Motivational enhancement treatment in outpatient addiction centers: A multisite randomized trial

Background/Objectives: Motivational Enhancement Treatment in Spanish (METS) is a brief intervention aimed at resolving patient ambivalence towards behavior change that has demonstrated efficacy in substance use disorder treatment to reduce use and increase treatment engagement in different populations. In order to have evidence for its implementation in Mexico, a multi-site, randomized, two-arm, controlled clinical trial was conducted at three outpatient addiction treatment centers in the country to compare the effect of METS with Counseling as Usual (CAU). Method: One hundred and twenty patients were randomized to receive three sessions of METS (n = 54) or CAU (n = 66) during the first four weeks of treatment and were assessed during the following 12 weeks. Primary outcome measures were self-reported days of substance use and of treatment services utilization, which were tested using Generalized Estimating Equations. Results: Results associated both conditions with significant changes in substance use over, whereas there were no differences between conditions in substance use or in service utilization. Conclusions: Findings do not support the hypothesis that METS is more effective than CAU, but suggest that brief interventions at treatment initiation may improve patient outcomes.     

Employee adaptive performance and job satisfaction during organizational crisis: the role of self-leadership

This study tests the hypothesis that self-leadership is positively related with employee adaptive performance and job satisfaction in rapid change and unpredictable work environments. This assumption was tested through a quasi-experimental study regarding the implementation of a self-leadership training programme in the Private Banking department of an international bank. Change in private bankers’ self-leadership, adaptive performance and job satisfaction was measured three times, over a period of 8 months. During the fourth month of the training programme implementation, the bank underwent an unexpected bailout. Fifty-two private bankers were randomly assigned to an experimental group (n = 28) and to a control group (n = 24). The results showed an increase in self-leadership, adaptive performance and job satisfaction for the experimental group, while job satisfaction decreased for participants in the control group. Our findings suggest that change in the level of self-leadership is positively related with change in the level of adaptive performance and job satisfaction over time. This study presents new evidence that individual adaptive performance and job satisfaction can be enhanced through self-leadership training. Self-leadership training can be used as a valuable tool to help organizations improve employees’ adaptive performance and job satisfaction, especially during organizational crisis.     

The Holistic Way: John Wesley’s Practical Piety as a Resource for Integrated Healthcare

In the midst of the multifarious healthcare of the 21st century an Anglican clergyman from the 18th century named John Wesley can serve as a valuable resource for contemporary Christians seeking to faithfully live a life of well-being which incorporates different forms of medicine. In order to explore Wesley’s contributions to integrative care this essay will first situate Wesley in his 18th century context—a time period not completely unlike our own in which medicine was also experiencing dramatic shifts in practice and philosophy. In order to demonstrate his integration of the medical knowledge of his day the essay will look at Wesley’s own medical practices and his relationships to physicians as forging a “middle way” between physic and empiricism. The essay will examine Wesley’s theology as a practical piety which is grounded in a holistic sotieriology that sustains an integrative medicine (caring for body, mind, and spirit). Finally, the essay concludes with possibilities for integrated medicine in our own day as informed by a Wesleyan “way” of holistic practice.

Fluent Reading as the Improvement of Stimulus Control: Additive Effects of Performance-Based Interventions to Repeated Reading on Students' Reading and Error Rates

The impact of adding performance-based interventions to a skill-based intervention on oral reading fluency was examined with 3 elementary students identified as having difficulty with reading. Two performance-based interventions were combined with the skill-based intervention Repeated Reading (RR) to create the three instructional packages investigated. The packages included Repeated Readings (RR), Repeated Readings with Performance Feedback (RR/FB), and Repeated Readings with Performance Feedback and Contingent Reward (RR/FB/REW). Results suggested that Repeated Reading (RR) alone led to the greatest increase in reading fluency for participants with the highest reading rates and lowest error rates at baseline. In contrast, the participant who exhibited the lowest reading rate and highest error rate benefited the most when Repeated Readings was offered in conjunction with Performance Feedback (RR/FB) or Performance Feedback plus Contingent Reward (RR/FB/RW). Implications for blending skill- and performance-based interventions to develop stimulus control over fluent reading and future research directions are discussed.     

THE NEED FOR TRUE CONTROVERSIES IN PSYCHOANALYSIS: THE DEBATES ON MELANIE KLEIN AND JACQUES LACAN IN THE RÍO DE LA PLATA

Controversies are part of the process of scientific knowing. In psychoanalysis, the diversity of theoretical, technical and epistemological positions makes the debate particularly necessary and by the same token difficult. In this paper, the author examines the function of controversies and the obstacles to their development, taking as examples the debates held in the Rao de la Plata (Buenos Aires and Montevideo) during the nineteen seventies, when the dominant Kleinian ideas came into contact with Lacanian thought. The author examines different examples of argumentative discourses, using concepts taken from the theory of argumentation. The major difficulties encountered did not hinge on characteristics pertaining to psychoanalytic theories (i.e. the lack of commensurability between them), but on the defensive strategies aimed at keeping each theory's premises safe from the opposing party's arguments. A true debate implies the construction of a shared argumentative field that makes it possible to lay out the different positions and see some interaction between them and is guided by the search for the best argument. When this occurs, controversies promote the discipline's development, even when they fail to reach any consensus.     

Judgment of line orientation depends on gender, education, and type of error

Visuospatial tasks are particularly proficient at eliciting gender differences during neuropsychological performance. Here we tested the hypothesis that gender and education are related to different types of visuospatial errors on a task of line orientation that allowed the independent scoring of correct responses ("hits", or H) and one type of incorrect responses ("commission errors", or CE). We studied 343 volunteers of roughly comparable ages and with different levels of education. Education and gender were significantly associated with H scores, which were higher in men and in the groups with higher education. In contrast, the differences between men and women on CE depended on education. We concluded that (I) the ability to find the correct responses differs from the ability to avoid the wrong responses amidst an array of possible alternatives, and that (II) education interacts with gender to promote a stable performance on CE earlier in men than in women.