Family Involvement in Residential Treatment: Staff, Parent, and Adolescent Perspectives

We conducted interviews with staff members, parents, and adolescents at a residential treatment center to examine the frequency, nature, and satisfaction with contact between parents and adolescents and parents and staff. We also assessed perceived barriers to family involvement and possible solutions for improving this involvement. Results indicated that there is more contact between parents and adolescents than in previous studies. In addition, contact between parents and staff occurred frequently, although there were discrepancies regarding their reasons for the contact. Most parents and adolescents reported that the amount of contact was adequate, but the majority of staff members perceived there to be not enough contact. Adolescents reported that there was not enough contact with secondary sources of support, most often other family members. Barriers to family involvement included transportation, parent responsibilities and personal problems, and legal issues. In addition, parents reported that strained family relationships and problematic adolescent behavior interfered with their involvement. The need for residential treatment centers to broaden services to include parents as well as members of the larger support network is discussed.     

Acute treatment of inpatients with psychotic symptoms using Acceptance and Commitment Therapy: pilot results

Cognitive behavior therapy (CBT) has been demonstrated in a number of randomized controlled trials to be efficacious as an adjunctive treatment for psychotic disorders. Emerging evidence suggests the usefulness of CBT interventions that incorporate acceptance/mindfulness-based approaches for this population. The current study extended previous research by Bach and Hayes (2002. The use of Acceptance and Commitment Therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70, 1129-1139) using Acceptance and Commitment Therapy (ACT) in the treatment of psychosis. Psychiatric inpatients with psychotic symptoms were randomly assigned to enhanced treatment as usual (ETAU) or ETAU plus individual sessions of ACT. At discharge from the hospital, results suggested short-term advantages in the ACT group in affective symptoms, overall improvement, social impairment, and distress associated with hallucinations. In addition, more participants in the ACT condition reached clinically significant symptom improvement at discharge. Although 4-month rehospitalization rates were lower in the ACT group, these differences did not reach statistical significance. Decreases in the believability of hallucinations during treatment were observed only in the ACT condition, and change in believability was strongly associated with change in distress after controlling for change in the frequency of hallucinations. Results are interpreted as largely consistent with the findings of Bach and Hayes and warrant further investigations with larger samples.     

The Balancing Act—Ethical Issues in Parent Training Research: Confidentiality,Harm Reduction,and Methodology

Attention and disruptive behavior disorders present considerable challenges for children and their parents. These challenges have led to the development of parenting programs; however, there is a paucity of literature that discusses the ethical dilemmas parent training researchers face. This article reviews ethical principles and professional standards relevant to parent training research and provides case material to illustrate the challenge of balancing ethical adherence and empirical rigor using three ethical issues that commonly arise in parent training research. In particular, this article focuses on ethical issues surrounding confidentiality in a group setting, use of control groups, and limiting changes in medication/treatment status outside of the treatment protocol.     

冠心病诊治中的过度医疗

近年来,过度医疗问题引起了医学伦理学界的普遍关注。过度医疗是一个经济现象,同时也是一个伦理问题．确切的说是一个医学一社会问题。结合冠心病过度医疗的特点,从医学伦理学角度剖析冠心病过度医疗的原因,并提出了医者、患者、医疗机构和社会针对冠心病过度医疗应采取的措施。     

从指南看冠心病降脂治疗的现状及分析

层出不穷的试验研究和不断更新的指南使人们对冠心病防治的认识不断加深,但指南的实施和普及却不理想,大多数冠心病患者并未真正受益于降脂治疗。现就NCEP-ATP指南的更新和目前冠心病患者降脂治疗的现状、主要影响因素(患者的依从性、医务工作者的医疗质量、药物有效性以及效价比与经济条件)及可能的改善措施做一综述。     

外科脓毒症：从科学认识到合理防治

脓毒症(sepsis)是一种严重威胁患者生命的外科危重症,也是诱发脓毒性休克(septic shock)、多器官功能障碍综合征(MODS)的重要原因。基于对脓毒症的病理生理的认识正不断深入,脓毒症的防治水平业已取得重要的进展。深入认识脓毒症,研究新的防治策略,实施正确的治疗,将有助于提高脓毒症的临床治疗水平。     

肿瘤治疗模式的哲学思考

外科手术往往是肿瘤治疗的首选方法,对于不能手术或已丧失手术机会者才考虑放疗,化疗。近年来,出现了诱导分化和凋亡等治疗手段,且在某些肿瘤的治疗上已取得了可喜的效果,这点新概念,新手术的出现,使得以往的肿瘤治疗模式受到了冲击,从以人为本,预防为主的哲学思想出发,我们似科可以提出这样的肿瘤治疗模式,诱导分化→启动凋亡→手术,放疗,化疗。     

The Political Color Line in America: Many “Peoples of Color” or Black Exceptionalism?

Despite the successes of the civil rights movement, a largely impermeable color line continues to restrict African Americans from assimilation into the broader American society. In the meantime high rates of immigration have produced an increasingly culturally diverse population. A "people of color" hypothesis suggests that the color line the new immigrants face resembles that imposed on African Americans. A "black exceptionalism" hypothesis suggests instead that the color line will be more porous for them, allowing for greater assimilation over successive generations, including a gradual weakening of politicized racial and ethnic group consciousness. Using data from Los Angeles County Social Surveys, we find that the largest new immigrant group, Latinos, like blacks, show strongly group-interested policy preferences and strong group consciousness. However, both effects are stronger for recent Latino immigrants than for the U.S.-born. We conclude that the new immigrant groups are increasingly likely to assimilate politically into the broader society in future generations, whereas a rather strict color line will continue to restrict blacks and maintain their distinctiveness.     

The impact of individualist and collectivist group norms on evaluations of dissenting group members

Two experiments were conducted to investigate the impact of individualist and collectivist norms on evaluations of dissenting group members. In the first experiment (N = 113), group norms prescribing individualism or collectivism were manipulated and participants were asked to evaluate a group member who expressed an attitude dissenting from or concordant with the group. In line with predictions, group members with concordant attitudes were evaluated more positively than group members with dissenting attitudes when norms prescribed collectivism. However, for high identifiers, we found an attenuation of the preference for concordant over dissenting attitudes when norms prescribed individualism. These findings were replicated in a second experiment (N = 87), where dissent was operationalized in a way that did not reveal the content of the attitude. The discussion focused on the importance of individualist norms for broadening latitudes of acceptable group member behavior.