Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value-consistent choices and personalized informational preferences. We argue for a three-step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical-technical information and are asked to make a decision about screening; (3) during post-test counselling, women are supported in decision-making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre-test) counselling, where techniques for expanding genome analysis and burdensome test-outcomes challenge counselling of patients. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non‐invasive prenatal testing (NIPT) in first‐trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value‐consistent choices and personalized informational preferences. We argue for a three‐step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical‐technical information and are asked to make a decision about screening; (3) during post‐test counselling, women are supported in decision‐making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre‐test) counselling, where techniques for expanding genome analysis and burdensome test‐outcomes challenge counselling of patients. (shrink)

The World Health Organisation recently listed air pollution as the most significant threat to human health. Air pollution comprises particulate matter (PM), metals, black carbon and gases such as ozone (O3), nitrogen dioxide (NO2) and carbon monoxide (CO). In addition to respiratory and cardiovascular disease, PM exposure is linked with increased risk of neurodegeneration as well as neurodevelopmental impairments. Critically, studies suggest that PM crosses the placenta, making direct in utero exposure a reality. Rodent models reveal that neuroinflammation, neurotransmitter imbalance (...) and oxidative stress are triggered following gestational/early life exposure to PM, and may be exacerbated by concomitant mitochondrial dysfunction. Gestational PM exposure (potentiated by mitochondrial impairment in the metabolically active neonatal brain) not only impacts neurodevelopment but may sensitise the brain to subsequent cognitive impairment. Having reviewed this field, we conclude that strategies are urgently required to reduce exposure to PM during this sensitive developmental period. (shrink)

Abstract.Since the gene splicing debates of the 1980s, the public has been exposed to an ongoing sequence of genetic and reproductive technologies. Many issue areas have outcomes that lose track of people's inner values or engender opposing religious viewpoints defying final resolution. This essay relocates the discussion of what is an acceptable application from the individual to the societal level, examining technologies that stand to address large numbers of people and thus call for policy resolution, rather than individual fiat, in (...) their application. A major source of guidance is the “Genetic Frontiers” series of professional dialogues and conferences held by the National Conference for Community and Justice from 2002 to 2004. Genetic testing, human gene therapy, genetic engineering of plants and animals, and stem cell technology are examined. While differences in perspective on the beginning of life persist, a stepwise approach to the examination of genetic testing reveals areas of general agreement. Stewardship of life, human co‐creativity with the divine, and social justice help define the bounds of application of genetic engineering and therapy; compassionate care plays a major role in establishing stem cell policy. Active, sustained dialogue is a useful resource for enabling sharing of religious values and crystallization of policies. (shrink)

본 연구의 목표는 “도덕의 병원적 속성”에 대한 프로이트의 정의 및 대안을 비판적으로 분석하면서, 도덕으로 인해서 발생한 정신적 고통, 소위 도덕적 질병을 치유하기 위한 하나의 대안으로서 구조구성주의 상담모델을 구성하는 것이다. 이를 위해 필자는 일차적으로 니체, 프로이트 그리고 라캉으로 이어지는 윤리에 대한 비합리론적 이론과 플라톤, 칸트, 하버마스 그리고 매킨타이어로 이어지는 윤리에 대한 합리론적 이론 사이의 논쟁을 비판적으로 분석하고 이들을 “구조구성주의의 윤리설”(필자의 고유한 명칭)로 종합하는 것이고, 이차적으로 이를 근거로 한편에서는 정신분석적 상담모형과 인지행동치료 상담모형을 종합하고, 다른 한편으로는 베이지언 인지모형(Bayesian Cognition Model)과 크래이그의 수사학적 (...) 소통모형(Rhetorical Model of communication by Craig, R. T.)을 통합하는 새로운 상담모형, 즉 “구조구성주의 상담모형”(필자의 교유한 명칭)을 구성하고자 한다. 그러나 현재의 제한적인 이 지면에서 상기의 모든 내용을 다루는 것은 불가능하다. 이에 현재의 논문에서는 우선 일차적인 문제, 즉 윤리에 대한 합리론적 입장과 이것에 대한 비판인 정신분석적 입장을 비교하면서, 양자의 종합 가능성 및 그 필연성을 구조구성주의 윤리설이라는 이름으로 해명하는 데 집중할 것이다. 그리고 이를 근거로 구조구성주의 상담모델을 구성하는 작업은 차후에 다른 지면에서 수행될 것이다. (shrink)

The role of corporate counsel in the corporate governance process has been long overlooked. This paper uses recent comments by Breeden as the springboard for a discussion of the issues surrounding significant roles for lawyers in corporations. It considers these both from a practical and a theoretical perspective and identifies why it is problematic merely to assume hiring lawyers will ensure good compliance both in terms of legal and ethical obligations.

