Objective: The present work aims to conduct the first naturalistic empirical investigation of the process and outcome assessment of functional psychotherapy treatment. The FP model of psychotherapy is rooted in psychoanalysis and integrates the verbal communication approach founded on transference and countertransference dynamics with the analysis of bodily processes.Method: The study sample included ten patients recruited on a voluntary basis and treated by clinicians in their private practices. Each patient received FP with an average duration of 40 (...) h. Therapies had weekly sessions, were audio-recorded with the patient’s written consent, and lasted for an average of 10 months. Outcome and process tools included the Minnesota Multiphasic Personality Inventory-2 and the Luborsky’s the Core Conflictual Relationship Theme, used to assess therapeutic benefit, and the Metacognition Assessment Scale and the Italian Discourse Attributes Analysis Program system, used to evaluate therapeutic benefit and process. The MMPI-2 was used also in the follow-up assessment.Results: Results show that FP had a positive therapeutic outcome on the patients assessed in this study, and that the therapeutic benefits were maintained over time. Some specific features of the FP approach were found to contribute more than others to the observed therapeutic benefits.Conclusion: The current investigation constitutes a first step toward assessment of the therapeutic effectiveness of FP. Future developments should apply the methodology to a larger sample, possibly introducing different methodologies to enable detection of specific bodily oriented processes and techniques. (shrink)

Equine-Facilitated Psychotherapy is widely used, and the uses to which it can be put are still being developed. However, existing knowledge about this field is insufficient, and most of the research suffers from methodological problems that compromise its rigor. This review will explore research into the linked fields of Animal-Assisted Therapy and Equine-Assisted Activities/Therapies related to physical health. Existing knowledge of mental, emotional, and social applications of EAA/T is presented. Evaluation studies in the subfield suggest that people benefit (...) from interventions with horses. However, these studies suffer from fundamental problems, such as small sample size and lack of control groups. Naturalistic inquiry about theoretical aspects highlights the fundamental role that human-horse relations play in EAA/T, but these studies exhibit deficiencies in theory development. A multimethod approach could promote knowledge development for EFP. Suggestions for future research concern methodological solutions to improve evaluation studies, use of grounded theory method to develop theory, as well as applying attachment theory to the human-horse context, which may offer insight about the underlying processes for change. (shrink)

BackgroundThe legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists’ attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.Methods155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent. ResultsAmong the surveyed psychotherapists, there was a high consensus on important information that should be (...) communicated to patients in the context of informed consent. Almost all psychotherapists rated confidentiality and its exemptions (95%) and self-determined decision-making (97%) as important. The importance to disclose information regarding fees and the empirical effectiveness of the provided treatment, were both seen as important by more than 80% of participants. The disclosure of personal information about the therapist was rated as important by 60%. Other aspects, which are not direct components of informed consent but rather overarching goals, were also evaluated rather homogeneously: self-determined decision making of the patient was rated as important by almost all of the surveyed psychotherapists (97%). The following components were also judged as important by a majority of the participants: promotion of hope (80%) and discussion of treatment goals (93%). Most psychotherapists described the implementation of informed consent as an ongoing process, rather than a one-time event during the first session of therapy. Therapists’ age, postgraduate training, treated patient group, and setting influenced attitudes towards informed consent.ConclusionsThe present study shows that informed consent is perceived by psychotherapists as both a challenge and a resource. The implementation of informed consent in psychotherapy requires further research from a clinical and ethical perspective. (shrink)

