What is a difficult mental health case? An empirical study of relationships among domain variables

A difficult case in psychotherapy can be defined in many ways. This study proposes a model for that definition, in which three domains (patient characteristics, case characteristics, and therapist characteristics) are considered to impact on that definition. A total of 264 professionals received a questionnaire to assess the relative importance of a series of variables within and across these domains. Wilcoxon Matched-Pairs Signed-Ranks tests indicated that patient characteristics were considered more important than therapist or case characteristics in defining a difficult case. Case characteristics were considered more important than therapist characteristics. Pearson correlations, however, suggested that the three domains in the model are related. Correlations (for years of experience) and Kruskal-Wallis one-way ANOVA for ranks (for professions) also indicated that participants were able to identify variables within domains as important in that definition regardless of years of experience or professions. Across domains, the most important variables included the motivation of the client (a patient characteristic), dropout/attrition and multiple diagnoses (case characteristics), and the degree of therapist-client racial similarity (a therapist characteristic).     

Prayer Behavior in Rural Kilimanjaro,Tanzania

Theories and empirical evidence regarding prayer behavior generally emerge from studies of survey respondents in developed countries. The research we describe here adds to the literature by exploring links between demographic characteristics and the frequency and content of prayers for respondents in rural Tanzania. We surveyed 349 Christian households from six villages in the country's Kilimanjaro region. In some aspects our findings match results from survey research conducted elsewhere, and in other aspects our results differ from those commonly reported in the literature. We suggest that local cultural and socioeconomic conditions may account for the differences in outcomes. These results suggest a need for caution in applying to poor countries theories and expectations drawn from the developed country context.     

Indian Journey

What began as a trekking adventure becomes a search for spiritual “health” in the Buddhism of the Himalayan regions of India. The difficulties of Himalayan travel perhaps mirror the difficult ascent to the inner reaches of Buddhism. Freddy English is a free-lance writer and committed traveler. This journal is the first in what we hope will be a special series.     

The multiple baseline design across exemplars

Three variations of the multiple baseline design (MBD) have been identified in the behavioral literature: MBD across behaviors, subjects and situations. This analysis proposes an important variant of the MBD across behaviors, namely the MBD across exemplars. In this variant, two or more components (exemplars) of the behavior class form the baselines of the design. Thus, intervention is applied separately and sequentially to each target exemplar. The implicit rule of the MBD across exemplars can be seen in several published papers in the behavioral literature. The value of recognizing this variant of the MBD across behaviors is its usefulness as an alternative experimental intervention in clinical settings where the possibility of a convincing research design might not otherwise be seen.     

Implications of the United States census 2000 in analyzing and reporting new findings of disparities in health

This paper argues that, when analyzing and reporting new findings of disparities in health, two areas from the recent U.S. Census of 2000 should be considered for those findings to be meaningful. The first is to avoid analyzing and reporting findings of disparity with an emphasis on the term "Hispanic" and instead to specify the particular Hispanic group from which such findings were collected, such as Mexican-American versus Cuban communities. The second point is that such findings should also take into consideration combination of two or more races. For example, reporting would allow for multiple groupings for respondents who consider themselves African American and White, or African American, Asian, and White.     

Utility of verbal-nonverbal correspondence-training techniques in outpatient pediatric settings

Verbal-nonverbal correspondence training is a behavioral approach recommended in the development of adaptive behaviors and the reduction of problem behaviors. This paper summarizes research findings involving 4 verbal-nonverbal correspondence-training techniques and then illustrates the potential utility of these techniques in general pediatric settings. Particular emphasis is placed on strategies pediatricians could employ to teach patients how to use these techniques effectively to decrease problem behaviors at home (e.g., ADHD, refusing to take the prescribed medication, eating problems) among children seen in outpatient pediatric settings.     

The Vajjālaggam: A study in Indian virtue theory

The paper is meant to be a contribution to the study of Indian and comparative ethics. It treats the Vajjālaggam, an anthology of Prākrit stanzas (subhāsita literature) dealing with a variety of topics. Focusing on the ‘ethical’ sections of the VL, it tries to describe and analyse its underlying ethical system. In Part I the different ethical themes of the VL (Valour and Destiny, Virtues and Vices, Masters and Servants, Friendship and Affection, Poverty and Charity) are described in detail. In Part II it is shown that the VL. offers a clear example of a virtue ethic with a strong emphasis on self‐regarding virtues (gunas), based on a pluralistic and instrumental theory of the good. The paper also treats the crucial ethical problem of the relationship between personal well‐being and virtuousness as described in the VL.     

Indian Journey

What began as a trekking adventure becomes a search for spiritual “health” in the Buddhism of the Himalyan regions of India. The difficulties of Himalyan travel perhaps mirror the difficult ascent to the inner reaches of Buddhism. Freddy English is a free-lance writer and committed traveler. This journal is the second in a series, of which the first part appeared in our 45:4 issue.     

Management of hyperactive children through correspondence training procedures: A preliminary study

This study examined the clinical effects of correspondence training procedures in the management of three hyperactive boys between the ages of seven and 10 years. Two subjects were intervened with the “reinforcement of corresponding reports” procedure: reports about the inhibition of hyperactivity (inattention and overactivity) were reinforced only if they corresponded with the actual inhibition of hyperactivity. The “reinforcement set up contingent upon promises” procedure was used with the third subject: the reinforcer was set up (or displayed) contingent on the patient's promises about the inhibition of hyperactivity in the immediate future, and delivered contingent upon fulfillment of the promise (actual inhibition of hyperactivity). These interventions were programmed in a multipie baseline design across two subjects and a multiple baseline design across two behaviors. A changing-criterion design was also used with all subjects: the nonoccurrence of hyperactivity had to be observed across a pre-established criterion level for the actual delivery of the reinforcer. Consistently higher levels of correspondence occurred during treatment, relative to baseline observations. The results also demonstrated the generalization and maintenance of treatment effects. The use of correspondence training as a potential alternative in the development of hyperactive children's self-control is discussed.