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.     

A NOTE ON TRANSFER OF STIMULUS CONTROL IN THE DELAYED-CUE PROCEDURE: FACILITATION BY AN OVERT DIFFERENTIAL RESPONSE

This case study describes initially unsuccessful attempts to use the delayed-cue procedure to teach conditional discriminations to an individual with moderate mental retardation. The task was matching printed-word comparison stimuli to dictated-name sample stimuli. In three experiments, the subject typically waited for the delayed cue unless differential responses to the dictated samples (repeating the sample names) were required. Hence, the study provides an example of a way to make the delayed-cue method more effective. The stimulus control bases for the results are discussed.     

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 role of attention in the shift from orientation-dependent to orientation-invariant identification of disoriented objects

In two experiments, the naming of rotated line drawings of natural objects was examined after a training phase in which the objects were either attended or ignored. In the training phase of Experiment 1, subjects were presented with objects in a number of orientations over five repeated blocks of trials. In the center of each object, seven letters (Xs and Ts, colored red or blue) were presented in rapid succession. Half the subjects named aloud the rotated object and ignored the changing letter display (object-attend). The other half ignored the object and counted the number of red Ts, and then used this number to perform a simple multiplication (object-ignore). In the test phase, all subjects named the rotated objects. The results showed that in the first block of trials in the training phase, mean naming time in the object-attend condition increased the further an object was rotated from the upright. This effect of orientation for attended objects was much reduced in the later presentations of the test phase. In contrast, there was no such benefit of prior presentation observed for the naming of objects that had previously been ignored. Instead, a substantial orientation effect was shown for the naming of previously ignored objects, which was similar to the orientation effect observed for attended objects named in the first block. Similar results were found in Experiment 2, in which object-attend subjects in training covertly named the objects and then performed a letter count and multiplication task. In both experiments, performance on the letter count and multiplication task varied with the angle of the ignored object. The results suggest that full attentional resources must be allocated in order for orientation-invariant representations to be formed and used in the identification of rotated objects.     

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.     

Negative priming by rotated objects

Previous work has found that repeated exposure to ignored rotated objects is insufficient to allow the formation of orientation-invariant representations (Murray, 1995b). In this study, the negative priming paradigm was used to examine whether the identity of ignored rotated objects was encoded. Subjects were briefly presented with a prime followed by a probe display. One of the two overlapping drawings of objects in each display was selected for further processing, and the other was ignored. In one condition, the ignored objects were upright; in another, they were rotated 240°; and in a final condition, subjects repeatedly named the 240° objects prior to experiencing them as ignored objects in the priming task. Naming latency for the attended probe was slower when it was semantically related to the ignored prime in all conditions. The results suggest that unattended rotated objects are processed to a level of representation that is at least categorical.