Aboriginal Practitioners Offer Culturally Safe and Responsive CBT: Response to Commentaries

We appreciate the valuable commentaries that have been provided for our paper “Can CBT be effective for Aboriginal Australians? Perspectives of Aboriginal practitioners trained in CBT.” The international authors identify how CBT, with adaptations by culturally responsive practitioners can be of value for non‐Western and Indigenous peoples. The commentary by Australian psychologists Dudgeon and Kelly questions the value of CBT for Indigenous Australians, terming it a “Western therapy” that is “culturally unresponsive” and “culturally blind.” They also critique the methodology of the study. We argue that CBT can be adapted by culturally competent practitioners to be culturally safe in Australia, as elsewhere. Cultural safety is mostly a function of the therapist, not the therapy. In the Bennett‐Levy et al. (2014) study, CBT was delivered in a culturally responsive way by Aboriginal counsellors within their own communities. CBT is a particularly adaptable and versatile therapy, and embodies principles of empowerment and self‐determination that are central to Indigenous social and emotional well‐being. We are concerned that CBT, which has strong empirical support and has been adapted elsewhere for a range of cultures, including Indigenous cultures, may be being denied to Indigenous Australian clients. There is considerable opportunity to evaluate the effectiveness and versatility of CBT, and variations of its mode of delivery, for all Australians.     

Frankfurt in Fake Barn Country

It is very widely held that Frankfurt‐style cases—in which a counterfactual intervener stands by to bring it about that an agent performs an action but never actually acts because the agent performs that action on her own—show that free will does not require alternative possibilities. This essay argues that that conclusion is unjustified, because merely counterfactual interveners may make a difference to normative properties. It presents a modified version of a fake barn case to show how a counterfactual intervener can make the difference between an agent knowing a fact or merely truly believing that fact, by eliminating veretic epistemic luck. If counterfactual interveners can make this kind of difference to the epistemic status of agents, the essay argues, there is no reason why they can't make an analogous difference to agents' moral responsibility. It concludes that reflection on these cases reveals that despite the mountains of words spilled on the topic, we still don't fully understand what role access to alternative possibilities plays in whether or not agents are morally responsible for their actions.     

Thinking with Beauvoir on the Freedom of the Child

Among philosophers, Simone de Beauvoir is unique in treating childhood as a philosophical phenomenon. In both The Ethics of Ambiguity and The Second Sex, she examines the relationship between childhood and human freedom and considers its role in the development of subjectivity. Despite this, few sustained analyses of her treatment of the phenomenon exist. I argue that Beauvoir's conception of childhood is not uniform, but changes from The Ethics of Ambiguity to The Second Sex. Whereas the former presents children as lacking moral freedom, as not fully sovereign individuals, the latter suggests that children are just as free as adults. When children do not fully possess or exercise freedom, it is not because they are not in a position to do so, but rather because various social institutions hinder them. I find this position useful for developing a phenomenological account of childhood as a site for freedom. Hence, Beauvoir becomes a source for thinking of issues in philosophical anthropology concerning the temporality of human existence and the nature of human agency over a lifespan.     

Are all safety behaviours created equal? A comparison of novel and routinely used safety behaviours in obsessive-compulsive disorder

Contamination fear is one of the most common symptoms of obsessive-compulsive disorder (OCD). Exposure and response prevention (ERP) is effective for OCD, but a significant minority of treatment-seeking individuals refuse ERP entirely or drop out prematurely. Research suggests that safety behaviour (SB) may enhance the acceptability of ERP; however, questions remain about how to incorporate SB into existing treatments. Clinical participants with OCD and contamination fear (N = 57) were randomized to receive an exposure session with no SB (ERP), a routinely used SB (RU), or a never-used SB (NU). Significant reductions in contamination fear severity were observed in all conditions. Although omnibus comparisons were only marginally significant, pairwise comparisons revealed some condition differences. NU demonstrated significantly lower self-reported contamination fear severity at post-exposure, as well as marginally higher treatment acceptability ratings. Findings suggest that exposure with SB may be effective and acceptable, and are discussed in terms of cognitive-behavioural theory and treatment of anxiety and related disorders.     

Quantitative Meta-Analyses: Lateralization of Memory Functions Before and After Surgery in Children with Temporal Lobe Epilepsy

Neuropsychology Review - Memory deficits in children with epilepsy have been reported in some but not all studies assessing the effects of side of seizures and resection from the temporal lobe on...     

A path analysis of stress appraisals, emotions, coping, and performance satisfaction among athletes

Objectives

In this study we examined athletes’ stress appraisals, emotions, coping, and performance satisfaction ratings using a path analysis model. This is the first study to explore all of these constructs in a single study and provides a more holistic examination of the overall stressful experience that athletes encounter.

Design

Cross-sectional.

Methods

Participants were 557 athletes, aged between 18 and 64 years (M age = 22.28 years, SD = 5.72), who completed a pre-competition measure of stress appraisals and emotions. Participants also completed a coping questionnaire and a subjective performance measure after competing, with regards to how they coped during competition and how satisfied they were with their performance.

Results

Path analysis revealed that appraisals of uncontrollable-by-self, stressfulness, and centrality were positively associated with the relational meaning threat appraisals. Threat appraisals were associated with unpleasant emotions, prior to competition, and pre-ceded distraction- and disengagement-oriented coping. The pre-competition appraisals of controllable-by-self, centrality, controllable-by-others, and stressfulness were associated with challenge relational meanings, which in turn were linked to task-oriented coping during competition. Task-oriented coping was positively related to superior subjective performance.

Conclusions

Our findings support the notion that stress appraisals, emotions, and coping are highly related constructs that are also associated with performance satisfaction.