A Relational Encounter with Race

Race remains one of the most highly charged subjects of discourse in our society. At a cultural level, white racial identity has become dissociatively split off from the rest of identity formation. A racialized subjectivity is usually carried by those with darker skin colors, whereas whiteness is experienced as an unmarked and invisible state. The author argues that whites have dissociated the historical position of the oppressor from collective consciousness, due to our inability to tolerate an identification with the aggressor. Our disavowal of race as constitutive of subjectivity ensures that race becomes a site for enactments.

This paper follows the transference-countertransference dynamics between an African American patient mandated to treatment and the author, a white analyst born in South Africa. The haunting presence of racial trauma infused the analysis. Focus is placed on the rich, often unmetabolizable experiences of race, including the ways in which the structure of the treatment recreated the racial dynamics of slavery.     

Malleable conjoint partworths: How the breadth of response scales alters price sensitivity

In one laboratory study and one field study conducted with a large, representative sample of respondents, we show that seemingly innocuous questions that precede a conjoint task, such as demographic and usage-related screening questions can alter the price sensitivities recovered from the main conjoint task. The findings demonstrate that whether these prior questions use broad response categories (i.e., few scale points) or narrow response categories (i.e., many scale points) systematically influences consumers' price sensitivity in a CBC (Choice Based Conjoint) study. We suggest that this may occur because the narrow (vs. broad) response categories in the prior questions lead to consideration of a greater (vs. fewer) number of attributes during the key conjoint task. Since both groups of consumers readily consider the naturally salient price attribute, responding to previous questions with narrow (vs. broad) response categories leads to a greater (vs. fewer) number of non-price attributes being considered, and consequently, decrease the weight afforded to price and reduce price sensitivity.     

Addiction‐Specific CACREP Standards in Clinical Mental Health Counseling Programs: How Are They Met?

In 2009, the Council for Accreditation of Counseling and Related Educational Programs (CACREP) included training standards specific to addiction for clinical mental health counseling programs. This study surveyed CACREP‐accredited program coordinators to determine how addiction‐specific standards were addressed.     

Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services

Abstract

The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Participants completed a life events questionnaire and inventories assessing coping, dispositional hope, and PTSD and depression symptom severity. Hierarchical regression analyses were conducted controlling for relevant demographic variables. Greater levels of emotional avoidance and lower levels of emotional expression were significantly associated with increased PTSD and depression symptom severity. Dispositional hope was positively associated with depression symptoms only and perceptions of hope moderated the association between emotional avoidance coping and depression symptoms. Findings highlight the value of emotional coping strategies and perceptions of hope in posttraumatic adjustment. Specifically, employing coping techniques that encourage emotional expression may promote improved adjustment among trauma-exposed individuals, while reduced perceptions of hope and the use of avoidant coping strategies may place individuals at greater risk for depression following exposure to traumatic events.     

Adolescents with Poorly Controlled Type 1 Diabetes can Benefit from Coaching: A Case Report and Discussion

Traditional interventions aimed at improving patient self-management and at motivating the patients to change behaviour seem to be insufficient in adolescents with very high HbA1c. In this paper we present a case consisting of nine adolescents with poorly controlled diabetes type 1. They had previously shown continuously high levels of HbA1c for 2 years despite intensive follow-up and were therefore invited to participate in a coaching program. The coaching program was conducted by professional certified coaches and consisted of two group and eight individual coaching sessions. After completing the coaching sessions, HbA1c had decreased significantly in six out of nine of the adolescents. The participants were interviewed twice following the coaching sessions. All participants reported that they found the sessions very rewarding, and several explained that they now saw themselves differently and had gained more self-esteem and more energy.     