Psychotherapy with the use of psychedelic substances, including psilocybin, lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxymethamphetamine (MDMA), has demonstrated promise in treatment of post-traumatic stress disorder (PTSD), anxiety, addiction, and treatment-resistant depression. Psychedelic-assisted psychotherapy (PP) represents a unique psychopharmacological model that leverages the profound effects of the psychedelic experience. That experience is characterized by strong dependency on two key factors: participant mindset and the therapeutic environment. As such, therapeutic models that utilize psychedelics reflect the need for careful design (...) that promotes an open, flexible, trusting mindset and a supportive setting. To meet this need, the PP model is increasingly supplemented by auxiliary methods, including meditation, relaxation, visualization or spiritual practices. We suggest virtual reality (VR) as a full-spectrum tool able to capitalize on and catalyze the innately therapeutic aspects of the psychedelic experience, such as detachment from familiar reality, alteration of self-experience, augmentation of sensory perception and induction of mystical-type experiences. This is facilitated by VR’s evidenced capacity to: aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy. While these unique VR features appear promising, VR’s potential role in PP remains speculative due to lack of empirical evidence on the combined use of VR and PP. Given the increased commercial interest in this synergy there is an urgent need to evaluate this approach. We suggest specific VR models and their role within PP protocols to inspire future direction in scientific research, and provide a list of potential disadvantages, side effects and limitations that need to be carefully considered. These include sensory overstimulation, cyber-sickness, triggering memories of past traumatic events as well as distracting from the inner experience or strongly influencing its contents. A balanced, evidence-based approach may provide continuity across all phases of treatment, support transition into and out of an ASC, deepen acute ASC experiences including mystical states and enrich the psychotherapeutic process of integration. We conclude that the potential application of VR in modulating psychedelic-assisted psychotherapy demands further exploration and an evidence-based approach to both design and implementation. (shrink)

Using Grunbaum 1984 and 1993 as a springboard, Greenwood (this issue) claims to have offered several methodologically salubrious and exegetically illuminating theses on empirical evaluations of theoretical explanations of psychotherapeutic efficacy. According to his exegesis of Grunbaum's construction (1984, Ch. 2, Section C; 1993, 184-204) of Freud's "Tally Argument," that argument bespeaks a rife neglect of the epistemologically-significant distinction between empirical evaluations of the efficacy of psychotherapy and evaluations of theoretical explanations of that efficacy. Greenwood presents a defense of (...) a qualified version of Popper's critique of psychoanalysis against Grunbaum's objections to it (1984, Ch. 1B). Finally, Greenwood offers a clarification of the concept of a "placebo control" investigation, taking issue with Grunbaum's 1993 (84-87, 91-93). In the present paper, it is argued contra Greenwood that: (1) his purportedly "best" reading of Freud's Tally Argument and of its import founders, (2) the distinction that Greenwood bemoans as being neglected by mental health researchers actually is a commonplace in the literature on treatment-process and therapeutic outcome, (3) Greenwood's defense of Popper's critique of psychoanalysis is an anachronism, and (4) Greenwood's conceptual analysis of placebo controls is nebulous and misconceived. (shrink)

This manual presents a carefully researched, detailed psychodynamic treatment program for the alleviation of a transdiagnostic range of primary Axis I anxiety disorders, including panic disorder, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder, and related psychological problems. First exploring the principles of psychodynamic theory and formulation, the authors then present a three-phased process of Panic Focused Psychodynamic Psychotherapy-Extended Range : initial evaluation, interpretation of central conflicts and defense mechanisms, and termination. Each phase is discussed in (...) depth and relies on central case illustrations to demonstrate techniques and results. A subsequent chapter explores how to address complex issues that may arise during the course of treatment. Altogether, this manual not only provides a demonstrated, adaptable approach for anxiety disorders, but also clearly embodies a spirit of research and empiricism heretofore rare in psychodynamic psychotherapies, with an eye toward future development. (shrink)

What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in _Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis_, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout (...) the course of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. _Endings and Beginnings_ distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession. (shrink)

