Clinical pragmatism: a method of moral problem solving

This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in moral problem solving are discussed.     

Normative data on the Missouri Children's Picture Series and the Missouri Children's Behavior Checklist with southern black children

Normative data are presented for Southern black children on two objective personality inventories for children: the Missouri Children's Picture Series (MCPS), a child picture-sorting task, and the Missouri Children's Behavior Checklist (MBCL), a parent rating scale. The MCPS was administered to 615 black children attending public schools in a low socioeconomic area of the southeast United States. Parents returned the MBCL on 437 of the children. Means and standard deviations on eight MCPS personality scales and six MCBL behavior rating scales are presented for black males and females at ages 5 through 16, and effects of age, sex, and various scale intercorrelations are discussed. Results suggest systematic age and sex differences on the various scales for black children that are quite atypical when compared with the MCPS in other samples. Various empirical questions regarding the validity of these instruments when used with Southern black children are raised.     

TRAINING PARENTS IN BEHAVIORAL SELF-MANAGEMENT: AN ANALYSIS OF GENERALIZATION AND MAINTENANCE

This study examined the generalization and maintenance effects of three phases of parent training (Instructions plus Feedback and two Self-management Training phases) on levels of disruptive child behavior and the accuracy with which parents implemented programs. Data were collected from five families in three main settings: the initial training setting (the home), a variety of generalization settings in the community, and the family breakfast. A multiple baseline across subjects design was used. Instructions plus Feedback comprised instructing parents to use a range of behavior management procedures and provided home-based differential feedback concerning accuracy of program implementation. Self-management Training phases involved training parents in goal setting, self-monitoring, and planning skills, specific to their performance of appropriate parenting skills in generalization settings. Results indicated that the Instructions plus Feedback phase was sufficient to produce reduced levels of problem behavior at home and high levels of accurate implementation, but generalization effects out of home were equivocal. Self-management maintained reduced levels of problem behavior at home but, in addition, resulted in generalization effects in community settings for both children and parents. Maintenance probes 3 months following the program revealed the effects had been maintained.     

USE OF A SELF-RECORDING AND SUPERVISION PROGRAM TO CHANGE INSTITUTIONAL STAFF BEHAVIOR

The use of a self-recording and supervision program to increase interactions between direct care staff and profoundly retarded persons in a state residential facility was investigated. Following baseline, staff were provided with instructions regarding what to self-record, criteria for how many interactions to record, and a prepared card on which to make the recordings. Throughout the study, the staff supervisor monitored intermittently staff-client interactions. Observations indicated that when the staff recorded their interactions with clients in a loosely structured dayroom setting, the rate of interactions increased noticeably for each staff person. Behavioral ecology measures indicated that other staff responsibilities, such as maintaining the cleanliness of residents and the physical area, were not affected detrimentally when social interactions increased and actually showed small improvements. Additionally, small decreases in resident self-stimulatory and disruptive/aggressive behaviors occurred when the rate of social interactions from staff persons increased. Follow-up measures indicated that the rate of staff self-recording was variable, but when staff did self-record, the increased rate of staff-client interactions maintained.     

Emotional Environments: Selective Permeability,Political Affordances and Normative Settings

Topoi - I begin this article with an increasingly accepted claim: that emotions lend differential weight to states of affairs, helping us conceptually carve the world and make rational decisions. I...