行为社会政策：“助推”公共福利的实践与探索

行为社会政策是基于人的行为特点而设计, 使用“助推”作为政策工具来执行的社会政策。它是行为科学在社会政策范畴的应用, 其原理在于洞察人们做选择时的行为偏好, 以隐性且非明显经济刺激的方式谋求公众利益。从政策制定者的角度出发, 基于自愿性和信息性的统一, 可将行为社会政策中的助推策略分为增加策略、减少策略和转换策略; 三大策略被用于再住院率、儿童健康、社区养老、入学资助、就业问题、器官移植和精准扶贫等民生领域, 帮助人们做出更好的选择, 提高公共福利。作为一种新兴的方法和技术, 助推并非万能, 需要政策制定者对症下药、精确识别、权衡使用, 规避“行为官僚”, 才能真正实现国家治理现代化和社会利益最大化。     

心理咨询过程-效果研究现状及展望

心理咨询过程-效果研究考察咨询过程变量对咨询效果的影响。以人为中心流派、认知流派、行为流派、精神分析流派等都为该研究领域提供了理论基础。主要研究内容有咨询师的反应方式、会谈中的当事人行为、工作同盟、会谈中的重要内容等过程变量与效果的关系。该领域积累的成果还不多,这可能与过程-效果关系本身的复杂性有关,同时研究方法尚有许多欠缺,如考察复杂关系时使用的研究设计过于简单、测量工具不统一导致结果难以比较,有些测量工具不成熟信效度不高。未来的研究除了努力克服这些问题外,还应多考虑理论构建、内隐变量的调节和中介作用、当事人变量,在研究方法上应更为综合和多样化     

结果的接近性对正性结果评价影响的电生理证据

结果的接近性是指对已发生事件的实际结果与在心理上的理想结果或期待结果之间差距的接近程度。实验采用事件相关电位技术和类老虎机赌博任务探讨了结果的接近性对正性结果评价的影响。(1)行为评定结果表明, 结果的接近性不同水平诱发了不同的情绪体验, “差一点输”的赢钱使被试更多感到庆幸, “最理想”的赢钱使被试感到高兴; 结果的接近性也影响了随后trial的反应时, 与“一般”的赢钱和“最理想”的赢钱相比, “差一点输的”赢钱后的下一个trial中被试的反应时明显变长。(2)脑电结果表明, 结果的接近性不同水平诱发了不同的FRN和P300, 与“一般”的赢钱和“最理想”的赢钱相比, “差一点输”的赢钱诱发了波幅更大的FRN和波幅更大潜伏期更长的P300。这说明结果的接近性明显地影响了正性结果的认知评价加工。     

The Effects of Intent,Outcome, and Causality on Moral Judgments and Decision Processes

Over the past decade, moral judgments and their underlying decision processes have more frequently been considered from a dynamic and multi-factorial perspective rather than a binary approach (e.g., dual-system processes). The agent’s intent and his or her causal role in the outcome–as well as the outcome importance–are key psychological factors that influence moral decisions, especially judgments of punishment. The current research aimed to study the influence of intent, outcome, and causality variations on moral decisions, and to identify their interaction during the decision process by embedding the moral scenarios within an adapted mouse-tracking paradigm. Findings of the preregistered study (final n = 80) revealed main effects for intent, outcome, and causality on judgments of punishment, and an interaction between the effects of intent and causality. We furthermore explored the dynamics of these effects during the decision process via the analysis of mouse trajectories in the course of time. It allowed detecting when these factors intervened during the trial time course. The present findings thus both replicate and extend previous research on moral judgment, and evidence that, despite some ongoing challenges, mouse-tracking represents a promising tool to investigate moral decision-making.     

Depression and cognitive sequelae registered within the first year among young Danish TBI survivors

The aim of the study was to determine the proportion of depression and cognitive sequelae among young (15-30 years) Danish TBI survivors referred to interdisciplinary evaluation through a nationwide government-initiated health initiative. The cross-sectional study is based on data from the “Danish register for young adults with acquired brain injury” on TBI survivors included from October 2013 to December 2016. The main measures were Major depression inventory, Trail making test A and B, Fluency, Word learning with selective reminding, Matrix reasoning, Coding and Glasgow outcome scale - extended (GOS-E). During the study period, 131 young TBI survivors were referred to one of five national outpatient clinics. Ninety-six had complete data and of these 14.6% fulfilled the ICD-10 diagnostic criteria for depression and 34.4% had cognitive sequelae. An association was found between depression and cognitive sequelae (p = 0.004). Patients with both depression and cognitive sequelae (n = 10) had a significantly lower mean score on GOS-E (p = 0.0001). Depression and cognitive sequelae were frequent and associated with a poorer global functional outcome among young TBI survivors referred within a year after trauma. This finding and the notion that only 20% of the expected TBI population was referred to this nationwide health initiative indicate an unacknowledged need for interdisciplinary follow-up.     

THE TOTALITARIAN STATE OF MIND

The paper describes the development of Dynamic Interpersonal Therapy for use with complex depression (DITCC), and a pilot study testing DITCC’s effectiveness. The pilot found large pre-post improvements in well-being and distress; moderate rates of reliable improvement and clinically significant change; and curvilinear declines in depression and anxiety. Treatment completers and near-completers (N= 19) showed a significant curvilinear decline in symptoms of depression (PHQ-9) and anxiety (GAD-7). The results provide preliminary evidence that DITCC can be used as an effective treatment approach for complex depression. However, further research is needed to test its effectiveness in different settings with a larger sample size, using appropriate comparison groups under controlled conditions to further elaborate the short-term and long-term effects.     

Action Research on Meaning-Making at Residents' Meetings for Local Disability Policy1

This is the third in a series on residents' meetings (RMs) for municipal disability policymaking in Japan; members included people with disabilities (PWDs). I focused on members' meaning-making process for three community organizational goals: task, process, and relationship. Action research was employed in all three studies during my participation in RMs, which began in 2002. The present study is a follow-up on the meetings' development and covers 2013 to 2019. Meetings were divided into three phases: (a) use of the annual symposium to inform a broader audience about disability policies; (b) appreciation that PWDs can play active roles as supporters of others, especially other PWDs; and (c) recognition that contradiction and dilemma are present in attempts to provide “universal” social equipment for social minorities. The three goals were interrelated through uncertainty and vagueness of RMs; however, it enabled the members to interpret their multifaceted disability-related experiences. PWDs realized their power to help others and developed disability identities through intensive discussions, while they realized the difficulty of social acceptance of their power and the limited solidarity among PWDs.     

THE ‘OTHER 23 HOURS’: SPECIAL PROBLEMS OF PSYCHOTHERAPY IN A ‘SPECIAL’ HOSPITAL

In this paper, I describe and discuss the complexities of being a therapist in a maximum security forensic psychiatric hospital, working with patients who have committed acts of serious violence, and who also suffer from severe mental illness and personality disorders. I suggest that profound disturbances in the patient's inner world get played out in triangular disputes between the patient, the therapist and other professionals working in the hospital. I also describe how real events in the life of the institution impact on the therapeutic process, and the importance for the therapist of reflection on the ‘other 23 hours’ that the patient lives outside of therapy. Finally, I raise some ethical dilemmas that arise for therapists working in such settings, where the stated therapeutic aim is not only treatment but also the containment and prevention of future violence.     

Book Review Correspondence

Stanley Rothman, David J. Rothman, and Stephen P. Powers, Reply to TomBryder's Review of Hollywood's America
Tom Bryder, Rejoinder to Rothman, Rothman, and Powers