Issues in training clinical health psychologists

The author describes general issues in the training of clinical health psychologists and provides an overview of specific content needed in core health psychology and clinical health psychology assessment and intervention. Special attention is given to training in professional, personal, ethical and legal issues of practice.     

Smoking,self-regulation and moral positioning: A focus group study with British smokers from a disadvantaged community

Smoking in many Western societies has become a both moral aand health issue in recent years, but little is known about how smokers position themselves and regulate their behaviour in this context. In this article, we report the findings from a study investigating how smokers from an economically disadvantaged community in the East Midlands (UK) respond to concerns about the health impact of smoking on others. We conducted ten focus group (FG) discussions with mixed groups (by smoking status and gender; N?=?58 participants) covering a range of topics, including smoking norms, self-regulation, and smoking in diverse contexts. We transcribed all FG discussions before analysing the data using techniques from discourse anlysis. Smokers in general positioned themselves as socially responsible smokers and morally upstanding citizens. This position was bolstered in two main ways: ‘everyday accommodation’, whereby everyday efforts to accommodate the needs of non-smokers were referenced, and ‘taking a stand’, whereby proactive interventions to prevent smoking in (young) others were cited. We suggest that smoking cessation campaigns could usefully be informed by this ethic of care for others.     

What,and Where,Luck is: A Response to Jennifer Lackey

In ‘What Luck Is Not’, Lackey presents counterexamples to the two most prominent accounts of luck: the absence of control account and the modal account. I offer an account of luck that conjoins absence of control to a modal condition. I then show that Lackey's counterexamples mislocate the luck: the agents in her cases are lucky, but the luck precedes the event upon which Lackey focuses, and that event is itself only fortunate, not lucky. Finally I offer an account of fortune. Fortune is luck-involving, and therefore easily confused with luck, but it is not itself lucky.     

Content analysis of food advertising strategies and ethical implications on South African television

The study aimed to investigate strategies and ethical implications of food advertising in South African television. The sample included 343 food advertisements recorded over two weeks and 224 hours from two major South African TV channels. Results indicate 45 products of food advertisements. Fast food, restaurant and convenience food type had the highest number of products (17), followed by “beverage, drink and juice” (6), and “candy and sweets” group (6). Conceptual consumption (people are as interested in consuming ideas, information, and concepts as they are physically consuming things) was used as the main strategy (76.2%) for advertising food, while only 7% focused on physical consumption (fiber, energy and vitality). The majority of food advertisement used human models (78.5%), adults only (38%) and about half used both sexes. White models were used twice as often as Black models. Other advertisement strategies included claims to having fun (majority), being perceived of a higher status, acquiring a superior of products and adding social worth to the quality of person who consume the products. A few claims related to the physical benefit to the consumer, such as high fibre, whole grain, and weight loss.     

An Eastern Orthodox Theological Basis for Interplanetary Environmental Ethics

As a result of our technological advances in space exploration, human enterprise is no longer limited to the confines of planet Earth. Although several philosophical approaches to environmental ethics have already been advocated for human encounters with other planets such as Mars, it may be argued that various religious worldviews will significantly influence these suggested value systems. In this article, we present an Eastern Orthodox Christian interpretation of Creation and explore the theological meaning of the human vocation as Priests of Creation. An appropriate application of these two principles provides a theological basis for an interplanetary eco-praxis.     

Dual realities – The search for meaning: Psychodynamic therapy with physically ill people

Abstract

We summarize Kohut's (1971) bi-polar self which enables counsellors to understand and treat narcissistic behaviours and narcissistic personality disorders in a psychoanalytic framework. After Patton and Meara (1992), we describe Kohut's formulations regarding self-development and disorders of self and how such formulations inform critical components of psychoanalytic counselling with particular emphasis on the explicit and implicit strategies and characteristics the counsellor brings to the process. Finally, we suggest that a promising arena for future theorizing and applications of Kohut's ideas is consultation with parents, teachers and other community leaders to help prevent or remedy psychological self-injuries with systemic interventions outside short-term counselling or long-term therapy.

We have suggested that Kohut's self psychology is a good vehicle for understanding what brings a client to counselling: namely, disorders of the self or self-injury. We review strategies and ‘ways of being’ a counsellor must bring to and offer in the counselling encounter if the work is to succeed. We also examine implicit qualities (beyond the achievement of a mature bipolar self) we believe a counsellor or any facilitator must have if counselling or other helping relationships are to be effective. We purpose further conversations and empirical analyses which specifically and conceptually link critical components of psychoanalytic counselling to self psychology and to essential counsellor traits or virtues that seem intrinsic to good counselling practice.     

Accidental Communities: Race,Emergency Medicine,and the Problem of PolyHeme®

This article focuses on emergency medical care in black urban populations, suggesting that the classification of a “community” within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between “autonomy” and “community.” The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines a clinical trial for the blood substitute PolyHeme^® (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of “community.” The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment.     

Physicians' Silent Decisions: Because Patient Autonomy Does Not Always Come First

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time.     

Males' Reactions to Participating in Research on Dating Violence Victimization and Childhood Abuse

Childhood abuse and dating violence victimization are prevalent and devastating problems. Although there has been an abundance of research on these topics in recent years, researchers and institutional review boards often struggle with determining whether asking respondents questions on previous violence will result in increased emotional distress or other negative research outcomes. Empirical data are therefore needed that examine the research reactions of individuals who participate in research on childhood abuse and dating violence. This study examined this topic among a sample of male college students (N?=?193). Results showed that victims of childhood sexual abuse had more negative emotional reactions and victims of physical dating violence had more negative perceived drawbacks to research participation than nonvictims. However, victims and nonvictims did not differ on positive research reactions. These findings suggest that there are few differences between victims and nonvictims on research reactions.