Instituting heteronormative belief in the law: the case of California's Proposition 22

This paper is based on ethnography of the ‘worship time’ at ‘Breakfree’ Church, a Pentecostal congregation in suburban Perth. I begin by exploring the ritualistic ways in which music is used to catalyse an ecstatic experience. Making use of the metaphor of ‘break free’, borrowed from a popular worship song, I demonstrate that music is used in deliberate ways to assist people in leaving behind the profane and encountering the sacred. Drawing on the thought of theologian Friedrich Schleiermacher and philosopher Paul Ricoeur, I explore the ways music facilitates and symbolises this experience. I demonstrate that for church members, the ecstatic divine-human encounter is the centre of their church worship and the antidote to difficult experiences such as grief or illness.     

Accidental Communities: Race,Emergency Medicine,and the Problem of PolyHeme®

This article focuses on emergency medical care in black urban populations, suggesting that the classification of a “community” within clinical trial language is problematic. The article references a cultural history of black Americans with pre-hospital emergency medical treatment as relevant to contemporary emergency medicine paradigms. Part I explores a relationship between “autonomy” and “community.” The idea of community emerges as a displacement for the ethical principle of autonomy precisely at the moment that institutionalized medicine focuses on diversity. Part II examines a clinical trial for the blood substitute PolyHeme^® (Northfield Laboratories, Inc., Evanston, IL). It illustrates the ways in which bias in research paradigms and Institutional Review Board decisions attach to the notion and utility of the language of “community.” The conclusion's contemporary anecdote makes apparent the vitality of the issues of prehospital emergency medical care and the ways in which decisions and practices fall too easily into a narrative of culturally biased treatment.     

Toward a Reconstruction of Medical Morality

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.     

Multicultural Issues in Evidence-Based Interventions

SUMMARY

School psychologists involved in the delivery of psychological and educational interventions face the challenge of identifying interventions that will work within their schools. The evidence-based intervention (EBI) approach has received attention as a promising way to identify effective interventions. The national Task Force on Evidence Based Interventions in School Psychology (sponsored by the American Psychological Association Division 16 and the Society for the Study of School Psychology, and endorsed by the National Association of School Psychologists) has developed coding criteria to review, evaluate, and identify efficacious interventions. This paper expands the work of the Multicultural and Diversity Committee of the EBI Task Force and offers direction for school psychologists in selecting and implementing interventions appropriate for their settings. We explore the meaning of EBIs in the context of a diverse world and discuss the cultural considerations that are necessary to responsibly adopt an EBI perspective. The paper is organized into three sections where we (a) examine EBIs from a multicultural perspective, (b) describe recent advances in infusing a multicultural perspective into EBI work and the Procedural and Coding Manual for Review of EBIs, and (c) offer a set of guidelines for making decisions about implementing an EBI in a new setting.     

Organizational Identification and Perceived Intra-School Conflict Among Secondary Special Education and General Education Teachers

The relationships between the organizational variables-teacher assignment (general education or special education) and primary organizational identification (teachers' individual schools or respective district-level departments) and perceived organizational conflict were investigated. Four-hundred and fifty-four high school teachers—382 general education and 72 special education—responded to a three-part questionnaire. Both general education and special education teachers identified with both the school and the district-level departments to a greater than neutral level; the general education teachers identified more with their local schools than their district-level departments and the special education teachers identified equally with both their local school and the district-level department. Significant correlations between teacher organizational identification and perceived conflict were found for both groups of teachers—as the identification increased, the perception of conflict decreased. No significant differences were found in comparisons of general education and special education teachers on the identification or perceived conflict variables. Conclusions, with alternative causative factors, and recommendations for enhancing relationships between general educators and special educators are provided.     

‘Wholeness,Dignity and the Ageing Self’: A Conversation Between Philosophy and Theology

SUMMARY

Winifred Wing Han Lamb: My philosophical interest straddles the areas of education, religion and theology. As a teacher involved in school philosophy programs, I have also been interested in the philosophy of childhood and particularly in the recurring notion of the ‘whole child’ in education. In considering what ‘wholeness’ could mean for children's education, I have also been led to consider what meaning it holds for the self through the ‘changing scenes’ of life, especially in the face of the challenges of ageing.

