The Nature of Client Agency Prior to Therapy: A Qualitative Study on Clients’ Narratives

Client agency is considered a crucial contributor to good treatment outcome. Recent studies, however, differ strongly in how they conceptualise and investigate agency. The current study explores the nature of client agency in ten clients’ pre-treatment interviews. Applying Consensual Qualitative Research, we constructed three overarching categories, subdivided into 14 sub-categories capturing both between- and within-person differences in agency before therapy. We found that all participants oscillated between the experience of a lack of grip on problems on the one hand and noticing their involvement in the problem and taking action on the other. These results present a dynamic conceptualisation of client agency. This allows us to ask pertinent questions for both future research and clinical practice.     

The Facts and Practices of Moral Responsibility

Strawsonians about moral responsibility often claim that our practices of holding morally responsible fix the facts of moral responsibility, rather than the other way round. Many have argued that such ‘reversal’ claims have an unwelcome consequence: If our practices of holding morally responsible fix the facts of moral responsibility, does this not imply, absurdly, that if we held severely mentally ill people responsible, they would be responsible? We provide a new Strawsonian answer to this question, and we explore the relation between reversal claims and (in)compatibilism.     

From trust in caregivers’ support to exploration: The role of openness to negative affect and self‐regulation

Attachment theory assumes that trust in caregivers’ support and exploration are closely related. Little research tried to investigate this link, nor focuses on mechanisms that might explain this association. The present studies examined whether trust is related to exploration through a serial indirect effect of openness to negative affect and self‐regulation. In Study 1, 212 children, aged 8–13, completed questionnaires assessing trust, openness to negative affect, self‐regulation and exploration. The results showed that trust predicted exploration, but only to the extent to which openness to negative affect and self‐regulation were involved too. Study 2 refined these findings (n = 59, aged 9–12) using a behavioral measure of openness to negative affect and exploration, and with mother‐reported self‐regulation. Replicating this serial indirect effect of openness to negative affect and self‐regulation with multiple informants and methods, the present studies advance our understanding of how trust might foster exploration in preadolescence.     

Act First and Look Up the Law Afterward?: Medical Malpractice and the Ethics of Defensive Medicine

This essay examines the so-called phenomenon of "defensive medicine" and the problematic aspects of attempting to maintain the safest legal position possible. While physicians face genuine litigation threats they frequently overestimate legal peril. Many defensive practices are benign, but others alter patient care and increase costs in ways that are ethically suspect. Physicians should learn to evaluate realistically the legal risks of their profession and weigh the emotional, physical, and financial costs to the patient before employing a defensive measure.     

Beliefs About the True Self Explain Asymmetries Based on Moral Judgment

Past research has identified a number of asymmetries based on moral judgments. Beliefs about (a) what a person values, (b) whether a person is happy, (c) whether a person has shown weakness of will, and (d) whether a person deserves praise or blame seem to depend critically on whether participants themselves find the agent's behavior to be morally good or bad. To date, however, the origins of these asymmetries remain unknown. The present studies examine whether beliefs about an agent's “true self” explain these observed asymmetries based on moral judgment. Using the identical materials from previous studies in this area, a series of five experiments indicate that people show a general tendency to conclude that deep inside every individual there is a “true self” calling him or her to behave in ways that are morally virtuous. In turn, this belief causes people to hold different intuitions about what the agent values, whether the agent is happy, whether he or she has shown weakness of will, and whether he or she deserves praise or blame. These results not only help to answer important questions about how people attribute various mental states to others; they also contribute to important theoretical debates regarding how moral values may shape our beliefs about phenomena that, on the surface, appear to be decidedly non‐moral in nature.