Exploring unique roles for psychologists

Presents a comment on "Psychological Treatments" by D. H. Barlow. Barlow highlighted unique roles that psychologists can play in mental health service delivery by providing psychological treatments--treatments that psychologists would be uniquely qualified to design and deliver. In support of Barlow's position, the authors draw from their own clinical practice with special psychiatric populations, such as adults with severe and persistent mental illness and behaviorally disordered youths, to illustrate some potential unique roles for psychologists. The authors believe psychologists are uniquely trained to design such individualized functional behavioral analysis protocols because of their training in research design, behavior analysis, learning theory, and behavior change. Psychologists may also be uniquely qualified to design, implement, and evaluate many specialized therapy techniques, as Barlow has outlined and suggested.     

Computer-Facilitated Therapy: Reality-Based Dialogue with People with Schizophrenia

Schizophrenia is often characterized by deficits in information processing, attention, and memory that profoundly disrupt communication. Two vignettes are presented to illustrate how computer word-processing technique can be used with people with schizophrenia to facilitate reality-based conversation, to help them remember or remain focused in therapy session, and to participate with them in the development of cognitive-behavioral statements in managing their psychiatric symptoms. By visually representing the spoken words on the computer screen, the author hypothesizes that people with schizophrenia can partially compensate for the difficulties in remaining focused in a typically auditory-based conversational mode. Print-outs given from the conversational sessions can also be helpful as a memory aid.     

Ethical Obligations and Clinical Goals in End-of-Life Care: Deriving a Quality-of-Life Construct Based on the Islamic Concept of Accountability Before God (Taklīf)

End-of-life medical decision making presents a major challenge to patients and physicians alike. In order to determine whether it is ethically justifiable to forgo medical treatment in such scenarios, clinical data must be interpreted alongside patient values, as well as in light of the physician's ethical commitments. Though much has been written about this ethical issue from religious perspectives (especially Christian and Jewish), little work has been done from an Islamic point of view. To fill the gap in the literature around Islamic bioethical perspectives on the matter, we derive a theologically rooted rubric for goals of care. We use the Islamic obligation for Muslims to seek medical treatment as the foundation for determining the clinical conditions under which Muslim physicians have a duty to treat. We next link the theological concept of accountability before God (taklīf) to quality-of-life assessment. Using this construct, we suggest that a Muslim physician is not obligated to maintain or continue clinical treatment when patients who were formerly of, or had the potential to be, mukallaf (the term for a person who has taklīf), are now not expected to regain that status by means of continued clinical treatment.