Counselors ask their clients to become creative in their personal lives and within their counseling process. The process of counseling is a creative process. Growth is necessary for effective improvement in the counseling process. This paper will examine creativity from the point of view of the affective experience of the creator, and the relationship of this experience to the client in counseling. The position here is that the process of counseling is both a creative process and one that involves tensions (...) and turbulence. Based on a model of nonlinear dynamics, and ideas about the creative process, this study draws a dynamical fractal movie of the counseling process in which the counselor serves as an attractor for the construction of opposites in the client behavior that allow for growth and the construction of a new state of psychosocial events. (shrink)

In the past two decades, especially after the financial crisis of 2007–09, the literature for examining the availability of integration between the stock exchanges in developed and developing markets has grown. The importance of this topic stems from the significant implications of the linkage between exchange markets on various decisions taken by interested parties, such as policymakers and investors, in the decisions for portfolio diversification. This study examines the relationship between a developing stock exchange index, Amman Stock Exchange Index, and (...) the number of international indices, including S&P 500, NASDAQ, Nikkei, DAX, CAC, and HSI for 2008-2019. To validate the availability of the linkage between the indices, the author includes various tests of a correlation coefficient, stepwise regression analysis, and artificial neural network. Despite the results indicating that the ANN is more efficient than linear regression in investigating the availability of the relationship between ASEI and international indices, stepwise regression and neural network support this relationship. Furthermore, ANN results revealed that the S&P 500 index and year have the most substantial relationship with ASEI. Our research is theoretically and practically important; policymakers and investors can benefit from our findings. Future studies may explore the effect of different international stock market indices on ASEI or other developing markets. Further studies can use macroeconomic factors to build prediction models for stock market indices. (shrink)

Trotz aller Rationalisierungsbemühungen werden sich Leistungseinschränkungen im deutschen Gesundheitswesen nicht vermeiden lassen. Zwar sollten diese so weit möglich oberhalb der individuellen Arzt-Patient-Beziehung erfolgen, aus pragmatischen Gründen wird es sich aber nicht vermeiden lassen, dass Ärzte auch im Einzelfall Verantwortung für die Kosten ihrer Entscheidungen übernehmen, wie es bereits heute häufig der Fall ist. Der vorliegende Beitrag widmet sich deshalb der Frage, wie Ärzte in einer medizinisch rationalen und ethisch vertretbaren Art und Weise Kostenerwägungen in ihren Entscheidungen berücksichtigen können. Vorgeschlagen wird (...) ein vierstufiges Modell eines „ethischen Kostenbewusstseins“: 1) Unterlassung ineffektiver Maßnahmen im Sinne einer evidenzbasierten Medizin; 2) konsequente Berücksichtigung individueller Patientenpräferenzen; 3) Minimierung des diagnostischen und therapeutischen Aufwands für die Erreichung eines bestimmten Therapieziels; und 4) Verzicht auf teure Maßnahmen mit einem geringen/fraglichen Nutzengewinn für den Patienten. Stufen (1–3) sind durch die Prinzipien Wohltun, Nichtschaden und Respekt der Autonomie ethisch begründet, Stufe (4) durch das Prinzip der Gerechtigkeit. Für Entscheidungen auf der vierten Stufe sollten nach Möglichkeit lokale explizite Vorgaben wie z. B. kostensensible Leitlinien erarbeitet werden. Prozedurale Mindeststandards sind zu berücksichtigen, regelmäßige Kosten-Fallbesprechungen oder klinische Ethikberatung sollten zur Entscheidungsunterstützung verfügbar sein. Abschließend wird ein ethischer Algorithmus zur Abklärung des Einsatzes einer kostspieligen medizinischen Maßnahme vorgestellt. (shrink)

Critiques existing theoretical approaches and practices of philosophical counseling and presents a new model.

This book from award winning author Dr. Larry Crabb seeks to think through a model of counseling which can be integrated into the functioning of the local church. It contains a chart appendix.

Counseling Ethics for the 21st Century prepares students to address ethical issues arising in contemporary counseling practice. Drawing on their own clinical and practical experiences, authors Elliot D. Cohen and Gale Spieler Cohen present detailed, realistic, and engaging clinical case studies along with a comprehensive five-step model that can be used to manage the complex ethical problems raised throughout the book. Each chapter focuses on particular virtues in the context of examining a particular counseling issue, including online counseling, digital (...) record keeping, and social media. Students will be empowered to define problems, identify relevant facts, conduct ethical analyses, and make the best decisions for their clients. (shrink)

We investigate the modal logic of stepwise removal of objects, both for its intrinsic interest as a logic of quantification without replacement, and as a pilot study to better understand the complexity jumps between dynamic epistemic logics of model transformations and logics of freely chosen graph changes that get registered in a growing memory. After introducing this logic (MLSR) and its corresponding removal modality, we analyze its expressive power and prove a bisimulation characterization theorem. We then provide a (...) complete Hillbert-style axiomatization for the logic of stepwise removal in a hybrid language enriched with nominals and public announcement operators. Next, we show that model-checking for MLSR is PSPACE-complete, while its satisfiability problem is undecidable. Lastly, we consider an issue of fine-structure: the expressive power gained by adding the stepwise removal modality to fragments of first-order logic. (shrink)

This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support (...) the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy. (shrink)

Various approaches and methods are used in philosophical counselling. Two main trends can be observed: the first is the use of contemplative methods and the second constitutes approaches based on dialogical critical thinking. The author defends the idea that developing philosophical counselling on the basis of critical thinking presupposes that it is possible for counsellor and client to hold a philosophical dialogue where the relationship is one of expert/lay person. J. Šulavík has described this relationship in greater detail. (...) In the Socratic model, the philosopher and the lay person hold a dialogue whereby they ascertain opinions via inductive comparison and by defining things, creating a shared concept. While the Platonic and Enlightenment models were grounded in the authority of the expert philosopher, in the Socratic and postmodern models, the expert philosopher loses the power to manipulate those who know “less”. Lay people are not passive consumers of a particular “optimal” philosophy but through their own “philosophising” create philosophy and tailor it for themselves. While philosophising, therefore, the philosopher does not take on the role of “producer” of philosophy but of “adviser” (consultant). It is therefore supposed that people have a general need for philosophy and that ultimately they should create and reflect upon their own philosophy. (shrink)

