生殖系基因治疗技术的伦理论争及其核心问题

目前关于生殖系基因治疗技术的伦理争论仍然十分激烈。这些争论的核心环节在于"父母生育一个健康血缘后代的需要"如何获得道德合理性论证,而目前很多研究在某种程度上忽视了这一问题,因而既不能解释这些伦理争论产生的原因,也不能为解决这一问题提供有效的指导。     

Family Focused Treatment for Patients with Bipolar Disorder in Turkey: A Case Series

Family-focused therapy (FFT) is a 9-month, 21-session structured psychoeducational treatment for bipolar disorder. Several US-based studies have documented its efficacy as adjunctive to medication for depression stabilization and relapse prevention. However, FFT has never been applied outside of the United States. The objective of this case series is to explore the applicability of FFT in a non-Western culture. Ten patients with bipolar disorder and their family members attended the 9-month FFT as adjunctive to pharmacotherapy in an outpatient specialty clinic in Izmir, Turkey. Patients improved in Global Assessment of Functioning Scores and Clinical Global Impression Scores from pre- to posttreatment. Case studies are given, which illustrate the differences between Western and non-Western families coping with bipolar disorder. FFT was easily applied to a Turkish sample with few changes in format or focus. Adaptations included substitution of oral for written therapeutic tasks or homework assignments. Randomized controlled trials are needed to test the clinical effectiveness of FFT and other psychosocial interventions in non-Western cultures.     

Relational Drawings in Couple Therapy

In couple therapy sessions, partners often get into long and drawn-out discussions, heavy with pain, resentment, and blame. It is vital for the therapist to avoid becoming entangled in these escalating interactions. In this article, as one way of avoiding these interactions, a protocol is proposed of using relational drawings in couple therapy for opening space for new stories. This approach is strongly rooted in extensive therapeutic experience, as well as in dialogical ideas. Not the content of the partners' imagery is central, but rather the dialogical exchange about the drawings. In particular, the focus of the therapist is on the partners' interactions, their hesitations and their surprises. Working in this way opens space for the partners to reflect on what they experience as crucial in their bond. The protocol is illustrated with two detailed case examples.     

9/11 as a new temporal phase for Islam

Since the bombing of the twin towers, ‘Islam’ as a cultural narrative has entered a new temporal phase which in many ways signifies the re-imagining of a religion through the visual imagery of 9/11 and the global events which have unfolded since the apocalyptic images were first witnessed by the world. The distant proximity of 9/11 and the relocation of the perceived Islamic ‘resurgent atavism’ within the heartlands of power in Western soil constitute the formation of a new sociological imagination of Islam and 9/11 as a new liminal temporality. The association of the religion with a new category of risks in urban sites and the constant state of insecurity in seemingly secure spaces represents a new narrative phase of geo-politics in which the locus of this re-imagining mediated through ICTs, is one that happens not just in faraway places but within the ‘ontological securities’ of Western modernity, posing a liquid threat which is impervious to territorially bounded spheres.     

Some Thoughts on Language Use in Therapy

Drawing on the work of Ludwig Wittgenstein and his own experience as a therapist and educator/trainer, the author describes some of the issues involved in helping therapists to find their way out of various muddles and mazes that are deeply embedded in language.     

Clients Helping Therapists Find Solutions to their Therapy

This paper is offered as a beginning toward including client perspectives on treatment and client participation in supervision. Rather than see therapists as technical experts who do things to people, many of us now see therapists as nonexperts who create conversations with people (Goolishian & Anderson, 1992). This new shift challenges the traditional training positions of supervisor and supervisee, respectively. Including clients' voices the supervisor participate from a nonexpert position.     

Special Considerations in the Adaptation of Cognitive Behavioral Therapy for Insomnia With Active-Duty U.S. Army Personnel

Insomnia is highly prevalent among active-duty military service members. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-established and effective treatment; however, research and treatment recommendations have primarily focused on civilian or veteran populations. A multitude of military-specific factors directly impact service members’ sleep and the subsequent treatment recommendations. This article provides treatment considerations for the use of CBT-I with active-duty U.S. Army personnel. First, an overview of the theoretical model of insomnia, including military-specific predisposing, precipitating, and perpetuating factors, is presented, followed by a review of common comorbid conditions among service members with insomnia. Finally, discussion focuses on considerations and strategies for implementing components of CBT-I with service members, managing sleep during deployments, and adjusting sleep to accommodate overnight duties. Additional training resources and supplemental video examples (with actors) are provided.     

The Caregivers' Attachment and Relationship Education Class: A New and Promising Group Therapy for Caregivers of Individuals with Parkinson's Disease

The authors examined whether a newly developed group therapy, based on principles of attachment theory and emotionally focused couples therapy, can potentially address the unique mental health and relationship difficulties in caregivers of individuals with Parkinson's disease. A comprehensive outreach effort, involving a review of 251 military veterans' medical records, yielded enrollment of seven spousal caregivers in the group therapy. At 1-month follow-up, caregivers who initially reported mild or greater levels of caregiver burden demonstrated statistically reliable declines in psychological distress, relationship distress, or both. Posttreatment surveys indicated positive perceptions in overall helpfulness of treatment goals, as well as positive changes in insight (e.g., greater understanding of the patient's attachment needs) and behaviors (e.g., greater social contact and self-care of the caregiver). Results are considered in the context of inadequate access to treatment for caregivers of spouses with Parkinson's disease or other major medical issues.     

Characteristics and effectiveness of stand-alone body image treatments: a review of the empirical literature

This literature review examined the characteristics and effectiveness of treatments dedicated exclusively to body image. A total of 18 studies met selection criteria. All but one involved at least one cognitive-behavioural therapy (CBT) condition and only three compared CBT to another treatment approach. Twelve studies were conducted with non-clinical, body dissatisfied, participants and only one focussed on eating disordered women. Overall, the interventions were highly effective in improving body image and psychological variables and, to a lesser extent, eating attitude and behaviour. Changes were generally maintained at follow-up. Given their efficacy, more controlled trials of stand-alone body image treatments in clinical populations are needed. Investigating approaches other than CBT may open fruitful avenues of body image treatment.     

后现代科学与后现代医学述评

美国后现代中心主任格里芬等人提出“后现代科学”与“后现代医学”的理论,认为还原论的科学传统是造成当代世界诸多问题的祸魁,因而在后现代科学中重新强调人类以及自然的经验和意识,建构整体有机的生态科学观,并进而提出“心身相关”的后现代医学