Sexual Exploitation of Clients by Therapists

No abstract available for this article.     

Mostly heterosexual as a distinct sexual orientation group: A systematic review of the empirical evidence

We reviewed empirical evidence regarding whether mostly heterosexual exists as a sexual orientation distinct from two adjacent groups on a sexual continuum—exclusively heterosexual and substantially bisexual. We addressed the question: Do mostly heterosexuals show a unique profile of sexual and romantic characteristics that distinguishes them as a separate sexual orientation group? We found sufficient data in four areas to support an affirmative answer. Individuals who acknowledged a mostly heterosexual orientation were distinct from adjacent sexual orientation groups in having a small degree of same-sex sexual and/or romantic attraction and, occasionally, same-sex behavior; constituted a substantial prevalence in the population; were relatively stable in their orientation over time; and reported that this sexual identity was subjectively meaningful to them. Findings suggested that self-identification as mostly heterosexual or an acknowledgment of slight same-sex sexuality increases during the teenage years, peaks around the early twenties (somewhat sooner for men than women), and remains relatively high during young adulthood. Limited evidence suggested that prevalence is lower among older participants. These findings have implications for our conceptualization of sexual orientation as a continuum, the nature of sex differences in sexuality, developmental changes in sexuality, biologically based assessments of sexual orientation, and an etiological theory of mostly heterosexuality.     

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent among adolescents enrolled in behavioral health services but remains undertreated, and the first-line treatment option, stimulant medication, is underutilized. To address this gap, this article introduces the Medication Integration Protocol (MIP): ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about integrating medication interventions into primary care; managing medication priorities for adolescents with multiple diagnoses, including substance use problems; and the compatibility of MIP with everyday practice conditions.     

Counseling in Australia: Past,Present, and Future

The author describes the evolution of the counseling profession in Australia within the broader historic and sociocultural context. The process of professionalization is outlined, particularly over the past 15 years, and data on the demographic, professional, and practice characteristics of counselors are reviewed. Future professional directions and challenges are explored.     

Nonwork orientations relative to career: A multidimensional measure

Although scholars typically assess an individual's nonwork role orientation relative to career as a unitary construct, we argue that a person's orientation toward nonwork roles is multi-dimensional. Drawing on a literature review demonstrating the need for improved constructs capturing changing relationships between career and multi-faceted nonwork orientations, and empirical data from three studies with samples at different career stages (early and mid-career), we use factor analysis and data from qualitative and longitudinal studies to develop three unique scales to assess a person's nonwork priorities relative to career orientations: family, personal life, and community service. There were generally positive relationships between the protean career scales and the new nonwork role orientation measures. Future research should move beyond a binary work–life or work–family models and include multi-dimensional measures of nonwork orientations relative to career.     

肿瘤姑息治疗的全程介入

恶性肿瘤严重威胁人类健康,肿瘤本身以及针对肿瘤的治疗不仅会对患者的生理和心理产生重要影响,同时也会对照顾患者的家人产生各种心理影响。现有医疗条件下短时间内难以提高治愈率,就应更加注重将姑息治疗贯穿于肿瘤治疗的始终,不仅要及早介入,甚至延伸至居丧期。在肿瘤治疗过程中不断对肿瘤患者进行评估和适时调整姑息治疗策略,可有效地提高患者生活质量同时降低医疗成本,最终患者能够在不同阶段和各种治疗手段中获得最大受益。     

人文关怀在消除IVF—ET患者心理压力中的作用

近年我国不少生殖医学中心在如何提高体外受精一胚胎移植（IVF—ET）治疗成功率问题上,都将注意力集中在临床用药的研究、控制性超促排卵方案的改进以及实验室条件的改善上,大多忽视IVF—ET患者心理方面的治疗。有研究表明：IVF—ET治疗的成功,不仅与患者自身的病理及生理状况有关,更与患者在治疗过程中产生的心理压力有关。因此,建议医护人员在给不孕症患者实施IVF-ET助孕治疗的全过程中,应给予患者更多人文关怀,这样不仅能够减少IVF—ET患者心理健康问题的发生,而且可以改善患者的身心状态和应对治疗能力,从而提高IVF—ET治疗成功率。     

ICU成人患者镇痛药物的使用：阿片类及其他

ICU患者经历着各种各样的疼痛,镇痛治疗对于ICU患者至关重要.目前可用于ICU成年患者的镇痛药物很多,主要有阿片类镇痛药、解热镇痛抗炎药和对某些特殊疼痛状态有效的药物.阿片类药物仍是非神经性疼痛的一线用药,使用最多的是阿片受体激动药,包括吗啡、芬太尼、舒芬太尼、瑞芬太尼等,其中舒芬太尼、瑞芬太尼在国内ICU中使用经验不多;阿片受体部分激动药在国内ICU使用很少,包括喷他佐辛、地佐辛等;非甾体类镇痛药在国内ICU使用也很少,包括氟比洛芬酯、帕瑞昔布等.本文旨在简单介绍舒芬太尼、瑞芬太尼、部分阿片受体激动剂及非甾体类镇痛药在ICU的应用.     

Self-help for binge eating disorder in primary care: A randomized controlled trial with ethnically and racially diverse obese patients

Objective

The objective was to examine the effectiveness of a self-help treatment as a first line primary care intervention for binge eating disorder (BED) in obese patients. This study compared the effectiveness of a usual care plus self-help version of cognitive behavioral therapy (shCBT) to usual care (UC) only in ethnically/racially diverse obese patients with BED in primary care settings in an urban center.

Method

48 obese patients with BED were randomly assigned to either shCBT (N = 24) or UC (N = 24) for four months. Independent assessments were performed monthly throughout treatment and at post-treatment.

Results

Binge-eating remission rates did not differ significantly between shCBT (25%) and UC (8.3%) at post-treatment. Mixed models of binge eating frequency determined using the Eating Disorder Examination (EDE) revealed significant decreases for both conditions but that shCBT and UC did not differ. Mixed models of binge eating frequency from repeated monthly EDE-questionnaire assessments revealed a significant treatment-by-time interaction indicating that shCBT had significant reductions whereas UC did not during the four-month treatments. Mixed models revealed no differences between groups on associated eating disorder psychopathology or depression. No weight loss was observed in either condition.

Conclusions

Our findings suggest that pure self-help CBT did not show effectiveness relative to usual care for treating BED in obese patients in primary care. Thus, self-help CBT may not have utility as a front-line intervention for BED for obese patients in primary care and future studies should test guided-self-help methods for delivering CBT in primary care generalist settings.     

The Compatibility of Hegelian Recognition and Morality with the Ethics of Care

I draw connections between Hegel’s concepts of recognition and morality and demonstrate how they are compatible with an ethic of care. I explore Hegel’s Sittlichkeit and demonstrate the role that intersubjective recognition plays in the development and sustainment of ethical communities. I demonstrate how his emphasis on the community and interpersonal relationships play an important role in his moral theory. I then contrast Hegelian and Kantian views of morality and argue that Hegel’s account places greater emphasis on attending to the needs of others and showing genuine concern for their well-being. By highlighting the intersubjective nature of recognition between self-consciousnesses, and the interconnectedness of agents in an ethical community, I maintain Hegel’s morality is compatible with an ethic of care because it emerges out of intersubjective mutual recognition and its foundation is built upon responding to the needs of particular others and protecting the bonds of the community.