The mapping of therapeutic collaboration throughout counseling deepens our understanding of how the helping relationship fosters client change. To better understand the process of career construction counseling, we analyzed the therapeutic collaboration on six successful face-to-face cases. The participants were six Portuguese adults, five women and one man, real clients of a career counseling service, and four psychologists, three female and one male trained in the career intervention model. The participants completed demographic questions and measures of career certainty, vocational (...) identity, career indecision, and psychological functioning. The Therapeutic Collaboration Coding System was used to track collaboration throughout all interactive episodes. The clinical significance of the intervention was calculated by analyzing pre-post-test statistical differences for each case, with the Reliable Change Index and Z score. The findings evidenced a pattern of therapeutic collaboration evolution for good outcome cases. Based on this pattern, we propose a model of process-outcome evolution for the three phases of CCC. (shrink)

In Philosophical Issues in Counseling and Psychotherapy, James Hansen proposes resolutions to four fundamental philosophical questions about knowing, effectiveness, and truth. Presented within the context of the author's struggle to reconcile these philosophical questions with his understanding of patient care, Hansen gives unity and meaning to diverse and seemingly contradictory counseling models.

이 논문에서 필자는 대화가 자기인식 및 자기이해에 기여한다는 존 하드윅의 논의에서 출발하여, 대화의 특성을 분석함으로써 자기이해를 돕는 소통과 치유의 공동체 모델을 탐구할 것이다. 구체적으로 집단철학상담의 대화공동체를 모델로 삼아, 진정한 대화와 소통은 치유공동체로 발전해 나가는 출발점이 된다는 것을 논의하고자 한다. 즉 진정한 대화는 단지 커뮤니케이션을 위한 것이 아니라 자기이해와 자기인식을 촉진하는 역할을 한다는 것, 나아가 자기이해를 증진시키는 대화공동체는 치유공동체로 발전해 나갈 수 있다는 것을 보일 것이다. 여기서 소통과 치유는 별개의 독립적인 문제가 아니라 긴밀한 연관을 갖는다는 것이 드러날 것이다. 나아가 집단철학상담의 사례를 (...) 통해, 어떻게 한 공동체는 소통과 치유의 공동체로 발전해 나갈 수 있는지 그 조건들을 검토하고 논의할 것이다. (shrink)

Heuser, Eller and Byrne provide important descriptive ethics data about how physicians counsel women on the clinical management of pregnancies complicated by severe fetal anomalies. The authors present an account of what such counselling ought to be based on, the ethical concept of the fetus as a patient and the professional responsibility model of obstetric ethics. When there is certainty about the diagnosis and either a very high probability of either death as the outcome of the anomaly or (...) survival with severe and irreversible deficit of cognitive developmental capacity as a result of the anomaly diagnosed, the pregnant woman should be offered the alternatives of aggressive and non-aggressive obstetric management and induced abortion before viability. It is also ethically permissible to offer feticide followed by termination of pregnancy after viability in such cases. This ethically justified approach will reduce the variation in the actual practices of specialists in maternal–fetal medicine described by Heuser, Eller and Byrne. (shrink)

Following participation in Dr. Yair Caspi’s “Psychology in Judaism” workshop, the writers contemplate whether the teaching of Caspi’s model in academic settings could become simultaneously a fresh addition to interdisciplinary approaches to the teaching of Judaism in Israeli Academic life, and an academic addition to the contemporary trend to Jewish renewal in Israeli society. The model is based on weekly facilitated workshops in which participants both reflect on and discuss their lives and also explore unique interpretations of Jewish (...) texts and ideas, constantly seeking the borderline where their lives inform the text and vice versa. The process leads to the re-enchantment of ancient Jewish concepts, the reinvention of the Jewish religious experience in a contemporary paradigm and idiom, and the possibility of deep transformative insight. (shrink)

Although therapists often work with clients with whom they share a great many beliefs, there remain many cases where the therapist and client have very little in common. Spirituality is, especially in the latter kind of case, one specific area in which clashes and similarities may be important. However, recent evidence suggests spirituality is to a surprising extent ignored in therapy when exploring it would be therapeutically relevant and, even more, that counsellors often struggle when training to more effectively engage (...) with client spirituality. These results are problematic, especially when taken together. In this paper, I attempt to address this vexing issue in a way that brings together work on counselling and spirituality with recent discussions of intellectual virtue in contemporary epistemology. In particular, I show why it is important for the therapist to cultivate and maintain the virtue of intellectual humility with respect to spirituality in a counselling context. To this end, I explore, with reference to a particularly promising model of intellectual humility, how the therapist can be attentive to—and own—their limitations in a productive way when dealing with a wide range of spiritual backgrounds. (shrink)

