Skills training in the long-term management of stress and occupational burnout

The current managed healthcare environment stresses brief and effective short-term therapy. However, often this short-term treatment does not lead to long-term behavioral changes and clients return to therapy many times for help with the same dysfunctional behavioral patterns. The main problem with these traditional forms of treatment is the assumption that clients have the basic skills to change their ineffective behaviors. Yet, many people lack the basic skills to manage our highly stressful society, and may take years to master new behavioral management skills. Examining the relationship between stress and coping, this study explored both short-and long-term approaches to behavioral change relative to occupational burnout, and focused upon the teaching of skills to manage stress. Subjects who participated in a 6-week stressmanagement program reported only temporary decreases in burnout, while those subjects who received 1-hour coping “refresher” sessions at 5 months, 11 months, and 17 months showed consistent decreases in burnout throughout a 2 1/2 year period. These results suggest that psychologists can be much more effective behavioral change agents through long-term approaches that emphasize teaching new skills to manage chronic behavioral problems. Given the changes in the health insurance industry and the way therapeutic services are provided, the field may need to rethink approaches that are grounded in personality theory and abnormal psychology to approaches that emphasize principles of learning theory.     

Genetic Counseling for Fragile X Syndrome: Recommendations of the National Society of Genetic Counselors

The National Society of Genetic Counselors' (NSGC) recommendations for fragile X syndrome (FXS) genetic counseling are intended to assist health care professionals who provide genetic counseling for individuals and families in whom the diagnosis of FXS is strongly suspected or has been made. The recommendations are the opinions of genetic counselors with expertise in FXS counseling and are based on clinical experience, a review of pertinent English language medical articles, and reports of expert committees. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a particular client.     

Perspectives from the Edge: Chaplains in Greater Boston, 1945–2015

We follow Bender et al.’s (Religion on the Edge: De‐Centering and Recentering the Sociology of Religion) call to study religion “on the edge” by looking at the work of chaplains, religious professionals who work outside of congregations. Rather than studying chaplains within a single type of institution—the military, healthcare, or other sectors—we shift the unit of analysis to geography, asking where chaplains in Greater Boston worked between 1945 and the present. Based on coverage in the Boston Globe, we find that chaplains, mostly men, worked across Greater Boston between 1945 and 2015. The majority were Catholic with frequent minorities of Protestants and Jews, and—after 1995—a few Buddhists, Muslims, and Humanists. Most worked in higher education, healthcare, and prisons. While much of the chaplains’ work seems improvisational and varied, we identify services related to ceremonies, bearing witness, and working around death as common occurrences across the venues where chaplains worked. To the extent that these patterns are evident in other cities, they suggest that chaplains have regularly been a quiet part of the religious landscape, that they are a consistent part of the institutional field, and that their work has more commonalities across sectors than previous studies suggest.     

Sex differences in ADHD trajectories across childhood and adolescence

Previous studies have hinted at sex differences in developmental trajectories in ADHD symptoms; however, little is known about the nature or cause of these differences and their implications for clinical practice. We used growth mixture modelling in a community‐ascertained cohort of n = 1,571 participants to study sex differences in ADHD symptom developmental trajectories across the elementary and secondary school years. Participants were measured at ages 7, 8, 9, 10, 11, 12, 13, and 15. We found that females were more likely to show large symptom increases in early adolescence while males were more likely to show elevated symptoms from childhood. For both males and females, early adolescence represented a period of vulnerability characterized by relatively sudden symptom increases. Females affected by hyperactivity/impulsivity may be more likely to be excluded from diagnosis due to current age of onset criteria. More attention should be paid to early adolescence as a period of risk for hyperactivity/impulsivity symptom onset or worsening.     

