Practical and ethical issues in teaching psychological testing.

The use of children and adults as "practice" subjects in psychological testing courses raises practical and ethical concerns. Surveys examined how instructors of beginning child and adult testing courses handled these concerns. Instructors relied primarily on classmates and on client volunteers as practice subjects, but nearly one-third also included testing of child or adult clients. Recruitment, consent, supervision, feedback, and data handling procedures were examined. Ethical problems reported most frequently involved feedback, competency and preparation of students, and access to appropriate practice subjects. These findings guide recommendations for protecting the rights and well-being of individuals who contribute to training efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practical and ethical issues pertaining to test revisions.

Revisions of clinical psychological tests are occurring at more frequent intervals than in the past. These revisions involve such practical issues as the goals of the revision, the economic considerations relating to the revision, the methodology of the revision, and the degree to which the revision meets the available scientific and ethical standards governing the use of these tests in individual assessment. A tension between practical and ethical issues in the test revision process is inevitable and demands the best of psychologists in their decision making. Test developers, psychologists, patients, and consumers of the test interpretations and recommendations have legitimate interests and a stake in seeing that test revisions are applied with maximal effectiveness and fairness in the broadest sense. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Activation of self-observation: A core process among the psychotherapies.

Activation of self-observation is proposed as a core psychotherapy process. Self-observation entails an active scan of one's inner landscape (intentions, expectations, feelings, cognitions, and behaviors), the ability to introspect on one's own thoughts, and the realization of the relation of self to one's social and cultural environment. This process is collaboratively employed by psychotherapist and client within all psychotherapy orientations to help clients learn about their own functioning, change maladaptive responses, and generate new responses for the future. This article addresses (a) defining and distinguishing features of self-observation, (b) self-observation within the psychotherapeutic encounter, (c) ways in which psychotherapists accelerate this process, and (d) the implications of self-observation as a core psychotherapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacology and pharmacokinetics of methotrexate in rheumatic disease. Practical issues in treatment and design

Methotrexate (MTX) is among the most effective drugs for treatment of rheumatoid arthritis and has been proven valuable in the treatment of multiple other disorders of immune regulation. MTX has been administered at a wide range of doses and dose intervals, in conjunction with multiple other drugs, and in patients with a broad range of concomitant disorders. To design a safe and effective MTX treatment plan for an individual patient, the provider must have knowledge of the pharmacology and drug interactions of this effective but potentially dangerous medication. The first section of the article reviews MTX structure, pharmacology pharmacokinetics, and mechanisms of action in rheumatic disease. The second section examines factors that can be used to increase MTX efficacy and decrease toxicity.     

Cultural factors and social influence techniques in Naikan therapy: A Japanese self-observation method.

In light of an increasing interest in different forms of psychotherapy across cultures, a discussion is given of cultural factors and social influence techniques in Naikan therapy, a Japanese self-observation method. The goal of Naikan therapy is to restore the person's positive interpersonal relationships within a hierarchical Japanese social structure. The Naikan therapist arranges the physical and social environment to maximize the client's attention on self-observation and gives specific instructions to recollect the favors given to the client by significant others, especially by the mother. The client engages in self-observation of past interpersonal events for over 100 hrs continuously. The roles of therapist and client are discussed against the Japanese cultural background. Problems in Naikan therapy and its efficacy are reviewed from an empirical standpoint. It is concluded that the goal of Naikan therapy meets the Japanese value system and that cross-cultural studies of psychotherapy should consider various social influence techniques as they are applied in different cultures. (46 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practical and ethical assessment issues in rural, impoverished, and managed care settings.