In order to properly distinguish between pastoral and psychotherapeutic counseling, one must clarify both the interpretive presuppositions underlying each of these professional practices and their respective societal contexts. As a common ground for both kinds of practice, at least insofar as they maintain a distance from the usual medical-scientific model of therapeutic intervention, an ontology of playing is recommended. More precisely, in order for counseling to truly come “into play,” any latent neo-pastoral power discourses must be critically exposed. Psychoanalytic (...) counseling is characterized by rules of abstinence and neutrality as well as by attention to unconscious dynamics, especially those of transference and countertransference. Pastoral counseling, even when it takes place outside of the Ignatian exercises, can still orient itself toward the Ignatian model of spiritual accompaniment, thus requiring a discernment of spirits and a reference to transcendence. Both pastoral and psychotherapeutic counseling can profit from each other. Both must be evaluated in terms of whether, in the course of an authentic communication, they succeed in proposing what truly profits the person seeking advice. All of this applies with special urgency to bioethical decision making and conflict resolution: Persons seeking pastoral advice desire an authentic exposition of the values of the Gospel and their church community in order to reach a well-founded conclusion in conscience. Other persons (or even the same ones) seeking psychotherapeutic help in a bioethical conflict situation desire an empathetic mirroring back of the biographic background framing their decision and of possible psychic consequences that may ensue from their acting accordingly. (shrink)

This study tested four theoretical models of leadership with data from the ethnographic record. The first was a game-theoretical model of leadership in collective actions, in which followers prefer and reward a leader who monitors and sanctions free-riders as group size increases. The second was the dominance model, in which dominant leaders threaten followers with physical or social harm. The third, the prestige model, suggests leaders with valued skills and expertise are chosen by followers who strive to (...) emulate them. The fourth proposes that in small-scale, kin-based societies, men with high neural capital are best able to achieve and maintain positions of social influence (e.g., as headmen) and thereby often become polygynous and have more offspring than other men, which positively selects for greater neural capital. Using multiple search strategies we identified more than 1000 texts relevant to leadership in the Probability Sample of 60 cultures from the Human Relations Area Files (HRAF). We operationalized the model with variables and then coded all retrieved text records on the presence or absence of evidence for each of these 24 variables. We found mixed support for the collective action model, broad support for components of the prestige leadership style and the importance of neural capital and polygyny among leaders, but more limited support for the dominance leadership style. We found little evidence, however, of emulation of, or prestige-biased learning toward, leaders. We found that improving collective actions, having expertise, providing counsel, and being respected, having high neural capital, and being polygynous are common properties of leaders, which warrants a synthesis of the collective action, prestige, and neural capital and reproductive skew models. We sketch one such synthesis involving high-quality decision-making and other computational services. (shrink)

It is unfair to conclude that Western and Eastern differences have caused conflict in the practice of counselling, especially in mandated counselling. It is reasonable to assume that without the Western approach and understanding of counselling, the East would still be unable to develop their own theory of helping. How then does one compare different approaches? Such an assessment can be argued clearly from a cultural perspective as in the case of mandated counselling. This paper discusses (...) the influence of culture which has shaped the practice of mandated counselling and the appropriate practice of mandated counselling in a Malaysian setting. Many of the points discussed here are drawn from the data informed by seven informants in a research entitled ‘Mandated Counselling In Malaysia: A Heuristic Phenomenological Inquiry Of Involuntary Participation’. The phenomenon of counselling as originated and practised in the West, which has served as the significant model for the Malaysian style of counselling, is discussed. The concept of guidance and crisis intervention in counselling as practised in Malaysia has shaped the appropriate acceptance of mandated counselling. Respect for authority, a need to ‘save face’, directives from the authority and the values of we-ness makes mandated counselling in a Malaysian setting a relevant intervention. (shrink)

The purpose of the current study was to investigate the effects of COVID-19 on high school students' psychological symptoms and to understand how ready counselors and school counseling services are based on the data we have. Therefore, this research is designed under two different studies: Study 1: Effects of COVID-19 pandemic on students' psychological symptoms and Study 2: Views and expectations of students and school counselors about school counseling services. The first study was a quantitative study and included 549 high (...) school students. A structural equation model was created to examine the effects of COVID-19 pandemic on participants' psychological symptoms. The Impact of Event Scale-Revised scores showed that 107 individuals had a score of 50 and above pointing out that individuals in this group had severe impact of event/trauma symptomologies. The SEM analysis indicated that IES-R scores had a total effect of 0.79 on anxiety, 0.75 on depression, 0.74 on negative self-concept, 0.68 on somatization, and 0.66 on hostility scores. Furthermore, female students had significantly higher scores on anxiety, depression, negative self-concept, somatization, hostility, and impact of events variables than male students. Study 2 was a qualitative design and consisted of five school counselors and five students from different schools. The results indicated that students' difficulties during the coronavirus disease 2019 outbreak were educational, cognitive, emotional, physiological, relational, technological, and related to routines. Academic, social, emotional, and behavioral issues came to the fore among the difficulties that can be experienced if students start face-to-face education. On the other hand, the school counselors listed that family relations, personal–social, emotional, and academic themes were the difficulties experienced by the students at the beginning of the COVID-19. In addition, when COVID-19 started, the services offered by school counselors were discussed under services for the student, services for the family, and services for the teacher. Finally, according to the opinions of the school counselors, if students start face-to-face education, they may experience emotional, academic, and relational difficulties. In summary, it is vital that student personality services be prepared and implemented by school counseling services for schools based on the results. (shrink)

