Tainted therapy and mistaken memory: Avoiding malpractice and preserving evidence with possible adult victims of childhood sexual abuse

Recent malpractice cases reflect increased liability for psychotherapists working with possible adult victims of childhood sexual abuse. These cases have related to recovery of past memory of abuse and the fashion in which the therapist managed the recovery and treatment. Ways in which therapists may harm clients by omission and commission are explored. The emerging lack of clarity between investigative and therapeutic interviews is discussed. False memory is considered in relationship to malpractice liability, standards of care, and attempts to preserve potential evidence. The author proposes written informed consent and investigative interviewing procedures for working with potential memory recovery cases. Formats for general informed consent to psychotherapy for patient record keeping of newly emergent material are appended.     

基于认知特性的信息显示方式

大规模信息的不断涌现使目前的WIMP界面显示方式已无法满足信息显示的要求,同时也给人们处理和理解信息带来极大的困难.本文从认知工效学的角度,深入分析了目前WIMP界面中信息显示与交互方式所存在问题及其原因,并对近年来信息可视化领域中出现的焦点与场景(focus+context)显示技术作了简要的介绍,进一步分析了该技术所面临的挑战.     

Defining and Measuring Mechanisms of Change in Psychological Therapies: The Path Not Taken

Metcalf and Dimidjian (this issue) have provided an important review of the current evidence base for mindfulness‐based cognitive therapy (MBCT) and presented a helpful summary of the proposed mechanisms of change. It is necessary to engage in a continuous dialogue regarding the evidence base for change mechanisms, and the article by Metcalf and Dimidjian highlights an important barrier of concern to the field of treatment outcome research. The present commentary aims to expand the discussion regarding the definition, measurement, and evaluation of “mechanisms of change.” Using MBCT as an example, this commentary addresses the ambiguity surrounding the definition and operationalisation of these mechanisms in research on psychological therapies and how the method of measurement may impact the results obtained in clinical trials. It is argued that a potentially fruitful avenue of future research would involve investigation of techniques, important client‐therapeutic processes, and mechanisms in a single study in order to comprehensively evaluate how change occurs.     

体温计知识及诊断技术在近代中国的传播与应用——

19世纪末,体温计作为西方医学发展出的新型医疗器具被广泛应用于临床。体温计知识及诊断技术也是西方医学在华传播的重要内容之一,梳理并探讨了其在近代中国的传播途径和应用过程。中医界对于体温计及诊断技术则表现出既接纳又排斥的复杂态度。受中西汇通思想的影响,中医医家将“衷中参西”观念贯彻于诊疗模式,以体温计可以精确测知体温变化之长协助中医临床的辨证。虽然对于“传统”中医四诊诊断模式而言,体温计的应用不免会破坏其传统性,但也在不断受到西医新的诊疗器具与诊断技术的挑战中寻求传承与发展。

     

Tales of a Therapist

ABSTRACT

Historically, theorists and clinicians from various schools of family therapy have discussed therapist self-disclosure in terms of either helping or inhibiting therapeutic progress. Although postmodern language-based theorists and therapists accept and encourage its use, few clinical examples of therapist self-disclosure exist in the family therapy literature. In this paper, a postmodern family therapist working within the language-based tradition describes the use of self-disclosures with a couple. The therapist then reviews the effects of those self-disclosures through the eyes of husband, wife, and therapist.     

From Resistance to Buy-In: Experiences of Clinicians in Training Using Feedback-Informed Treatment

In this qualitative research study, the authors use grounded theory analysis to examine the experiences of clinicians in training and use client feedback to inform treatment. Twenty-six marriage and family therapy graduate students in their first or second semester of clinical practicum participated in this study. Participants were trained in eliciting and responding to client feedback at the end of every therapy session. At the end of the semester, participants reflected on their learning experience. Participant experiences reflected a developmental learning process beginning with significant challenges followed by positive clinical changes and positive clinician changes, culminating in overall buy-in regarding the importance of client feedback for nearly all clinicians. The results support the literature that client feedback directly informs the therapeutic process while suggesting important recommendations for training new clinicians in learning to use client feedback.     

Observed Attachment and Self-Report Affect Within Romantic Relationships

Adult attachment provides unique insights that help researchers and clinicians understand the complexities of individuals and relationships. In romantic relationships, individual attachment can explain partners' abilities for closeness and autonomy as well as how they experience affect within the relationship. These affective experiences during couple interactions have been shown to influence both proximal and distal relationship outcomes. Thus, the authors explore the impact of partners' observed attachment behaviors—coded using the AABQ—on continuous reports of their affective experiences during both difficult and positive marital conversations. Variables examining couple affective negativity and flexibility were developed using state space grids, and data were analyzed using GridWare. Results showed that observed female attachment behaviors significantly impacted a couple's affective experiences of negativity and flexibility during conversations, while there were no significant associations between male observed attachment behaviors and the couple affective experience. Clinical implications and suggestions for future research are discussed.     

The invasion of reality (or of negotiation): The psychoanalytic ethic and extinction anxiety

Extinction anxiety is the expression used to describe a pervasive and ever more realistic sense of futurelessness. A group emotion characterized by terror of the extinction of the human race, the family, or professional or shared cultural group, it grips the individual with a sense of desperation and impotence through the internal groups present in the mind of every individual. The contribution presented here aims to demonstrate how extinction anxiety has also infected psychoanalysts and psychoanalytic institutions, thereby seriously weakening the ethics of psychoanalysis. The term ethics here should not be confused with morals, but is intended as the happiness that is derived from the capacity to be responsible for one's self and one's own professional identity. The contagion of extinction anxiety has, in fact, accentuated the crisis of psychoanalysts and their faith in psychoanalysis. The author relates a particularly tormented clinical experience in order to show how only the relationship with psychoanalysis and its capacity to interpret the manifestations of the unconscious, enables the recognition of the effects of what he defines as a true invasion of reality, thus restoring to thought the power to establish a deep, transformative, and fecund relationship between internal and external reality.     

心理模型及其探查技术的研究

自从1943年Craik首次提出心理模型概念以来,有关心理模型的研究已大量涌现,目前有两条心理模型的研究思路．文章分别沿着这两条思路介绍有关心理模型的研究,并以访谈法和观察法为线索梳理了心理模型的探查技术．最后指出心理模型及其探查技术的研究趋向：两条研究思路的整合和多种探查技术的整合。     

神经外科高新技术应用中的人文问题

文在分析医疗高新技术给神经外科带来发展的同时,阐述了其所带来的一系列人文问题.并对神经外科医务人员如何在临床中合理应用医疗高新技术,把握好医患关系,合理利用医疗资源,表现良好的医德医风提出了要求.