The value turn in epistemology generated a particularly influential new position - virtue epistemology. It is an increasingly influential epistemological normative approach that opts for the intellectual virtues of the epistemic agent, rather than the truth-value of the proposition, as the central epistemic value. In the first part of this article we will attempt to briefly explain the value turn and outline the basic aspects of virtue epistemology, underlining the diversity of epistemic attitudes associated with this approach and their positive (...) impact on expanding epistemological horizons. The second part will be focused on the virtues of epistemic responsibility and epistemic justice as particularly appropriate for evaluating social processes such as, for example, testimony and conversational practices in general. In the third section we will show how the psychiatric and psychotherapeutic communicational act can be more efficiently analyzed and evaluated from the perspective of the virtue of epistemic justice, than from the traditional epistemic approach based on a monist concept of truth. The fourth and fifth section synthesize the discussion by introducing the concept of hermeneutic psychotherapy as a therapeutically and epistemically favorable framework for evaluating communicational acts in psychotherapy. nema. (shrink)

Previous research suggested a role of gaze in preference formation, not merely as an expression of preference, but also as a causal influence. According to the gaze cascade hypothesis, the longer subjects look at an item, the more likely they are to develop a preference for it. However, to date the connection between viewing and liking has been investigated predominately with self-paced viewing conditions in which the subjects were required to select certain items from simultaneously presented stimuli on the basis (...) of perceived visual attractiveness. Such conditions might promote a default, but non-mandatory connection between viewing and liking. To explore whether the connection is separable, we examined the evaluative processing of single naturalistic food images in a 2 x 2 design, conducted completely within subjects, in which we varied both the type of exposure (self-paced versus time-controlled) and the type of evaluation (non-exclusive versus exclusive). In the self-paced exclusive evaluation, longer viewing was associated with a higher likelihood of a positive evaluation. However, in the self-paced non-exclusive evaluation, the trend reversed such that longer viewing durations were associated with lesser ratings. Furthermore, in the time-controlled tasks, both with non-exclusive and exclusive evaluation, there was no significant relationship between the viewing duration and the evaluation. The overall pattern of results was consistent for viewing times measured in terms of exposure duration (i.e., the duration of stimulus presentation on the screen) and in terms of actual gaze duration (i.e., the amount of time the subject effectively gazed at the stimulus on the screen). The data indicated that viewing does not intrinsically lead to a higher evaluation when evaluating single food images; instead, the relationship between viewing duration and evaluation depends on the type of task. We suggest that self-determination of exposure duration may be a prerequisite for any influence from viewing time on evaluative processing, regardless of whether the influence is facilitative. Moreover, the purported facilitative link between viewing and liking appears to be limited to exclusive evaluation, when only a restricted number of items can be included in a chosen set. (shrink)

Drawing on recent findings, this study examines whether valence concordant electromyography (EMG) responses can be explained as an unconditional effect of mere stimulus processing or as somatosensory simulation driven by task-dependent processing strategies. While facial EMG over the Corrugator supercilii and the Zygomaticus major was measured, each participant performed two tasks with pictures of album covers. One task was an affective evaluation task and the other was to attribute the album covers to one of five decades. The Embodied Emotion (...) Account predicts that valence concordant EMG is more likely to occur if the task necessitates a somatosensory simulation of the evaluative meaning of stimuli. Results support this prediction with regard to Corrugator supercilii in that valence concordant EMG activity was only present in the affective evaluation task but not in the non-evaluative task. Results for the Zygomaticus major were ambiguous. Our findings are in line with the view that EMG activity is an embodied part of the evaluation process and not a mere physical outcome. (shrink)

