary results. Throughout they will show where and how REBT skills can make a significant contribution.