SOME ETHICAL CONSIDERATIONS OF SHORT-TERM WORKSHOPS IN THE PRINCIPLES AND METHODS OF BEHAVIOR MODIFICATION1

Workshops and seminars to expose different sectors of the professional community to the principles and applications of behavior modification are briefly discussed. The possible misapplication of procedures by conference participants, whose only exposure to behavioral methods has been at these workshops is viewed as a potentially serious ethical issue. It is suggested that the goals of such seminars and workshops must be clarified, and methods of evaluation of the participants' skills devised, lest we contribute to the misapplication of procedures and to the criticism that behavioral methods are unethical approaches to treatment.     

Developmental and Adjustment Issues of Gay, Lesbian, and Bisexual Adolescents: A Review of the Empirical Literature

Various studies have reported adjustment problems experienced by gay, lesbian, and bisexual (GLB) adolescents. A primary purpose of this paper is to critically review this literature. Difficulties that have been studied include past suicide attempts, substance use and abuse, conduct problems, and academic concerns. For example, a considerable number of GLB youth report a history of suicide attempts, with prevalence rates ranging from 11 to 42%. However, among other methodological concerns, studies in this area have not used a comparison sample of heterosexual youths. Characteristics of development particular to GLB adolescents are described, the empirical research on adjustment issues is reviewed, and potential risk and protective factors for GLB youths are discussed.     

Neuropsychological rehabilitation after brain injury: Scientific and professional issues

Neuropsychological rehabilitation after acquired brain injury is an important contribution to our health-care system. Despite a growing database which supports its clinical utility, the insurance coverage for this form of care is now being threatened. This paper addresses some of the professional and scientific issues that psychologists need to face in order to continue to provide these services.Invited Address, President's Mini-Convention To Your Health: Psychology Through the Life Span, American Psychological Association Convention, New York, August 12, 1995.     

FINDING THE SOMETHING IN NOTHING

Formless Infinity: Clinical Explorations of Matte Blanco and Bion. By Riccardo Lombardi. Translated by Karen Christenfeld, Gina Atkinson, Andrea Sabbadini, and Philip Slotkin. London/New York: Routledge, 2016. 282 pp.     

High School Girls’ Experience of Victimization by Boys: Where Sexual Harassment Meets Aggression

School-based research into sexual harassment, on the one hand, and aggression (including bullying) on the other, originate from different disciplinary traditions, but are beginning to connect. We examined whether the sexual harassment of high school girls by boys can be regarded as a form of aggression. Year 8 to 10 girls from 5 coeducational high schools (N = 679) responded to a 24-item version of the Direct and Indirect Aggression Scale, including 6 new sexually toned items; participants indicated how often they experienced each behavior. Principal components analysis identified 4 components: direct aggression, psychological aggression, cyberbullying, and sexual harassment. The latter included the more intrusive sexually toned behaviors, whereas verbal sexualized insults were a component of psychological aggression—the component that most strongly undermined girls’ sense of safety at school. Research and policies on school peer victimization need to explicitly include sexual aspects, in recognition of the harmfulness of such “everyday” psychological aggression.     

Balancing Legitimate Critical-Care Interests: Setting Defensible Care Limits Through Policy Development

Critical-care decision making is highly complex, given the need for health care providers and organizations to consider, and constructively respond to, the diverse interests and perspectives of a variety of legitimate stakeholders. Insights derived from an identified set of ethics-related considerations have the potential to meaningfully inform inclusive and deliberative policy development that aims to optimally balance the competing obligations that arise in this challenging, clinical decision-making domain. A potential, constructive outcome of such policy engagement is the collaborative development of an as-fair-as-possible dispute resolution process that incorporates an appropriated-justified, defensible critical-care obligation threshold.     

The Ethics of Organ Donor Registration Policies: Nudges and Respect for Autonomy

Governments must determine the legal procedures by which their residents are registered, or can register, as organ donors. Provided that governments recognize that people have a right to determine what happens to their organs after they die, there are four feasible options to choose from: opt-in, opt-out, mandated active choice, and voluntary active choice. We investigate the ethics of these policies' use of nudges to affect organ donor registration rates. We argue that the use of nudges in this context is morally problematic. It is disrespectful of people's autonomy to take advantage of their cognitive biases since doing so involves bypassing, not engaging, their rational capacities. We conclude that while mandated active choice policies are not problem free—they are coercive, after all—voluntary active choice, opt-in, and opt-out policies are potentially less respectful of people's autonomy since their use of nudges could significantly affect people's decision making.     

Culture, Health, and Financial Appraisals: Comparison of Worry in Older Japanese Americans and European Americans

There is limited understanding of the potential impact of cultural identification and values on the emotional experiences of older adults. This study considered potential differences in worry based on culture and acculturation type. The study also evaluated differences in worry based on self-appraisals of perceived health and financial status. Sixty-six older community-based Japanese Americans (JAs) and 65 older European Americans (EAs) completed the Penn State Worry Questionnaire (PSWQ) and the Worry Scale–Revised (WSR). Cultural differences were not found. Social desirability scores were elevated, particularly among JAs who had been relocated to internment camps during World War II. Irrespective of cultural status, elevated average daily worry frequency scores and WSR–Health scores were found in the group who perceived their health status to be poor/fair. Irrespective of cultural status, elevated average daily worry frequency scores, PSWQ scores, and WSR–Financial scores were found in the group who perceived their financial status to be poor/fair. Recommendations for using the WSR with older populations are discussed.     

“Heartbreaking” Referrals,Professional “Disgrace”: The Impact of Medicare Ineligibility on the Counseling Profession

To better understand the impact of the Medicare mental health coverage gap, the authors analyzed survey data provided by 1,859 members of the American Counseling Association using a conventional qualitative content analysis. One overarching theme, direct impact of Medicare policy on the counseling profession, is presented, along with 3 thematic categories: emotional impact on providers, economic toll on providers, and negative influence on profession's credibility. Implications for the counseling profession are discussed.