Hotep's Story: Exploring the Wounds of Health Vulnerability in the US

A wide variety of forms of domination hasresulted in a highly heterogeneous health riskcategory, ``the vulnerable.' The study of healthinequities sheds light on forces thatgenerate, sustain, and alter vulnerabilities toillness, injury, suffering and death. Thispaper analyzes the case of a high-risk teenfrom a Boston ghetto that illuminatesintersections between ``race' and class in theconstruction of vulnerability in the US.Exploration of his ``wounds' helps specify howlarge-scale social and cultural forces becomeembodied as individual experience of disparatehealth risk. The case demonstrates that healthinequities would not occur if resources –employment, income, wealth, education, housing,profiling in the legal system, and health care– were more justly managed in keeping withstandards outlined in the Universal Declarationof Human Rights. Professional responses to the``wounds of vulnerability' may reveal importantaspects of who we are and what our work asscholars, practitioners, and advocates mustbecome.     

The Role of Referent and Expert Power in Mutual Help

This study explored the roles of referent power (i.e., influence based on sense of identification) and expert power (i.e., influence based on knowledge and expertise) in Schizophrenics Anonymous (SA), a mutual-help group for persons experiencing a schizophrenia-related illness. The study describes SA participants' experience of referent and expert power with SA members, SA leaders, and with mental health professionals. It also examines whether or not referent and expert power ascribed to fellow SA participants predicts the perceived helpfulness of the group. One hundred fifty-six SA participants were surveyed. Participants reported experiencing higher levels of referent power with fellow SA members and leaders than with mental health professionals. They reported higher levels of expert power for mental health professionals and SA leaders than for SA members. The respondents' ratings of their SA group's helpfulness was significantly correlated with ratings of referent and expert power. Although expert power was the best independent predictor of helpfulness, a significant interaction between referent and expert power indicated that when members reported high referent power, expert power was not related to helpfulness. These results are interpreted to suggest that there are multiple forms of social influence at work in mutual help.     

A Pathological View of Disease

This paper is a response to Christopher Boorse's recent defense of hisBiostatistical Theory (BST) of health and disease. Boorse maintains that hisconcept of theoretical health and disease reflects the ``consideredusage of pathologists.' I argue that pathologists do not use ``disease' inthe purely theoretical way that is required by the BST. Pathology does notdraw a sharp distinction between theoretical and practical aspects ofmedicine. Pathology does not even need a theoretical concept of disease. Itsfocus is not theoretical, but practical; pathology's goal is to contribute tothe healing of patients. Pathology, even experimental pathology, is notvalue-free. Not only ``disease' but also such terms as ``nerve' and ``organ'are laden with conceptual values.     

Auguste Comte on Positivism and Happiness

Auguste Comte (1798–1857) is the founder of a French school of thought that became famous for its encyclopaedic account of the sciences as well as for its exposition of what was designed as a way out of a state of intellectual and moral crisis. This essay demonstrates that there is a linkage between the diagnosis of crisis and the pursuit of happiness in Comte's foundation of positivism. It begins by distinguishing Comte's notion of positivism from that of a value-free science. In analysing Comte's peculiar usage of the term happiness, the essay shows that happiness is understood as the result of the convergence (consensus) of three components: a scientific conception of the world, the feelings of love and veneration, and a wisely ordered activity. The essay then demonstrates that the first of these components is of primary importance inasmuch as it is to frame a new horizon within which man is expected to return to a healthy state of mind, to reshape both his hopes and activities, and to discover his own participation in a supreme order acting through the laws of nature as well as through those of the civilization in which he lives. Conveying this new horizon to citizens of a lasting Republic is the sacred mission of sociology. The essay concludes by pointing out that Comte's conception of happiness can be assessed as unifying some main qualities of life as they are classified in Ruut Veenhoven's fourfold matrix.     

"中小学生心理健康"公众观的调查和分析

本研究调查分析了家长、教师对中小学生心理健康判断标准的认识.因素分析表明,家长主要强调四个因素"精神和神经病症"、"良好品行"、"健康人格"和"循环性";教师则强调五个因素"精神分裂症状"、"神经质"、"好学生标准"、"不良人格"和"不良品行".公众对于情、意、个性及社会适应等同心理健康的关系认识较为清楚,但对认知、品行及体征与之的关系认识则片面和模糊."好学生标准"对判断有重要影响.     

Health Focused Psychotherapy In Treating a Dual Diagnosed Patient

Health-focused psychotherapy offers a contemporary model used in assessment, treatment planning and evaluation in addressing patients with both medical and psychiatric diagnoses. Clinicians in the health and mental health disciplines must know and understand the importance of standards of care and models of intervention and evaluation in clinical practice for this type of patient. Examined is the use of a specific model providing a tailored orientation to patient education, along with the development and use of a clinical algorithm and care pathway for clinical practice. Provided is a case study for applying the development and use of a clinical algorithm and care pathway for a dual diagnosed patient receiving health-focused psychotherapy.     

Recommendations for the Treatment of Hypochondriac Patients

Hypochondriasis is a debilitating condition in which patients are persistently preoccupied with the possibility of being seriously ill. Its is a costly problem for the health care system whose treatment has not received systematic attention until recently. Although based on few controlled studies, results indicated that various brief cognitive-behavioral techniques produce significant changes in illness fears and attitudes. A list of therapeutic questions that require further study is presented and some indications for both therapists and patients are given.     

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.     

Stewardship Models of Pastoral Care,Counselling and Supervision: The Commonians Meet Ricoeur at Worship

The common factors debate in psychology and, more recently, marriage and family therapy is slow to erupt in pastoral care and counselling. This article introduces the common factors debate into pastoral science by proposing the Stewardship Models of Pastoral Ministry and Supervision. The model integrates common factors research and pastoral practice using Ricoeur’s “economy of the gift” ethic. The model’s focus is pastoral care, counselling and supervision in congregations, a unique community context in search of an adequate pastoral praxis.     

Toward a Comprehensive Strategy for Effective Practitioner–Scientist Partnerships and Larger-Scale Community Health and Well-Being

This article articulates joint priorities for the fields of prevention science and community psychology. These priorities are intended to address issues raised by the frequent observation of natural tensions between community practitioners and scientists. The first priority is to expand the knowledge base on practitioner–scientist partnerships, particularly on factors associated with positive outcomes within communities. To further articulate this priority, the paper first discusses the rapid growth in community-based partnerships and the emergent research on them. Next described is an illustrative research project on a partnership model that links state university extension and public school delivery systems. The article then turns to the second, related priority of future capacity-building for diffusion of effective partnership-based interventions to achieve larger-scale health and well-being across communities. It outlines two salient tasks: clarification of a conceptual framework and the formulation of a comprehensive capacity-building strategy for diffusion. The comprehensive strategy would require careful attention to the expansion of networks of effective partnerships, partnership-based research agendas, and requisite policy-making.