Plato's dialogues can be read as a carefully staged exhibition and investigation of paideia, education in the broadest sense, including all that affects the formation of character and mind. The twentieth century textbook Plato — the Plato of the Myth of the Cave and the Divided Line, the ascent to the Good through Forms and Ideas — is but one of his elusive multiple authorial personae, each taking a different perspective on his investigations. As its focused problems differ, each Platonic (...) dialogue exhibits a somewhat different model for learning; each adds a distinctive dimension to Plato's fully considered counsel for education. Setting aside the important difficult questions about the chronological sequence in which the dialogues were written and revised, we can trace the argumentative rationale of Plato's fully considered views on paideia, on who should be educated by whom for what, on the stages and presuppositions of different kinds of learning. Those views are inextricably connected with his views about the structure of the soul, about the virtues and the politeia that can sustain a good life; and about cosmology and metaphysics. (shrink)

This paper aims to elucidate the emphatic demand of the Listening Pastoral inside the Catholic Church. The Supreme Pontiff, Pope Francis, dreams with a clergy with a greater capacity to handle the Christian community in its most relevant urgencies, such as youth accompaniment, specially an active listening made with attentive ears. From this base the article proposes a new method for accompaniment: a pastoral of listening according to the Humanistic Integrative Counseling model. However, the Listening Pastoral doesn’t have agents (...) with the required formation, therefore, beyond the technique, it is important the attitudes of the professional, who welcomes the marginalized and weakened. At the end of the article a list of attitudes will be presented having in mind a pastoral accompaniment. (shrink)

During an Australian qualitative and empirical study looking at lesbian, gay, bisexual, and transgender client's experiences of counseling, and counselor's experiences of working with minority clients, a large body of unsolicited data emerged related to experiences of religious-based homophobia. Analysis of the data suggests that a lifelong process of posttraumatic recovery for many lesbian, gay, bisexual, and transgender people follows prior experiences of religious-based homophobia. This paper discusses the sociological debate related to how counselors find themselves at the crossroad between (...) a healthy lifestyle model of homosexuality based in well established contemporary professional ethics versus long standing religious-based attitudes and constraints toward homosexuality. This intersection of conflicting beliefs generates a controversial social and political environment in which counselors must make a basic decision to either support minority clients according to ethical guidelines or to side with socially conservative constructs that, rightly or wrongly, rely largely on Western religious traditions. (shrink)

In The Virtuous Therapist, authors Elliot D. Cohen and Gale Spieler Cohen provide a systematic, philosophical approach to mental health ethics. Their comprehensive model of ethical decision making is developed to a number of difficult ethical problems counselors will experience. The issues raised in the book are timely, ethically engaging, and of practical importance to those working in the field.

This article explores the potential utility of the theory of Holism as developed by South African philosopher, British Commonwealth statesman and military leader, Jan Smuts, for philosophical counselling or practice. Central to the philosophical counseling process is philosophical counsellors or practitioners applying the work of philosophers to inspire, educate and guide their counselees in dealing with life problems. For example, Logic-Based Therapy, a method of philosophical counselling developed by Elliot Cohen, provides a rational framework for confronting problems of (...) living, where the counselor helps the counselee find an uplifting philosophy that promotes a guiding virtue that acts as an antidote to unrealistic and often self-defeating conclusions derived from irrational premises. We present the argument that Holism is one such uplifting philosophy which can be of utility to philosophical counselors or practitioners to help their counselees with confronting problems of living. Furthermore, we argue that Smuts’ articulation of freedom can act as a guiding virtue within this uplifting philosophy of Holism in accordance with the methodology of LBT. Smuts’ contribution to philosophy and psychology is arguably inadequately credited, and for this reason, and to the best of our knowledge, Smuts’ theory of Holism has yet to be discussed in the context of philosophical counseling or practice. Given these omissions, we begin this article with a discussion of his influence on 20th Century Anglo-American psychology. We then provide a brief historical context, and an introduction to the central argument of Smuts’ Holism, as well as a brief overview of the origins of Smut’s Holism and an introduction to his book Holism and Evolution. In the remainder of the article, we discuss several foundational concepts that underlie Smuts’ theory of Holism, as articulated and developed in his book Holism and Evolution, to substantiate our arguments. We conclude by highlighting the limitations of our article, limitations to Smuts’ model, and the challenges inherent in the use of a now largely antiquated theory, even by Smuts’ own admission nineteen years after its publication, for the purposes of contextualizing and substantiating the arguments and recommendations presented herein. (shrink)

The question of what counts as a successful outcome of the process of genetics counselling has recently become central because of the increasing calls for efficiency in health care, and for means of measuring efficiency. Angus Clarke has drawn attention to this trend, and has argued against both a measure in terms of the number of terminations of pregnancy performed as a result of counselling, and an assessment in terms of the contribution of genetics counselling to a (...) national eugenics policy. He suggests instead a measure of workload. There are good arguments for supporting Clarke's position up to a point. In looking for an appropriate measure, much turns on how genetics counselling is defined. It is here understood in the context of an autonomy model of health care. It is argued that there is a contradiction between such an interpretation and the termination measure of outcome. The political philosophy underlying this outcome is also defective. Workload is not sufficient as a measure of outcome however; it is essential to look at the proper goals of an activity. It is argued that these must be connected in some way with the genetic health of the population; that the promotion of reproductive autonomy itself is not sufficient as a goal. The concern for genetic health, however, is interpreted in a way that avoids Clarke's concerns about a national eugenics policy. (shrink)

