Protecting confidentiality rights: the need for an ethical practice model

All psychologists must uphold the same ethical standards about confidentiality even though each state imposes different legal limits on their ability to protect clients' confidences. The resulting ethical-legal confusion is exacerbated by legally based confidentiality training that treats legal exceptions as if they were the rule and fosters the impression that attorneys are now the only real experts about this aspect of practice. This article provides an ethics-based confidentiality practice model that clarifies the ethical rule and puts its legal exceptions into ethical perspective. Like the Confidentiality section of the American Psychological Association's (2002) Ethical Principles of Psychologists and Code of Conduct, this outline would apply to all psychologists regardless of state laws, but the details of its implementation would vary according to role and setting. It can be used as a universal training outline, a consultation and supervision tool, a guide to professional practice, and a basis for clearer ongoing conversation about the ethics of "conditional confidentiality." Psychologists can use this practice model to regain their status as experts about the confidentiality ethics of their own profession.     

对“家属签字”制度的立法思考

李丽云悲剧的发生,使《医疗机构管理条例》第三十三条规定的“家属签字”制度成为公众及法律界人士关注的焦点。“家属签字”制度受到道德和法律的双重拷问。从“家属签字”制度中潜在的法律推定出发,对“家属签字”制度的正当性依据、“特殊情况”下对患者的求生推定等六方面问题做些有益探讨,以期完善我国医疗管理法律法规。     

近年高等中医院校师承教育试点班研究

中医院校教育改革已经开始注重中医特色和优势,部分学校在中医专业恢复师承教育,开办试点班。试点班以中医课程为主,培养方向是中医特色临床。在师承教育试点班里,已经把纯中医人才和中西医结合人才的培养相对分开。恢复师承教育试点班是一个积极而有效的探索,它在推进院校教育结构调整,完善教育体制等方面具有重要的作用。     

克雷佩林与精神病人的时代形象

精神疾病分类学不仅构建了对于这种疾病的评价,也决定了病人的名誉及其在法律关系中的责任。通过这些直接或间接的作用,精神疾病分类学塑造了一个时代的精神病人的形象。概述了克雷佩林的理论体系和分类思想,分析了贯穿其间的哲学讨论及其产生的社会影响,在此基础上说明起始阶段的精神疾病分类学如何塑造了那样一种精神病人的时代形象。     

新型农村合作医疗制度进一步发展的瓶颈分析

提出制约新农合制度发展的瓶颈有：筹资方式及筹资成本问题、筹资水平、补偿内容的设计问题、过多照搬了城镇职工基本医疗保险的资金管理方式、管理能力与管理手段、位于卫生局内的合管办、无法实现“解决因病致贫、因病返贫”的政策目标。     

从量变到质变--浅谈经验医学到循证医学的转变

循证医学是近十年来国际医学界倡导的一种新的医学模式,强调用科学的方法寻求最佳研究证据以指导临床决策.经验医学到循证医学的转变,是从量变到质变的过程,体现了事物发展的一般规律.     

Cognitive and emotional characteristics of New Religious Movement members: New questions and data on the mental health issue

The common assumption that members of so-called “cults” and New Religious Movements (NRMs) have mental health problems is usually countered by empirical research suggesting a normal personality profile. Going further than the normality–pathology distinction, we investigated affective-relational (parental and adult attachment) and cognitive (need for closure) needs, world assumptions, and past and present depression as reported by members (N?=?113) of a variety of NRMs in Belgium that are somewhat socially contested. Comparisons were made with data from the general population. Results suggest a fragile past (insecure attachment history, high need for closure, and depressive tendencies) but a positive present (positive world assumptions, security in adult attachment, no depression) and an optimistic future, at least on the basis of self-perceptions. Overall, the pattern of results fit well with what we know from psychology of conversion in general.     

Preschoolers with Asthma: Narratives of Family Functioning Predict Behavior Problems

This study tested a model predicting behavior symptoms in preschoolers with asthma. Specifically, it examined the role that asthma severity and children's representations of family functioning may play in the development of child behavior problems in a sample of 53 low-income preschoolers. The study included parent report of asthma severity and a narrative story-stem method to assess children's representations of both general and disease-specific family processes. A regression model tested the inclusion of both types of family processes in predicting child internalizing and externalizing behavior. Disease severity and children's family narratives independently predicted children's behavior over and above the combined effects of demographic variables including child age, socioeconomic status, and family structure. Although children's narratives about general family functioning predicted children's behavior, narratives about family response to asthma symptoms did not. Findings support that both disease severity and family functioning are important considerations in understanding children's behavior problems in the context of asthma. Clinical applications of findings may include: (1) Informing family based-assessments to incorporate children's narratives, and (2) A focus on reducing asthma symptoms and strengthening family functioning to prevent or address child behavior problems.     

Male Emotional Intimacy: How Therapeutic Men's Groups Can Enhance Couples Therapy

Men's difficulty with emotional intimacy is a problem that therapists regularly encounter in working with heterosexual couples in therapy. The first part of this article describes historical and cultural factors that contribute to this dilemma in men's marriages and same-sex friendships. Therapeutic men's groups can provide a corrective experience for men, helping them to develop emotional intimacy skills while augmenting their work in couples therapy. A model for such groups is presented, including guidelines for referral, screening, and collaboration with other therapists. Our therapeutic approach encourages relationship-based learning through direct emotional expression and supportive feedback. We emphasize the development of friendship skills , core attributes of friendship ( connection, communication, commitment, and cooperation ) that contribute to emotional intimacy in men's relationships. Case examples are included to illustrate how this model works in clinical practice, as well as specific suggestions for further study that could lead to a more evidence-based practice.