« La malléabilité du cadre thérapeutique comme support d’élaboration sur les terrains de l’aide internationale »

IntroductionIn the field of international aid, the projects set up, including psychological care systems, must respond to international and local requirements regarding their financing and sustainability. In these contexts, clinical questions intersect with those of the systems and culture. The traumatic dimension remains prevalent, and these contexts often must deal with multiple local and international requirements. These dimensions can influence the devices set up and their evolution.ObjectivesThrough feedback from an action-research conducted in Cambodia, we question the evolutions and adaptations of a therapeutic device with abused children.MethodFor one year, a device based on mediation was proposed for 10 children hosted within a local child protection NGO. We describe here its implementation and its evolution in the field.ResultsThe setting up of the system was a vector of different meetings. The adjustments were made in relation to the institutional context, the meetings with the local actors and the specificities of the clinic.ConclusionThe evolutions of the therapeutic device seem to signify the processes at play, both on the institutional and intersubjective scene. Regarding these field returns, the malleability of the therapeutic devices in these contexts seems to support the expression and the processual evolution, allowing a work of psychic elaboration.     

The importance of including quality-of-life indices in international social and economic development activities

Psychology has not been a visible player in international social and economic development efforts. Through its demonstrated commitment to the concept of quality of life, psychology has an opportunity to help shape foreign policy and to improve the lives of countless people around the globe. Poverty has reached unacceptable limits of humanitarian tolerance and political consequence throughout the world. The United Nations estimates that 20% of the world's population now lives in conditions of absolute poverty in which there is an absence of even the bare essentials for living. Social and economic development efforts have often failed despite good intentions because they have often concentrated on improving peoples' material level of living but not their quality of life. This article addresses the need to include quality-of-life (QOL) indices in international social and economic development efforts. In addition, the article calls attention to the need to use valid cross-cultural measurement strategies (i.e., culturally equivalent) when assessing QOL across cultural and national boundaries. Current approaches to social and economic development rely heavily on interventions that do not reflect the actual peoples' perceptions of life satisfaction and subjective well-being. Self-serving political and economic national interests have kept new approaches to development from being implemented. New interventions must be holistic, decentralized, integrated, empowering, participatory, and human-resource directed, and must include culturally equivalent objective and subjective quality-of-life indices as the arbiters of success.     

Do Internet‐Based Support Interventions Change Perceptions of Social Support?: An Experimental Trial of Approaches for Supporting Diabetes Self‐Management

Internet-based support groups are a rapidly growing segment of mutual aid programs for individuals with chronic illnesses and other challenges. Previous studies have informed us about the content of online exchanges between support group members, but we know little about the ability of these interventions to change participants' perceptions of support. A randomized trial of 160 adult Type 2 diabetes patients provided novice Internet users with computers and Internet access to 1 of 4 conditions: (a) diabetes information only, (b) a personal self-management coach, (c) a social support intervention, or (d) a personal self-management coach and the support intervention. After 3 months, individuals in the 2 support conditions reported significant increases in support on a diabetes-specific support measure and a general support scale. Participants' age was significantly related to change in social support, but intervention effects were still significant after accounting for this relationship. This report is a critical first step in evaluating the long-term effects of Internet-based support for diabetes self-management. The discussion identifies directions for future research.     

Factors contributing to the survival of self-help groups

Despite the growing utilization of self-help groups, there have been only a handful of studies that have examined the factors that contribute to their survival. The purpose of this study was to explore the factors that contribute to self-help group survival by examining their relationship with external sources (i.e., national and local self-help organizations, professionals) and group organizational characteristics (i.e., leadership diversification, recruitment, attendance at group meetings). Representatives from 245 active and 94 recently disbanded self-help groups were included in the analysis. Results indicated that the primary factors that discriminated between active and disbanded groups were the number of new people to attend a meeting, average group meeting attendance, length of existence, leadership diversification, outreach to potential group members, and support from national and local organizations. Results are discussed in terms of what national self-help organizations, self-help clearinghouses, and others who interact with self-help groups can do to empower and support them.     

The institutionalization of community interventions in Chile: characteristics and contradictions

A critical analysis of the consequences of successive institutionalization of community intervention in Chile is presented. This analysis is based on research of current community interventions in Chile, whose results are compared with Chilean community practice from previous historical periods. Chilean community intervention was formerly practiced out of governmental institutions and universities and was sustained primarily by foreign agencies and ecclesiastical institutions. Nowadays, with the return to democracy, the vast majority of community intervention programs are financed, partially or totally, by means of governmental resources. This institutionalization of community interventions has had consequences worthy of critical analysis: an increase in the number and stability of intervention programs; and also negative consequences for intervention goals, definition of target groups, and intervention practices. Dilemmas, such as assistance vs. promotion or adaptation vs. social change, have arisen. These dilemmas show the contradictions of a Community Psychology, which has left behind the position of institutional marginality to form part of Chilean society's normal psychosocial care. They also show the need for a paradigm shift from a critical view of the social world to a constructionist one.     

