The Test–Retest Reliability and Predictive Validity of a Battery of Newly Developed Occupational Performance Assessments

The Canadian Occupational Performance Measure was used as a tool to compare goals for intervention identified by seven clients living in a long-term residential program and diagnosed with schizophrenia, with their goals as identified by the occupational therapist. In-depth interviews were conducted in conjunction with the use of the Canadian Occupational Performance Measure. Data analysis revealed an overarching theme that described the clients' concerns as, “I want to accomplish goals outside of the residence program.” During the analysis, however, the data revealed that the occupational therapist primarily focused her attention on goals to be achieved within the residence program, emphasizing programming and symptom management as each client's priorities for intervention, rather than community involvement. The findings reveal how data from the Canadian Occupational Performance Measure was used to reveal client/therapist disconnect in goal setting and the need to continue to examine client-centered practices in mental health settings.     

Learning to Heal from Those Who Know! The “Lived” Experience of a Peer Support Program for Adult Survivors of Childhood Trauma

This study explored the dual phenomenon of experiencing a peer support residential trauma program from the perspective of (a) a client, and (b) a facilitator. It sought both positive and negative subjective interpretations. Participants were former clients and current facilitators of the program. Data were collected through a focus group, and analyzed using interpretative phenomenological analysis. One superordinate theme, altruistic growth, overarched 2 subordinate themes. The first, modeling through respect, included subthemes of respect and hope and empowerment. The second subordinate theme, reciprocal model of care, encapsulated personal challenges such as facing the mirror, old demons, and burnout and breaking points. Conversely, participants mused on these challenges as opportunities for further healing through opportunities for self-nurturing and gratitude. Implications for treatment of adult survivors of childhood trauma are discussed. For facilitators, the program was seen as offering further personal reflection and a giving forward that was interpreted as altruistic growth.     

Who's Responsible? Our Mutual Implication in Each Other's Suffering

In this paper, I examine the social and psychological roots of what I call neoliberal subjectivity, a version of contemporary subjectivity marked by a repudiation of vulnerability that has arisen from the social, economic, and political milieu of the past 30 years. The defense mechanisms involved in such a repudiation cause a decline in empathic capacities and in the capacity to experience ourselves as responsible and accountable for the suffering of others. I look at the way conflicts in the area of accountability and responsibility are lived both within our patients and within the interaction between patient and analyst. I argue that contemporary definitions of empathy normalize the repudiation of vulnerability and thereby foster an experience of empathy in which one can sustain a safe distance from the suffering other and not hold oneself accountable. A two-way version of empathy that counters neoliberal trends requires that we examine the ways we seek refuge in identifications that distance us from vulnerability, and it requires us to recognize the harm we inflict when we do so.     

Nature of spelling errors in transcortical sensory aphasia: A case study

The nature and extent of spelling errors in a patient with transcortical sensory aphasia were investigated. The two experimental conditions required the patient to spell monosyllabic and polysyllabic words both verbally and in written form. Analysis of the spelling errors revealed partially preserved knowledge of the visual image of a word as a whole, as well as preserved knowledge of temporal order. Our patient's error patterns in both conditions were more similar than dissimilar. These findings in conjunction with results reported in the literature indicate that patients exhibiting different aphasia syndromes use separate spelling strategies.     

Characteristics of Blood-Injection-Injury Fears in People Receiving Intravenous Chemotherapy

Blood-Injection-Injury (BII) phobia is associated with distress and avoidance in response to blood, injury, or receiving injections. BII phobia can therefore create problems for those receiving medical procedures such as chemotherapy. The prevalence rate of BII in the general population has been estimated to be less than 5% but as many as 19% of outpatients receiving chemotherapy surveyed by Carey and Harris (Behaviour Change 22:5–90, 2005) reported BII concerns. This study examined the extent and characteristics of BII concerns among outpatients receiving chemotherapy for the first time (n = 124). Almost 17% of the sample had scores on the Mutilation Questionnaire comparable to samples with clinical BII phobia. Those assigned to a high BII concern group based on Mutilation Questionnaire scores reported higher somatic and fainting responses to BII stimuli and elevated disgust sensitivity, compared to groups selected for low BII concerns. Females had significantly higher Mutilation Questionnaire scores than males. Thus, the BII concerns of outpatients receiving chemotherapy appear qualitatively similar to the concerns reported by clinical BII phobia samples and analogue student samples. We suggest that the standard inclusion of a brief, reliable screening measure of BII concerns for outpatients scheduled for chemotherapy, coupled with brief, effective interventions to reduce BII-related distress, may be warranted.     

The ontology of artifacts

Beginning with Aristotle, philosophers have taken artifacts to be ontologically deficient. This paper proposes a theory of artifacts, according to which artifacts are ontologically on a par with other material objects. I formulate a nonreductive theory that regards artifacts as constituted by—but not identical to—aggregates of particles. After setting out the theory, I rebut a number of arguments that disparage the ontological status of artifacts.     

Making sense of ourselves: self-narratives and personal identity

Some philosophers take personal identity to be a matter of self-narrative. I argue, to the contrary, that self-narrative views cannot stand alone as views of personal (or numerical) identity. First, I consider Dennett’s self-narrative view, according to which selves are fictional characters—abstractions, like centers of gravity—generated by brains. Neural activity is to be interpreted from the intentional stance as producing a story. I argue that this is implausible. The inadequacy is masked by Dennett’s ambiguous use of ‘us’: sometimes ‘us’ refers to real human beings, and sometimes ‘us’ refers to selves or fictional characters. Second, I consider Schechtmann’s view that self-narratives create persons (in the sense that she calls ‘characterization’ or personality. I argue that the sense in which a self-narrative creates a person cannot stand on its own: a person must already exist (in the sense of numerical identity) in order for there to be a self-narrative. Finally, I offer my own account of persons.