The Problem of Integrating Behavioral Health in the Medical Home and the Questions It Leads to

Psychology and other behavioral health professions have amassed a broad empirical and clinical literature suggesting many medical presentations are best responded to with the addition of evidence based behavioral interventions. Despite this, psychology has not achieved a regular presence as part of medical practice. We suggest specific reasons for the current state of affairs including clinical, operational, societal labels, financial and training dimensions. Medical, psychological, administrative, and financial perspectives are reviewed. If the goals of health care system reform are to be reached then we must identify and challenge the current limitations of health care. This paper will identify the elements that need to be changed in order for psychology to be integrated into medicine rather than excluded from its policy, planning and operations.     

Medical Psychology Services in Dutch General Hospitals: State of the Art Developments and Recommendations for the Future

In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in general, teaching and academic hospitals. Nowadays, they are an integrated non-medical specialism working in the medical setting of hospitals in the Netherlands, and are a full-member of the medical board. This paper discusses several topics: the position of the general hospital in the health care system in the Netherlands, the emergence of medical psychology in Dutch hospitals, the role of the professional association of medical psychologists, and the characteristics of patients seen by clinical psychologists. Following the discussion about the situation of medical psychology in other countries, recommendations are formulated for the further development of medical psychology in the Netherlands as well as in other countries.     

对于中国古典道家"自我"的一种新的解读

中国古典道家中并没有“自我”这一概念,但却拥有丰富的关于“自我”的思想。该文在对照西方传统自我观念的基础上,理解中国古典道家的“自我”。指出道家的自我是一种无知的自我、无为的自我、无欲的自我;是一种顺应的自我;是一种幽默化的自我。希望这种解读在某种意义上能够丰富与发展“自我”的概念,并为心理学对于当代中国人“自我”的研究提供些许借鉴。     

安乐死对象的界定

目前关于安乐死对象的界定,突出了医学要件,忽略了权利要件。为安乐死立法,必须对安乐死对象作出法律界定,应该满足两个条件：一是自然条件,即存在死亡痛苦;二是权利条件,即公民享得并行使安乐死的权利。不规定和具备权利条件,仅存在死亡痛苦,在法律上不能列为安乐死对象。     

论哲学思维在医学思维活动中的作用

医学思维活动离不开哲学思维的作用。医学思维和哲学思维的主要区别表现和思辨性和抽象性两个方面。虽然哲学思维不能代替医学思维,但是,哲学思维是医学思维的一般前提,医学思想往往由哲学思想过渡而来,医学认识的突破也以哲学思维为先导。医学家自觉运用哲学思维于医学认识之中,将会使医学思维更有效地进行。     

Peer assessments of normative and individual teacher–student support predict social acceptance and engagement among low-achieving children

This study used hierarchical linear modeling to predict first grade students' peer acceptance, classroom engagement, and sense of school belonging from measures of normative classroom teacher–student support and individual teacher–student support. Participants were 509 (54.4% male) ethnically diverse, first grade children attending one of three Texas School districts (1 urban, 2 small city) who scored below their school district median on a measure of literacy administered at the beginning of first grade. Peer nominations from 5147 classmates were used to assess both normative and individual levels of teacher support. Normative classroom teacher–student support predicted children's peer acceptance and classroom engagement, above the effects of child gender, ethnic minority status, and individual teacher–student support. Results are discussed in terms of implications for teacher preparation and professional development.     

Parent Involvement in Early Intervention for Disadvantaged Children: Does It Matter?

This study investigated the association between parent involvement in early intervention and children's later school competence. Parents (N = 704) of children participating in the Chicago Longitudinal Study were interviewed retrospectively about their school involvement in preschool and kindergarten. Parents reported on the activities in which they participated and their frequency of program participation. Results indicated that even after controlling for family background, the number of activities in which parents participated in preschool and kindergarten was significantly associated with higher reading achievement, with lower rates of grade retention at age 14 (eighth grade), and with fewer years in special education. The frequency of parent involvement was only marginally associated with reading achievement but was associated with lower rates of grade retention and fewer years in special education. A confirmatory analysis indicated that teacher ratings of parent involvement in first and second grade were significantly associated with higher reading achievement in eighth grade, lower grade retention rates, and lower rates of special education placement through eighth grade. Findings support the benefits of parent involvement in early childhood programs.     

Group interpersonal skills training in a natural setting: an experimental study.

This study assessed effectiveness of group interpersonal skills training conducted in a natural setting with nonanalogue clients. Subjects (Ss) in a behavioral-training condition received 4 hr of instruction consisting of modeling, behavioral rehearsal, coaching, feedback and reinforcement. Training focused on positive and negative social responses and on initiating interactions, as well as reacting to interactions initiated by others. Subjects in a discussion-control condition engaged in focused discussion of interpersonal concerns but received no experiential practice. Within a pre-test-post-test control group design, subjective and objective measures were used to assess training effects. When compared to Ss involved in group discussion. Ss participating in group behavioral training revealed greater pre- to post-test changes on selfreported probability of engaging in selected interpersonal responses and on objective measures of eye contact, speech duration, positive affective responses, use of no-statements, compliance, refusals and requests for new behavior. Support for generalization of training is presented and methodological issues are discussed.     

Modes of understanding and mindfulness in clinical medicine

Beginning with a case vignette, this paper uses a semiotic approach to analyze several different kinds of understanding used in clinical medicine. By outlining semiotic structures, four distinct modes of understanding can be defined: (1) the representational mode, corresponding to scientific medicine; (2) the pragmatic mode, constituting the basic standpoint of medicine; (3) the hermeneutic mode, underlying the empathic, humanistic spirit of medicine; and (4) the ontologic mode, associated with both the ethical and ritual aspects of medicine. Clarifying the relationship between these modes avoids common confusions in clinical situations. Although experienced clinicians intuitively use these different modes, they do not necessarily reflect upon them. They are instead mindful of them, and this unique multi-modal consciousness, I suggest, provides a model for integrating theory and practice.This work was supported in part by the Robert Wood Johnson Clinical Scholars Program.