Response to Difficult Patients in Group Analysis: The Personification of I:A/M

The author focuses on the application of Hopper's proposal of an additional basic assumption (I:A/M) using a model of clinicians' theories: bridging theory, psychological theory, and clinical theory (Michels, 1999). This paper will describe the potential for advances in understanding particular group formations seen in clinical practice and other settings.     

The Child and Adolescent Functional Assessment Scale (CAFAS): Review and Current Status

Measures of impairment in psychological and behavioral functioning have a long history in the field of children's mental health, and appear particularly useful in eligibility determination, treatment planning, and outcome evaluation of services for children and adolescents with serious emotional disturbance (SED). One recently developed multidimensional measure of functional impairment—the Child and Adolescent Functional Assessment Scale (CAFAS; K. Hodges, 1989, 1997)—has enjoyed widespread use nationwide. It has been adopted as a tool for making treatment eligibility decisions and documenting outcomes on a statewide level in more than 20 states and on a local level in dozens of research and demonstration projects. In this paper, the technical merits of the CAFAS are closely examined, with the conclusion that empirical evidence is lacking to support its valid use in making the types of treatment decisions for which it is currently being employed across the nation. Furthermore, there appears to be little concern among mental health researchers, practitioners, administrators, and state legislators about these apparent limitations of the CAFAS. The potential benefits of establishing objective and valid level-of-need criteria, using the CAFAS are numerous and the interest in doing so is clear; however, the psychometric limitations of the scale identified in this review need to be addressed before its full potential can be realized.     

Look Who's Talking: Measuring Self-Disclosure in MFT

While self-disclosure plays a prominent role in the development and maintenance of the therapeutic relationship, most marriage and family therapy clinical research fails to include measures of self-disclosure. A factor analysis of Chelune's (1976) Self Disclosure Situations Survey (SDSS) reduces the number of items in this measure from 20 to six. Researchers are encouraged to consider conducting clinical research with specific attention to the construct of self-disclosure. The revised SDSS could easily be added as part of the self-report information collected in clinical studies.     

现代复苏的药物应用现状的理性思考

回顾了复苏药物应用研究的现状,运用创新思维的科学方法对现代复苏药物临床应用研究中的医学和伦理难题进行了理性分析,阐明了理论,逻辑思维,哲学思考对临床实践和医学研究的重要性。     

Quantitative Anatomy: Power Beyond the Images

Positron emission tomography (PET) is a frontiermedical technology that, in contrast to the othercomputer-assisted technologies providing anatomicalpictures, produces functional images. I argue that PETalso opens up an avenue for shifting from images (asa tool for representation of biomedical data) back toanalysis of measurements (as a tool for quantificationof physiology). Admittedly, quantification of functionrequires structural constraints. I coined the emerginginterpretational framework quantitative anatomyin an attempt to conceptualize the PET merger betweenmeasuring and imaging, the two competing meansmedicine uses to examine the human body. Anatomyjustifies interpretations that fit the existingknowledge of a larger clinical audience, whilestatistical data possess an unexplored potential tointroduce mathematical rigor in the evaluation offunction, but are still a black box for the majorityof clinicians. This epistemological change is beingcarried out by PET users in action as well as indiscourse.     

A case study of behavioral assessment and treatment of insect phobia

We assessed the academic performance of a 14-year-old boy with insect phobia in the context of feared stimuli. The dependent measure was math calculation rate across three conditions that varied therapist statements about the presence of crickets and the actual presence of live crickets. Subsequent treatment consisted of graduated exposure and contingent rewards for math problem completion. Assessment results indicated that the boy's performance was consistently low in the presence of live crickets but not when he was spuriously informed that crickets were present (the primary referral concern). Treatment results indicated no effect from exposure alone and a dramatic effect when exposure was combined with contingent rewards.     

The Treatment Planning of Experienced Counselors: A Qualitative Examination

Using consensual qualitative research, the authors examined the treatment planning process of experienced counselors (N = 9). The data analysis resulted in 4 domains: assessment steps, clinical impressions, treatment factors, and treatment strategies. These domains describe the process used by experienced counselors in making clinical decisions and offer insight into the nature of clinical expertise and the need for further research on treatment planning.     

What People Want From Their Professionals: Attitudes Toward Decision‐making Strategies

Attitudes toward four types of decision‐making strategies—clinical/fully rational, clinical/heuristic, actuarial/fully rational, and actuarial/heuristic—were examined across three studies. In Study 1, undergraduate students were split randomly between legal and medical decision‐making scenarios and asked to rate each strategy in terms of the following: (i) preference; (ii) accuracy; (iii) fairness; (iv) ethicalness; and (v) its perceived similarity to the strategies used by actual legal and medical professionals to make decisions. Studies 2 and 3 extended Study 1 by using a more relevant scenario and a community sample, respectively. Across the three studies, the clinical/fully rational strategy tended to be rated the highest across all attitudinal judgments, whereas the actuarial/heuristic strategy tended to receive the lowest ratings. Considering the two strategy‐differentiating factors separately, clinically based strategies tended to be rated higher than actuarially based strategies, and fully rational strategies were always rated higher than heuristic‐based strategies. The potential implications of the results for professionals' and those affected by their decisions are discussed. Copyright © 2011 John Wiley & Sons, Ltd.     

Assessment and Diagnosis of Eating Disorders: A Guide for Professional Counselors

Despite the prevalence of and risk associated with disordered eating, there are few guidelines for counselors on how to conduct an eating disorder assessment. Given the importance of the clinical interview, the purpose of this article is to provide recommendations for the assessment and diagnosis of eating disorders that (a) specifically focus on assessment in the context of a clinical interview and (b) can be used by counselors whether or not they specialize in eating disorder treatment.     

A Study of Clinical Supervision Techniques and Training in Substance Abuse Treatment

Data from 57 clinical supervisors in licensed substance abuse treatment programs indicate that 28% had completed formal graduate course work in clinical supervision and 33% were professionally licensed or certified. Findings raise concerns about the scope and quality of clinical supervision available to substance abuse counselors.