Typical Development of Roles and the Impact of Schizophrenia on the Development of Adult Social Roles

Abstract

This chapter is a literature review that explores the nature of interaction between parents and children with emotional disorders, issues between parents and professionals when children are psychiatrically hospitalized, and the nature of parent involvement in child psychiatric settings.     

Chapter 3 Integrative Short-Term Treatment of the Borderline Patient

Abstract

The realities of current practice necessitate that clinicians engage in briefer forms of treatment with borderline patients despite the fact that long-term treatment has been considered the treatment of choice because of their entrenched and pervasive personality difficulties, severe developmental arrests, and history of trauma. Most short-term treatment models are ill-suited for work with the borderline population because they favor highly motivated and well-functioning patients who have circumscribed problems. Nevertheless, there is a considerable body of practice principles that can be adapted to brief treatment with borderlines. This paper reviews the clinical features of borderline disorders and current views on their origins and treatment and then describes the components of an integrative short-term treatment framework.     

A Statement of Principles for Health Care Journalists

Many journalism organizations have published codes of ethics in recent years. The Association of Newspaper Editors, for example, lists 47 different codes on its website. But an organization of health care journalists felt that none of those codes addressed the unique challenges of covering complex health care topics. The Association of Health Care Journalists (AHCJ) is an independent, non-profit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. AHCJ has written a statement of principles for its 750 members. In it, AHCJ states some of the unique challenges faced by journalists covering health care, and offers suggestions on how to face those challenges. Bioethicists are invited to comment on the statement, and to help generate continued discussion of the issues addressed therein.     

Deception,Catholicism, and Hope: Understanding Problems in the Communication of Unfavorable Prognoses in Traditionally-Catholic Countries

The doctor's use of deception in appropriate circumstances has commonly been considered a necessity of the medical art. Resistance to full and frank communication is typical of many traditionally Catholic countries, and particularly of Italy, a western country where Catholicism remains particularly influential. The Catholic teaching on truth and lies, and the problem of telling the truth to a severely ill patient is discussed. It is suggested that the contemporary Catholic model of gradually telling a terminal patient the truth, which looks reasonable and feasible in theory, is rarely followed in practice, as in the majority of cases the truth is not told tout court. Problems stem from the way in which medicine is currently practiced in Italy; from the synergism between Catholicism and the medical tradition's grounded paternalism; and from the ambiguity of the term ‘hope’. Catholic ethics in fact recommends that the truth must be told without destroying hope, but the Catholic meaning of ‘hope’ is very different from its meaning in current language.     

Reasonable People,Double Jeopardy,and Justice

The equipoise requirement in clinical research demands that, if patients are to be randomly assigned to one of two interventions in a clinical trial, there must be genuine doubt about which is better. This reflects the traditional view that physicians must never knowingly compromise the care of their patients, even for the sake of future patients. Equipoise has proven to be deeply problematic, especially in the Third World. Some recent critics have argued against equipoise on the grounds that clinical research is fundamentally distinct from clinical care, and thus should be governed by different norms. I argue against this “difference position,” and instead take issue with the traditional, exclusively patient-centered account of physicians' obligations that equipoise presupposes. In place of this traditional view, I propose a Kantian test for the reasonable partiality that physicians should show their patients, focusing on its application in clinical research and medical education.     

The Relationship,If Any,Between Marriage and Infidelity

SUMMARY

Infidelity has been hypothesized to be caused by any number of factors, including unhappy marriages. The current article explores the myths about infidelity and its treatment. Advice is offered to those treating affairs, and to those interested in successful marriages.     

Undercurrents

SUMMARY

In a story-telling mode, with a personal and intimate flavor, this article takes a look at one approach to the treatment of an extramarital affair. With roots in Bowen theory, and an attention to the underlying dynamics of the emotional system, the treatment is further enriched by an improvisational approach which acknowledges the self of therapist.     

Infidelity

SUMMARY

In this article, we provide an overview of infidelity theory, research, and treatment. We discuss the effect of infidelity on couples and delineate three types of infidelityemotional, physical, and infidelity including aspects of both. Further, we expand traditional thinking about infidelity by reviewing the role of the Internet in infidelity, and explore infidelity within the context of comarital relationships. Finally, we discuss the overarching theories and common models used in infidelity treatment.     

Power Tools

SUMMARY

“Power Tools” describes the classic ways in which power is exercised in the dyadic equal consenting adult personal partnership. It is necessary to abstract in order to talk usefully about how power works. As the author is male, there is an inescapable bias, as males and females define and experience power quite differently.     

Effects of Varying Levels of Treatment Integrity on Toddler Aggressive Behavior

Abstract

Effects of different levels of treatment integrity for a time-out intervention in relation to the aggressive behavior of an 18-month-old were investigated. The time-out intervention was composed of four steps and treatment integrity was systematically varied at 50%, 25%, 75%, and 100%. The results suggest that the 75% and 100% treatment integrity conditions were most effective for decreasing aggressive behavior. Further, there were only minor differences in aggressive behavior between the 25% and 50% treatment integrity conditions. Discussion focuses on the need for assessing optimal and minimum levels of treatment integrity for producing behavior change and the implications for classroom-based interventions.