Thinking about the Needy, Justice, and International Organizations

This article has three main parts, Section 2 considers the nature and extent to which individuals who are well-off have a moral obligation to aid the worlds needy. Drawing on a pluralistic approach to morality, which includes consequentialist, virtue-based, and deontological elements, it is contended that most who are well-off should do much more than they do to aid the needy, and that they are open to serious moral criticism if they simply ignore the needy. Part one also focuses on the United States, and illustrates both how incredibly wealthy the U.S. is and some of the spending habits of its citizens; however, its considerations apply to the well-off generally. Section 3 considers whether justice provides reasons for helping the needy. Noting that justice in an extremely complex notion, it discusses numerous considerations relevant to justices scope and implications, including an extended Rawlsian conception of justice, an absolute conception, a comparative conception, the distinction between natural and social justice, and various elements of common-sense morality. Section 2 also distinguishes between agent-relative justice-based reasons, which are relevant to whether we act justly, and agent-neutral justice-based reasons, which are relevant to whether we have reasons of justicefor acting. Correspondingly, it argues that even if one can ignore the needy without acting unjustly, as philosophers like Robert Nozick and Jan Narveson contend, there may be powerful reasons of justicefor addressing their plight. Section 4 briefly address the responsibilities of international organizations like the World Bank, the International Monetary Fund (IMF), and World Trade Organization (WTO). Drawing on Section 2, it is suggested that in addition to standard reasons to act justlytowards needy members of the worlds community, there will be reasons of justicefor such organizations to aid the needy in both present, and future, generations. The article concludes by contending that the well-off in countries like the U.S. have reason to view international organizations like the World Bank, IMF, and WTO as their agents, and to seek to insure that they alleviate misfortunes amongst the worlds needy.     

Global Inequality and International Institutions

This article considers the links between international institutions and global economic justice: how international institutions might be morally important; how they have changed; and at what those changes imply for justice. The institutional structure of international society has evolved in ways that help to undercut the arguments of those who take a restrictionist position towards global economic justice. There is now a denser and more integrated network of shared institutions and practices within which social expectations of global justice and injustice have become more securely established. But, at the same time, our major international social institutions continue to constitute a deformed political order. This combination of density and deformity shapes how we should think about international justice in general and has important implications for the scope, character, and modalities of global economic justice. Having laid out a view of normative development and where it leads, the article then examines why international distributive justice remains so marginal to current practice.     

Driving examiners’ views on data-driven assessment of test candidates: An interview study

Vehicles are increasingly equipped with sensors that capture the state of the driver, the vehicle, and the environment. These developments are relevant to formal driver testing, but little is known about the extent to which driving examiners would support the use of sensor data in their job. This semi-structured interview study examined the opinions of 37 driving examiners about data-driven assessment of test candidates. The results showed that the examiners were supportive of using data to explain their pass/fail verdict to the candidate. According to the examiners, data in an easily accessible form such as graphs of eye movements, headway, speed, or braking behavior, and color-coded scores, supplemented with camera images, would allow them to eliminate doubt or help them convince disagreeing test-takers. The examiners were skeptical about higher levels of decision support, noting that forming an overall picture of the candidate’s abilities requires integrating multiple context-dependent sources of information. The interviews yielded other possible applications of data collection and sharing, such as selecting optimal routes, improving standardization, and training and pre-selecting candidates before they are allowed to take the driving test. Finally, the interviews focused on an increasingly viable form of data collection: simulator-based driver testing. This yielded a divided picture, with about half of the examiners being positive and half negative about using simulators in driver testing. In conclusion, this study has provided important insights regarding the use of data as an explanation aid for examiners. Future research should consider the views of test candidates and experimentally evaluate different forms of data-driven support in the driving test.     

Explaining the effects of a decision intervention on mammography intentions: The roles of worry,fear and perceived susceptibility to breast cancer

Objective: This study examines the effects of a mammography decision intervention on perceived susceptibility to breast cancer (PSBC) and emotion and investigates how these outcomes predict mammography intentions.

Design: Randomised between-subjects online experiment. Participants were stratified into two levels of risk. Within each stratum, conditions included a basic information condition and six decision intervention conditions that included personalised risk estimates and varied according to a 2 (amount of information: brief vs. extended) × 3 (format: expository vs. untailored exemplar vs. tailored exemplar) design. Participants included 2465 US women ages 35–49.

Main Outcome Measures: PSBC as a percentage, PSBC as a frequency, worry, fear and mammography intentions.

Results: The intervention resulted in significant reductions in PSBC as a percentage for women in both strata and significant increases in worry and fear for women in the upper risk stratum. Of the possible mediators examined, only PSBC as a percentage was a consistent mediator of the effect of the intervention on mammography intentions.

Conclusion: The results provide insight into the mechanism of action of the intervention by showing that PSBC mediated the effects of the intervention on mammography intentions.