Towards an evidence‐base for student wellbeing and mental health: Definitions,developmental transitions and data sets

Against a background of huge changes in the world of university and college students since the turn of the millennium, together with a multitude of reports on student mental health/wellbeing, this article argues that the field of student mental health is hampered by the imprecise use of terms, a rush to action by universities in the absence of a robust evidence‐base, and a lack of overall coordination and collaboration in the collection and use of data. In response, we argue for clearer and more consistent use of definitions of, as well as differentiations between, student wellbeing and mental health, for a longitudinal approach to the student body that captures their developmental transitions to and through university, and a strategic and systematic approach to the use of bona fide measures in the collection of data on wellbeing and on the process of outcomes in embedded university counselling services. Such a coordinated approach will provide the necessary evidence‐base upon which to develop and deliver appropriate support and interventions to underpin and enhance the quality of students’ lives and learning while at university or college.     

Exploring the depths of the rainforest: a metaphor for teaching critical reflection

Many social welfare and social work students struggle to demonstrate competence in the complex process of critical reflection through to the stage of transformed thinking and action. Examples of how students learn critical reflection as an interpretive experience are scarce. This paper presents, as a case study, the process one of the authors experienced while critically reflecting on teaching critical reflection. The paper explores how this approach unlocked disturbing insights into how personally held values, views and knowledge influenced her performance relating to teaching critical reflection. Experiencing what she asks of her students raised questions regarding the duty of care that social welfare and social work educators have to ensure their students engage in critical, and transformative, self-discovery in safe and supportive ways. We propose that in the early stages of social welfare and social work degrees, rather than assessing students’ critical reflection of an event, educators examine students’ capacity to learn critical reflection in a different way. Drawing on critical hermeneutics, and a theory of visual thinking, the paper outlines the cognitive map of a process of critical reflection on teaching critical reflection. We present this as a metaphor of walking through a rainforest.     

Longitudinal Profiles of Girls’ Irritable,Defiant and Antagonistic Oppositional Symptoms: Evidence for Group Based Differences in Symptom Severity

Three subdimensions of ODD symptoms have been proposed –angry/irritable (IR), argumentative/defiant (DF) and antagonism (AN). This study tested whether longitudinal symptom trajectories could be identified by these subdimensions. Group-based trajectory analysis was used to identify developmental trajectories of IR, DF and AN symptoms. Multi-group trajectory analysis was then used to identify how subdimension trajectories were linked together over time. Data were drawn from the Pittsburgh Girls Study (PGS; N = 2450), an urban community sample of girls between the ages of five--eight at baseline. We included five waves of annual data across ages five-13 to model trajectories. Three trajectories were identified for each ODD subdimension: DF and AN were characterized by high, medium and low severity groups; IR was characterized by low, medium stable, and high increasing groups. Multi-trajectory analysis confirmed these subdimensions were best linked together based on symptom severity. We did not identify girls’ trajectory groups that were characterized predominantly by a particular subdimension of ODD symptoms. Membership in more severe symptom groups was significantly associated with worse outcomes five years later. In childhood and early adolescence girls with high levels of ODD symptoms can be identified, and these youth are characterized by a persistently elevated profile of IR, DF and AN symptoms. Further studies in clinical samples are required to examine the ICD-10 proposal that ODD with irritability is a distinct or more severe form of ODD.     

INTERPRETING PUTNAM'S DIALECTICAL METHOD IN PHILOSOPHY

Abstract: Hilary Putnam's philosophical views have undergone extensive interpretation over many years. One such interpretive work is George Myerson's book Rhetoric, Reason and Society. Myerson's interest in dialogic rationalism leads him to examine the views of many theorists of rationality, philosophers and nonphilosophers alike. As a prominent philosopher of rationality, Putnam is at the very center of this examination. Notwithstanding this fact, I contend that Myerson misinterprets the dialectical character of Putnam's philosophy in general and of Putnam's views on rationality in particular. This misinterpretation, I argue, is revealing of an illusion of thought to which Myerson is subject, an illusion that makes it seem that it is possible to theorize intelligibly about rationality from a metaphysical standpoint. This same illusion, I claim, also makes it seem that Myerson's positive views on rationality are intelligible. Employing a close textual analysis of Myerson's book, I argue that neither scenario is the case.