Ce que soigner veut dire. Le peintre,le patient et le bon samaritain

The hyper-medicalization of our societies and our absolute confidence in curative medicine have made us gradually lose the deep meaning of the words of ailments. Many are now calling on the public authorities to promote a “policy of Care”. The use of anglicisms is certainly “trendy” but opposing “cure” and “care” does not make sense. We invite our readers to try to recover the meaning and the value of the verb to treat and the word care(s), plural and yet so singular. To carry out this quest, we will focus our attention on a few works of art which will perhaps allow us, in three stages, to (re)discover the deep meaning of the care relationship.     

Systematic Review and Meta-Analysis of Stepped Care Psychological Prevention and Treatment Approaches for Posttraumatic Stress Disorder

Stepped care approaches have been developed to increase treatment accessibility for individuals with posttraumatic stress disorder (PTSD). However, despite guidelines recommending stepped care, it is currently unclear how the approach compares to other treatments for PTSD in terms of symptom reduction, cost, and client-rated acceptability. We conducted a systematic review and meta-analysis of randomized controlled and open trials evaluating stepped care prevention (i.e., targeting those with recent trauma exposure at risk of developing PTSD) and treatment approaches for adults and adolescents/children with PTSD. Eight prevention and four treatment studies were included. There was considerable variation in the sample types, stepped approaches, and control conditions. Most studies found no significant differences between stepped care (both prevention and treatment) and control (active and usual care) in terms of PTSD severity, loss of PTSD diagnosis, depression severity, and quality of life at the final follow-up. There was some evidence to suggest that stepped care was more cost-effective, and as acceptable or more acceptable compared to controls. Interpretations were tempered by high statistical heterogeneity, risk of bias, and lack of recommended evidence-based treatments. Stepped care can make PTSD treatment more accessible; however, more high-quality research is needed comparing stepped care to active controls.     

“Oilfield Trash or Oilfield Treasure? A Pastoral Response to Living in the Extraction Economy of the Permian Basin” by Rev. Dr. Dawn Darwin Weaks

The climate crisis is witnessed on a global scale and it is also experienced in the local communities that work in extractive industries. In this article, a pastor in the Permian Basin explores the term “oilfield trash” as it is used for oilfield workers in the Permian Basin, connecting the epithet with the negative conditions for quality of life there, and comparing it to treatment of oilfield workers in Norway. Treatment of workers is identified as essential to esteem of communities and land. Renaming workers “treasure” in keeping with the tradition of Isaiah 62:4 is identified as part of the healing needed for extractive communities to transition away from fossil fuels. Four avenues of congregational ministry within mining economies are identified, with the way of “partnership” with the workers in the industry recommended as offering hope for churches to help relieve the climate crisis.     

Assessing quality of care and observance of human rights in residential mental health facilities in Greece through the WHO QualityRights tool kit

In this paper, we present and reflect upon the process of evaluating two residential mental health facilities in Thessaloniki, Greece, through the WHO QualityRights tool kit. The QualityRights tool kit is a structured process for assessing quality of care and human rights in mental health and social care facilities, in accordance with the United Nations Convention on the Rights of Persons with Disabilities (CRPD), introduced by the World Health Organization in 2012. We have piloted the use of the Toolkit in two supported accommodation facilities, a hostel and a service supervising independent living in apartments, for individuals with long-term severe mental health problems in the region of Thessaloniki. In this paper, we present the methodology and process of evaluating the facilities, including the challenges posed to the evaluation process by restrictions due to the Covid-19 pandemic. We showcase the outcome of this evaluation through presenting a summary of the results and the ensuing recommendations for improvement. Finally, we reflect on the usefulness, appropriateness and relevance of the Toolkit for evaluating mental health care facilities in the particular context of contemporary Greece.     

Never ready: Addictions counselors dealing with client death

This study explored the experiences of addictions counselors who have undergone client death and the immediate and long-lasting impacts of client death on addictions counselors through the consensual qualitative research (CQR) method. We conducted semistructured interviews with 10 participants exploring their lived, in-depth, experiences in working with clients with addictive disorders with focus given to the death of clients and how they responded to the experience. Results from a data analysis process using the CQR method indicate eight domains: (a) professional ethics, (b) coping skills, (c) client care, (d) preparation for profession, (e) experience of addiction, (f) agency impact, (g) exploring the death experience, (h) recommendations, and 28 categories embedded in each of these domains. Implications for counselor education, training, and practice are discussed.     

PROMOTING PARENT-PROVIDER INTERACTION DURING YOUNG CHILDREN'S HEALTH-SUPERVISION VISITS

We prompted parents to increase their interactions with health-care providers during their children's health-supervision visits. Before scheduled appointments we asked parents of 32 infants and young children if they had specific child health questions or concerns. Sixteen parents randomly assigned to the prompted group were then prompted to initiate discussions of their concerns. Sixteen control parents discussed unrelated topics before their appointments. Prompted parents initiated significantly more interactions with health-care providers and more health and behavioral topics were discussed during their appointments. Both parent groups reported satisfaction with health-care services. Further research is needed to determine the clinical significance of outcomes associated with enhanced parent-provider interaction during children's health-supervision visits. These visits are ideal settings for behavioral research on improving health care for children and their families.     

Just health care (I): Is beneficence enough?

Few in our society believe that access to health care should be determined primarily by ability to pay. We believe instead that society has an obligation to assure access to adequate health care for all. This is the view explicitly endorsed in the President's Commission Report Securing Access to Health Care. But there is an important moral ambiguity here, for this obligation may be construed as being either beneficence-based or justice-based. A beneficience-based construal would yield a much weaker obligation with respect to the distribution of health care. In the first section of this paper I argue that the President's Commission is committed only to this weaker construal of this obligation. In the second section I argue that such a beneficence-based obligation is really rooted in a libertarian conception of justice, similar to that recently articulated by Engelhardt, and that this conception is seriously flawed when it comes to effecting a just distribution of health care.     

When is enough enough? We are only beginning

Sheridan (1995) presents the problem of the psychologist consulting to a medical residency program as an example of the difficulty one experiences in attempting to challenge, even from a data-based perspective, the calcification inherent in health systems and medical education in particular. This paper responds to her challenging questions, “How much should we get involved in changing health care and medical education, and at what level (local, national) should psychology intervene (if at all)?” It is suggested that psychologists pick up the challenge to bring about change, whenever possible, with the admonition—we are only beginning.     

Clinical psychology in medical settings: Psychology's role in health care

The number of clinical psychologists working in medical settings has grown along with the range of services provided by psychologists to patients with a multitude of medical problems across the lifespan. Medical care cost savings brought about by these psychological interventions is highlighted along with issues of public policy and specialization of training. The opportunity for ongoing development of clinical psychology in medical settings is described as unlimited and the mission of the newJournal of Clinical Psychology in Medical Settings is presented as supporting that growth.