Toward a further understanding of assent

Arranging assent opportunities is an increasingly common strategy for involving clients in therapeutic decisions within behavior analysis. Recent behavior-analytic articles have helped create a basic behavioral definition and conceptualization of assent, but much more guidance is needed for practitioners and researchers interested in embedding assent into their practices. The purpose of this article is to advance the conceptualization and understanding of assent and assent practices by refining previous definitions and conceptualizations of assent and providing six essential considerations for embedding assent into practice. The six considerations consist of determining the applicability and feasibility of assent, assessing assent-related skills, arranging assent procedures and teaching assent-related skills, arranging fair choices, selecting opportunities to assess assent, and informally assessing assent. Following the discussion of the considerations for assent practices, we issue a call for specific topics of research on assent.     

Evaluation of the Bifactor Structure of the Dispositional Hope Scale

The Dispositional Hope Scale (DHS; Snyder et al., 1991) is composed of items assessing an individual's perception of his or her agency and pathways. This study examined support for the bifactor structure and relation of the factors in this model with depressive symptoms. It also examined cross-gender measurement invariance for the bifactor model. A community sample of 413 women and 257 men completed the DHS. Confirmatory factor analysis indicated more support for the bifactor model than the 1- and 2-factor models. Results also indicated full measurement invariance across gender for the bifactor and the 2-factor models. The general and the specific agency factors, but not the specific pathways factor, correlated with depressive symptoms. The better support for the bifactor model suggests that ideally hope has to be measured and examined by factors reflecting high covariance for agency and pathways, and also factors reflecting unique variances for agency and pathways. The support for full cross-gender measurement invariance indicated that there are no differences in measurement and scaling properties for the DHS across ratings provided by women and men, and therefore the DHS ratings can be scored in the same way for women and men.     

SBNR Identity: The Role of Impersonal God Representations,Individualistic Spirituality,and Dissimilarity With Religious Groups

We conducted two studies investigating the extent to which self-identification as Spiritual but not Religious (SBNR) was associated with (H1) the development of idiosyncratic religious beliefs and exposure to religious diversity and/or (H2) negative attitudes toward organized religion and being hurt by members of a religious group. In Study 1, SBNRs scored higher than religious and nonreligious participants on belief in God as an impersonal cosmic force (but not as a personal being) and individualistic spirituality. Although SBNRs had positive attitudes toward religion, they were less positive than those identifying as religious. Exposure to religious diversity and hurt by religious groups were not significant predictors of SBNR. We replicated these results in Study 2 using a multi-item measure of God representations and also found that SBNRs’ attitudes toward religion were predicted by a perceived dissimilarity with religious groups over and above individualism, secular group participation, perceptions of Christianity as too structured, and liberalism.     

Primary Care for the Elderly Bereaved: Recommendations for Medical Education

The aim of this study was to explore the current practices of primary care physicians (PCPs) in providing bereavement care to elderly patients, with implications for medical education. A total of 63 PCPs answered a brief online survey about their typical practices, barriers, comfort level with bereavement, and confidence in their ability to diagnose prolonged grief disorder (PGD). They were recruited through an online newsletter and contacts of one of the authors. The results found that two-thirds of the PCPs do not routinely screen their elderly patients for recent losses, nor do they refer to mental health clinicians when loss is identified. Barriers included not learning of the deaths in patients’ lives and lack of time during clinic visits. Those PCPs who had experienced their own losses were significantly more comfortable in speaking to patients about recent losses and more confident in their ability to diagnose PGD. We recommend bereavement education be incorporated into the medical school curriculum from the outset, utilizing the psychological principle of graded exposure to bereaved individuals.