La bibliografía reporta amplitud en lo concerniente al campo de la edición de revistas científicas donde los avances científico tecnológicos aportaron una nueva dinámica. Las nuevas tecnologías de la información y la comunicación sirven de herramientas y han transformado radicalmente el escenario de la evaluación de la publicación científica. Variedad de perspectivas, instrumentos e indicadores impactan en los procesos de evaluación. El objetivo de este trabajo es ofrecer una valoración del proceso actual de evaluación de las publicaciones científicas seriadas. Los (...) procedimientos utilizados son la revisión bibliográfica, análisis de textos y síntesis de los hallazgos desde lo teórico. Se concluye que la publicación científica seriada ha pasado a ser, más que un proceso singular de la comunicación científica, el modo fundamental de evaluación de la calidad del trabajo científico, de ahí la importancia de tener claridad y propuestas propias de los indicadores de la evaluación. There is amplitude in bibliography, regarding the edition of scientific journals, where the scientific technological achievements that have been made in recent times have contributed with a new dynamic. The edition in digital format has its name due to the appearance of the new information and communication technologies. The recently emerged perspectives, instruments and indicators impact evaluation of publications processes and the accreditation in the higher education. The aim of this document is to offer an assessment on the current situation of the evaluation process of serialized scientific publications through the use of indicators. The text analysis and bibliographic review procedures were used to achieve the previous goal. In conclusion, the serialized scientific publications have become the main way quality of scientific research evaluation rather than a specific process of scientific communication. That is why is important to be certain of the combination of indicators for evaluating the scientific publications. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“What Is Actually Being Measured?”: Causality and Underlying Scientific Thinking Process in the Assessment of DepressionGreta Kaluzeviciute-Moreton, PhD (bio)Depression is a complex mental health phenomenon due to its multifaceted nature. For one, depression is thought to have a significant genetic component, with studies suggesting that heritability is a significant factor in the development of the disorder (Sullivan, Neale, Kendler, 2000). In clinical psychology, environmental factors such as childhood (...) trauma, chronic stress, social isolation and negative life events (e.g., the loss of a loved one) have been documented as significant risk factors for the development of depression or as trigger events for depressive episodes (Fu & Parahoo, 2009; Kendler, Kuhn, & Prescott, 2004; Neitzke, 2016). Despite this, causal theories of mental health conditions are often tricky and/or scarcely reflected in both diagnostic and rating scales. For instance, the Diagnostic and Statistical Manual of Mental Disorders classifies mental health disorders primarily based on observable symptoms and behaviors, rather than on the underlying psychological and neurobiological processes that may contribute to these symptoms (Kendler, 2006).Similarly, rating scales for depression are typically designed to assess the severity of symptoms, rather than their underlying causes, that is, most rating scales are used as screening tools to identify individuals who may require further evaluation and treatment. Some rating scales may include items related to causal factors, such as the Beck Depression Inventory-II (BDI-II) includes an item that asks about “loss of interest in sex,” which could be related to either biological or psychological factors. Several rating scales include items assessing risk factors for depression, such as family history of depression or personal history of trauma. This may be indicative of both genetic and environmental risk factors, such as the Patient Health [End Page 255] Questionnaire-9, includes an item that asks about family history of depression. However, while risk and causal factors are related, they are distinct in the assessment of depression. Risk factors refer to factors that increase the likelihood of developing depression, while causal factors refer to factors that directly contribute to the development of the condition. The presence of a risk factor does not necessarily mean that an individual will develop depression (Peterson & Seligman, 1984). However, the two are frequently blurred and equated in psychotherapy research (Westen & Bradley, 2005).As such, the historical issues of rating and diagnostic scales, aptly depicted by the Le Moigne (2023) as full of “composite, if not contradictory, heritage, weaving together the classificatory and discontinuous tradition of psychiatry, on the one hand, and the psychometric and continuous tradition of psychology, on the other” (p. XX ), suffer from an epistemological oversight when it comes to the assessment of causal factors in complex mental health conditions, such as depression. In turn, this contributes to a wider psychometric issue: what is actually being measured? Le Moigne’s detailed overview predominantly focuses on “superficial” symptomatology of depression (which contributed to two distinct forms of evaluation: hetero- and self-evaluation), and its subsequent impact on the classification and taxonomy of depression throughout history. However, the overarching conceptualization of depression (including a more detailed consideration of causal factors and their assessment) and the usefulness of rating scales in applied research (such as psychotherapy) remain in the background.The question of “what is actually being measured” is obviously not new in psychometrics. However, it is important to continuously revisit this issue, given that rating scales (such as the BDI) are considered to be universally applicable “evidence-based” tools (Rogers, Adler, Bungay, & Wilson, 2005) as well as a common and well-accepted form of scientific thinking in psychotherapy research (Kaluzeviciute & Willemsen, 2020). From an epistemological point of view, a scientific thinking style entails not only cognitive operations common to methodology, but also practices of generating, sharing, assimilating and transforming knowledge(Hacking, 2012).Therefore, it is important to acknowledge that any scientific tool, including rating scales, encompasses not just what but also how researchers find out about their studied phenomena (i.e., a scientific thinking style conveys a performative quality) (Kaluzeviciute & Willemsen, 2020). As identified by Le Moigne (2023), taxonomy leads toward a category-based logic in that it considers the examined phenomenon to be shared by only a... (shrink)

