Mind, Body, and Spirit: Family Physicians’ Beliefs, Attitudes, and Practices Regarding the Integration of Patient Spirituality into Medical Care

This study used a qualitative approach to explore family physicians’ beliefs, attitudes, and practices regarding the integration of patient spirituality into clinical care. Participants included family medicine residents completing training in the Southwest USA. The qualitative approach drew upon phenomenology and elements of grounded-theory. In-depth interviews were conducted with each participant. Interviews were recorded, transcribed and coded using grounded-theory techniques. Four main themes regarding physicians’ attitudes, beliefs, and practices were apparent from the analyses; (1) nature of spiritual assessment in practice, (2) experience connecting spirituality and medicine, (3) personal barriers to clinical practice, and (4) reflected strengths of an integrated approach. There was an almost unanimous conviction among respondents that openness to discussing spirituality contributes to better health and physician–patient relationships and addressing spiritual issues requires sensitivity, patience, tolerance for ambiguity, dealing with time constraints, and sensitivity to ones “own spiritual place.” The residents’ voices in this study reflect an awareness of religious diversity, a sensitivity to the degree to which their beliefs differ from those of their patients, and a deep respect for the individual beliefs of their patients. Implications for practice and education are discussed.Michael M. Olson, Ph.D., is a member of the Department of Family Medicine, University of Texas Medical Branch in Galveston.M. Kay Sandor, Ph.D., R.N., is in the School of Nursing.Victor Sierpina, M.D., is in the Department of Family Medicine.Harold Vanderpool, Ph.D., Th.M., represents the Institute for Medical Humanities at the university and Patricia Dayao, M.A., is a graduate student there.Funding for this study provided in part by the John G. and Marie Stella Kenedy Foundation and the George Washington Institute for Spirituality and Health/John Templeton Foundation. Correspondence to Michael M. Olson, mmolson@utmb.edu.     

Videoconferencing at Psychology Internships: Interns’ Perceptions of Interactive Television Experiences and Prospects

This article reviews the use and perceptions of videoconferencing in psychology internship training from the perspective of interns. Videoconferencing offers a means of expanding training beyond conventional on-site models. Psychology interns completed an online survey about their experiences with videoconferencing and perspectives of its impact on training. Most participants encountered it in their didactics. Some used it for supervision or other purposes. Interns’ perspectives were complex, with videoconferencing seen as supporting learning similar to conventional training in some ways, yet as less desirable overall. Direct comparisons between videoconferencing and on-site training revealed interns perceived videoconferencing as somewhat less effective, and as deleteriously affecting learning dynamics. Challenges and potential benefits of incorporating videoconferencing into psychology internship training were identified. Potential benefits include augmenting available internship training and increasing rural sites’ access to training.     

Treatment of compulsive shoplifting by altering social contingencies

and (1968) described the successful treatment of a three-year-old child with chronic constipation by a simple rearrangement of social contingencies. It was felt therefore that it might be worthwhile briefly reporting a case of compulsive shoplifting, where treatment was effected by an alteration in social contingencies.     

Activation and elaboration effects in recognition and word priming

Two experiments investigated the effect of direct and indirect activation on subsequent accessibility to individual items. In the first experiment, words were semantically processed in the context of either phonologically (rhyming) or conceptually (categorical) related words and tested subsequently for recognition and word completion. On the completion test the initial three letters of a word are presented for completion. The previously presented target word is one of several possible completions. The presence of different contexts had no differential effect either on recognition memory—which persisted at high levels for two days—or on completion—which decayed in the course of about 15 min.

In the second experiment, the contexts were presented but the target words were not. Thus the rhyming and categorical contexts were directly activated but not the actual words that were scored on the subsequent tests. Prior activation of phonologically similar items affected both recognition and completion performance on immediate testing, but not after 10 min. Conceptual activation affected only recognition—an effect that lasted for a period of days. Completion performance demonstrates access to the integration component of recognition. The results were compared with attempts to demonstrate independence of recognition and completion.     

Tacit Integration and Referential Structure in the Language Comprehension of Aphasics and Normals

Aphasics, brain-damaged patients with no language deficit, neurologically intact elderly subjects, and university undergraduates matched pictures to sentences having compelling tacit implications (e.g., the sentence The fox grabs the hen strongly invites one to assume that the fox will eat the hen). All groups made, for the same sentences, qualitatively similar referential errors consisting in choosing a tacit implication picture. Two auxiliary experiments using the same target sentences in other interpretive situations permitted ruling out the possibility that these errors were due to the putative intrinsic semantic properties of the sentences, showing that the sentences which were most liable to elicit integrative error varied from task to task. These results are interpreted within the conceptual framework which posits that reliable directions for interpretation are couched by the speaker in the very structure of his utterances (the utterance's referential structure) providing the hearer with means to restructure the relevant personal knowledge integrated into the interpretive process in accordance with the speaker's communicative intent. The determination of the referential structure (RSD) of utterances thus seems critical to their correct or, more precisely, conventional interpretation, and, along with the tacit integration of relevant sources of personal knowledge, constitutes the principal cognitive device enabling us to understand each other. But this device appears to be easily corruptible. It is suggested that many errors made by aphasics in language interpretation are due to a failure to follow all referential instructions, but that qualitatively similar failures also occur in normal subjects, though to a lesser degree. Language interpretation is a fallible process and aphasic errors provide remarkable clues for the understanding of its subtle referential mechanisms.