Groups to Resolve Conflicts Between Groups: Diplomacy with a Therapeutic Dimension

The group self, an individual's self-perception as a member of a group, is distinguished from the group's self, a personification of the group as a person with a self. The perceived group's self of an opposing other group is often a repository for attributes group members are not ready to recognize in their own group's self. Theoretically, the need for an adversarial other to hold one's own group's unwanted attributes—and thus to complete one's own group's self—contributes, however unconsciously, to the apparent intractability of intergroup disputes. In dealing with these issues, I compare intergroup conflict resolution (ICR) groups with therapy groups, on the one hand, and advocacy groups on the other. All of this sets the stage for a presentation of two ICR projects and their analysis in group-developmental terms.     

The Late Life Reconstruction of Selfhood Analyzed in Peter Hall's Film She's Been Away

The film She's Been Away tells the story of an old woman who had been locked in a mental asylum while a teenager, for willfully violating repressive sexual codes. Sixty years later her ward is closed and she moves in with her nephew and his wife. Faced with what appears to be a hopeless situation, she manages to forge a sense of a meaningful closure to a misspent life. Through narrative, story structure, and characterization the film throws into focus coping mechanisms and ego strategies deployed by a triple disadvantaged person (woman, old, and mad) in her ascent to a reconstructed selfhood. As the protagonist ties both ends of her life, and faces the abyss in between she makes genuine adaptive use of so-called regressive, late-life development assets (available to a lesser degree to elderly people in normal life circumstances), primarily the abolition of linear time. Through this abolition she makes reminiscing an actual reality while still maintaining a functional separation between the real and the remembered. Her portrayal is a valuable document for gerontologists as it explores, through artistic imagination and intuition, the workings of an aging mind in search for a meaningful sense of closure.     

Conflict of interest in medicine in Lithuania: legal and ethical aspects

The current legal framework within the Lithuanian health system is described including a review of the physician’s autonomy, rights and duties, and patients’ rights including the right to reimbursement. The role of ethical codes and the law are discussed. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Early Developmental Precursors of Externalizing Behavior in Middle Childhood and Adolescence

This study examined the infancy- and toddler-age precursors of children's later externalizing problem behavior. Risk constructs included suboptimal patterns of observed caregiver-child interaction and the caregiver's perception of child difficultness and resistance to control. In addition, a novel dimension of caregiver-child relationship quality, the caregiver's perception of her toddler's unresponsiveness to her, was examined as a possible precursor of children's externalizing behavior. Externalizing problem outcomes were assessed throughout the school-age period and again at age 17, using multiple informants. As toddlers, children at risk for later externalizing behavior were perceived as difficult and resistant to control, and relationships with their caregivers were relatively low in warmth and affective enjoyment. Finally, the caregiver's perception of her toddler as emotionally unresponsive to her was a consistent predictor of later externalizing behavior, suggesting that negative maternal cognitions associated with child conduct problems may begin in toddlerhood. These predictive patterns were similar for boys and girls, and with minor exceptions, generalized across different subdimensions of externalizing problem behavior. Our findings underscore the importance of the infancy and toddler periods to children's long-term behavioral adjustment, and indicate the desirability of further research into the nature of caregivers' early perceptions of child unresponsiveness.     

Family-Based Therapy for Adolescent Drug Abuse: Knowns and Unknowns

Family-based therapy is one of the most thoroughly studied treatments for adolescent drug abuse. Considerable empirical support exists for the efficacy of family-based therapy in curtailing adolescent drug use and cooccurring behavior problems. This article extends knowledge of the effects of family-based therapy for adolescent drug abuse by reviewing 16 controlled trials and 4 therapy process studies from a treatment development perspective. We articulate knowns and unknowns regarding the outcomes of treatment as well as the components, processes, mechanisms, moderators, and boundaries of effective family-based therapy for adolescent drug abuse. The review highlights areas of progress and future research needs within the specialty of family-based therapy for adolescent drug abuse.     

Professional Autonomy and the Normative Structure of Medical Practice

Professional autonomy is often described as a claim of professionalsthat has to serve primarily their own interests. However, it can also beseen as an element of a professional ideal that can function as astandard for professional, i.e. medical practice. This normativeunderstanding of the medical profession and professional autonomy facesthree threats today. 1) Internal erosion of professional autonomy due toa lack of internal quality control by the medical profession; 2)the increasing upward pressure on health care expenses that calls for ahealth care policy that could imply limitations for the professionalautonomy of physicians; 3) a distorted understanding of theprofession as being based on a formal type of knowledge and relatedtechnology, in which other normative dimensions of medical practice areneglected and which frustrates meaningful communication betweenphysicians and patients. To answer these threats a normative structureanalysis of medical practice is presented, that indicates whichprinciples and norms are constitutive for medical practice. It isconcluded that professional autonomy, normatively understood, should bemaintained to avoid the lure of the technological imperative and toprotect patients against third parties' pressure to undertreatment.However, this professional autonomy can only be maintained if members ofthe profession subject their activities and decisions to a criticalevaluation by other members of the profession and by patients and ifthey continue to critically reflect on the values that regulate today'smedicine.     

Global Progress I: Empirical Evidence for ongoing Increase in Quality-of-life

This paper argues that both the relativist and the pessimist critiques of the idea of progress are inadequate. Progress is defined as increase in global quality of life (QOL). Such QOL is intrinsically subjective, but not relative. It can be reliably measured through life satisfaction-type questions. The World Database of Happiness provides extensive data on social, economic and psychological factors that correlate with overall QOL. They include wealth, health, security, knowledge, freedom and equality. Various statistical data suggest that all these QOL indicators have undergone significant improvements during the last half century, in most of the world. This gives strong support to the thesis that progress objectively occurs.     

The Therapeutic Factors Inventory: Development of a Scale

Although Yalom's (1995) framework of the therapeutic factors facilitating outcome in group has been accepted by group specialists, no empirically based instrument assesses all of these factors. The Therapeutic Factors Inventory (TFI), with 11 scales based on the therapeutic factors, has been designed to fill this gap. This article summarizes the development and preliminary reliability testing of the TFI. Each scale of the instrument demonstrated high internal consistency; however, one scale obtained unacceptably low test-retest reliability. Further validity testing is needed. Implications of these findings are discussed.