The ArgumentIs genetic counseling a form of eugenics? To some extent, the answer depends upon how the terms “eugenics” and “genetic counseling” are defined. This paper reviews the eugenic implications of four models of genetic counseling. The complexities of slapping the eugenic label on genetic counseling are illustrated with three cases drawn from clinical practice. However, even though genetic counseling is not always a eugenic activity, genetic counselors work in a medical/ financial setting that has the net eugenic effect of, (...) and profits from, reducing the number of people with genetic disorders. (shrink)

In this issue of The Journal of Clinical Ethics, Professor Ruth Tallman argues that pediatricians ought to support adolescent football players in their athletic goals. She does not deny that doing so means “helping children hurt themselves”; rather she argues that this would be consistent with a shared decision-making model in which both the physician and the patient seek to promote the patient’s well-being in light of the patient’s own goals. I argue that this ignores the role of the (...) parents, meaning that Tallman is suggesting “helping parents allow their children to hurt themselves.” As a general pediatrician, I would classify this as child neglect, if not downright child abuse. I argue that pediatricians should counsel directively against youth tackle football, employ a deliberative approach to shared decision making within the triadic doctorpatient- parent relationship, and support youth sport policies that seek to reduce traumatic brain injury by advocating for flag football, by prohibiting checking in boys’ ice hockey, and by minimizing heading the ball in soccer below a certain age. (shrink)

Much of the research on the delivery of advice by professionals such as physicians, health workers and counsellors, both on the telephone and in face-to-face interaction more generally, has focused on the theme of client resistance and the consequent need for professionals to adopt particular formats to assist in the uptake of the advice. In this article we consider one setting, Kid’s Helpline, the national Australian counselling service for children and young people, where there is an institutional mandate not (...) to give explicit advice in accordance with the values of self-direction and empowerment. The article examines one practice, the use of script proposals by counsellors, which appears to offer a way of providing support which is consistent with these values. Script proposals entail the counsellors packaging their advice as something that the caller might say — at some future time — to a third party such as a friend, teacher, parent or partner, and involve the counsellor adopting the speaking position of the caller in what appears as a rehearsal of a forthcoming strip of interaction. Although the core feature of a script proposal is the counsellor’s use of direct reported speech, they appear to be delivered not so much as exact words to be followed, but as the type of conversation that the client needs to have with the third party. Script proposals, in short, provide models of what to say as well as alluding to how these could be emulated by the client. In their design, script proposals invariably incorporate one or more of the most common rhetorical formats for maximizing the persuasive force of an utterance such as a three-part list or a contrastive pair. Script proposals, moreover, stand in a complex relation to the prior talk and one of their functions appears to be to summarize, respecify or expand upon the client’s own ideas or suggestions for problem solving that have emerged in these preceding sequences. (shrink)

This book provides an elaboration and evaluation of the dominant conceptions of genetic counseling as they are accounted for in three different models: the teaching model; the psychotherapeutic model; and the responsibility model. The elaboration of these models involves an identification of the larger traditions, visions and theories of communication that underwrite them; the evaluation entails an assessment of each model’s theses and ultimately a comparison of their adequacy in response to two important concerns in genetic (...) counseling: the contested values of non-directiveness and the recognition of differences across perspectives, with special focus on how religious and spiritual beliefs of patients are coordinated with the networks of meaning in genetics. Several insights are made explicit in this project through the work of Robert Brandom. Brandom’s deontic scorekeeping model demonstrates how dialogue is at the root of grasping a conceptual content. Against this backdrop, professional communications such as genetic counseling can be seen as late developments in linguistic practices that have structural challenges. Brandom’s model reminds us that the professional needs the client’s understanding to grasp conceptual content in a particular context. (shrink)

When philosophers cultivate a professional interest in philosophical practice as a form of counseling therapy, the implicit bias of their practice is likely to emulate the “helping profession” model of client engagement. The effort seems noble enough, but emulating the model of the helping professions might actually be incommensurate with the philos­pher’s calling. The philosophical temperament emulates a less constraining but more aggressive model of intervention than we find operating in the professional domain of therapeutic counseling practices. (...) While the philosophical temperament resolves to question and analyze its subject-matter without the encumbrances of social constraint or the promise of utility, it employs methods of philosophical questioning and analysis decidedly more agonistic than can be motivated under the auspices of the “helping profession” model of therapeutic intervention. The philosophical temperament is a challenging temperament, a probing, testing, exploring, engaging temperament whose only vested commitment is to further inquiry. After setting up this distinction between philosophical practice and the helping professions I pose some thoughts regarding the philosophical encounter within a counseling situation, with emphasis on the challenge of translating back and forth between the client’s subject matter and the philosopher’s frame of reference. In the course of negoti­ating these challenges, the philosophical temperament encounters two divergent paths we must learn to travel with equal facility: we must make room for beneficial critique in philosophical counseling while motivating effective critical perspective within the client’s own world-view. The challenge is to see such a philosophical encounter as a place of translation, in which the counselor’s philosophical temperament is exposed to the alterity of the client’s domain of experience without losing its critical facility. In this way, the philosophical encounter is exercised in a movement between worlds, as an interweaving dance of translation and innovation characteristic of a “place” of mutual engagement. The resulting tension in these dialogical encounters is a direct consequence of the philosophical intervention in a client’s personal life. The philosopher’s challenge is to negotiate carefully between two domains of translation (between the cognitive-emotive domain of lived-experience and the philosophical domain of conceptual thinking, reflective inquiry and critical analysis), and to establish connections between these domains to facilitate philosophical encounters in a space of shared listening. (shrink)