The notion of ‘wholeness’ holds an intuitive appeal and invites articulation of the deep truths of our faith with respect to persons in all ‘sorts and conditions.’ In section one of this chapter, I attempt that articulation. But this conversation needs to be complementary. Our chapter is the beginning of a dialogue between philosophy and theology in which both affirm the ageing self in the light of the human search for wholeness and dignity.

Heather Thomson: My theological research into humanity as an image of God led me to inquire about the way in which we could speak meaningfully of ageing and dying in terms of imaging God. This challenged how God-likeness was to be understood in relation to glory, honour and power, terms associated with imaging God and exerting dominion. In searching for a theological view of the self that would confer dignity on the ageing, I was led into conversation with various philosophies of the self, some very helpful for my task.

It seems to me that, if ageing people are to be counted as having dignity and worth, and not discounted, then one's theory of the human person was significant. In pondering the issue, it appeared that a conversation between philosophy and theology would be fruitful. Hence, this joint paper. We each speak from our own discipline but find resonance with each other's work. We see this as a first step in a constructive conversation.     

Computerised Cognitive Behavioural Therapy in an Adult Mental Health Service: A Pilot Study of Outcomes and Alliance

This pilot study aimed to explore the clinical outcomes and therapeutic relationship for clients of an adult mental health service using Beating the Blues, a computerised cognitive behaviour therapy (CCBT) package. Sixteen participants completed the programme and reported a significant reduction in Beck Depression Inventory scores posttreatment. Participants' mean item ratings on the relationship measure were above the neutral midpoint, but no association was found between the therapeutic relationship and outcome. The results are discussed in terms of the utility of CCBT as part of a stepped-care model and how further research might usefully explore the nature of the relationship formed between clients and CCBT programmes.     

The Acceptability of Computer-Aided Cognitive Behavioural Therapy: A Pragmatic Study

The clinical and cost-effectiveness of a computer-aided cognitive behavioural therapy (CCBT) programme, Beating the Blues, is indicated by a number of studies, but relatively little is known about its acceptability for patients with depression, anxiety, or both. This study investigated the acceptability of Beating the Blues offered on eight scheduled clinic visits with brief face-to-face support. Pre and posttreatment measures explored the relationship among programme acceptability, treatment continuation, and outcomes for people accessing the programme in routine care. Two hundred and nineteen patients with depression, anxiety, or both were offered Beating the Blues in 11 primary and secondary care practices. One hundred and ninety-one (87%) completed the pretreatment measures and 84 (38%) completed a treatment feedback questionnaire. Analysis of treatment acceptability for CCBT indicated a positive patient experience with the programme. Pretreatment expectancies predicted CCBT treatment completion but not outcomes. No differences were found between men and women on pretreatment measures. Posttreatment, women reported more favourable responses to the therapy, finding the programme more helpful and more satisfactory, than did men. No relationship between treatment acceptability and age was found. Study limitations, including research methods and attrition rates, and implications for future research are discussed. It is concluded that the Beating the Blues CCBT programme is an acceptable treatment for common mental health problems in routine care.     

Autobiographical Memory Specificity in Patients with Tinnitus Versus Patients with Depression and Normal Controls

Several studies show that patients with depression and post-traumatic stress disorder respond with fewer specific autobiographical memories in a cued memory task (i.e. the autobiographical memory test; AMT) compared to healthy controls. One previous study found this phenomenon among tinnitus patients as well (Andersson, Ingerholt, & Jansson, 2003). The aim of this study was to replicate the previous study with an additional control group of depressed patients and memory errors as measured with the AMT as an additional outcome. We included 20 normal hearing tinnitus patients, 20 healthy controls and 20 persons diagnosed with clinical depression. The AMT was administered together with self-report measures of depression, anxiety and tinnitus distress. Both the tinnitus and depression groups differed from the healthy control group in that they reported fewer specific autobiographical memories. There were, however, differences between the tinnitus and depression groups in terms of the errors made on the AMT. The depression group had more overgeneral memories than the normal control group, whereas the tinnitus group did not differ from the control group on this memory error. The tinnitus group had more semantic associations and non-memories than the other two groups, suggesting that executive functioning may play a role for the tinnitus group when completing the AMT. Clinical and theoretical implications of the findings are discussed.