By RICHARD A. FRIEDMAN, M.D.
The New York Times
Published: August 19, 2013
Fully 1 in 5 Americans take at least one psychiatric medication. Yet when it comes to mental health, we are facing a crisis in drug innovation.
Sure, we have many antidepressants, antipsychotics, hypnotic medications and the like. But their popularity masks two serious problems.
First, each of these drug classes is filled with “me too” drugs, which are essentially just copies of one another; we have six S.S.R.I. antidepressants that essentially do the same thing, and likewise for the 10 new atypical antipsychotic drugs.
Second, the available drugs leave a lot to be desired: patients with illnesses like schizophrenia, major depression and bipolar disorder often fail to respond adequately to these medications or cannot tolerate their side effects.
The entire story is here.
Thursday, September 5, 2013
Wednesday, September 4, 2013
The Contribution of the Quality of Therapists' Personal Lives to the Development of the Working Alliance
By Helene A. Nissen-Lie, Odd E. Havik, Per A. Hoglend, Jon T. Monsen, and Michael Helge Ronnestad
Journal of Counseling Psychology. 2013 Aug 19
Abstract
Research suggests that the person of the psychotherapist is important for the process and outcome of psychotherapy, but little is known about the relationship between therapists' personal experiences and the quality of their therapeutic work. This study investigates 2 factors (Personal Satisfactions and Personal Burdens) reflecting therapists' quality of life that emerged from the self-reports of a large international sample of psychotherapists (N = 4,828) (Orlinsky & Rønnestad, 2004, 2005) using the Quality of Personal Life scales of the Development of Psychotherapists Common Core Questionnaire (Orlinsky et al., 1999). These factors were investigated as predictors of alliance levels and growth (using the Working Alliance Inventory) rated by both patients and therapists in a large (227 patients and 70 therapists) naturalistic outpatient psychotherapy study (Havik et al., 1995). The Personal Burdens scale was strongly and inversely related to the growth of the alliance as rated by the patients, but was unrelated to therapist-rated alliance. Conversely, the factor scale of therapists' Personal Satisfactions was clearly and positively associated with therapist-rated alliance growth, but was unrelated to the patients' ratings of the alliance. The findings suggest that the working alliance is influenced by therapists' quality of life, but in divergent ways when rated by patients or by therapists. It seems that patients are particularly sensitive to their therapists' private life experience of distress, which presumably is communicated through the therapists' in-session behaviors, whereas the therapists' judgments of alliance quality were positively biased by their own sense of personal well-being.
Introduction
The notion that the psychotherapist as an individual is important for psychotherapeutic outcomes stems in part from the well-known and frequently cited finding of meta-analyses that therapy outcome appears to be less related to the use of different therapy methods associated with established schools of therapy, and significantly related to differences between the individual psychotherapists providing the therapy (Benish, Imel, & Wampold, 2008; Blatt, Zuroff, Quinlan, & Pilkonis, 1996; Huppert et al., 2001; Kim, Wampold, & Bolt, 2006). Moreover, in efforts to identify the characteristics in therapists that promote treatment success or failure, the studies to date suggest that experience level, type of training, theoretical orientation, and so forth have limited value in distinguishing between more or less successful therapists (Beutler et al., 2004; Dunkle & Friedlander, 1996; Sandell et al., 2007; Skovholt & Jennings, 2004; Strupp & Hadley, 1977). Instead, therapists' interpersonal qualities appear to be more relevant, such as their facilitative interpersonal skills (Anderson, Ogles, Pattersen, Lambert, & Vermeersch, 2009); their ability to be affirmative, responsive, and empathic (Bohart, Elliott, Greenberg, & Watson, 2002; Najavits & Strupp, 1994); their ability to resist counteraggression when confronted with devaluation and rejections by patients (von der Lippe, Monsen, Ronnestad, & Eilertsen, 2008); and their interpersonal functioning in their personal lives (Dunkle & Friedlander, 1996; Hersoug, Hoglend, Havik, von der Lippe, & Monsen, 2009b). Hence, although therapists are professional helpers, it may be that their personal characteristics are more important than their professional qualifications in determining their therapeutic capabilities. This suggestion echoes the statements of Rosenzweig (1936), Strupp (1958), and Rogers (1957, 1961), who emphasized that studying the personal characteristics of psychotherapists is necessary in order to understand patient development in psychotherapy.