In the course of demographic change, the proportion of older people in many countries is rising continuously and more and more people are experiencing a long time together as a couple. In old age, subjective wellbeing and health aspects are associated with partners’ satisfaction with couple relationship. The need for couple counseling in old age is growing in parallel with demographic developments. However, empirical studies on couple therapy with older people in long-term couple relationships exist to date only to a (...) limited extent. The present contribution deals with this knowledge gap. In an explanative two phases design, research has been conducted with long-term couples in couple counseling of which we would like to present here the central qualitative study. The aim is to be able to describe details of these factors. Older couples who have lived in long-term couple relationships were interviewed after using standardized questionnaires concerning the individual and couple-related stress factors and problems at the beginning and the end of their couple counseling process. Five couples from this study were the interviewees for the following study. The couples were interviewed separately. In this interview study and central part of this contribution, the stress factors, problem areas and coping processes of the older couples were examined. The results serve as a suggestion for further research and can only be interpreted with caution due to the small sample of five case studies: The central results of the study are summarized in a circular process model and are discussed in the light of relevant theoretical approaches. The culmination of massive chronic and acute strains and losses associated with feelings of excessive demands and desperation gave rise to emotional alienation of the partners. In the course of couple therapy, the partners mutually opened their thoughts and emotions and modified their previous dysfunctional pattern of interaction. Thus, emotional and physical rapprochement of the partners was fostered with the effect that subjective load of the partners and dissatisfaction of the couple relationship decreased, and subjective emotional wellbeing increased. To prevent negative emotions and destructive conflicts with their spouse, some of the interviewed partners actively used avoidance strategies in couple interactions. Upon completion of couple therapy changes in the couple relationships appeared instable as soon as overcharging stress factors occurred again. The results suggest that an approach to couple therapy for older people in long-term couple relationships should prioritize emotional safeness and attachment in couple relationship to facilitate constructive conflict management. The couple therapy process should emphasize emotion regulation strategies based on age-related strengths and consider age-related vulnerabilities. Moreover, long-term couples may benefit from catamnestic consultation appointments to consolidate the developed changes. (shrink)

Pastoral care is a biblical mandate to the Church to be involved in the lives of God's peop A key metaphor used by Jesus to describe his pastoral role was that of a shepherd. Thi to be God's shepherds and instruments of healing and transformation in God's world is imperative to all people, clergy and laity alike. The brokenness in South African society strikingly apparent, exacerbated by the effects of exceptionally high criminal behaviour statistics show. The demand for pastoral care (...) and assistance with various personal proble is on the increase, with many non-church goers turning to churches for help. Also appare in South Africa is the acute shortage of trained individuals to offer care and counselling. T task of offering care is not the sole responsibility of clergy, as all are called to be shepherds a caregivers. The importance and urgency in training church-based counselling teams cannot overstated. More so in that we are becoming increasingly aware that not only are individu in need of care, but whole communities are struggling with trauma and life's challenges, a often do not know whom to turn to. In pursuance of the realisation that pastoral care is t function and duty of all Christians, this article will delineate in particular an explanation lay counselling, reasons for its importance including biblical foundations, where and ho ordinary South Africans can get involved, and will propose certain models and approach for getting started. These models will not be discussed in depth, but present an opportun for the next. Teams for these models consist of professional counsellors, but ought not to restricted to a select few, as all are called to this special ministry and can be trained for t task, which will include on-going supervision and mentoring. The overall purpose of t article is to highlight the urgency of training lay counsellors and some recommendations w be made how to apply it, in an attempt to be faithful to the biblical mandate and examples by Jesus Christ. (shrink)

Complex student models often include key parameters critical to their behavior and effectiveness. For example, one meta-cognitive model of student help-seeking in intelligent tutors includes 15 rules and 10 parameters. We explore whether or not this model can be improved both in accuracy and generalization by using a variety of techniques to select and tune parameters.We show that such techniques are important by demonstrating that the normal method of fitting parameters on an initial data set generalizes poorly to (...) new test data sets. We then show that stepwise regression can improve generalization, but at a cost to initial performance. Finally, we show that causal search algorithms can yield simpler models that perform comparably on test data, but without the loss in training set performance. The resulting help-seeking model is easier to understand and classifies a more realistic number of student actions as help-seeking errors. (shrink)

