Enhancing Consultee Problem-Solving Skills in Consultative Interactions

Selected empirical research on consultative problem solving is reviewed. Although there is general support for the effectiveness of consultation in resolving a variety of presenting problems and in improving consultees' skills for solving future problems, there is a need for additional methods to facilitate the process. Direct training of consultees in behavior management, communication, and consultation process skills is advocated as one means of attaining this goal.     

The rationing of health care: A doctor's dilemma

Physicians are currently presented with very difficult ethical issues regarding who receives what level of medical care and for how long. A meaningful response to these perplexing issues necessitates a collaboration of doctors with others steeped in religious and ethical traditions. This paper addresses the complicated issue of the rationing of health care, and this issue is then addressed by responses from representatives of the religious community. This symposium took place at the New York Hospital—Cornell Medical Center in March 1991.The Rev. Curtis W. Hart, M.Div. is Director of Pastoral Care and Education at the New York Hospital—Cornell Medical Center.The Rev. Paul Conner, O.P., is Associate Professor and Director of the Master's Program in Public Health Care Ethics at New York Medical College. Larry Rasmussen, Th.D., is Reinhold Niebuhr Professor of Social Ethics at Union Theological Seminary in New York. Dr. Harlan J. Wechsler is Rabbi of Congregation Or Zarua and Visiting Professor of Philosophy at Jewish Theological Seminary in New York.     

EFFECTS OF MEMORY AIDS ON THE DYADIC CONVERSATIONS OF INDIVIDUALS WITH DEMENTIA

The effects of a prosthetic memory aid on the conversational content and social skills of dyads with dementia were evaluated. Six individuals with moderate to severe dementia served as either subject or partner in dyads during 5-min conversational probes conducted three times per week in daycare and nursing-home settings. During phases when a memory aid, consisting of personally relevant picture and sentence stimuli, was available, most subjects used their own aid to improve the quality of conversations by increasing the frequency of on-topic statements, diminishing nonproductive utterances, lengthening their conversational turn, and/or increasing the frequency of turns taken. Most partners demonstrated awareness of social discourse conventions by appropriately relinquishing conversational dominance, decreasing both content and nonproductive utterances, and increasing acknowledging or affirmative comments when subjects used memory aids. Naive judges' ratings of aided and unaided conversational samples on seven conversational dimensions reflected differences in perceptions of significant improvement as a function of the conversational discourse style of each dyad.     

Concurrent Use of Cigarettes,Alcohol, and Coffee1

The interrelationships between cigarette, alcohol, and coffee use were examined in 307 U.S. army trainees and 304 U.S. enlisted army personnel. Usage patterns indicated distinct gender differences in this occupational setting. Among women, cigarette use and alcohol consumption were positively correlated; whereas for men, cigarette and coffee use were positively related. For both males and females, alcohol and coffee use were only weakly correlated. As demonstrated in other studies, nonsmokers showed a consistent pattern of abstention from coffee and alcohol or moderate alcohol use.     

The myth of science education

It is argued that the manner in which we teach science in the high schools represents an outdated positivistic conception of science. The standard presentation of a year of each of chemistry, biology and physics should be replaced by an integrated science plus history, philosophy, and sociology of science which would take a total of three years to complete. A proper appreciation for the true nature of science is essential to the continued health of the scientific enterprise.     

Affective influences on individual and group judgments

Do emotional states influence the social judgments made by groups and individuals? Based on affect-cognition theories and research on group judgmental shifts, we predicted that group discussion will enhance positive mood effects on judgments, but inhibit affectively-based distortions in dysphoric moods. Positive, neutral and negative moods were induced using audiovisual presentations. Individual and group consensus judgments of nine person categories on three judgmental dimensions (evaluation, competence and self-confidence) were obtained in two experimental sessions separated by a two-week interval. Results showed that individuals made more positive judgments when happy, and more negative judgments when sad than did controls. Group discussion resulted in a further polarization of positive judgments, and the attenuation of negative judgments. The findings are interpreted as evidence for the important role affect plays in mediating both individual cognitive processes and interactive social behaviours. The implications of the results for contemporary affect-cognition theories and models of group behaviour are considered.     

Internalizing and externalizing characteristics of sexually and/or physically abused children

This study evaluates the behavioral consequences of childhood abuse (sexual, physical, or both), with particular focus on prevalence of posttraumatic stress disorder (PTSD). Three abuse type groups and nonabused controls were contrasted on behavioral rating scales and on structured psychiatric interview data. The participants (109 abused children and 16 normal control children) were recruited from Arkansas Children’s Hospital and local agencies for abused children. As expected, proportionately more females than males were sexually abused. Overall, males were rated as more disturbed than females. Type of abuse did not consistently influence behavioral ratings. Externalizing scores were significantly higher than internalizing scores in all abused groups. PTSD was diagnosed in 50% of the abused children, with a higher rate for boys who had been sexually abused as opposed to physically abused only (58% versus 13%). The most frequent comorbid condition with PTSD was Separation Anxiety. Sexually abused boys were hospitalized for psychiatric treatment at a higher rate than were other abused children.     

On the dynamics of dying

This study is concerned with dynamic processes that underly the rapid, degenerative changes associated with the “dying” stage of the multicellular organism's life cycle. The interaction between negative and positive feedback cycles is discussed: negative feedback cycles underly the superstability characteristic of health and illness. When negative feedback cycles fade in the dying phase of life, positive feedback cycles, previously held in check by the negative feedback cycles to which they had been coupled, rise explosively, driving physiologic variables from their normal values towards extremes. This results in the rapid downturn that we associate with dying—an accelerating disintegration terminating in death. A medical case history is analyzed.