An Ethical Exploration of Barriers to Research on Controlled Drugs

We examine the ethical, social, and regulatory barriers that may hinder research on therapeutic potential of certain controversial controlled substances like marijuana, heroin, or ketamine. Hazards for individuals and society and potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of these substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may, however, limit research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns pertinent to research with illicit and addictive substances, such as undue inducement, informed consent, therapeutic misconception, and risk to participants, researchers, and institutions. We consider the perspectives of key research stakeholders and explore whether they may be infected with bias. We conclude by proposing an empirical research agenda to provide an evidentiary basis for ethical reasoning.     

Prompting reflection and learning in career construction counseling

Adopting the overall framework provided for an international inquiry into career counseling interventions, this article reports on a qualitative study into the efficacy of a relatively new approach to practice in England. Using career construction interviews as the counseling intervention, research involving two adult participants was undertaken. Interpersonal process recall (IPR) was used to explicate the perceptions and understandings of both the participants and the counselor in the process. Outcome analysis framed the approach used to making sense of the data collected. Two contrasting responses were immediately evident from participants in the counseling intervention: one positive and one negative. The use of the IPR process enabled an understanding of the value of a structured process of reflection.     

Narrative Approaches to Organizational Development: A Case Study of Implementation of Collaborative Helping

Across North America, community agencies and state/provincial jurisdictions are embracing family‐centered approaches to service delivery that are grounded in strength‐based, culturally responsive, accountable partnerships with families. This article details a collaborative consultation process to initiate and sustain organizational change toward this effort. It draws on innovative ideas from narrative theory, organizational development, and implementation science to highlight a three component approach. This approach includes the use of appreciative inquiry focus groups to elicit existing best practices, the provision of clinical training, and ongoing coaching with practice leaders to build on those better moments and develop concrete practice frameworks, and leadership coaching and organizational consultation to develop organizational structures that institutionalize family‐centered practice. While the article uses a principle‐based practice framework, Collaborative Helping, to illustrate this process, the approach is applicable with a variety of clinical frameworks grounded in family‐centered values and principles.     

Understanding supervisee nondisclosures in supervision with videorecording review and interpersonal process recall

The purpose of this qualitative multiple case study was to obtain an in‐depth understanding of supervisees' in‐the‐moment nondisclosure experiences, perceptions and internal processes as they occurred in clinical supervision involving videorecording review. The supervisees who participated in the study were students in their first year of a master's‐level counselling practicum in Western Canada. Utilising interpersonal process recall (IPR) interview methods, supervisees were asked to share their moment‐by‐moment nondisclosures that occurred during a recent videorecorded supervision session in which the supervisory dyad reviewed a videorecording of the supervisee's clinical work. Thematic analysis across cases yielded five overarching themes: (a) validation; (b) safety; (c) growth and accomplishment; (d) performance anxiety; and (e) avoidance. The findings revealed a broad range of positive and negative supervisee nondisclosures that were influenced by the supervision modality of videorecording review and the IPR interview. Implications for clinical supervision, limitations of the study and suggestions for future research are discussed.     

Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta‐analysis

Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent–infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta‐analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta‐analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta‐analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta‐analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: –0.46; 95% confidence interval [CI] [–0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent–infant interaction (SMD: –0.10; 95% CI [–0.46, 0.26]), parental depression (SMD: –1.55; 95% CI [–3.74, 0.64]) or parental global distress (SMD: –0.19, 95% CI [–3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation‐based treatment with non‐mentalization‐based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.     

Defining the new concept of sustainable success – A state-of-the-art analysis on the phenomenon

Research on success and sustainability has been somewhat limited and narrow. Yet, in the current world, a positively oriented understanding about the concept of sustainable success is needed. The purpose of this research was to analyze what kind of research about sustainable success has been conducted and what the elements of sustainable success according to research found around this topic are. These questions were answered through a literature review or a state-of-the-art review that focused on nine articles that were chosen for a more detailed analysis. The findings illustrate how success and sustainability appeared as research targets and what the main elements of success and sustainability were in the data. None of the articles under review used positive psychological knowledge or strength-based approaches in their definition of success and sustainability. The need for a conceptual definition for sustainable success appeared evident. From the perspective adopted in this research, sustainable success consists of positive development, flourishing, and well-being, and also top performances. It is based on positive educational psychological knowledge. Educational psychological research alongside multidisciplinary perspectives can provide new and innovative ways of understanding and guiding people's behaviors toward sustainability.     

