Informal Caregiving to Persons with AIDS in the United States: Caregiver Burden Among Central Cities Residents Eighteen to Forty-Nine Years Old

Characteristics and caregiving experiences of friends and family members caring for people with AIDS (PWAs) were examined. Based on a probability sample of informal AIDS caregivers ages 18–49 living in central cities of the United States (n = 260), analyses were conducted to (a) identify the sociodemographic characteristics of young central city caregivers; and (b) examine the effects of caregiver characteristics (relationship to PWA, gender, race/ethnicity, income, sexual orientation, HIV status, perceived susceptibility), and level of objective caregiving demands, on subjective caregiver burden. Results indicate that the largest group of caregivers in this age category are male friends of the PWA—a group not typically found among caregivers to persons with other types of illnesses. In general, gay or bisexual caregivers, caregivers who have traditional family ties to the PWA, men relative to women, and lower income caregivers, report the greatest burden. While level of caregiving demands represents the most influential predictor of caregiver burden, white and male caregivers experience greater burden, independent of level of involvement and other caregiver characteristics. Receiving instrumental support with caregiving buffers the impact of high objective demands on subjective burden.     

Clinical pragmatism: a method of moral problem solving

This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in moral problem solving are discussed.     

African Americans and Consultation

This article reviews key issues related to racial minorities working as consultants, provides an analysis of possible impediments to successful consultation by stage of the process, and provides examples of how majority consultants can provide support for this underrepresented group in the field. Implications for training are discussed.     

Journal Reviews

Journal of Child Psychotherapy Samuels , Andrew (ed.). (1996). ‘Symposium: post-Jungian thought,’The Psychoanalytic Review Schwartz -Salant , Nathan . ‘On the interactive field as analytic object’. In The Interactive Field in Analysis, Vol 1. Chiron Clinical Series Jacobs , Theodore J. ‘On therapeutic interventions in the analysis of certain “unana-lyzable” patients’. Contemporary Psychoanalysis Guntrip , Harry . ‘My experience of analysis with Fairbairn and Winnicott. (How complete a result does psychoanalytic therapy achieve?)’. First published in The International Review of Psycho-Analysis Padel , John . ‘The case of Harry Guntrip’. Markillie , Ronald . ‘Some personal recollections and impressions of Harry Guntrip.’ Published together in The International Journal of Psycho-Analysis Plaut , F. ‘Analytiker als Minorität’. [Analysts as a minority]. Analytische Psychologic Samuels , Andrew ‘The politics of transformation/the transformation of polities’, International Journal of Psychotherapy     

Presence and absence through the mirror of transference: a model of the transcendent function

The workings of the transcendent function are explored through the development of a model of psychical process which is founded on the symbolism of the mirror. The model consists in a three-dimensional psychical manifold comprising apperceptive, reflective, and subjective axes. A fourth, temporal axis is implicit in the process character of the model. A fifth, affective axis is not discussed. The model is used to enhance understanding of both failed and successful transcendent functioning. Parallels with modes of initiation are developed. The transference role of the therapist is explored.     

CLASSWIDE PEER TUTORING: AN INTEGRATION STRATEGY TO IMPROVE READING SKILLS AND PROMOTE PEER INTERACTIONS AMONG STUDENTS WITH AUTISM AND GENERAL EDUCATION PEERS

A multiple baseline design across subjects with a reversal was used to examine the effects of classwide peer tutoring relative to traditional reading instruction on reading skills and social interaction time for 3 high-functioning students with autism and their typical peers in integrated, general education classrooms. Traditional reading instruction consisted largely of teacher-led instruction with individual student participation and seat work. Classwide peer tutoring consisted of 25 to 30 min of well-specified instruction in which tutor—learner pairs worked together on a classwide basis on reading fluency and comprehension skills. All students participated in 15- to 20-min unstructured free-time activities immediately following reading instruction. Results of reading assessments demonstrated that classwide peer tutoring increased reading fluency and correct responses to reading comprehension questions for students with autism and their peers. The procedure further increased the total duration of free-time social interactions for students with autism and typical peers, with individual variation in performance.     

REDUCING ESCAPE BEHAVIOR AND INCREASING TASK COMPLETION WITH FUNCTIONAL COMMUNICATION TRAINING,EXTINCTION AND RESPONSE CHAINING

The effects of functional communication training, extinction, and response chaining on 3 subjects' escape-maintained aberrant behavior were evaluated using a multielement design. Functional communication training consisted of teaching subjects a verbal response that was functionally equivalent to their aberrant behavior. Subjects initially were allowed to escape from a task contingent on the trained verbal response. In subsequent treatment phases, escape was contingent on the trained verbal response plus the completion of the specified number of steps in the task (response chaining). The number of steps was increased until a subject completed the task to obtain a break. Results showed that the treatment reduced rates of aberrant behavior and that the chaining procedure was effective in decreasing the availability of escape.     

The relationship of spiritual maturity to level of object relations development and God image

Several theoretical studies have suggested that spiritual maturity parallels psychological maturity from an object relations perspective in that both involve a relationality that is characterized by mature dependence (Shackelford, 1978; Pingleton, 1984). In addition, previous research has suggested that there is a positive relationship between level of object relations development and God image (Rizzuto, 1979; McDargh, 1983, 1986; Birky & Ball, 1988; Brokaw, 1991). In light of this, the present study theoretically and empirically explored the notion that both level of object relations development and God image are positively correlated with spiritual maturity. The results suggest initial support for the present hypotheses. Theoretical as well as clinical implications of the results are discussed.This paper was presented at the 1994 American Psychological Association Annual Meeting, Los Angeles, CA.     

The role of fairness orientation and supervisor attributions in absence disciplinary decisions

The present study investigated the role of the work value of fairness and attributions regarding the causes of absence in supervisor disciplinary decisions. It was hypothesized that supervisors who valued fairness, and those who made internal attributions regarding the cause of a particular absence incident, render more severe disciplinary decisions than supervisors who value fairness less, and who make external attributions. Furthermore, it was hypothesized that the degree to which supervisors valued fairness moderates the relationship between external attributions and the severity of disciplinary decisions. Using a policy capturing approach, results were consistent with predictions. Implications of the results for research and practice are discussed.     

New Directions for Performance Appraisal: Some Findings and Observations

The changing emphasis on the aims of performance appraisal systems is discussed, with particular reference to the notion of appraisal as a motivating mechanism. The contention of the Total Quality school that the traditional focus on the assessment function of appraisal is counterproductive is supported, and some data are presented illustrating the doubtful value and accuracy of appraisal ratings, both for evaluating staff and as validation criteria for personality measures. Some implications of recent organizational changes for the development role of performance appraisal are reviewed, with particular reference to upward feedback and competency-based appraisal. Finally, the emerging shape of a new approach to meeting the purposes formerly served by appraisal systems is described.