The rising costs of new psychological tests, increased frequency of test revisions, and difficulty receiving authorization and reimbursement from managed care companies make it increasingly difficult for practitioners to provide the best standard of care to clients when conducting psychological and neuropsychological assessments. Practitioners, especially those in low-income and rural areas, may struggle with handling these practical realities while maintaining ethical standards in conducting psychological assessment. Suggestions for how to manage practical challenges faced by practitioners who provide psychological assessments, such as selecting tests when authorization or reimbursement by a third-party payer is restricted or denied, purchasing psychological tests on a budget, and providing assessments with a limited number of qualified staff are discussed. The authors also provide recommendations for the future prevention of these challenges through work with test developers, test publishing corporations, third-party payers, political action groups, and the psychology profession itself. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practical issues in developing and operating a halfway house program

During its six years of operation, the halfway house program of the Southern Arizona Mental Health Center has developed a well-defined set of program goals, referral procedures, staffing patterns, and procedures for operating the houses, many of which are described here. The program serves 25 residents in four adjacent houses. It is operated as a therapeutic community with a broad range of structured activities and treatment modalities and an emphasis on solving reality problems. The staff of director, therapist-counselors, residential (or nighttime) counselors, and volunteer counselors is supplemented by the services of consultants, the mental health center, and community agencies.     

Expert modeling, self-observation using videotape, and acquisition of basic therapy skills.

Self-observation and observation of an experienced therapist were evaluated as aids in learning listening skills. 48 female college students interviewed mock clients before and after training. Training groups observed a videotape of an experienced therapist lecturing about listening skills, an experienced therapist modeling listening skills, a novice therapist attempting to use listening skills, or the S's own pretraining interview. All groups' skills improved significantly. Ss completed measures regarding feelings during interviews and about training. Trends indicated that Ss observing themselves improved least on all measures of both skill and feelings, and yet expressed most positive reaction to their training. Ss observing the experienced model improved most of all the groups in use of skills. Results raise questions about the usefulness of videotaping and support greater use of expert modeling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical issues in supervision.

Suggests the need for a review of current ethical standards regarding supervision of psychotherapists and presents alternative approaches to the supervisor–supervisee relationship. Group or vertical supervision (with peers and senior personnel) may reduce supervisee anxiety and provide more opportunities for objective support. Sharing supervisees may encourage supervisors to compare supervisory problems. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Moral issues in psychotherapy.

"The first moral obligation of the psychotherapist is to be competent. The more skillful he becomes, the better he fulfills his main ethical responsibility." 4 typical examples of moral issues which arise frequently in the practice of psychotherapy are specified. "One of the falsehoods with which some therapists console themselves is that their form of treatment is purely technical, so they need take no stand on moral issues… . The illusion that our art transcends morality has kept us from forthright study of the ethical and religious disciplines. We psychologists would take a dim view of any experts in philosopy and religion who might hang out a shingle to practice psychotherapy. We would deplore their lack of training in our discipline. My thesis is that scholars in religions and ethics have a right to take an equally dim view of most psychotherapists." The "meaning and contribution of psychotherapy will be enlarged as its practitioners add to their growing technical competence a broader and deeper realization of life's persistent ethical problems." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonempirical issues in psychology.

The general decline of radical empiricism has led to a renewed appreciation of the role of nonempirical contributions to the advancement of science. In psychology, this has meant the development of a theoretical wing comparable to the well-established theoretical traditions that exist in other scientific disciplines. Theoretical psychology is no longer the collection of vague generalities that once made up the traditional "systems and theories" course. It is an active subdiscipline with a well-articulated research program and a growing corpus of special methods and results. This article surveys the types of issues dealt with by theoretical psychologists and discusses the relation between their work and empirical research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training issues.

This interesting set of articles, taken as a group, suggests that we have come a long way toward the integration of family therapy into the training of psychologists. The question is no longer "Should psychologists be trained in family therapy?" but "How can such training best be accomplished, in what settings, with what approaches, and how related to other elements of the graduate or postdoctoral program?" The articles by Ribordy (see record 1989-13401-001) and by Lebow (see record 1989-13365-001) address the central issues in training from different vantages (the family institute versus the academic program) but converge on many points. I will comment mainly on these two articles, but first I want to take note of some of the ideas raised by Berger and Jurkovic (see record 1989-12730-001). They describe and persuasively illustrate a contextual approach to family work that emphasizes the varying settings in which therapy may occur. Thus they are concerned with a "supersystem" that incorporates these extra therapeutic systems as well as clinicians and family. It will be no great surprise to the readers of this Journal that many of these same points emerge from Ribordy's and Lebow's more general discussions of training issues. They explore the separate territories of the academic graduate program and the family institute as settings for training and ably outline the advantages and disadvantages of each. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity issues in clinical assessment.

