Treating fetuses: The patient as person

The medical treatment in utero of human beings raises several ethical questions. I argue that treatment is sufficient to establish the fetus as person; and consider how conflicts between the interests of the fetus and mother are to be resolved when such treatment is proposed. My arguments rest upon a 'relational model' of ethical discourse derived from H. Richard Niebuhr's "ethics of the fitting." I conclude that the limitation of personal autonomy is rarely justified, but may be when direct, grave, harm to others is imminent; and that educative rather than punitive measures are the best prospect for protecting fetal life.     

Brief assessment and treatment of pica using differential reinforcement,response interruption and redirection,and competing stimuli

Pica is a life threating form of challenging behavior displayed by individuals with intellectual and developmental disabilities. In most cases, pica is maintained by automatic reinforcement. Common interventions for pica use some combination of response blocking, response interruption and redirection (RIRD), differential reinforcement of alternative behavior (DRA), and noncontingent reinforcement with competing stimuli. However, there is need for additional research regarding DRA procedures that emphasize skills acquisition by teaching alternative behaviors that modify the established behavioral chain of pica responses that occur in the presence of non-edible stimuli. There is also a need to examine the generality of recent advances in competing stimulus assessment (CSA) methodologies—namely, the augmented-CSA (A-CSA)—to pica. Thus, the purpose of the present investigation was to systematically replicate and extend previous research for the assessment and treatment of pica in an individual with IDD. First, we conducted a functional analysis to identify environmental variables associated with pica. Next, taught Patrick a differential response (i.e., discard pica items in trash receptacle) to earn reinforcers in conjunction with a RIRD procedure. Finally, we conducted an A-CSA for pica. Overall, low rates of pica were maintained over time with a combination of these procedures, and treatment was generalized across settings and people.     

“In my own comfort zone”: Clients' experiences of relational aspects of online therapy for alcohol problems

Background

Therapists and counsellors increasingly use online video applications to offer treatment in place of face-to-face delivery. In the alcohol treatment sector, this offers a range of potential benefits for treatment providers. However, the impact of working remotely via video on the therapeutic relationship remains unclear and under-researched.

Aims

This study aimed to explore how alcohol treatment clients make sense of the relational aspects of therapy delivered remotely, and to examine how the use of remote therapy might disrupt existing ideas around the therapeutic relationship.

Methodology

This study utilised a qualitative design using thematic analysis, with 15 participant interviews with adult service users from a single treatment provider. All participants had previously undertaken at least four 1-h online therapy sessions.

Findings

The themes that were identified highlighted the significance of the participants' own homes as the site of therapy, with emphasis on the comfort of the home, and the presence of family members and pets. Participants stressed the importance of viewing the face of the therapist, the establishment of a therapeutic bond and specific therapist qualities. Participants also reflected on issues around denial and avoidance associated with self-image and identity.

Discussion

There are nuanced and potentially unforeseen consequences of undertaking therapy for alcohol problems via video, relating to the significance of the therapy environment and relationship between client and therapist. This may include issues of shame, denial and avoidance, which are of particular significance for clients experiencing difficulties associated with alcohol.     

A plausible role of imagination in pretend play,counterfactual reasoning,and executive functions

A notable observation is the similarities in the cognitive processes of pretend play (PP) and counterfactual reasoning (CFR) as both involve thinking about alternatives to reality. It is argued by Weisberg and Gopnik (Cogn. Sci., 37, 2013, 1368) that alternative thinking in PP and CFR is underpinned by an imaginary representational capacity but few studies have empirically investigated this link. We use a variable latent modelling approach to test a hypothetical model of the structural relationship of PP and CFR predicting that if PP and CFR are cognitively similar; they should have similar patterns of associations with Executive Functions (EFs). Data were collected on PP, CFR, EFs and Language from 189 children (M = 4.8 years, males = 101, females = 88). Confirmatory factor analyses showed that measures of PP and CFR loaded onto single latent constructs and were significantly correlated (r = .51, p = .001) with each other. Hierarchical multiple regression analyses revealed that EF accounted for unique significant variance in both PP (β = 21) and CFR (β = 22). The results of the structural equation modelling revealed that the data were a good fit for the hypothetical model. We discuss the plausible role of a general underlying imaginative representational capacity to explain similarities in the cognitive mechanisms of different states of alternative thinking like PP and CFR.     

“Shame: The Misplaced Debt of Structural Sin”

Although sexual violence and economic distress are often understood and responded to as individual problems, they are rooted in and must be understood within the social systems of patriarchy and advanced global capitalism, both of which normalize these traumas. The problem is that social systems divert guilt for structural sin onto individuals in the form of shame, which I argue is the misplaced debt of structural sin. Through narrative and analysis, I demonstrate the problems of silence, judgement, and death associated with the misplaced debt of shame in structural sin. Preliminarily, I suggest that the theology of the cross enables Christians to name structural sin for what it actually is; judge who or what is truly guilty; and remove shame and guilt from survivors to foster flourishing.     

Cognitive load and person memory: the role of perceived group variability

Two studies investigated the effects of cognitive busyness and group variability on participants' memory for stereotype‐related information. In Study 1, participants formed an impression of an experimentally created group that was either homogeneous or heterogeneous in composition. While learning about the group, half of the participants were made cognitively busy, the others were not. The results supported our prediction that stereotypical efforts on memory are moderated by both the availability of processing resources and the variability of the target group under consideration. Under optimal processing circumstances, participants' recollections were dominated by the perceived variability of the group in question. That is, participants displayed preferential recall for stereotype‐consistent information when they believed the group to be homogeneous in composition, but a tendency to recall more stereotype‐inconsistent information when they considered the group to be heterogeneous in nature. Under sub‐optimal processing conditions, however, a different pattern emerged. Now, participants preferentially recalled stereotype‐consistent information regardless of the perceived variability of the group. These results were largely replicated in Study 2 when the perceived variability of a real social group was manipulated. We consider the implications of these findings for contemporary theories of stereotyping. Copyright © 1999 John Wiley & Sons, Ltd.