Psychoanalysis is becoming an impossible profession within the public welfare system in Sweden

Abstract

The preconditions for psychoanalytic practice within the Swedish public welfare system are analyzed in this article. Psychoanalysis remains a one-to-one treatment and relies on the analyst's capacity to use his or her own subjective response. The development of the psychoanalytic process is dependent on unconscious reality, making it impossible to work with a model that has a strict relation between diagnosis, treatment method, and result. Objectivity and the desire to predict treatment outcomes characterize the immanent logic in the complex system of laws and recommendations that affects most practices within the field of medicine. As a consequence of this development, psychoanalysis and psychodynamic therapy are marginalized, since our treatment methods are not adapted to the present industrialization and economization of the medical health sector, with the result that the preconditions for psychoanalytic training have changed dramatically. The exclusion of psychoanalysis from the national health insurance scheme is a demanding challenge at a time when the Swedish welfare model is undergoing fundamental changes.     

Measuring adaptability demands of jobs and the adaptability of military and civilians

Jobs within the military and in civil society differ in character and requirements. It is assumed that differences in job types both within civil and military domains require different dimensions of adaptability competency. The present study investigates this assumption. The Dutch Adaptability Dimensions And Performance Test (D-ADAPT) was used to measure both the adaptability demands of jobs, and of self-assessed adaptability competency of employees. In addition, the predictive value of certain personality traits (openness, neuroticism, and conscientiousness) and other relevant personal characteristics (cognitive flexibility, learning goal orientation) on various adaptability dimensions was explored. Military personnel were found to estimate their adaptability competency as higher than civilians did. With respect to the civilian jobs, the adaptability demands varied across job types. This was not found in the set of military jobs, possibly due to a smaller variety of jobs included. This study also shows that a variety of personal characteristics predict different dimensions of adaptability. Cognitive flexibility was found to be the best predictor for adaptability in general. Openness turned out to be a good predictor within the civilian group, whereas neuroticism was a better predictor within the military group. Results of this study contribute to a better understanding of work adaptability and influencing personality characteristics. Practical implications for selection and training of personnel can be derived, based on the acquisition of adaptability competency that matches the type of job.     

Ethical Issues in Psychologists' Professional Practice: Agreement Over Problematic Professional Behaviors Among Spanish Psychologists

A sample of 703 Spanish psychologists completed an online survey containing 114 behaviors related to professional practice in different areas. The aim of the study was to learn which professional behaviors create ethical dilemmas most often for psychologists and how they respond to these issues. Findings suggest that psychologists who have actually faced a particular dilemma are less strict on judging the inappropriateness of a possible ethical transgression than those psychologists who have not experienced it. Also, four clusters can be identified according to the attitude of respondents toward the dilemmas, namely “rejection,” “aprioristic,” “utilitarian,” and “no conflict.”     

Professional Boundary Ethics Attitudes and Awareness Among Nurses and Physicians in a University Hospital in the Kingdom of Saudi Arabia

This study sought to gauge ethical attitudes about professional boundary issues of physicians and nurses in the Kingdom of Saudi Arabia. Respondents scored 10 relevant boundary vignettes as to their ethical acceptability. The group as a whole proved “aware/ ethically conservative,” but with the physicians' score falling on the “less ethically conservative” part of the spectrum compared to nurses. The degree of ethicality was more related to profession than to gender, with nurses being more “ethical” than physicians.     

Book Review: Managing Mental Health in the Community: Chaos and Containment

Abstract

The British Association of Counselling first introduced a Code of Ethics and Practice for Counsellors in 1984. It has subse-quendy been revised three times. The codes have to be sufficiently broad to be accepted by the membership of BAC, who come from a wide range of theoretical backgrounds. Inevitably this means that the codes do not satisfy everyone nor do they resolve all ethical dilemmas. This paper focuses on sections of the codes which are unsatisfactory, or inadequate for psychodynamic counsellors. It also looks at the influence of psychodynamic counsellors in changes to the clauses on sexual exploitation. Finally the absence of any mention of dual and multiple relationships is discussed.     

A Draft Model Aggregated Code of Ethics for Bioethicists

Bioethicists function in an environment in which their peers—healthcare executives, lawyers, nurses, physicians—assert the integrity of their fields through codes of professional ethics. Is it time for bioethics to assert its integrity by developing a code of ethics? Answering in the affirmative, this paper lays out a case by reviewing the historical nature and function of professional codes of ethics. Arguing that professional codes are aggregative enterprises growing in response to a field's historical experiences, it asserts that bioethics now needs to assert its integrity and independence and has already developed a body of formal statements that could be aggregated to create a comprehensive code of ethics for bioethics. A Draft Model Aggregated Code of Ethics for Bioethicists is offered in the hope that analysis and criticism of this draft code will promote further discussion of the nature and content of a code of ethics for bioethicists.     

The Use of Metaphors with African-American Couples

SUMMARY

There is a dearth of data in the literature on African-American couples. This omission probably reflects the assumption that interventions that are effective with one race are effective with others. This paper explores the use of metaphor as a tool for working with an underserved and neglected population. Since the African-American culture is extensive in its use of metaphor, this medium provides a fertile channel for therapeutic communication.     

Sources of influence on the professional development of psychologists and psychiatrists in Norway and Germany

Background: There are many professional psychotherapists, but no psychotherapy profession. The psychotherapists’ professions vary between countries, the most frequent being psychiatry and clinical psychology.

Aim: As these professions have different basic training and also may be impacted differently by other factors, we wanted to study potential differences as to perceived influences on their development as psychotherapists across career level, theoretical orientation, and gender.

Methods: More than 2500 Norwegian and German psychiatrists and psychologists reported data on their professional development in the DPCCQ/2000, a lengthy multi-part survey instrument developed within the ‘Collaborative Research Network’ of the Society for Psychotherapy Research. The four groups were compared for differences, and a series of multiple regression analyses were conducted to examine the impact of profession on a variety of aspects of therapist experiences.

Results: Although a few therapist experiences (e.g. teaching, treating patients, institutional conditions) had a significantly different impact between the two professions, as a main effect, they only accounted for less than 1% or the variance.

Conclusion: Profession seems to have little influence on perceived development as a psychotherapist, and it is reasonable to conclude that other therapist qualities, often personal qualities, are more important for therapeutic processes and outcomes.     

Narrative counselling with a young engineer

This case study applied a narrative approach to develop the sense of self as a career resource for a young male engineer in his first working year. The participant client attended eight sessions lasting 60 to 90 minutes each over a period of five months. The case sessional data were thematically analysed. Following the intervention, the participant displayed career strengths of willingness to deal with challenges, enhanced adaptability strategies and volition to elect preferred work setting. He also displayed an enhanced future orientation. Narrative counselling appeared to support career adaptability development.     

Career adaptability, turnover and loyalty during organizational downsizing

During organizational restructuring and downsizing, employees often worry about being redundant, actually are redundant, and/or feel unsatisfied with their jobs. Employees, in turn, often react with poor loyalty to and high voluntary exit from the organization. The current study addresses this process from a careers' perspective, showing that career adaptability in the form of employees' career exploration and planning can account for at least some of these relationships. Redundancy fostered employees' career adaptive behaviors while job insecurity inhibited their career planning. Career planning, in turn, positively predicted employees' loyalty to the organization five months later while career exploration negatively predicted employees' loyalty, and positively predicted employees' exit reactions in the form of turnover intentions, job-search behaviors, and actual turnover. Implications and directions for future research are discussed.