Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm

In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.     

Couples, Existential Psychotherapy, and Myocardial Infarction: A Ten Year Evaluation Study

Existential psychotherapy with couples after the occurrence of a myocardial infarction can be a useful, effective, and productive service approach in combination with medical services and cardiac rehabilitation services. In this article the existential treatment dynamics of holding, telling, mastering, and honoring with couples after a heart attack are described and illustrated. In addition, data from a 10-year before-after field evaluation study is reported, which supports the usefulness of the treatment approach.     

Association of Behavioral Self-Regulation with Concurrent Functional Capacity Among Stroke Rehabilitation Patients

The purpose of this study was to test the hypothesis that the Behavioral Dyscontrol Scale (BDS), a measure of the executive cognitive capacity to use an intention to guide purposeful, goal-directed activity would be strongly associated with concurrent functional status after controlling for age, sex, education, severity of pain, medical comorbidity, depression, and general mental status, in a sample of 246 elderly inpatients receiving rehabilitation services following hospitalization for stroke. Functional status was assessed by rehabilitation nurses' ratings of patients on 11 ADL items and on the Barthel Index. The BDS was the strongest predictor for 11 of the 12 dependent variables. Although it correlated significantly with all outcomes, the MMSE entered only one of the regression models. Of the other covariates, only age and severity of pain made an additional contribution to the prediction of functional ability for more than 1 dependent variable. Consistent with prior results in several other samples, the ability to use intentions to guide purposeful behavior appears to be an important contributor to everyday functioning among older adults.     

Working together: Editing a book as narrative research methodology

This paper is a multi‐layered account that begins with an overview of narrative inquiry and narrative analysis methodologies, and then leads into an examination of how the process of editing a book can represent an example of narrative research. The author describes how she came to create two books that provide an insider's view of counsellors' role development within the fields of health and rehabilitation. Taking the task of editor a step further, she gathered additional reflexive data from chapter authors once the books were published: these data provide insight into the challenges created by undertaking a project of this kind, in particular the adoption of a reflexive voice. The paper concludes with a discussion of how both projects meet the criteria for narrative inquiry.     

Neuropsychological Functioning and Antiretroviral Treatment in HIV/AIDS: A Review

This article presents a review of studies that have investigated the neuropsychological effects of antiretroviral treatment (ART) for HIV-1 infection. It provides a brief overview of the era of monotherapy, dual-therapy, and an extended overview of the current era of combination antiretroviral therapy (CART). This review highlights that while CART has had a dramatic effect on the incidence and the severity of HIV-associated neurocognitive disorders (HAND), HAND, in its mild form, still remains prevalent. New causes of this sustained prevalence are poor CNS penetration of some antiretroviral agents, drug resistance, poor adherence, potential neurotoxicity, co-morbidities such as the long-term CART side effects in relation to cardio-vascular disease, and chronic HIV brain infection that may facilitate the expression of new forms of neurodegenerative processes. The review emphasizes the need to address methodological limitations of published studies and the need for large and representative cross-disciplinary longitudinal investigations across the HIV illness span.     

Interdivisional Healthcare Committee: Speaking with One Voice on Cross-Cutting Issues in Health Care Psychology

One of the greatest challenges facing psychology in health settings today is the need for unification on critical issues of client access, workforce oversupply, education and training, and outcomes evalutions. Health care psychology specialty areas can no longer afford to operate in parallel. A unified vision is needed to overcome threats to the viability of the profession and to maximize the potential for achieving common goals. The current paper describes the formation of the Interdivisional Healthcare Committee (IHC), whose purpose is to establish a common agenda for promoting the professional, educational, and scientific goals of health care psychology. The IHC's initiative to develop new CPT codes for increasing access to psychologists' services in health care settings is outlined.     

The psychological treatment of memory impairment: A review of empirical studies

Memory impairment is a frequent effect of many different forms of brain dysfunction. Memory impairment is also a frequent focus of treatment interventions, and there have been many different treatment methods suggested. The suggested methods include direct retraining, the use of spared skills in compensating for the impairment (alternate functional systems), and the use of behavioral strategies to circumvent the manifest memory dysfunction (behavioral prosthetics). Unfortunately, there are very few studies comparing the various suggested treatment methods. The present paper evaluates the empirical evidence related to the treatment of memory dysfunction and suggests directions for future investigations. Although the evidence is not conclusive, it appears that some forms of treatment may be helpful in remediating certain types of memory impairment. An approach likely to be productive would include some consideration of the impaired neurological and psychological mechanisms responsible for the manifest memory deficit as well as a consideration of the etiology of the injury thought to be causally related to the memory deficit. As yet, there have been no rigorous empirical evaluations of these considerations.     

Ecological Neuropsychology: An Alternative to the Deficit Model for Conceptualizing and Serving Students with Learning Disabilities

The present paper contends that children with learning disabilities are better served when assessment and intervention are conceptualized within an ecological neuropsychology perspective than within the traditional deficit model perspective, which is the predominant approach to intervention in medical and educational settings. The deficit method conceptualizes problems as within the child, and the major consequence of this approach is that little time is spent analyzing the learning environment or other systems that might impact the child's ability to be successful in an academic setting. Therefore, rehabilitation efforts have had limited success. In contrast, ecological neuropsychology is a strength-based approach that considers the child, as well as the systems within which he/she interacts, when assessing, diagnosing, and intervening with students who are experiencing learning difficulties.     

非失语脑中风患者的神经心理障碍与一年疗效和康复预测的关系

本文以７９例脑中风患者为对象,研究结果如下：１．自编ＡＤＬ,再测信度和结构效度合格。２．一年前后ＡＤＬ、ＤＮＦ及疗效与同期测定的插棍测验、瑞文测验、小棍测验、临摹图形、说同类词及抑郁（一年后）有显著相关。３．初发病时这些指标及图形拼凑测验与一年后ＡＤＬ、ＤＮＦ及疗效也有显著相关。４．ＤＮＦ１和ＡＤＬ１对疗效有明显预测作用,可解释变量的３５％（ＡＤＬ２）、３７％（疗效）和４１％（ＤＮＦ２）。单独心理变量可解释变量的２７％（ＡＤＬ２）、３３％（ＤＮＦ２）和２１％（疗效）。     

Experience-dependent neuropsychological recovery and the treatment of chronic alcoholism

This paper reviews the relationship between cognitive status and treatment outcome in chronic alcoholics, the natural history of recovery, and the role of cognitively oriented remediation programs in facilitating recovery. Seven studies of experience-dependent recovery are described in which behavioral improvement was noted. Various recommendations for treatment over the course of recovery are made, guided by anticipated changes in capacity to process complex information over time.