Extant research underlines the critical challenge for firms to rigorously and consistently evaluate their growing number of cross-sector partnerships for sustainability and suggests formalizing evaluation processes by introducing formal practices. However, empirical research is scant and inconclusive. This study aims to develop an empirically grounded understanding of how firms formalize the evaluation processes of such partnerships and of what drives this formalization, to complement the so far mostly conceptual literature. We inductively analyzed 31 semi-structured interviews with 33 experts (...) from firms and their partnering nonprofits and further secondary data on organizations’ partnerships. We contribute to the cross-sector partnership research by analyzing firms’ practices related to the formalization of the internal as well as the joint partnership evaluation process with nonprofits. We propose a conceptual framework to explain why firms implement different formal practices to reduce the dependency on individuals’ skills, experiences, or judgments in evaluating partnerships. (shrink)

O objetivo deste estudo foi relatar características mencionadas por adolescentes do sexo feminino, em avaliação para psicoterapia, acerca de si mesmas, bem como seus planos em relação ao futuro. Participaram do estudo cinco adolescentes de 13 a 17 anos, que vivenciavam em seus contextos familiares a..

Building on a functionalist framework for decision-making in legal translation, a holistic approach to quality is presented in order to respond to the specificities of this field and overcome the shortcomings of general models of translation quality evaluation. The proposed approach connects legal, contextual, macrotextual and microtextual variables for the definition of the translation adequacy strategy, which guides problem-solving and the rest of the translation process. The same parameters remain traceable between the translation brief and the translation product (...) both in pre-delivery revision and in post-delivery assessment. They are the yardstick for identifying predictable evaluative criteria and competence requirements for translators and quality controllers. The implications of the approach on quality assessment and quality management practices are also discussed. Overall, the model illustrates the potential benefits of enhancing predictability and reducing subjectivity on the basis of specific legal translation methodologies. It supports the need for legal translation expertise in quality evaluation and the relevance of Legal Translation Studies to raising standards in professional practice. (shrink)

How do social audiences negotiate and handle stigmatized organizations? What role do their heterogenous values, norms and power play in this process? Addressing these questions is important from a business ethics perspective to improve our understanding of the ethical standards against which organizations are judged as well as the involved prosecutorial incentives. Moreover, it illuminates ethical concerns about when and how power imbalances may induce inequity in the burdens imposed by such social evaluations. We address these questions building on (...) two event-based case studies involving Hells Angels Motorcycle Club Norway, and contribute to organizational stigma theory in three ways. First, social evaluations of a stigmatized organization by multiple audiences are found to interact, collide and combine in a labelling contest. Second, we show that labels employed in this contest are pushed to either negative extremes or positive extremes. Finally, we show when and how power represents a double-edged sword in social evaluation processes, which can be wielded either to the benefit or to the detriment of the actors under evaluation. (shrink)

John Greenwood (this issue) claims that neglect of an important methodological distinction has contributed directly to the "epistemic impoverishment" of empirical studies of all forms of professional psychotherapy. I challenge this claim, as well as other important claims he makes about the efficacy of psychoanalysis and other forms of psychotherapy.

