Dialectical Behavior Group Therapy is Feasible and Reduces Emotional Dysfunction in Multiple Sclerosis

We examined whether dialectical behavior therapy (DBT) was feasible and effective in multiple sclerosis (MS). A convenience sample of 20 patients with anxiety or depression symptoms received either DBT (n = 10) or standard medical care (n = 10). The DBT protocol was found to be feasible in the MS population studied (e.g., good retention and acceptability). For the DBT group, significant improvements were demonstrated in self-rated and clinician-rated depressive symptoms, clinician-rated anxiety symptoms, self-rated general psychopathology symptoms, and quality of life. In contrast, the standard medical care group retained for exploratory purposes showed no significant improvements. This pilot work provides preliminary support for the utility of DBT in MS, but further work is needed to clarify this benefit using a large, randomized controlled approach.     

Pilot study evaluation of suicide prevention gatekeeper training utilising STORM in a British university setting

Recent years have seen increasing awareness of the wide range of mental health problems faced by students. Gatekeeper training has been shown to have a positive impact on knowledge and attitudes about suicide prevention, although the evidence for skills acquisition is limited. We utilised the STORM® training package in an exploratory study to determine explore whether skills training could be successfully implemented in an educational establishment in the United Kingdom. In a pilot study assessing competence before and after the intervention there was evidence of acquisition of skills, improved attitudes and increased confidence. Further research should include a randomised controlled trial of such training.     

Does client self‐booking reduce ‘did not attends’ (DNAs) in a counselling service?

An important problem for our counselling service is the high number of clients who ‘did not attend’ (DNA) for their booked appointment. This paper aims to describe how we tackled this problem within our counselling service by using a Plan‐Do‐Study‐Act (PDSA) cycle (Langley, Nolan Norman and Provost, 1996). The results found that by devising a system whereby clients could self‐book their appointments we were able to reduce the DNA rate for first appointments from 31.70% to 2%. This has useful time and financial implications. We would expect that the self‐booking approach we have outlined here is adaptable for other counselling services.     

Parents’ Communication with Siblings of Children Affected by an Inherited Genetic Condition

The objective of this study was to explore parents’ communication about risk with siblings of children affected by an inherited genetic condition, and to ascertain what level of support, if any, is required from health professionals. Semi-structured interviews were conducted with affected and unaffected children and their parents. Families were affected by one of six genetic conditions representing different patterns of inheritance and variations in age of onset, life expectancy and impact on families. Interviews were analysed using constructivist grounded theory and informed by models which focused on three different aspects of family communication. Interviews with 33 families showed that siblings’ information and support needs go largely unrecognized by health professionals and sometimes by parents. Some siblings were actively informed about the genetic condition by parents, others were left to find out and assimilate information by themselves. Siblings were given information about the current symptoms and management of the genetic condition but were less likely to know about its hereditary nature and their own potential risk. When siblings were fully informed about the condition and included in family discussion, they had a better understanding of their role within their family, and family relationships were reported to be more harmonious. The information and support needs of siblings can be overlooked. Parents with the responsibility for caring for a child affected by a genetic condition may require support from health professionals to understand and respond to their unaffected children’s need for more information about the genetic condition and its implications for the children’s own future health and reproductive decision-making.     

The effects of session length on demand functions generated using FR schedules

In comparing open and closed economies, researchers often arrange shorter sessions under the former condition than under the latter. Several studies indicate that session length per se can affect performance and there are some data that indicate that this variable can influence demand functions. To provide further data, the present study exposed domestic hens to series of increasing fixed-ratio schedules with the length of the open-economy sessions varied over 10, 40, 60, and 120 min. Session time affected the total-session response rates and pause lengths. The shortest session gave the greatest response rates and shortest pauses and the longest gave the lowest response rates and longest pauses. The total-session demand functions also changed with session length: The shortest session gave steeper initial slopes (i.e., the functions were more elastic at small ratios) and smaller rates of change of elasticity than the longest session. Response rates, pauses, and demand functions were, however, similar for equivalent periods of responding taken from within sessions of different overall lengths (e.g., total-session data for 10-min sessions and the data for the first 10 min of 120-min sessions). These findings suggest that differences in session length can confound the results of studies comparing open and closed economies when those economies are arranged in sessions that differ substantially in length, hence data for equivalent-length periods of responding, rather than total-session data, should be of primary interest under these conditions.     

“You cannot forgive and you cannot forget”: The Serbian refugee settlement experience in Australia

Currently, there is limited research on the settlement experiences of refugees from the Balkan regions and in particular Serbia. There is also a need to provide a contextual understanding of the refugee settlement experience. The current study explored the refugee experience of 12 male Serbian refugees (aged 30 to 65), who migrated to Australia following the Yugoslav Civil War (1991–2001). A qualitative, phenomenological methodology explored the experiences of the refugees from their own perspective. Thematic coding of the interview data revealed the two major themes of settlement and traumatic experiences, as central to the experiences of this group of refugees. Language difficulties, discrimination, stigmatization of Serbian identity, multiple losses and grief, and failing of the justice system to establish accountability and provide reparation to the victims were all significant obstacles to successful settlement. Most salient, however, were the experiences of torture and trauma. Participants were still trying to negotiate these memories years after the events. Nevertheless, some participants showed strong resilience and the belief that they became stronger as a consequence of their experiences. We encourage those working with Serbian refugees to help them search for meaning in their stories of trauma.     

Paying for kidneys: the case against prohibition

We argue that healthy people should be allowed to sell one of their kidneys while they are alive--that the current prohibition on payment for kidneys ought to be overturned. Our argument has three parts. First, we argue that the moral basis for the current policy on live kidney donations and on the sale of other kinds of tissue implies that we ought to legalize the sale of kidneys. Second, we address the objection that the sale of kidneys is intrinsically wrong because it violates the Kantian duty of respect for humanity. Third, we address a range of consequentialist objections based on the idea that kidney sales will be exploitative. Throughout the paper, we argue only that it ought to be legal for an individual to receive payment for a kidney. We do not argue that it ought to be legal for an individual to buy a kidney.