Classification of adult attachment: an integrative taxonomy from attachment and psychoanalytic theories.

Developmental and psychoanalytic theorists have focused increasingly on empirically determined early childhood antecedents of adult attachments, with several resulting taxonomic models. This article suggests a theoretically based and clinically based model of attachment consistent with both psychoanalytic and attachment theories, resulting in an integrative taxonomy of four adult attachment styles: dependent, avoidant, hostile, and resistant-ambivalent. These styles reflect behavioral manifestations of dependence and anger, as derived from the interaction of primitive relational drives, defenses, and interpersonal experience. In addition to theoretical construction, brief clinical examples are presented to facilitate discussion of the model.     

Representation by counsel: Right or obligation?

Since the Supreme Court's decision in Faretta v. California (1975), courts have generally permitted defendants to represent themselves, as long as they are competent to do so. The problem lies in the definition of competency to waive counsel, which has been vaguely defined by the courts. Little is known about the frequency of, or reasons for, attempts to waive counsel, about the process of forensic evaluation of such competency, and about the success of such attempts. The authors briefly review the case law on competency to waive representation, report on a longitudinal prospective study of these issues in a population of defendants referred to an inpatient forensic facility for evaluation of all types of competency related to their criminal prosecutions, and discuss the significance of the issue for forensic clinicians. A key question for courts, lawyers, and clinicians is whether a competency evaluation can be invoked to overcome a defendant's constitutional rights to self-representation and bail.     

Suggestiveness in photospread line-ups: Similarity induces distinctiveness

The present research examined whether line-ups based on target (‘suspect’) face similarity are biased or suggestive. Four experiments are described in which subjects constructed photographic line-ups by selecting foils similar in appearance to a target. Later, another group of subjects who had not seen the faces before (mock witnesses) were asked to pick out the targets from the line-ups. All four experiments showed that mock witnesses selected the target significantly more often than expected by chance, thereby demonstrating suggestiveness. Three alternative line-up construction methods were also evaluated. In these methods, foil selection was based not only on target similarity but also on similarity with one or more of the other line-up faces. Results showed that alternative line-up targets were not selected significantly more often than chance, suggesting that bias was reduced. An overall analysis showed that the alternative line-ups were significantly less suggestive than target-based line-ups. The results indicate that foil selection procedures that incorporate foil-to-foil similarity produce fairer line-ups than those exclusively based on target similarity.     

Just health care (II): Is equality too much?

In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence [1]. Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by Rawls and Daniels, rather than strong egalitarian lines. Further, given the empirical complexity associated with the distribution of contemporary health care, I argue that what we really need to address the relevant policy issues adequately is a theory of health care justice, as opposed to an all-purpose conception of justice. Daniels has made an important start toward that goal, though there are some large policy areas which I discuss that his account of health care justice does not really speak to. Finally, practical matters of health care justice really need to be addressed in a ‘non-ideal’ mode, a framework in which philosophers have done little.     

The wilderness therapy program: An empirical study of its effects with adolescents in an outpatient setting

The results of a study of the Wilderness Therapy Program involving 23 adolescents in outpatient counseling are presented. Data were collected before and after four trips on measures of locus of control, behavioral symptoms, self-efficacy, self-esteem, and a number of measures designed specifically for this program. Following a one and one-half to two week backpacking trip that included daily therapy, significant change was found for locus of control, self-esteem and symptom reduction. Positive changes were noted on the other measures as well. Future directions and social work implications were discussed.