Ethics in Supervision: Consideration of the Supervisory Alliance and Countertransference Management of Psychology Doctoral Students

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference (CT) is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to the bond dimension of the relationship.     

Paranoia predicts out-group prejudice: preliminary experimental data

This article examines the relationships between exposure to terrorism news and state social paranoia, death anxiety and Islamophobia. In two experiments we show that, contrary to previous research in this area, the terrorism news condition did not significantly increase state social paranoia, death anxiety and prejudice towards Muslims, but that paranoid thinking was the sole predictor of Islamophobia. Trait paranoia is associated with both poor well-being and with negative perceptions of Muslim competitive players – a form of inter-relational prejudice. Results indicated that the frequency of paranoid thoughts mediates the relationship between death anxiety and anti-Muslim prejudice and trait paranoia is the main predictor of the negative perceptions of a Muslim competing player. This study elucidates new pathways to understanding terror management theory, by including paranoia as a type of thinking that predisposes individuals to be suspicious of salient out-groups.     

Doctors,Patients, and Nudging in the Clinical Context—Four Views on Nudging and Informed Consent

In an analysis of recent work on nudging we distinguish three positions on the relationship between nudging founded in libertarian paternalism and the protection of personal autonomy through informed consent. We argue that all three positions fail to provide adequate protection of personal autonomy in the clinical context. Acknowledging that nudging may be beneficial, we suggest a fourth position according to which nudging and informed consent are valuable in different domains of interaction.     

The protection of patients’ rights in clinical trials

The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a free, secret ballot should be preferred to direct appointment), the avoidance of conflict of interest during the election of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should, on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’ rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005. The author is Chairman, Bioethics Committee of the Warsaw Regional Chamber of Physicians and Dentists.     

APPLICANT REACTIONS TO PRE-EMPLOYMENT APPLICATION BLANKS: A LEGAL AND PROCEDURAL JUSTICE PERSPECTIVE

The current research investigated applicant reactions derived from common application blanks. Previous work has found applications to be riddled with legally inadvisable items, but limited research has attempted to understand how such items might affect applicants. By using organizational justice theory as a framework, two studies examined applicant reactions from two application blanks: a legally advisable application and a legally problematic application. It was found that applicants completing the legally problematic application had lower perceptions of justice and expressed higher litigation intentions compared to those completing the legally advisable application, especially for those that were rejected without an explanation.

Efficacy of self-administered treatments for pathological academic worry: A randomized controlled trial

Research on treatments for reducing pathological worry is limited. In particular, academic worry is a common theme in generalized anxiety disorder (GAD) samples as well as non-clinical student samples. Given the high cost of anxiety disorders to society, research is needed to examine the efficacy of self-administered treatments designed to reduce pathological worry. The primary goal of this study was to investigate the benefits of three self-administered interventions for reducing academic worry. College students (N = 113) experiencing clinically significant academic worry were randomized to either: (a) worry exposure (WE); (b) expressive writing (EW); (c) relaxation consisting of pulsed audio-photic stimulation (APS); or (d) waitlist control (WLC). Participants were instructed to practice their interventions three times per week for one month and completed home practice logs online to track treatment adherence. Academic worry, general anxiety, and perceived stress were assessed at baseline and post-treatment. Academic worry and general anxiety were also assessed at a three-month follow-up. Those assigned to the WE and APS conditions showed significant improvement relative to EW and WLC at post-treatment. All treatment conditions showed continued improvement by follow-up, with no between-group differences. Treatment and public health implications are discussed.     

布氏杆菌病诊治体会

加强对布氏杆菌病流行病学资料、临床特点、诊断、治疗、预后及本病误诊误治的前因后果等方面的认识,回顾性分析潍坊医学院附属医院近两年收治的28例布氏杆菌病病例,并总结布氏杆菌病在诊断、治疗等方面的特点.经查阅国内外资料分析所得,近20余年,布氏杆菌病发病率呈上升趋势,传播途径复杂,临床表现无特异性,易误诊误治;利福平、四环素及喹诺酮药物疗效肯定,治愈率高.临床医师须加强对本病的全面认识,提高诊断率并提供规范治疗、减轻患者心理及精神负担.     

临床护士心理弹性现状及其影响因素的研究

了解临床护士心理弹性现状,分析影响护士心理弹性的因素,为管理者掌握临床护士心理健康状况,提高心理弹性水平提供参考依据。采用中文版心理弹性量表（CD—RISC）,对535名临床护士进行调查。结果显示,临床护士心理弹性总分为（56．78±18．43）分;其心理弹性在不同人口统计学方面差异均有统计学意义（P〈0．05）;多元逐步回归分析显示心理弹性的主要影响因素是：工作年限和是否为独生子女。临床护士心理弹性处于中等水平,医院管理者应重视培养个体心理弹性素质,有针对性地开展弹性拓展训练,提高护理质量。