Including a Spiritual Dimension in Family Therapy: Ethical Considerations

The inclusion of a spiritual dimension in family therapy theory and clinical practice may well be viewed as an important professional challenge of the nineties. Following a working definition of terms, this paper explores the ethical complexities inherent in operationalizing a spiritual orientation in therapy in light of the following principles adopted from medical ethics: Respect for clients' autonomy, safeguarding clients' welfare, protecting them from harm, and treating them justly and honestly.     

Computer‐based training to teach observers to accurately score problem behavior using fast forwarding at 5x normal speed

The current study evaluated whether a computer‐based training program could improve observers' accuracy in scoring discrete instances of problem behavior at 5x normal speed using a multiple‐baseline design across subjects. During pretraining and posttraining, observers attempted to score multiple examples of problem behavior at 5.0x without feedback. During training, participants scored multiple examples of problem behavior at 5.0x with automated feedback. Researchers measured omission (missing problem behavior) and commission (scoring other behavior as problem behavior) errors and the total duration of scoring time to determine the observers' accuracy and efficiency, respectively. After training, all participants scored instances of problem behavior with less than 11% error using 5.0x. The time required to score the videos across 90‐min observations was reduced by 66%. Results extend previous evaluations of fast forwarding by demonstrating that the training program could be used to teach observers to accurately score problem behavior using a speed faster than 3.5x.     

Women's exposure to thin-and-beautiful media images: body image effects of media-ideal internalization and impact-reduction interventions

Exposure to media images of thin-and-beautiful women negatively affects the body image and mood states of young women. However, not all women are equally susceptible to these effects. The present experimental investigation with 123 young college women evaluated the moderating effects of the extent of internalization of media ideals. It also examined the preventative impact of two brief interventions (i.e., media literacy information with and without a dissonance-induction procedure). Results indicated that relative to a control group, the exposure to thin-and-beautiful media images adversely influenced the state body image of participants with high internalization levels. Media-literacy psychoeducation prior to the media exposure prevented this adverse effect. Adding a pre-exposure dissonance-induction procedure did not significantly enhance the preventative effects relative to psychoeducation alone. These results and their implications for the treatment and prevention of body image disturbances are discussed in the context of the empirical literature on the media's effects on body image.     

Love and space in the nursing home

Nursing homes and other institutionsdesigned for persons with impairments are not,in fact, designed for persons with impairments.They are typically designed for theimpairments, not the persons, and therebybecome a part of the problem by reinforcingphysical and cultural manifestations of theimpairments. In the essay that follows, Idescribe an architectural design project inwhich students were asked to make changes to anexisting nursing home for the persons who livedthere. This requires not only becoming familiarwith the spaces, but with the personsthemselves and designing space to helparticulate their voices and being. This revised version was published online in June 2006 with corrections to the Cover Date.     

A Social Version of Gerotranscendence: Case Study

This article reexamines the concept of gerotranscendence in the light of anthropological findings. Particular social patterns in a nursing home reveal a unique reality communal to its tenants. The author assumes that the tenants' spontaneous patterns of social gathering construct a collective death consciousness which is spiritual in its nature. Tornstam's term another paradigm seems suitable not only for a developmental shift in old age but also for the situational shift in the daily life of the subjects. Anthropological concepts, as well as contextual and inter-subjective parameters, join to indicate that some gerotranscendence dimensions are experienced in what the author terms as sitting and giving episodes.     

Self‐Stigma,Mental Health Literacy,and Health Outcomes in Integrated Care

The authors describe research on the self‐stigma of mental illness and help seeking, mental health literacy, and health outcomes in an integrated care medical center. Results revealed that self‐stigma of mental illness and self‐stigma of seeking help had an inverse relationship with mental health literacy. No statistically significant relationships were found between health outcomes, either type of self‐stigma, and mental health literacy. The authors discuss these and other findings and offer research and counseling implications.     

“Loving Nature” Nature’s Way: Exploring Radical Participation With Nature Through the Metaphor of Complex,Dynamic Self-Systems

The Western metaphor of self-as-identity—as a static, inherently exclusive entity—has been instrumental, historically, to our radical separation from nature, and still hampers a reviving of genuine participation with nature. Suggesting an alternative to this metaphor (informed by literacy as technology), I explore the more nature-informed metaphor of dynamic, complex self-systems, involving both natural and human subsystems. Through this latter metaphor, I re-vision radical participation with nature: in the process of perception, in epistemology/ontology, and in the ways of indigenous, oral cultures. This systems metaphor also sheds contrasting light on literacy-informed, Western ways.     

The association between cognitive ability across the lifespan and health literacy in old age: The Lothian Birth Cohort 1936

Three hundred and four participants in the Lothian Birth Cohort 1936 study took a validated IQ-type test at age 11 years and a battery of cognitive tests at age 70 years. Three tests of health literacy were completed at age 72 years; the Rapid Estimate of Adult Literacy in Medicine (REALM), the Test of Functional Health Literacy in Adults (S-TOFHLA), and the Newest Vital Sign (NVS). Participants who had a lower childhood IQ exhibited poorer performance on all three tests of health literacy taken in older adulthood. Relative cognitive change from age 11 to 70 and education were also important factors influencing performance on health literacy tasks, independent of childhood cognitive ability. It is important to understand the determinants of low health literacy in order to support individuals in managing their own health.