Thanks to Ken Pope for this information.
Neuroscience and the law
Nature Reviews Neuroscience
September 2013 Vol 14 No 9
New insights into the neural processes that underlie cognition and behaviour have led to discussions about the relevance of these discoveries for the criminal justice system. Conversely, laws can influence neuroscience, for example, with regard to psychoactive drugs and stem cell research. Nature Reviews Neuroscience presents a series of articles that explore the interaction between neuroscience and the law.
There are three articles at this site are behind paywalls.
The neuroscience of memory: implications for the courtroom
Joyce W. Lacy & Craig E. L. Stark
Effects of Schedule I drug laws on neuroscience research and treatment innovation
David J. Nutt, Leslie A. King & David E. Nichols
The influence of neuroscience on US Supreme Court decisions about adolescents' criminal culpability
Laurence Steinberg
These articles can be found here.
September 2013 Vol 14 No 9
New insights into the neural processes that underlie cognition and behaviour have led to discussions about the relevance of these discoveries for the criminal justice system. Conversely, laws can influence neuroscience, for example, with regard to psychoactive drugs and stem cell research. Nature Reviews Neuroscience presents a series of articles that explore the interaction between neuroscience and the law.
There are three articles at this site are behind paywalls.
The neuroscience of memory: implications for the courtroom
Joyce W. Lacy & Craig E. L. Stark
Effects of Schedule I drug laws on neuroscience research and treatment innovation
David J. Nutt, Leslie A. King & David E. Nichols
The influence of neuroscience on US Supreme Court decisions about adolescents' criminal culpability
Laurence Steinberg
These articles can be found here.
Tuesday, September 3, 2013
Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis
By H. Knuppel, M. Mertz, M. Schmidhuber, G. Neitzke, and D. Strech
PLOS Medicine - Open Access
Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines.
The entire article is here.
PLOS Medicine - Open Access
Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines.
The entire article is here.
End of Life Decisions: Measuring Consciousness
By David DiSalvo
Forbes Magazine
Originally published August 17, 2013
An experimental tool designed to “peek” into a patient’s brain and find signs of consciousness could eventually give doctors a way to more accurately judge chances of recovery from serious brain trauma – and in the process change the nature of end-of-life decisions.
(cut)
This knowledge could potentially change the way end-of-life decisions are made by providing doctors and loved ones with a firmer means to evaluate whether a patient has the capacity to recover.
The entire story is here.
Forbes Magazine
Originally published August 17, 2013
An experimental tool designed to “peek” into a patient’s brain and find signs of consciousness could eventually give doctors a way to more accurately judge chances of recovery from serious brain trauma – and in the process change the nature of end-of-life decisions.
(cut)
This knowledge could potentially change the way end-of-life decisions are made by providing doctors and loved ones with a firmer means to evaluate whether a patient has the capacity to recover.
The entire story is here.
Monday, September 2, 2013
Moral Mondays
Religious and Ethics Weekly
August 23, 2013
Religious leaders in North Carolina are being arrested in growing numbers to protest new laws they say adversely affect the poor, the aging, and children.
August 23, 2013
Religious leaders in North Carolina are being arrested in growing numbers to protest new laws they say adversely affect the poor, the aging, and children.
Watch Moral Mondays on PBS. See more from Religion & Ethics NewsWeekly.
Michel Foucault’s Controversial Life and Philosophy
Published by OpenCulture here.
