The Nature and Meaning of the Near-Death Experience for Patients and Critical Care Nurses

This study was designed to develop a conceptual framework for the near-death experience (NDE), reflecting its nature and meaning for the patient and the critical care nurse. The study used naturalistic inquiry to examine the question: What is the nature and meaning of an NDE and how has it influenced the individual's view of the self, the future, and feelings and beliefs about life and death? The NDE Scale (Greyson, 1983) was used with patients and semi-structured interview guides were used with both nurses and patients to explore the NDE from a comprehensive perspective. An NDE was defined as the report of “unusual” recollections associated with a period of unconsciousness during either serious illness or injury, or resuscitation from a cardiac or respiratory arrest. The sample included 12 patients who experienced an NDE and 19 nurses who cared for patients who experienced NDEs. This study highlighted the emotional aspects of the NDE. Patients described how the NDE transformed their lives and nurses reported how their experiences with patients changed them personally and professionally.     

Fostering Client Creativity in Family Therapy: A Process Research Study

Creativity has been shown to enhance problem solving, and to increase flexibility and adaptability—qualities associated with positive therapeutic outcomes. Literature related to therapist and/or client creativity is primarily anecdotal. Empirical literature addressing how therapists can facilitate the creativity of their clients in family therapy is scarce. In this study, the researchers used process methodology to code the behavior of therapists and clients in 31 videotaped family therapy sessions. Results show a significant positive correlation between interventions that induce positive affect and the creative client behaviors of optimism and playfulness.     

A Research Tool to Increase Attention to Experimental Materials: Manipulating Presentation Format

Experimental approaches require researchers in a variety of applied business disciplines to design experimental materials. This research is often busy and difficult to secure high-level professionals; thus, researchers must ensure sufficient attention to experimental materials to provide usable data. The current study suggests an experimental design feature to encourage participants to thoroughly process information contained in experimental materials. Based on Reynolds' (1992) selective attention strategy (SAS) model, variations in presentation format were expected to influence the relative salience of information presented. Two aspects of presentation format were manipulated to increase salience: display (paragraph vs. bullet point) and typeface (standard vs. bold underlined). Results indicate display improved ability to retrieve information, but typeface did not. Implications for the design of experimental materials are discussed.     

Ecological Momentary Assessment Research in Behavioral medicine

Behavioral medicine research often seeks to examine relatively complex theoretical models and clinical processes. Traditional designs, based on retrospective self-report in the natural environment or laboratory-based studies, cannot assess complex and temporally dynamic psychological, behavioral, and physiological processes in the natural environment. An alternate research approach, Ecological Momentary Assessment (EMA), provides a method to collect such data. This research approach and these data allow investigation of a number of research questions not amenable to other data collection methods. Examples of research questions uniquely suited for EMA data include, but are not limited to: (1) the comparison of retrospective data to momentary data; (2) evaluation of physiological and psychosocial processes in the natural environment; (3) the relation of symptoms and other disease processes to characteristics of the natural environment; and (4) examination of dynamic changes in psychosocial variables that may mediate improvement following treatment. Despite the strengths of EMA data, a number of challenges exist – including logistic, analytic, and interpretation problems – to the easy implementation of EMA approaches in behavioral medicine.     

Using action research to develop an assessment system in a voluntary sector counselling service

Voluntary sector low and no cost counselling services very often find themselves overwhelmed by clients. This paper describes how one agency decided to deal with this problem by introducing a system of assessment for differential contracts. A piece of action research enabled the development and introduction of a model of assessment that reflected the values of the agency. The guiding principle of the assessment was that the client's way of managing in the world was the best guide to clinical need. The different lengths of contract are described, together with the criteria for deciding which might be appropriate for a client. The model was introduced on the understanding that it could and would be continuously monitored. The reactions of counsellors and clients that were gathered in a review of the working of the model a year later are described.     

Cultural diversity: Mapping the experiences of students on an international counsellor training programme

This research study explores one part of a diverse counselling training landscape in the shape of an international postgraduate education and training programme for counsellors. The research sample includes participants from Tanzania, the Gambia, Ghana, Nigeria, Indonesia, China, Taiwan, Iceland, Japan, Greece, Portugal, Lebanon and Saudi Arabia. Cultural diversity is examined in relation to the learning and development of international counselling students. Qualitative analysis of interview data is used to identify issues related to student expectations, the process of becoming a counsellor and student learning outcomes. Some issues in counsellor training appear to be shared across all international students, while other issues arise from specific cultural backgrounds of students. The implications of these findings are discussed.     

Daydreaming, Consciousness, and Self-Representations: Empirical Approaches to Theories of William James and Sigmund Freud

In honor of Saul Rosenzweig's lifelong efforts to provide empirical tests of psychoanalytic theories, this paper has focused on a series of research approaches to examining the concepts of William James and Sigmund Freud relating to waking fantasy, ongoing thought, and beliefs about the self. Studies involving projective methods, psychometric analyses of self-report questionnaires, laboratory tests of daydreaming during signal-detection tasks, thought-sampling during natural daily activities and psychological correlates of actual-self and ideal-self discrepancies are described. Clinical applications of these methods are also presented. The findings in general point to the value of James's conception of conscious thought as an important basis along with cognitive unconscious processes for studying clinical phenomena, personality, and even the metaphors of dreams. Rosenzweig's emphasis on formal research testing of psychoanalytic processes is supported.     

A reassessment of psychoanalytic education: Controversies and changes2

To understand the many controversies surrounding psychoanalytic education, it is necessary first to understand the unique role played by education in our field where control of educational structures remains the most important measure of professional success for the majority of psychoanalysts. To keep debate about educational policy focused on the task of strengthening the intellectual basis of psychoanalysis, it is also necessary to understand that forces affecting education arise from at least three different domains which can too easily become confused with one another: 1) the domain of knowledge‐ intellectual, scientific and clinical; 2) the domain of the organized professional community; and 3) the domain of local institutional politics. The authors explore controversy arising within and among each of these domains. They also explore the major alternatives proposed to the Eitingon model of psychoanalytic education, arguing that excessive authoritarianism in education arises not from the existence of hierarchical structures per se (as suggested by the ‘French model’), but from two other factors: the condensation of all important professional functions into the single ‘monolithic’ position of the training analyst, and the lack of agreed upon methodology for determining the validity of theoretical propositions. The solution lies not in obliterating all gaps in expertise and status by doing away with hierarchical structures altogether, but rather in strengthening the intellectual, scholarly and research context within which psychoanalytic education takes place. We must attempt to relocate our experience of a gap where it belongs: not between those who are training analysts and those who are not, but between what we feel we already know about mental life and what we do not yet know.     

Pragmatism, Pluralism, and Psychotherapy Relationships: An Interview with John C. Norcross, Ph.D.

John C. Norcross has made significant contributions in the areas of the transtheoretical model of change, psychotherapy integration, and empirically supported psychotherapy relationships. This interview explores the contributions of pragmatic philosophy and his personal upbringing to his work as a psychotherapy researcher and practitioner. Dr. Norcross discusses the status of the psychotherapy integration movement, the work of the Task Force on Empirically Supported Psychotherapy Relationships, and future trends in psychotherapy over the next 25 years. He emphasizes the importance of a methodological rigor that recognizes the unique characteristics of the psychotherapy relationship. He describes his current interest in the psychotherapy of psychotherapists, illustrating it with his personal challenges in balancing work and home.