An exploration of the therapeutic process while using computerised cognitive behaviour therapy

Background: Modern technologies that offer an alternative to face‐to‐face therapy have gained ground in the NHS. Critics have argued that some of the important elements of the therapeutic change process necessarily require a human therapist. Yet, the traditional understanding of the change process in psychotherapy is challenged by evidence that some computerised cognitive behaviour therapy (cCBT) programs may be as effective as face‐to‐face therapy, suggesting that in certain cases the interaction between user and a cCBT product satisfies sufficient criteria for personal change without the need for actual human contact. Aim: This study used the cCBT package Blues Begone as a means of investigating the process by which a computer‐mediated program helped adults with mild depression help themselves. Method: Seven qualitative interviews were conducted with mildly depressed users who had completed Blues Begone in their own homes without any additional human help or support. Findings: Interpretive phenomenological analysis (IPA) was performed with four main themes emerging. These were: the meaningful relationship; shape from confusion; stimulation and empowerment. This study illustrates some of the ways that some depressed users make use of cCBT self help.     

Christianity in Iran: A Brief Survey

This article reviews the long and varied history of Christianity in the country now known as Iran. The historical emphasis is on the Assyrian Church of the East, although other churches are also mentioned. The relationship, successively, with Zoroastrianism and with Islam, as the dominant religious traditions, is discussed, as are its implications for the wider Islamic world. Western contacts with Iran, and, in particular, those of western churches, are also examined. In the light of this historical analysis, and from discussion of the situation since the Islamic Revolution, some conclusions are advanced about the prospects for Christianity in the new contemporary context.     

Mother of God: A History of the Virgin Mary

Starting from the context in which there is an increasing emphasis on ecclesial revitalisation and churchplanting, the analytical model of the Australian National Church Life Survey (NCLS) research is introduced and described in its background and characteristics. The model shows particular interest in a specific church profile which is created based on local church surveys. The article describes the profile, examines the theological concepts and argues for in-depth empirical research in a Dutch context concerning the use of the profile.     

The Second Vatican Council 50th anniversary: visions and re-visions

On 21 November 2014, the 50th anniversary of the solemn promulgation of Lumen Gentium and Unitatis Redintegratio was celebrated. Between ‘aggiornamento’ and ‘ressourcement’ the Catholic Church had been striving to understand itself and its Tradition more precisely, in order to be newly relevant, lastingly true and authoritative in the future ? an indispensible task, if the gospel were to be proclaimed to the contemporary world, but not an easy one. It is little wonder that this completion of the Council's endeavours was preceded by its so-called ‘black week’. Questions remain as to the outcome of it all, and the articles assembled in this issue assess the reception of these two conciliar texts after 50 years. Where do the achievements lie? Where are the shortcomings? Where do questions need to be asked today that reach beyond the horizon of Vatican II?     

Gender: Genetics,Genitality, Generosity (Grace), Gentility

After acknowledging that gender is defined at many levels and that definitions may not be concordant across all of these layers of human development, this essay illuminates how these threads intertwine with one another to produce a final product that we call a person. Gene expression, gender identity, sexual orientation, and anatomic structures are not always coterminus. Arbitrarily assigning an infant child with maldefined genitalia to a socially defined gender role on the basis of surgical convenience may (should) be perceived as an act of violence, and an untruth. A further intent of this article is to help in pastoral settings to respond to events which raise points of anxiety and concern, among persons of faith, which are sometimes associated with instances of discrepancy.     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

The Duty to Rescue and the Limits of Confidentiality

Surveys and routine clinical procedures applied in research protocols are typically considered only minimally risky to participants. The apparent benign nature of "minimal risk" tasks increases the chance that investigators and Institutional Review Boards (IRBs) will overlook the probability that clinical tools will identify signs, symptoms, or definitive test results that are clinically-relevant to subjects' welfare. "Minimal risk" procedures may also pose a particular hazard to participants in clinical research by increasing the therapeutic misconception because the tasks mimic clinical care and are often conducted in clinical settings. Investigators should anticipate which measures could yield clinically-important findings and should describe explicit plans for data monitoring, disclosure, and follow-up. Protocols that include reliable and valid clinical measures should prompt a more detailed risk assessment by the IRB, even when the tasks meet the regulatory criteria for minimal physical, psychological, or emotional risk.     

Will the “Real Boy” Please Behave: Dosing Dilemmas for Parents of Boys with ADHD

The use of Ritalin and other stimulant drug treatments for attention-deficit hyperactivity disorder (ADHD) raises distinctive moral dilemmas for parents; these moral dilemmas have not been adequately addressed in the bioethics literature. This paper draws upon data from a qualitative empirical study to investigate parents' use of the moral ideal of authenticity as part of their narrative justifications for dosing decisions and actions. I show that therapeutic decisions and actions are embedded in valued cultural ideals about masculinity, self-actualization and success, as well as in moral conceptions of authenticity and personal freedom. I argue that this investigation of parents' moral justifications and dosing dilemmas raises questions about the validity of authenticity as a transcendent moral principle. Moreover, this study demonstrates that in order to be relevant, bioethical analysis of neurocognitive enhancement must engage with ground-up studies of moral principles and decision-making in context.     

Curriculum-Based Measurement

Abstract

Curriculum-based measurement (CBM) has evolved as a reliable and valid method for measuring and monitoring student performance in basic academic skills. While the efficacy of CBM for assessing reading skills is not in question, issues remain regarding whether or not a difference exists between CBM probes derived directly from the instructional curriculum and generic probes. The current study extends previous research comparing the utility of two types of CBM reading probe materials. Both types of probes were administered to 13 second grade students twice weekly for 5 weeks. No significant differences were found between the two probe types' measurement of performance or progress over time, which suggests that school psychologists and educational professionals can use generic or curriculum-dependent probes in curriculum-based measurement.     

Multicriteria Classification with Unknown Categories: A Clustering–Sorting Approach and an Application to Conflict Management

This work proposes an approach to cluster and sort a set of alternatives considering multi‐criteria categories with a partial order structure. It can be considered a heuristic approach because it does not attempt to derive an optimal partial order among all conceivable clusters of alternatives. Rather than this, it intends to be a simple approach that is transparent to the Decision Maker (DM) whose assistance is sought to help shaping the results. The approach proposed arises from the conjugation of traditional Clustering analysis and Multi‐criteria sorting tools. At the outset, the number of categories and their characteristics is unknown. First, we need to detect only the clusters themselves on the basis of a similarity measure independent of the preferences of the DM. Next, we detect potential partial order relations that might exist between them, according to the subjective preferences of the DM. Such preferences are elicited only after the DM has examined the clusters detected and deemed that these categories made sense. The new approach performs very well in a real‐world problem of management of intragroup conflicts and conflict handling strategies. Copyright © 2012 John Wiley & Sons, Ltd.