Let's close the confidentiality gap

An examination of the interface between the law of privileged communication and the professional standards of confidentiality reveals a considerable gap between what the law is and what counseling and guidance personnel believe it is. The nature of the law is discussed, and evidence of disagreement with and misunderstanding of the law by counseling and guidance personnel is presented. Several recommendations are made to close the gap by bringing knowledge and attitude of counseling and guidance personnel into agreement with the law as well as modifying the law to reflect the needs of clients, counselors, and society.     

Trust,Testimony, and Prejudice in the Credibility Economy

In this paper I argue for a special kind of injustice I call “trust injustice.” Taking Miranda Fricker's work on epistemic injustice as my starting point, I argue that there are some ethical constraints on trust relationships. If I am right about this, then we sometimes have duties to maintain trust relationships that are independent of the social roles we play.     

An Object-Relations Approach to Psychotherapy with Marital Couples,Families, and Children

AN APPROACH to object relations is presented here that conceptualizes the dynamics of interpersonal relationships. Although it is beyond the scope of this paper to provide a thorough review of the object-relations school of thought, the concepts introduced here have direct clinical implications for understanding and influencing the dynamics of the patient-therapist dyad, of the marital pair, and of the family unit. Included are the following concepts: (a) Couples in conflict are viewed as more similar than dissimilar despite apparent differences; (b) The therapist's countertransference reactions are seen as not irrational but a valid reflection of the patient's struggle; (c) The adult or child who is the identified patient is often a carrier or container of the split-off, unacceptable impulses of the other(s); (d) The individual is perceived as part of a unit in which even the more obvious pathological traits have an inherent healthy reparative function.     

Parallel Processing Response Times and Experimental Determination of the Stopping Rule

It was formerly demonstrated that virtually all reasonable exhaustive serial models, and a more constrained set of exhaustive parallel models, cannot predict critical effects associated with self-terminating models. The present investigation greatly generalizes the parallel class of models covered by similar "impossibility" theorems. Specifically, we prove that if an exhaustive parallel model is not super capacity, and if targets are processed at least as fast as non-targets, then it cannot predict such (self-terminating) effects. Such effects are ubiquitous in the experimental literature, offering strong confirmation for self-terminating processing. Copyright 1997 Academic Press. Copyright 1997 Academic Press     

Assessing cognitive impairment in Indigenous Australians: Re‐evaluation of the Kimberley Indigenous Cognitive Assessment in Western Australia and the Northern Territory

The Kimberley Indigenous Cognitive Assessment (KICA) was initially developed and validated as a culturally appropriate dementia screening tool for older Indigenous people living in the Kimberley. This paper describes the re‐evaluation of the psychometric properties of the cognitive section (KICA‐Cog) of this tool in two different populations, including a Northern Territory sample, and a larger population‐based cohort from the Kimberley. In both populations, participants were evaluated on the KICA‐Cog tool, and independently assessed by expert clinical raters blinded to the KICA scores, to determine validity and reliability of dementia diagnosis for both groups. Community consultation, feedback and education were integral parts of the research. for the Northern Territory sample, 52 participants were selected primarily through health services. Sensitivity was 82.4% and specificity was 87.5% for diagnosis of dementia, with area under the curve (AUC) of .95, based on a cut‐off score of 31/32 of a possible 39. for the Kimberley sample, 363 participants from multiple communities formed part of a prevalence study of dementia. Sensitivity was 93.3% and specificity was 98.4% for a cut‐off score of 33/34, with AUC = .98 (95% confidence interval: 0.97–0.99). There was no education bias found. The KICA‐Cog appears to be most reliable at a cut‐off of 33/39.