Notre entreprise consiste à comparer la théorie cartésienne de l’admiration avec une théorie neuroscientifique de l’évaluation cognitive afin d’établir les filiations et les ruptures conceptuelles et doctrinales qui existent sur ce point avec le cartésianisme. Nous questionnons plus largement le passage de la pure évaluation cognitive au déclenchement des réactions corporelles dans le cadre du processus émotionnel : à quelles difficultés Descartes s’est-t-il confronté dans la description neurologique du passage de la cognition à l’émotion? Et les neurosciences parviennent-elles, dans le (...) rapport qu’elles entretiennent avec les sciences cognitives, à surmonter ces difficultés? Nous comparons ainsi l’articulation entre l’évaluation cognitive et le déclenchement des émotions que développe le neurobiologiste Joseph LeDoux dans son ouvrage The Emotional Brain et les passages où Descartes articule l’admiration avec le déclenchement des autres passions dans les Passions de l’âme et le Traité de l’homme. Cette étude nous conduira finalement à montrer ce que le philosophe peut trouver dans les théories neuroscientifiques pour surmonter certaines difficultés ouvertes par le cartésianisme. (shrink)

Instead of attempting to reduce rituals of healing to so‐called primitive psychotherapy this essay raises the question of whether contemporary psychotherapies might not fruitfully be viewed as ritual processes through which a small segment of modern society receives ritual leadership in times of crisis. Selected phenomena in contemporary psychotherapeutic practice are analyzed in an attempt to discern the ritual processes which are manifest in them. It is concluded that most modalities of contemporary psychotherapy manifest elements of ritualized submission, (...) containment, and enactment. (shrink)

The second edition of The Great Psychotherapy Debate has been updated and revised to include a history of healing practices, medicine, and psychotherapy, an expanded theoretical presentation of the contextual model, an examination of therapist effects, and a thorough review of the research on common factors such as the alliance, expectations, and empathy.

The Great Psychotherapy Debate: Models, Methods, and Findings comprehensively reviews the research on psychotherapy to dispute the commonly held view that the benefits of psychotherapy are derived from the specific ingredients contained in a given treatment (medical model). The author reviews the literature related to the absolute efficacy of psychotherapy, the relative efficacy of various treatments, the specificity of ingredients contained in established therapies, effects due to common factors, such as the working alliance, adherence and allegiance (...) to the therapeutic protocol, and effects that are produced by different therapists. In each case, the evidence convincingly corroborates the contextual model and disconfirms the prevailing medical model. (shrink)

Since the Nuremberg trials (1947–1949), informed consent has become central for ethical practice in patient care and biomedical research. Codes of ethics emanating from the Nuremberg Code (1947) recognize the importance of protecting patients and research subjects from abuses, manipulation and deception. Informed consent empowers individuals to autonomously and voluntarily accept or reject participation in either clinical treatment or research. In some cases, however, the underlying mental or physical condition of the individual may alter his or her cognitive abilities and (...) compromise the informed consent process. This is particularly true in chronic psychiatric conditions such as Treatment-Resistant Depression (TRD), where individuals may fail to respond to traditional antidepressant treatments (e.g., psychotherapy, pharmacotherapy). Moreover, it may raise further concerns for an individual’s motivation to consent and the level of understanding of the treatment or research procedure. This paper focuses on the informed consent process for Vagus Nerve Stimulation (VNS) in the treatment of individuals diagnosed with TRD. Specifically, the paper addresses how depression may affect the decision-making capacity of an individual and the potential ethical and legal impact of failure to appreciate the seven elements of the consenting process (competence, voluntariness, disclosure, recommendation, understanding, decision, and authorization). To ensure the protection of vulnerable individuals with psychiatric disorders such as TRD and promote ethical behavior in biomedical research and patient care while avoiding potential legal pitfalls, we propose a paradigm that requires a stringent evaluation process of decision-making capacity for informed consent. (shrink)

Scientific evidence is crucial in a burgeoning number of litigated cases, legislative enactments, regulatory decisions, and scholarly arguments. Evaluating Scientific Evidence explores the question of what counts as scientific knowledge, a question that has become a focus of heated courtroom and scholarly debate, not only in the United States, but in other common law countries such as the United Kingdom, Canada and Australia. Controversies are rife over what is permissible use of genetic information, whether chemical exposure causes disease, whether future (...) dangerousness of violent or sexual offenders can be predicted, whether such time-honored methods of criminal identification have any better foundation than ancient divination rituals, among other important topics. This book examines the process of evaluating scientific evidence in both civil and criminal contexts, and explains how decisions by nonscientists that embody scientific knowledge can be improved. (shrink)