Self-Esteem and Its Relationship to Mental Health and Quality of Life in Adults with Cystic Fibrosis

Research from the general population indicates an important role for self-esteem in mental health, but limited research in this area exists in the cystic fibrosis (CF) literature. This study aimed to explore the predictive value of self-esteem and health-related quality of life (HRQoL) in mental health symptoms in adults with CF. Seventy-four participants, recruited online, completed the Clinical Outcomes in Routine Evaluation-Outcome Measure 34 (CORE-OM), Rosenberg Self-esteem Scale and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Comparably high levels of self-esteem were found, but HRQoL was lower than previous research. Thirty percent of participants scored within the clinical range for mental health difficulty. Hierarchical regression, controlling for gender, explored the value of four CFQ-R subscales (physical, social, emotional and role functioning) and self-esteem in predicting CORE-OM total score. Gender accounted for 8.2 % of the variance in mental health scores while the five independent variables accounted for a further 73.0 % of variance. Of the five variables, CFQ-R emotional functioning and self-esteem were significant predictors of mental health symptoms. Results are discussed in relation to clinical implications and potential uses for internet technologies to promote socialisation.     

Acceptability of Psychotherapy, Pharmacotherapy, and Self-Directed Therapies in Australians Living with Chronic Hepatitis C

Despite the prevalence of psychiatric co-morbidity in chronic hepatitis C (CHC), treatment is under-researched. Patient preferences are likely to affect treatment uptake, adherence, and success. Thus, the acceptability of psychological supports was explored. A postal survey of Australian CHC outpatients of the Royal Adelaide Hospital and online survey of Australians living with CHC was conducted, assessing demographic and disease-related variables, psychosocial characteristics, past experience with psychological support, and psychological support acceptability. The final sample of 156 patients (58 % male) had significantly worse depression, anxiety, stress, and social support than norms. The most acceptable support type was individual psychotherapy (83 %), followed by bibliotherapy (61 %), pharmacotherapy (56 %), online therapy (45 %), and group psychotherapy (37 %). The most prominent predictor of support acceptability was satisfaction with past use. While individual psychotherapy acceptability was encouragingly high, potentially less costly modalities including group psychotherapy or online therapy may be hampered by low acceptability, the reasons for which need to be further explored.     

Source confusion influences the effectiveness of the autobiographical IAT

We examined the claim that the autobiographical Implicit Association Test (aIAT) can detect concealed memories. Subjects read action statements (e.g., “break the toothpick”) and either performed the action or completed math problems. They then imagined some of these actions and some new actions. Two weeks later, the subjects completed a memory test and then an aIAT in which they categorized true and false statements (e.g., “I am in front of the computer”) and whether they had or had not performed actions from Session 1. For half of the subjects, the nonperformed statements were actions that they saw but did not perform; for the remaining subjects, these statements were actions that they saw and imagined but did not perform. Our results showed that the aIAT can distinguish between true autobiographical events (performed actions) and false events (nonperformed actions), but that it is less effective, the more that subjects remember performing actions that they did not really perform. Thus, the diagnosticity of the aIAT may be limited.     

The Chinese Life-Steps Program: A Cultural Adaptation of a Cognitive-Behavioral Intervention to Enhance HIV Medication Adherence

China is considered to be the new frontier of the global AIDS pandemic. Although effective treatment for HIV is becoming widely available in China, adherence to treatment remains a challenge. This study aimed to adapt an intervention promoting HIV-medication adherence—favorably evaluated in the West—for Chinese HIV-positive patients. The adaptation process was theory-driven and covered several key issues of cultural adaptation. We considered the importance of interpersonal relationships and family in China and cultural notions of health. Using an evidence-based treatment protocol originally designed for Western HIV-positive patients, we developed an 11-step Chinese Life-Steps program with an additional culture-specific intervention option. We describe in detail how the cultural elements were incorporated into the intervention and put into practice at each stage. Clinical considerations are also outlined and followed by two case examples that are provided to illustrate our application of the intervention. Finally, we discuss practical and research issues and limitations emerging from our field experiments in a HIV clinic in Beijing. The intervention was tailored to address both universal and culturally specific barriers to adherence and is readily applicable to generalized clinical settings. This evidence-based intervention provides a case example of the process of adapting behavioral interventions to culturally diverse communities with limited resources.     

Spring

Impossible Love, Or Why the Heart Must Go Wrong A Conversation with Jan Bauer, Ginette Paris, and James Hillman

How to Love a Woman: On Intimacy and the Erotic Life of Women By Clarissa Pinkola Estes