Democracy,Equality and Toleration

In this paper I comment on a recent “letter” by Burleigh Wilkins addressed to nascent egalitarian democracies which offers advice on the achievement of religious toleration. I argue that while Wilkins’ advice is sound as far as it goes, it is nevertheless underdeveloped insofar as his letter fails to distinguish two competing conceptions of toleration – liberal-pluralist and republican-secularist – both of which are consistent with the advice he offers, but each of which yields very different policy recommendations (as can be seen by consideration of The United States v. Lee in America and, I’affaire du foulard in France). I argue that a democratic society of equals must be committed to liberal-pluralist rather than republican-secularist toleration. Some material in this paper is drawn from Catriona McKinnon, Toleration: A Critical Introduction (London: Routledge, 2006). This paper was written during a Fellowship on the Philosophy Program, School of Advanced Study, University of London. I am grateful to the University of York for a sabbatical term, and the Leverhulme Trust for a Study Abroad Fellowship, during which this paper was written. I would like to thank John Horton and Cécile Laborde for very useful written comments, and two anonymous referees for The Journal of Ethics for their reports.     

Book Discussion Section: COMPARATIVE ETHICS,ISLAM, AND HUMAN RIGHTS: Internal Pluralism and the Possible Development of Tradition

Dialogue with three major Muslim authors shows that Islam can take a positive stance toward human rights while also presenting differing interpretations of the meaning and scope of rights. Because of their subordination of norms reached through reason to those drawn from faith, as well as negative experiences of the impact of Western colonization of parts of the Muslim world, Abul A‘la Maududi and Sayyid Qutb place significant restrictions on rights of conscience. 'Abdolkarim Soroush's positive support for the role of reason in Islamic faith and his less‐negative assessment of the West lead him to more vigorous support for the human rights agenda. This study raises the question of whether the humility needed in comparative ethics and the respect for others at the root of human rights are necessarily linked.     

Interventions to Empower Adults with Eating Disorders and Their Partners around the Transition to Parenthood

The transition to parenthood is perceived as a stressful life event, when parents experience an immense change of their psychological focus and a reorientation of roles and responsibilities in the family system. This process may be even more challenging in the presence of a parental eating disorder history. This paper reviews the impact of parental eating disorders on the parents, the couple relationship, and their child during the perinatal period. A parental eating disorder is associated with more negative expectations of parental efficacy as well as specific difficulties in couple communication over the child’s feeding, shape, and weight. Providers who better understand the effects of an eating disorder on parental functioning can more effectively intervene early on. We also present couple- or parent-based, empirically supported interventions for adults with eating disorders and their partners in the prenatal and postnatal periods: Uniting Couples in the treatment of Anorexia Nervosa (UCAN) and Uniting couples In the Treatment of Eating disorders (UNITE) both enhance recovery from the eating disorder through a couple-based intervention; the Maudsley Model of Treatment for Adults with Anorexia Nervosa (MANTRA) incorporates the support of partners, when appropriate; Parent-Based Prevention (PBP) focuses on improving parental functioning and reducing risk of negative parental and child outcomes. Finally, we discuss the clinical implications of addressing parental eating disorders and encourage more research on these families.     

Relative Cost Effectiveness of In-Person and Internet Interventions for Relationship Distress

While the efficacy of couple therapy has been repeatedly demonstrated, most distressed couples do not seek treatment. To improve reach and overcome barriers to therapy, Integrative Behavioral Couple Therapy (IBCT) was translated into a web-based program, OurRelationship (OR). While both IBCT and OR have been shown to improve relationship and individual functioning, the goal of the present study was to compare the relative cost effectiveness of these two treatment modalities. In IBCT, 74% of couples experienced reliable improvement, compared to 55% of couples in OR. Within-group Cohen's d effect sizes during treatment for relationship satisfaction were d = 0.87 for IBCT and d = 0.96 for OR. Relative cost effectiveness analyses revealed that even at the highest expense estimates for OR and the lowest expense estimates for IBCT, OR was more cost effective in creating reliable improvement once at least 229 couples were served and was more cost effective in creating large-size effects once at least 153 couples were served. Cost-effectiveness increases for both IBCT and OR as more couples are served; however, this cost savings occurs at a much more rapid rate for OR. These findings demonstrate that despite higher initial development costs, Internet programs are a cost-effective option for dissemination either as a stand-alone service or as an initial intervention in a stepped care model with more intensive in-person services.     

Family Science in the Context of the COVID-19 Pandemic: Solutions and New Directions

The coronavirus disease 2019 (COVID-19) pandemic has precipitated substantial global disruption and will continue to pose major challenges. In recognition of the challenges currently faced by family scientists, we share our perspectives about conducting family research in the context of the COVID-19 pandemic. There are two primary issues we address in this article. First, we present a range of potential solutions to challenges in research, resulting from the pandemic, and discuss strategies for preserving ongoing research efforts. We discuss approaches to scaling back existing protocols, share ideas for adapting laboratory-based measures for online administration (e.g., using video chat platforms), and suggest strategies for addressing missing data and reduced sample size due to lower participation rates and funding restrictions. We also discuss the importance of measuring COVID-19 relevant factors to use as controls or explore as moderators of primary hypotheses. Second, we discuss how the COVID-19 pandemic represents a scientifically important context for understanding how families adjust and adapt to change and adversity. Increased stress precipitated by the pandemic, varying from acute stress associated with job loss to more chronic and enduring stress, will undoubtedly take a toll. We discuss ways that family scientists can contribute to pandemic-related research to promote optimal family functioning and protect the health of family members.     

Expanding Possibilities: Flexibility and Solidarity with Under-resourced Immigrant Families During the COVID-19 Pandemic

The novel coronavirus has added new anxieties and forms of grieving to the myriad practical and emotional burdens already present in the lives of underserved and uninsured immigrant families and communities. In this article, we relate our experiences since the COVID-19 crisis to the lessons we have learned over time as mental health professionals working with families in no-cost, student-managed community comprehensive health clinics in academic-community partnerships. We compare and contrast the learnings of flexibility of time, space, procedures, or attendance we acquired in this clinical community setting during regular times, with the new challenges families and therapists face, and the adaptations needed to continue to work with our clients in culturally responsive and empowering ways during the COVID-19 pandemic. We describe families, students, professionals, promotoras (community links), and IT support staff joining together in solidarity as the creative problem solvers of new possibilities when families do not have access to Wi-Fi, smartphones, or computers, or suffer overcrowding and lack of privacy. We describe many anxieties related to economic insecurity or fear of facing death alone, but also how to visualize expanding possibilities in styles of parenting or types of emotional support among family members as elements of hope that may endure beyond these unprecedented tragic times of loss and uncertainty.     

Psychotherapy as a skilled practice

While psychotherapy is related to both science and art, it is primarily a craft activity requiring the development of skilful practice, epitomized by the discipline of the analytic attitude. In terms of the forms of knowledge outlined by Aristotle, this places psychotherapy in the realm of ‘technê’ (arts and craft) rather than epistêmê (science). In particular, the technê of psychotherapy is concerned with the development of phronesis (practical wisdom) in both patient and analyst and its ultimate aim is concerned with the promotion of eudaimonia, a state of well-being considered by Aristotle to be definitive of ‘the good life’. It is therefore fundamentally an ethical endeavour. The nature of psychotherapeutic skill is illustrated by analogy with three other forms of technê – music, meditation and pottery. Clinical examples illustrate the crafting of interpretations and the art of patient holding.