Michel Foucault’s colorful life and hugely influential work were both struggles against limitation—the limits of language, of social structures and stultifying historical identities.
Michel Foucault’s colorful life and hugely influential work were both struggles against limitation—the limits of language, of social structures and stultifying historical identities.
Sunday, September 1, 2013
Good Deeds Gone Bad
By MATTHEW HUTSON
The New York Times
Published: August 16, 2013
ON your way to work today you may have paused to let another car merge into your lane. Or you stopped to give a dollar to a subway artist. A minute later, another chance to do the same may have appeared. Did your first act make the second more tempting? Or did you decide you had done your good deed for the day?
Strangely, researchers have demonstrated both reactions — moral consistency and moral compensation — repeatedly in laboratories, leading them to ask why virtue sometimes begets more virtue and sometimes allows for vice. In doing so, they have shed an interesting light on how the conscience works.
We often look to past behavior for clues about who we are and what we want, and then behave accordingly. Of course, we seek consistency not only with desirable behaviors, but also with less noble acts: in one study, subjects assigned to wear sunglasses they knew were counterfeit were more likely to cheat during the experiment.
The entire article is here.
The New York Times
Published: August 16, 2013
ON your way to work today you may have paused to let another car merge into your lane. Or you stopped to give a dollar to a subway artist. A minute later, another chance to do the same may have appeared. Did your first act make the second more tempting? Or did you decide you had done your good deed for the day?
Strangely, researchers have demonstrated both reactions — moral consistency and moral compensation — repeatedly in laboratories, leading them to ask why virtue sometimes begets more virtue and sometimes allows for vice. In doing so, they have shed an interesting light on how the conscience works.
We often look to past behavior for clues about who we are and what we want, and then behave accordingly. Of course, we seek consistency not only with desirable behaviors, but also with less noble acts: in one study, subjects assigned to wear sunglasses they knew were counterfeit were more likely to cheat during the experiment.
The entire article is here.
Looking at the HIPAA Final Omnibus Rule: An Attorney’s Perspective
By Mark Hagland
Healthcare Informatics
Originally published August 18, 2013
The stringent requirements embedded in what is being called the “HIPAA Final Omnibus Rule”—a set of regulations published by the Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) on Jan. 25—are changing the ground rules for healthcare provider organizations across the U.S. when it comes to safeguarding protected health information (PHI). Those requirements extend the privacy, security, enforcement, and breach notification rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for economic and Clinical Health (HITECH) Act.
With compliance with the “Omnibus Rule” required by September 23, healthcare leaders have no time to waste when it comes to understanding and addressing the new requirements.
Recently, Kathryn Coburn, who is of counsel with the Los Altos, Calif.-based law firm of Cooke, Kobrick & Wu, LLP, spoke with HCI Editor-in-Chief Mark Hagland regarding this important topic. The Santa Monica-based Coburn has spent 30 years in healthcare law. Below are excerpts from that interview.
Healthcare Informatics
Originally published August 18, 2013
The stringent requirements embedded in what is being called the “HIPAA Final Omnibus Rule”—a set of regulations published by the Office for Civil Rights (OCR) of the Department of Health and Human Services (HHS) on Jan. 25—are changing the ground rules for healthcare provider organizations across the U.S. when it comes to safeguarding protected health information (PHI). Those requirements extend the privacy, security, enforcement, and breach notification rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for economic and Clinical Health (HITECH) Act.
With compliance with the “Omnibus Rule” required by September 23, healthcare leaders have no time to waste when it comes to understanding and addressing the new requirements.
Recently, Kathryn Coburn, who is of counsel with the Los Altos, Calif.-based law firm of Cooke, Kobrick & Wu, LLP, spoke with HCI Editor-in-Chief Mark Hagland regarding this important topic. The Santa Monica-based Coburn has spent 30 years in healthcare law. Below are excerpts from that interview.
Thanks to Ken Pope for this information.
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