BackgroundSome persons conceived with donor gametes react negatively when they found their birth via donor conception. They request access to information about and seek to communicate with the donor. However, some countries mandate donor anonymity. Other countries allow donor-conceived persons to access donor information, but they can only use this access if their parents have disclosed donor conception to them. We investigated a thorny issue of donor conception: whether donor conception should be shifted from an anonymous basis to a non-anonymous (...) basis.MethodsWe review the issues and concerns regarding donor conception. We then consider the impact of direct-to-consumer genetic testing on donor conception, as well as the influence of donor conception on offspring’s identity and the potential of different types of donors. To discuss the future policy of donor conception, the policies on the anonymity of gamete donors were investigated using publicly-available documents in 15 countries.ResultsThe aim of mandating donor anonymity is to protect the privacy of the donor and intended parents. However, the diffusion of direct-to-consumer genetic testing may make it impossible to maintain anonymity. Birth via donor conception shapes the offspring’s identity, and the donor may further influence the development of offspring’s identity through communications. It remains important to disclose donor conception to donor-conceived offspring and to provide them with donor information. However, that information might be insufficient for some donor-conceived persons. Here are benefits to having open-identity donors and known donors. Such donors can make an agreement with the parents regarding future communication with the offspring, although both sides should respect privacy. Subsequent counseling for all parties involved can result in better tripartite communication agreements.ConclusionsIn sum, ethical and practical issues that complicate donor anonymity are driving a shift to non-anonymous donor conception, in which all parties come to a communication agreement. To pave the way for such a donor conception system, transitional measures can be put into place. For countries that already adopted non-anonymous donor conception, ensuring the communication agreements is important to protect the rights of parents, donor, and offspring. (shrink)

Weak Quantum Theory (WQT) and the Model of Pragmatic Information (MPI) are two psychophysical concepts developed on the basis of quantum physics. The present study contributes to their empirical examination. The issue of the study is whether WQT and MPI can not only explain ‘psi’-phenomena theoretically but also prove to be consistent with the empirical phenomenology of extrasensory perception (ESP). From the main statements of both models, 33 deductions for psychic readings are derived. Psychic readings are defined as settings, (...) in which psychics support or counsel clients by using information not mediated through the five senses. A qualitative approach is chosen to explore how the psychics experience extrasensory perceptions. Eight psychics are interviewed with a half-structured method. The reports are examined regarding deductive and inductive aspects, using a multi-level structured content analysis. The vast majority of deductions is clearly confirmed by the reports. Even though the study has to be seen as an explorative attempt with many aspects to be specified, WQT and MPI prove to be coherent and helpful concepts to explain ESP in psychic readings. (shrink)

Genetic predispositions often concern not only individual persons, but also other family members. Advances in the development of genetic tests lead to a growing number of genetic diagnoses in medical practice and to an increasing importance of genetic counseling. In the present article, a number of ethical foundations and preconditions for this issue are discussed. Four different models for the handling of genetic information are presented and analyzed including a discussion of practical implications. The different models’ ranges of content reach (...) from a strictly autonomous position over self-governed arrangements in the practice of genetic counseling up to the involvement of official bodies and committees. The different models show a number of elements which seem to be very useful for the handling of genetic data in families from an ethical perspective. In contrast, the limitations of the standard medical attempt regarding confidentiality and personal autonomy in the context of genetic information in the family are described. Finally, recommendations for further ethical research and the development of genetic counseling in families are given. (shrink)

BackgroundSolution-focused model is an intervention method that fully mobilizes patients’ initiative through their potential. We aimed to investigate the effects of SFM on anxiety and postpartum depression in nulliparous pregnant women compared with routine care services.MethodsWe chose the mothers diagnosed as depressed or with depressive tendency by Edinburgh Postpartum Depression Scale at 28 weeks of gestation and divided them into the intervention and control groups. The control group only took the routine pregnancy healthy nursing, while the SFM group took (...) the regular nursing and SFM counselling. Different assessments were conducted at 28 weeks of gestation, post-delivery, and post-intervention to evaluate the anxiety and depression levels of the patients. Finally, nursing satisfaction was evaluated by the nursing satisfaction questionnaire.ResultsCompared with the control group, SFM could decrease the scores of anxiety and depression more effectively and influence sleep quality more positively. We also found that SFM resulted in significantly higher nursing satisfaction than that in the control group.ConclusionIn conclusion, SFM could effectively alleviate anxiety and PPD in nulliparous pregnant women. (shrink)

This book is intended to be used as an addendum to a more comprehensive text associated with the Professional Counseling Orientation and Ethical Practice training required by the Council for the Accreditation of Counselling and Related Education Programs (CACREP, F.1. a - m.). The goal of this text is to provide - as stated in the title - practical examples of managing ethical concerns for practicing counselors and counselors in training. Much has been made of the science to service (...) problem in counseling (Murray, 2009), with the consensus being that there is a gap between the academics writing the books and papers and the clinicians actually doing the work. This text is an effort to meet the needs of both by providing an overview of case examples that are relatable and accessible; and responses to these cases that meet the careful scrutiny required by the ACA. (shrink)

Mechanistic models are built using knowledge as the primary information source, with well-established biological and physical laws determining the causal relationships within the model. Once the causal structure of the model is determined, parameters must be defined in order to accurately reproduce relevant data. Determining parameters and their values is particularly challenging in the case of models of pathophysiology, for which data for calibration is sparse. Multiple data sources might be required, and data may not be in a (...) uniform or desirable format. We describe a calibration strategy to address the challenges of scarcity and heterogeneity of calibration data. Our strategy focuses on parameters whose initial values cannot be easily derived from the literature, and our goal is to determine the values of these parameters via calibration with constraints set by relevant data. When combined with a covariance matrix adaptation evolution strategy, this step-by-step approach can be applied to a wide range of biological models. We describe a stepwise, integrative and iterative approach to multiscale mechanistic model calibration, and provide an example of calibrating a pathophysiological lung adenocarcinoma model. Using the approach described here we illustrate the successful calibration of a complex knowledge-based mechanistic model using only the limited heterogeneous datasets publicly available in the literature. (shrink)