The use of consultation in psychological practice: ethical, legal, and clinical considerations

The importance of consulting with other professionals to maintain acceptable standards of care is well documented in many health care professions. However, evidence indicates that many psychologists fail to utilize consultation when needed, and that consultation use varies along dimensions such as the education and training of the consultee, the type of setting, number of years in practice, and proximity to available consultants. In this article, we review the research on the use of consultation by psychologists as well as other health care professionals. We discuss the clinical, ethical, and legal implications of seeking consultation as a professional psychologist. Finally, a detailed and practical model for the regular use of consultation is given to improve the routine use of consultation in clinical practice.     

DEPRESSION IN WOMEN AS RELATED TO ANGER AND MUTUALITY IN RELATIONSHIPS

Self-in-relation theory (Jordan, Kaplan, Miller, Stiver, & Surrey, 1991) proposes that a lack of mutuality in women's relationships predisposes them to depression and inhibits their ability to acknowledge and address effectively emotions such as anger. Research linking anger to depression has not examined women's emotional expressivity within the context of their partner relationships. Women's depression as a function of both their level of anger suppression or inappropriate anger expression and the level of perceived relationship mutuality was studied in a sample of 223 college women, aged 18 to 54. Lower levels of mutuality and higher levels of suppressed or inappropriately expressed anger were associated with depression. Moreover, mutuality made contributions to predicting depression beyond that explained by anger. Lower mutuality was also related to higher anger suppression, but unrelated to inappropriately expressed anger.     

An Assessment of the Effectiveness of Two Tactics to Reduce Arousal in Crowded Mass Transit Settings1

Studies of crowding in various settings have shown that individuals are aroused and frequently suffer from ill health. Several studies have shown that it is possible to successfully intervene in residential, shopping, and classroom settings to reduce the negative effects of crowding. The present laboratory experiment assessed the effectiveness of two tactics commonly used by passengers in crowded mass transit settings. Results indicated that the two tactics, reading a newspaper or talking to others, failed to reduce arousal. An explanation for the failure of these tactics is offered.     

The effect of mood and incentives on helping: Are there some things money can't buy?

Happy, guilty, and neutral mood states were induced in participants who were then provided with an opportunity to donate blood for free, to donate in exchange for $5, or to choose between donating for free or for $5. As expected, there was a significantly higher incidence of helping when subjects felt happy and guilty as opposed to emotively neutral. Contrary to predictions, helping was unaffected by the type of incentive (donate for $5, donate for free, choose $5/free) subjects were offered in interaction with their mood state. However, the type of incentive did seem to influence the postdonation emotions of subjects: Guilty subjects who donated for money felt significantly less guilty following donation than prior to it and happy subjects felt more self-altruistic (kind and generous) following donation when they helped for free. The results are discussed in terms of Cialdini's negative state relief model (for negative moods) and the intrinsic qualities of helping (for positive moods).     

Working with families: a psychoanalytic approach. Thoughts on the Conference Workshop

An account of the work done before, during and after the Workshop meetings is given, with emphasis on the method of working with clinical material through a psychoanalytical framework. Some of the leaders' concerns about using an experiential approach in teaching/learning groups are discussed.     

Haloperidol and the treatment of stuttering

Reports of the use of haloperidol in the treatment of stuttering show that it does reduce the severity of the disorder in some subjects. Two trials of the drug in adult stutterers confirmed this effect in 17% of the 52 subjects tested. Side effects —principally drowsiness—caused many subjects to discontinue taking the drug and only one subject voluntarily continued on haloperidol after the trial concluded. It is concluded that haloperidol, a potentially simple remedy, is not the treatment of choice in adults who stutter.     

Extinction of a phobia of physical examination in a seven-year-old mentally retarded boy—A case study

Counterconditioning is a process in which aversive stimuli that ordinarily evoke emotional or avoidance responses are paired with positive stimuli which evoke incompatible activities. Several sets of operations have been employed to induce these incompatible activities (e.g. food, Jones, 1924; relaxation. Grossberg, 1964; positive imagery, Lazarus and Abramowitz, 1962; pharmacological agents, Friedman, 1966; laughter, Ventis, 1973).Although the Counterconditioning process has been successfully applied to a wide variety of emotional disorders, special problems arise when the procedure is applied to the mentally retarded. First, because of the limitations in cognitive abilities, it is generally impossible to train the subject in either relaxation or positive imagery processes. Consequently, it is necessary to place the child in direct contact with the anxiety-inducing situation. Secondly, it is often difficult to find an anxiety-free situation which is incompatible with the anxiety-arousing situation and which can be practically implemented, particularly when the phobia involved is complex.The purpose of this paper is to describe a case whereby a phobic response of physical examination by male doctors in a 7–yr-old mentally retarded boy was extinguished by pairing the examination with an anxiety-free situation, i.e. an extremely comfortable relationship between the patient and a nurse on the ward. Previous research had indicated that parents and people who have positive relationships with a person might possibly serve as effective anxiety reducers in fear-provoking situations (Jersild and Holmes, 1935).     

Formalized historiography,the structure of scientific and literary texts: Part I. some issues posed by computational methodology

The examination of theorizing and techniques for scientific language analysis applied to ‘history’ clearly generalizes to imply a domain of applicability potentially coextensive for behavioral scientists with the scope of cultural behavior. It is argued that the computer and related science and technology are moving toward a relationship vis-à-vis symbolic acts analogous to microscopy for the ‘sub-visual’ in scale and telescopes for astronomic phenomena. Content analysis is one of the points of departure, as also contemporary syntactic analysis, from which present ideas and algorithms have moved on. How ‘far’ — both at present and in prospect — is the subject of these articles.