Ethical Issues in HIV/STD Prevention Research With High Risk Youth: Providing Help,Preserving Validity

Many preventive intervention studies with adolescents address high-risk behaviors such as drug and alcohol use, and unprotected sex. Randomized controlled trials (RCT) are the gold standard methodology used to test the effectiveness of these behavioral interventions. Interventions outside the rigidly described protocol are prohibited. However, there are ethical challenges to implementing inflexible intervention protocols, especially when the target population is young, experiences many stressful events, and lives in a resource-poor environment. Teens who are at high risk for substance use or sexual risk behaviors tend to be at risk for other problems such as exposure to violence, sexual and physical abuse, depression, and homelessness. How should investigators deal with the psychological and social needs of teenagers in prevention programs in an ethically appropriate way and at the same time preserve the validity of RCT results? We have identified program characteristics, participant characteristics, interaction with parents, and problems with adolescents not in the study as sources of ethical dilemmas in RCT with at-risk adolescents. As a result of our experience, we recommend that every behavioral intervention study develop an ethics protocol, which should include rules for providing help to participants, has contact information for experts to provide guidance, and an emergency procedure for dealing with life threatening situations. In addition, studies should have a resource manual, train research staff in these ethical issues, and work with a data safety and monitoring board or ethics committee.     

The “Place” of Place‐Based Pedagogy in Teaching Religion: Brooklyn and Its Religions

Place‐based pedagogy offers students a distinctive way to be attentive to a particular expression of a given religion while enabling them to minimize generalizations on the basis of that experience. Place‐based pedagogies decenter the traditional classroom as the sole locus of learning and emphasize the value of learning within varied spatial frameworks including undeveloped natural environments and built environments in rural, suburban, or urban communities. This article, set in Brooklyn, New York, is a case study of place‐based teaching in an urban context. “Brooklyn and Its Religions” is a course that provides students with a place to explore diverse expressions of Judaism, Christianity, and Islam. The article describes the course and analyzes students' field reports in two settings to demonstrate the value of place‐based learning for studying religion in Brooklyn.     

Empathy,Tact and the Freedom to be Natural

This paper explores the concepts of tact and empathy in the context of the Freud–Ferenczi correspondence around Ferenczi’s “The Elasticity of Psycho-Analytic Technique” paper. It goes on to explore the problems that they encounter in the neighborhood of reconciling science and subjectivity, in relation to the work on personal knowledge of the Hungarian philosopher Michael Polanyi and concludes with some implications for psychoanalytic training.     

The Analyst’s Private Space: Spontaneity,Ritual, Psychotherapeutic Action,and Self-Care

The contemplation, containing, and linking that circulate within the analyst’s private space are positioned as key to states of psychic equivalence (the melding of psychic reality and material reality) and to sustained states of unknowing, which are held to be necessary for analytic work and fantastic spontaneity. These modes of practice are considered as they relate to rituals that promote the analyst’s self care. An account of a psychotherapy with a 5-year-old electively mute girl is offered to illustrate the work undertaken in the analyst’s private space, as he seeks to build and sustain potential space and the possibilities borne through play.     

Motivational interviewing in health promotion: it sounds like something is changing.

Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been applied in public health, medical, and health promotion settings. This article provides an overview of MI, outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed, nuances associated with the use of MI in health promotion and chronic disease prevention are described, and future directions are offered.     

Career guidance in England today: reform,accidental injury or attempted murder?

ABSTRACT

In 2011 England's career guidance profession lost its ‘own’ public service organisation and its former dedicated stream of public funding. The immediate causes lay in decisions by the government of the day, but this article revisits the profession's history to seek explanations for its later vulnerability. It is argued that decisions taken early in the profession's history, specifically its complete separation from adult employment services and basing claims to professional expertise almost wholly on occupational psychology, though maybe right at the time, were to have fateful consequences. The article proceeds to argue that career guidance will certainly survive its recent trauma, but the most likely outcome of the current ‘reforms’ – a market in career guidance services – will not create the kind of comprehensive education-to-work bridging service that was once intended and which is still needed.