Interoceptive Abnormalities and Suicidality: A Systematic Review

Dysfunction of interoception (i.e., difficulties sensing the physiological state of one's own body) is increasingly linked to different mental health disorders and suicidal outcomes. The aim of this study was to systematically review the literature on the association between suicidality and interoception, as well as identify potential confounders and mediators of the relationship. We conducted a systematic review of four databases, allowing for critical examination of the role of different measures of interoception (accuracy, sensibility, awareness, cognitive/emotional evaluation) across the suicide continuum (ideation, plans, attempts, deaths). The search strategy identified 22 studies (14,988 participants). Preliminary but limited evidence was found for impaired interoceptive accuracy among those reporting suicide attempt histories. We found evidence of interoceptive sensibility disturbances across the suicide continuum, including experiences of not trusting one’s own body sensations and impaired abilities to sustain and control attention to such sensations. Consistent evidence was also reported for disturbances related to cognitive and emotional evaluations of interoceptive sensations. The latter was particularly pronounced for those reporting suicide attempts, relative to those reporting suicidal thinking or planning alone. Overall, this review’s results suggest that interoceptive abnormalities are potentially important indicators of risk for suicidal thinking, intentions, and behaviors. However, due to the inconsistent adjustment for variables of interest, and cross-sectional designs, it is unclear whether interoceptive changes and disturbances have a direct role, or whether the association is explained and mediated by key third variables (e.g. depression, disordered eating, emotional dysregulation). We discuss the implications with respect to suicidal risk and therapeutic interventions.     

Constructing We‐ness: A Communal Coping Intervention for Couples Facing Chronic Illness

Communal coping occurs when relationship partners view a stressful health problem as “ours,” rather than yours or mine, and take collaborative action to deal with it. Although research employing linguistic (we‐talk) and other measures of communal coping demonstrates relevance to a variety of chronic illnesses, the literature offers little about how clinicians can actively promote we‐ness and teamwork to help patients and their partners achieve the health benefits this appears to confer. This paper highlights clinical and supporting scientific features of a narrative intervention designed to foster communal coping by couples in which one partner has a chronic illness. The illustrative illness is diabetes, but with modification the protocol is suitable for other chronic conditions as well. Grounded in systemic and narrative models of problem maintenance and change, the communal coping intervention represents a distillation of research and clinical experience with family consultation over several decades. In contrast to more directive and educational approaches, the intervention consists entirely of questions, with no direct suggestions or instruction about how patients, partners, or couples should change. These questions comprise 8 sequential modules (Coping Challenges, Trajectory and Focus, Illness as External Invader, You as a Couple, Past Teamwork in Overcoming Adversity, Present and Future Teamwork, Obstacles to Teamwork, and Wrap‐Up), described here in manual‐like detail.     

The Academic Productivist Regime: Affective Dynamics in the Moral-Political Economy of Publishing

With proliferating neoliberal modes of science governance, publishing has become more important. Recent studies point to researchers’ feeling of exhaustion and anxiety as responses to academic performance regimes. Yet how affects underpin publishing in scientific cultures and communities, and what this implies for STS scholarship has remained underexplored. Drawing on insights from ethnographic fieldwork and the cultural studies of affect, this article traces the role of emotions, including hope, contempt, and excitement for understanding the new academic productivist regime at a Czech research institution. While junior researchers’ orientations are fostered through rendering publications objects of hope, a moral-political economy intersects with geopolitical history and values of research organization to shape the publication practices of many senior scientists. An affective labor of combat and equanimity is necessary for managing these orientations that are corporeally energized by a dynamic of thrill. This four-pronged approach makes palpable how emotions render scientists’ bodies hopeful, combative and excited while intersecting with ideals of meritocratic research organization and assessment. Frustration and failure are never entirely absent but serve as an immanent driving force for a publishing culture that thrives on adrenaline, combativeness, and hope. This makes it difficult to leverage failures towards criticism of the academic productivist regime—both for the scientists differently affected within the institution and STS researchers. Different engagements with this regime require a more capacious accounting for the pleasure and thrill generated by the uncertainty of publication outcome as well as by unacknowledged practices of care.