科学主义的尴尬与中医学的多向度发展

近５０年的中医现代化研究暴露了科学主义试图消解其他向度存在的独尊倾向,而经络实质研究、证客观化研究等方面的失败,宣告了科学主义并不是解决中医学所有问题的灵丹妙药。科学主义所遇到的这种尴尬局面表明,中医学应该有多种向度的发展,除了现代化研究这一模式之外,至少还应当有两种向度的存在,即原有形态的传统中医学体系应继续存在下去,传统中医学在技术上与西医学的结合应当受到鼓励。     

Concordant Spiritual Orientations as a Factor in Physician--Patient Spiritual Discussions: A Qualitative Study

Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.     

On the existence and uniqueness of JML estimates for the partial credit model

A necessary and sufficient condition is given in this paper for the existence and uniqueness of the maximum likelihood (the so-called joint maximum likelihood) estimate of the parameters of the Partial Credit Model. This condition is stated in terms of a structural property of the pattern of the data matrix that can be easily verified on the basis of a simple iterative procedure. The result is proved by using an argument of Haberman (1977). The author wishes to thank the Editor and the anonymous reviewers for their comments that helped to substantially improve the final version of this paper. This research was supported in part by a MURST grant (ex 60%).     

Bilateral Art: Integrating Art Therapy,Family Therapy,and Neuroscience

This paper describes the systemic use of a neurologically-based art therapy modality—bilateral art—that engages both dominant and non-dominant hands in the process of creating images in response to opposing cognitions or feelings. It describes both neuroscience and family therapy perspectives that argue for the use of bilateral art. A specific protocol for bilateral art therapy is provided along with a case study demonstrating integration of the protocol into the systemic treatment of a young family. Carole M. McNamee, PhD, is Research Professor and Clinical Associate, Director of the Arts in Healthcare Project, The Family Therapy Center, Department of Human Development, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (cmcnamee@vt.edu).     

Indian Women’s Experience of a Narrative Intervention Using Art And Writing*

International and minority populations tend to underutilize mental health services, including marriage and family therapy. Models of marriage and family therapy developed in the West may reflect Western values and norms inappropriate for diverse cultural contexts. This article presents an exploratory, qualitative study of a narrative therapy approach with Asian Indian women. This study adds to the small body of narrative-based empirical studies, and has a unique focus on intercultural applications and the experience of participants. Participant experience was examined along four phenomenological dimensions. Findings indicate the suitability of narrative interventions and nontraditional treatment delivery for this population.*This research was presented in 2004 at the annual conference of the American Association for Marriage and Family Therapy.     

Communication flow and change theory within a family therapy supervision model

This article portrays a model of family therapy clinical supervision using change theory that is most appropriate for use with the videotape, audiotape, case presentation and debriefing from the live session. The most powerful tool during this process is that of communication and assessment of change theorys tools of confidence and conviction. The concepts presented are meant to add an additional dimension to family therapy supervision in cooperation of other theories, not as an end in themselves.Special thanks to Ms. Geri Koncilja of the Informational Technology Center at Colorado State University, Pueblo for illustration and graphic assistance.     

Protective Factors as Moderators of Risk Factors in Adolescence Bullying

The present study examined the role played by protective factors in moderating the effects of risk factors over bullying and victimization in a sample of 679 male adolescents recruited in Italian high schools. Boys’ involvement in bullying revealed that one in three students has bullied others at least sometimes in the previous three months, and one in six has been victimized at the same rate; victimization decreases with age. The family related risk factor (conflicting parents) was positively associated with bullying and with victimization (together with punitive parenting); the same applied for risk factor related to the individual ways of dealing with problems (emotionally oriented coping skills). Protective factors related to the family context (supportive and authoritative parents) and to the individual (problem solving coping skills) were negatively associated to bullying and victimization. Hierarchical regression analyses revealed a moderating effect of supportive parenting on punitive parenting and on emotionally oriented coping strategies in predicting victimization. Problem solving coping strategies helped buffer the negative impact of emotionally oriented coping strategies over bullying. Implications of results for practitioners and for future studies are addressed.     

Who's in Charge?: Coparenting in South and Southeast Asian Families

In light of the evolving roles of parents and the involvement of extended family within Asian cultures, the traditionally Western dyadic coparenting construct must be reconceptualized to include not only the coparenting relationship, but also other caregivers within the coparenting network. Theoretical and empirical evidence on coparental systems are discussed and two studies from South and Southeast Asian cultures are presented to highlight subcultural variations in cocaregiving networks. Results indicated that mothers were the primary caregivers across both cultural contexts. Extended family members assumed important coparental responsibilities in both cultural contexts. These findings highlight the need to reconceptualize and expand the dyadic coparental unit to include extended family members. We also discuss the relevance of the broader coparental network in examining the Asian childs education as well as cognitive and socioemotional development.     

Use of newsletters to promote environmental political action: an experimental analysis

The managers of beach businesses were randomly assigned to receive no intervention or two newsletters per week for 6 weeks that presented economic consequences of damage to coastal water quality and how to contact politicians. The percentage of proenvironmental political contacts was significantly greater in the experimental (newsletter) group than in the control group. Logistical regression showed that contacts in the newsletter group were more than five times that of controls after adjusting for history of contacts and predisposition to take such action. Results suggest that the intervention can promote political action that could influence environmental policies and human health.     

Emancipatory responses to oppression: the template of land-use planning and the Old Order Amish of Ontario

In this paper I discuss the clash of values between the Old Order Amish community of Ontario and the dominant social paradigm in agriculture. Land-use and agricultural regulations, designed for an industrial style of agriculture, are experienced as a threat to the survival of the Old Order Amish agricultural social economy and community. The paper describes how I have worked with the Old Order Amish to respond to these challenges and to create public policies that will allow them to maintain their human and agricultural diversity and small-scale sustainable farm practices. Four case studies illuminating the oppressive land-use regulations along with the emancipatory responses to the oppression are examined. The social transformation themes include principles and processes for community psychologists, land-use planners, and community economic development practitioners to consider. The article has heuristic value for a practice-based approach to social change.