The data investigators should provide to support the validity of inferences they make based on scores from a measure depend on (a) whether the measure is assumed to assess a hypothetical construct or behavior and (b) the purposes for which the measure is intended. The authors distinguish between the representational phase of validity assessment, which establishes that a measure produces scores that reflect the construct or behavior it purports to assess, and the elaborative validity phase, in which the meaning and utility of scores are examined. Key issues relevant to convergent, discriminant, and criterion-related validity are examined for measures of latent traits or constructs and then for measures of behaviors or response classes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Methodological issues in P technique.

The P technique is a multiple time series in which observations are taken in a definite time series and usually consists of measures which are not independent. This lack of independence creates statistical problems which are examined. Much work is needed on the fundamental theory of analysis of multiple time series. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic issues in borderline disorders.

Current theories and psychological test findings on borderline disorders reveal that there are patients whose clinical behaviors are similar to one another; they are afflicted with such symptoms of emotional instability as intense problematic interpersonal relationships, and a tendency to injure themselves or to set up situations in which they are victimized. At best, these patients are difficult to treat. They manifest traits representative of various personality disturbances (see, e.g., American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 3rd ed.), as well as severe affective disorders. At times, they appear schizophrenic; often, their behavior is neurotic. As they are in transition, they cannot be diagnosed at a given moment in time, except by inference from a longitudinal study of their behavior, and by an analysis of the transference and countertransference that is being experienced. In this author's opinion, many psychological test findings lack reliability and validity and there is no basis for the label borderline disorder as a stable, discrete entity, at least not yet. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Educational issues in childhood cancer.

Discusses the general educational issues for children with cancer, with reference to the short- and long-term consequences of its type and treatment, and focuses on related assessment and intervention issues. Cognitive outcome and school performance are affected by the type and location of the tumor. Radiation therapy results in several side effects, like persistent vomiting and prolonged weight loss, which may interfere with ability to attend school, or cause long-term learning problems. Some chemotherapeutic agents may lower blood counts and affect the energy and concentration levels, or result in long-term neurodevelopmental problems. Deficits in processing speed, visual-motor integration attention and concentration may also result, especially in those under age 3–4 yrs. There must be repeated assessments and individualized educational plans based on understanding of school related effects in children with cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological issues in civil liberties.

"Many observers of the current crisis of civil liberties in this country agree with regard to one of its aspects: this is a time of growing conformism… of severely restricted tolerance for deviation from the medium and the mediocre." Among the major variables relating to conformism are "an inducement to go along," the "situational context," and "individual predispositions." Four processes of conformism, called consentience, conformance, convergence, and compliance, are identified and discussed. The utility of distinguishing between these processes is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training issues in behavior therapy.

This article addresses training issues in behavior therapy. Methods and skills that are most important for affecting changes in client behavior are identified, and the progress that has been made in demonstrating that these skills can be taught effectively are reviewed. Among the skills discussed are the decision-making skills used to identify problems, to select appropriate interventions, and to evaluate client progress as well as the relationship and technical skills used to implement interventions effectively. A critical goal of professional training is to prepare students to be active learners over the course of their careers. Within this context, issues of quality assurance, the role of broad-based scientific training, and the importance of research on training are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contemporary issues in clinical training.

66 directors of clinical training and 118 randomly selected clinicians responded to a questionnaire concerning issues in clinical training. Directors of training were more favorably inclined toward the scientist–professional model than were random clinicians. Random clinicians were more favorably inclined toward alternative, professional models of training than were directors of training. A factor analysis revealed that endorsement of either a scientist–professional model or a professional model and a rejection of the alternative model accounted for 45% of the variance of responses to the questionnaire. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)