A central theme in recent research on attitudes is the distinction between deliberate, "explicit" attitudes and automatic, "implicit" attitudes. The present article provides an integrative review of the available evidence on implicit and explicit attitude change that is guided by a distinction between associative and propositional processes. Whereas associative processes are characterized by mere activation independent of subjective truth or falsity, propositional reasoning is concerned with the validation of evaluations and beliefs. The proposed associative-propositional evaluation model makes specific assumptions (...) about the mutual interplay of the 2 processes, implying several mechanisms that lead to symmetric or asymmetric changes in implicit and explicit attitudes. The model integrates a broad range of empirical evidence and implies several new predictions for implicit and explicit attitude change. (shrink)

The Therapeutic Process presents an informative, sequential, well-defined, and clinically rich guide to the process of psychodynamic psychotherapy. Specifically designed to have broad appeal and value for the beginning clinician as well as the more experienced clinician, this book includes many illustrative examples and well-defined terms.

IntroductionRheumatologists are the primary healthcare professionals responsible for patients with rheumatic diseases and should acquire medical ethical competencies, such as the informed consent process. The objective clinical structured examination is a valuable tool for assessing clinical competencies. We report the performance of 90 rheumatologist trainees participating in a station designed to evaluate the ICP during the 2018 and 2019 national accreditations.MethodsThe station was validated and represented a medical encounter in which the rheumatologist informed a patient with systemic lupus erythematosus (...) with clinically active nephritis about renal biopsy. A trained patient–actor and an evaluator were instructed to assess ICP skills in obtaining formal informed consent, delivering bad news and overall communication with patients. The evaluator used a tailored checklist and form.ResultsCandidate performance varied with ICP content and was superior for potential benefit information but significantly reduced for potential complications and biopsy description. Only 17.8% of the candidates mentioned the legal perspective of ICP. Death was omitted by the majority of the candidates ; after the patient–actor challenged candidates, only 57.1% of them gave a clear and positive answer. Evaluators frequently rated candidate communications skills as superior, but ≥1 negative aspect was identified in 69% of the candidates.ConclusionsEthical competencies are mandatory for professional rheumatologists. It seems necessary to include an ethics competency framework in the curriculum throughout the rheumatology residency. (shrink)

Since Freud, clinicians have understood that disturbing memories contribute to psychopathology and that new emotional experiences contribute to therapeutic change. Yet, controversy remains about what is truly essential to bring about psychotherapeutic change. Mounting evidence from empirical studies suggests that emotional arousal is a key ingredient in therapeutic change in many modalities. In addition, memory seems to play an important role but there is a lack of consensus on the role of understanding what happened in the past in bringing about (...) therapeutic change. The core idea of this paper is that therapeutic change in a variety of modalities, including behavioral therapy, cognitive-behavioral therapy, emotion-focused therapy, and psychodynamic psychotherapy, results from the updating of prior emotional memories through a process of reconsolidation that incorporates new emotional experiences. We present an integrated memory model with three interactive components – autobiographical (event) memories, semantic structures, and emotional responses – supported by emerging evidence from cognitive neuroscience on implicit and explicit emotion, implicit and explicit memory, emotion-memory interactions, memory reconsolidation, and the relationship between autobiographical and semantic memory. We propose that the essential ingredients of therapeutic change include: (1) reactivating old memories; (2) engaging in new emotional experiences that are incorporated into these reactivated memories via the process of reconsolidation; and (3) reinforcing the integrated memory structure by practicing a new way of behaving and experiencing the world in a variety of contexts. The implications of this new, neurobiologically grounded synthesis for research, clinical practice, and teaching are discussed. (shrink)